Using the Health Belief Model to Understand Age Differences in Perceptions and Responses to the COVID-19 Pandemic

Abstract

COVID-19 severity and mortality risk are greater for older adults whereas economic impact is deeper for younger adults. Using the Health Belief Model (HBM) as a framework, this study used a web-based survey to examine how perceived COVID-19 susceptibility and severity and perceived efficacy of recommended health behaviors varied by age group and were related to the adoption of health behaviors. Proportional odds logistic regression was used to examine the relationship between age group and perceived COVID-19 susceptibility, severity, impact, and health behavior efficacy and adoption. Structural equation modeling based on HBM constructs examined the relationships between health beliefs and behaviors. Data from 820 participants (Ontario, Canada) were analyzed (age: 42.7, 16.2 years; 79% women). Middle-aged and older adults reported greater concerns about the personal risk of hospitalization and mortality, economic impact, and social impact of COVID-19 than young adults. Middle-aged adults also reported greatest concern for other age groups. Adoption and perceived efficacy of health behaviors was similar across age groups with few exceptions. Both middle-aged and older-adults were more likely to perceive their own and each other's age groups as responding adequately to COVID-19 compared to young adults. Structural equation modeling indicated perceived benefits of health behaviors were the primary driver of behavior uptake, with socioeconomic factors and perceived severity and susceptibility indirectly associated with uptake through their influence on perceived benefits. Overall, these results suggest adoption of health behaviors is very high with few differences between age groups, despite differences in perceived impact of COVID-19. Public health communications should focus on the benefits of health behaviors to drive adoption.

Citizens’ health practices during the COVID -19 pandemic in Indonesia: Applying the health belief model

“…Prior cross-sectional reports revealed that good knowledge was significantly and positively correlated with practice against the COVID-19 transmission (Bechard et al, 2021;Muslih et al, 2021). It is in line with another study; approximately 52.9% of the individuals had positive knowledge regarding COVID-19 among Ethiopian citizens (Shewasinad Yehualashet et al, 2021).…”

“…This situation is in line with the previous literature established that inadequate health practices among Indonesian citizens (Rias et al, 2020) or low public behaviors of citizens regarding the COVID-19 pandemic (Jose et al, 2021), complicating efforts to prevent the spread of this pandemic. Consequently, the containment of the COVID-19 pandemic must continue to rely on personal health behaviors control to decline the exposure (Bechard et al, 2021;Jose et al, 2021).…”

“…Preventing and or reducing the spread of infection is accomplished by practical personal care measures, which involved washing hands, wearing a mask, and required standard social distancing that could mitigate the COVID-19 transmission (Rias et al, 2020;Bechard et al, 2021;Muslih et al, 2021). Notably, these activities should be encouraged and viewed as primary preventative measures targeting COVID-19 immediately to protect its transmission (Muslih et al, 2021).…”

A Predictive Model of Pandemic Disaster Fear Caused by Coronavirus (COVID-19): Implications for Decision-Makers

“…Differences in perception, as well as the fear of coronavirus disease, among different age groups, have been the subject of a significant number of theoretical and empirical studies [ 65 , 66 , 67 ], with a consensus that elderly members of the population are one of the most vulnerable risk groups in society [ 68 ].…”

Individual differences in COVID-19 mitigation behaviors: The roles of age, gender, psychological state, and financial status

“…For example, the perceived risk of death from COVID-19 increases with age (e.g., mortality risk), but the perceived risk of being infected decreases with age as does the perceived risk of running out of money [ 4 , 5 ]. It is unclear how these risk perceptions combine to affect mitigation behaviors, particularly in older adults, although structural equation modeling suggests that the perceived effectiveness of mitigation behaviors and not perceived COVID-19 risks predicts mitigation behaviors [ 6 ].…”