Determinants of COVID-19 preventive behaviours among adults with chronic diseases in the USA: An analysis of the nationally representative COVID-19 impact survey

Jessica Y. Islam, Denise C. Vidot, Marlene Camacho-Rivera

Research output: Contribution to journalArticlepeer-review

Abstract

Background Preventive behaviours have been recommended to control the spread of SARS-CoV-2. Adults with chronic diseases (CDs) are at higher risk of COVID-19-related mortality compared to the general population. Our objective was to evaluate adherence to COVID-19 preventive behaviours among adults without CDs compared with those with CDs and identify determinants of non-adherence to COVID-19 preventive behaviours. Study design Cross-sectional. Setting and participants We used data from the nationally representative COVID-19 Impact Survey (n=10 760) conducted in the USA. Primary measures Adults with CDs were categorised based on a self-reported diagnosis of diabetes, high blood pressure, heart disease/heart attack/stroke, asthma, chronic obstructive pulmonary disease (COPD), bronchitis or emphysema, cystic fibrosis, liver disease, compromised immune system, or cancer (54%). Results Compared with adults without CDs, adults with CDs were more likely to adhere to preventive behaviours including wearing a face mask (χ 2 -p<0.001), social distancing (χ 2 -p<0.001), washing or sanitising hands (χ 2 -p<0.001), and avoiding some or all restaurants (χ 2 -p=0.002) and public or crowded places (χ 2 -p=0.001). Adults with a high school degree or below [Adjusted prevalence ratio (aPR):1.82, 95% Confidence interval (CI)1.04 to 3.17], household income <US50 000 (aPR:2.03, 95% CI 1.34 to 2.72), uninsured (aPR:1.65, 95% CI1.09 to 2.52), employed (aPR:1.48, 95% CI 1.02 to 2.17), residing in rural areas (aPR:1.70, 95% CI 1.01 to 2.85) and without any CD (aPR:1.78, 95% CI 1.24 to 2.55) were more likely to not adhere to COVID-19 preventive behaviours. Conclusion Adults with CDs are more likely to adhere to recommended COVID-19 preventive behaviours. Public health messaging targeting specific demographic groups and geographic areas, such as adults without CD or adults living in rural areas, should be prioritised.

Original languageEnglish (US)
Article numbere044600
JournalBMJ open
Volume11
Issue number2
DOIs
StatePublished - Feb 9 2021

Keywords

  • epidemiology
  • infection control
  • preventive medicine
  • public health

ASJC Scopus subject areas

  • Medicine(all)

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