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. 2021 Feb 9;11(2):e044600.
doi: 10.1136/bmjopen-2020-044600.

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  1 , Denise C Vidot  2 , Marlene Camacho-Rivera  3
Affiliations

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 et al. BMJ Open. .

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 (χ2-p<0.001), social distancing (χ2-p<0.001), washing or sanitising hands (χ2-p<0.001), and avoiding some or all restaurants (χ2-p=0.002) and public or crowded places (χ2-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 <US$50 000 (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.

Keywords: epidemiology; infection control; preventive medicine; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Adherence to COVID-19 preventive behaviours among those without chronic diseases compared with those with chronic diseases in the USA.
Figure 2
Figure 2
Associations of adherence to COVID-19 preventive behaviours among US adults with chronic diseases
See this image and copyright information in PMC

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