Staying Safe for the Long Haul: A Health Belief Model Analysis of COVID-19 Preventive Behaviors Through the Lens of Long COVID

• Published in: Clinical nursing research Vol. 34; no. 6; pp. 267 - 276
• Main Authors: Guidry, Jeanine P.D., Laestadius, Linnea I., Burton, Candace W., Perrin, Paul B., Miller, Carrie A., Pinto, Melissa D., Stevens, Michael P., Chelimsky, Thomas, Gharbo, Raouf, Cuddeback, Gary S., Carlyle, Kellie E.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.07.2025
• Subjects: Adult; Aged; COVID-19 - prevention & control; COVID-19 - psychology; Female; Health Behavior; Health Belief Model; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; SARS-CoV-2; Surveys and Questionnaires; United States; United States; COVID-19; long COVID; preventive behaviors; health belief model
• ISSN: 1054-7738; 1552-3799
• DOI: 10.1177/10547738251360170

Health problems associated with post-acute COVID-19, also known as “Long COVID,” range from mild to severe. The best defense against this potentially serious condition is to prevent COVID-19 infection and reinfection. The same preventive measures for COVID-19 may be used to help prevent the spread of Long COVID. This study used the Health Belief Model (HBM) to examine whether and how public understanding and awareness of Long COVID and its prevention shape the adoption of COVID-19 preventive behaviors. N = 605 English-speaking U.S.-based adults were recruited via Qualtrics. Predictors of intention to carry out COVID-19 preventive behaviors were investigated. Outcomes included behaviors relevant to preventing both acute and Long COVID. Across all models, except the one examining intent to get a vaccine booster, Black respondents were more likely than White respondents to express intent to carry out COVID-19 preventive behaviors. In addition, HBM constructs added significantly to the regression models. Susceptibility to Long COVID was significant for all behavioral outcomes (all ps < .05), self-efficacy for wearing a mask (p < .001), and self-efficacy for testing for COVID-19 after exposure and before a social event (ps < .001). In addition, perceived benefits for Long COVID prevention predicted intent of mask-wearing (p < .001), testing before a social event (p = .002), and getting a vaccine booster (p = .001). Perceived severity of Long COVID did not significantly predict adherence to preventive behaviors. U.S. adults are more likely to express intent to carry out COVID-19 preventive behaviors, such as masking and receiving booster vaccines, when they report feeling greater susceptibility to Long COVID as well as greater self-efficacy for engaging in these preventive behaviors. Public health messaging about Long COVID with incorporation of HBM constructs may be an effective means of increasing continued recommended COVID-19 preventive behaviors, which also hold co-benefits for prevention of infections, such as influenza and measles, as well as emerging viruses such as avian flu.