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

## TL;DR

This study explores how beliefs about Long COVID influence people's willingness to follow preventive measures like mask-wearing and vaccination.

## Contribution

The study applies the Health Belief Model to examine how perceptions of Long COVID affect preventive behavior intentions, particularly among Black U.S. adults.

## Key findings

- Black respondents were more likely than White respondents to intend to follow preventive behaviors.
- Perceived susceptibility to Long COVID predicted all preventive behaviors, while self-efficacy predicted mask-wearing and testing.
- Perceived benefits predicted mask-wearing, testing, and booster shots, but severity did not significantly influence behavior.

## Abstract

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.