DOI: 10.5061/dryad.dbrv15f2x
title: Application of health belief model for the assessment of COVID-19 preventive behavior and its determinants among students: A structural equation modeling analysis

description: Background: COVID-19 is a new pandemic that poses a threat to people
 globally. In Ethiopia, where classrooms are limited, students are at
 higher risk for COVID-19 unless they take consistent preventative actions.
 However, there is a lack of evidence in the study area regarding student
 compliance with COVID-19 preventive behavior (CPB) and its predictors.
 Objective: This study aimed to assess CPB and its predictors among
 students based on the perspective of the Health Belief Model (HBM). Method
 and materials: A school-based cross-sectional survey was conducted from
 November to December 2020 to evaluate the determinants of CPB among high
 school students using a self-administered structured questionnaire. 370
 participants were selected using stratified simple random sampling.
 Descriptive statistics were used to summarize data, and partial least
 squares structural equation modeling (PLS-SEM) analyses to evaluate the
 measurement and structural models proposed by the HBM and to identify
 associations between HBM variables. A T-value of &gt; 1.96 with 95% CI
 and a P-value of &lt; 0.05 were used to declare the statistical
 significance of path coefficients.  Result: A total of 370
 students participated with a response rate of 92%. The median
 (interquartile range) age of the participants (51.9% females) was 18 (2)
 years. Only 97 (26.2%), 121 (32.7%), and 108 (29.2%) of the students had
 good practice in keeping physical distance, frequent hand washing, and
 facemask use respectively. The HBM explained 43% of the variance in CPB.
 Perceived barrier (β= - 0.15, p &lt; 0.001) and self-efficacy (β=
 0.51, p &lt;0.001) were significant predictors of student compliance
 to CPB. Moreover, the measurement model demonstrated that the instrument
 had acceptable reliability and validity. Conclusion and recommendations:
 COVID-19 prevention practice is quite low among students. HBM demonstrated
 adequate predictive utility in predicting CPBs among students, where
 perceived barriers and self-efficacy emerged as significant predictors of
 CPBs. According to the findings of this study, theory-based behavioral
 change interventions are urgently required for students to improve their
 prevention practice. Furthermore, these interventions will be effective if
 they are designed to remove barriers to CPBs and improve students'
 self-efficacy in taking preventive measures.
description: Data were
 collected using a
 structured self-disinterred questionnaire. The self-administered technique
 was selected over the interviewer-administered method for the following
 reasons: a) all of the study participants were literate, b) it can reduce
 social desirability bias, and c) this approach is
 resource-efficient. Four BSc nurses and
 two public health professionals were participated in the data collection
 process as a data collector and supervisor respectively, after they
 received a one-day training on the purpose of the study, the data
 collection process, the ethical considerations, and the precautions that
 should be taken during the data collection process. The data were
 collected at school from Monday to Friday.