%0 Journal Article
%@ 2292-9495
%I JMIR Publications
%V 10
%N 
%P e49687
%T Factors Associated With Levels of Public Engagement in Protective Behaviors During the Early COVID-19 Pandemic: Causal-Comparative Study Based on the Health Belief Model
%A Tang,Chia-Chun
%A Chen,Hsi
%A Tsai,Shao-Yu
%A Wu,Wei-Wen
%+ School of Nursing, National Taiwan University College of Medicine, No. 1, Sec. 1, Jen-Ai Road, Taipei, 100233, Taiwan, 886 2223123456 ext 288422, weiwen@ntu.edu.tw
%K infectious disease
%K protective behavior
%K COVID
%K health belief model
%K causal comparative
%K causal
%K protective
%K prevention
%K opinion
%K opinions
%K attitude
%K attitudes
%K COVID-19
%K pandemic
%K infection control
%K public safety
%K public health
%K survey
%K surveys
%D 2023
%7 19.12.2023
%9 Original Paper
%J JMIR Hum Factors
%G English
%X Background: While the challenges of COVID-19 are still unfolding, the enhancement of protective behavior remains a top priority in global health care. However, current behavior-promoting strategies may be inefficient without first identifying the individuals with lower engagement in protective behavior and the associating factors. Objective: This study aimed to identify individuals with and potential contributing factors to low engagement in protective behavior during the COVID-19 pandemic. Methods: This is a causal-comparative study. A theory-based web-based survey was used to investigate individuals’ protective behavior and potential associating factors. During June 2020, the distribution of the survey was targeted to 3 areas: Taiwan, Japan, and North America. Based on the theory of the health belief model (HBM), the survey collected participants’ various perceptions toward COVID-19 and a collection of protective behaviors. In addition to the descriptive analysis, cluster analysis, ANOVA, and Fisher exact and chi-square tests were used. Results: A total of 384 responses were analyzed. More than half of the respondents lived in Taiwan, followed by Japan, then North America. The respondents were grouped into 3 clusters according to their engagement level in all protective behaviors. These 3 clusters were significantly different from each other in terms of the participants’ sex, residency, perceived barriers, self-efficacy, and cues of action. Conclusions: This study used an HBM-based questionnaire to assess protective behaviors against COVID-19 and the associated factors across multiple countries. The findings indicate significant differences in various HBM concepts among individuals with varying levels of behavioral engagement. 
%R 10.2196/49687
%U https://humanfactors.jmir.org/2023/1/e49687
%U https://doi.org/10.2196/49687