Preventive behaviors of COVID-19 in the Iranian adult population during the pandemic: Integrated effect of the health belief model and the planned behavior intention using causal path analysis

Background: This study aimed to investigate the integration of the health belief model (HBM) and the theory of intention to plan preventive behavior for COVID-19 during the pandemic.Methods: In a cross-sectional study, a sample of 480 adult participants from different outpatient clinics were recruited in the study. The participant responded by self-report; the health belief model (HBM) scale, preventive behavior scale, subjective norms scale, the intention of planned behavior scale, and perceived control behavior scale were measured. The hypothesized causal path models were examined using SEM analysis.Results: The HBM had significant effects on perceived behavior control (0=0.60, P=0.001), the intended preventive behavior (0=0.32, P=0.001), and subjective norm (0=0.53, P=0.001). Subsequently, the intention of preventive behavior (0==0.39, P=0.001) and subjective norms (0=0.27, P=0.001) significantly affected the performance of preventive behaviors. The estimated fitting criteria showed that the hypothesized model fits relatively well.Conclusion: The health belief model with the integration of subjective norms, perceived control behavior and mediation by the intention of planned behavior in a pathway relationship explains well the preventive behavior of COVID-19. The findings present a deeper understanding of how integrating HBM and intended planned behavior enhances people's preventive behavior against COVID-19.