Abstract
Cancer patients have an increased risk of severe COVID-19 outcomes and were recommended to be vaccinated, wear a mask, practice social distancing, and increase hand hygiene. We used the Health Belief Model (HBM) to identify constructs that were associated with the likelihood of adhering to and advocating for CDC COVID-19 prevention recommendations. We surveyed adult cancer patients who had an onsite appointment at the Penn State Cancer Institute or at the Hematology and Oncology Associates of Northeastern Pennsylvania. Survey measures included adherence to and informing others of COVID-19 recommendations as well as HBM constructs. Relationships between HBM constructs and outcomes were assessed with Spearman’s correlation and multivariable ordinal logistic regression. Of the 106 participants who completed the survey for our objectives of interest, 76% always wore a mask, 29% always practiced social distancing, and 24% washed their hands at least 10 times a day. Limited advocacy behaviors were captured for the COVID-19 vaccine (30%), social distancing (36%), and wearing masks (27%). Perceived benefits, perceived barriers, and cues-to-action were positively associated with the likelihood of adherence or advocacy of COVID-19 recommendations among cancer patients, whereas perceived susceptibility and self-efficacy were negatively associated with the likelihood of adherence or advocacy of COVID-19 recommendations among cancer patients. Perceived benefits may be the strongest predictor for adherence and advocacy for specific COVID-19 guidelines. Future messaging and educational campaigns focused on improving adherence to or advocacy of specific health behaviors should be informed by the HBM and originate from multiple outlets.
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Acknowledgements
Savanna Ledford was supported by the Cancer Epidemiology Education in Special Populations (CEESP) Program (Grant R25CA112383) from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Savanna Ledford with the assistance of all authors. The first draft of the manuscript was written by Savanna Ledford and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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This study was determined by Penn State IRB (STUDY00019970) to be exempted from regulatory review because the dataset provided by the PA DOH to Penn State did not include personally identifiable information.
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Conflict outside of this work in the past 3 years for Monika Joshi includes research grants for AstraZeneca, Pfizer, Eisai (drug only), and BMS advisory board—Seagen.
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Ledford, S.G., Moss, J.L., Alles, S. et al. Behaviors and Advocacy Related to COVID-19 among Cancer Patients: The Health Belief Model and Opportunities for Messaging and Education. J Canc Educ 38, 1690–1696 (2023). https://doi.org/10.1007/s13187-023-02323-7
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DOI: https://doi.org/10.1007/s13187-023-02323-7