Adherence to COVID-19 Protective Behaviors among Iranian Adults: Survey of the Role of Health Literacy and Health Belief Model

Background: The coronavirus is one of the largest pandemics in the world that has occurred in recent years. The virus has so far killed millions of people around the world. To prevent the coronavirus, health behaviors are essential. Therefore, identifying the effective factors of coronavirus preventive behaviors can be effective in designing and implementing health interventions. Methods This study was a cross-sectional design that was implemented in Iran in 2021. Participants were recruited randomly from healthcare centers by medical records (n = 380, 64.7% female, mean age 32.14 years). The data collection included a demographic form, health literacy questionnaire, and Coronavirus disease (COVID-19) protective questionnaire. Analyses were adjusted for confounders using hierarchical regression analysis. Results According to the analysis, among participants COVID-19 preventive behaviors (CPBs) distributions, wearing masks was the highest and avoiding touching my face and do not leaving home were the lowest. Educational level, gender, perceive benefits, perceived barriers and self-efficacy trust were all significant predictors of COVID-19 protective behaviors. Also, among dimensions of the health literacy, all of them except decision-making were significant predictors of adherence to COVID-19 preventive behaviors. The most COVID-19 preventive behaviors distributions, among Iranian adults were wearing mask (66.3%) and covering mouth and nose while sneezing or coughing (44.2%) questions as “Always”. Conclusions this research shows health literacy and cognitive factors have a potential and determinative role in the health of patients with COVID-19. Wearing mask has been the highest preventive behavior in patients with COVID-19, which indicates the effect of educational level as demographic factors in these groups of patients. Therefore, these factors can be considered in prevention and treatment programs in health system.