The use of the health belief model to assess U.S. college students’ perceptions of COVID-19 and adherence to preventive measures


Background: This study utilized the Health Belief Model to examine college students’ perceptions of the COVID-19 pandemic. It examined the extent to which the Health Belief Model and perceived threat are associated with the adoption of COVID-19 preventive measures among college students.
Design and Methods: An online questionnaire was utilized and sent to a simple random sample of college students at a large Midwestern university in the United States between May and July of 2020. The number of undergraduate and graduate students who participated in this study was 1,723.
Results: The study found that the Health Belief Model and perceived threat are significantly associated with COVID-19 preventive measures. College students with higher Health Belief Model scores were more likely to adhere to COVID-19 preventive measures than those with lower scores. College students also reported high cues to action and low perceived barriers to most of the COVID-19 preventive measures.
Conclusion: Applying the Health Belief Model is crucial for health professionals and university administrators for developing effective communication messages for COVID-19 prevention and future health outbreaks.  



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United Nations. United Nations comprehensive response to COVID-19: Saving lives, protecting societies, recovering better. 2020. Accessed: 17 January 2021. Available from:

WHO. WHO coronavirus disease (COVID-19) Dashboard. 2021. Accessed: 15 March 2021. Available from:

Ulmer RR, Sellnow TL, Seeger MW. Effective crisis communication: Moving from crisis to opportunity. Sage Publications; 2017.

Institute for Public Relations [Internet]. Crisis management and communications (Updated September 2014). 2014. Accessed: 13 December 2020. Available from:

Seeger MW, Reynolds B, Sellnow TL. Crisis and emergency risk communication in health contexts: Applying the CDC model to pandemic influenza. In Heath RL, O’Hair DH editors. Handbook of risk and crisis and crisis communication. New York: Routledge; 2009. p. 493-506.

CDC. COVID-19: How to protect yourself & others. 2021. Accessed: 12 March 2021. Available from:

CDC. Public health guidance for community-related exposure. 2021. Accessed: 03 March 2021. Available from:

Salmon CT, Atkin C. Using media campaigns for health promotion. In: Thompson TL, Dorsey A, Miller KI, Parrott R, editors. Handbook of health communication. New York: Taylor & Francis, Inc; 2003. p. 449-472.

Wrighton MS, Lawrence SJ. Reopening colleges and universities during the covid-19 pandemic. Ann Intern Med 2020;173:664-5.

The New York Times [Internet]. Tracking the coronavirus at U.S. colleges and universities. 2020. Accessed: 2 March 2021. Available from:


CDC. Older adults: At greater risk requiring hospitalization or dying if diagnosed with COVID-19. 2021. Accessed: 28 February 2021. Available from:


WHO. Advice for the public.2021. Accessed: 13 January 2021. Available from: public#:~:text=Protect%20yourself%20and%20others%20from,a%20bent%20elbow%20or%20tissue.

WHO. #HealthAtHome. 2021. Accessed: 11 January 2021. Available from:

CDC. If you have pets. 2021. Accessed: 23 January 2021. Available from:

WHO. Origins of the SARS-CoV-2 virus. 2021. Accessed: 02 January 2021. Available from:

CDC. How much sleep do I need?. 2017. Accessed: 14 November 2020. Available from:

WHO. Technical guidance publications. 2021. Accessed: 13 February 2021. Available from:

Champion VL, Skinner CS. The health belief model. In Glanz, KB, Rimer K, Viswanath K editors. Health behavior and health education: Theory, research, and practice. San Francisco: Jossey-Bass; 2008. p.45-65.

Rosenstock IM. The health belief model and preventive health behavior. Health Educ Monogr 1974;2:354-86.

Janz NK, Becker MH. The health belief model: A decade later. Health Educ Q 1984;11:1-47.

Maiman LA, Becker MH. The health belief model: Origins and correlates in psychological theory. Health Educ Monogr 1974;2:336-53.

Cummings KM, Jette AM, Brock BM, Haefner DP. Psychosocial determinants of immunization behavior in a swine influenza campaign. Med Care 1979;17:639-49.

Yang ZJ. Predicting young adults’ intentions to get the H1N1 vaccine: An integrated model. J Health Commun 2015;20:69-79.

Fall E, Izaute M, Chakroun-Baggioni N. How can the health belief model and self-determination theory predict both influenza vaccination and vaccination intention? A longitudinal study among university students. Psychol Health 2018;33:746-64.

King KA, Vidourek RA, English L, Merianos AL. Vigorous physical activity among college students: using the health belief model to assess involvement and social support. Arch Exerc Health Dis 2013;4:267-79.

Das BM, Evans EM. Understanding weight management perceptions in first-year college students using the health belief model. J Am Coll Health 2014;62:488-97.

Duncan SE, Annunziato RA. Barriers to self-management behaviors in college students with food allergies. J Am Coll Health 2018;66:331-9.

Case K, Crook B, Lazard A, Mackert M. Formative research to identify perceptions of e-cigarettes in college students: Implications for future health communication campaigns. J Am Coll Health 2016;64:380-9.

Mackert M, Lazard A, Guadagno M, Hughes Wagner J. The role of implied motion in engaging audiences for health promotion: Encouraging naps on a college campus. J Am Coll Health 2014;62:542-51.

Alsulaiman SA, Rentner TL. The health belief model and preventive measures: A study of the ministry of health campaign on coronavirus in Saudi Arabia. J Inter Crisis Risk Commun Res 2018;1:3.

Ross TP, Ross LT, Rahman A, Cataldo S. The bicycle helmet attitudes scale: using the health belief model to predict helmet use among undergraduates. J Am Coll Health 2010;59:29-36.

Guilford K, McKinley E, Turner L. Breast cancer knowledge, beliefs, and screening behaviors of college women: application of the health belief model. Am J Health Educ 2017;48:256-63.

Fehr SK, Vidourek RA, King KA, Nabors LA. Perceived barriers and benefits of condom use among college students. Am J Health Stud 2017;32:80.

Wong LP, Alias H, Wong PF, et al. The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay. Hum Vaccin Immunotherap 2020;16:2204-14.

Guidry JP, Laestadius LI, Vraga EK, et al. Willingness to get the COVID-19 vaccine with and without emergency use authorization. Am J Infect Control 2021;49:137-42.

Champion VL. Instrument refinement for breast cancer screening behaviors. Nurs Res 1993;42:139–43.

Champion VL. Instrument development for health belief model constructs. Adv Nurs Sci 1984;6:73-85.

American Veterinary Medical Association. Where the (not-so) wild things are: AVMA releases data on top, bottom states for dog, cat and overall pet ownership. 2018. Accessed: 03 February 2021. Available from:

King KA, Singh M, Bernard A, et al. Employing the health belief model to examine stress management among college students. Am J Health Stud 2012;27:192-203.

Sogari G, Velez-Argumedo C, Gómez MI, Mora C. College students and eating habits: A study using an ecological model for healthy behavior. Nutrients 2018;10:1823.

American College Health Association (ACHA). ACHA guidelines: Considerations for reopening institutions of higher education for the spring semester 2021. 2020. Accessed: 12 January 2021. Available from:

Chandler-Coley R, Ross H, Ozoya O, et al. Exploring black college females’ perceptions regarding HIV prevention message content. J Health Commun 2017;22:102-10.

Bai GH. Fighting COVID-19 with Mongolian fiddle stories. Multilingua 2020;39:577-86.

Riley AH, Sangalang A, Critchlow E, et al. Entertainment-education campaigns and COVID-19: How three global organizations adapted the health communication strategy for pandemic response and takeaways for the future. Health Commun 2021;36:42-9.

Original Articles
Health belief model (HBM), COVID-19, college students, preventive measures
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How to Cite
Alsulaiman, S. A., & Rentner, T. L. (2021). The use of the health belief model to assess U.S. college students’ perceptions of COVID-19 and adherence to preventive measures. Journal of Public Health Research.