The Role Of Worry and Health Beliefs in COVID-19 Protective Behaviors Among Lung Cancer Patients

Abstract

Coronavirus disease 2019 (COVID-19) is a serious public health threat, and lung cancer patients are at high risk of poor outcomes from COVID-19 relative to the general population. Little is known about lung cancer patients’ beliefs and emotions regarding COVID-19 and COVID-19 protective behaviors (i.e., mask wearing, social distancing, hand hygiene). Prior research has found that Health Belief Model (HBM) variables (i.e., perceived risk of acquiring the illness, perceived illness severity, perceived benefits of and barriers to the preventive health behavior) and worry are predictive of engagement in preventive health behaviors. Drawing upon the HBM and theories of the role of emotion in decision-making, the current study examined psychological correlates of lung cancer patients’ engagement in COVID-19 protective behaviors. Lung cancer patients (N = 191) were recruited from Indiana University Simon Comprehensive Cancer Center to participate in a one-time survey from August 2021 through May 2022. Descriptive statistics were used to characterize COVID-19 protective behaviors. Multiple hierarchical regression models were used to examine associations between HBM constructs and engagement in COVID-19 protective behaviors. Higher-order regression models were then used to examine whether worry about COVID-19 was associated with COVID-19 protective behaviors above and beyond the effects of HBM variables. In general, the present sample showed high rates of engagement in all COVID-19 protective behaviors. Fewer perceived barriers to mask wearing were associated with greater mask wearing, and greater worry about COVID-19 was associated with greater mask wearing above and beyond the effects of HBM variables. Greater perceived severity of COVID-19 was associated with more social distancing, and higher levels of worry about COVID-19 were associated with more social distancing above and beyond the effects of HBM variables. HBM constructs (i.e., perceived risk of COVID-19, perceived severity of COVID-19) and worry about COVID-19 were unrelated to hand hygiene. Most findings are in line with theories on the central role of emotion in health-related decision-making and warrant replication in longitudinal research. Results point to several potential intervention targets, including worry about COVID-19, perceived severity of COVID-19, and perceived barriers to mask wearing, to improve COVID-19 protective behaviors in lung cancer patients.