Structural equation modeling for explaining preventive health practices of rural adults in the new normal context of COVID-19 pandemic 10.55131/jphd/2023/210210

Main Article Content

Muhammed Ashraful Alam
Md. Nazmul Haque
Shuvashis Saha
Faiza Farheen
Suphawadee Panthumas
J.A. Zuenkova

Abstract

The effects of the coronavirus disease 2019 (COVID-19) are not only limited to health, they also impinge on the social life and economy of communities around the globe. Challenges faced by developing countries such as Bangladesh were multi-factorial and its rural population was highly vulnerable in this situation due to their cultural and sociodemographic context. Preventive behavioral changes were considered the best way to fight against the virus in absence of specific treatment and vaccines. This study has tried to explain preventive health practices during the COVID-19 pandemic, and aimed to explore the causal relationships of its major determinants through structural equation modeling (SEM) based on reasoned action approach (RAA). This cross-sectional study was conducted in 2020 among 810 rural Bangladeshi respondents aged 18-55 years. Around half of the respondents showed poor knowledge, motivation and practice regarding COVID-19 and its prevention. Along with socio-demographic factors, information, attitude, motivation, and intention of the people were found to be associated with the adoption of preventive health practices. The causal model of the COVID-19 prevention behaviors was assessed and justified through SEM. The model fits well with the empirical data (GFI=0.94, CFI=0.97, NFI=0.97, RMSEA=0.05, SRMR=0.04). Intention significantly influenced COVID-19 prevention behavior directly, showing the highest effect (β=0.89, p<0.001). Attitude (β=0.83, p<0.001) and motivation (β=0.15, p<0.001) also showed significant direct effects on intention. All the predictors together explained 79.6% of the variance for COVID-19 preventive behaviors. Adequate knowledge, a positive attitude, proper motivation, and positive intention can encourage rural adults to adopt healthy behaviors against COVID-19. The theoretical model of the study effectively explained COVID-19 preventive behaviors rationally and provided a roadmap for policy-makers to formulate strategies to combat COVID-19 and any future similar pandemic.

Article Details

How to Cite
1.
Muhammed Ashraful Alam, Md. Nazmul Haque, Shuvashis Saha, Faiza Farheen, Suphawadee Panthumas, J.A. Zuenkova. Structural equation modeling for explaining preventive health practices of rural adults in the new normal context of COVID-19 pandemic: 10.55131/jphd/2023/210210. J Public Hlth Dev [Internet]. 2023 Apr. 24 [cited 2024 Apr. 19];21(2):112-25. Available from: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/263191
Section
Original Articles
Author Biographies

Muhammed Ashraful Alam, Dhaka Medical College Hospital (DMCH), Bangladesh

Dhaka Medical College Hospital (DMCH), Bangladesh

Md. Nazmul Haque, Dhaka Medical College Hospital (DMCH), Bangladesh

Dhaka Medical College Hospital (DMCH), Bangladesh

Shuvashis Saha, Center for Integrated Social Development (CISD), Bangladesh

Center for Integrated Social Development (CISD), Bangladesh

Faiza Farheen, Center for Integrated Social Development (CISD), Bangladesh

Center for Integrated Social Development (CISD), Bangladesh

Suphawadee Panthumas, Public Health Department, Mahidol University, Amnatcharoen Campus, Thailand

Public Health Department, Mahidol University, Amnatcharoen Campus, Thailand

J.A. Zuenkova, Peoples Friendship University of Russia (RUDN University), Moscow 117198, Russian Federation

Peoples Friendship University of Russia (RUDN University), Moscow 117198, Russian Federation

References

Kumar V, Pruthvishree B, Pande T, Sinha D, Singh B, Dhama K, Malik YS. SARS-CoV-2 (COVID-19): Zoonotic origin and susceptibility of domestic and wild animals. J Pure Appl Microbiol. 2020 May 28;14(suppl 1):741-7. doi: 10.22207/JPAM.14. SPL1.11.

The Washington Post. History’s deadliest pandemics, from ancient Rome to modern America [Internet]. 2020 [cited 2020 Aug 24]. Available from: https://www. washingtonpost .com/graphics/2020/local/retropolis/coronavirus-deadliest-pandemics/.

Centers for Disease Control and Prevention (CDC). How to protect yourself & others [Internet]. 2020 [cited 2020 Aug 24]. Available from: https://www.cdc.gov/coronavirus/ 2019-ncov/prevent-getting-sick/prevention.html.

World Health Organization (WHO). Coronavirus disease (COVID-19) advice for the public [Internet]. 2020 [cited 2020 Aug 24]. Available from: https://www.who.int/emergencies/ diseases/novel-coronavirus-2019/advice-for-public.

United Nations Children’s Fund (UNICEF). One of the best defences against coronavirus [Internet]. 2020 [Cited 2020 Aug 24]. Available from: https://www.unicef.org/ coronavirus/water-sanitation-one-of-best-defences-against-coronavirus.

Guan WJ, Chen RC, Zhong NS. Strategies for the prevention and management of coronavirus disease 2019. Eur Respir J. 2020;55(4): 2000597. doi: 10.1183/13993003. 00597-2020.

The World Economic Forum COVID Action Platform. Why wearing a mask is the most important thing we can do to stop the spread of COVID-19 [Internet]. 2020 [cited 2020 Aug 24]. Available from: https://www.weforum.org/ agenda/2020/08/why-wearing-a-mask-is-the-most-important-thing-we-can-do-to-stop-the-spread-of-covid-19/

The Business Standard. Economy, or health? [Internet]. 2020 [cited 2020 Aug 24]. Available from: https:// tbsnews.net/coronavirus-chronicle/ covid-19-bangladesh/economy-or-health-68404.

Business Line. How is Covid-19 playing out in rural India? [Internet]. 2020 [Cited 2020 Aug 24]. Available from: https://www. thehindubusinessline.com/opinion/how-is-covid-19-playing-out-in-rural-india/article31671013.ece.

Ramachandran S. The COVID-19 Catastrophe in Bangladesh [Internet]. 2020 [cited 2020 Aug 24]. Available from: https://thediplomat.com/ 2020/04/the-covid-19-catastrophe-in-bangladesh/

Cheng VC, Wong SC, Chuang VW, So SY, Chen JH, Sridhar S, et al. The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. J Infect. 2020;81(1): 107-14. doi: 10.1016/j.jinf.2020.04.024

Forbes. Should everyone wear a mask in public? Maybe-but it’s complicated [Internet]. 2020 [cited 2020 Aug 30]. Available from: https://www.forbes. com/sites/tarahaelle/2020/04/01/ should-everyone-wear-a-mask-in-public-maybe-but-its-complicated/ #fa242c1a02fd.

Forbes. Anti-mask rallies continue in U.S. amid rising Coronavirus cases and deaths [Internet]. 2020 [cited 2020 July 16]. Available from: https://www. forbes.com/sites/tommybeer/2020/ 07/16/anti-mask-rallies-continue-in-us-amid-rising-coronavirus-cases-and-deaths/#41cbebfe2246.

British Broadcasting Corporation (BBC). Coronavirus: Why are Americans so angry about masks? [Internet]. 2020 [Cited 2020 Aug 30]. Available from: https://www.bbc. com/news/world-us-canada-53477121.

ALJAZEERA. Coronavirus: in dense Bangladesh, social distancing a tough task [Internet]. 2020 [Cited 2020 Aug 30]. Available from: https://www. aljazeera.com/news/2020/03/ coronavirus-dense-bangladesh-social-distancing-tough-task-200320103733470 .html.

The Independent. Covid-19: social-distancing rules largely unheeded in capital [Internet]. 2020 [cited 2020 Aug 30]. Available from: http://www. theindependentbd.com /post/250391.

The Business Standard. Lack of soap, water failing Dhaka Wasa’s noble initiative [Internet]. 2020 [Cited 2020 Sept 7]. Available from: https:// tbsnews.net/coronavirus-chronicle/ covid-19-bangladesh/lack-soap-water-failing-dhaka-wasas-noble-initiative-63274.

The Financial Express. WHO reviewing report urging new guidance over airborne spread of coronavirus [Internet]. 2020 [cited 2020 Sept 7]. Available from: https:// thefinancialexpress.com.bd/health/who-reviewing-report-urging-new-guidance-over-airborne-spread-of-coronavirus-1594094038.

Mahmud F. Bangladesh founder’s birth centenary event postponed [Internet]. 2020 [cited 2020 Aug 24]. Available form: https://www.aljazeera.com/ news/2020/03/coronavirus-bangladesh-founder-birth-centenary-event-postponed-200309113459629.html.

Chowdhury T. Fears grow over Bangladesh’s COVID-19 response [Internet]. 2020 [cited 2020 Aug 24]. Available from: https://www.aljazeera. com/news/2020/03/fears-grow-bangladeshs-covid-19-response-200323111803294.html.

BBC. Coronavirus lockdown protest: What’s behind the US demonstrations? [Internet]. 2020 [cited 2020 Jul 15]. Available from: https://www.bbc.com/ news/world-us-canada-52359100.

The New York Times. Spain’s courts, already strained, face crisis as lockdown lifts [Internet]. 2020 [cited 2020 Jul 15]. Available from: https://www.nytimes.com /2020/05/25/ world/europe/spain-courts-coronavirus.html.

Anwar S, Nasrullah M, Hosen MJ. COVID-19 and Bangladesh: Challenges and How to Address Them. Front Public Health. 2020;8:154. doi: 10.3389/fpubh.2020.00154.

Fishbein M. A reasoned action approach to health promotion. Med Decis Making. 2008;28(6):834-44. doi: 10.1177/0272989X08326092.

Ajzen I. The theory of planned behavior. Organizational behavior and human decision processes. 1991; 50(2):179–211.

Hosseini Z, Gharlipour Gharghani Z, Mansoori A, Aghamolaei T, Mohammadi Nasrabadi M. Application of the theory of reasoned action to promoting breakfast consumption. Med J Islam Repub Iran. 2015;29:289.

Dhaka Tribune. Covid-19: Dhaka division worst at wearing face masks [Internet]. 2020. Available from: https://www.dhakatribune.com/health/coronavirus/2020/07/28/dhaka-division-worst-in-bangladesh-for-wearing-masks

National Institute of Population Research and Training (NIPORT), International Coaching Federation (ICF). Bangladesh Demographic and Health Survey 2017-18: Key indicators. Dhaka, Bangladesh, and Rockville, Maryland, USA: NIPORT, and ICF [Internet]. 2019 [Cited 2020 Aug 30]. Available from: https://dhsprogram. com/pubs/pdf/PR104/PR104.pdf.

Christine R. Washing hands with ash, and other COVID-19 information from Bangladeshi community radio [Internet]. 2020 [cited 2020 Aug 30]. Available from: https://www.forbes. com/sites/christinero/2020/04/03/washing-hands-with-ash-and-other-covid-19-information-from-bangladeshi-community-radio/#15782f984ce3.

Jadhav R. Covid-19: Why water to wash hands is a luxury in rural India [Internet]. Business Line. 2020 [cited 2020 Aug 30]. Available from: https://www.thehindubusinessline. com/news/covid-19-why-water-to-wash-hands-is-a-luxury-in-rural-india/article31498753.ece.

UNICEF Fact Sheet. Handwashing stations and supplies for the COVID-19 response [Internet]. 2020 [cited 2020 Aug 30]. Available from: https://www. unicef.org/media/68896/file/ Handwashing-Facility-Factsheet.pdf.

The Financial Express. Mask-wearing mandatory in BD: Not everyone cares [Internet]. 2020 [cited 2020 Aug 30]. Available from: https:// thefinancialexpress.com.bd/health/ mask-wearing-mandatory-in-bd-not-everyone-cares-1595928041.

The Telegraph. Mass religious events spark fears of coronavirus spread in Asia [Internet]. 2020 [cited 2020 Aug 30]. Available from: https://www. telegraph.co.uk/news/2020/03/19/ mass-religious-events-spark-fears-coronavirus-spread-asia/.

Hausenblas HA, Carron AV, Mack DE. Application of the theories of reasoned action and planned behavior to exercise behavior: A meta-analysis. J Sport Exerc Psychol. 1997;19(1):36-51.

Ferdous MZ, Islam MS, Sikder MT, Mosaddek ASM, Zegarra-Valdivia JA, Gozal D. Knowledge, attitude, and practice regarding COVID-19 outbreak in Bangladesh: An online-based cross-sectional study. PLOS ONE. 2020; 15(10):e0239254. doi: 10.1371/journal. pone.0239254.

Honarvar B, Lankarani KB, Kharmandar A, Shaygani F, Zahedroozgar M, Rahmanian Haghighi MR, et al. Knowledge, attitudes, risk perceptions, and practices of adults toward COVID-19: a population and field-based study from Iran. Int J Public Health. 2020;65(6):731-9. doi: 10.1007/s00038-020-01406-2.

Azlan AA, Hamzah MR, Sern TJ, Ayub SH, Mohamad E. Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia. PLOS ONE. 2020;15(5):e0233668. doi: 10.1371/journal.pone.0233668.

Paul A, Sikdar D, Hossain MM, Amin MR, Deeba F, Mahanta J, et al. Knowledge, attitudes, and practices toward the novel coronavirus among Bangladeshis: Implications for mitigation measures. PLOS ONE. 2020;15(9):e0238492. doi: 10.1371/ journal.pone.0238492.

Hayat K, Rosenthal M, Xu S, Arshed M, Li P, Zhai P, et al. View of Pakistani Residents toward Coronavirus Disease (COVID-19) during a Rapid Outbreak: A Rapid Online Survey. Int J Environ Res Public Health. 2020;17(10). doi: 10.3390/ijerph17103347.

Kartheek AV, Gara KH, Vanamali DR. Knowledge, attitude and practices towards COVID-19 among Indian residents during the pandemic: A cross-sectional online survey. J Dr NTR Univ Health Sci. 2020;9(2):107-15. doi: 10.4103/JDRNTRUHS.JDRNTRUHS_75_20.

Utami SM, Swarjana IK, Satriani NLA, Diyu IANP. Factors associated with the utilization of health services among patients with hypertension during the Covid-19 pandemic: a cross-sectional study in West Lombok Regency, Indonesia. J Public Hlth Dev. 2022;20(2):43-53. doi: https://doi.org/ 10.55131/jphd/2022/200204.