Application of health belief model for the assessment of COVID-19 preventive behavior and its determinants among students: A structural equation modeling analysis

Background: COVID-19 is a new pandemic that poses a threat to people globally. In Ethiopia, where classrooms are limited, students are at higher risk for COVID-19 unless they take consistent preventative actions. However, there is a lack of evidence in the study area regarding student compliance with COVID-19 preventive behavior (CPB) and its predictors. Objective: This study aimed to assess CPB and its predictors among students based on the perspective of the Health Belief Model (HBM). Method and materials: A school-based cross-sectional survey was conducted from November to December 2020 to evaluate the determinants of CPB among high school students using a self-administered structured questionnaire. 370 participants were selected using stratified simple random sampling. Descriptive statistics were used to summarize data, and partial least squares structural equation modeling (PLS-SEM) analyses to evaluate the measurement and structural models proposed by the HBM and to identify associations between HBM variables. A T-value of > 1.96 with 95% CI and a P-value of < 0.05 were used to declare the statistical significance of path coefficients. Result: A total of 370 students participated with a response rate of 92%. The median (interquartile range) age of the participants (51.9% females) was 18 (2) years. Only 97 (26.2%), 121 (32.7%), and 108 (29.2%) of the students had good practice in keeping physical distance, frequent hand washing, and facemask use respectively. The HBM explained 43% of the variance in CPB. Perceived barrier (β= - 0.15, p < 0.001) and self-efficacy (β= 0.51, p