Urban-rural Disparities on Personal Health Behaviors and the Influencing Factors during the COVID-19 Outbreak in China: Based on an Extended IMB Model
Abstract Background: Health behavior was conducive to control the COVID-19 epidemic. This study aimed to determine the differences in health behaviors and related factors among rural-urban residents in China. Methods: From February 14 to 22, 2020, the peak of COVID-19 epidemic in China, a total of 2449 participants(urban residents,1783(72.81%) and rural residents, 666 (27.19%)) were recruited by snowball sampling on WeChat and Tencent QQ social platforms. Data were collected through the Web-questionnaire guided by an information–motivation–behavioral skills model. Multiple-group structural equation model was applied to analyze the factors. Results: Rural residents had lower health behavior scores than urban residents, even after adjusting demographic characteristics (33.86 vs. 34.29, P=0.042, total score was 40). In urban and rural residents, motivation, behavioral skills and health risk stress had significant direct positive and negative influences effects on health behaviors, respectively. Information and positive perception of interventions had direct effects on health behaviors in rural residents, but not in urban residents. All the factors were mediated by behavioral skills in rural and urban residents. Conclusions: This study suggest that the government should pay attention to substantial rural-urban disparities and implement different COVID-19 prevention and intervention policies for health behaviors targeting rural and urban residents.