95% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
ORIGINAL RESEARCH article
Front. Psychol.
Sec. Health Psychology
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1496183
Diabetes as a predictor of COVID-19 preventive behaviors Authors
Provisionally accepted- 1 School of Public Health, Applied Health Science, Indiana University, Bloomington, United States
- 2 School of Medicine, Indiana University Bloomington, Indianapolis, Indiana, United States
Introduction: We explored if diabetes status predicted differences in behavioral pathways associated with staying home at the beginning of the coronavirus-19 infectious disease , wearing a mask, and vaccinating in a convenience sample of US adults over a 12-month period of the COVID-19 pandemic (from May 2020 through June 2021).Methods: We included participants who completed web-based in May-June, 2020 (baseline), and at the 6-, 9-, 11-and 12-months follow-ups (n=966). We collected information on demographic characteristics (baseline) and surveys with Likert-scale type questions to assess Health Beliefs Model and Theory of Planned Behavior constructs related to staying home (6-month), wearing masks in public spaces (9-month), and receiving the COVID-19 vaccine (11-and 12-month). Structural equation modeling was conducted to assess behavioral pathways and direct and indirect associations with diabetes. Results: Constructs of the Theory of Planned Behavior and the Health Beliefs Model explained intention to stay home, to wear a mask, to vaccinate, and COVID-19 vaccination status. DiabetesWhat is already known? People with diabetes were particularly impacted at the beginning of the COVID-19 pandemic and faced unique psychosocial determinants. Diabetes may play a role predicting behavioral pathways associated with COVID preventive behaviors including staying home, wearing a mask, and receiving a vaccine.What is added? Diabetes predicted intention to stay at home but not intention to mask or engage in vaccination behaviors in this longitudinal study. A model combining Health Beliefs Model and Theory of Planned Behavior constructs was effective in explaining intention to stay home, wear a mask, and vaccinate in a US sample of people with and without diabetes.What are the implications for public health practice? This information can be used to design preventive interventions for people with and without diabetes. status predicted intention to stay home directly (β=0.21, p<0.05) and indirectly through perceived severity (β=0.11, p<0.01). Overall, diabetes status was not associated with intention to wear a mask or vaccination.Conclusion: Findings from this study highlight relevant pathways that can be leveraged to promote preventive behaviors in people with diabetes.
Keywords: COVID-19, psychosocial, Health Beliefs Model, Theory of Planned Behavior, type 1 diabetes, type 2 diabetes
Received: 26 Nov 2024; Accepted: 02 Apr 2025.
Copyright: © 2025 Gonzalez Casanova, Klingensmith, Myers, Anwar and de Groot. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ines Gonzalez Casanova, School of Public Health, Applied Health Science, Indiana University, Bloomington, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.