Chronic Conditions and Adherence to COVID-19 Preventive Measures in Pitt County, North Carolina.

INTRODUCTION

Individuals with chronic conditions have increased risk of severe COVID-19 infection. Few studies have been conducted in the U.S. regarding their engagement in recommended preventive behaviors. This study examines the associations between chronic conditions and adherence to COVID-19 preventive measures and vaccination intent in a community-based study conducted during the COVID-19 pandemic.

METHODS

A cross-sectional study was conducted in July-December 2020 among residents in Pitt County, North Carolina. Online surveys collected information on demographics; physical health and health behaviors; and COVID-19 preventive behaviors, including vaccination intent. Logistic regression estimated the associations between any chronic condition (versus none) and adherence to each preventive measure (always/most of the time versus half the time or less), adjusting for age, race, biologic sex, smoking, and alcohol. Analyses were repeated with an increasing number of chronic conditions.

RESULTS

Among 671 participants, adherence to preventive measures was often >90%. Intent to vaccinate showed evidence of a statistically significant dose-response relationship with each additional number of chronic conditions (AOR=1.19; 95% CI=1.03, 1.37). An increased odds of wearing a facemask in public was also found for any chronic condition, although this did not reach statistical significance (AOR=1.69; 95% CI=0.97, 2.95). The authors did not find significant associations between having a chronic condition and adherence to other preventive measures such as avoiding large crowds or distancing 6 feet apart.

CONCLUSION

Adoption of preventive measures is an essential public health tool during epidemics/pandemics, particularly in the absence of vaccines. The study findings have implications for future public health messaging during a large-scale epidemic based on whether someone is likely engaged with and more trusting of the healthcare system (those with chronic conditions) versus those who are not.