Harutyunyan Tsovinar, Hayrumyan Varduhi, Aslanyan Lusine, Sedrakyan Tamara, Sargsyan Zhanna
Turpanjian College of Health Sciences, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan, 0019, Armenia.
BMC Public Health. 2025 Sep 1;25(1):2995. doi: 10.1186/s12889-025-24235-5.
Health behavior theories have proven effective in understanding individuals' COVID-19-related protective behaviors. This study aimed to identify predictors of mask-wearing behavior during the COVID-19 pandemic in Armenia using the constructs of the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). We conducted a telephone survey in 2021 in a nationwide sample of adult Armenian population selected via stratified two stage random sampling. The survey questionnaire included questions on socio-demographic characteristics, COVID-19 protective behaviors, knowledge, vaccination status, and constructs from the HBM and TPB. Mask-wearing in public places in the past 14 days was analyzed using multivariable logistic regression with variable entry in blocks. The majority of 3,439 respondents were females (71.2%). The mean age was 49.44 years. Approximately 52% always/usually wore masks. The final logistic regression model, incorporating socio-demographic characteristics, COVID-19 knowledge, vaccination status, HBM constructs, and perceived social norm, explained 23% of the variance in mask-wearing behavior. Age, perceived threat, benefits, barriers, cues to action, and social norm were significantly and independently associated with mask-wearing. While several socio-demographic factors and theory-based constructs emerged as significant predictors, their limited explanatory power highlights the importance of exploring additional factors influencing mask-wearing behavior. The study stresses the role of social norms in shaping COVID-19 preventive behaviors and provides important evidence for public health interventions globally in Armenia, and other post-Soviet countries, where theory-based approaches to health behavior change are scarce.
健康行为理论已被证明在理解个体与新冠疫情相关的防护行为方面是有效的。本研究旨在运用健康信念模型（HBM）和计划行为理论（TPB）的概念，确定亚美尼亚新冠疫情期间戴口罩行为的预测因素。我们于2021年通过分层两阶段随机抽样，对全国成年亚美尼亚人口样本进行了电话调查。调查问卷包括社会人口学特征、新冠防护行为、知识、疫苗接种状况以及来自HBM和TPB的概念等问题。使用逐步纳入变量的多变量逻辑回归分析过去14天内在公共场所戴口罩的情况。3439名受访者中大多数为女性（71.2%）。平均年龄为49.44岁。约52%的人总是/通常戴口罩。纳入社会人口学特征、新冠知识、疫苗接种状况、HBM概念和感知社会规范的最终逻辑回归模型，解释了戴口罩行为差异的23%。年龄、感知威胁、益处、障碍、行动线索和社会规范与戴口罩显著且独立相关。虽然一些社会人口学因素和基于理论的概念成为显著预测因素，但其有限的解释力凸显了探索影响戴口罩行为的其他因素的重要性。该研究强调了社会规范在塑造新冠疫情预防行为中的作用，并为亚美尼亚以及其他前苏联国家（这些国家缺乏基于理论的健康行为改变方法）全球范围内的公共卫生干预提供了重要证据。
