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Background: The health belief model suggests that individuals' beliefs affect behaviors associated with health. This study examined whether Ohioans' pre-existing medical health diagnoses affected their belief about personal health risk and their compliance with social distancing during the coronavirus disease 2019 (COVID-19) pandemic. Prior research examining physical and mental diagnoses and social distancing compliance is nearly nonexistent. We examined whether physical and mental health diagnoses influenced individuals' beliefs that their health is at risk and their adherence with social distancing guidelines. Methods: The study used longitudinal cohort data from the Toledo Adolescent Relationships Study (TARS) (n = 790), which surveyed Ohioans prior to and during the COVID-19 pandemic. Dependent variables included belief that an individual's own health was at risk and social distancing compliance. Independent variables included physical and mental health diagnoses, pandemic-related factors (fear of COVID-19, political beliefs about the pandemic, friends social distance, family social distance, COVID-19 exposure), and sociodemographic variables (age, gender, race/ethnicity, educational level). Results: Individuals who had a pre-existing physical health diagnosis were more likely to believe that their personal health was at risk during the pandemic but were not more likely to comply with social distancing guidelines. In contrast, individuals who had a pre-existing mental health diagnosis were more compliant with social distancing guidelines but were not more likely to believe their personal health was at risk. Individuals who expressed greater fear of COVID-19 believed their health is more at risk than those who expressed lower levels of fear. Conclusion: Health considerations are important to account for in assessments of responses to the pandemic, beliefs about personal health risk, and social distancing behavior. Additional research is needed to understand the divergence in the findings regarding physical health, beliefs about personal health risk, and social distancing compliance. Further, research is needed to understand how mental health issues impact decision-making related to social distancing compliance.
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This content will become publicly available on December 10, 2026
Adolescents’ Longitudinal Adherence To Public Health Guidelines Across One Year of COVID-19
In response to COVID-19, the CDC issued hygiene, protective equipment, and physical distancing guidelines to reduce virus transmission. Adherence was crucial for public health, particularly in the earliest stage of COVID-19, before effective treatments emerged. Still, there was wide variation in willingness and/or ability to follow the recommendations. One group that might be expected to flout rules and take risks under normal circumstances is adolescents. This developmental stage predisposes one to push boundaries and seek the company of peers. Adolescents with a history of lawbreaking might be even more inclined to disregard public health guidelines due to experiential and dispositional factors. We employed a longitudinal study launched prior to the pandemic to identify which pre-pandemic factors predict adolescents’ adherence to—or disregard for—public health guidelines during a crisis. The sample (N = 75, 30% justice-involved) came from predominantly minoritized communities in a southwestern U.S. city. Data were collected in three waves over one year. Analyses tested whether adherence varied by time period, local infection trajectories, justice involvement, pre-pandemic mental health, risk-taking, and rule orientation. Results revealed that adherence declined over time and was generally lower among justice-involved adolescents. In addition, justice-involved adolescents with higher depressive symptoms displayed lower adherence, whereas those reporting higher anxiety symptoms displayed higher adherence. Understanding these factors is crucial for developing strategies to promote adherence to public health guidelines among adolescents during public health emergencies.
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- PAR ID:
- 10654773
- Publisher / Repository:
- Springer
- Date Published:
- Journal Name:
- Journal of Child and Family Studies
- ISSN:
- 1062-1024
- Subject(s) / Keyword(s):
- COVID-19 · Adherence · Longitudinal · Mental health · Risky behaviors
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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