Factors Influencing Health Behaviours during the COVID-19 Outbreak in China: an Extended IMB Model

Abstract Objectives This study explored the factors influencing health behaviours during the coronavirus disease 2019 (COVID-19) outbreak in China. The impact of perceived stress and positive perception of interventions on health behaviours in China were assessed using the extended information-motivation-behaviour skills (IMB) model. Study design Cross-sectional survey. Methods The Questionstar online survey tool was used to construct a structured questionnaire based on the IMB model. Between 14 and 22 February 2020, during the peak of COVID-19 epidemic in China, 2449 participants were recruited by snowball sampling on WeChat and Tencent QQ social media platforms in China. Data were collected through an online questionnaire and structural equation modelling was performed to evaluate the extended IMB model. Results Health behaviours were assessed using a scoring system (total score range 8–40); the average health behaviour score in this study was 34.62 ± 4.44. The term ‘health risk stress’ refers to the impact that perceived stress has on health and this was experienced by 39.9% of participants. Only 35.9% of participants answered all 7 questions on COVID-19 information correctly. The final model showed that information, motivation, behavioural skills, heath risk stress and positive perception of interventions had significant direct effects on health behaviours. Health behaviours were positively associated with the positive perception of interventions, but negatively associated with health risk stress. Behavioural skills had the greatest impact on health behaviours. Conclusions In the face of public health emergencies, the extended IMB model has been used as a theoretical framework to construct more effective interventions. The government should pay attention to publicity and guidance, strengthen positive interactions with the public and disclose relevant information in a timely manner to gain trust and to maintain the positive public perception of the interventions. In terms of health education, the government should focus on behavioural skills, promptly rectify ineffective prevention information and raise awareness about the disease in order to relieve stress and anxiety in the population.