Background Slowing the spread of the novel coronavirus (COVID-19) requires behavioral changes such as physical distancing (e.g., staying a 6-foot distance from others, avoiding mass gatherings, reducing houseguests), wearing masks, reducing trips to nonessential business establishments, and increasing hand washing. Like other health behaviors, COVID-19 related behaviors may be related to risk representations. Risk representations are the cognitive responses a person holds about illness risk such as, identity (i.e., label/characteristics of risk), cause (i.e., factors causing condition), timeline (i.e., onset/duration of risk), consequences (i.e., intrapersonal/interpersonal outcomes), behavioral efficacy (i.e., if and how the condition can be controlled/treated), and illness risk coherence (i.e., extent to which representations, behaviors, and beliefs are congruent). The current study applies the Common-Sense Model of Self-Regulation (CSM-SR) to evaluate how risk representations may relate to COVID-19 protective and risk behaviors. Methods Participants include 400 workers from Amazon’s Mechanical Turk aged ≥ 18 years and US residents. Participants completed an online survey measuring risk representations (B-IPQ) and COVID-19 related behaviors, specifically, physical distancing, hand washing, and shopping frequency. Results Risk coherence, consequences, timeline, emotional representation, and behavioral efficacy were related to risk and protective behaviors. Conclusions Risk representations vary in their relationship to COVID-19 risk and protective behaviors. Implications include the importance of coherent, targeted, consistent health communication, and effective health policy in mitigating the spread of COVID-19.

People with chronic illnesses are at increased risk of contracting COVID‐19. Still, little is known about whether such an increased risk relates to COVID‐19‐related protective behaviors among those with chronic illness. This study compares the self‐reported COVID‐19 risky and protective behaviors—specifically physically distancing, handwashing, and having houseguests—of people (N = 936) (1) living with chronic illnesses or (2) cohabiting with someone with chronic illness to those who fall in neither category at the beginning of the COVID‐19 pandemic (April 2020). Study results were mixed: people with a chronic illness were more likely to have had houseguests in the past 5 days and less likely to have increased their handwashing in response to the pandemic, but were also more likely to physical distance when outside the home. Those cohabiting with someone with a chronic illness were more likely to have had houseguests, but did not differ in other outcomes.