Adaptation of the Information, Motivation, and Behavioral Skills Framework for Understanding COVID-19 Prevention Behaviors among Youth and Young Adults by Sexual Identity, Gender Identity and Race/Ethnicity

Abstract

Youth and young adults (YYA) have been uniquely affected by COVID-19. Behavioral models have not yet been applied to understand YYA’s preventive behavior, though the Information–Motivation–Behavior (IMB) model may be appropriate. We used data from a national, diverse survey of COVID-19 effects and prevention behaviors in YYA ages 14–24 (n = 1026) and conducted an exploratory factor analysis and bivariate linear regressions to assess the association between demographics and IMB measures. Significant differences by sexual identity were identified, with bisexual/pansexual, gay/lesbian, and queer populations reporting significantly lower prevention stigma, in comparison to their straight respondents. Non-binary respondents (vs. women/girls) and transgender and gender diverse individuals (vs. cisgender) had significantly higher intentions to social distance. Racial/ethnicity differences were also found in lower prevention efficacy beliefs (Latinx and multiracial vs. white), and lower motivation norms (Black and Latinx vs. white). Our findings about critical disparities in IMB measures provide recommendations for future prevention research, practice, and policy development in response to the pandemic, particularly related to highly marginalized communities.

“Being Queer, It Was Really Isolating”: Stigma and Mental Health Among Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) Young People During COVID-19

“…We obtained informed consent for interviews electronically using the secure, web-based software platform REDCap (Harris et al, 2009). Sociodemographic data were collected in the larger survey described by Phillips et al (2023). For participants under 18 years, we assessed decisional capacity using a modified version of the Evaluation to Consent Form (Moser et al, 2002;UCSD Task Force on Decisional Capacity, 2003).…”

“…Interviewees were recruited from a nationwide survey ("The YYA COVID-19 Study") (Phillips et al, 2023) that explored COVID-19 experiences among minoritized YYA from February 2021 to March 2022. Participants completed the survey at two time points and answered questions about COVID prevention and mental health.…”

“…The semistructured interview guide was informed by socialecological and intersectionality models (Bronfenbrenner, 1999;Crenshaw, 1994), as well as the parent study's survey findings on youth's quantitative experiences of mental health, COVID-19 prevention motivations, stigma, and social support (Phillips et al, 2023). Interview questions were organized semichronologically and explored participants' social, familial, and romantic relationships (Jairath et al, 2021); how these relationships and their lives changed as a function of the pandemic and sociopolitical events; how youth might have experienced stigma or growth related to their different identities and social contexts during the pandemic; and perceptions of COVID-19 risk, prevention, and responsibility (Table 1).…”