Protection Behaviors and Related Factors Against COVID‑19 in the Healthcare Workers of the Hospitals in Iran: A Cross‑Sectional Study

Reyhaneh Toghanian, Saeed Ghasemi, Meimanat Hosseini, Malihe Nasiri


Background: Protective behaviors play a key role in reducing the incidence of COVID‑19 in HealthCare Workers (HCWs), and these behaviors are related to other factors. These related factors have not been comprehensively evaluated and determined in the literature. This study aimed to determine protection behaviors against COVID‑19 and their related factors using the Protection Motivation Theory (PMT) among HCWs of hospitals in Tehran, Iran, in 2021.

Materials and Methods: For this cross‑sectional study, 270 HCWs of different wards in 3 hospitals in Tehran, Iran, were selected through multistage sampling (April to July 2021). The participants completed a self‑reporting questionnaire which consisted of a demographic characteristics form and questions about protective behaviors against COVID‑19 and other constructs of the PMT (60 items). Data analysis was performed using descriptive and inferential methods.

Results: The mean score of the protective behaviors of the HCWs was 4.20 (SD = 0.56) and was significantly higher in the nurses, women, married individuals, and those with a BSc degree compared with others (p < 0.05). Furthermore, the results of multiple regression analysis showed that protection behavior among HCWs could be strongly predicted by the type of profession, protection motivation/intention, and self‑efficacy constructs (F14, 255 = 16.34, p < 0.001).

Conclusions: The protection behaviors of HCWs against COVID‑19 were relatively desirable and these behaviors were related to and predicted by various factors. These results could apply to developing plans for protective behaviors against COVID‑19 and possibly other infectious diseases among HCWs. Further research in this regard is recommended.


COVID‑19, cross‑sectional studies, health behavior, health personnel, motivation

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Centers for Disease Control and Prevention. COVID‑19. Identifying the source of the outbreak (Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases). Available from: https://www.‑ncov/science/about‑epidemiology/ identifying‑source‑outbreak.html. [Last accessed on 2021 Oct 28].

World Health Organization WHOCoronavirus (COVID‑19) Dashboard. Available from: [Last accessed on 2021 Nov 08].

World Health Organization Global, Iran (Islamic Republic of). available From: ir. [Last accessed 2021 Nov 08].

Alshamrani MM, El‑Saed A, Al Zunitan M, Almulhem R, Almohrij S. Risk of COVID‑19 morbidity and mortality among healthcare workers working in a Large Tertiary Care Hospital. Int J Infect Dis 2021;109:238‑43.

Kalantar SH, Mortazavi SJ, Bagheri N, Dehghan Manshadi SA, Moharrami A, Ariamloo P, et al. Prevalence of coronavirus disease‑2019 among healthcare workers in imam Khomeini hospital complex in Tehran, Iran. J Orthop Spine Trauma 2021;6:30‑2.

Nguyen LH, Drew DA, Joshi AD, Guo CG, Ma W, Mehta RS, et al. Risk of COVID‑19 among frontline healthcare workers and the general community: A prospective cohort study. medRxiv 2020:2020.04.29.20084111. doi: 10.1101/2020.04.29.20084111.

Alajmi J, Jeremijenko AM, Abraham JC, Alishaq M, Concepcion EG, Butt AA, et al. COVID‑19 infection among healthcare workers in a national healthcare system: The Qatar experience. Int J Infect Dis 2020;100:386‑9.

Wei JT, Liu ZD, Fan ZW, Zhao L, Cao WC. Epidemiology of and risk factors for covid‑19 infection among health care workers: A multi‑centre comparative study. Int J Environ Res Public Health 2020;17:7149.

World Health Organization Home/Diseases/Coronavirus disease (COVID‑19)/Advice for the public: Coronavirus disease (COVID‑19). Available from: https://www.‑coronavirus‑2019/ advice‑for‑public. [Last accessed on 2021 Oct 28].

Bashirian S, Jenabi E, Khazaei S, Barati M, Karimi‑Shahanjarini A, Zareian S, et al. Factors associated with preventive behaviours of COVID‑19 among hospital staff in Iran in 2020: An application of the protection motivation theory. J Hosp Infect 2020;105:430‑3.

Conner M, Norman P. Predicting and Changing Health Behavior, Research and Practice with Social Cognition Models. 3rd ed. McGraw‑Hill Global Education Holdings, LLC; 2015.

Ezati Rad R, Mohseni S, Kamalzadeh Takhti H, Hassani Azad M, Shahabi N, Aghamolaei T, et al. Application of the protection motivation theory for predicting COVID‑19 preventive behaviors in Hormozgan, Iran: A cross‑sectional study. BMC Public Health 2021;21:466.

Mortada E, Abdel‑Azeem A, Al Showair A, Zalat MM. Preventive behaviors towards Covid‑19 pandemic among healthcare providers in Saudi Arabia using the protection motivation theory. Risk Manag Healthc Policy 2021;14:685‑94.

Al‑Rasheed M. Protective behavior against COVID‑19 among the public in Kuwait: An examination of the protection motivation theory, trust in Government, and sociodemographic factors. Soc Work Public Health 2020;35:546‑56.

Papageorge NW, Zahn MV, Belot M, van den Broek‑Altenburg E, Choi S, Jamison JC, et al. Socio‑demographic factors associated with self‑protecting behavior during the Covid‑19 pandemic. J Popul Econ 2021;34:691–738.

Hanson CL, Crandall A, Barnes MD, Novilla ML. Protection motivation during COVID‑19: A cross‑sectional study of family health, media, and economic influences. Health Educ Behav 2021;48:434‑45.

Saqlain M, Munir MM, Rehman SU, Gulzar A, Naz S, Ahmed Z, et al. Knowledge, attitude, practice and perceived barriers among healthcare workers regarding COVID‑19: A cross‑sectional survey from Pakistan. J Hosp Infect 2020;105:419‑23.

Arslanca T, Fidan C, Daggez M, Dursun P. Knowledge, preventive behaviors and risk perception of the COVID‑19 pandemic: A cross‑sectional study in Turkish health care workers. PLoS One 2021;16:e0250017. doi: 10.1371/journal. pone. 0250017.

Lai X, Wang X, Yang Q, Xu X, Tang Y, Liu C, et al. Will healthcare workers improve infection prevention and control behaviors as COVID‑19 risk emerges and increases, in China?. Antimicrob Resist Infect Control 2020;9:83.


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