Effects of Age, Gender, Health Status, and Political Party on COVID-19–Related Concerns and Prevention Behaviors: Results of a Large, Longitudinal Cross-sectional Survey

BACKGROUND: With conflicting information about COVID-19, the general public may be uncertain about how to proceed in terms of precautionary behavior and decisions about whether to return to activity. OBJECTIVE: The aim of this study is to determine the factors associated with COVID-19–related concerns, precautionary behaviors, and willingness to return to activity. METHODS: National survey data were obtained from the Democracy Fund + UCLA Nationscape Project, an ongoing cross-sectional weekly survey. The sample was provided by Lucid, a web-based market research platform. Three outcomes were evaluated: (1) COVID-19–related concerns, (2) precautionary behaviors, and (3) willingness to return to activity. Key independent variables included age, gender, race or ethnicity, education, household income, political party support, religion, news consumption, number of medication prescriptions, perceived COVID-19 status, and timing of peak COVID-19 infections by state. RESULTS: The data included 125,508 responses from web-based surveys conducted over 20 consecutive weeks during the COVID-19 pandemic (comprising approximately 6250 adults per week), between March 19 and August 5, 2020, approved by the University of California, Los Angeles (UCLA) Institutional Review Board for analysis. A substantial number of participants were not willing to return to activity even after the restrictions were lifted. Weighted multivariate logistic regressions indicated the following groups had different outcomes (all P<.001): individuals aged ≥65 years (COVID-19–related concerns: OR 2.05, 95% CI 1.93-2.18; precautionary behaviors: OR 2.38, 95% CI 2.02-2.80; return to activity: OR 0.41, 95% CI 0.37-0.46 vs 18-40 years); men (COVID-19–related concerns: OR 0.73, 95% CI 0.70-0.75; precautionary behaviors: OR 0.74, 95% CI 0.67-0.81; return to activity: OR 2.00, 95% CI 1.88-2.12 vs women); taking ≥4 medications (COVID-19–related concerns: OR 1.47, 95% CI 1.40-1.54; precautionary behaviors: OR 1.36, 95% CI 1.20-1.555; return to activity: OR 0.75, 95% CI 0.69-0.81 vs <3 medications); Republicans (COVID-19–related concerns: OR 0.40, 95% CI 0.38-0.42; precautionary behaviors: OR 0.45, 95% CI 0.40-0.50; return to activity: OR 2.22, 95% CI 2.09-2.36 vs Democrats); and adults who reported having COVID-19 (COVID-19–related concerns: OR 1.24, 95% CI 1.12-1.39; precautionary behaviors: OR 0.65, 95% CI 0.52-0.81; return to activity: OR 3.99, 95% CI 3.48-4.58 vs those who did not). CONCLUSIONS: Participants’ age, party affiliation, and perceived COVID-19 status were strongly associated with their COVID-19–related concerns, precautionary behaviors, and willingness to return to activity. Future studies need to develop and test targeted messaging approaches and consider political partisanship to encourage preventative behaviors and willingness to return to activities.