Social Cognitive Predictors of Health Promotion Self-Efficacy among Older Adults during the COVID-19 Pandemic

RESEARCH OBJECTIVES: To examine the relative importance of social cognitive predictors on health promotion self-efficacy among community-living adults, aged >65 years during COVID-19. DESIGN: This cross-sectional study was a secondary analysis of baseline data from a larger chronic disease self-management support intervention. SETTING: This study was conducted in the general community setting. PARTICIPANTS: The mean age of participants (n=75) was 72.4 years old (SD=5.8; 44 female). Seventy participants (93%) reported living with long term disability resulting from arthritis (n=33), degenerative disk disease (n=18), stroke (n=6), and other conditions (n=18). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Health promotion self-efficacy was measured using the Self-Rated Abilities for Health Practices Scale [3]. Independent predictors of performance including performance accomplishment, vicarious learning, verbal persuasion, and affective states [4] were assessed using the health directed behavior subscale of the Health Education Impact Questionnaire [5], positive social interaction subscale of the Medical Outcomes Survey - Social Support Scale (MOS-SSS) [6], informational support subscale of MOS-SSS, and the Depression Anxiety Stress Scale [7], respectively. RESULTS: After controlling for age and sex, linear regression analyses revealed statistically significant associations between health promotion self-efficacy and: (i) performance accomplishment (health-directed behavior; β=2.98, p=0.04); (ii) verbal persuasion (informational support; β=5.30, p=0.01); and (iii) affective state (depressive symptoms; β=-0.84; p< 0.001). Vicarious learning (positive social interaction; β=-1.23; p=0.55) did not significantly predict health promotion self-efficacy. Overall, this model was statistically significant (p< 0.001) and explained 48% of the health promotion self-efficacy variance. CONCLUSIONS: Verbal communication supports and strategies to address depressive symptoms and facilitate health-directed behaviors may improve health promotion self-efficacy in the context of physical and social distancing (i.e., COVID prevention strategies). A lack of relationship between self-efficacy and vicarious learning highlights the overall impact COVID had on in-person engagement. AUTHOR(S) DISCLOSURES: We report no real or perceived conflicts of interest.