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Coronavirus disease 2019 (COVID-19) became a global pandemic within a few months. Even though Bangladesh has been badly affected by COVID-19, the pandemic is still a concern across the country. This study was conducted to explore regional variations in preventive health practices of rural adults during the COVID-19 pandemic, and to determine the predictors regarding COVID-19 prevention. A cross-sectional survey was conducted in rural Bangladesh in 2020 among 810 respondents selected by multi-stage random sampling. Data collection was done by face-to-face interviews using a questionnaire. The results showed that almost half of the rural adults (48.1%) had poor health practices regarding COVID-19 prevention. Rural adults of the Mymensingh district showed relatively better health practices during the pandemic (U = 58,747.5, p < 0.001). Not only the background issues but also information, attitude, motivation, and intention in COVID-19 prevention were significant in predicting the health practices of rural adults in COVID-19 prevention. The significant regional effect was determined in COVID-19 prevention behavior of rural adults (p < 0.001) in hierarchical regression, explained through a modified reasoned action approach. Health programs should be strengthened more, not only to improve preventive health practices of rural adults but also to establish regional equity in COVID-19 prevention, ensuring region-specific initiatives on behavioral changes.
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