Factors Associated With Physical Activity and COVID-19 Preventive Behaviors: A Cross-Sectional Study in Indonesian Adults

Main Article Content

Novita Intan Arovah
Juni Kurniawaty
Hartiah Haroen


Studies have shown that coronavirus disease (COVID-19) preventive measures and regular physical activity are essential for reducing disease risk. As such, utilizing the health belief model (HBM) framework, this cross-sectional study aimed to assess the association between sociodemographic and social-cognitive explored factors with physical activity and COVID-19 preventive behaviors in a nationally represented sample of 871 Indonesian adults. The Global Physical Activity Questionnaire was used to assess physical activity levels. The COVID-19 preventive behaviors and the social-cognitive factors were measured using instruments adapted from the WHO-COVID-19 Snapshot Monitoring and based on the HBM framework. Logistic regression was used to evaluate the association between the outcomes and each potential correlate, adjusted for potential confounders. The results showed that women were more likely to engage in sufficient COVID-19 preventive behaviors, while older adults were less likely to be physically active. Participants with high social-cognitive processes were also more likely to engage in sufficient COVID-19 preventive behaviors and be physically active. The perceived barrier, however, was not associated with COVID-19 preventive practices. The findings support using the HBM in understanding COVID-19 preventive and physical activity behaviors. Interventions to improve COVID-19 preventive practices in this target population should focus more on men, while physical activity promotion should focus more on older adults.

Article Details

How to Cite
Arovah, N. I., Kurniawaty, J., & Haroen, H. (2023). Factors Associated With Physical Activity and COVID-19 Preventive Behaviors: A Cross-Sectional Study in Indonesian Adults. Journal of Population and Social Studies [JPSS], 31, 318–336. Retrieved from https://so03.tci-thaijo.org/index.php/jpss/article/view/257807
Research Articles
Author Biography

Novita Intan Arovah, Department of Sports Science, Sports Science Faculty, Yogyakarta State University, Yogyakarta, Indonesia

Corresponding author


• Al-Sabbagh, M. Q., Al-Ani, A., Mafrachi, B., Siyam, A., Isleem, U., Massad, F. I., Alsabbagh, Q., & Abufaraj, M. (2022). Predictors of adherence with home quarantine during COVID-19 crisis: The case of health belief model. Psychology, Health & Medicine, 27(1), 215–227. https://doi.org/10.1080/13548506.2021.1871770

• Amarie, A., Udijono, A., Kusariana, N., & Saraswati, L. D. (2020). Description of knowledge, attitude, and practice of coronavirus disease-19 prevention based on gender and age in Java Island community. Journal of Public Health for Tropical and Coastal Region, 3(2), 26–30. https://doi.org/10.14710/jphtcr.v3i2.9487

• Aminah, A., & Amaliyah, E. (2021). Knowledge, attitudes and behavior of nursing students towards the Covid-19 pandemic in Indonesia. Jurnal Aisyah: Jurnal Ilmu Kesehatan, 6(1), 91–96. https://doi.org/10.30604/jika.v6i1.436

• Armstrong, T., & Bull, F. (2006). Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ). Journal of Public Health, 14(2), 66–70. https://doi.org/10.1007/s10389-006-0024-x

• Arovah, N. I., & Kushartanti, B. M. W. (2019). Moderate-vigorous physical activity and clinical parameters in adults with type 2 diabetes mellitus: A report from the Walking with Diabetes study. Romanian Journal of Diabetes Nutrition and Metabolic Diseases, 26(2), 107–117. https://www.rjdnmd.org/index.php/RJDNMD/article/view/566

• Arovah, N. I., & Kushartanti, B. W. (2020). The acute effect of a moderate intensity ergocycle exercise on the coagulation parameters in type 2 diabetes mellitus patients: A feasibility study. Clinical Diabetology, 9(4), 219–225. https://doi.org/10.5603/DK.2020.0029

• Ar-yuwat, S., Clark, M. J., Hunter, A., & James, K. S. (2013). Determinants of physical activity in primary school students using the health belief model. Journal of Multidisciplinary Healthcare, 6, 119–126. https://doi.org/10.2147/JMDH.S40876

• Bertocchi, L., Vecchio, R., Sorbello, S., Correale, L., Gentile, L., Buzzachera, C., Gaeta, M., & Odone, A. (2021). Impact of the COVID-19 pandemic on physical activity among university students in Pavia, Northern Italy. Acta Bio Medica: Atenei Parmensis, 92(S6), Article e2021443. https://doi.org/10.23750/abm.v92is6.12232

• Bu, F., Bone, J. K., Mitchell, J. J., Steptoe, A., & Fancourt, D. (2021). Longitudinal changes in physical activity during and after the first national lockdown due to the COVID-19 pandemic in England. Scientific Reports, 11(1), Article 17723. https://doi.org/10.1038/s41598-021-97065-1

• Bull, F. C., Maslin, T. S., & Armstrong, T. (2009). Global Physical Activity Questionnaire (GPAQ): Nine country reliability and validity study. Journal of Physical Activity and Health, 6(6), 790–804. https://doi.org/10.1123/jpah.6.6.790

• Chen, H., Li, X., Gao, J., Liu, X., Mao, Y., Wang, R., Zheng, P., Xiao, Q., Jia, Y., Fu, H., & Dai, J. (2021). Health Belief Model perspective on the control of COVID-19 vaccine hesitancy and the promotion of vaccination in China: Web-based cross-sectional study. Journal of Medical Internet Research, 23(9), Article e29329. https://doi.org/10.2196/29329

• da Silveira, M. P., da Silva Fagundes, K. K., Bizuti, M. R., Starck, É., Rossi, R. C., & de Resende e Silva, D. T. (2021). Physical exercise as a tool to help the immune system against COVID-19: An integrative review of the current literature. Clinical and Experimental Medicine, 21(1), 15–28. https://doi.org/10.1007/s10238-020-00650-3

• Ding, K., Yang, J., Chin, M. K., Sullivan, L., Durstine, J. L., Violant-Holz, V., Demirhan, G., Oliveira, N., Popeska, B., Kuan, G., Khan, W., Dai, J., Xu, X., Mladenova, Z., Balasekaran, G., Smith, G. A., & on behalf of Global Community Health-Covid-Collaborative Research Team. (2021). Physical Activity among adults residing in 11 countries during the COVID-19 pandemic lockdown. International Journal of Environmental Research and Public Health, 18(13), Article 7056. https://doi.org/10.3390/ijerph18137056

• Duarsa, A. B. S., Mardiah, A., Hanafi, F., Karmila, D., & Anulus, A. (2021). Health belief model concept on the prevention of coronavirus disease-19 using path analysis in West Nusa Tenggara, Indonesia. International Journal of One Health, 7(1), 31¬–36. www.doi.org/10.14202/IJOH.2021.31-36

• Erawan, M. A. S. P., Zaid, Z., Pratondo, K., & Lestari, A. Y. (2021). Predicting Covid-19 vaccination intention: The role of Health Belief Model of Muslim societies in Yogyakarta. Al-Sihah: The Public Health Science Journal, 13(1), 36–50. https://doi.org/10.24252/al-sihah.v13i1.20647

• Fathian-Dastgerdi, Z., Khoshgoftar, M., Tavakoli, B., & Jaleh, M. (2021). Factors associated with preventive behaviors of COVID-19 among adolescents: Applying the health belief model. Research in Social and Administrative Pharmacy, 17(10), 1786–1790. https://doi.org/10.1016/j.sapharm.2021.01.014

• Fikriana, R., Fahrany, F., & Rusli, S. A. (2021). Health belief associated with adherence to health protocol in preventing coronavirus diseases on patients’ family. Open Access Macedonian Journal of Medical Sciences, 9(B), 1011–1015. https://doi.org/10.3889/oamjms.2021.6762

• Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.) (2008). Health behavior and health education: theory, research, and practice (4th ed.). Jossey-Bass.

• Guidry, J. P., O’Donnell, N. H., Austin, L. L., Coman, I. A., Adams, J., & Perrin, P. B. (2021). Stay socially distant and wash your hands: Using the Health Belief Model to determine intent for COVID-19 preventive behaviors at the beginning of the pandemic. Health Education & Behavior, 48(4), 424–433. https://doi.org/10.1177/10901981211019920

• Hosseini, H., Moradi, R., Kazemi, A., & Shahshahani, M. S. (2017). Determinants of physical activity in middle-aged woman in Isfahan using the health belief model. Journal of Education and Health Promotion, 6, Article 26. https://doi.org/10.4103/jehp.jehp_68_15

• Iacob, C. I., Ionescu, D., Avram, E., & Cojocaru, D. (2021). COVID-19 pandemic worry and vaccination intention: The mediating role of the Health Belief Model components. Frontiers in Psychology, 12, Article 674018. https://doi.org/10.3389/fpsyg.2021.674018

• Jamil, K., Harapan, H., Winardi, W., Yufika, A., Anwar, S., Librianty, N., Prashanti, N. P., Sari, T. W., Utomo, P., Dwiamelia, T., Natha, P. C., Salwiyadi, S., Asrizal, F., Ikram, I., Wulandari, I., Haryanto, S., Fenobileri, N., Wagner, A., & Mudatsir, M. (2020). Knowledge of coronavirus disease 2019 (COVID-19) among healthcare providers: A cross-sectional study in Indonesia. Asian Pacific Journal of Tropical Medicine, 13(9), 402–408. https://doi.org/10.4103/1995-7645.290584

• Karimy, M., Bastami, F., Sharifat, R., Heydarabadi, A. B., Hatamzadeh, N., Pakpour, A. H., Cheraghian, B., Zamani-Alavijeh, F., Jasemzadeh, M., & Araban, M. (2021). Factors related to preventive COVID-19 behaviors using health belief model among general population: A cross-sectional study in Iran. BMC Public Health, 21(1), Article 1934. https://doi.org/10.1186/s12889-021-11983-3

• Katewongsa, P., Widyastari, D. A., Saonuam, P., Haemathulin, N., & Wongsingha, N. (2021). The effects of the COVID-19 pandemic on the physical activity of the Thai population: Evidence from Thailand's Surveillance on Physical Activity 2020. Journal of Sport and Health Science, 10(3), 341–348. https://doi.org/10.1016/j.jshs.2020.10.001

• Kemp, S. (2021, February 11). Digital 2021: Indonesia. DataReportal. https://datareportal.com/reports/digital-2021-indonesia

• Mazza, M. G., De Lorenzo, R., Conte, C., Poletti, S., Vai, B., Bollettini, I., Melloni, E. M. T., Furlan, R., Ciceri, F., COVID-19 BioB Outpatient Clinic Study group, & Rovere-Querini, P. (2020). Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain, Behavior, and Immunity, 89, 594–600. https://doi.org/10.1016/j.bbi.2020.07.037

• Mazza, M. G., Palladini, M., De Lorenzo, R., Bravi, B., Poletti, S., Furlan, R., Ciceri, F., COVID-19 BioB Outpatient Clinic Study Group, Rovere-Querini, P., & Benedetti, F. (2021). One-year mental health outcomes in a cohort of COVID-19 survivors. Journal of Psychiatric Research, 145, 118–124. https://doi.org/10.1016/j.jpsychires.2021.11.031

• Mehanna, A., Elhadi, Y. A. M., & Lucero-Prisno, D. E. III. (2021). Public willingness to adhere to COVID-19 precautionary measures in Sudan: An application of the Health Belief Model. Pan African Medical Journal, 39, Article 135. https://doi.org/10.11604/pamj.2021.39.135.29171

• Ministry of Health of the Republic of Indonesia. (2019). Laporan Nasional Riskesdas 2018 [National Risk Report 2018]. http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf

• Ministry of Health of the Republic of Indonesia. (2021). Peta sebaran COVID-19 [COVID-19 distribution Map]. Indonesian Health Ministry. Retrieved December 12, 2021, from https://covid19.go.id/peta-sebaran-covid19

• Muslih, M., Susanti, H. D., Rias, Y. A., & Chung, M.-H. (2021). Knowledge, attitude, and practice of Indonesian residents toward COVID-19: A cross-sectional survey. International Journal of Environmental Research and Public Health, 18(9), Article 4473. https://doi.org/10.3390/ijerph18094473

• Naseer, K., Qazi, J., Qazi, A., Avuglah, B. K., Tahir, R., Rasheed, R. A., Khan, S. K., Khan, B. A., Zeeshan, M., & Humayun, M. A. (2021). Travel behaviour prediction amid Covid-19 underlaying situational awareness theory and health belief model. Behaviour & Information Technology, 1–11. https://doi.org/10.1080/0144929X.2021.1984579

• Nieman, D. C. (2021). Exercise is medicine for immune function: Implication for COVID-19. Current Sports Medicine Reports, 20(8), 395–401. https://doi.org/10.1249/JSR.0000000000000867

• Nurhayati-Wolff, H. (2021, August 16). Internet penetration rate in Indonesia 2017-2026. Statista. https://www.statista.com/statistics/254460/internet-penetration-rate-in-indonesia/

• Pengpid, S., & Peltzer, K. (2018). Prevalence, social and health correlates of physical inactivity among community-dwelling older adults in Indonesia. African Journal for Physical Activity and Health Sciences, 24(1), 15–27. https://hdl.handle.net/10520/EJC-e35bd2640

• Raamkumar, A. S., Tan, S. G., & Wee, H. L. (2020). Use of Health Belief Model-based deep learning classifiers for COVID-19 social media content to examine public perceptions of physical distancing: Model development and case study. JMIR Public Health and Surveillance, 6(3), Article e20493. https://doi.org/10.2196/20493

• Rizki, S. A., Kurniawan, J., Budimulia, P., Sylvanus, P., Alexandra, A., Sinaga, T. D., Kurniawan, A., & Lugito, N. P. H. (2021). Knowledge, attitude, and practice in Indonesian health care workers regarding COVID-19. Asia Pacific Journal of Public Health, 33(5), 662–664. https://doi.org/10.1177/10105395211011017

• Rosha, B. C., Suryaputri, I. Y., Irawan, I. R., Arfines, P. P., & Triwinarto, A. (2021). Factors affecting public non-compliance with large-scale social restrictions to control COVID-19 transmission in Greater Jakarta, Indonesia. Journal of Preventive Medicine & Public Health, 54(4), 221–229. https://doi.org/10.3961/jpmph.21.101

• Saefi, M., Fauzi, A., Kristiana, E., Adi, W. C., Muchson, M., Setiawan, M. E., Islami, N. N., Ningrum, D. E. A. F., Ikhsan, M. A., & Ramadhani, M. (2020). Survey data of COVID-19-related knowledge, attitude, and practices among Indonesian undergraduate students. Data in Brief, 31, Article 105855. https://doi.org/10.1016/j.dib.2020.105855

• Scudiero, O., Lombardo, B., Brancaccio, M., Mennitti, C., Cesaro, A., Fimiani, F., Gentile, L., Moscarella, E., Amodio, F., Ranieri, A., Gragnano, F., Laneri, S., Mazzaccara, C., Di Micco, P., Caiazza, M., D'Alicandro, G., Limongelli, G., Calabro, P., Pero, R., & Frisso, G. (2021). Exercise, immune system, nutrition, respiratory and cardiovascular diseases during COVID-19: A complex combination. International Journal of Environmental Research and Public Health, 18(3), Article 904. https://doi.org/10.3390/ijerph18030904

• Shahnazi, H., Ahmadi-Livani, M., Pahlavanzadeh, B., Rajabi, A., Hamrah, M. S., & Charkazi, A. (2020). Assessing preventive health behaviors from COVID-19: A cross sectional study with health belief model in Golestan Province, Northern of Iran. Infectious Diseases of Poverty, 9(1), Article 157. https://doi.org/10.1186/s40249-020-00776-2

• Shewasinad Yehualashet, S., Asefa, K. K., Mekonnen, A. G., Gemeda, B. N., Shiferaw, W. S., Aynalem, Y. A., Bilchut, A. H., Derseh, B. T., Mekuria, A. D., & Mekonnen, W. N. (2021). Predictors of adherence to COVID-19 prevention measure among communities in North Shoa Zone, Ethiopia based on health belief model: A cross-sectional study. PLOS ONE, 16(1), Article e0246006. https://doi.org/10.1371/journal.pone.0246006

• Simpson, R. J., Kunz, H., Agha, N., & Graff, R. (2015). Exercise and the Regulation of Immune Functions. Progress in Molecular Biology and Translational Science, 135, 355–380. https://doi.org/10.1016/bs.pmbts.2015.08.001

• Spence, J. C., Rhodes, R. E., McCurdy, A., Mangan, A., Hopkins, D., & Mummery, W. K. (2021). Determinants of physical activity among adults in the United Kingdom during the COVID‐19 pandemic: The DUK‐COVID study. British Journal of Health Psychology, 26(2), 588–605. https://doi.org/10.1111/bjhp.12497

• Sulistyawati, S., Rokhmayanti, R., Aji, B., Wijayanti, S. P. M., Hastuti, S. K. W., Sukesi, T. W., & Mulasari, S. A. (2021). Knowledge, attitudes, practices and information needs during the COVID-19 pandemic in Indonesia. Risk Management and Healthcare Policy, 14, 163–175. https://doi.org/10.2147/RMHP.S288579

• Syed, M. H., Meraya, A. M., Yasmeen, A., Albarraq, A. A., Alqahtani, S. S., Kashan, A. S. N., Algarni, M. A., & Alam, N. (2021). Application of the Health Belief Model to assess community preventive practices against COVID-19 in Saudi Arabia. Saudi Pharmaceutical Journal, 29(11), 1329–1335. https://doi.org/10.1016/j.jsps.2021.09.010

• Tadesse, T., Alemu, T., Amogne, G., Endazenaw, G., & Mamo, E. (2020). Predictors of coronavirus disease 2019 (COVID-19) prevention practices using Health Belief Model among employees in Addis Ababa, Ethiopia, 2020. Infection and Drug Resistance, 13, 3751–3761. https://doi.org/10.2147/IDR.S275933

• Walrave, M., Waeterloos, C., & Ponnet, K. (2020). Adoption of a contact tracing app for containing COVID-19: A Health Belief Model approach. JMIR Public Health Surveill, 6(3), Article e20572. https://doi.org/10.2196/20572

• Winarti, E., Wahyuni, C. U., Rias, Y. A., Mirasa, Y. A., Sidabutar, S., & Wardhani, D. L. (2021). Citizens’ health practices during the COVID-19 pandemic in Indonesia: Applying the health belief model. Belitung Nursing Journal, 7(4), 277–284. https://doi.org/10.33546/bnj.1560

• Wood, C. J., Clow, A., Hucklebridge, F., Law, R., & Smyth, N. (2018). Physical fitness and prior physical activity are both associated with less cortisol secretion during psychosocial stress. Anxiety, Stress, and Coping, 31(2), 135–145. https://doi.org/10.1080/10615806.2017.1390083

• World Health Organization. (‎2020, July 29)‎. Survey tool and guidance: Rapid, simple, flexible behavioural insights on COVID-19. Regional Office for Europe. https://apps.who.int/iris/handle/10665/333549

• World Health Organization. (2021). WHO Coronavirus (COVID-19) Dashboard: Situation by Region, Country, Territory & Area. Retrieved December 12, 2021, from https://covid19.who.int/table

• Yanti, B., Mulyadi, E., Wahiduddin, W., Novika, R. G. H., Arina, Y. M. D., Martani, N. S., & Nawan, N. (2020). Community knowledge, attitudes, and behavior towards social distancing policy as prevention transmission of COVID-19 in Indonesia. Indonesian Journal of Health Administration, 8, 4–14. https://doi.org/10.20473/jaki.v8i0.2020.4-14

• Yeganeh, L. T., & Karami, H. (2021). Investigating corona preventive behaviors based on health belief pattern. Journal of Research in Environmental Health, 7(2), 183–190. https://dx.doi.org/10.22038/jreh.2021.57705.1426

• Zareipour, M. A., Ardakani, M. F., Moradali, M. R., Jadgal, M. S., & Movahed, E. (2020). Determinants of COVID-19 prevention behavior in the elderly in Urmia: Application of Health Belief Model. Open Access Macedonian Journal of Medical Sciences, 8(T1), 646–650. https://doi.org/10.3889/oamjms.2020.5653

• Zar'in, A. U., & Arovah, N. I. (2021). Physical activities and construct of Health Belief Models in the Special Region of Yogyakarta in the era of pandemy Covid-19. Budapest International Research and Critics in Linguistics and Education (BirLE) Journal, 4(2), 698–709. https://doi.org/10.33258/birle.v4i2.1831

• Zheng, Q., Cui, G., Chen, J., Gao, H., Wei, Y., Uede, T., Chen, Z., & Diao, H. (2015). Regular exercise enhances the immune response against microbial antigens through up-regulation of toll-like receptor signaling pathways. Cellular Physiology and Biochemistry, 37(2), 735–746. https://doi.org/10.1159/000430391