BACKGROUND: Preventive behaviours have been recommended to control the spread of SARS-CoV-2 . Adults with chronic diseases (CDs) are at higher risk of COVID-19-related mortality compared to the general population . Our objective was to evaluate adherence to COVID-19 preventive behaviours among adults without CDs compared with those with CDs and identify determinants of non-adherence to COVID-19 preventive behaviours . STUDY

DESIGN: Cross-sectional .

SETTING AND

PARTICIPANTS: We used data from the nationally representative COVID-19 Impact Survey (n=10 760) conducted in the USA . PRIMARY MEASURES: Adults with CDs were categorised based on a self-reported diagnosis of diabetes, high blood pressure, heart disease/heart attack/stroke, asthma, chronic obstructive pulmonary disease (COPD), bronchitis or emphysema, cystic fibrosis, liver disease, compromised immune system, or cancer (54 %).

RESULTS: Compared with adults without CDs, adults with CDs were more likely to adhere to preventive behaviours including wearing a face mask (& #967; 2-p <0.001), social distancing (& #967; 2-p <0.001), washing or sanitising hands (& #967; 2-p <0.001), and avoiding some or all restaurants (& #967; 2-p=0.002) and public or crowded places (& #967; 2-p=0.001). Adults with a high school degree or below [Adjusted prevalence ratio (aPR):1.82 , 95% Confidence interval (CI) 1.04 to 3.17], household income

CONCLUSION: Adults with CDs are more likely to adhere to recommended COVID-19 preventive behaviours . Public health messaging targeting specific demographic groups and geographic areas, such as adults without CD or adults living in rural areas, should be prioritised.