Revelations from the Clinic: Protective Behaviors and Perceptions among People at High Risk for Severe Illness from COVID-19

Frances R. Greathouse, Sally T. Nagia, Morsi S. Rayyan, Beth A. Bailey

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objectives: The CDC has warned of increased risk for severe COVID-19 illness among those with certain preexisting conditions. Protective behaviors such as social distancing and mask-wearing have been shown effective at curbing infection rates. These practices are subject to individual perceptions of risk and responsibility. This study aimed to characterize the risk perceptions and protective behaviors of residents in a rural central Michigan region. Specifically, we examined whether individual risk status predicted protective behaviors and concern about the pandemic. Methods: Participants were identified via medical records at participating clinics. The high-risk group was those with conditions that put them at increased risk of severe illness from COVID-19, and was compared to healthy controls. Data were collected via phone survey. Participants were asked about their protective behaviors and level of concern about the ongoing pandemic. Results: A total of 150 patients participated in the survey; 73 were high-risk acknowledgers, 29 were high-risk deniers, and 48 were healthy controls. There was no significant difference between the groups on level of concern regarding the pandemic or protective behaviors (P >.05). Compared to other comorbidities, obese people were significantly more likely to deny their risk (P <.05). Conclusions: In this study, high risk, whether acknowledged or denied, did not appear to significantly impact behaviors or concern. The high percentage of those at high risk who did not acknowledge this suggests many factors including a potential lack of patient education regarding their comorbidities, specifically, how their illness increases their risk of severe illness from COVID-19.

Original languageEnglish
JournalJournal of Primary Care and Community Health
StatePublished - 2021


  • COVID-19
  • comorbidities
  • patient education
  • protective behaviors
  • social distancing


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