Volume 22, Issue 1 (4-2026)
J Health Syst Res 2026, 22(1): 192-201 |
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Research code: IR.KUMS.REC.1400.455
Ethics code: IR.KUMS.REC.1400.455
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Darvishi-Gilan H, Emami M A, Ghavami M, Karami B, Behjati F, Soltani S et al . Exploring the Causes of Inadequate Adherence to and Lack of Prevention against COVID-19: A Qualitative Study. J Health Syst Res 2026; 22 (1) :192-201
URL: http://hsr.mui.ac.ir/article-1-1884-en.html
URL: http://hsr.mui.ac.ir/article-1-1884-en.html
Hadi Darvishi-Gilan1 
, Mohammad Ali Emami2 , Maryam Ghavami3 , Badriyeh Karami4 , Fatemeh Behjati5 , Shahin Soltani6 , Shakiba Zahed7
, Mohammad Ali Emami2 , Maryam Ghavami3 , Badriyeh Karami4 , Fatemeh Behjati5 , Shahin Soltani6 , Shakiba Zahed7
1- PhD, Department of Health Education and Health Promotion AND Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
2- General Practitioner, Isfahan Healthcare City, Isfahan University of Medical Sciences, Isfahan, Iran
3- PhD Candidate, Department of Health Education and Health Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4- PhD, Behavioral Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
5- Student of Medicine, Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
6- Assistant Professor, Environmental Determinants of Health Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
7- PhD, Department of Health Education and Health Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
2- General Practitioner, Isfahan Healthcare City, Isfahan University of Medical Sciences, Isfahan, Iran
3- PhD Candidate, Department of Health Education and Health Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4- PhD, Behavioral Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
5- Student of Medicine, Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
6- Assistant Professor, Environmental Determinants of Health Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
7- PhD, Department of Health Education and Health Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract: (240 Views)
Background: The present study aimed at exploring the causes of inadequate adherence to and lack of prevention against coronavirus disease 2019 (COVID-19) which was conducted in two socioeconomically deprived cities in Iran to identify barriers and challenges to COVID-19 prevention in order to inform the improvement of public health strategies and enhance community awareness in these underserved areas.
Methods: This qualitative study was carried out in Gilan-e Gharb City, Kermanshah Province, Iran, and Khorramabad City, Lorestan Province, Iran, over a 13-month period from November 2021 to November 2022. Data were collected through 11 in-depth, semi-structured individual interviews and analyzed using conventional content analysis.
Findings: Participants comprised 7 women and 4 men, with a mean age of 45.54 ± 15.78 years. Findings were organized around four primary preventive behaviors: 1) non-use of face masks, 2) non-use of disinfectants, 3) face-to-face social interactions, and 4) vaccine refusal or hesitancy. These were classified into three main themes encompassing 12 sub-themes: 1) social factors (economic constraints, policy-making deficiencies, normative challenges, cultural barriers, and environmental factors), 2) individual factors (personality-related factors, physical/comorbid conditions, and perceptual/cognitive factors), and 3) educational challenges (ineffective media, absence of preventive learning, insufficient awareness, and illiteracy).
Conclusion: Overcoming these barriers appears achievable through short-, medium-, and long-term planning, inter-sectoral and inter-ministerial coordination, and efforts to build public trust. Further research using diverse methodologies and settings is recommended to eliminate these obstacles and develop evidence-based, targeted interventions for the effective control of current and future pandemics. COVID-19 serves as a stark reminding that humanity remains vulnerable to emerging, unknown, and lethal viral diseases, highlighting the critical importance of primary prevention.
Methods: This qualitative study was carried out in Gilan-e Gharb City, Kermanshah Province, Iran, and Khorramabad City, Lorestan Province, Iran, over a 13-month period from November 2021 to November 2022. Data were collected through 11 in-depth, semi-structured individual interviews and analyzed using conventional content analysis.
Findings: Participants comprised 7 women and 4 men, with a mean age of 45.54 ± 15.78 years. Findings were organized around four primary preventive behaviors: 1) non-use of face masks, 2) non-use of disinfectants, 3) face-to-face social interactions, and 4) vaccine refusal or hesitancy. These were classified into three main themes encompassing 12 sub-themes: 1) social factors (economic constraints, policy-making deficiencies, normative challenges, cultural barriers, and environmental factors), 2) individual factors (personality-related factors, physical/comorbid conditions, and perceptual/cognitive factors), and 3) educational challenges (ineffective media, absence of preventive learning, insufficient awareness, and illiteracy).
Conclusion: Overcoming these barriers appears achievable through short-, medium-, and long-term planning, inter-sectoral and inter-ministerial coordination, and efforts to build public trust. Further research using diverse methodologies and settings is recommended to eliminate these obstacles and develop evidence-based, targeted interventions for the effective control of current and future pandemics. COVID-19 serves as a stark reminding that humanity remains vulnerable to emerging, unknown, and lethal viral diseases, highlighting the critical importance of primary prevention.
Keywords: COVID-19, Prevention barriers, Face mask, Disinfectant, Face-to-face social interaction, Vaccine, Health promotion
Type of Study: Research |
Subject:
education health and promotion
Received: 2024/09/4 | Accepted: 2025/01/15 | Published: 2026/04/4
Received: 2024/09/4 | Accepted: 2025/01/15 | Published: 2026/04/4
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