Preventive measures against COVID-19 played a crucial role in mitigating transmission. Social and structural factors influence individuals’ trust in health care and engagement in health-promoting behaviors. This study investigates racial-ethnic differences in COVID-19 prevention behaviors and beliefs among public housing residents in the South Bronx, NYC. Data come from the Nurse-Community-Family Partnership study, a randomized controlled trial conducted during the COVID-19 pandemic. The analytic sample (n = 200) was limited to adult participants who identified as non-Hispanic Black, Hispanic Black, Hispanic White, or Hispanic Other. Multilevel logistic regression models estimated odds ratios and 95% confidence intervals, adjusted for sex, age, and education. The odds of receiving a COVID-19 vaccine were 3.8 times greater for Hispanic White participants and 2.5 times greater for Hispanic Other participants than for non-Hispanic Black participants. In addition, the odds of practicing social distancing were 2.2 times greater for Hispanic Other participants than for non-Hispanic Black counterparts. COVID-19-related government mistrust was associated with an 88% decrease in the odds of vaccinating, a 58% decrease in the odds of practicing social distancing, and a 77% decrease in the odds of mask-wearing. COVID-19 vaccine mistrust was associated with a 93% decrease in the odds of vaccination. When adjusted for mistrust, differences in vaccination rates by racial-ethnic groups were no longer significant. Addressing mistrust is pivotal for improving public health outcomes. Interventions that enhance trust in health institutions through cultural competence, community engagement, and greater representation in health care can help bridge the gap in prevention behaviors among racially minoritized groups.
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