text: Factors associated with COVID 19 preventive health behaviors among the general public in Mexico City and the State of Mexico To evaluate factors associated with COVID 19 preventive health behaviors among adults in Mexico City and the State of Mexico We conducted a cross sectional survey from June to October 2020 through a structured internet based questionnaire in a non probabilistic sample of adults 18 years living in Mexico City and the State of Mexico The independent variables included sociodemographic and clinical factors health literacy access to COVID 19 information and perception of COVID 19 risk and of preventive measures effectiveness The dependent variable was COVID 19 preventive health behaviors defined as the number of preventive actions adopted by participants The data were analyzed through multivariate negative binomial regression analysis The survey was completed by 1 030 participants Most participants were women 70 7 had a high school or above level of education 98 8 and had adequate health literacy and access to COVID 19 information Only 18 perceived having a high susceptibility to COVID 19 though 83 8 recognized the diseases severity and 87 1 the effectiveness of preventive measures The median number of COVID 19 preventive actions was 13 5 range 0 19 The factors associated with preventive health behavior were being female of older age a professional worker a homemaker or a retiree engaging in regular physical exercise having high health literacy and access to COVID 19 information sources and perceiving COVID 19 as severe and preventive measures as effective People with high education and internet access in Mexico City and the State of Mexico reported significant engagement in COVID 19 preventive actions during the first wave of the COVID 19 pandemic 