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ABSTRACTIntroduction: Implementing health protocols became a challenge for olderadults living in rural area. This study aimed to analyze the factors influencing implementation of COVID-19 health protocols among elderly in rural areas based on the Theory of Planned Behavior (TPB).Methods:This study used an explanatory survey with cross-sectional approach. The sample consisted of 100 older adults who resided in rural areas. Data were collected using the TPB questionnaire and COVID-19 health protocol questionnaire, both have 21 items. The data were analyzed using bivariate and multivariate analysis. Bivariate analysis used Pearson correlation, Chi-square test, and Fisher’s exact test. Multivariate analysis used multiple linear regression with a level of significance = 0.05. The independent variables were attitude toward behavior, subjective norm and perceived behavioral control while the dependent variable was the implementation of COVID-19 health protocols.Results:Gender (p<0.001), age (p<0.001), employment status (p<0.001), attitude toward behavior (p<0.001), subjective norm (p<0.001) and perceived behavioral control (p<0.001) were significantly associated with the implementation of COVID-19 health protocols, while education level (p=1.000) was not significantly associated with the implementation. The R-square shows 0.610 which indicates that TPB model can predict 61% ofimplementation of COVID-19 health protocols.Conclusions:The most dominant factor in increasing the implementation of the COVID-19 health protocol is attitude toward behavior.Nurse need to provide education to elderly and their family to increase the implementation of COVID-19 health protocols as prevention of transmission of COVID-19.Keywords:attitude; COVID-19; elderly; perceived behavioral control; subjective norm; theory of planned behaviorIntroductionCoronavirus Disease (COVID-19) is an infectious disease that has been affecting many countries globally since late-2019. Indonesia reported its first positive COVID-19 case on March 2, 2020 (Melia, Triana and Prasetyo, 2020). This disease can infect humans of all ages, including the elderly. The elderly population is a priority population in preventing the transmission of COVID-19 (Géa et al., 2022). The COVID-19 patients aged 60 years and over have a higher mortality compared to younger patients (Karadavut and Altintop, 2022). Elderly with comorbidities such as heart disease, diabetes mellitus,hypertension, chronic kidney failure and chronic lung disease have a greater risk of being infected with COVID-19 compared to the same population without comorbidities (Tobing and Wulandari, 2021; Ventura, Molinelli and Barranco, 2021).Implementing health protocols is one of the factors to prevent the transmission of COVID-19. In Indonesia, and many countries, the protocols consist of wearing a mask, avoiding crowds, keeping a distance and implementing clean and healthy lifestyles (Ministry of Health, 2020).The protocols need to be implemented by all population groups including the elderly regardless of the residence, both rural and urban. In rural areas, people tend to have