Figure 1 - uploaded by Wimalin Rimpeekool
Content may be subject to copyright.
Knowledge-Attitude-Behaviour and Health Belief mixed model (KAB-HBM)
Source publication
Background:
This qualitative study employed the Knowledge-Attitude-Behaviour (KAB) model and Health Belief Model (HBM) to investigate factors influencing Thai consumer decision making about use of nutrition labels. Labels include both Nutrition Information Panels (1998-) and Guideline Daily Amounts labels (2011-).
Method:
In-depth interviews wer...
Context in source publication
Context 1
... line with another study (Guthrie, Fox, Cleveland, & Welsh, 1995) we found that consumers were more likely to use nutrition labels when they perceived a personal susceptibility to a diet-health problem. We therefore propose that this mixed model (Figure 1) better explains consumer responses to nutrition labels and that this understanding will contribute to more effective promotional strategies. Most of the existing qualitative studies of nutrition labels have investigated consumers' understanding and interpretation of label information but few have explored their motivation. ...
Citations
... and 80.8%, but only 7.2% of the study participants could understand the information on nutrition labels (Kamboj et al., 2022). More so, other studies in Thailand and across Europe found similar observations where consumer awareness and use of nutrition labels when buying prepackaged foods were high but the nutrition knowledge and understanding of nutrition labels were comparatively low Rimpeekool et al., 2015). A global review has documented that generally, consumers find nutrition labels to be a useful source of nutrition information (Campos et al., 2011). ...
... The factors consistently reported in almost all countries as the main barriers to consumer use of nutrition labels comprised time constraints, small font size, difficulty in understanding, and unfamiliar language. These factors are in line with the findings of other studies where these same factors were reported as the barriers to consumer use of nutrition labels (Besler et al., 2012;Donga & Patel, 2018;Perumal et al., 2022;Rimpeekool et al., 2015;Shamim et al., 2022). However, in Zimbabwe, mistrust was the principal barrier reported by the study participants. ...
The purpose of nutrition information on a nutrition label is to communicate to consumers the nutritional content of prepackaged foods so that they would be able to identify healthy foods before purchase. Many systematic reviews in the area of consumer awareness, knowledge, understanding, and use of nutrition labels have focused on the United States, Canada, Asia, Europe, Australia, and New Zealand, and little attention has been given to African countries. To review the state of consumer awareness, knowledge, understanding, and use of nutrition labels within the African region, identify barriers to the use of nutrition labels, identify consumers who are more likely to use labels, and assess the factors that affect purchasing decisions. Searches were done in electronic databases (PubMed, Google Scholar, Semantic Scholar, Web of Science) and the reference lists of relevant research articles (back referencing). The review was limited to cross-sectional peer-reviewed research articles which were published in the English Language between January 2000 and June 2022. Twenty-six peer-reviewed papers from 10 African countries that met our inclusion criteria are included in this systematic review. The overall crude means of levels of awareness, knowledge, understanding, and use of nutrition labels were found to be 74.2%, 56.4%, 45.3%, and 69.1%, respectively. Consumer levels of knowledge and understanding of nutrition labels across the 10 African countries were low compared to the awareness and use of nutrition labels.
... Correspondingly, Green et al. (2020) revealed that these could negatively impact an individual's motivation towards healthy behavior. HBM proposes that perceived barriers are one of the main determinants of health behaviors (Rimpeekool et al., 2016). If individuals perceive significant barriers to reducing a health threat, they are less likely to take action to reduce the threat. ...
... The study findings underscore a significant and positive impact of perceived benefits and perceived barriers on the utilization of NFP labels. These results align with established literature emphasizing the influential role of perceived benefits and barriers in shaping consumer behavior toward nutrition-related information (Keller et al., 1997;Petrovici et al., 2012;Rimpeekool et al., 2016;Samoggia and Riedel, 2020). Lim and Weissmann (2023) found that individuals who perceived greater benefits from using nutrition labels were more likely to use them and make healthier food choices. ...
Purpose
This study examines how health-conscious consumers utilize nutrition facts panel labels when purchasing food products, focusing specifically on the dimension of ethical evaluation. It aims to understand how ethical considerations influence the decision-making process of consumers who prioritize health. By analyzing the impact of ethical evaluation on label usage, the study sheds light on the significance of ethics in consumer behavior in the context of purchasing packaged edible oil.
Design/methodology/approach
Empirical data were collected using an online survey and a non-ordered questionnaire. In total, 469 valid responses were obtained. The study used SPSS version 27.0 and SmartPLS version 3 for demographic analysis and structural equation modeling.
Findings
The findings suggest that three factors – perceived benefits, perceived threats, and nutrition self-efficacy, positively impact the use of NFP labels. However, perceived barriers negatively influence the use of NFP labels. In additionally, ethical evaluation mediates the usage of NFP labels.
Practical implications
In the health belief model, ethical evaluation functions as a mediator and has a greater influence on NFP label use. This study provides a framework for marketers to promote consumer health consciousness by encouraging them to incorporate NFP labels.
Originality/value
This study is one of the first attempts to demonstrate that ethical evaluation mediate health beliefs and the use of nutrition labels.
... It was noted that consumers who may sense a "personal threat" from unsafe food and consider "doing something about it" will be more likely to engage in food safety behavior. Believing that nutrition influences health, being well-educated, and being motivated by health concerns, all increased the likelihood of using nutrition labels [21]. Higher levels of perceived benefit and higher confidence in reading and understanding food labels were associated with higher frequency of food label use [22]. ...
... Accordingly, public health interventions con-tributing to strategies motivating consumers to use food labels can provide useful insight for developing promotional campaigns. This is a critical gap that needs to be addressed, as better-educated participants were more likely to understand food labels but not more likely to use labels [8,21]. ...
Food labels are low-cost, informational tools that can help curb the spread of diet-related non-communicable diseases. This study described consumers’ knowledge, attitudes, and practices related to food labels in Jordan and explored the relationship between knowledge and attitude with comprehensive use of food labels. A cross-sectional, online survey assessed Jordanian adult consumers’ ability to comprehend the nutritional contents of food labels (knowledge score), their attitudes towards food labels (attitude scale), and how frequently they used different parts of food labels (practice scale). Multivariate logistic regression models assessed predictors of comprehensive use of food labels. A total of 939 adults participated in the study. Total mean scores for the practice scale (14 questions), attitude scale (8 questions), and knowledge score (4 questions) were 49.50 (SD, 11.36; min, 5; max, 70), 29.70 (SD, 5.23; min, 5; max, 40), and 1.39 (SD, 1.33; min, 0; max, 4), respectively. Comprehensive users of food labels (26.4%) were more likely female, responsible for grocery shopping, and had higher mean knowledge and attitude scores. Jordanian consumers seem to have good practices and attitudes related to food label use but suboptimal knowledge regarding content. Future interventions should focus more on enhancing knowledge and awareness related to food labels.
... Researchers have developed several theories to understand why consumers make certain choices to provide frameworks for their decision-making processes [63]. These theories include the "Theory of Planned Behaviour (TPB)" [64][65][66], "Social cognitive theory" (SCT) [67][68][69][70], Health belief model (HBM) [52,[71][72][73], "Information motivation behavioural skills model (IMB)" [74], Diffusion of innovation theory (DIT) and Social Learning Theory (SLT) [55,75,76] are the most used theories in the context of F&NL research. These theories provide insights into how attitudes, beliefs, social norms, and personal experiences influence consumer behaviour. ...
Many consumers realize that eating ultra-processed packaged foods leads to a bad diet, a major cause of poor health. Food & Nutrition Labelling (F&NL) have become an essential tool for consumers to make informed decisions about their food choices and to identify nutrient levels, ingredients, and allergens. Several theories have been used to explain the different dimensions of consumer behavior towards F&NL. This study attempts a review of these theories. The review identified 108 empirical studies based on an extensive literature search. The most used theories are Theory of Planned Behavior and Social Cognitive Theory. Different respondents like adults, children, low-income individuals, and pregnant women have been used in contributing to the use of these theories. Among the key dependent variables that have been used, intention to use nutritional information, label efficacy and health outcome are some of the significant ones. Furthermore, attitude, perceived behavioral control and subjective norms are frequently used as independent variables.
... Researchers have developed several theories to understand why consumers make certain choices to provide frameworks for their decision-making processes [63]. These theories include the "Theory of Planned Behaviour (TPB)" [64][65][66], "Social cognitive theory" (SCT) [67][68][69][70], Health belief model (HBM) [52,[71][72][73], "Information motivation behavioural skills model (IMB)" [74], Diffusion of innovation theory (DIT) and Social Learning Theory (SLT) [55,75,76] are the most used theories in the context of F&NL research. These theories provide insights into how attitudes, beliefs, social norms, and personal experiences influence consumer behaviour. ...
Studying consumer behaviour towards food and nutrition labelling (F&NL) is increasingly becoming important across the world. Bibliometric analysis is a way to identify influential research, track trends, and understand methodologies in any field. In this paper, we used bibliometric analysis and a review of theories too to critically evaluate theories and concepts used in studying consumer behaviour towards F&NL. Using the Scopus database, we obtained 1017 articles, which were further filtered to perform various analyses like Co-occurrence and co-authorship network analysis. We found limited East and Southeast Asia-based research. Personal beliefs, attitudes, and past experiences were identified as influencers of consumer behaviour regarding food labelling. Trending topics were food waste, purchase intention, and sustainability labels.
... Park and Oh [50] integrated the Theory of Planned Behavior (TPB) and the health belief model (HBM), and they argued that higher perceived susceptibility and perceived severity reflect the perception of the disease and are important factors in promoting health behaviors. Rimpeekool et al. [51] integrated the Knowledge-Attitude-Behavior model (KAB) and the health belief model, and their findings revealed that the attitude towards using nutrition labels is determined by personal health knowledge and the perception of a healthy diet (perceived susceptibility and perceived severity). From their research outcomes on dietary supplements, Tzeng and Ho [52] pointed out that the perception of health threats will affect the subsequent attitude towards the product when customers' perceived susceptibility increases. ...
Since the outbreak of COVID-19, the pandemic has become an important topic of global public health. To reduce the rapid spread of the pandemic, compliance with preventive behaviors has become one of the important guidelines from the World Health Organization (WHO). Healthcare workers stand on the frontline for pandemic prevention, and preventive behaviors are essential measures to protect their health and safety. The purpose of this study was to propose an integrative model that explained and predicted COVID-19 preventive behaviors among healthcare workers. The study integrated workplace safety climate and the health belief model (HBM) to verify the impact of workplace safety climate and health belief factors on the safety attitude, safety compliance, and safety satisfaction of healthcare workers performing COVID-19 pandemic prevention behaviors. A cross-sectional study was conducted from March to August 2021 with a self-administered online questionnaire. The sample of the study was drawn from healthcare workers of a famous medical institution in Taipei City as research subjects. After collecting 273 valid questionnaires and verifying them through the analysis of structural equation modeling (SEM), the findings revealed that workplace safety climate had an impact on health belief factors, and then health belief factors had impacts on safety attitudes. In addition, safety attitude affected safety compliance, while safety compliance further affected safety satisfaction. The study showed that workplace safety climate can strengthen healthcare workers’ health beliefs and further affect their safety attitudes, safety compliance, and safety satisfaction. The study attempted to propose a model of healthcare workers’ pandemic prevention behaviors as a reference for medical facility administrators in real practice.
... This demonstrates how small businesses, such as coffee shops, can benefit from disruptive innovation by providing game-changing technological skills, as well as how small businesses can benefit from disruptive innovation through collaboration and joint venture formation. Given Thailand's highly competitive hotel, food services, and restaurant sector, which comprises more than 100,000 restaurants and over 5,000 hotels and resorts, mobile applications are being viewed as a new approach for Thai restaurants to attract new consumers and keep existing ones and more studies required to explore factors that influence Thai consumer online purchasing intention which include consumer attitude, perceived usefulness and e-service quality (Mohammed, 2020;Maichum et al., 2016;Rimpeekool et al., 2016;Jeaheng et al., 2019;Puriwat and Tripopsakul, 2017;Wang and Prompanyo, 2020). COVID-19 created an unprecedented crisis globally. ...
... Moreover, e-service quality was also identified as an important factor in driving online purchase intention for organic foods. This includes factors such as application ease of accessibility, ability, and effectiveness when purchasing online (Mohammed, 2020;Maichum et al., 2016;Rimpeekool et al., 2016;Jeaheng et al., 2019). Several studies have also noted that factors such as product price, quality assurance certification, and trustworthiness of the online applications can affect consumer purchase behaviour towards organic products purchased through mobile applications and e-commerce platforms (Jindal, 2022;Mohammed, 2020;Maichum et al., 2016;Rimpeekool et al., 2016). ...
... This includes factors such as application ease of accessibility, ability, and effectiveness when purchasing online (Mohammed, 2020;Maichum et al., 2016;Rimpeekool et al., 2016;Jeaheng et al., 2019). Several studies have also noted that factors such as product price, quality assurance certification, and trustworthiness of the online applications can affect consumer purchase behaviour towards organic products purchased through mobile applications and e-commerce platforms (Jindal, 2022;Mohammed, 2020;Maichum et al., 2016;Rimpeekool et al., 2016). ...
... Two publications (Rimpeekool et al., 2015a(Rimpeekool et al., , 2015b based on a small qualitative sample of Thai consumers also explored the use and comprehension of GDA. Participants were from urban Bangkok and rural Ranong. ...
... This was particularly true of the monochrome GDA, although consumers reported somewhat better comprehension when colors or text were used (Pongutta et al., 2019;Weangsong, 2015). The GDA was easier to read than the longer and more detailed NIP; however the NIP was more widely recognized (Rimpeekool et al., 2015b). The GDA was estimated to be available on just 35% of packaged products in one study (Pongutta et al., 2018), with most participants reporting difficulty finding it due to typical placement on the corner of packages (Rimpeekool et al., 2015a). ...
Thailand has used front‐of‐pack labelling (FoPL) policies to support its public health objectives of improving consumer nutrition to reduce the risk of noncommunicable disease. A rapid literature review explored the current types of FoPL systems in Thailand and how they are understood by consumers. Twelve studies were included, most of which examined the mandatory Guideline Daily Amount (GDA) label. Evidence showed gaps in consumer comprehension of the GDA—consistent with international literature demonstrating the GDA is not as effective at improving identification and choice of healthier foods as interpretive labels. Thai consumers reported somewhat better comprehension when colors or text were added to the GDA. Thai stakeholders should consider supplementing or replacing the GDA with one of the newer FoPL systems shown to be more effective in other countries. More rigorous research is necessary to ensure potential FoPL schemes have intended effects among Thai consumers to inform policy action.
... This research was informed by both the knowledge, attitude and behaviour (K-A-B) model and the health belief model (HBM). A similar type of integrated behaviour model has been used in other international studies as well [38,39]. The KAB model, also known as knowledge, attitudes and practices (K-A-P) is an important model of health education and asserts that a behaviour change is influenced by knowledge as well as attitude [40]. ...
Oral cancer is highly prevalent in the Indian subcontinent. With the increasing immigration of Indians to Australia, a potential rise in oral cancer cases can be expected if they continue engaging in oral cancer risk practices. Unfortunately, little is known on this topic in the Australian context. This study aimed to generate new insights into this area by examining Indian immigrants' knowledge, attitudes and practices regarding oral cancer in Australia and their perceived role of general practitioners in raising oral cancer awareness. Exploring these aspects could determine the oral cancer risk behaviours of Indians in Australia along with any contributing factors which could help identify potential preventative strategies. A cross-sectional survey was undertaken of 164 Indians across Australia. Data were analysed using SPSS software with descriptive statistics. Respondents had varying levels of knowledge about oral cancer (mean total score 61%), particularly around risk factors such as alcohol and areca nut use as well as oral cancer-related signs/symptoms. The majority (87.7%) had not received any information about oral cancer in a health care setting but were receptive (71-90%) to general practitioners playing a more active role in this area. Respondents were engaging in positive preventative oral health care though few were currently (6.7%) or previously (14.7%) chewing tobacco preparations. Further research is needed through larger studies to confirm the study findings and inform the development of culturally tailored strategies particularly involving general practitioners, to raise oral cancer awareness and provide early screening for Indian immigrants.
... Under such circumstances, people are more likely to utilize and act in accordance with the information on nutrition labels. The HBM model has been implemented in many studies in the field of health and also those examining the topic of food labeling [15,22,23]. ...
... In accordance with the HBM model, the findings of Lin et al. [15] for US data show that the probability of searching for information on food labels is positively correlated with the perceived benefits of using the information and negatively correlated with the perceived barriers to using the label information. In addition, individuals who feel strongly that what they eat can influence their risk of getting a disease (response efficacy) are more likely to use food label information [15,22]. ...
... In the current study, 59.3% of the sample reported that the information on food labels often or always affects their decision to purchase a food product, while 22.8% said that the information never or rarely affects their decision. In addition, most of the participants reported that they maintain a balanced and healthy diet (69.9%). ...
Background
Food labeling to encourage healthier food choices may have positive long-term effects. Yet previous studies point to challenges in terms of how consumers understand and use labeling information. The current study seeks to determine how psychological factors related to health and nutrition, food label perceptions, nutrition habits and sociodemographic factors are associated with consumers’ decisions to seek and use the information on nutrition food labels more frequently.
Methods
The survey was conducted by a polling company in Israel between November 11 and December 12, 2019. Participants comprised a representative sample of the adult population in Israel age 21 and over. A total of 513 people returned the completed questionnaires, which included the following parts: personal details; frequency of searching for information on food product labels; perceived health risks of foods high in sodium, sugar and saturated fats; Health Belief Model constructs related to food labeling. The statistical analysis entailed ordinal logistics regressions.
Results
While 59.3% of the sample reported that the information on food labels often or always affects their decision to purchase a food product, more than 20% reported often or always consuming products that are high in sugar (32.0%), saturated fats (31.3%) and salt (20.4%). The results of the analytical model show the following HBM variables to be significantly associated with frequency of using information on food labels: higher levels of perceived benefit (OR = 1.72, CI 95% = 1.12–2.64); higher confidence in reading and understanding food labels (OR = 2.48, CI 95% = 1.62–3.78); and higher perceptions of the importance of nutrition (OR = 2.76, CI 95% =1.97–3.87). In addition, women and married people were found to use food label information more frequently.
Conclusions
General public information campaigns and HMOs campaigns with messages to motivate the use of food labels should emphasize the benefits of using labels to select food products. These messages should aim at increasing individuals’ perceived confidence in understanding the information on nutrition labels. The recent front-of-package labeling reform could be an important policy step for achieving healthier nutrition.
