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... Risk reduction measures such as social distancing, hand washing, and wearing a facemask can rarely be enforced entirely by coercion unless students must understand what is expected of them and feel strongly about the importance of compliance. In this regard, Health Belief Model (HBM) is the most appropriate fit behavioral framework to understand why students are /aren't participating in COVID-19 preventive measures [20]. ...
... The HBM was developed in the 1950s for the purpose to explain why people do/don't take a certain preventive measure if they face the risk of being ill [20][21][22]. According to this model, students are most likely to take COVID-19 preventative measures if they perceive the threat of contracting the infection is to be serious, feel they are personally susceptible to the infection, have the confidence of executing the recommended preventive actions, and perceive that there are fewer costs than benefits to engaging in preventive measures [23]. ...
... Measurements. The questionnaire used for this study was adapted from different literature by the research team [20,25,28,40,41]. The instrument was initially prepared in English and then translated into the local language (Amharic). ...
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Background COVID-19 is a new pandemic that poses a threat to people globally. In Ethiopia, where classrooms are limited, students are at higher risk for COVID-19 unless they take consistent preventative actions. However, there is a lack of evidence in the study area regarding student compliance with COVID-19 preventive behavior (CPB) and its predictors. Objective This study aimed to assess CPB and its predictors among students based on the perspective of the Health Belief Model (HBM). Method and materials A school-based cross-sectional survey was conducted from November to December 2020 to evaluate the determinants of CPB among high school students using a self-administered structured questionnaire. 370 participants were selected using stratified simple random sampling. Descriptive statistics were used to summarize data, and partial least squares structural equation modeling (PLS-SEM) analyses to evaluate the measurement and structural models proposed by the HBM and to identify associations between HBM variables. A T-value of > 1.96 with 95% CI and a P-value of < 0.05 were used to declare the statistical significance of path coefficients. Result A total of 370 students participated with a response rate of 92%. The median (interquartile range) age of the participants (51.9% females) was 18 (2) years. Only 97 (26.2%), 121 (32.7%), and 108 (29.2%) of the students had good practice in keeping physical distance, frequent hand washing, and facemask use respectively. The HBM explained 43% of the variance in CPB. Perceived barrier (β = - 0.15, p < 0.001) and self-efficacy (β = 0.51, p <0.001) were significant predictors of student compliance to CPB. Moreover, the measurement model demonstrated that the instrument had acceptable reliability and validity. Conclusion and recommendations COVID-19 prevention practice is quite low among students. HBM demonstrated adequate predictive utility in predicting CPBs among students, where perceived barriers and self-efficacy emerged as significant predictors of CPBs. According to the findings of this study, theory-based behavioral change interventions are urgently required for students to improve their prevention practice. Furthermore, these interventions will be effective if they are designed to remove barriers to CPBs and improve students’ self-efficacy in taking preventive measures.
... [13,21,27] The low level of parents' education is a protective factor against non-adherence to TB screening, assuming that the level of education does not guarantee a person's level of knowledge in this study, especially regarding TB. [25] Also, it is necessary to assess the complexity of sociodemographic and HBM component's relationships to the non-adherence of TB screening. [23,28,29] The results of this study showed that the distance to health facilities is one of the factors which significantly associated with the non-adherence of TB screening in children with smear-positive TB patients' close contact (p<0.05). The results are consistent with previous research in Pandeglang and China, where the long distance to health facilities increases the risk of non-adherence to TB screening. ...
... [4] These discrepancies can be caused by the limited number of subjects, as well as linkages with other factors, such as the lack of time, constraints on access and distance to health facilities (perceived barriers), and knowledge factors. [23,29] The limitation of this study is that the design used in this study is cross-sectional, so it has weakness in seeing risk factors and their effects, and can't describe the course of the disease. This design has the weakest appearance, compared to the case control or cohort design which analyzes the causal relationship between variables and then follows up the changes. ...
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Background: TB screening in children having close contact with smear-positive TB patients is urgent to conduct to improve the case detection rate and to achieve the “End TB” target. In fact, the implementation of screening in Indonesia is still inadequate.Objective: To analyze the factors associated with the non-adherence of TB screening in children aged <15 years with smear-positive TB patients’ close contact.Methods: A cross-sectional study was conducted in Semarang between February and August 2020. Subjects were children <15 years old with smear-positive TB patient's close contact. Data were collected from interviewed parents or guardians of the child using a structured questionnaire. Chi-square or Fisher's exact test analysis was used to identify the factor associated with non-adherence to TB screening in children.Results: A total of 84 children were recruited into this study. The proportion of children who did not undergo the screening is still high (86,9%), and there was a significant association with children's age (OR 13,556, 95% CI=3.135-58,613), parents' age (OR 41,143, 95% CI=4,025-420,604), parents’ education level (OR 0,114, 95%CI=0.027–0.477), distance to health facilities, knowledge level, perceived barriers, and cues to action. There was no significant association between children’s gender, economic level, perceived threats with non-adherence of screening.Conclusion: Children and parents’ age, education level, distance to health facilities, knowledge level, perception of barriers, and cues to action associated with the non-adherence of TB screening in children aged <15 years with smear-positive TB patients’ close contact.
... Bolded numbers are considered statistically significant results (< 0.05). VOC, Variants of concern; RC, Reference category vaccination), including perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy (Abraham & Sheeran, 2014). Our findings suggest that perceived severity of COVID-19, and perceived benefits of the booster dose, may influence Canadians' hesitancy toward continued COVID-19 vaccinations. ...
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Objective COVID-19 transmission, emergence of variants of concern, and weakened immunity have led to recommended vaccine booster doses for COVID-19. Vaccine hesitancy challenges broad immunization coverage. We deployed a cross-national survey to investigate knowledge, beliefs, and behaviours toward continued COVID-19 vaccination. Methods We administered a national, cross-sectional online survey among adults in Canada between March 16 and March 26, 2022. We utilized descriptive statistics to summarize our sample, and tested for demographic differences, perceptions of vaccine effectiveness, recommended doses, and trust in decisions, using the Rao-Scott correction for weighted chi-squared tests. Multivariable logistic regression was adjusted for relevant covariates to identify sociodemographic factors and beliefs associated with vaccine hesitancy. Results We collected 2202 completed questionnaires. Lower education status (high school: odds ratio (OR) 1.90, 95% confidence interval (CI) 1.29, 2.81) and having children (OR 1.89, CI 1.39, 2.57) were associated with increased odds of experiencing hesitancy toward a booster dose, while higher income (100,000–149,999: OR 0.60, CI 0.39, 0.91; $150,000 or more: OR 0.49, CI 0.29, 0.82) was associated with decreased odds. Disbelief in vaccine effectiveness (against infection: OR 3.69, CI 1.98, 6.90; serious illness: OR 3.15, CI 1.69, 5.86), disagreeing with government decision-making (somewhat disagree: OR 2.70, CI 1.38, 5.29; strongly disagree: OR 4.62, CI 2.20, 9.7), and beliefs in over-vaccinating (OR 2.07, CI 1.53, 2.80) were found associated with booster dose hesitancy. Conclusion COVID-19 vaccine hesitancy may develop or increase regarding subsequent vaccines. Our findings indicate factors to consider when targeting vaccine-hesitant populations.
... Two researchers derived the main ideas from the raw data and decoded them using independent coding based on a pre-existing conceptual framework which was organized into themes and sub-themes. This conceptual framework was concluded from Health Belief Model (Rosenstock, 1974) [19] and Social Determinants of Health (WHO, 2010) [20] which explain health-related behavior and socioeconomic context. Reassembling codes showed the findings in the form of a chain diagram. ...
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Purpose Vaccine-preventable diseases have decreased globally. However, measles and diphtheria outbreaks still occur in Southern Thailand, where Muslims are predominant with a documented low vaccine coverage. The purpose of this study was to investigate Muslim parents’ beliefs and factors influencing them to complete immunization of children aged 0–5 years in Y.L. province, Thailand. Method A descriptive qualitative study was conducted, using focus group discussion with 26 participants. They are parents whose children had complete or incomplete vaccination and community/religious leaders. Data were analyzed using content-analysis and triangulation method was used to ensure trustworthiness. Results Four major themes emerged from the analysis: (1) positive vaccine beliefs, which included knowledge and awareness of vaccination, trust in vaccine efficacy, and religious beliefs; (2) positive factors influencing positive beliefs and vaccine acceptance, which were accessibility of reliable sources, and imitation of leaders and health-community-network; (3) negative vaccine beliefs, including bias in vaccine efficacy and safety, personal beliefs about sources of vaccines, and religious misconceptions regarding the value of vaccines and Halal concerns; and (4) negative factors influencing negative beliefs and refusal of vaccination, which were perception of disadvantages of vaccines spread by word-of-mouth, trust in person over empirical evidence, religious views based on self-interpretation, and lack of public information on Halal vaccines. Conclusion Both positive and negative factors influencing complete immunization were found in this study. To enhance vaccine acceptance, health care providers should understand Muslim cultural beliefs by offering parents a chance to express their attitudes and encourage vaccination via religious leaders and community role models.
... Moreover, the selection of HBM is based on four pillars: the subjective senses of vulnerability, benefits and obstacles (Abraham and Sheeran, 2014). Recently, further elaboration of this model includes indications of action, inciting factors, and the concept of self-efficacy. ...
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Purpose Honey is a product that has been consumed for thousands of years owing to honey's nutritional value and unique properties. This survey aimed to assess factors affecting consumer behaviour for honey in countries of the Balkans and Western Europe, on a comparative basis. Design/methodology/approach The high importance of honey consumption along with findings from previous surveys on consumer behaviour are included in the introduction chapter. Based on these, and focussing on the fundamental consumer behaviour theories (stimulus-organism-response (SOR) model, theory of planned behaviour (TPB), and health belief model (HBM)), a questionnaire was designed and answered by 2,113 individuals from the Balkans and Western Europe, of which 2,088 were honey consumers. Principal component analysis (PCA) analysis was used to interpret the results. Findings According to the analysis, both Western Europeans and Balkans consume honey weekly, whilst only a few consume honey daily. A crucial difference between the two samples is that Western Europeans consider honey to be an expensive product, whilst Balkans considers honey's price acceptable. In general, men consume more honey than women, and households with children purchase honey more often and in more significant quantities. In conclusion, the main reason affecting European honey consumption is the health impact, which is related to therapeutic properties and high nutritional value of honey. Originality/value PCA results clarified the factors affecting honey consumption, whilst at the same time, consumer profiles of Balkan and Western European consumers were outlined and compared with each other, outlining a more detailed description of honey consumption in Europe.
... The HBM explains the health behavior of the people in the face of an illness (Abraham & Sheeran, 2014;Costa, 2020;Rosenstock, 1990). This model has been extensively used in health behavior research and extended to determine people's responses to symptoms, their behavior as a response to a diagnosed illness, and specifically, to the people complying with medical regimens (Glanz et al., 1992;Sulat et al., 2018). ...
Article
The ongoing COVID-19 pandemic has deeply affected physical and psychological health of people. It also had a huge impact on their dietary choices. This study specifically attempts to determine the impact of the constructs of health belief model on consumer purchase intention of organic food in the pandemic scenario. A survey was conducted among 413 Indian organic food consumers. The proposed hypotheses are tested by employing structural equation modeling. The findings highlight those perceived benefits is an important predictor of consumers’ behavioral intention to buy organic food, followed by cues to action and perceived threats. It is also found that consumers’ age moderates the impact of perceived threat and perceived barrier on consumers’ purchase intention, with a 22% difference in model prediction. In conclusion, the health belief model is found to be one of the most suitable models to predict consumer intention toward organic food purchase during the COVID-19 pandemic.
... Th e virus outbreak of Middle East Respiratory Syndrome (MERS) in South Korea in 2015 provoked fear, which resulted in a mass reduction in transit use and travel behavior, where fear had a signifi cant infl uence on travel with a reduction in trip frequency (Kim et al. 2017). Perceived control, theory of extended planned behavior and health belief model can explain these choices about the decisions (Abraham & Sheeran 2007;Chen & Tung 2014;Wallston 2007). Family pressure also describes the reluctance to travel immediately aft er the restrictions are over. ...
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COVID-19 pandemic and subsequent has created recession in the tourism industry on the global scale impacting the livelihood of the millions of people worldwide. Speedy recovery of the tourism industry is essential to ensure the development progress do not retard drastically due to this pandemic. As the world is severely affected by the COVID-19 pandemic and international tourism will take quite a bit longer time to recover, domestic tourism could be a way forward for the recuperation of the industry. Therefore, this article aims to understand the potential of domestic tourism to keep the momentum of tourism development, after the pandemic situation gets over. Data on general characteristics of the respondents and their attitude towards travel after restrictions are over were collected using online survey. Descriptive and regression analyses were used to understand the relationship between travel decisions and respondents’ attributes. The travel decision was found significantly related to the age and geographic origin of the respondents indicating those who are less susceptible to infection are willing to travel sooner than other. Study indicates the expansion of tourism demand in relatively less popular destinations and diversified tourism products which might pose both the challenges and opportunities for tourism industry in post-COVID-19 situation. The findings of our study are expected to help in planning the post-pandemic recovery of the tourism industry in the country.
... 10 In its original form, HBM is structured on four axes, which describe and predict the behavior and beliefs of the subject, serving as both an interpretive and modifying behavioral theoretical tool. 13 The main components determining the behavioral framework of each subject are: perceived severity (beliefs about the seriousness of an illness and its possible effects if contracted), perceived susceptibility (the subjective sense of danger or risk about contracting a disease), perceived benefits (of a behavioral change, aiming at the depreciation of the first two structural components: reducing the likelihood of contracting a disease or treat its complications effectively) and perceived barriers (practical or psycho-emotional obstacles and limiting factors to the achievement of the final health-goal). [14][15][16] The updated version of HBM, which has been widely used in literature, incorporates two new descriptive components aiming to increase its predictive power: self-efficacy (a concept introduced to describe the confidence of a person in his or her own ability to demonstrate behavior that will lead to the desired result) and cues to action (internal and external stimuli that can act as signals and trigger the subject to take a health action). ...
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Background: Studies of the behavior of blood donors suggest that the examination of their incentives and reported barriers could be utilized in designing targeted recruiting strategies and awareness-raising campaigns. Methodology: Data was collected via a questionnaire based on the Health Belief Model (HBM), aimed to examine reported incentives, limitations, benefits, and self-efficacy of 261 blood donors at Thriasio General Hospital from January 1 to March 1, 2020, after required permission provided. The analysis was performed by the use of the SPSS statistical software. In addition, a Greek translation of the K6+ distress scale was provided. Results: Our sample consisted of 261 blood donors, the majority of which were men (88.5%), 40-50 years old (36.4%), high school graduates (49.4%), and married (53.3%). Heightened awareness of increased blood needs and blood shortages was mentioned. 92.8% of respondents believe that blood donation is an act of contribution to society or beneficial for their health (86.6%). The limited working hours of blood donation services are the main obstacle mentioned by the participants (32.8%), while 80.7% emphasized the need for public information campaigns. Based on the K6 scale answers score, most participants are classified in the intermediate-risk category for Serious Mental Illness (SMI). Conclusion: The study of beliefs and incentives of blood donors is a critical factor in developing an effective recruiting strategy in a volunteering frame. Public information campaigns regarding the blood donation process and reminders aiming at the return of blood donors after the necessary time interval could facilitate this effort.
... Demographic characteristics such as socioeconomic status, gender, ethnicity, and age are ith preventive health-related behavior patterns and different health services. It should be noted that even when services were publicly financed, socioeconomic status was associated with health-related behavior patterns (Abraham & Sheeran, 2014). ...
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Hepatitis B virus is one of the transfusion transmission infectious agents of public health relevance. Its prevalence varies across the globe. Establishing the seroprevalence of the disease is critical for informing the direction of preventive and control strategies. The purpose of this review is to retrospect the Hepatitis B Vaccine among Blood Donors and to discuss the Hepatitis B Virus Archetypal Framework specifically, Knowledge of Hepatitis B Virus Infection, Knowledge of Hepatitis B Vaccine, Perception about Hepatitis B Vaccination, Factors Influencing Utilization of Hepatitis B Vaccine, and the Level of Utilization of Hepatitis B Vaccine. The core constructs of this model function as four variables. These are; client perceived vulnerability to HBV infection, perceived availability and accessibility of vaccination, and perceived effect of the infection complementing awareness of Hepatitis B infection, and other factors that may affect the use of coverage to increase or decrease. Perceived susceptibility is described as believing in the likelihood of suffering a disease or illness. The review recommends that policymakers and other stakeholders in the health sector should take the initiative towards introducing the birth dose vaccine for HBV infection as it has been proven efficacious in the prevention of mother-to-child transmission. Additionally, the HB vaccine could be added to the list of drugs permitted by the National Health Insurance Scheme (NHIS) to promote the uptake of HBV in Ghana.
... For example, individuals reporting symptoms of tuberculosis were more likely to voluntarily sign up for x-rays compared to those without symptoms, and experiencing headaches related to dental diseases prompted people to brush their teeth regularly (Walker, Steinfort, and Keyler 2015;Hochbaum 1958). Indirect experience with someone close, such as a family member or friend, who is experiencing a disease may also constitute an internal trigger that may motivate behavior change for self (Sheeran and Abraham 1996). Thus, in the current study, having COVID-19 or knowing someone affected by COVID-19 may function as an COVID-19 exposure that influences COVID-19 health behaviors. ...
Article
The Coronavirus Disease 2019 (COVID-19) has affected 55 million people and caused more than 1,333,742 deaths globally in eight months since its first outbreak. People are increasingly engaging with information using interpersonal communication, traditional and social media to understand the novel virus. The deluge of information can be detrimental in containing this illness that primarily depends on human behavior for transmission. In this environment, health communication theories can provide an insight into the decision-making process of adopting prevention behaviors recommended by public health authorities. We propose that information cues will influence protective behaviors indirectly mediated by perceived susceptibility and perceived severity of COVID-19 threat. In early April 2020, a cross-sectional survey was conducted among a convenience sample among 1,545 people across the United States. Results showed that informational cues influence the behavior of staying at home and maintaining social distancing mediated by perceived susceptibility and perceived severity. Use of social media was shown to have a negative influence on perceived susceptibility and social distancing, suggesting the confounding role of misinformation in influencing people’s perception of threat from COVID-19, and their compliance to heath recommendations. Theoretical and practical implications are further discussed.
... The participants are greatly affected by their memories of sharing contaminated needles/syringes and unsafe sexual behaviours as described in the Health Belief Model. 44,45 This may have motivated them to participate in HIV vaccine trials to reduce HIV infection among themselves and the community at large. A multi-site study in the US, Canada, and the Netherlands revealed similar findings that volunteers were motivated to participate in the HIV vaccine trial to reduce risk behaviour. ...
Article
Background: HIV vaccine efficacy trials require the active participation of volunteers who are committed and adherent to the study protocol. However, information about the influence of Injecting Drug Users (IDUs) to participate in HIV vaccine efficacy trials in low-income countries is inadequate. The present study explored the factors that motivate or hinder IDUs from participating in HIV vaccine efficacy trials in Dar es Salaam, Tanzania. Methods: A qualitative descriptive study design was employed among IDUs at Muhimbili National Hospital (MNH). A purposeful sampling technique was used to recruit the participants. Three (3) focus group discussions (FGDs) and 10 In-Depth Interviews (IDIs) were used to collect the data. The data from participants were audio-recorded, transcribed, and analysed using the content analysis approach. Findings: The participants reported that altruism and the desire to reduce risks of HIV infection were the motivators to participate in hypothetical HIV vaccine trials. In addition, participants reported to consult close relatives towards motivation to participate in the vaccine trial. In contrast, the perceived fear of vaccine side effects, lack of information about HIV vaccine studies, and HIV-related stigma towards participants were described as barriers to participate in the HIV vaccine trials. Conclusion: Participation in a hypothetical HIV vaccine trial among IDUs is influenced by positive and negative factors. Actual recruitment plans could be made through a better explanation of HIV vaccine trials, the expected individual and collective benefits associated with the trials. Community involvement and sensitisation is likely to enhance participation in future HIV vaccine trials in Tanzania.
... 8 The TPB assumes that constructs, including attitudes, subjective norms, and perceived behavioral control, drive people's intention to perform a healthy behavior. 9 Associations have been established between the theoretical constructs of HBM [10][11][12][13] and TPB [14][15][16] and HPV vaccination intention and uptake. ...
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Importance Human papillomavirus (HPV) vaccine hesitancy or refusal is common among parents of adolescents. An understanding of public perceptions from the perspective of behavior change theories can facilitate effective and targeted vaccine promotion strategies. Objective To develop and validate deep learning models for understanding public perceptions of HPV vaccines from the perspective of behavior change theories using data from social media. Design, Setting, and Participants This retrospective cohort study, conducted from April to August 2019, included longitudinal and geographic analyses of public perceptions regarding HPV vaccines, using sampled HPV vaccine–related Twitter discussions collected from January 2014 to October 2018. Main Outcomes and Measures The prevalence of social media discussions related to the construct of health belief model (HBM) and theory of planned behavior (TPB), categorized by deep learning algorithms. Locally estimated scatterplot smoothing (LOESS) revealed trends of constructs. Social media users’ US state–level home location information was extracted from their profiles, and geographic analyses were performed to identify the clustering of public perceptions of the HPV vaccine. Results A total of 1 431 463 English-language posts from 486 116 unique usernames were collected. Deep learning algorithms achieved F-1 scores ranging from 0.6805 (95% CI, 0.6516-0.7094) to 0.9421 (95% CI, 0.9380-0.9462) in mapping discussions to the constructs of behavior change theories. LOESS revealed trends in constructs; for example, prevalence of perceived barriers, a construct of HBM, deceased from its apex in July 2015 (56.2%) to its lowest prevalence in October 2018 (28.4%; difference, 27.8%; P < .001); Positive attitudes toward the HPV vaccine, a construct of TPB, increased from early 2017 (30.7%) to 41.9% at the end of the study (difference, 11.2%; P < .001), while negative attitudes decreased from 42.3% to 31.3% (difference, 11.0%; P < .001) during the same period. Interstate variations in public perceptions of the HPV vaccine were also identified; for example, the states of Ohio and Maine showed a relatively high prevalence of perceived barriers (11 531 of 17 106 [67.4%] and 1157 of 1684 [68.7%]) and negative attitudes (9655 of 17 197 [56.1%] and 1080 of 1793 [60.2%]). Conclusions and Relevance This cohort study provided a good understanding of public perceptions on social media and evolving trends in terms of multiple dimensions. The interstate variations of public perceptions could be associated with the rise of local antivaccine sentiment. The methods described in this study represent an early contribution to using existing empirically and theoretically based frameworks that describe human decision-making in conjunction with more intelligent deep learning algorithms. Furthermore, these data demonstrate the ability to collect large-scale HPV vaccine perception and intention data that can inform public health communication and education programs designed to improve immunization rates at the community, state, or even national level.
... Il existe donc une difficulté dans l'observance des prescriptions. Cette dernière dépend pour l'essentiel de l'importance de la maladie à traiter et des difficultés de mise en oeuvre de la prévention et des traitements (1). Elle dépend également de la confiance de l'éleveur en ses conseillers. ...
... In general, psychological behavior change theories provide a structured approach to promote a particular behavior. Based on a review of previous research about the positive relations between the usage of concepts of behavior change theories and physical activity behavioral outcomes (Abraham and Sheeran 2005;Jones et al. 2014;Nigg et al. 2011;Sweet et al. 2012;Patrick et al. 2014) we selected the following theories as a basis to conduct and analyze focus group interviews and to design the feedback for the web app customers. ...
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Behavior change apps are widespread, but the scientific base of the app-concept is rarely disclosed. The aim of this article is to present the methodological approach used for the development of a so-called “fitness feedback demonstrator” within an already existing journey planner web app to motivate people to increase their physical activity behavior while using public transport. Firstly, we introduce the behavior change theories applied for the design of the feedback, followed by the analysis of focus-group discussions about the desired content of the fitness feedback. Secondly, we describe how we conducted a field test to measure the number of steps taken when using public transport. Finally, we used the feedback from potential users in terms of design/attractiveness and comprehensibility of the added fitness information. The “fitness feedback demonstrator” is a good practical example of how to make use of the different research expertise to develop a theory-based tool to encourage persons to integrate physical activity into their daily routines.
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Background The survival rates for children with cancer, particularly in developing countries, remain low. A key factor contributing to these poor survival rates is the late diagnosis of pediatric cancer, which is often due to insufficient treatment-seeking behaviors by parents. This study aimed to explore the factors that influence the treatment-seeking behavior among caregivers of children with cancer. Methods This study employed a scoping review approach. Data was gathered from three sources: PubMed, CINAHL, and Medline. The search protocol adhered to the PRISMA guidelines for scoping reviews, using the terms (“children OR childhood”) AND (“cancer OR malignancy”) AND (“factors OR causes”) AND (“health-seeking behavior OR treatment-seeking behavior”) AND (“treatment delay”). Selected studies were based on original research, utilized either a cross-sectional or qualitative approach, focused on caregivers of children diagnosed with cancer, and were published in the last ten years (2013–2023). Results A total of nine articles met the criteria for inclusion: seven were cross-sectional studies, while two were qualitative studies. The ages of the children ranged from 1 to 18 years. Caregivers included parents (mother, father, or both), uncles, siblings, and cousins. The number of respondents varied from 12 to 200. The findings of the studies indicate that a range of complex and interrelated factors affects parental behavior, which includes child-related factors, parent-related factors, knowledge-related factors, perception-related factors, access to health services, and levels of social support. Conclusion This study highlights that caregiver behavior in seeking treatment for children with cancer is influenced by various factors that all contribute to delays in the treatment. We advocate for increased health promotion initiatives by the government and policymakers aimed at enhancing parents’ knowledge and awareness regarding childhood cancer and its early detection. Expanding the cancer service network in developing countries could improve public access to pediatric cancer services.
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Background: Chronic kidney disease (CKD) patients undergoing hemodialysis (HD) often face challenges that can decrease their quality of life. Adherence to medication, including antihypertensive therapy, is crucial in improving patients' quality of life. Objective: This study aims to analyze the relationship between antihypertensive medication adherence and quality of life (QoL) and Quality Adjusted Life Years (QALY) in Chronic Kidney Disease (CKD) patients with hypertension undergoing hemodialysis at RSUD R.T Notopuro Sidoarjo. Methods: Data were prospectively collected from questionnaires, medical records, pharmacy records, and hospital systems between September-November 2024. A total of 73 patients were selected using purposive sampling. Inclusion criteria included CKD patients aged ≥18 years, undergoing HD, completing the questionnaires, and able to communicate effectively. The HillBone questionnaire was used to assess medication adherence, and the EQ5D5L questionnaire was used to measure quality of life. Data were analyzed using Spearman’s Rho correlation, Mann-Whitney, Chi-Square, independent t-test, and One Way Anova. Results: The majority of respondents were male (61.65%) and aged 51-60 years (45.21%). Of the 73 patients, 70 (95.89%) were non-adherent to antihypertensive medication. The average quality of life score was 0.752, QALY was 25.48, and VAS was 71.3. Significant relationships were found between medication adherence and QoL, utility values, and QALY (P=0.002), as well as between adherence and QoL (P=0.033). Conclusion: The majority of hemodialysis patients at RSUD RT. Notopuro Sidoarjo are non-adherent to antihypertensive medication, with a positive correlation between utility values (EQ5D5L) and QALY. Medication adherence affects patients' quality of life.
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Understanding and predicting customer engagement (CE) is crucial, especially in the context of medical and health insurance (MHI). In the current global landscape, particularly in light of the COVID-19 pandemic in 2020, gaining insights into customer behavior is essential for shaping future decisions and strategies. This study aims to investigate CE in private hospitals in Malaysia by utilizing the Health Belief Model (HBM). The HBM offers a comprehensive view of how customer beliefs and behaviors affect CE, making it well-suited for this research context. The study employs variance-based structural equation modeling through Smart PLS 4.0, using a sample of 150 private hospital customers in Malaysia. The findings reveal a significant relationship between Cues to Action (CA) and Self-Efficacy (SE) on CE, while perceived risk (PR) does not mediate the relationship between CA and SE about CE.
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Purpose Tanzania is the fifth country with the highest sickle cell disease (SCD) prevalence globally. Although hydroxyurea (HU) is available, only 25% of persons with SCD are reported to use it in Tanzania. Perceived disease threat is associated with medication usage in patients with chronic diseases. We assessed the factors associated with caregivers’ perceived threat of SCD complications and its relationship with HU use among children with SCD in Dar-es-Salaam. Methods We conducted a cross-sectional hospital-based study from May to August 2023. We enrolled 374 caregivers of health-insured children with SCD from 4 public SCD clinics. We adapted the modified original and revised Champion’s Health Belief Model Scales to derive perceived threat scores. We used Mann-Whitney and Kruskal-Wallis tests to compare the outcomes across sociodemographic characteristics and regression analysis for factors associated with perceived SCD threat. Results The median score (InterQuartile Range) for perceived threat of SCD complications was 559 (175, 598). Sixty-one percent of caregivers had a high SCD perceived threat. The caregivers of under-five children had 141 lower median SCD threat scores than those of children aged 13–17 years, p-value < 0.001. Participants from Regional Referral Hospitals (RRH) had lower median threat scores compared to participants attending Muhimbili National Hospital (MNH), 177 for Amana RRH, 325 Temeke RRH, 585 MNH Mloganzila, and 557 MNH Upanga, p-value <0.001. Children of caregivers with high perceived SCD threat were 3.4 times more likely to use HU compared to those with low SCD threat perception (Incidence Rate Ratio 3.4, 95% CI: 2.7–4.5). Conclusion The perceived threat of SCD predicts the likelihood of SCD patients using HU in Dar-es-Salaam, Tanzania. We recommend health education to caregivers aiming to improve their SCD threat perception and thus improve the use of HU among children with SCD in similar settings.
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Background: Cardiovascular disease (CVD) is the commonest disease-causing morbidity and mortality around worldwide. Individuals' health attitudes, habits, and lifestyle patterns are influenced by their knowledge of the disease and risk factors. Public awareness about the minimization of modifiable cardiovascular disease risk factors is required to improve cardiovascular health. This study assessed knowledge and attitude of cardiovascular risks among young adults in BuleHora, Ethiopia. Methods: A community-based descriptive study was conducted from January 15 to February 15, 2021, among young adults in BuleHora town. A validated self-administered questionnaire was used to gather data. Based on the single population proportion formula the obtained sample size was 216. The data will be coded, checked and cleaned data (edited) will be entered into SPSS statistics version 25 for analysis. Descriptive statistics were used. Result: The overall knowledge and attitude among younger adults about cardio-vascular risk were, all among 63% had average knowledge, and 36 % had good knowledge. About 52% had a neutral attitude and only 23% had a favorable attitude. There was a moderate positive correlation (r=0.7) between knowledge and attitude about cardio-vascular risks, the mean knowledge value is 15.3(SD=5.02) and the mean attitude value is 27.25(SD=10.25). No significant association was found between knowledge and attitude with their selected socio-demographic variables of younger adults. Conclusion: Younger adults were in very less knowledge and attitude about cardiovascular risks in the selected setting. Educational intervention on the cardiovascular risks and their harmful effects is necessary.
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Background Dementia is a worldwide public health concern. Implementing lifestyle changes that target modifiable risk factors is crucial for reducing the risk of dementia. The aim of this study was to investigate the effect of having family members with dementia on individuals' health beliefs and tendencies towards adopting healthier lifestyles and behaviours. Methods A cross‐sectional, comparative study was conducted with 338 people aged 40 years and older, of whom 168 have the experience of having family members with dementia, and 170 have no such experience. Data were collected using a characteristics form, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction scale, and the modified Charlson comorbidity index. Descriptive statistics, Pearson's chi‐square and independent t ‐tests, were used. Results Those with family members with dementia were more likely to have greater motivation to modify their lifestyle (perceived susceptibility, severity, benefits, and cues to action) to reduce their risk of developing dementia. Additionally, they had greater perceived barriers to gain by adopting a healthy lifestyle, in contrast to those without such family members. Conclusion The presence of family members with dementia could be an important factor to consider when designing initiatives targeting health beliefs related to dementia prevention behaviours and lifestyle changes.
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Despite the significant success of India’s COVID-19 vaccination program, a sizeable proportion of the adult population remains unvaccinated or has received a single dose of the vaccine. Despite the recommendations of the Government of India for the two doses of the COVID-19 vaccine and the precautionary booster dose, many people were still hesitant towards the COVID-19 full vaccination. Hence, this study aimed to identify the primary behavioral and psychological factors contributing to vaccine hesitancy. Cross-sectional data was collected via a multi-stage sampling design by using a scheduled sample survey in the Gorakhpur district of Uttar Pradesh, India, between 15 July 2022 to 30 September 2022. This study has utilized three health behavior models—the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the 5C Psychological Antecedents of vaccination, and employed bivariate and multivariable binary logistic regression model to assess the level of vaccine hesitancy and predictive health behavior of the respondents. Results indicate that among the constructs of the HBM and 5C Antecedents models, "perceived benefits", "confidence" and "collective responsibility" showed a lesser likelihood of COVID-19 vaccine hesitancy. However, in the TPB model constructs, a ‘negative attitude towards the vaccine’ showed a four times higher likelihood of COVID-19 vaccine hesitancy. From the future policy perspective, this study suggested that addressing the issue of ‘negative attitudes towards the vaccine’ and increasing the trust or confidence for the vaccine through increasing awareness about the benefits of the vaccination in India may reduce vaccine hesitancy.
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Backgrounds: Dermatitis is skin inflammation in response to the influence of endogenous factors, causing clinical abnormalities in the form of polymorphic efflorescence and complaints of itching. Objective: The aim of this research is to analyze the behavior of seaweed farmers in preventing dermatitis in Bantaeng Sub-district. Methods: This research uses a quantitative research design using analytical methods with a cross sectional approach. This research was conducted in the Bantaeng Sub-district area. The population in this study was all 229 seaweed workers in the Lamalaka Village area. The data analysis used was univariate and bivariate with the chi-square statistical test. Results: The results of the research show that there is a significant relationship between susceptibility (0.001 < 0.05), severity (0.020 < 0.05), motivation (0.000 < 0.05), benefits (0.000 < 0.05) and barriers (0.002 < 0.05) in dermatitis prevention behavior. Conclusion: The implication of this study is the need to develop a more intensive training program tailored to the needs of seaweed farmers in Bantaeng Sub-district, with a focus on increasing understanding of the benefits of preventing dermatitis and overcoming perceived barriers, so as to encourage the adoption of more effective and sustainable preventive behavior.
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Background Initiation of antenatal care during the first trimester is crucial for reducing maternal and neonatal morbidity and mortality. Unfortunately, only 24% of pregnant women in Malawi initiate antenatal care during this time with even lower rates of 15% at Area 25 Health Centre in Lilongwe. Despite such cases, there is little literature on obstacles that prevent women from accessing first-trimester antenatal care in Malawi. Aim To explore perceptions of pregnant women and how they influence antenatal care visits during the first trimester at Area 25 Health Centre in Lilongwe, Malawi. Methods We employed a qualitative exploratory study on 55 purposely identified participants. The participants were aged between 18 and 37 years with a gestational period of 36 weeks and below and attended antenatal care at Area 25 Health Centre in Lilongwe Urban, Malawi. Data were collected by MN and 2 data collectors from 19th March 2021 to 16th April 2021 through a total of 15 In-depth Interviews (IDIs) and four Focus Group Discussions (FGDs). Data were manually analysed using thematic analysis, which included categorization and deductive theme identification with reference to the study objectives and the Health Belief Model (HBM). Results Pregnant women perceived that the first-trimester antenatal care visits were only for those experiencing ill health conditions like backache, headache, and HIV/AIDS during pregnancy. First-trimester pregnancy was perceived as too small and not worthy of seeking antenatal care; the women placed a low value on it. The majority of those who initiated antenatal care in the first trimester had previously experienced disorders and complications such as previous cesarean sections and abortions. In addition to limited knowledge about the required total number of ANC visits, challenges such as long-distance, preoccupation with business, multiple antenatal visits, scheduling of antenatal care visits, negative attitude of health workers, adherence to COVID-19 containment measures, and inadequate partner support, were identified as barriers to seeking antenatal care during the first trimester. Conclusion The negative perceptions among pregnant women, coupled with various health systems, socio-economic and individual barriers, contributed to low attendance rates for first trimester antenatal care in Malawi. Addressing knowledge gaps and overcoming barriers related to economic, individual and health care delivery can improve women’s early antenatal care visits. Future research should consider the pregnant women from diverse socioeconomic backgrounds to gain a better understanding of these perceptions and barriers.
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Background Cardiovascular disease (CVD) prevention is of great importance due to the high prevalence of CVDs and elevated treatment expenses among patients and healthcare systems. One of the most effective strategies is the improvement of knowledge and attitude levels toward CVD symptoms and risk factors. Objective This study aimed to explore the level of knowledge and attitude about CVD among the general population in Najran city, Saudi Arabia. Methods A descriptive cross-sectional study was carried out between November and December 2022 among the Najran population. A structured questionnaire comprised socio-demographic characteristics, attitudes, and knowledge about CVD and risk factors. Ethical approval was taken from the ethical committee. Results The study included 527 participants living in Najran city aged 18 to 60 years old. Most participants were Saudi nationals (97.3%, N = 513), two-thirds had a university degree (68.9%, N = 126), and approximately half of them were females (51.8%). Furthermore, about two-thirds of the participants (60.7%, N = 320) showed a good knowledge level, and most reported an excellent attitude (87.3%, N = 460). Participants who had a university degree showed significantly better attitude levels (p-value = 0.043). No factors revealed a significant impact on the knowledge level. Conclusion Moderate knowledge and excellent attitude levels were seen among the Saudi population. Increasing the knowledge level among the total population is essential. It will be reflected in their attitude and practice. Thus, structured educational programs and utilization of available CVD guidelines should be strengthened as a better preventive strategy to overcome this condition. Also, using mass and social media to increase population awareness and good health responsibility is an effective way to limit the risk of CVD incidence.
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Objectives Using a multi‐ethnic Asian population, this study assessed adherence to prescribed home exercise programs, explored factors predicting adherence, and evaluated whether home exercise adherence was associated with physical activity. Methods A prospective cohort study was conducted in 68 older adults (aged ≥65 years) from two geriatric outpatient clinics in Singapore, who were receiving tailored home exercises while undergoing 6 weeks of outpatient physical therapy for falls prevention. Adherence was measured as the percentage of prescribed sessions completed. Predictor variables included sociodemographic factors, clinical characteristics, intervention‐specific factors, and physical and psychosocial measures. Multivariable linear regressions were performed to develop a model that best predicted adherence to prescribed exercise. Physical activity levels, measured by accelerometry, were analyzed by cross‐sectional univariate analysis at 6 weeks. Results The mean adherence rate was 65% (SD 34.3%). In the regression model, the number of medications [ B = 0.360, 95% CI (0.098–0.630)], social support for exercising [ B = 0.080, 95% CI (0.015–0.145)], and self‐efficacy for exercising [ B = −0.034, 95% CI (−0.068–0.000)] significantly explained 31% ( R ² = 0.312) of the variance in exercise adherence. Older adults with better adherence took more steps/day at 6 weeks [ B = 0.001, 95% CI (0.000–0.001)]. Conclusions Low adherence to home exercise programs among older adults in Singapore, emphasizing the need for improvement. Counterintuitively, older adults with more medications, lower exercise self‐efficacy, but with greater social support demonstrated higher adherence. Addressing unmet social support needs is crucial for enhancing adherence rates and reducing fall risks.
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Background Parents are more concerned about the available evidence of the safety, efficacy, and tolerability of the pediatric COVID-19 vaccine. Aim To assess the parents’ willingness to vaccinate their children against COVID-19 and associate it with health belief model constructs. Materials and Methods A countrywide, online, self-administered, cross-sectional survey was conducted from December 15, 2021 to March 8, 2022. The HBM approach was used as a theoretical context to assess the predictors of parents’ willingness to vaccinate their children against COVID-19. Results The majority (1,563; 95.4%) of parents are intended to immunize their children against COVID-19. Parent education, financial status, job, number of children, age-related vaccination status of the child, and household suffering from chronic disorders were significantly associated with a parent's willingness to recommend the COVID-19 vaccine for their children. The findings of HBM constructs indicated that perceived benefits (OR 14.222; 95% CI 7.192-28.124) of the COVID-19 vaccine in children, susceptibility (OR 7.758; 95% CI 3.508-17.155) of children toward COVID-19, and severity (OR 3.820; 95% CI 2.092-6.977) of COVID-19 infection in children were significantly associated with parent acceptance to vaccinate their children. Parents’ higher perception of barriers (OR 0.609; 95% CI 0.372-0.999) to vaccination reduces the intention to vaccinate children against COVID-19. Conclusion The findings of our study reveal that the value of HBM constructs in the identification of predictors associated with the parents’ willingness to encourage COVID-19 vaccine for their children. It is important to improve health and reduce the barriers to COVID-19 vaccination among Indian parents having children less than 18 years.
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AbstrakAngka kematian ibu (AKI) di Indonesia menduduki urutan pertama di Asia Tenggara yaitu sebesar 214 per 100.000 kelahiran hidup pada tahun 2014. Tujuan penelitian ini adalah untuk melihat gambaran kepatuhan konsumsi tablet zat besi pada ibu hamil di Rumah sakit Umum Aliyah (RSUA) dan Rumah Sakit Umum Daerah (RSUD) Kota Kendari. Jenis penelitian adalah deskriptif observasional. Besar sampel adalah 100 responden. Sampel dipilih secara Random Sampling. Data dikumpulkan menggunakan kuesioner dan dianalisi secara deskriptif. Hasil penelitian memperlihatkan bahwa ibu yang mengkonsumsi tablet besi selama periode kehamilan hanya sebesar 40 %. Hanya terdapat 16 % ibu yang patuh mengkonsumsi tablet besi dalam jumlah yang direkomenadasikan. Secara keseluruhan kepatuhan konsumsi suplemen besi pada ibu yang melahirkan di dua rumah sakit yang kami teliti sangat rendah. Konseling gizi pada saat ibu melakukan kunjungan untuk pemeriksaan ANC perlu diperkuat melalui peningkatan kapasitas petugas. Kata Kunci: Anemia, ibu hamil, kepatuhan, tablet zat besi
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This study uses a health belief model to examine the preventive behavioral orientation or self-protective measures adopted by people in the face of the current COVID-19 pandemic. A total of 603 participants were selected from the city of Bangalore, India. The data was collected through an online survey with participants’ age varying between 17 and 54 and mean as 23 years (SD = 4.32). The findings revealed that perceived barrier has significant negative impact, while perceived threat, perceived consequences, perceived benefits, community and individual self-efficacy, and general health cues have a positive influence on an individual’s intention to follow self-protective measures against COVID-19. Based on the constructs of the health belief model, this study proposes multiple health-related interventions to reduce the spread of COVID-19.
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Objective: This study aimed to determine local factors that promote or prevent parents' responsible use of antibiotics for their children in Perth, Western Australia. Methods: The Health Belief Model was used to guide this study. Four focus group discussions were conducted, with 26 participants. Participants were recruited purposively through a parent group organisation. The Framework Method was utilised to analyse the data. Results: Participants agreed that antimicrobial resistance (AMR) is a serious health problem. However, participants admitted that they lacked awareness of AMR, inhibiting their ability to assess the risks of developing AMR infections among their children. Participants knew the indications and risks of antibiotic use but still viewed antibiotics as a time-saving solution that minimised disruption to their routine. Participants' previous experiences in managing their children's illness increased their confidence and linked their positive and negative experiences with their general practitioners in their judicious use of antibiotics. Conclusions: While parents demonstrated awareness of the indications of antibiotics, they continue to lack AMR awareness and overvalue antibiotics. Implications for public health: The findings highlight that incorporating parent empowerment and participation in decision-making regarding antibiotics use, and maintaining a positive relationship with healthcare providers, were important strategies to encourage the appropriate use of antibiotics.
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Covid-19 vaccine hesitancy among young adults is a current public health issue that needs to be addressed considering the seasonally driven waves of disease and the administration of vaccine boosters. As a prevention measure, the EU Covid certificate had been implemented to increase vaccine uptake, but its application was controversial. Our study investigated students’ opinions and attitudes towards Covid-19 vaccination and the EU Covid certificate through a mixed-methods design. An 18-item questionnaire was administered to 200 students during a vaccination campaign in September 2021 at the University of Bordeaux, France. Simultaneously, 30 students attended a semi-structured interview. Collected data were analyzed separately then discussed together through a parallel and convergent approach. Results showed that vaccine hesitancy was high among students, mostly from fear of short-term side effects. However, respondents decided to get vaccinated to obtain the EU Covid certificate, even if they considered it as a violation of their freedom. Straightforward communication about Covid-19 vaccination did not reach students, although this was a strong expectation from governmental and health institutions. Findings suggest that key health personnel should provide evidence-based information about vaccines in efforts of building trust with young people.
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Before vaccines for COVID-19 became available, a set of infection prevention behaviors constituted the primary means to mitigate the virus spread. Our study aimed to identify important predictors of this set of behaviors. Whereas social and health psychological theories suggest a limited set of predictors, machine learning analyses can identify correlates from a larger pool of candidate predictors. We used random forests to rank 115 candidate correlates of infection prevention behavior in 56,072 participants across 28 countries, administered in March-May 2020. The machine-learning model predicted 52% of the variance in infection prevention behavior in a separate test sample—exceeding the performance of psychological models of health behavior. Results indicated the two most important predictors related to individual-level injunctive norms. Illustrating how data-driven methods can complement theory, some of the most important predictors were not derived from theories of health behavior—and some theoretically-derived predictors were relatively unimportant.
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Community perceptions of early-stage pandemics may have significant implications for subsequent disease control and management. Perceptions of COVID-19 among Indonesian citizens were assessed 2 months after the first reported case in the country. The study used an online survey tool, which was adapted from a standardized questionnaire for risk perception of an infectious disease outbreak. The questions of the survey involved respondents' perceived level of knowledge, preparedness, efficacy of control measures, newness, infectiousness, seriousness, motivating and hindering factors, and effectiveness of prevention methods, as well as questions that assessed actual level of knowledge of respondents such as causative agents, modes of transmission, number of total cases, and available control measures. A total of 1,043 respondents participated in this study. The main sources of information of respondents were social media (85.2%) and online news (82.2%). Nearly all respondents were aware that COVID-19 is a viral disease with saliva droplets (97.1%) and contaminated surfaces (86.5%) being its main modes of transmission. Participants showed a good level of knowledge pertaining to control measures, an adequate level of belief toward their efficacy, and a willingness to implement such measures. More than 95% of the respondents perceived COVID-19 to be either serious or very serious. However, the level of anxiety among respondents was moderate, suggesting the presence of risk tolerance in the community. Individual characteristics such as gender, educational background, and occupation were found to have a statistically significant relationship with risk perception and tolerance, but voluntary participation in control measures was high and similar. This indicates that the COVID-19 health campaign during early pandemic in Indonesia was a success. This research also revealed certain areas where health promotion, education, and awareness might be improved.
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Background Female adolescent and young adult (AYA) cancer survivors face higher infertility and pregnancy risks than peers with no cancer history. Preconception health behaviors such as physical activity (PA), tobacco smoking, and alcohol intake influence reproductive outcomes. In general populations, pregnancy intention is positively associated with healthy preconception behaviors, but it has not been studied among AYA survivors. The authors hypothesized that higher pregnancy intention would be associated with healthier behaviors, especially among AYA survivors with perceived infertility risk. Methods A cross‐sectional analysis was conducted with data collected between 2013 and 2017 from 1071 female AYA survivors aged 18 to 39 years who had completed their primary cancer treatment and enrolled in an ovarian function study. Self‐reported intention dimensions were measured as a pregnancy intention score (PIS) and trying now to become pregnant. Multivariable linear (PA), binary (smoking), and ordinal (alcohol use) logistic regressions were used to estimate associations between intentions and preconception behaviors, with adjustments made for demographic and cancer characteristics. Effect modification by perceived infertility risk was assessed. Results The mean PIS was 1.1 (SD, 0.77) on a 0 to 2 scale (2 = high intention), and 8.9% were attempting pregnancy now. A higher PIS was associated with increased PA (β, 0.08; 95% CI, 0.11‐1.04), whereas ambivalence in pregnancy intention was associated with lower alcohol consumption (odds ratio, 0.72; 95% CI, 0.55‐0.95). Pregnancy intentions were not associated with smoking. Perceived infertility risk strengthened the relationship between PIS and PA (P < .05). Conclusions Pregnancy intentions were associated with some healthier preconception behaviors in AYA survivors. Medical professionals caring for AYA survivors may consider pregnancy intention screening to guide conversations on preconception health.
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Objective: An effective vaccine against COVID-19 is a desired solution to curb the spread of the disease. However, vaccine hesitancy might hinder high uptake rates and thus undermine efforts to eliminate COVID-19 once an effective vaccine became available. The present contribution addresses this issue by examining two ways of increasing the intention to get vaccinated against COVID-19. Method: Two preregistered online studies were conducted (N = 2,315 participants from the United Kingdom) in which knowledge about and beliefs in herd immunity through vaccination, as well as empathy for those most vulnerable to the virus, were either measured (Study 1) or manipulated (Study 2). As a dependent variable, individuals’ self-reported vaccination intention once a vaccine against COVID-19 became available was assessed. Results: In Study 1 (N = 310), the intention to get vaccinated against COVID-19 was correlated with knowledge about and belief in herd immunity through vaccination (r = .58, p < .001), as well as with empathy for those most vulnerable to the virus (r = .26, p < .001). In Study 2 (N = 2,005), information about herd immunity through vaccination (Cohen’s d = .13, p = .003) and empathy (Cohen’s d = .22, p < .001) independently promoted vaccination intention. Conclusions: The motivation to get vaccinated against COVID-19 was related to and could be causally promoted by both mere information about herd immunity through vaccination and by empathy. As such, the present research provides a better understanding of the intention to get vaccinated against COVID-19.
Article
Objective The association of urban population sociodemographic factors and components of pandemic influenza risk perception were studied. Methods A prospective questionnaire-based study was undertaken between March 14, 2019 and October 18, 2019. A total of 464 questionnaires were distributed to 4 primary medical centers in 2 cities in England and Wales. Persons aged over 16 years presenting to the medical centers were asked to participate. Results A total of 222 questionnaires were completed (return rate 47.8%). Participants were aged 16-84 years, with a median age of 45.5 years. Prevalence of 1 or more chronic diseases was 29.1%. Seasonal flu vaccination within 5 years was reported by 58.9%. Bivariate analyses of chronic disease and influenza vaccination observed a statistically significant association with influenza personal susceptibility expression (OR = 0.45; 95% CI: 0.22 - 0.94) and (OR = 0.50; 95% CI: 0.25 - 0.99) respectively. Multivariate analysis observed a statistically significant association between the presence of chronic disease and low comparative risk expression (OR = 0.33; 95% CI: 0.15 – 0.74) ( P = 0.007). Conclusions Respondents identifying as ‘healthy’ are more likely to express lower risk perception of pandemic influenza. Importantly, this target group is not the usual focus of influenza campaigns and are perhaps more likely to disregard health advice. Factors influencing perceptions of this target group could be an important focus of future pandemic risk perception research.
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Threats and response efficacyperceptions are core conceptsof the protection motivationtheory, and recent years have witnessed a considerable growth of research on the effect of thesefactors on adaptation to air pollution. However, few studies use appropriate designs to deal with endogeneity issues, a situation that raises serious questions on the validity of their findings. To overcome this problem, this study uses the instrumental variables method to test the effect of perceived threats and response efficacy on adaptation to smog episodes. The results of this study show that the conjunction of a moderate to high perception of threats with a high perception of response efficacy is positively associated with the adoption of the recommended behavior. The increase of perceived threats does not seem to have an effect on the behavior of individuals with low response efficacy perception. Moreover, change in perceived response efficacy does not lead to any change in the behavior of individuals with low threat perceptions. Concerning policy implications, this study suggests that smog warnings and health communication campaigns could be more effective if they provide accurate information simultaneously on air pollution level, its adverse effects, and advice on how to mitigate these effects.
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The present review aims to map the current literature on educational interventions to promote food literacy in type 2 diabetes, with a particular focus on the concept of patient engagement. The systematic review was implemented on five databases with no restrictions on the publication year. The studies selected for the review were focused on patients with type 2 diabetes, ranging from 2003 to 2021 and published in 13 countries (44% USA). Thirty-three articles were analyzed. Twenty-seven articles targeted singular patients; fifteen articles conceptualized patient engagement as self-management. In seven articles, the provider is a multidisciplinary team. Twenty articles did not report a theoretical framework in the intervention development, and eleven did not use an intervention material. Twenty-six articles did not use a technology proxy. Outcome categories were narratively mapped into four areas: clinical, psychological, behavioral, and literacy. To date, most of the interventions are heterogeneous in the adopted methodology, measures, and outcomes considered. More attention should be given to the psychosocial characterization of patient engagement as well as the technological support. High-quality, randomized controlled trials and longitudinal studies are lacking and need to be conducted to verify the efficacy of these insights.
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Background: An acute cardiac incident is a life-changing event that often necessitates surgery. Although surgery has high success rates, rehabilitation, behavioral changes, and self-care are critical to long-term health. Recent systematic reviews have highlighted the potential of technology in this area; however, significant shortcomings have also been identified, particularly with regard to patient experience. Objective: This study aims to improve future systems and to explore the experiences of cardiac patients during key phases after hospitalization: recuperation, initial rehabilitation, and long-term self-management. The key objective is to provide a holistic understanding of behavioral factors that impact people across these phases, understand how experiences evolve over time, and provide user-centered recommendations to improve the design of cardiac rehabilitation and self-management technologies. Methods: Semistructured interviews were conducted with people who attended rehabilitation programs following hospitalization for acute cardiac events. Interviews were developed and data were analyzed via the Theoretical Domains Framework, a pragmatic framework that synthesizes prior theories of behavioral change. Results: Three phases that arise posthospitalization were examined, namely, recuperation, rehabilitation, and long-term self-management. Through these phases, we describe the impact of key factors and important changes that occur in patients' experiences over time, including the desire for and redefinition of normal life, the need for different types of formal and informal knowledge, the benefits of safe zoning and connectedness, and the need to recognize capability. The use of the Theoretical Domains Framework allows us to show how factors that influence behavior evolve over time and to identify potential sources of tension. Conclusions: This study provides empirically grounded recommendations for the design of technology-mediated cardiac rehabilitation and self-management systems. Key recommendations include the use of technology to support a normal life, leveraging social influences to extend participants' sense of normality, the use of technology to provide a safe zone, the need to support both emotional and physical well-being, and a focus on recognizing capability and providing recommendations that are positive and reinforce this capability.
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Objective: To determine the predictors of acceptance and willingness to pay (WTP) for the COVID-19 vaccine among the Indian public and to provide insights for future demand forecasts and pricing considerations. Methods: A nationwide, web-based, self-administered, cross-sectional survey was conducted from 5 to 20 October 2020. The health belief model (HBM) approach was used as a theoretical framework to assess the predictors of acceptance of and WTP for the COVID-19 vaccine. Results: Of 2 480 respondents, 2 451 completed the online survey, yielding a response rate of 98.8%. Participants who participated in the survey had diverse demographics in terms of their location, educational level, occupation type, and family income. Among 2 451 respondents, the majority (89.3%) intended to receive the COVID-19 vaccine. Respondents with high perceived benefits of COVID-19 vaccination, such as reduction in worry (OR 5.87; 95% CI 4.39-7.96) and sickness (OR 4.31; 95% CI 3.31-5.62), showed higher intention to receive the vaccine. However, respondents with a high perception of the side effects and barriers to vaccination (OR 0.36; 95% CI 0.25-0.54) and vaccine shortage (OR 0.58; 95% CI 0.41-0.81) showed lower intention to receive the vaccine. The majority (2 162, 88.21%) of respondents were willing to pay an amount of INR: 500-1 000 or USD: 6.81-13.62 for a dose of COVID-19 vaccine, with a median (Q1, Q3) of INR: 500 (500, 1 000) or USD: 6.81 (6.81, 13.62). The higher marginal WTP for the COVID-19 vaccine was influenced by advanced age, marital status, female sex, intermediate educational background, high family income, fair or poor perceived health status, and no affordable barriers. Conclusions: The majority of respondents intended to receive the COVID-19 vaccine. Healthcare interventions focusing on HBM constructs and demographic predictors associated with low intention to receive the vaccine can be effective in enhancing the coverage of the COVID-19 vaccine. The findings of this study provide guidance for the future price considerations of the COVID-19 vaccine.
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Background: Zoonoses prevention relies mainly on the implementation of different biosecurity measures. This study aimed to assess the level of implementation of biosecurity measures by veterinary practitioners and students and to identify the possible behaviour change determinants. Methods: The data was collected through a cross-sectional survey (N = 382). Statistical analyses were implemented based on the Health Belief Model to identify the possible determinant of the behaviours and the explanatory variables of the perceptions. Results: The survey showed a good level of implementation of the biosecurity measures (median of 81%). The implementation was associated with a higher perception of the zoonoses' susceptibility and the measures' benefits, and with a lower perception of the zoonoses' severity. The study also revealed that the decision to implement a measure was mainly taken on a case-by-case basis depending on the perceived risk of exposure related to a specific context or intervention. Conclusion: The main determining factors identified for the implementation of biosecurity measures (BSMs) were the risk susceptibility and the benefits of the biosecurity measures, which could be influenced by evidence-based communication. The methodology developed can be applied regularly and in other countries to better capture these changes in perceptions over time.
Article
Physicians highlight that annual flu vaccination is the best strategy for preventing seasonal flu and flu-associated complications and it reduces the burden of infectious diseases. Path analyses were used to understand whether health beliefs (barriers, benefits, susceptibility, severity) influence flu vaccinations, in turn, enhance self-rated health of White, African American, Hispanic, and Asian adults in the U.S. (N = 446). Multiple-group analyses were performed to see whether given paths vary across the four groups. Regardless of race, perceived barriers and benefits significantly influenced flu vaccination. There was a group variance in the path-model of the perceived barriers, flu vaccination, and self-rated health. Although the direct effect of perceived barriers on flu vaccination was shown for all racial groups, the direct effect of perceived barriers on self-rated health was shown only for Asians. Social workers and healthcare providers should be educated to appropriately interpret different meanings of health beliefs of diverse racial groups.
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Background: The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) has given rise to a global pandemic affecting 215 countries and over 40 million people as of October 2020. Meanwhile, we are also experiencing an infodemic induced by the overabundance of information, some accurate and some not, spreading rapidly across social media platforms. Social media has arguably shifted the information acquisition and dissemination of a considerable large population of internet users towards higher interactivities. Objective: This study aimed to investigate the COVID-19 related health beliefs on one of the mainstream social media platforms, Twitter, as well as the potential impacting factors associated with the fluctuations in health beliefs on social media. Methods: We used COVID-19-related posts from the mainstream social media platform Twitter to monitor health beliefs. 92,687,660 tweets corresponding to 8,967,986 unique users from January 6 to June 21, 2020 were retrieved. To quantify the health beliefs, we employed the health belief model (HBM) with four core constructs: perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. We utilized natural language processing (NLP) and machine learning techniques to automate the process of judging the conformity of each tweet with each of the four HBM constructs. 5,000 tweets were manually annotated for training the machine learning architecture. Results: The machine learning classifiers yielded AUCs over 0.86 for the classification of all the four HBM constructs. Our analyses revealed a basic reproduction number R_0 of 7.62 for trends in the number of Twitter users posting health belief-related contents over the study period. The fluctuations in the number of health belief-related tweets could reflect dynamics in cases and death statistics, systematic interventions, and public events. Specifically, we observed scientific events, such as scientific publications, and non-scientific events, such as speeches of politicians, are comparable in their abilities to influence health beliefs trends on social media through a Kruskal-Wallis test (P-value = .78 and .92 for perceived benefits and perceived barriers, respectively). Conclusions: As an analogy of the classic epidemiology model where an infection is considered to be spreading in a population with an R_0>1, the number of users tweeting about COVID-19 health beliefs is amplifying in an epidemic manner and could partially intensify the infodemic. It is "unhealthy" that both scientific and non-scientific events constitute no disparity in impacting the health belief trends on Twitter since non-scientific events, such as politicians' speeches, might not be endorsed by substantial evidence and could be misleading sometimes. Clinicaltrial:
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The growing popularity of raw meat-based diets for pets is accompanied by increasing concern regarding possible health implications of this practice for pet owners through the storage and preparation of raw meat. This study aimed to explore pet owners' knowledge and perceptions about the safety of raw meat-based feeding and to determine self-reported food safety practices during raw meat-based pet food preparation. An online questionnaire was distributed via social media platforms and completed by pet owners practicing raw meat-based feeding (n = 174). Almost all participants (95%) reported confidence that their pets' raw meat-based food is safe. Two-thirds of respondents (67%) reported that they had researched food safety information regarding raw meat-based feeding, yet only 8% asked a veterinarian for food safety advice. Respondents were aware of pathogens that may be present in raw meat-based diets and of food safety practices; however, they did not report consistent implementation of appropriate food safety practices. Malpractices, such as rinsing of raw meat (27%) and absence of segregation of utensils and kitchen surfaces (52%), were reported. The risk to pet owners of foodborne illness associated with raw meat-based feeding was perceived to be low by 89% of pet owners. Participants perceived low susceptibility to foodborne illness but high self-efficacy, which may be an indication of optimistic bias. This study has identified a need to increase pet owners' awareness of the possible risks to human health associated with raw meat-based feeding of animals. The provision of comprehensive food safety information, intended to target the perceptions of pet owners identified in this study, is needed to improve pet owners' food safety practices and thus to reduce the potential food safety risks associated with raw meat preparation and storage in the domestic environment. Highlights:
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Although Jordan has applied lockdown in response to COVID-19 pandemic, many people were not adherent to the quarantine. We aimed to examine the attitudes of the Jordanians and how these attitudes can predict their adherence using the health belief model (HBM). A cross-sectional study of 5057 participants using an inter-net-based questionnaire was conducted during lockdown. Multivariable ordinal regression analyses were used to estimate predictors of adherence to home quarantine. Overall, 646 (12.8%), 2078 (41.2%), and 2317 (46%) of participants showed poor, intermediate , and strict adherence, respectively. Of the HBM constructs, seriousness (β= 0.116, 95% CI 0.027 to 0.205), benefits (β= 0.056, 95% CI 0.002 to 0.110) and barriers (β=-0.025, 95% CI-0.035 to-0.015) were significant predictors. We identified income insecurity (β=-0.096, 95% CI-0.144 to-0.046), social withdrawal (β=-0.062, 95% CI-0.121 to-0.004), religious concerns (β=-0.149, 95% CI-0.202 to-0.096) and health consequences (β= 0.065, 95% CI 0.011 to 0.11) as barriers. Governmental instructions were the only predictive external cue (β= 0.055, 95% CI 0.004 to 0.014). Our findings suggest that a high number of Jordanians are adherent with the quarantine, demonstrating the ability of governmental policies in tackling potential barriers. ARTICLE HISTORY
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This study aims to empirically measure the distinctive characteristics of customers who did and did not order food through Online Food Delivery services (OFDs) during the COVID‐19 outbreak in India. Data is collected from 462 OFDs customers. Binary logistic regression is used to examine the respondents’ characteristics, such as age, patronage frequency before the lockdown, affective and instrumental beliefs, product involvement, and the perceived threat, to examine the significant differences between the two categories of OFDs customers. The binary logistic regression concludes that respondents exhibiting high‐perceived threat, less product involvement, less perceived benefit on OFDs, and less frequency of online food orders are less likely to order food through OFDs. This study provides specific guidelines to create crisis management strategies.
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Background: To diminish the risk of spreading the COVID-19 virus, apps have been developed that trace contacts with COVID-19-infected individuals and warn individuals who are at risk of having contracted the virus. However, the effectiveness of these apps highly depends on their uptake by the population. Objective: The present study investigated factors influencing app use intention, based on the health belief model. Moreover, associations with respondents' news consumption and their health condition was investigated. Methods: A survey was administered in Belgium (Flanders) to 1,500 18- to 64-year-old respondents. Structural equation modelling was used to investigate the relationships among the model's constructs. Results: In total, 48.70% of respondents intend to use the COVID-19 tracing app. The most important predictor was perceived benefits of the app, followed by self-efficacy and perceived barriers. Perceived severity and perceived vulnerability were not related to app uptake intention. Moreover, cues to action, individuals' exposure to (digital) media content, was positively associated with app use intention. As respondents' age increased, their perceived benefits and self-efficacy for using the app decreased. Conclusions: Initiatives to stimulate COVID-19 app uptake should enhance perceived benefits and self-efficacy. A perceived barrier for some potential users is their concern about privacy. Therefore, when developing and launching an app, how individuals' privacy is protected should be further clarified. To sustain perceived benefits in the long run, supplementary options could be integrated to inform and assist users. Clinicaltrial:
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Aim To develop an instrument to investigate knowledge and predictive factors of needlestick and sharps injuries (NSIs) in nursing students during clinical placements. Design Instrument development and cross‐sectional study for psychometric testing. Methods A self‐administered instrument including demographic data, injury epidemiology and predictive factors of NSIs was developed between October 2018–January 2019. Content validity was assessed by a panel of experts. The instrument's factor structure and discriminant validity were explored using principal components analysis. The STROBE guidelines were followed. Results Evidence of content validity was found (S‐CVI 0.75; I‐CVI 0.50–1.00). A three‐factor structure was shown by exploratory factor analysis. Of the 238 participants, 39% had been injured at least once, of which 67.3% in the second year. Higher perceptions of “personal exposure” (4.06, SD 3.78) were reported by third‐year students. Higher scores for “perceived benefits” of preventive behaviours (13.6, SD 1.46) were reported by second‐year students.
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Purpose: To measure the psychometric properties of a reduced, 27-statement version of the Glaucoma Treatment Compliance Assessment Tool (GTCAT). Methods: We administered the GTCAT to 183 participants who were using a single bottle of an ocular hypotensive agent, and objectively measured adherence with Medication Event Monitoring System devices over 60 days. Adherence was the number of days with correctly timed bottle openings divided by the total number of study days. Using the 47-statement GTCAT, we created a reduced GTCAT by removing statements that: (1) did not load using Principal Components Analysis (PCA); (2) did not have a univariable association with adherence; or (3) were highly correlated (.75 or higher) with another statement. We assessed the construct validity of the remaining statements using PCA and assessed the predictive validity using multiple logistic regression analysis. Results: We removed 20 statements because they did not appear in the PCA analysis; were not predictive of adherence; and/or had high correlation. PCA of the reduced GTCAT (27 statements) extracted 5 components of the Health Belief Model (knowledge, susceptibility, cues-to-action, self-efficacy, and barriers). Multiple regression showed that the 27 statements predicted adherence (Rsq = .11, p = .03). Conclusions: The reduced version of the GTCAT is associated with adherence, which suggests that after external validation, future glaucoma medication adherence studies could use the reduced version to efficiently measure health behaviors and determine the benefit of the GTCAT to develop personalized interventions in glaucoma adherence.
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Heart failure is often accompanied by severe malnutrition, which in combination with chronic inflammation, neuro-hormonal activation and reduced physical activity, is involved in the vicious cycle of heart failure, with progressive deterioration to cardiac cachexia. To date no specific treatment has been found for the cardiac cachexia syndrome. Although several alternative therapeutic trials have been investigated, the main treatment strategy for cardiac cachexia consists of nutritional intervention and exercise training. The main goal of nutritional intervention is maintenance of the body weight (without edema) within the normal range or slightly lower, and the avoidance of further tissue loss with long-term energy substrate restoration. No specific recommendations have been published for macro-and micronutrient ingredients. Patients should cover their daily caloric needs according to their activities, with individualized increases in the amount of proteins and sufficient vitamins and electrolytes. Particular attention should be paid to the needs of those patients with renal dysfunction or gut malabsorption and those on chronic diuretic treatment. Prolonged periods of fasting should be avoided. Enteral nutrition is the method of choice, if feasible, but parenteral supplementation may be indicated. Exercise training, and particularly aerobic training and or strength training, are strongly recommended for improving skeletal muscle abnormalities in heart failure with cachexia. Exercise training induces beneficial effects in protein synthesis, with anabolic, anti-inflammatory and anti-oxidative stress effects. Further study is needed to investigate the pathophysiological mechanisms of the cardiac cachexia syndrome and to develop specific preventive and therapeutic strategies.
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Presents an integrative theoretical framework to explain and to predict psychological changes achieved by different modes of treatment. This theory states that psychological procedures, whatever their form, alter the level and strength of self-efficacy. It is hypothesized that expectations of personal efficacy determine whether coping behavior will be initiated, how much effort will be expended, and how long it will be sustained in the face of obstacles and aversive experiences. Persistence in activities that are subjectively threatening but in fact relatively safe produces, through experiences of mastery, further enhancement of self-efficacy and corresponding reductions in defensive behavior. In the proposed model, expectations of personal efficacy are derived from 4 principal sources of information: performance accomplishments, vicarious experience, verbal persuasion, and physiological states. Factors influencing the cognitive processing of efficacy information arise from enactive, vicarious, exhortative, and emotive sources. The differential power of diverse therapeutic procedures is analyzed in terms of the postulated cognitive mechanism of operation. Findings are reported from microanalyses of enactive, vicarious, and emotive modes of treatment that support the hypothesized relationship between perceived self-efficacy and behavioral changes. (21/2 p ref)
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In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. (46 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This chapter outlines the two basic routes to persuasion. One route is based on the thoughtful consideration of arguments central to the issue, whereas the other is based on the affective associations or simple inferences tied to peripheral cues in the persuasion context. This chapter discusses a wide variety of variables that proved instrumental in affecting the elaboration likelihood, and thus the route to persuasion. One of the basic postulates of the Elaboration Likelihood Model—that variables may affect persuasion by increasing or decreasing scrutiny of message arguments—has been highly useful in accounting for the effects of a seemingly diverse list of variables. The reviewers of the attitude change literature have been disappointed with the many conflicting effects observed, even for ostensibly simple variables. The Elaboration Likelihood Model (ELM) attempts to place these many conflicting results and theories under one conceptual umbrella by specifying the major processes underlying persuasion and indicating the way many of the traditionally studied variables and theories relate to these basic processes. The ELM may prove useful in providing a guiding set of postulates from which to interpret previous work and in suggesting new hypotheses to be explored in future research. Copyright © 1986 Academic Press Inc. Published by Elsevier Inc. All rights reserved.
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An evaluation study of an intervention for prevention of skin cancer among all age groups was conducted in four kibbutzim (collective settlements) in Israel. The sample for this study was restricted to the 43 (8.4%) elderly persons aged 60 and over who participated in the study. The objectives of this study were to assess: (a) behavioral adherence to messages regarding sun‐exposure protective behaviors (SEPB) and early detection; (b) long‐term changes (after 4 months) in skin cancer related behavior and in general health beliefs; and (c) the explanatory power of the original Health Belief Model (HBM) variables (formulated specifically for skin cancer), and of an expanded HBM, which also includes the value of health (VH), the measure of internal health locus of control (HLC‐I), and the interaction of these two in the elderly's engagement in two kinds of skin cancer protective behaviors: SEPB, and self‐examination (SE). The findings of this study show a significant change in the recommended direction in SEPB. Beliefs about skin cancer generally remained stable over the 4‐month period; basic health beliefs, however, changed during this period. The addition of an interactive effect of the VH and of HLC‐I to a model built on the original HBM dimensions was found to significantly increase the explanatory power of the VH and of the HLC‐I variables, as well as of the expanded HBM, regarding engagement in the two kinds of protective behaviors. The theoretical and practical importance of these findings for health education programs for the elderly is discussed.
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A survey of 619 Detroit-area women was conducted in order to understand why women do or do not perform breast self-examination and obtain or not obtain professional breast examinations. The survey assessed these behaviors and women's beliefs about (a) their susceptibility to breast cancer, (b) the seventy or seriousness of breast cancer, (c) the benefits of breast examinations and (d) the costs or disadvantages of the examinations. Separate sets of questions measured seventy of breast cancer when it is treated (a) late (seventy-late) and (b) promptly (seventy-early). Predictions were derived by combining the health belief model with the theory of subjective expected utility. Path analysis supported most predictions of the combined theory. As predicted, high severity-late increased perceived benefit, high seventy-early decreased benefit, and perceived benefit mediated the effects of seventy on behavior. Implications for understanding health decisions, measuring health beliefs, and modifying health behaviors are discussed.
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The majority of studies in health psychology use self-report measures. However, there is a growing body of evidence indicating that this methodology may be problematic for a significant minority of the population: individuals who possess a repressive coping style (repressors). Repressors, who fail to report negative affect, answer many self-report measures in a positive fashion. Research has identified an association between repressors, who are identified by low trait anxiety scores and high defensiveness scores, and adverse health outcomes. Therefore, repressors are an important group for health psychologists to investigate. Health psychology research should use more than one method of data collection in an attempt to unravel this difficult methodological problem.
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This experiment applied a new twist on cognitive dissonance theory to the problem of AIDS prevention among sexually active young adults. Dissonance was created after a proattitudinal advocacy by inducing hypocrisy-having subjects publicly advocate the importance of safe sex and then systematically making the subjects mindful of their own past failures to use condoms. It was predicted that the induction of hypocrisy would motivate subjects to reduce dissonance by purchasing condoms at the completion of the experiment. The results showed that more subjects in the hypocrisy condition bought condoms and also bought more condoms, on average, than subjects in the control conditions. The implications of the hypocrisy procedure for AIDS prevention programs and for current views of dissonance theory are discussed.
Chapter
Do people know what they are doing? This admittedly simplistic phrasing conceals some questions of fundamental significance to a psychological theory of actions: Are human actions thoughtful and rational or are they often mindless and automatic? Are they consciously determined or do they frequently stem from unconscious forces inaccessible to human cognizance? In the present chapter we deal with some of the foregoing problems using as our frame of reference a theory of lay epistemology developed recently by Kruglanski and his colleagues (see, Kruglanski, 1980; Kruglanski & Ajzen, 1983; Kruglanski, Baldwin, & Towson, in press; Kruglanski & Klar, 1982, Bar-Tal, Yarkin, & Bar-Tal, 1982). Our central thesis will be that voluntary actions by definition are based on intentions which essentially are types of knowledge about what it is that a person wishes to do. Thus, a general theory about the acquisition of all knowledge should be of help in elucidating how a particular knowledge is acquired, in this instance, the knowledge of one’s intentions.
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Interviewed 120 sunbathing and nonsunbathing beachgoers about their health practices, knowledge about skin cancer, moods, and social rewards obtained through sunbathing. Ss also completed personality questionnaires. Data were considered using a theoretical perspective combining aspects of health belief, social influence, social learning, and risk-taking models. Results indicate that sunbathing was related to having a positive attitude toward risk taking, having little knowledge about skin cancer, reporting a relaxed mood, having friends who sunbathe, and engaging in activities related to maintaining a positive physical appearance. Sunscreen use was related to sex, having knowledge about skin cancer, knowing people who have had cancer, and reporting high levels of anxiety.
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73 18–73 yr old women attending a health fair completed a questionnaire about breast self-examination (BSE) that included a measure of locus of control and performed a breast examination (BE) on a life-like model while 2 observers recorded their behavior. Results show that BSE performance was predictable based on the self-confidence exhibited in conducting the BE, previous practice, knowledge of the procedure, chance, and on a powerful others health locus of control. Behavior was generally not related to health belief model variables. Findings suggest that lesion detection was related to behavioral skills, and techniques were determined by psychosocial variables. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This study tests the causal relationships postulated in the Health Belief Model by using a causal modeling technique, the LISREL system. It analyzes causal relationships between American women's health beliefs and their preventive dental visists. Data are from a 1980 national family dental survey. Various causal models consistent with previous theory and research are specified and tested. A model that best fits the data shows that, in contrast to the one-way causal relationships from health beliefs to dental visits postulated in the original formulation of the Health Belief Model, four types of causal relationships exist. The findings are compared with previous studies. The importance of causal analysis is discussed. We conclude that a number of requirements must be completed before our final model can be accepted: (1) replication of this model on a new set of data; (2) longitudinal-prospective analyses exhibiting the hypothesized relationships through time; and (3) experimental testing by manipulation of one or more independent variables in experimental-clinical trials.
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A protocol is developed which allows the translation of the Health Belief Model (HBM) to practice in supplying empirical needs assessment data on which to build responsive and effective VD education. The HBM is recognized as among the most important theoretical formulations to explain health behavior available in the health education literature, although there has to date been no information as to how to bridge the gap between theory and practice for actual, specific, and detailed programmatic input. The present study describes a procedure for using the HBM as a tool enabling practitioners to isolate those beliefs that need to be addressed for a given population. Prior attempts at belief identification have been limited to the four major dimensions of the HBM (perceptions of susceptibility, seriousness, barriers, and benefits), often with a single item to address each gross dimension. Such efforts are incapable of determining discrete areas of beliefs subject to change through direct educational intervention. The conceptualization and development of an extended view of these dimensions to include numerous individual entities enables the practitioner to create a data base which overcomes this limitation. The development of the VD Health Belief Scale is detailed. Subscales were operationalized by developing standardized attitude scales comprised of Likert-type items requiring a response on a five-point scale of agreements instrument refinement occurred at several stages; and selected items were screened through internal consistency item analysis. Resultant scales had acceptable reliability with alphas of .89, .66, .91, .86, and .84. A straightforward procedure is described to explain how the measure is used to develop appropriate needs assessment data using the HBM framework. Studies performed by the authors utilizing the procedure are presented to illustrate the application of the research protocol.
Article
A proposed theory of planned behavior, an extension of Ajzen and Fishbein's (1980, Understanding attitudes and predicting social behavior. Englewood-Cliffs, NJ: Prentice-Hall) theory of reasoned action, was tested in two experiments. The extended theory incorporates perceived control over behavioral achievement as a determinant of intention (Version 1) as well as behavior (Version 2). In Experiment 1, college students' attendance of class lectures was recorded over a 6-week period; in Experiment 2, the behavioral goal was getting an “A” in a course. Attitudes, subjective norms, perceived behavioral control, and intentions were assessed halfway through the period of observation in the first experiment, and at two points in time in the second experiment. The results were evaluated by means of hierarchical regression analyses. As expected, the theory of planned behavior permitted more accurate prediction of intentions and goal attainment than did the theory of reasoned action. In both experiments, perceived behavioral control added significantly to the prediction of intentions. Its contribution to the prediction of behavior was significant in the second wave of Experiment 2, at which time the students' perceptions of behavioral control had become quite accurate. Contrary to expectations, there was little evidence for interactions between perceived behavioral control and the theory's other independent variables.
Article
The purpose of this study was to determine the effects that a controlled-usage alcohol education program had on a university population. The program was developed incorporating factors of the Health Belief Model (HBM) and persuasive communication strategies. Observation in the form of a questionnaire occurred during the second, fourth, and ninth weeks of the academic quarter. The results of the multivariate analysis of variance demonstrated the overall effectiveness of the program. Univariate comparisons between experimental and control groups demonstrating statistical significance were behavioral intention towards responsible alcohol use and knowledge about alcohol. Discussion of the results and recommendations for further research are reported.
Article
A randomized trial of various postcard reminder "cues" was performed to improve understanding of health-related behavior and to find better strategies for improving influenza vaccination compliance. Data were gathered on 283 high-risk patients (92 per cent response rate) who received: 1) a "neutral" card simply announcing the availability of vaccine; 2) a "Health-Belief-Model" card written to take advantage of the association between certain health beliefs and vaccination behavior; 3) a "personal" card signed by the patient's physician; or 4) no postcard. The highest rate of vaccination occurred among recipients of the Health-Belief-Model postcard (51.5 per cent vs. 20.2 per cent for control, p < 0.001). Linear logistic regression analysis found that age, prior vaccination history and experimental group had a significant effect on likelihood of being vaccinated. After adjusting for age and prior vaccination experience, the vaccination rate was found to be significantly higher for persons receiving the Health-Belief-Model postcard compared with persons receiving no postcard or a neutral postcard. We conclude that reminder postcards emphasizing elements of the health belief model may help increase vaccination rates.
Article
The present research was designed to identify psychosocial correlates of adherence among patients receiving hemodialysis at two outpatient clinics. The 116 participants were interviewed concerning their knowledge of treatment, health beliefs, treatment history, social support, personal characteristics, and adherence to the medication, diet and fluid-intake aspects of the regimen. In addition, medical record data were obtained on serum phosphorus and serum potassium levels, and on between-dialysis weight gains. The magnitude of relationships between predictors and adherence measures varied, depending on the method used to measure adherence. For the self-report measures, beliefs concerning the efficacy of the behavior and barriers to the behavior, along with reported family problems, proved to be consistent predictors. Other beliefs and characteristics did not contribute significantly. For the medical chart information, however, the predictive factors were less consistent. In general, situational factors seem to be the major contributors to patient adherence, and adherence itself is seen as a complex and multidimensional phenomenon.
Article
As the importance of social psychological factors in health has been increasingly recognized, a premium has been increasing recognized, a premium has been placed on the elucidation of theoretical models of preventive health behavior. Two of the more comprehensive and extensively investigated models advanced are the Health Belief oodel and Protection Motivation Theory. In the present article, the organization and research of the two frameworks are compared. In addition, several interesting features of Protection Motivation Theory that have been highlighted by recent research are discussed.
Article
This study tested an expanded version of the Health Belief Model (HBM) in the prediction of condom use during vaginal intercourse among African American college students. Results from regression analyses indicated that only the core HBM explained a significant amount of variance in condom use. Perceived barriers and gender were the only significant predictors of condom use. Perceived barriers were found to mediate the correlation between gender and condom use. Specifically, controlling for perceived barriers, the tendency for men to use condoms increased. Consistent with past research findings, high levels of HIV/AIDS risk knowledge was not significantly correlated with condom use. The findings suggest a need to consider additional (e.g., sociocultural) factors associated with African American sexual decision making and condom use to develop applicable conceptual models and HIV/AIDS prevention approaches.
Article
Sun protective cognition and behaviour was studied on beaches in Australia (n =113) and in the UK (n = 376). Cognition measures based on social psychological models, including the Theory of Planned Behaviour, were used to construct a model of sunscreen use. Path analysis showed that knowledge, norms, perceived threat, self-efficacy and perceived importance of short-term negative consequences of sun exposure accounted for 44% of the variance in intentions to use sunscreen. A measure of prior planning contributed as much to the prediction of behaviour as did intentions and there was support for both a moderating and a mediating influence of planning on intention. The results support theoretical proposals that post-decisional cognitions should be added to current theoretical models and have implications for intervention design.
Article
Recent theoretical and empirical research has challenged the assumption of health psychologists employing social cognitive models that beliefs can confidently be inferred on the basis of questionnaire responses. It is charged that responses to questionnaires are a function of the intelligibility of the items, constructs and theoretical framework to survey participants. To investigate this contention, cognitions specified by Protection Motivation Theory (PMT) were measured with respect to intentions to use a condom and intentions to use dental floss. Three alternative formats of a questionnaire which varied the order of presentation of PMT items were distributed to student samples. Analyses showed that while questionnaire format did not affect the reliability of cognition measures, there was some variation in the significance and strength of correlations between PMT cognitions across formats. Individual differences in social desirability and salience of the target behaviour had small and predictable effects upon reliabilities and intercorrelations. Implications for the measurement of health beliefs and the status of questionnaire responses are outlined and suggestions are made for controlling bias associated with respondents' capacity to “read” a questionnaire.
Article
In the course of a feasibility study of continuous subcutaneous insulin infusion pumps, 382 insulin-requiring diabetic patients were offered a choice of CSII, intensified conventional treatment or conventional treatment. Two hundred and eighty-six (75%) patients completed newly developed diabetes-specific measures of health beliefs and attributions before any change of treatment regimen. The scales were useful predictors of patients' choice of treatment. Furthermore, they were useful in predicting efficacy of treatment in terms of glycosylated haemoglobin measures of diabetes control after one year of treatment in the study. The implications of the findings for introducing patients to new forms of treatment are discussed.
Article
The present study sought to apply the Health Belief Model and the Theory of Planned Behaviour to the prediction of attendance at health checks. In addition, the way in which patients were invited to the health checks and the effect this had on both the uptake of the service and the role of cognitive factors in predicting attendance was analysed. Based in a single general practice, 818 patients were either sent an invitation letter which included an appointment time or they were sent an open invitation to contact the practice to make their own appointment time. Prior to the commencement of the programme health belief questionnaires were sent to patients. The results of the study firstly showed that letters offering patients an appointment produced a much higher attendance rate (70%) than letters containing an open invitation (37%). Secondly, through stepwise discriminant function analyses, the predictors of attendance behaviour were found to vary according to how patients were invited. For patients sent an appointment, attenders were found to be more likely than non-attenders to place a high value on their health, to believe that their health is influenced by powerful others, that certain referent groups would advise them to attend, that attending would lead to positive outcomes and that motivational barriers would not prevent them from attending. For patients sent an open invitation, intention to attend and perceived control were found to be independent predictors of attendance behaviour. These results suggest that attendance at health checks may not be a homogeneous behaviour such that the beliefs which distinguish attenders and non-attenders may be seen to vary according to the way in which the service is offered.
Article
Demographic characteristics, health behaviour and knowledge of breast cancer were assessed in 183 women from a regional breast screening unit and compared with those of 182 women from a breast clinic and 41 control subjects. A questionnaire yielded information on (i) demographic characteristics and cancer-related behaviours including breast self-examination (BSE), use of screening and promptness of presentation of breast symptoms in the clinic group, (ii) the extent and effects of knowledge about breast cancer and (iii) the role of Health Belief Model dimensions. Results showed the screening unit attenders to be significantly older and to be significantly more likely to be from higher social classes. Differences between the groups in health beliefs and knowledge did not remain once the effects of age and social class were partialled out. While attitudes towards BSE and its practice related to health beliefs. only a minority of the women indicated that they practised BSE with any regularity. The results suggest that screening is failing to attract a truly representative sample of the community and raise the possibility that this failure is a consequence of sociological as much as psychological factors.
Article
The paper reports a prospective longitudinal comparison of the Health Belief Model (Rosenstock, 1966) and the Theory of Planned Behaviour (Ajzen, 1985) in which the ability of the models to predict and understand the factors determining use of protective helmets among 162 schoolboy cyclists was examined by path analysis. The TPB emerged with greater economy and less redundancy than the HBM. A second path analysis examined whether intention, which is not included among the original components of the HBM, might mediate the links between the predictor variables and behaviour, and this proved to be correct. Lastly, the effects of prior behaviour were examined and found to have a significant effect on helmet use in both models. It was concluded that the TPB had greater predictive utility than the HBM. The implications of the findings are discussed and suggestions for future research are offered.
Article
This study attempted to validate the Health Belief Model (HBM) as a model for explaining health behavior among elderly people diagnosed with hypertension. Using the construct validation perspective within psychometric theory, factor analysis with principal axis factoring and orthogonal varimax rotation was performed on data obtained from 275 elderly patients seen for hypertension in outpatient clinics. The structure of the HBM as originally proposed by Rosenstock (1966) was not confirmed. Instead, a six-factor structure reflecting a decision-making perspec tive as opposed to a belief perspective was obtained This factor structure accounted for 100% of the variance and was established on the basis of eigenvalues meeting more than one criterion for factor retention. The six factors are (a) inference of susceptibility, (b) understanding of hypertension, (c) use of health services, (d) inference of illness, (e) likelihood of disease-related complications, and (f) health locus of control. This study reveals patients' need to process information about their illness and health, to apply their cognitive-inferential skills to analyze and draw conclusions from this information, and to use these inferences to chart their course of behavioral response to their illness and its management.
Article
Lack of adherence to health-promoting advice challenges the successful prevention and management of many conditions. The Health Belief Model (HBM) was developed in 1966 to predict health-promoting behaviour and has been used in patients with wide variety of disease. The HBM has also been used to inform the development of interventions to improve health behaviours. Several reviews have documented the HBM's performance in predicting behaviour, but no review has addressed its utility in the design of interventions or the efficacy of these interventions. A systematic review was conducted to identify interventional studies which use the HBM as the theoretical basis for intervention design. The HBM has been used continuously in the development of behaviour change interventions for 40 years. Of 18 eligible studies, 14 (78%) reported significant improvements in adherence, with 7 (39%) showing moderate to large effects. However, only six studies used the HBM in its entirety and five different studies measured health beliefs as outcomes. Intervention success appeared to be unrelated to HBM construct addressed challenging the utility of this model as the theoretical basis for adherence-enhancing interventions. Interventions need to be described in full to allow for the identification of effective components and replication of studies.