Different types of mobile phone use while driving and influencing factors on intention and behavior: Insights from an expanded theory of planned behavior

Mobile phone use while driving (MPUWD) is a significant concern due to its negative impact on road safety. This cross-sectional study aimed to assess different types of MPUWD and identify factors influencing intention and behavior among drivers in Zahedan. A total of 392 participants provided information on demographic and driving characteristics, as well as constructs derived from the Theory of Planned Behavior (TPB) augmented with moral norms. Findings revealed that a majority of drivers (86.4%) engaged in MPUWD, primarily involving calling, using applications, and texting. However, most participants did not intend to use their phones while driving in the following week. Multiple regression analysis identified age, receiving driving fines, subjective norm, and perceived behavior control as significant predictors of intention for MPUWD. Additionally, factors such as age, receiving driving fines, driving hours, car gearbox type, attitude, perceived behavior control, behavioral intention, and moral norm were significant predictors of actual MPUWD. Older participants demonstrated better behavior in various mobile phone activities while driving. Overall, the study emphasized that the main TPB constructs and moral norms have a greater influence compared to other variables in predicting MPUWD. Perceived behavioral control was the most important predictor of the intention and behavior of MPUWD. Understanding these factors can guide efforts to discourage MPUWD through targeted interventions and strategies to promote safer driving practices.

Factors affecting intent to perpetrate violence against nurses: Theory of Planned Behavior approach

BACKGROUND

The Theory of Planned Behavior (TPB) has been found to predict target behaviors. The literature examining this model lacks attention to violence toward nurses.

PURPOSE

To explore the association between the public's exposure to violence and intention to employ violence toward nurses, under the TPB framework.

METHODS

A cross-sectional study (705 participants) employed a self-report questionnaire. Path analysis assessed TPB variables' mediation between prior exposure to violence and violent intent toward nurses.

DISCUSSION

The TPB variables, that is attitudes, subjective norms, and perceived control, mediated only the association between exposure to physical violence and intention to act violently. Subjective norms were the strongest mediator. The explained variance was 31%.

CONCLUSION

When addressing violence against nurses, policymakers must consider attitudes, subjective norms, and perceived control among patients and their attendants. Violence directed at nurses and health care workers reflects societal violence and the "upstream approaches" needed to mitigate violence in health care settings.

Using the theory of planned behaviour to predict pre-service teachers' preferences for scientific sources

BACKGROUND

Despite the growing emphasis on research-based teacher education and calls for evidence-informed practice, teachers tend to prefer experiential over scientific knowledge sources to inform their actions, justify decisions and analyse educational problems. This tendency already occurs as early as during initial teacher education, and it is possibly bolstered by school internships where mentors emphasise the value of practical over scientific knowledge.

AIMS

The present study applied the theory of planned behaviour (TPB) to investigate under what conditions pre-service teachers intend to use and prefer scientific sources from educational research.

METHODS

The study's participants were 343 pre-service teachers in a half-year school internship who indicated their attitudes towards educational research, behavioural control (i.e. self-efficacy), perceived subjective norm, intentions of using research and preference for scientific sources in a survey. Perceived subjective norm was established by measuring whether pre-service teachers believed their mentors considered research-based knowledge.

RESULTS

In line with the predictions of the standard TPB model, structural equation modelling confirmed the effects of positive attitudes, self-efficacy and perceived subjective norm on pre-service teachers' intentions of using research. In turn, intentions and self-efficacy predicted preferences for scientific sources but not the use of scientific sources when planning a lesson in the internship.

CONCLUSIONS

Pre-service teachers' scientific source preferences are shaped not only by personal dispositions but also by the social context of school.

Predicting nurses' safety compliance behaviour in a developing economy, using the theory of planned behaviour: A configurational approach

AIM

The study's main objective was to use a fuzzy set qualitative comparative analysis to identify the configuration of recipes that predict nurses' safety compliance behaviour.

DESIGN

A cross-sectional design.

METHODS

A survey was used where questionnaires were collected from 285 nurses across four primary healthcare hospitals within the Ashanti Region, Ghana. The data collection happened between June 1 to August 2, 2022. A fuzzy set qualitative comparative analysis was used to identify the recipes of psychological factors that determine nurses' safety compliance behaviour.

RESULTS

Results from the study suggest that the necessary configurations that explained nurses' safety compliance behaviour came from the presence of subjective norm, attitude, perceived behavioural control, perceived organizational support and negation of intention. The result highlights the need for safety protocols to be conscious of the interplay between nurses' assessment of self, social clues and perception of management care and support since such psychological factors must be considered concurrently to achieve the optimal safety compliance behaviour among nurses.

CONCLUSION

A health and safety protocol that fails to recognize the importance of psychological antecedents on subordinates' safety compliance behaviour could limit the safety policy's usefulness in bringing the appropriate behavioural change in nurses.

IMPACT

To date, no study has combined the antecedents of theory planned behaviour with perceived organizational support and cue to action to assess how they collectively predict nurses' safety compliance behaviour. Findings from the study suggest that nurses in primary health facilities inform their safety compliance behaviour by assessing self-capabilities, social signals from superiors and colleagues and perception of management support. Hospital administrators and nursing managers in sub-Saharan Africa may rely on these psychological forces to persuade nurses to develop positive safety compliance behaviour at the health facility.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Digital Dating Abuse: An Application of the Theory of Planned Behavior

Social media and other technologies are being increasingly adopted as mechanisms to perpetrate abuse against dating partners. Using Ajzen's theory of planned behavior as a framework, a sample of 352 emerging adults completed a questionnaire that assessed the core constructs of the theory of planned behavior (i.e., attitudes, subjective norms, perceived behavioral control), as well as intentions to commit three types of digital dating abuse in the near future: digital monitoring and control, digital direct aggression, and digital sexual coercion. The models explained 44%, 34%, and 44% of the variance in intentions to commit digitally facilitated monitoring and control, direct aggression, and sexual coercion, respectively. Attitudes and subjective norms significantly predicted intentions, whereas perceived behavioral control did not. Given the increasing prevalence of digital dating abuse, prevention efforts should target attitudes toward digital dating abuse-related behaviors and perceptions of social acceptability and engagement.

A qualitative exploration of exercise motivation among colorectal cancer survivors: an application of the theory of planned behavior

PURPOSE

The purpose of this qualitative study was to use semi-structured interviews and thematic analysis to elicit key influencing factors (i.e., behavioral, normative, and control beliefs) related to physical activity and exercise in colorectal cancer survivors.

METHODS

Colorectal cancer survivors (N = 17) were recruited from exercise programs designed for colorectal cancer survivors at the Yonsei Cancer Center, Seoul, South Korea. A purposive sampling method was used. Interview questions were informed by the theory of planned behavior (TPB). Semi-structured face-to-face interviews were conducted, and open-ended questions addressed the research question. Interviews were transcribed verbatim and analyzed using thematic analysis.

RESULTS

Participants were on average 2.2 years post-treatment. The mean age of the sample was 55.9 years. Key behavioral, normative, and control beliefs emerged in the data. For behavioral beliefs, colorectal cancer survivors believed that exercise would result in physical and psychological improvements, and improve their bowel problems. For normative beliefs, most colorectal cancer survivors wanted their oncologists' approval for participation of exercise. Family members, more specifically the spouse, were also influencing factors for colorectal cancer survivors adopting physical activity. The most frequently mentioned control belief was that supervised exercise with an exercise specialist made exercise participation easier.

CONCLUSIONS AND IMPLICATIONS

Beliefs identified in this study can inform TPB-based physical activity interventions tailored for colorectal cancer survivors. While information alone may not lead to behavior change, integrating these beliefs with other influential factors can potentially enhance intervention efficacy and promote physical activity in this population.

Determinants of HPV vaccine uptake intentions in Chinese clinical interns: an extended theory of planned behavior approach

Background

This study aims to utilize the extended Theory of Planned Behavior (TPB) model to examine the intentions of clinical interns in China towards Human papillomaviruses (HPV) vaccination. It also fills a significant gap in the literature concerning vaccine acceptance in this specific population.

Methods

This cross-sectional study was carried out with clinical interns in Shandong Province, China, with a total of 1,619 participants. Data were collected through self-reported questionnaires, including demographic characteristics, TPB variables, and HPV-related health knowledge. Hierarchical regression analysis was employed to identify key factors influencing vaccination intentions, and Structural Equation Modeling (SEM) was used to analyze the interrelationships between these factors.

Results

This study initially identified key predictors affecting clinical interns' intentions to receive the HPV vaccine through hierarchical regression analysis. The preliminary model, which accounted for demographic factors, revealed foundational impacts of household income and HPV-related clinical experience on intentions. After integrating TPB variables-attitude, subjective norm, perceived behavioral control, and HPV-related health knowledge-the model's explanatory power was enhanced to 37.30%. SEM analysis focused on the interplay among TPB constructs and extended variables, confirming their significance in forming vaccination intentions, with subjective norm having the most substantial impact (β = 0.375, p < 0.001). The extended TPB model explained over half of the variance in vaccination intentions, substantiating the hypotheses and revealing the psychological determinants behind clinical interns' decision-making for HPV vaccination.

Conclusion

The extended TPB model from this study effectively explains the vaccination intentions among clinical interns for HPV, offering theoretical support for public health strategies and educational interventions targeting this group. These findings are of significant importance for public health practice and future health promotion strategies.

Using the Theory of Planned Behavior to determine COVID-19 vaccination intentions and behavior among international and domestic college students in the United States

Vaccination is the most effective strategy for preventing infectious diseases such as COVID-19. College students are important targets for COVID-19 vaccines given this population's lower intentions to be vaccinated; however, limited research has focused on international college students' vaccination status. This study explored how psychosocial factors from the Theory of Planned Behavior (TPB; attitudes, perceived behavioral control, subjective norms, and behavioral intentions) related to students' receipt of the full course of COVID-19 vaccines and their plans to receive a booster. Students were recruited via Amazon mTurk and the Office of the Registrar at a U.S. state university. We used binary logistic regression to examine associations between students' psychosocial factors and full COVID-19 vaccination status. Hierarchical multiple regression was employed to evaluate relationships between these factors and students' intentions to receive a booster. The majority of students in our sample (81% of international students and 55% of domestic students) received the complete vaccination series. Attitudes were significantly associated with all students' full vaccination status, while perceived behavioral control was significantly associated with domestic students' status. Students' intentions to receive COVID-19 vaccines were significantly correlated with their intentions to receive a booster, with international students scoring higher on booster intentions. Among the combined college student population, attitudes, intentions to receive COVID-19 vaccines, and subjective norms were significantly related to students' intentions to receive a booster. Findings support the TPB's potential utility in evidence-based interventions to enhance college students' COVID-19 vaccination rates. Implications for stakeholders and future research directions are discussed.

Integrating the theory of planned behavior and the self-determination theory to promote Mediterranean diet adherence: A randomized controlled trial

The Mediterranean diet (MD) is one of the healthiest and most sustainable food regimes. Nevertheless, MD diffusion is still limited, emphasizing the need to understand the psychosocial factors that could predict and promote its adoption. Starting from an integrated model of Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT), the present randomized controlled trial investigated the effect of manipulating motivation (autonomous vs. controlled) on intention and MD adherence behavior. Participants included 726 Italian adults randomly allocated to one of three conditions: autonomous motivation manipulation, controlled motivation manipulation, and control group. TPB variables were measured immediately after manipulation (T1), while MD adherence was evaluated 2 weeks later (T2). Results from multivariate analyses of variance highlighted that participants in the autonomous motivation condition reported higher intention and a more favorable cognitive attitude than control group participants. However, no change in behavior was found. Moreover, a path analysis with mediation effect showed that the impact of autonomous motivation condition versus control group on intention was mediated by cognitive attitude. Findings support the integration of TPB and SDT to encourage intention to adhere to the MD, also suggesting that prompting autonomous motivation may help to promote a greater diffusion of this healthy and sustainable dietary pattern.

Examining the moderating effect of perceived risk from particulate matter on outdoor sports participants: a theory of planned behavior perspective

Purpose

This study, drawing from the theoretical framework of the Theory of Planned Behavior (TPB), examines the structural relationship among attitudes, subjective norms, perceived behavioral control (PBC), and behavioral intention. The study focuses on investigating how the perceived risk associated with particulate matter moderates the relationships between "attitudes and behavioral intention," "subjective norms and behavioral intention," and "PBC and behavioral intention" within the context of individuals engaged in outdoor sports.

Design/methodology/approach

The data were collected from outdoor sports gatherings facilitated through a popular South Korean sports meetup application. Confirmatory factor analysis was employed to establish the construct validity of the measurement scale, assess factor loadings, averaged variance extracted (AVE), and construct reliability (CR). We also ensured the reliability of the measurement scale through Cronbach's α analysis. To achieve our research objectives, we utilized structural equation modeling with maximum likelihood estimation to examine the positive relationships under investigation. Additionally, we performed moderation analysis using the statistical software Jamovi.

Findings

The findings demonstrate the significant impacts of attitudes, subjective norms, and PBC on behavioral intention and reveal that perceived risk acts as a moderator, influencing the relationship between PBC and behavioral intention.

Application of Bayesian structural equation modeling in construction and demolition waste management studies: Development of an extended theory of planned behavior

Sustainable construction and demolition waste management relies heavily on the attitudes and actions of its constituents; nevertheless, deep analysis for introducing the best estimator is rarely attained. The main objective of this study is to perform a comparison analysis among different approaches of Structural Equation Modeling (SEM) in Construction and Demolition Waste Management (C&DWM) modeling based on an Extended Theory of Planned Behaviour (Extended TPB). The introduced research model includes twelve latent variables, six independent variables, one mediator, three control variables, and one dependent variable. Maximum likelihood (ML), partial least square (PLS), and Bayesian estimators were considered in this study. The output of SEM with the Bayesian estimator was 85.8%, and among effectiveness of six main variables on C&DWM Behavioral (Depenmalaydent variables), five of them have significant relations. Meanwhile, the variation based on SEM with ML estimator was equal to 78.2%, and four correlations with dependent variable have significant relationship. At the conclusion, the R-square of SEM with the PLS estimator was equivalent to 73.4% and three correlations with the dependent variable had significant relationships. At the same time, the values of the three statistical indices include root mean square error (RMSE), mean absolute percentage error (MPE), and mean absolute error (MSE) with involving Bayesian estimator are lower than both ML and PLS estimators. Therefore, compared to both PLS and ML, the predicted values of the Bayesian estimator are closer to the observed values. The lower values of MPE, RMSE, and MSE and the higher values of R-square will generate better goodness of fit for SEM with a Bayesian estimator. Moreover, the SEM with a Bayesian estimator revealed better data fit than both the PLS and ML estimators. The pattern shows that the relationship between research variables can change with different estimators. Hence, researchers using the SEM technique must carefully consider the primary estimator for their data analysis. The precaution is necessary because higher error means different regression coefficients in the research model.

Evaluation of an Educational Intervention Based on Theory of Planned Behavior to Reduce Suicidal Ideation and Attempts in Drug Addicts Receiving Methadone: A Quasi-Experimental Study

BACKGROUND

Drug addiction can lead to suicidal ideation or suicide attempt so that half of those who attempt suicide have a history of substance abuse. The purpose of this study was to investigate the effect of educational intervention based on Theory of Planned Behavior (TPB) on reducing suicidal ideation and suicide attempt of addicts.

METHODS

A longitudinal quasi-experimental educational intervention was conducted on 200 methadone-treated addicts with suicidal ideation under the auspices of government addiction centers of Shiraz city from 2021 to 2022. Baseline data on demographic characteristics, suicidal ideation, and TPB questionnaire were collected from two groups at the beginning of the study and then three months after the intervention. The experiment group received educational intervention including sessions of individual and group counseling, training and organizational supports. The questionnaire was completed by both the experimental and control groups before the educational intervention and three months after the educational intervention. Data were analyzed using SPSS 22 software through independent t-test, Chi-square and paired t-test (p = 0.05).

RESULTS

The mean age of addicts in the experimental and control groups was 38.80 ± 11.64 and 39.41 ± 11.18 years, respectively (p = 0.206). 22% of the experimental group and 18% of the control group had a history of suicide. According to the results, there was no significant difference between the experimental and control groups in terms of knowledge, attitude, subjective norms and perceived behavioral control before the educational intervention, however, the mentioned variables increased significantly in the experimental group three months after the educational intervention. There was no significant difference in suicide attempt and suicidal ideation between the experimental and control groups before the educational intervention, however, there was a significant change in the experimental group after the educational intervention.

CONCLUSION

The results of the present study showed the effect of educational intervention on the knowledge, attitude, subjective norms, perceived behavioral control, suicidal ideation and suicidal attempt of addicts, thus confirming the effectiveness of the TPB-based intervention on reducing suicide of addicts.

Theory of Planned Behavior applied to the choice of food with preservatives by owners and for their dogs

Many pet owners make food choices for their pets that are similar to those they make for themselves, and food characteristics such as the presence of preservatives can influence this decision. The Theory of Planned Behavior (TPB) is a tool used to predict intentions and behavior and can be an important indicator for the pet food industry. The aim of this study was to investigate pet owner behavior regarding food with or without preservatives, based on the behavior prediction of TPB. A questionnaire was distributed with questions related to direct (attitude, subjective norms, and perceived behavioral control) and indirect (behavioral beliefs, normative beliefs, and intentions) measures for the analysis of TPB. For the statistical analysis the structural equation modeling (SEM) was used. The correlation between owner behavior and the behavior imposed on their dog's diet was evaluated by paired T test or paired Wilcoxon test according to variables' adherence or not to normality, respectively. A total of 1,021 answers were evaluated after the inclusion and exclusion criteria were applied. The results indicated that TPB was effective in predicting the intentions (r2 = 0.58 for dogs and r2 = 0.59 for owners) and behavior (r2 = 0.58 for dogs and r2 = 0.57 for owners) regarding the intake of diets without preservatives. It was observed that owners are more concerned with the diet of their dogs than their own and they believe that the intake of preservatives can be prejudicial to the health of their dogs (p<0.001). However, owners trust more in pet food manufacturers than human food manufacturers (p<0.001). Therefore, it can be concluded that TPB can be an important tool to understand consumer behavior towards their dog food, and that the industry should intensify its approach on safety of preservatives in pet food, since many owners still believe they can be prejudicial to dogs.

Effects of educational interventions based on the theory of planned behavior on oral cancer-related knowledge and tobacco smoking in adults: a cluster randomized controlled trial

BACKGROUND

The theory of planned behavior (TPB) is an effective model for facilitating behavioral change. The aim of the present study was to evaluate the impact of TPB-based educational interventions on oral cancer-related knowledge and tobacco smoking behavior in an Iranian adult population in 2022.

METHODS

In this randomized controlled trial, a total of 400 healthy individuals were enrolled. The study was implemented in 20 urban health centers in the south of Tehran, Iran. The health centers were randomly allocated into two intervention groups. In group PowerPoint (PP), the participants received education through a 20-minute PowerPoint presentation complemented by a pamphlet. Group WhatsApp (WA) was educated via WhatsApp messages and images. Data was collected using a structured questionnaire at baseline, and at one- and three-month follow-ups. The outcomes were evaluated in terms of knowledge, tobacco smoking behavior, and the related model constructs i.e. intention, attitude, subjective norm, and perceived behavioral control. Generalized estimating equations (GEE) regression models were applied to assess the effect of interventions on repeated measurements of the outcomes. All analyses were conducted using STATA Software Version 17.

RESULTS

Out of all the participants, 249 (62%) were women. The mean and standard deviation (SD) of age were 39.67 and 13.80 years. Overall, group PP had a significantly higher score of knowledge compared to group WA (β = 0.43, p = 0.005). No significant differences were found between the groups with regard to tobacco smoking and the related TPB constructs, except for attitude with a higher score in group PP compared to group WA (β = 0.50, p = 0.004). At the three-month follow-up, both interventions had significant effects on increasing knowledge (β = 4.41), decreasing tobacco smoking (OR = 0.54), and increasing intention (β = 1.11), attitude (β = 1.22), subjective norm (β = 1.37), and perceived behavioral control (β = 1.08) (P < 0.001).

CONCLUSIONS

Both interventions were effective in improving knowledge, tobacco smoking, and the TPB constructs after three months. Therefore, the application of both methods could be considered in the design and implementation of oral cancer prevention programs.

TRIAL REGISTRATION

The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).

Effect of nutrition education integrating the health belief model and theory of planned behavior on dietary diversity of pregnant women in Southeast Ethiopia: a cluster randomized controlled trial

BACKGROUND

Maternal anemia, miscarriage, low birth weight (LBW), preterm birth (PTB), intrauterine growth restriction (IUGR), prenatal and infant mortality, morbidity, and the risk of chronic disease later in life are all increased by a lack of dietary diversity during pregnancy. However, evidence for the effect of nutrition education on the dietary diversity score (DDS) among pregnant women was sparse in Ethiopia, particularly in the study areas. This study aimed to assess the effect of nutrition education on dietary diversity among pregnant women in urban settings in Southeast Ethiopia.

METHODS

A community-based two-arm parallel cluster randomized controlled trial was conducted among 447 randomly selected pregnant women attending antenatal care (224 intervention group and 223 control group) at health facilities from February to December 2021. A multistage cluster sampling technique, followed by systematic sampling, was used to select the pregnant women. Pregnant women who participated in the interventions were given nutrition education starting at 16 weeks of gestation and continuing for 6 months. We used a pre-tested, interviewer-administered, structured questionnaire to collect the data. A 24-hour qualitative dietary recall was used to calculate the dietary diversity score (DDS). A multivariable generalized estimating equation (GEE) model was conducted to evaluate the intervention effect.

RESULTS

After the intervention, the proportion of adequate dietary diversity was 14.15% higher in the intervention arm compared to the control group (45.09% versus 30.94%, P = 0.002). The overall difference in adequate dietary diversity between the two groups was 8.5%. After adjusting for background characteristics, the multivariable GEE binary logistic model revealed that having received intervention [(AOR = 1.89, 95% CI: 1.27, 2.79)], being literate [(AOR = 3.41, 95% CI: 1.13, 10.23)], and having high wealth [(AOR = 1.60, 95% CI: 1.09, 2.35)] significantly improved adequate dietary diversity.

CONCLUSION

The findings indicated that having received the intervention, being literate, and having a high level of wealth significantly improved maternal dietary diversity. Efforts should be made to increase nutrition education using the health belief model (HBM) and the theory of planned behavior (TPB). Moreover, there is a need to improve literacy and economic empowerment through income-generating activities to enhance adequate dietary diversification during pregnancy.

TRIAL REGISTRATION

Clinicaltrials.gov (PACTR202201731802989, Retrospectively registered on 24 January 2022).

Theory of planned behavior and college student 24-hour dietary recalls

Objective: The transition to college is marked by poorer eating behaviors, making emerging adulthood a particularly salient intervention point for improving lifelong health. The present study aims to better understand what psychosocial factors predict eating behaviors of college students using the Theory of Planned Behavior (TPB). Participants & Methods: Dietary recalls were analyzed the Healthy Eating Index (HEI)-2015 scoring system for 67 university students between the ages of 18 and 25 (70.1% female; 49.3% White, 20.9% Black/African American, 13.4% Asian). Results: Haye's PROCESS Model 6 was used. The full model accounted for a significant amount of variance in HEI-2015 scores (F[3, 63] = 3.09, p = .033, R2 = .12). The final model suggested a significant indirect effect of PBC on the relation between ATT and HEI-2015 (β = .859, SE = .637, 95% CI [.009, 2.482]). Conclusions: Although some college students might have favorable attitudes, only those who believe this is within their control actually ate a (somewhat) healthier diet.

Factors influencing nurses' intent to provide care involved in coronavirus disease 2019: Theory of planned behaviour perspectives

AIMS AND OBJECTIVES

To identify the factors influencing the intent to provide care among nurses involved in coronavirus disease 2019 (COVID-19) care.

BACKGROUND

COVID-19 was first reported in Wuhan, China, in 2019. In 2020, the World Health Organisation declared it a pandemic, leading to 5,827,104 deaths and 421,203,495 confirmed cases as of 19 February 2022. The high transmissibility of COVID-19 has prolonged the pandemic for over 2 years, resulting in deleterious effects on nurses' physical and mental health. The fear of infection and isolation may lead to negative experiences and perceptions among COVID-19 frontline nurses, which may ultimately degrade the quality of patient care. Thus, it is essential to identify factors influencing of nurses' intent to provide care.

DESIGN

Cross-sectional study.

METHODS

Data were collected from 169 nurses involved in direct COVID-19 care at a hospital designated for infectious disease care in Korea from August to September 2021 using an online questionnaire. STROBE checklist was followed.

RESULTS

Nurses' intent to provide care significantly differed based on whether they lived with parents and had adequate availability of personal protection equipment. The correlation analysis indicated that the intent to provide care was significantly positively correlated with normative beliefs, control beliefs, attitude towards the behaviour, subjective norms and perceived behavioural control. Perceived behavioural control, control beliefs and attitude towards the behaviour were significant factors influencing nurses' intent to provide COVID-19 care.

CONCLUSION

This study showed that nurses perceived behavioural control and positive behaviour towards providing COVID-19 care fundamentally influenced their intent to provide care.

RELEVANCE TO CLINICAL PRACTICE

In clinical practice, the safety and rights of individual nurses who participated in COVID-19-related patient care are promoted, and ultimately, the quality of patient care is improved. Furthermore, active support at the organisation and government level is needed to strengthen the capabilities necessary for nursing patients with infectious diseases.

Extending the theory of planned behavior to examine the role of meat-eater identity: The case of dry-aged beef

Dry-aged beef provides superior qualities and a unique taste experience due to its exceptional sensory attributes, including tenderness, juiciness, and flavor, compared to traditional beef. Our study focused on the factors that impact consumers' intention to consume and willingness to pay for dry-aged beef. We implemented an extended version of the Theory of Planned Behavior (TPB) model that contains a measure of meat-eater identity to analyze the intention to consume and the willingness to pay a premium for dry-aged beef steak that has undergone 21-30 days of aging. An online survey was conducted with a stratified sample of Italian respondents (n = 944). The data were analyzed using partial least squares structural equation modeling (PLS-SEM). The TPB's effectiveness was enhanced by adding the meat-eater identity construct to the model. Specifically, it was found that the participants' meat-eater identity significantly influenced their intention to consume. The results also revealed that the most critical impact of identity comes from the mediated influence of attitudes, subjective norms, and perceived behavioral control. Finally, the intention to consume strongly influenced the willingness to pay for a dry-aged beef steak.

Predictive modeling of consumer purchase behavior on social media: Integrating theory of planned behavior and machine learning for actionable insights

In recent times, it has been observed that social media exerts a favorable influence on consumer purchasing behavior. Many organizations are adopting the utilization of social media platforms as a means to promote products and services. Hence, it is crucial for enterprises to understand the consumer buying behavior in order to thrive. This article presents a novel approach that combines the theory of planned behavior (TPB) with machine learning techniques to develop accurate predictive models for consumer purchase behavior. This study examines three distinct factors of the theory of planned behavior (attitude, social norm, and perceived behavioral control) that provide insights into the primary determinants influencing online purchasing behavior. A total of eight machine learning algorithms, namely K-nearest neighbor, Decision Tree, Random Forest, Logistic Regression, Naive Bayes, Support Vector Machine, AdaBoost, and Gradient Boosting, were utilized in order to forecast consumer purchasing behavior. Empirical findings indicate that gradient boosting demonstrates superior performance in predicting customer buying behavior, with an accuracy rate of 0.91 and a macro F1 score of 0.91. This holds true when all factors, namely attitude (ATTD), social norm (SN), and perceived behavioral control (PBC), are included in the analysis. Furthermore, we incorporated Explainable AI (XAI), specifically LIME (Local Interpretable Model-Agnostic Explanations), to elucidate how the best machine learning model (i.e. gradient boosting) makes its prediction. The findings indicate that LIME has demonstrated a high level of confidence in accurately predicting the influence of low and high behavior. The outcome presented in this article has several implications. For instance, this article presents a novel way to combine the theory of planned behavior with machine learning techniques in order to predict consumer purchase behavior. This integration allows for a comprehensive analysis of factors influencing online purchasing decisions. Also, the incorporation of Explainable AI enhances the transparency and interpretability of the model. This feature is valuable for organizations seeking insights into factors driving predictions and the reasons behind certain outcomes. Moreover, these observations have the potential to offer valuable insights for businesses in customizing their marketing strategies to align with these influential factors.

Integrating health belief model and theory of planned behavior to assess COVID-19 vaccine acceptance among urban slum people in Bangladesh

INTRODUCTION

The vaccination against coronavirus disease 2019 (COVID-19) has been identified as a promising strategy to reduce the severity of the pandemic. Despite the safe and effective COVID-19 vaccines, bringing socioeconomically disadvantaged people under vaccination coverage has been challenging for developing countries like Bangladesh. Therefore, this study explored the determinants of vaccine acceptance among urban slum residents of Bangladesh using the Health Belief Model (HBM) and Theory of Planned Behavior (TPB).

METHODS

A face-to-face survey of 400 urban slum dwellers in two large cities in Bangladesh was conducted between July 5 to August 5, 2021. The questionnaire included vaccine acceptance, socio-demographics, health-related characteristics, trust in health authorities, reasons for vaccine hesitancy, and dimensions of HBM and TPB frameworks. Hierarchical logistic regression was performed to evaluate the association between these characteristics and vaccination acceptance.

RESULTS

Around 82% (n = 327) of respondents were willing to accept the COVID-19 vaccine. In a fully adjusted model, respondents with secondary level education had higher intention (OR = 46.93, 95%CI = 1.21-1807.90, p < 0. 05) to accept COVID-19 vaccine. Respondents with bad (OR = 0.11, 95%CI = 0.01-0.35, p<0.05) or very bad (OR = 0.01, 95%CI = 0.01-0.35, p<0.05) health conditions were less interested in the COVID-19 vaccination. In regard to HBM dimensions, greater perceived susceptibility (OR = 1.75, 95% CI = 1.12-2.75, p < 0.05), and perceived benefits (OR = 3.28, 95% CI = 1.17-6.00, p < 0.001) were associated with a greater willingness to get vaccinated. In regard to TPB, higher self-efficacy in preventing illness without the vaccine increased the desire to get vaccinated (OR = 1.55, 95% CI = 1.02-2.37, p < 0.05). Fear of unknown side effects, religious beliefs, contraindications to vaccination, and insufficient information on the vaccine were the main reasons for vaccine hesitancy.

CONCLUSIONS

These findings offer valuable insights for policymakers in Bangladesh to design targeted interventions that address vaccine hesitancy and increase vaccination acceptability among socially disadvantaged individuals in urban areas. Strategies should focus on providing accurate and accessible information about the vaccine, communicating its positive impact effectively, engaging with religious leaders to address misconceptions, and tailoring vaccination campaigns to meet the unique needs of different demographic groups.

Mothers' intention to vaccinate their daughters against human papillomavirus in NorthWest Ethiopia, using the theory of planned behavior

Human papillomavirus (HPV) is the second most common cause of cancer worldwide among females. HPV vaccination is highly protective against HPV infection and can reduce 56% of HPV infections. Therefore, the study aims to assess mothers' intention to vaccinate their daughters aged 9-14 years old against human papillomavirus in Debre Tabor town, Northwest Ethiopia, using the theory of planned behavior. A community-based cross-sectional study design was employed using the theory of planned behavior from November 1 to 30, 2022, in Northwest Ethiopia. A total sample of 449 study participants was enrolled. The study participants were selected using a multi-stage random sampling technique. Data was collected using an interview-administered questionnaire. The data was entered into EPI data version 4.6 and then, exported to SPSS version 23 for analysis. Those variables with a p-value <.05 with 95% CI were considered significant predictors. Mothers' positive intention to vaccinate their daughters aged 9-14 years against HPV was 67.5%. Attitude, perceived behavioral control, and subjective norm were significant predictors with (AOR = 10.09, 95% CI = 6.23-16.32), (AOR = 4.12, 95% CI = 2.71-6.26), and (AOR = 16.397, 95% CI = 9.69-27.748), respectively. Only two-thirds of mothers have a positive intention to vaccinate their daughters against human papillomavirus. Attitude, perceived behavioral control, and subjective norm were predictors. Therefore, it is better to do community mobilization toward the advantage of HPV vaccination.

Intention and practice on personal preventive measures against COVID-19 among older adults in the Kingdom of Saudi Arabia: an epidemiological study using the Theory of Planned Behaviour

Introduction

Older adults aged 65 years and above are among the most vulnerable to adverse outcomes and death following a COVID-19 infection. The weekly epidemiological updates by the World Health Organisation show that the continued emergence of concerning subtypes of the virus indicates that the pandemic remains a public health concern and the public should continue to comply with personal preventive measures (PPMs). This study applies the Theory of Planned Behaviour (TPB) which is rooted in the field of Public Health, Epidemiology, and Preventive Medicine to Saudi older adults to predict their health behaviour.

Methods

This behavioural epidemiological study recruited older adult participants aged 65 years of age and above. A tool which consisted of sociodemographic and health-related questions, as well as questions regarding the components of the TPB, namely, Attitude, Subjective Norm, Perceived Behavioural Control was used. Bivariate analyses, followed by unadjusted and adjusted multivariable logistic regression analyses were performed to derive odds ratios and 95% confidence intervals.

Results

The total number of participants was 502. The mean age was 70.34 years, with similar distributions between males and females. In total, 52.2% intended to practice PPMs, whereas only 48% had a good practice. Also, 56% had a favourable Attitude towards PPMs, 61.4% had a positive Subjective Norm and 39.8% had perceived they had a high control over their behaviour. Females, and high educational status were predictors for high intention to practice PPMs (OR = 1.59, 95% CI = 1.01-2.52 and OR = 2.72, 95% CI = 1.44-5.16 respectively). Further predictors included Attitudes, Subjective Norm and Perceived Behavioural Control. Results also show that intention to practice was significantly associated with a lower odd of practicing PPMs (OR = 0.06, 95% CI = 0.04-0.10).

Conclusion

Current findings highlight the need to continue with public health efforts targeting vulnerable older adults. Also, the fact that intention negatively predicted practice highlights the need for further behavioural epidemiological studies addressing the intention-behaviour gap.

Application of the extended theory of planned behavior to predict dentist intention and behavior in providing caries preventive care for preschool children

BACKGROUND

Various studies show a gap between evidence-based recommendations and the preventive practice of dentists. This study aimed to create and assess an extended Theory of Planned Behavior (TPB) model on dentists' intentions to do caries preventive measures and related barriers experienced by dentists.

METHODS

A total of 362 general dentists from 34 Indonesian provinces were included in this study. A self-administered online questionnaire consisted of three sections: dentist characteristics and practice pattern, TPB questionnaire, and dentist perceived behavior regarding preventive care for pediatric patients. The questionnaire was distributed and the data was analyzed through structural equation modeling.

RESULTS

TPB's extended version is a fit and relevant model, explaining 55.3% of dentists' intentions to undertake preventive procedures and 17.8% of preventive practices. Perceived behavioral control was the most powerful predictor of intention (44.2%) and practice (8.8%), while parental barriers were the most significant barrier to provide preventive care (18.9%).

CONCLUSION

Extending the TPB by taking barriers from multiple stakeholders as a consideration has a higher predictive level for preventive practices. Each barrier should be addressed through oral health programs and policies, and dentists must be taught to overcome these barriers (through formal or continuing education) in order to maximize caries prevention strategies.

A model of purchase intention of complementary and alternative medicines: the role of social media influencers' endorsements

BACKGROUND

Social Media Influencers (SMIs) are a fashionable way of marketing products by creating electronic word-of-mouth (e-WOM) on social media. The marketing of complementary and alternative medicines (CAMs) by SMIs is becoming increasingly popular and gaining credibility within consumers on social media platforms. Nonetheless, advising about healthcare products on social media should be examined as it is different from endorsing other kinds of commercial products. The aim of this study is to develop a model that provides the underlying mechanisms of the stimuli of SMIs on social media towards consumers' purchase intention of CAMs.

METHODS

This study used best fit framework synthesis methods to develop the model. A priori theory selection was conducted by identifying a BeHEMoTh strategy (Behavior of Interest, Health context, Exclusions and Models or Theories) to systematically approach identifying relevant models and theories relative to the research aim. Further evidence derived from primary research studies that describe the behavior identified is coded against selected a priori theory to develop the model.

RESULTS

This study presents a novel model for understanding the purchase behavior of CAMs using SMIs as a marketing strategy. The model included two well-known theories (theory of planned behaviour theory and source credibility theory) as well as extensive existing research from a multidisciplinary perspective. The model is exclusively designed to help identify elements affecting perceived source credibility and factors that have an influence over consumers' preferences to purchase CAMs by taking into consideration SMIs' endorsements.

CONCLUSIONS

This study provides unique insights introducing new research areas to health literature and offers, new roles for healthcare professionals in this digital era by gaining new skills and competencies required to provide more credible and accurate information about CAMs. The study also highlights the new marketing era of online health-related product endorsements and recommends that policymakers and researchers carefully evaluate the impact of SMI's on the use of CAMs, as well as to regulate the content of these promotional materials.

Understanding the perceptions of sedentary college students' engagement in physical activity: application of the theory of planned behavior

OBJECTIVE

To understand salient beliefs related to physical activity (PA) in sedentary college students.

PARTICIPANTS

Thirty-seven students from a large research university participating in a larger research project were subsequently invited to participate in small focus groups.

METHODS

Using the Theory of Planned Behavior as a framework, semi-structured focus groups were conducted to understand the perceptions of using mobile technology as a tool to increase PA.

RESULTS

A grounded theory approach revealed that students generally had positive attitudes about PA and relied heavily on social support as a facilitator of PA behavior change. The structured exercise program delivered via the mobile app increased perceived behavioral control. Other key findings include academic barriers, desire to avoid chronic disease, and inconsistent efficacy of the mobile application among this population.

CONCLUSIONS

Interventions designed to increase PA in this population should focus on structured activity, increased self-monitoring, positive outcome expectancies, and social support.