Adopting an Extended Theory of Planned Behaviour to Examine Buying Intention and Behaviour of Nutrition-Labelled Menu for Healthy Food Choices in Quick Service Restaurants: Does the Culture of Consumers Really Matter?

This research aims to examine an extended model of the Theory of Planned Behaviour (TPB) to understand the determinants of consumers' intentions to buy and recommend nutrition-labelled menu (NLM) items for making healthy food choices. The research examines the influence of attitude towards behaviour (ATT), subjective norms (SNs), perceived behavioural control (PBC) and health consciousness on consumers' intentions to buy and recommend NLM. The research also examines the role of culture in shaping buying and recommendation intentions of NLM by undertaking a comparative study of the extended model among consumers in two different countries that have enough variation based on Hofstede's cultural dimensions, i.e., the Kingdom of Saudi Arabia (KSA) and the United Kingdom (UK). The results of questionnaire surveys analysed with SmartPLS version 4 showed that ATT, SNs and health consciousness significantly predict intentions to buy NLM items among KSA consumers in quick service restaurants (QSRs). However, PBC did not have a significant influence on KSA consumers' intentions to buy NLM items. On the other hand, ATT, PBC and health consciousness significantly predict intentions to buy NLM items among UK consumers in QSRs. Nonetheless, SNs did not have a significant influence on UK consumers' intentions to buy NLM items. The intention to buy NLM significantly predicts the intentions to recommend NLM among consumers in both countries (KSA and UK). The results of a multi-group analysis showed significant differences between the KSA and the UK regarding the influence of both SNs and PBC on consumers' intentions to buy NLMs as well as on their indirect influence on intentions to recommend NLM items. The results value the role of culture in shaping consumers' intentions to buy and to recommend NLM items for healthy food choices, which has numerous implications for international QSRs, policy makers, and academics.

Integrating the Theory of Planned Behavior and Bonding Social Capital to Examine Chinese Women's Tampon Use Intentions

This study integrates the theory of planned behavior with a structural approach to examining social capital to investigate how bonding social capital affected Chinese women's tampon use intentions. Bonding social capital was operationalized as network closure, which included two main dimensions: density and hierarchy. Results from an online survey (N = 766) showed that network density was positively associated with attitudes toward, social norms about, and perceived behavior control around tampon usage, while network hierarchy negatively predicted attitudes only. Moreover, the indirect effects of network density on tampon use intentions were mediated by descriptive norms and perceived behavior control. Examining women's intentions to adopt a rarely used product in China, this study extended the theory of planned behavior into the realm of social capital in an understudied context. The findings provide practical implications for health communication practitioners in public education concerning feminine hygiene products and gynecological health.

[Micronutrient Powders Feeding Behaviors of Baby Caregivers in Remote Rural Areas of Sichuan Province: A Study Based on the Theory of Reasoned Action]

Objective

To explore the status quo and influencing factors of feeding behaviors of micronutrient powders (MNP), or yingyangbao in Pinyin, the Chinese Romanization system, of baby caregivers in remote rural areas of Sichuan Province.

Methods

In 2019, caregivers of babies aged 6 to 24 months from 6 counties of Sichuan Province were selected as the respondents of the survey through a multistage cluster random sampling method. Data concerning the baby caregivers' attitude of behavior, subjective norms, behavioral intention, and feeding behaviors about MNP feeding were collected with a questionnaire through a structured interview. Based on the theory of reasoned action, a structural equation model was constructed to explore the influencing factors of feeding behaviors.

Results

A total of 1002 valid samples were included in the study. The effective feeding rate of MNP among the baby caregivers was 55.49%. The results of model analysis suggested that attitude of behavior ( β direct=0.212, 95% CI: 0.105-0.327), subjective norm ( β direct=0.123, 95% CI: 0.016-0.228), and behavioral intention ( β direct=0.162, 95% CI: 0.093-0.224) could have a significant direct impact on MNP feeding behaviors. Behavior attitude ( β indirect=0.044, 95% CI: 0.023-0.073) and subjective norms ( β indirect=0.018, 95% CI: 0.001-0.040) could have a significant indirect impact on MNP feeding behaviors through the intermediary of behavioral intention. Among the three theoretical elements, attitude of behavior had the largest total effect on the feeding behavior ( β total=0.256, 95% CI: 0.148-0.366).

Conclusion

The effective feeding rate of MNP among baby caregivers in remote rural areas of Sichuan Province is low. The attitude of behavior and subjective norms of caregivers may have a direct impact on their feeding behavior, and both attitude of behavior and subjective norms can have an indirect impact on the feeding behavior through the intermediary of behavioral intention. The influence of attitude of behavior attitude on feeding behavior is greater than that of subjective norms. Future intervention plans for promoting effective MNP feeding should incorporate health education for baby caregivers and their important social relations. Thus, baby caregivers' attitude and willingness for MNP feeding will be strengthened and the effective feeding rate of MNP will be improved accordingly.

Do environmental knowledge and green trust matter for purchase intention of eco-friendly home appliances? An application of extended theory of planned behavior

This study aims to identify the determinants of consumers' intentions to buy eco-friendly appliances for their households. This research scrutinizes the linkage between environmental knowledge (EK), consumer attitude (CAT), green trust (GT), and purchase intention (PI) in an emerging economy's context. This study analyzes survey data from 331 Pakistani consumers using energy-efficient household products. SEM is employed to assess the formulated hypotheses. Empirical findings suggest that EK positively and significantly influences CAT and green trust. Similarly, CAT has a negative and insignificant influence on PI. In contrast, green trust is significantly and positively related to PIs. The research outcomes further disclose that perceived consumer effectiveness (PCE) and perceived behavioral control (PBC) positively influence PI. The study extends the B2B sales literature and suggests future directions for academics and practitioners.

Impact of adverse events during community-wide mass drug administration for soil-transmitted helminths on subsequent participation-a Theory of Planned Behaviour analysis

BACKGROUND

Experiencing adverse events (AEs) during mass drug administration (MDA) could affect participation in future MDAs. This study aims to understand the potential influence of AEs during a community-wide MDA (cMDA) trial for soil-transmitted helminths (STH) in India on intention to participate in future cMDAs.

METHODS

This study was conducted using a multi-method quantitative and qualitative approach among 74 participants who experienced an AE during STH cMDA and the 12 participants who subsequently refused cMDA treatment of the ongoing DeWorm3 trial. Path analysis and thematic analysis guided by the Theory of Planned Behaviour, was used.

PRINCIPAL FINDINGS

Among 74 individuals who reported an AE, 12% refused treatment in the cMDA immediately subsequent to their AE and 4% refused in all subsequent cMDAs. Of these 74 individuals, 59 (80%) completed a survey and eight participated in in-depth interviews. A positive attitude towards deworming and perceived ability to participate in cMDA (perceived behavioural control) were significant predictors of intention to participate in cMDA (p<0.05). A positive attitude towards cMDA was associated with caste (χ2 = 3.83, P = 0.05), particularly among the scheduled caste/scheduled tribe (SC/ST) (62%). Perceived behavioural control in cMDA participation was associated with occupation (χ2 = 5.02, P<0.05), with higher perceived control among those engaged in skilled occupations (78%). Intention to participate in subsequent cMDAs was associated with caste and family type (χ2 = 3.83, P = 0.05 and χ2 = 7.50, P<0.05 respectively) and was higher among SC/ST (62%) and those with extended families (67%). In-depth interviews demonstrated that perceived severe AEs may lead to treatment refusal in future, particularly if children were affected.

CONCLUSIONS

Intention to participate in future STH cMDAs was associated with caste (SC/ST) and family type (extended families). Therefore, community mobilization messages about potential AEs and their management may need to intentionally target non-SC/ST households, nuclear families, and those engaged in unskilled occupations to increase cMDA participation given the possibility of AEs occurring.

TRIAL REGISTRATION

NCT03014167, ClinicalTrials.gov.

Applying the theory of planned behavior to investigate type 2 diabetes patients' intention to receive injection therapy

Objectives

This study applied the theory of planned behavior (TPB) in shared decision making (SDM) to understand behavioral intention in patients with type 2 diabetes with regard to injection therapy for blood sugar control.

Methods

A cross sectional study was conducted. Two hundred and fifty-four patients with type 2 diabetes participated this study and were interviewed by pharmacists in different clinics. A patient decision aid (PDA) entitled "Should I receive injection therapy regarding my type 2 diabetes condition?" was developed for this study and served as interview agenda which comprised 18 items to inquire their willingness to use injection therapy and related considerations during the SDM process.

Results

The questionnaires were revised using item analysis, exploratory factor analysis, and a criteria of Cronbach's α > 0.7. This resulted in three constructs for all questionnaires that fit the TPB model. Attitude (β = 0.432; P < 0.001) and PBC (β = 0.258; P < 0.001) were directly correlated with intention. TPB explained 35.2% of the variance in intention toward the use of injection therapy.

Conclusions

Attitude and PBC toward injection therapy positively and significantly influence the patients' intention to use injection therapy.

Practical implications

These findings identify a key association for understanding behavioral intention in patients with type 2 diabetes with regard to blood sugar control during SDM.

Barriers to family planning use in the Eastern Democratic Republic of the Congo: an application of the theory of planned behaviour using a longitudinal survey

OBJECTIVE

In the Democratic Republic of the Congo, there is a low adherence of the population to the use of family planning (FP) due to various social barriers. This study aimed to understand the drives from social barriers to the use of FP in women in the Kivu, a region particularly affected by poverty and many years of conflicts. A theory of planned behaviour (TPB) using a generalised structural equation modelling has been applied to understand the complex sociocultural drivers to the intention and the ultimate decision to use FP.

DESIGN

Longitudinal study.

SETTING

A community-based approach was used to investigate FP use in the North and South-Kivu regions.

PARTICIPANTS

Overall, 1812 women 15 years and older were enrolled in the baseline study and 1055 were retrieved during the follow-up.

PRIMARY AND SECONDARY OUTCOMES

FP use and intention to use FP.

RESULTS

The mean age was 36±12.9 years, with a minimum of 15 years old and a maximum of 94 years old. Among sexually active participants, more than 40% used a modern contraceptive method at the last sexual intercourse. Education was positively and significantly associated with intention to use FP (β=0.367; p=0.008). Being married was positively and marginally significantly associated with intention to use FP (β=0.524: p=0.050). Subjective norms were negatively and significantly associated with intention to use FP (β=-0.572; p=0.003) while perceived control was positively associated with intention to use FP (β=0.578; p<0.0001). Education and perceived control were positively and significantly associated with the use of FP (respectively, β=0.422, p=0.017; and β=0.374; p=0.017), while Intention to use FP was positively and marginally significantly associated with the use of FP (β=0.583; p=0.052).

CONCLUSION

TPB helped understand sociocultural barriers to FP use and it can be useful to define adapted strategies in different contexts.

Assessing the impact of entrepreneurial education activity on entrepreneurial intention and behavior: role of behavioral entrepreneurial mindset

This study explores the relationship between Entrepreneurship Education (EE) and Entrepreneurial Intentions (EI) using the Theory of Planned Behavior (TPB). From January through May of 2022, students from 10 Chinese institutions were surveyed using an online questionnaire. According to the research, students' EI scores rose significantly after participating in EE. In addition, students in China had a more significant impact on EI regarding factors like perceived feasibility and desirability. This study extends the body of knowledge about the connection between prior exposure and early intervention (EI) by demonstrating the beneficial effects of PE on EI. In addition, the results suggest that girls have lower EI than males, which is good news for gender equality. Lastly, the behavioral entrepreneur attitude has a favorable correlation with EI. Policymakers and university administrators might use the findings to understand better how and when extracurricular activities (EE) improve students' emotional intelligence (EI). A pioneering empirical study in a developing South-Asian setting shows the relevance of EE on EI among students at private universities. According to the study, EE generates EI, and entrepreneurial enthusiasm is crucial.

Shot Talk: Development and Pilot Test of a Theory of Planned Behavior Campaign to Combat College Student COVID-19 Vaccine Hesitancy

Among college students, evidence of relatively lower levels of concern of COVID-19 infection, rapid rates of transmission, and lagging vaccination rates substantiates a need to combat college student COVID-19 vaccine hesitancy. This two-phase study comprised formative research, development, and pilot testing of a campaign to combat COVID-19 vaccine hesitancy among college students. In phase one, focus group discussions with college students (N = 48) uncovered their specific attitudes, subjective norms, and perceived behavioral control toward the COVID-19 vaccine. Thematic analysis revealed concerns about vaccine safety, efficacy, cost, and politicization, as well as perceived barriers to accessing information and the vaccine itself. Guided by formative research from phase one and the theory of planned behavior, phase two comprised campaign development and pilot testing. Participants (N = 30) completed a pretest and posttest survey assessing TPB constructs and awareness of information toward COVID-19 vaccination surrounding a two-week peer-to-peer campaign called Shot Talk. Results revealed increases in safety-related attitudes, perceived behavioral control, and awareness of information regarding COVID-19 vaccination. Practical implications for theory-driven campaigns and strategic messaging for primary COVID-19 vaccination and beyond are discussed.

Predicting the Protective Behavioral Intentions for Parents with Young Children Living in Taipei City and New Taipei City Using the Theory of Planned Behavior for Air Polluted with PM2.5

While studies on the damaging effects of PM2.5 air pollution are abundant, studies seeking to understand the factors that influence human behaviors for the avoidance of exposure to PM2.5 are lacking. Theory of Planned Behavior (TPB) can be used to investigate the effects of Attitudes (AT), Subjective Norms (SN), and Perceived Behavioral Controls (PBC) in the Behavioral Intentions (BI) of parents with young children against exposure to PM2.5. Questionnaires, based on the TPB used to predict BI, were distributed to 610 parents in Taipei City and New Taipei City. Our results revealed that the AT of both groups had a significant positive predictive effect on their PBC and BI. While the SN of the Taipei group affected BI directly, there was no significant effect on the BI from the SN of the New Taipei group. Using path analysis, Taipei City and New Taipei City groups had different BI paths: All five hypotheses are statistically significant and form four paths in the Taipei City group. While only four hypotheses in the New Taipei City group formed three paths and no path for SN-BI. Both groups formed behaviors that were based on the SN/PBC around them, which ultimately contributed to the BI of their protective behaviors.

A Structural Model for Aggression in Middle School Students in Korea: Based on Ajzen's Theory of Planned Behavior

(1) Purpose: The purpose of this study was to construct a hypothetical model for the variables that can explain aggression in middle school students in order to promote mental health and the growth and development of middle school students in Korea. Through this model, we tried to confirm the structural relationship between the variables and their influence. (2) Methods: The subjects of this study were middle school students in the Korean city of D, and the data collection period was from July to September 2016. The data were collected from the final 310 completed copies of the questionnaire, excluding 23 copies with insufficient data. SPSS 26.0 and AMOS 26.0 were used for data analysis. (3) Results: The fit indices of the final model (GFI = 0.88, AGFI = 0.84, IFI = 0.95, CFI = 0.95, SRMR = 0.06, and RMSEA = 0.07) met the acceptable levels. The variables that affected middle school students' aggression were parenting behavior and aggression regulation intention, and together, their explanatory power for aggression was 50.5%. Perceived behavioral control was the most influential variable for aggression regulation intention. (4) Conclusions: The results of this study will be used as a basis for studying aggression and developing aggression control training programs with the aim of reducing aggression in middle school students.

Applying a Combination of SEM and fsQCA to Predict Tourist Resource-Saving Behavioral Intentions in Rural Tourism: An Extension of the Theory of Planned Behavior

How to save resources and protect the environment at destinations is one of the hot issues in tourism. One effective solution is to cultivate tourist resource-saving behavioral intentions (TRSBI). Prior studies mainly use Structural equation modeling (SEM) to explore its antecedents, whereas other potential methods (i.e., fuzzy-set qualitative comparative analysis, fsQCA for short) have been less adopted. This study combines SEM and fsQCA to examine TRSBI in a rural tourism context. Specifically, SEM is executed to investigate how environmental concern influences TRSBI based on the theory of planned behavior (TPB), while fsQCA is applied to uncover the multiple configurations in the TRSBI formation. The findings from SEM indicated that (1) environmental concern positively and directly influenced TRSBI; (2) TPB constructs (i.e., attitudes toward the behavior, subjective norms, and perceived behavioral control) positively and separately mediated the associations of environmental concern with TRSBI. The fsQCA outcomes showed that three configurations result in a high level of TRSBI: (1) high attitudes toward the behavior, subjective norms, and perceived behavioral control, (2) high attitudes toward the behavior, subjective norms, and environmental concern, and (3) high attitudes toward the behavior, perceived behavioral control, and environmental concern. The combined approaches offer a systematic and holistic solution to explore TRSBI in rural tourism.

Mobile phone use among truck drivers: The application and extension of the theory of planned behavior

Commercial truck drivers are particularly exposed to the risks associated with distracted driving, especially with mobile phone use while driving (MPWD), due to their higher driving exposure (DE) (e.g., high driving frequency, long driving hours and distance). However, despite being identified as one of the major causes in truck crashes, truck drivers' MPWD behavior has received little attention. In the current work, the theory of planned behavior (TPB), extended with DE, was applied to explore the determinants of MPWD among commercial truck drivers in China and examine the correlations between drivers' DE and psychological factors. We conducted an Internet survey and collected 420 valid questionnaires, which measured truck drivers' 5 standard TPB variables, DE and demographics. Structural equation modelling was used to analyze the data from the survey. The results showed strong support for the application of the proposed TPB model in explaining truck drivers' MPWD behavior. Specifically, truck drivers' behavioral intention (BI) had the greatest direct positive effect on MPWD behavior, while perceived behavioral control (PBC) had no direct positive effect. Moreover, PBC, attitude (ATT) and DE were significantly and positively associated with BI, while subjective norm was insignificant. As expected, DE has significant positive effects on truck drivers' psychological factors underlying MPWD behavior, especially on ATT and PBC, indicating that truck drivers with higher DE tend to have more positive attitudes toward MPWD and feel more confident about performing this risky behavior. These results may have notable practical implications in providing theoretical support for management and intervention of commercial truck drivers.

Salient beliefs and intention to use pre-exposure prophylaxis among pregnant and breastfeeding women in Zambia: Application of the Theory of Planned Behaviour

Primary HIV prevention is a priority for pregnant and breastfeeding women in sub-Saharan Africa; however, such services should be designed to optimise uptake and continuation. Between September and December 2021, we enrolled 389 women who were not living with HIV into a cross-sectional study from antenatal/postnatal settings at Chipata Level 1 Hospital. We used the Theory of Planned Behaviour to study the relationship between salient beliefs and intention to use pre-exposure prophylaxis (PrEP) among eligible pregnant and breastfeeding women. On a seven-point scale, participants had positive attitudes towards PrEP (mean = 6.65, SD = 0.71), anticipated approval of PrEP use from significant others (mean = 6.09, SD = 1.51), felt confident that they could take PrEP if they desired (mean = 6.52, SD = 1.09) and had favourable intentions to use PrEP (mean = 6.01, SD = 1.36). Attitude, subjective norms, and perceived behavioural control significantly predicted intention to use PrEP respectively (β = 0.24; β = 0.55; β = 0.22, all p < 0.01). Social cognitive interventions are needed to promote social norms supportive of PrEP use during pregnancy and breastfeeding.

Research on the impact mechanism of enterprise green technology innovation based on the analysis framework of theory of planned behavior: evidence from heavily polluting listed enterprises in China

Under the background of China's ecological civilization construction, enterprises green technology innovation (GTI) has attracted more and more attention. In this paper, the internal factors and external factors, subjective factors, and objective factors of each relevant subject are comprehensively considered, and the analysis framework of the impact mechanism of enterprise GTI is constructed. Then, taking 211 heavily polluting listed enterprises in China from 2010 to 2019 as the sample, integrating the mediating effect model and the moderating effect model, this paper empirically discusses the relationships among corporate endowments, executive characteristics, and enterprise GTI. The results demonstrate that corporate endowments have a positive impact on GTI, and executive characteristics act on GTI as a mediating variable during the impact process; market forces respectively play a weakening and strengthening role in moderating the main effect and the intermediate effect; government intervention and social background have positive moderating effects on the relationship between executive characteristics and GTI; the three moderating variables have a remarkable joint-moderating effect on the relationships between executive characteristics and GTI.

Decision-Making in Virtual Reality Sports Games Explained via the Lens of Extended Planned Behavior Theory

This study aims to determine whether the effect of interactivity on participation in virtual sports has risen because of the COVID-19 pandemic and if there is a difference in decision-making. The significance of social factors may be highlighted even more as a rationale for using virtual reality (VR) sports apps throughout the prolonged COVID-19 epidemic. A model was built based on the literature to describe the intention to participate in VR sports, and eight associated hypotheses were established. A sample of 301 submissions from a user poll on Korea's cycling information sharing website was used for our analysis. SPSS 23.0 (IBM, Armonk, NY, USA) and AMOS 18.0 (IBM, Armonk, NY, USA) were used to validate Hypotheses 1-8 using a multigroup structural equation model (SEM) analysis and multigroup analysis. Although some hypotheses were not validated, the impact of perceived interaction presented as an extra variable altered based on the group participating before and after the COVID-19 epidemic, and the study's goal was achieved. Given that information technology has evolved by overcoming physical space and socio-cultural constraints to create a society that connects people, the importance of online interaction, such as networking and competition between users, will be emphasized in the VR sports field in the future.

Prediction of Helmet Use Behavior among Motorcyclists Based on the Theory of Planned Behavior

BACKGROUND

Road traffic injuries (RTIs) are one of the most critical factors that endanger human health. More specifically, head and neck injuries are the main causes of deaths and disabilities among motorcyclists. This study aimed to investigate the predictive factors of helmet use behavior among motorcyclists based on the theory of planned behavior (TPB).

STUDY DESIGN

This study followed the cross-sectional design.

METHODS

This study was conducted on randomly selected 730 motorcyclist employees in Qom, Iran, in 2021. The data collection tool was a self-administered researcher-made questionnaire, including items on demographic characteristics, history of RTIs, and constructs of TPB. Data were analyzed using descriptive summary statistics, analysis of variance, independent samples t test, Pearson correlation coefficient, and structural equation modeling (SEM).

RESULTS

In this study, only 9.8% of the participants reported that they always used a helmet while riding a motorcycle. About 60% reported a history of a motorcycle crash, and 11.5% had a history of head injuries. The direct effect of attitude, subjective norms, and perceived behavioral control on the intention to use a helmet were statistically significant, explaining 59% of the variation in behavioral intention (intention to use a helmet) (R2=0.59). Moreover, perceived behavioral control and behavioral intention had significant effects on helmet use behavior (R2=0.26).

CONCLUSION

The prevalence of helmet use among the studied population was very low. Moreover, TPB was useful in identifying the determinants of behavior and especially behavioral intention of helmet use among motorcyclists.

Factors Contributing to Citizens' Participation in COVID-19 Prevention and Control in China: An Integrated Model Based on Theory of Planned Behavior, Norm Activation Model, and Political Opportunity Structure Theory

Chinese citizens' participation in COVID-19 prevention and control has made great contributions to the successful fight against the pandemic. The factors that have impacted citizens' participation have rarely been reported based on both social-psychological and political environmental theories. This paper presented a study to explore the determinants of Chinese citizens' participation in COVID-19 prevention and control based on a combined model of the theory of planned behavior, the norm activation model, and political opportunity structure theory. A dataset involving 463 respondents from Harbin in northeast China was acquired and analyzed. The results showed that the comprehensive model explained 62.9% of the total variance in citizens' participation behavior. The openness to public participation not only significantly directly influenced citizens' participation but also indirectly affected participation behaviors through attitude and perceived behavioral control, both of which were important mediators and had the greatest overall impacts. The awareness of consequences and subjective norms were crucial antecedents to the activation of other influencing factors. Personal norms indirectly affected participation behavior through the mediation of attitude. The empirical results showed the comprehensiveness, effectiveness, and high explanatory power of the postulated model. The study also provides both new theoretical perspectives for explaining public participation and useful practical implications for future policy development in promoting citizens' participation in public health emergency management.

Predictors of return to work and psychological well-being among women during/after long-term sick leave due to common mental disorders - a prospective cohort study based on the theory of planned behaviour

Common mental disorders are associated with long-term sick leave, especially among women. There is a lack of theory-based research regarding the impact of personal factors on return to work and psychological well-being. Therefore, the aim of this study was to examine whether return-to-work beliefs and perceived health were predictors of return to work and psychological well-being among women during or after long-term sick leave for common mental disorders, based on the Theory of Planned Behaviour. This was a prospective cohort study with a 1-year follow-up. At baseline, women (n = 282) had been on full- or part-time sick leave for common mental disorders for 2-24 months. Data were collected in October 2019-January 2020 and October 2020-January 2021 in Sweden. The Social Insurance Agency identified the women at baseline. The Return-To-Work Beliefs Questionnaire, EuroQol Visual Analogue Scale and General Health Questionnaire-12 were used. Multiple logistic and linear regression analyses were conducted. The women were divided into two groups: full-time sick leave or part-time sick leave at baseline. The results showed that stronger return-to-work intention significantly predicted return to work among women on full-time sick leave at baseline. No significant predictors of return to work were found among women on part-time sick leave at baseline. Psychological well-being was predicted by stronger social pressure to return to work (full-time group) and a more positive attitude toward returning to work and better perceived health (part-time group). We concluded that the Theory of Planned Behaviour can be useful for understanding return to work among women on full-time sick leave, and what underlies psychological well-being in both groups. However, return to work and psychological well-being were predicted by different factors, indicating that a multifactorial approach should be used in supporting women to return to work after long-term sick leave for common mental disorders.

Predicting physical activity among adults with visual impairments using the theory of planned behavior

BACKGROUND

Using the theory of planned behavior (TPB), Haegele et al.1 created the beliefs of individuals with visual impairments about physical activity scale (BIVIPA-1) to examine individuals with visual impairments' (VI) motivation toward physical activity (PA). The overall factorial tenability of the BIVIPA-1 remains unclear due to its item configuration.

OBJECTIVE/HYPOTHESIS

The purposes of this cross-sectional study were to: (a) use confirmatory factor analysis to explore the structure of the expanded BIVIPA-2 and (b) test the predictive utility of TPB constructs on PA among adults with VI.

METHODS

Adults with VI (n = 236) completed the BIVIPA-2 and a multi-item PA recall instrument. A CFA was performed on the BIVIPA-2, and structural equation modeling was used to explore the relationship between theory constructs and PA.

RESULTS

The CFA results showed that the underlying structure of BIVIPA-2 was tenable for adults with VI based on TPB. Structural equation modeling showed limited support for the theorized predictive roles of theory variables on PA, as attitude predicted physical activity intention. Interestingly, subjective norm was a direct predictor for PA among adults with VI (β = 0.145).

CONCLUSIONS

TPB had limited predictive utility for physical activity among individuals with VI. The predictive relationship of subjective norms on PA may be somewhat unique to this population. Researchers may consider expanding the model to examine social support and subjective norms constructs and PA among individuals with VI.

Predictors of Medication Adherence of Patients With Coronary Heart Disease After Percutaneous Coronary Intervention: A Structural Equation Modeling Based on the Extended Theory of Planned Behavior

BACKGROUND

The theory of planned behavior (TPB), combined with social support, forms the extended TPB, which has shown to predict adherence to health-related behavior effectively, but few studies have applied it to explain medication adherence in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).

OBJECTIVES

The aim of this study was to explore the factors associated with medication adherence and the underlying mechanisms based on the extended TPB among patients with CHD after PCI.

METHODS

A cross-sectional descriptive study was conducted among patients with CHD after PCI in 2 major hospitals in Guangzhou, China. Medication adherence was measured with the Medication Adherence Report Scale. Constructs of the TPB contributing to medication adherence were assessed by the Theory of Planned Behavior Questionnaire for Medication Adherence. Social support was measured by the Multidimensional Scale of Perceived Social Support. Structural equation modeling was used to examine the hypotheses based on the extended TPB.

RESULTS

A total of 300 patients were surveyed and 26.0% of them were nonadherent. The structural equation modeling had good fit indices and estimated 62.6% of the variance in medication adherence. Regarding the relationships between the extended TPB constructs and medication adherence, "intention" was directly associated with medication adherence, and "perceived behavioral control" positively predicted medication adherence directly and indirectly. "Affective attitude" and "subjective norm" were indirectly associated with medication adherence through "intention." Social support exerted an indirect effect on medication adherence through "subjective norm."

CONCLUSIONS

The extended TPB is an appropriate model to predict medication adherence and provides an effective framework for adherence-enhancing interventions.

COVID-19 vaccine uptake and hesitancy survey in Northern Ireland and Republic of Ireland: Applying the theory of planned behaviour

The Coronavirus Disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first appeared in Wuhan, China in late 2019 and since then has caused unprecedented economic and social disruption as well as presenting a major challenge to public health. Despite mass progress in COVID-19 vaccination uptake, vaccine hesitancy or anti-vax information has been reported that can delay public acceptance of a vaccine. An online cross-sectional survey (n = 439) assessed COVID-19 vaccine uptake and hesitancy in adults in Northern Ireland and the Republic of Ireland. Participants completed an adapted version of the Theory of Planned Behaviour Vaccine Questionnaire, the Vaccine Attitudes Scale (VAX), Vaccine Confidence Scale, and questions on previous experience of COVID-19. Results showed that 66.7% of the sample intended to get a vaccination as soon as possible, 27.15% reported they will get a vaccine when others get theirs and when it is clear there are no side effects. 6.15% had no intention of getting a vaccine. Overall, there is a high mean intention (M = 6.12) and confidence to get a COVID-19 vaccine. There was low vaccine hesitancy (M = 2.49) as measured by the VAX scale. A further analysis of the sub factors of the VAX showed there is uncertainty and mistrust of side effects for children. The finding demonstrate that the Theory of Planned Behaviour can be useful in making recommendations for public health considerations when encouraging vaccine uptake and reducing vaccine hesitancy.

Intention to use institutional delivery service and its predictors among pregnant women, North West Ethiopia: Using theory of planned behavior

BACKGROUND

Improving institutional delivery service is the most crucial strategies to reduce maternal and neonatal mortalities. In developing countries, only 50% of pregnant women deliver in health facilities and in Ethiopia only 48% of pregnant women deliver in health facilities. Maternal mortality remains the highest in Ethiopia. This study assessed intention to use institutional delivery service and its predictors among pregnant women using theory of planned behavior.

METHODS

Community-based cross-sectional study was conducted among 645 Yilmana Densa District Pregnant women using multi-stage followed by cluster sampling technique. Data were entered into Epi Data version 4.6.0.2 and analyzed with STATA version 14. Binary logistic regression analysis was done to identify independent predictors of intention at 95% confidence level and P < 0.05 was used to determine statistically significant predictors.

RESULTS

Intention of pregnant women to use institutional delivery service was 74.3% (CI; 70.71%, 77.6%). In the multivariable logistic regression; those who had 1-3 and 4 &above antenatal care 2.85(1.41, 5.75) and 3.14(1.16, 8.45) respectively, those who had past experience of institutional delivery (AOR = 3.39, 95%CI: 1.72, 6.71), parity of 1-3 and 4 & above % (AOR = 0.37, 0.19, 0.71) and (AOR = 0.25, 95%CI: 0.12, 0.55) respectively, rural residence (AOR = 0.51, 95%CI: 0.27, 0.96), favorable attitude (AOR = 2.93, 95%CI: 1.56, 5.50), favorable perceived behavioral control (AOR = 2.60, 95%CI: 1.44, 4.69) were factors significantly associated with intention to use institutional delivery service.

CONCLUSION AND RECOMMENDATION

Majority of the pregnant women were intended to deliver in the institution. Good Knowledge on institutional delivery, antenatal care visit, past experience of institutional delivery, rural residence, parity, attitude and perceived behavioral control were identified factors significantly associated with intention to use institutional delivery service. So, strengthening awareness creation and behavioral change communication programs are required at all levels of health system to raise intention of residents towards institutional delivery.