Perceived benefits and barriers and self-efficacy affecting the attendance of health education programs among uninsured primary care patients

Weight management practices of health center providers in the United States

BACKGROUND

We examined weight management counseling practices of Health Resources and Services Administration-funded health center (HC) providers for patients with overweight (POW) and obesity (POB) status, focusing on weight-related conditions, risk factors, and health care utilization.

METHOD

We used a nationally representative cross-sectional survey of HC patients and multilevel generalized structural equation logistic regression models to assess the association of provider counseling practices for POW and POB and by three obesity classes. Dependent variables included being told by the HC provider that weight was a problem, receiving a diet or exercise recommendation, referral to a nutritionist, or receiving weight loss prescriptions. Independent variables included weight-related conditions such as diabetes and hypertension, risk factors such as smoking, and health service utilization such as five or more primary care visits.

RESULTS

All POB classes had higher odds of receiving all five counseling interventions than POW. Patients with diabetes and high cholesterol had higher odds of diet recommendations (OR = 1.8) and nutritionist referrals (OR = 2.3), while patients with cardiovascular disease had higher odds of nutritionist referral (OR = 2.0) and receiving weight loss prescriptions (OR = 2.6). Respondents with POB class III and diabetes had higher odds of receiving exercise recommendations (OR = 3.4), while POB class 1 and had hypertension had lower odds of nutritionist referral (OR = 0.3).

CONCLUSIONS

Variations in HC primary care providers' weight management counseling practices between POW and POB present missed opportunities for consistent practice and early intervention. Assessing providers' counseling practices for patients with comorbid conditions is essential to the successful management of the obesity crisis.

Challenges for contactless online food delivery services during the COVID-19 pandemic in Taiwan: Moderating effects of perceived government response

The COVID-19 pandemic has affected numerous industries worldwide, altered consumer behavior, and increased demand for contactless online food delivery (OFD) services. COVID-19 information from the government may influence the public's information-seeking behavior regarding OFD services. Thus, exploring the relationship between contactless OFD and consumer perceptions of the government response during the pandemic is essential. This paper probed the effects exerted by three behavioral beliefs, namely health consciousness, self-efficacy, and perceived benefits, on consumers' intention and attitude toward contactless online food delivery (OFD) services. This study explored the moderating impact exerted by perceived government response to the COVID-19 pandemic on the relationship between attitude and intention toward OFD services. The study results indicated that self-efficacy and perceived benefits positively influenced the respondents' attitude toward contactless OFD services. Health consciousness negatively influenced their attitude toward these services. The respondents' attitude toward contactless OFD services to be positively related to their behavioral intention toward such services. Perceived government response to COVID-19 moderated the relationship between respondents' attitude and behavioral intention toward contactless OFD services. Based on the study findings, some suggestions are provided for governments, other relevant agencies, and OFD service providers herein.

Rashid MF, Hod R, Dapari R, Hassan MR. A unique double tango: Construct validation and reliability analysis of risk perception, attitude and practice (RPAP) questionnaire on dengue infection

Introduction/background

Dengue fever remains a public health threat despite being preventable. A solution to the constant problem of dengue infection will require active intervention and a paradigm shift. Assessing perceived risk and correlating it with the attitude and practice of the community will help in designing appropriate measures. However, possible instruments for these assessments come with limitations.

Objective

The aim is to develop and validate a new scoring-based questionnaire, using dual statistical approaches to measure risk perception, attitude, and practices (RPAP) related to dengue in the community.

Methods

The RPAP questionnaire was developed bilingually using the International Society for Pharmacoeconomics and Outcome Research (ISPOR) guidelines. Content analysis was reviewed scrupulously by four expert panels. The initial 35-item scale was tested among 253 Malaysian respondents recruited non-probabilistically via multiple online platforms. Two statistical methods were employed to measure the construct validity: Exploratory Factor Analysis (EFA) as part of the Classical Test Theory (CTT) measurement, while Rasch Measurement Analysis (Rasch) was performed for the Item Response Theory (IRT) measurement. All results were cross-validated with their counterpart to ensure stability. Confirmatory Factor Analysis (CFA) was used to obtain a model fit index.

Results

29 questions were retained after the final analysis. Both EFA and Rasch analysis detect multidimensionality. Nine latent factors were extracted from EFA, while only eight factors remained in the final model following CFA: 1) perceived susceptibility; 2) perceived severity; 3) perceived barrier; 4) perceived benefit; 5) cues to action; 6) self-efficacy; 7) attitude; and 8) practice. All items had adequate factor loadings and showed good internal consistency. The final model after CFA achieved a good fit with an RMSEA value of 0.061, SRMR of 0.068, PNFI of 0.649, and GFI of 0.996.

Conclusion

The RPAP questionnaire contains 29 items and is a reliable and accurate psychometric instrument for measuring the risk perception of dengue fever, attitude, and practice of the community in dengue prevention. The Rasch measurement provides additional rigour to complement the CTT analysis. This RPAP questionnaire is suitable for use in studies related to dengue prevention in the community.

Developing and validating a questionnaire to assess an individual's perceived risk of four major non-communicable diseases in Myanmar

Adopting healthy lifestyles is greatly influenced by an individual's perceived risk of developing non-communicable diseases (NCDs). This study aimed to develop and validate a questionnaire that can assess an individual's perceived risk of developing four major NCDs. We used the exploratory sequential mixed methods design. The qualitative part developed a questionnaire by two rounds of Delphi expert panels. The quantitative part validated the questionnaire using both exploratory (EFA) and confirmatory factor analysis (CFA). We used separate samples for EFA (n = 150) and CFA (n = 210). The participants were aged between 25-60 years of both sexes with no known history of NCDs, and face-to-face interviews were conducted. First, we generated an 86-item questionnaire based on the health belief model. Two expert panels ensured the questionnaire's content validity. The experts removed the overlapped items and items that did not represent the specific construct and developed a 51-item questionnaire. Next, we validated the questionnaire. We conducted a parallel analysis to determine the number of factors to be extracted. EFA constituted a five-factor model with 22 high loading items, which extracted 54% of the variance. We run four CFA models (single factor, five-factor, bifactor, and hierarchical) and tested the hypothesized five-factor model. It was found that the 21-item questionnaire (removed one efficacy item due to low loading) was satisfied with good psychometric properties and fitted with observed data in the bifactor model (RMSEA = 0.051, CFI = 0.954, TLI = 0.938, SRMR = 0.054). Hence, an individual's perceived risk of getting NCDs was constituted with a general perceived risk construct and five specific constructs (perceived susceptibility, perceived barrier, perceived benefit, perceived self-efficacy, and perceived behavioral change intention). It can be measured using the developed questionnaire (NCD-PR5-21). Further research is warranted to assess the questionnaire's utility in a mismatch between risk perception and current risk; and individualized counseling for behavioral change communication.

The Process Of Farmers' Occupational Health Behavior by Health Belief Model: Evidence From Iran

Farm work is considered among the highest risk jobs throughout the world. Occupational health behavior is a critical factor that influences agricultural job-related injuries and diseases. Yet, while educational programs have been set up to encourage farmers to behave more safely, many of these programs do not sufficiently take into account the factors that induce farmers to exhibit risky behavior. The present study aimed to explore the factors underpinning farmers' occupational health behavior using the Health Belief Model (HBM). The study was conducted using aquestionnaire survey of 382 farmers representative of the farmers of Kermanshah province, Iran. The face and content validity of the questionnaire was confirmed by apanel of experts in occupational health, and its reliability by apilot study establishing internal consistency measured by Cronbach's alpha. The results showed that four dimensions of the HBM (perceived susceptibility, perceived benefits, cues to action, and perceived self-efficacy) influence farmers' occupational health behavior (FOHB), with the theoretical model accounting for 54.9% of the variance of FOHB. The findings confirm the potential of the HBM to explain FOHB and the relevance of using the theory in studying farmers' protective behaviors such as the use of chemical pesticides, protection against sunlight, protection of hearing, etc.

Farmers' Preventive Behavior Analysis Against Sunlight Using the Health Belief Model: A Study from Iran

Agriculture is one of the major sources of employment and income in many countries, especially in developing countries. Farmers are exposed to numerous harmful factors such as sunlight and ultraviolet radiation. These factors contribute to multiple diseases including skin cancer. The aim of this study was to analyze the farmer's preventive behavior against sunlight using the Health Belief Model (HBM). This descriptive study was conducted by survey methodology and a questionnaire. The population of the research was composed of farmers in Kermanshah Province (N = 126,900). The sample size was determined as 382 farmers using the Krejcie and Morgan table. The validity of the questionnaire was confirmed by relevant professors and experts, and the reliability was confirmed through a pilot study and the calculation of Cronbach's alpha coefficient, which was estimated at 0.70-0.83. Findings showed that the HBM structures had a significant effect on the farmer's preventive behavior, so that the perceived barriers, susceptibility, severity, benefits, self-efficacy, and cues to action have the strongest impact on the farmer's preventive behavior against sunlight. The results illustrated that components of the HBM were appropriate predictors for farmers' preventive behavior against sunlight.

Understanding High Incidence of Severe Obesity and Very Low Food Security in Food Pantry Clients: Implications For Social Work

The United States is facing two interconnected social and public health crises of severe obesity and food insecurity within the social-ecological environment. Marginalized groups experience the highest rates and the greatest impacts in terms of morbidity, mortality, and financial burdens. Consequences include experiencing multimorbidities, mental health issues, and decreased quality of life. Food pantries have served as spaces to obtain food to meet household needs, but for some, food pantries have become long-term solutions. We surveyed 2,634 people who accessed pantries in 2005, 2010, and 2013 across 32 counties in a Midwest state. The authors sought to understand to what extent does length of time using a food pantry, food security status, income sources, use of federal food benefits, visiting a doctor, and demographic variables increase odds of severe obesity. More than 14% were severely obese; those who were long-term food pantry users and very low food secure were 1.732 times more likely to be severely obese. Receiving Disability/Supplemental Security Income, seeing a doctor in the last year, being female, and older age reduced the odds of severe obesity. Discussion includes implications for social workers who interact with groups likely to experience very low food security and severe obesity at different systems levels.