Theory of Planned Behaviour and Health Belief Model: females’ intention on breast cancer screening

Factors affecting the intention to wear helmets for e-bike riders: the case of Chinese college students

As the popularity of electric bicycles (e-bikes) continues to surge, the number of accidents involving them has commensurately increased. A significant factor contributing to the high fatality rate in these accidents is the low usage of helmets among e-bike riders. Helmets have been proven to reduce the severity of injuries, yet their usage remains unexpectedly low. This issue is particularly pronounced among college students, the primary buyer group for e-bikes. Regrettably, there is a lack of research exploring their intentions to wear helmets. Understanding determinants of their intentions to wear helmets is crucial in promoting safe e-bike travel. Therefore, the present study aims to develop an integrated theoretical model that combines the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM) to examine the factors influencing e-bike riders' helmet-wearing intentions among college students. Additionally, two variables-descriptive norms and law enforcement-are incorporated. The results indicate that the integrated model accounts for 76% of the variance in helmet-wearing intention, surpassing single-theory models. Specifically, the TPB accounts for 65%, while the HBM explains 53%. Notably, law enforcement emerges as the most influential factor, highlighting the crucial role of enforcing regulations and promoting awareness. Other significant factors include subjective and descriptive norms, attitudes, perceived benefits, perceived susceptibility, perceived barriers, and perceived severity. These findings provide valuable insights for policy development and targeted interventions aimed at improving helmet wear rates among e-bike riders, especially among the college student population.

Structural equation models of health behaviour, psychological well-being, symptom severity and quality of life in abdominal bloating

Background

The objective of this study was to investigate the inter-relationship between psychosocial variables and their impact on symptom severity and quality of life (QoL) concerning abdominal bloating.

Methods

The study adopted a cross-sectional design with purposive sampling. Participants who consented and met the criteria for bloating based on the Rome IV classification completed designated questionnaires. Independent variables comprised health beliefs, intentions, health-promoting behaviors, social support, depression, and anxiety, while dependent variables included bloating severity (general and within 24 h) and QoL. Structural Equation Modeling (SEM) was conducted utilizing Mplus 8.0 to analyze the relationships between these factors.

Results

A total of 323 participants, with a mean age of 27.69 years (SD = 11.50), predominantly females (64.7%), volunteered to participate in the study. The final SEM model exhibited good fit based on various indices (CFI = 0.922, SRMR = 0.064, RMSEA (95% CI) = 0.048 (0.041-0.054), p-value = 0.714), with 15 significant path relationships identified. The model explained 12.0% of the variance in severity within 24 h, 6% in general severity, and 53.8% in QoL.

Conclusion

The findings underscore the significant influence of health beliefs, intentions, behaviors, social support, depression, and anxiety on symptom severity and QoL in individuals experiencing abdominal bloating.

Disparities in Mammography Screening: Analyzing Barriers to Access Using Individual Patient Perspectives and the Health Belief Model

OBJECTIVE

The objective of our study is to explore Nepali women's beliefs about access to mammography screening, and motivations to get screened or not. This work was intended to be hypothesis generating for subsequent quantitative analysis and to inform policy and decision-making to improve access.

METHODS

We conducted structured qualitative interviews among nine Nepali women in the Northeast of the United States receiving care at a local community health center and among nine white women receiving mammography care at a large academic medical center in the Northeast. We analyzed the transcripts using a mixed deductive (content analysis) and inductive (grounded theory) approach. Deductive codes were generated from the Health Belief Model which states that a person's belief in the real threat of a disease with their belief in the effectiveness of the recommended health service or behavior or action will predict the likelihood the person will adopt the behavior. We compared and contrasted qualitative results from both groups.

RESULTS

We found that eligible Nepali women who had not received mammography screening had no knowledge of its availability and its importance. Primary care physicians emerged as a critical link in addressing this disparity: trust was found to be high among Nepali women with their established primary care provider.

CONCLUSION

The findings of this study suggest that the role of primary care practitioners in conversations around the importance and eligibility for mammography screening is of critical importance, especially for underserved groups with limited health knowledge of screening opportunities and potential health benefits. Follow-up research should focus on primary care practices.

The use of self-protective measures to prevent COVID-19 spread: an application of the health belief model

This study uses a health belief model to examine the preventive behavioral orientation or self-protective measures adopted by people in the face of the current COVID-19 pandemic. A total of 603 participants were selected from the city of Bangalore, India. The data was collected through an online survey with participants' age varying between 17 and 54 and mean as 23 years (SD = 4.32). The findings revealed that perceived barrier has significant negative impact, while perceived threat, perceived consequences, perceived benefits, community and individual self-efficacy, and general health cues have a positive influence on an individual's intention to follow self-protective measures against COVID-19. Based on the constructs of the health belief model, this study proposes multiple health-related interventions to reduce the spread of COVID-19.

Determinants of Low-Income Women's Participation in Self-Collected Samples for Cervical Cancer Detection: Application of the Theory of Planned Behavior

BACKGROUND

Low-income women (LIW) are underrepresented in physician-provided cervical cancer screening. Providing women with an option for Human Papillomavirus (HPV) self-sampling would increase cervical cancer screening. However, little is known about LIW's attitude towards self-sampling for cervical cancer. We determined the associations between the Theory of Planned Behavior (TPB) constructs and LIW intention for participation in the HPV self-sampling.

METHODS

A 44-item survey was administered among women receiving food from a food pantry in central Texas. Independent variables included TPB constructs (i.e., attitudes, subjective norms, and perceived control). The outcome variables were intentions and preference for self-sampling. Both variables were measured on a 5-point scale. Hierarchical linear regression models were used to analyze the data.

RESULTS

A sample of 241 participants (age 50.13 ± 9.60 years) comprising non-Hispanic White (40%), Black/African American (27%), and Hispanic (30%) participated in the study. The participants were current with a pap test (54.8%) and preferred self-sampling (42%). The participant's attitudes and subjective norms were significantly associated with their intention for self-sampling, accounting for 38.7% of the variance (p < .001). Women who were overdue for pap testing versus current with pap testing had increased odds of preferring self-sampling (OR = 1.72, 95% CI: 1.27, 6.04).

CONCLUSIONS

The key predictors for LIW's intention for self-sampling included attitudes and subjective norms. Future research should use the TPB as a framework to examine whether intention predicts self-sampling behavior among LIW.

Practice, confidence and continuity of breast self-examination among women in Thailand during COVID-19 pandemic: a cross-sectional study

OBJECTIVE

Breast self-examination (BSE) is the most feasible screening tool compared with clinical breast examination and mammography. It is crucial to address the associated factors of practising BSE to develop a targeted BSE promotion programme and improve the BSE quality in Thai women, particularly during the COVID-19 pandemic.

DESIGN AND SETTING

We conducted a cross-sectional study in Thailand's north and northeast region from March 2020 to November 2022.

PARTICIPANTS

This study involved 405 women aged 30-70 years old.

VARIABLES AND OUTCOMES

Demographic information, health status and BSE were collected using a modified questionnaire based on the Champion Health Belief Model. The outcomes were ever-practising BSE, BSE practice within the last 6 months, continuity of BSE and confidence in doing BSE. Logistic regression and decision tree analysis identified the associated factors.

RESULTS

75.55% of participants ever performed BSE. Around 74.18% did BSE within the last 6 months. Diploma graduates (adjusted OR (aOR) 25.48, 95% CI 2.04 to 318.07), 21-40 reproductive years (aOR 4.29, 95% CI 1.22 to 15.08), ever pregnant (aOR 3.31, 95% CI 1.05 to 10.49), not drinking alcohol (aOR 2.1, 95% CI 1.04 to 4.55), not receiving hormone replacement (aOR 5.51, 95% CI 2.04 to 14.89), higher knowledge (aOR 1.29, 95% CI 1.09 to 1.52), attitude (aOR 1.15, 95% CI 1.05 to 1.26) and practice/cues of action towards BSE were associated with ever-practising BSE. Frequent high-fat diet, high awareness of breast cancer, lower knowledge of BSE and lower attitude toward BSE were associated with not practising BSE within 6 months and BSE discontinuation. Only high knowledge of BSE was associated with absolute confidence in BSE (p<0.05).

CONCLUSION

Despite having a higher percentage than other studies in different countries prior to the pandemic, it is still crucial to improve knowledge of BSE to encourage BSE practice, confidence and continuity of BSE in Thai women. Moreover, the BSE campaign should target women with prolonged exposure to oestrogen and sedentary lifestyle.

An extended health belief model for COVID-19: understanding the media-based processes leading to social distancing and panic buying

Building on the health belief model (HBM), this research tests, over six months, how the exposure to COVID-related information in the media affects fear, which in turn conditions beliefs about the severity of the virus, susceptibility of getting the virus, and benefits of safety measures. These health beliefs ultimately lead to social distancing and panic buying. As a first contribution, we find that fear is not directly triggered by the objective severity of a crisis, but rather formed over time by the way individuals are exposed to media. Second, we show that fear affects behaviors through the components of the HBM which relate to the risks/benefits of a situation. Last, we find that critical thinking about media content amplifies the "adaptive" responses of our model (e.g., health beliefs, social distancing) and reduces its "maladaptive" responses (e.g., panic buying). Interestingly, we note that the beneficial effect of critical thinking about media content disappears as the level of fear increases over time. The implications of these findings for policymakers, media companies, and theory are further discussed.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11747-022-00865-8.

Under the COVID-19 Environment, Will Tourism Decision Making, Environmental Risks, and Epidemic Prevention Attitudes Affect the People's Firm Belief in Participating in Leisure Tourism Activities?

The study was conducted to understand the travel intentions of Dajia Matsu pilgrimage participants through tourism decision making, environmental risk perception, epidemic prevention attitude, and physical and mental health assessment. A questionnaire survey was used to collect 230 questionnaires in the field during the 2021 pilgrimage, and structural analysis was conducted using SPSS 26.0 and AMOS 20.0 statistical programs. The results showed that environmental risk and physical and mental health awareness were not significantly associated with the travel intention of Dajia Matsu pilgrimage participants (p > 0.05), while travel decision and attitude toward epidemic prevention were significantly associated with travel intention (p < 0.05).

Determinants of women's decision to undergo early mammography: A survey study

For young women, mammography has limited effectiveness and entails exposure to radiation, discomfort, and additional expense. This study identifies factors associated with women's willingness to undergo mammography despite official guidelines to the contrary. Using the Health Belief Model, we surveyed Israeli women aged 40-51 who are not at high risk of breast cancer and who had or had never undergone mammography. The results show that sociodemographic characteristics, private insurance coverage, out-of-pocket payments to physicians, and three Health Belief Model categories - lower perceived barriers to mammography, higher expectations of benefits, and stronger health motivation - are associated with the decision to undergo mammography. In addition, higher levels of perceived susceptibility to illness and experience with mammography are significant predictors of intentions to undergo early mammography. Understanding the determinants of women's tendency to undergo mammography contrary to recommendations may help nurses and healthcare policymakers to create health promotion programs targeting this group of women. Preventing unnecessary mammograms may reduce costs to households and health maintenance organizations, mitigate ineffective use of medical facilities, and alleviate the burden on the healthcare system.

Breast Cancer Screening Behaviors in Women Aged 40 Years and Over in a Semi-Urban Region in Turkey: Relationships with Health Beliefs

In this study, we aimed to determine the breast cancer screening behavior of women and to investigate the relationship between health beliefs and screening behaviors. The study was cross-sectional. It was conducted between April 2017 and June 2017 with 416 women aged ≥40. The Sociodemographic Information Form and the Champion's Health Belief Model Scale were used to collect data. In the statistical analysis, the number, percentage, mean, standard deviation, Pearson chi-square test, and multivariate binary logistic regression analysis were used. The rates for participating women performing breast self-examination, having clinical breast examination, and undergoing mammography were 11.8%, 8.9%, and 11.3%, respectively. Perceived susceptibility, seriousness, self-efficacy, benefits, health motivation, and perceived barriers were found to have strong associations with screening behaviors (p < 0.05). In this study, we found that few women performed breast self-examination, had clinical breast examination and mammography. In the present study, women perceived barriers related to both performing breast self-examination and undergoing mammography.