Applying the Health Belief Model to college students' health behavior

The Importance of Knowledge on Dementia Risk Factors in the General Public: A Cross-Sectional Study

ABSTRACT

The purpose of this study was to determine the influence of knowledge and beliefs on beneficial behaviors and dementia risk scores. A online survey was conducted among Chinese community residents over 18 years old. Multivariate logistic regression was used to identify the impact of knowledge and beliefs on dementia risk scores and beneficial behaviors. The respondents were 760 adults (mean age = 47.6 years, 60.8% female). Knowledge and beliefs were associated with cognitive activities (knowledge, odds ratio [OR] = 1.04; beliefs, OR = 1.17) and dementia risk scores (knowledge, OR = 0.95; beliefs, OR = 0.82). Additionally, lower perceived susceptibility (OR = 1.68; 95% CI, 1.04 to 2.72) and higher perceived benefits (OR = 0.68; 95% CI, 0.57 to 0.80) were associated with lower dementia risk scores. Knowledge and beliefs can promote beneficial behaviors and reduce dementia risk. In particular, perceptions of dementia susceptibility and benefits should be enhanced, which will greatly reduce dementia risk in the general public.

"Not me!": Optimistic bias and college students' perceived susceptibility, severity, benefits, and self-efficacy in following COVID-19 preventive guidelines

Objective The COVID-19 pandemic has created unprecedented challenges for university administrators and health professionals to keep doors open and students safe. Optimistic bias and the Health Belief Model serve as foundations for understanding students' perceived susceptibility and severity for contracting the virus and their perceived benefits and self-efficacy for following prevention recommendations. Participants: A total of 1,773 undergraduate and graduate students from a large mid-western university participated. Methods: Students were emailed an online survey examining their perceptions and knowledge of COVID-19 and their adherence to recommended preventive measures. Results: Almost one-half of students do not think they will get COVID-19 but said their friends are at risk. The majority are following most Centers for Disease Control and Prevention recommendations and understand the perceived benefits of doing so. Conclusions: Results could aid university officials in developing effective COVID-19 messages that could lead to reductions in cases numbers, deaths, and spread of the virus.

Chinese undergraduates' mental health help-seeking behavior: the health belief model

The detection rate of mental health problems among undergraduates has recently risen significantly. However, undergraduates underutilize mental health services; approximately a third only of undergraduates in need of treatment use school counseling resources. Based on a social psychological theoretical framework, the health belief model, factors of undergraduates' willingness to seek help when dealing with psychological problems were investigated. A cross-sectional online questionnaire and a snowball sampling method with 446 undergraduates investigated perceived susceptibility, perceived severity, perceived behavioral benefits, perceived barriers, self-efficacy, and cues to action to understand how students' mental health-seeking behaviors are affected. We found that perceived susceptibility (p < 0.01), perceived severity (p < 0.01), perceived benefits (p < 0.01), perceived barriers (p < 0.01), self-efficacy (p < 0.01), and cues to action (p < 0.01) significantly correlated with behavioral intention. Encouragement or counseling from others would be more likely to motivate undergraduates to seek mental health help. In addition, we used a bias-corrected Bootstrap approach to test the significance of the mediating effect, the mediation effect of cues to action between undergraduates' perceived susceptibility and mental health help-seeking behavior was utterly significant [mediation effect value of 0.077, with an SE value of 0.027 and a 95% CI (0.028, 0.133)]. It demonstrated that those who perceived themselves to be at high risk of developing a mental illness and who had received encouragement or counseling to seek mental health help were more likely to be motivated to seek mental health help. Multiple regression analyses indicated that self-efficacy (Z = 5.425, p < 0.01) and cues to action (Z = 6.673, p < 0.01) independently influenced behavioral intentions. Encouragement or counseling from others would be more likely to motivate undergraduates to seek mental health help.

The influence of COVID-19 on health seeking behaviors among students attending a minority-serving institution in the U.S

Objective: The goal of this research was to examine the effects of COVID-19 on health seeking behaviors among students attending a minority-serving institution (MSI). Participants: Students [N = 580, Mage (SD) = 27.7 ± 9.1 years] from a midsized university in the U.S. Methods: Cross-sectional survey, distributed between February-March 2021, assessing visits with a healthcare professional before and during the pandemic. Comparison by time and between groups using McNemar's test and ordinal logistic regression. Results: In-person medical care decreased during the pandemic (p = 0.096). Higher frequency of doctor visits pre-pandemic resulted in less contact with students' healthcare providers during the pandemic (p < 0.001). Those that indicated their health status as Excellent were mostly likely to visit their healthcare provider in-person during the pandemic (p = 0.026). Virtual contacts with their healthcare provider increased during the pandemic (p < 0.001). Conclusions: The COVID-19 pandemic has changed health seeking behaviors among students attending an MSI.

Effects of physical health beliefs on college students' physical exercise behavior intention: mediating effects of exercise imagery

OBJECTIVE

This study explores the relationship between physical health beliefs and physical exercise behavior intention of college students and constructs a mediation model through the mediation role of exercise imagery.

METHODS

Using the stratified cluster sampling method, 1356 college students were measured in group psychology by using the Physical Health Beliefs Scale, Exercise Imagery Inventory, and Physical Exercise Behavior Intention Scale. The statistical software Mplus 8.1, SPSS 22.0 and SPSS PROCESS 3.3 were used for statistical processing. The common method deviation test was carried out by Harman single-factor control method. Finally, the bootstrap sampling test method and process plug-in were used to test the significance of intermediary effect.

RESULTS

(1) physical health beliefs have a significant predictive effect on physical exercise behavior intention (β = 0.32, p < 0.001); (2) exercise imagery (β = 0.13, p < 0.001) mediate the relationship between physical health beliefs and physical exercise behavior intention (physical health beliefs → exercise imagery → physical exercise behavior intention (95% Cl: 0.14, 0.32)).

CONCLUSION

physical health beliefs can directly improve the physical exercise behavior intention of college students, which can also affect college students' physical exercise behavior intention indirectly through exercise imagery. The findings suggest that exercise imagery are important variables that mediate the effect of the college students' physical health beliefs on their physical exercise behavior intention.

Knowledge, Awareness, and Practices toward Colorectal Cancer and Its Dietary and Lifestyle-Related Risk Factors among Jordanian University Students: A Cross-Sectional Study

Background

Globally, colorectal cancer (CRC) incidence is rising, and it is a leading cause of mortality, with greater death rates pronounced in developing countries, including Jordan. Understanding knowledge and awareness of etiologic factors, unhealthy lifestyles, and dietary patterns is crucial for combating ailments. Hence, this study is aimed at investigating the level of knowledge and awareness of CRC-related risk factors, practices, and possible associations of studied variables among young Jordanians. Methodology. A cross-sectional, observational study was conducted using an online self-reported assessment of anthropometrics, knowledge, awareness, and dietary and lifestyle practices toward CRC and its related risk factors.

Results

A study of 795 Jordanian university students found that 93.8% were Jordanians, 73.0% were female, aged 18-24, and single. Most participants were from medical and science schools (69.4%). The vast majority (about 84%) were found to have good knowledge and awareness of CRC and its risk factors, but this was not reflected in their dietary practices. There are significant differences in physical activity, smoking, vegetable consumption, and serving sizes of red meat and processed meats between the sexes. Academic study specialties significantly impact knowledge and awareness.

Conclusion

The study reveals that while young Jordanian university students have good knowledge and awareness about CRC and its risk factors, these levels are not reflected in their dietary behaviors and food choices for CRC prevention, highlighting the need for national programs to improve these practices, particularly in the younger population.

Socioeconomic and Behavioral Determinants of Cardiovascular Risk in Russia: A Structural Equation Modeling Approach

Purpose

Despite much attention within the literature, the multiple risk factors associated with CVD mortality in Russia are still not fully understood. Drawing on the Health Belief Model as a theoretical framework, we aim to elicit socioeconomic and behavioral determinants of cardiovascular risks in Russian men and women.

Methods

Using the Know Your Heart project data, we utilize regression analysis and then structural equation modeling (latent class analysis and mediation analysis) to study the determinants of CVD risks.

Results

OLS and ordered logit regressions show that the key factors defining cardiovascular health behaviors in Russia are health-related actions to reduce the perceived threat of diseases (physical activity and GP visits), perceived barriers to behavioral change (financial constraints), and cues to action (awareness of the federal health check-up program). The latent class analysis further identifies three distinct groups of the population with different CVD risk levels. Over one-third of respondents belong to the "high CVD risk" class characterized by the highest share of smokers and alcohol abusers who evade contact with primary care and face financial constraints. In the mediation analysis, we find that employment mediates the relationship between physical activity and CVD risks: physically active individuals have a greater chance of employment, and employment further mitigates CVD risks. We also find an indication of the selection of the healthy into employment in the causal relationship between GP visits, having a job, and CVD risks.

Conclusion

A corresponding set of policy actions stem from these findings. These include reinforcing the change of perceptions of CVD risks and lowering barriers to health care; raising awareness of the free preventive check-up program in the "high CVD risk" group; making sports and exercise accessible to the elderly; and using off-putting labels on alcohol products as behavioral nudges among "physically active but drinking" males.

Comparing Vocal Health and Attitudes to Voice care in Primary Teachers and Voiceover Artists - A Survey Study Using the Health Belief Model

OBJECTIVES

A range of professions experience high demands on their voices and are potentially at risk of developing voice disorders. Teachers have been studied extensively in this respect, while voiceover artists are a growing professional group with unknown levels of voice training, voice problems and voice care attitudes. To better understand profession-specific voice care requirements, we compared voice training, voice care habits and self-reported voice problems of these two professional groups and measured attitudes to voice care, informed by the Health Belief Model (HBM).

STUDY DESIGN

The study was a cross-sectional survey study with two cohorts.

METHODS

We surveyed 264 Scottish primary school teachers and 96 UK voiceover artists . Responses were obtained with multiple-choice and free-text questions. Attitudes to voice care were assessed with Likert-type questions that addressed five dimensions of the HBM.

RESULTS

Most voiceover artists had some level of voice training, compared to a minority of teachers. Low numbers of teachers reported regular voice care, compared to over half of voiceover artists. Higher numbers of teachers reported work-related voice problems. Voiceover artists reported greater awareness for vocal health and perceived potential effects of voice problems on their work as more severe. Voiceover artists also saw voice care as more beneficial. Teachers perceived barriers to voice care as substantially higher and felt less confident about voice care. Teachers with existing voice problems showed increased perceptions of voice problem susceptibility and severity and saw more benefit in voice care. Cronbach's alpha was below 0.7 for about half of the HBM-informed survey subsets, suggesting that reliability could be improved.

CONCLUSIONS

Both groups reported substantial levels of voice problems, and different attitudes to voice care suggest that the two groups require different approaches to preventative intervention. Future studies will benefit from the inclusion of further attitude dimensions beyond the HBM.

Mobile opportunity against stress: Open study protocol on the effectiveness of a mobile platform for stress self-management in the post-pandemic era

Mobile health platforms have shown promise in the management of various mental health conditions (including stress, anxiety, and depression) and cognitive behavioral strategies emerged as a popular and effective option offered by the platforms. This paper presents the protocol of a study aimed to test the effectiveness of a mobile platform that uses cognitive-behavioral strategies for stress self-management in the Tuscany region (Italy). The mobile app is adapted to the specific needs of each vulnerable population for which it is designed: young and older people, healthcare professionals, entrepreneurs. The app will be evaluated on the following outcomes: (i) perceived susceptibility and severity of the pandemic situation, perceived benefits, and costs of preventive health behaviors, (ii) knowledge about Covid-19 preventive behaviors and negative consequences of social distancing, (iii) stress and psychopathological symptoms (i.e., anxiety, depression, and post-traumatic stress symptoms) and cognitive distortions. If successful, we expect that the platform could give various groups clinical benefits by providing symptom self-monitoring and early intervention, consolidating the number of mental health programs available, and decreasing barriers to treatment-seeking. This population-level approach has the potential to improve mental health outcomes in pandemic periods for many people.

The relationship between health belief and sleep quality of Chinese college students: The mediating role of physical activity and moderating effect of mobile phone addiction

Background

Poor sleep quality has become a common health problem encountered by college students.

Methods

Health belief scale (HBS), physical activity rating scale (PARS-3), mobile phone addiction tendency scale (MPATS) and Pittsburgh sleep quality index (PSQI) were adopted to analyze the data collected from survey questionnaires, which were filled out by 1,019 college students (including 429 males and 590 females) from five comprehensive colleges and universities from March 2022 to April 2022. The data collected from survey questionnaires were analyzed using SPSS and its macro-program PROCESS.

Results

(1) Health belief, physical activity, mobile phone addiction and sleep quality are significantly associated with each other (P < 0.01); (2) physical activity plays a mediating role between health belief and sleep quality, and the mediating effects account for 14.77%; (3) mobile phone addiction can significantly moderate the effect size of health belief (β = 0.062, p < 0.05) and physical activity (β = 0.073, P < 0.05) on sleep quality, and significantly moderate the effect size of health belief on physical activity (β = -0.112, p < 0.001).

Conclusion

The health belief of college students can significantly improve their sleep quality; college students' health belief can not only improve their sleep quality directly, but also improve their sleep quality through physical activity; mobile phone addiction can significantly moderate the effect size of health belief on sleep quality, the effect size of health belief on physical activity, and the effect size of physical activity on sleep quality.

Effects of the COVID-19 pandemic on psychological health in a sample of Italian adults: A three-wave longitudinal study

The COVID-19 pandemic and the resulting societal restrictions have had negative implications for mental health in the general population. The aims of the present longitudinal study were (i) to investigate changes in psychopathological symptoms and psychological well-being in a sample of Italian individuals surveyed at different points of the pandemic and (ii) to evaluate the potential risk and protective factors associated with the psychopathological outcomes. Self-reported data on psychiatric symptoms, and psychological well-being were collected in March 2020 (T0, the lockdown phase), in May 2020 (T1, the end of the lockdown phase), and in November 2020 (T2, the second wave of COVID-19 infection). 1258 participants (M_age=23.43, SD_age=6.45; 75.4% female) were recruited at T0. Of these, 712 also completed the T1 survey, and 369 also completed the T2 survey. A significant decrease in anxiety, depressive, posttraumatic, and obsessive-compulsive symptoms and a significant increase in psychological well-being were observed from T0 to T1. All psychopathological symptoms increased, and psychological well-being decreased significantly from T1 to T2. Several demographic, psychological and COVID-19-related factors emerged as predictors over the course of the pandemic. The current findings indicated that psychological health covaried with the intensity of the COVID-19 pandemic and the associated societal restrictions.

‘We just don’t have this in us…’: Understanding factors behind low levels of physical activity in South Asian immigrants in Metro-Vancouver, Canada

Background

South Asian immigrants in western countries are at a high risk for metabolic syndrome and associated chronic disease. While a physically active lifestyle is crucial in decreasing this risk, physical activity (PA) levels among this group remain low. The objectives of this study were to explore social and cultural factors that influence PA behavior, investigate how immigration process intersects with PA behaviors to influence PA levels and to engage community in a discussion about what can be done to increase PA in the South Asian community.

Methods

For this qualitative study, we conducted four Focus Group Discussions (FGDs) among a subset of participants who were part of a larger study. FGD data was coded and analysed using directed content analysis to identify key categories.

Results

Participants expressed a range of opinions, attitudes and beliefs about PA. Most believed they were sufficiently active. Women talked about restrictive social and cultural norms that discouraged uptake of exercise. Post-immigration levels of PA were low due to change in type of work and added responsibilities.

Conclusion

Health promoters need to consider social, cultural, and structural contexts when exploring possible behavior change interventions for South Asian immigrants.

Associations between Awareness of the Risk of Exposure to Pollutants Occurring at Fire Scenes and Health Beliefs among Metropolitan Firefighters in the Republic of Korea

Firefighters are repeatedly exposed to various pollutants that occur at fire scenes. There are three levels of exposure: primary exposure to pollutants, secondary exposure to pollutants on personal protective equipment (PPE), and tertiary exposure to contaminated fire stations and fire engines due to pollutants on PPE. Therefore, it is important for firefighters to be aware of the risk of exposure to pollutants and to practice health behaviors such as appropriate PPE management. No clear association has been established in the existing literature between firefighters’ risk perception level and their health beliefs about the health impact of awareness of exposure to hazardous substances at fire scenes. This study aims to evaluate the relationship between awareness of the exposure risk to primary, secondary, and tertiary pollutants and health beliefs. It was designed as a cross-sectional study, in which a web-based survey was conducted from 13 May to 31 May 2021. The analysis was conducted in 1940 firefighters working in the Seoul metropolis who agreed to participate in the research. Participants who perceived susceptibility were likely to be aware of the primary (adjusted odds ratio (AOR) = 2.10, 95% confidence interval (CI) 1.16–3.80), secondary (AOR = 2.77, 95% CI 1.77–4.32), and tertiary (AOR = 2.73, 95% CI 1.85–4.03) exposure risks. Participants who perceived barriers were unlikely to be aware of the risk of exposure to primary (AOR = 0.67, 95% CI 0.49–0.91), secondary (AOR = 0.77, 95% CI 0.61–0.96), and tertiary (AOR = 0.75, 95% CI 0.62–0.91) pollutants. Educational intervention is recommended to improve perceived susceptibility and awareness of the risk of exposure to pollutants and reduce perceived barriers. Consequently, educational intervention is expected to positively impact firefighters’ management of appropriate PPE. We confirmed an association between occupational exposure risk and firefighters’ health beliefs. In the health belief model (HBM), health beliefs that affect health behavior also affect awareness of the exposure risk level. Therefore, an intervention for health beliefs can also be used to raise job-related exposure risk awareness. Regular training on the health impacts of fire scenes is necessary for both newcomers and incumbents to enable firefighters to better recognize the risks of each occupational exposure level. Additionally, laws and regulations are necessary for the removal of harmful substances that contaminate PPE, such as self-contained breathing apparatus (SCBA), during exposure to a fire scene. Our research can be used as a basis for improving fire policies and education programs in the future.

Medical students and doctors' perceptions toward COVID-19 health communication on social media

BACKGROUND

Ineffective health communication could cause the increase of COVID-19 cases in Indonesia. Medical students can involve in efforts in health communication on social media to positively impact prevention behaviors during a pandemic. This study aims to identify and analyze medical students' and internship doctors' perceptions toward health communication related to COVID-19 through social media.

MATERIALS AND METHODS

A mixed method with exploratory sequential used. A qualitative study was done using phenomenology approach through deep and semi-structured interviewing. After data analysis, the draft of the instrument prepared. Items in the draft selected based on the respondents' answer. Then, a quantitative cross-sectional study was used. The data obtained from 399 medical students and doctors at a University in Indonesia using Google Form on October 14 to October 20, 2020 through media social. Data were analyzed using Pearson Correlation and Chi-square (alternative: Fisher's exact test) and logistic regression analysis with P < 0.05 and 95% confidence interval, respectively.

RESULTS

Based on interview, respondents communicate health on social media because the condition of COVID-19 in Indonesia is dangerous, feel vulnerable to COVID-19, understand the benefits, obligations, or responsibilities as a candidate and/or medical personnel and believe they can create content/find valid sources. Meanwhile, the perception of limited knowledge is their biggest obstacle in conducting health communication. There were a relationship between gender (P = 0.028, PR = 0.657), perceived severity (P = 0.044, PR (Prevalence Ratio) =4.844 [0.725-32,354]), perceived susceptibility (P = 0.005, PR = 1.803 [1.182-2.750]), perceived barrier (P < 0.001, PR = 2.543 [1.908-3.388]), and self-efficacy (P = 0.012, PR = 1.810 [1.120-2.926]) with health communication behavior. The perceived barrier (P < 0.001, RR = 4.278 [2.709-6.754]) and perceived susceptibility (P = 0.004, PR = 2.304 [1.302-4.077]) were the most influenced behavior.

CONCLUSIONS

This study showed that perceived severity, perceived susceptibility, perceived barrier, and self-efficacy are predictor factors of health communication behavior related to COVID-19 on social media with perceptions of susceptibility and perceived barriers as the most influential variables. It is necessary to provide communication learning on social media as effectively and applied directly to reduce perceived barriers and increase self-efficacy.

Education based on the health belief model to improve the level of physical activity

[Purpose]

This study aimed to investigate the effect of education based on the health belief model on the physical activity of the staff of the University of Medical Sciences.

[Methods]

This semi-experimental study was conducted on 130 university staff aged 25-50 years from the Hamadan University of Medical Sciences. Inclusion criteria were having at least 1 year of work experience, lack of acute and chronic physical and mental illnesses, and not using drugs that affect physical activity. The samples were randomly divided into two groups. The experimental group received three training sessions based on the health belief model. Before and 2 months after training, the control and experimental groups were evaluated via the following questionnaires: (1) demographic information questionnaire, (2) Health Belief Model Questionnaire, and (3) International Physical Activity Questionnaire. Finally, data were analyzed statistically.

[Results]

The training process resulted in a significant increase in the mean scores of the health belief model constructs in the experimental group, but changes in the control group were not significant. Self-efficacy was the strongest predictor of physical activity.

[Conclusion]

The health belief model is a useful model for improving individuals' understanding of the benefits of physical activity.

The Outcomes of an Interventional Oral Health Program on Dental Students' Oral Hygiene

Dental students are an interesting population because they are expected to have a higher level of knowledge of and to exhibit better oral hygiene habits, and thus have a greater impact on the environment, families, and society as a whole. The aim of this research was to determine the state of oral hygiene in dental students before and after the interventional health education program. The research sample consisted of 119 students of dentistry in their first and fourth years of study. The first research stage was conducted before health education intervention (for the evaluation of selected oral health parameters, the Decayed, Missing and Filled index, Greene–Vermillion index, Silness–Löe plaque index, Silness–Löe gingival index, and the Community Periodontal Index of Treatment Needs index were used). The second stage was conducted as a clinical measurement of oral health changes. The conducted health education intervention, to an extent, led to changes in the state of oral hygiene among the students, and thus healthier habits. There was a statistically significant difference in the examined population between the beginning of the study and after the health education intervention program. Although a significant improvement in oral hygiene and oral health was noticed after the health education intervention program, the state of oral hygiene was still not at a satisfactory level among the dental students, contrary to our expectations.

How beliefs about weight malleability and risk perceptions for obesity influence parents' information seeking and feeding

This study surveyed 185 parents to determine whether their perceived risk of their child developing obesity and their implicit theories about the malleability of weight independently and/or interactively predict their child-feeding and pursuit of child-related obesity risk information. Higher risk perceptions were associated with healthier feeding intentions and more information seeking. More incremental (malleable) beliefs predicted healthier feeding intentions and greater pursuit of environmental, but not genetic, information. Contrary to hypotheses, the influence of implicit theories and risk perceptions were primarily independent; however, more incremental beliefs predicted less "junk food" feeding among only parents with lower perceived risk.

Factors influencing COVID-19 vaccination intention among overseas and domestic Chinese university students: a cross-sectional survey

To vaccinate the Chinese on a nationwide scale timely and effectively, it is necessary to assess the vaccination uptake intention of the public. University students are opinion leaders, who have an important impact on the vaccination uptake intention of others around them. As a group with strong population mobility, overseas university students have an extra influence on the spread of COVID-19 and the prevention and control of the pandemic. Thus, it is necessary to investigate the vaccination uptake intention of overseas and domestic university students to promote vaccination and control the pandemic globally. However, little is known about the COVID-19 vaccination uptake intention among overseas and domestic university students. This study aimed to explore the difference between overseas and domestic Chinese university students' COVID-19 vaccination uptake intentions and influencing factors using the Health Belief Model. A cross-sectional survey using an online questionnaire was conducted among 370 overseas university students and 463 domestic university students between January and February 2021. More than half of the respondents (536, 64.3%) reported vaccination uptake intentions, with overseas and domestic university students reporting similar vaccination uptake intentions (64.1% vs 64.6%, p > .05). Perceived benefits, perceived barriers, and cues to action were important factors that influenced the vaccination intention among overseas and domestic university students. It is worth trying to communicate the benefits of the vaccine, enhance the role of cues to action, and eliminate the potential barriers among overseas and domestic university students through creative propagation to further promote the COVID-19 vaccination.

Development and validation of a questionnaire measuring knowledge, attitudes, and practices (KAP) to healthy eating and activity patterns in school children (HEAPS)

BACKGROUND

Development of culturally appropriate and psychometrically sound instruments that measure knowledge and health behaviors of children will help to inform appropriate interventions.

AIM

To develop and test the validity and reliability of a questionnaire measuring knowledge, attitudes, and practices to healthy eating and activity patterns in school children in India.

METHODS

Review of literature, focus-group discussions, and theoretical constructs of the Health Belief Model guided the development of an item pool. Face and content validity were assessed by children and a panel of experts and the item content validity, item difficulty, and discrimination indices were calculated. Construct validity was determined using the principal axis method of exploratory factor analysis among a cross-sectional sample of children (n=252). Internal consistency (Cronbach α values >0.7) and test-retest reliability (intraclass correlation coefficient values >0.75) were estimated.

RESULTS

Item content validity index for clarity and relevance were satisfactory (>0.80) and internal consistency for knowledge (Kuder-Richardson 20 = 0.832), attitude (Cronbach's α = 0.912), and practice items (Cronbach's α = 0.769) were good. Four factors (children's eating habits, family dietary practices, and consumption of healthy and unhealthy foods) and two factors (moderate to vigorous activities and sedentary activities) explained 67.7% and 48.2% of the total variance in practice items. Intraclass correlation coefficient estimates ranged from good to excellent (0.72-0.99).

CONCLUSIONS

The results of the validity and reliability of the 84-item knowledge, attitudes, and practices to healthy eating and activity patterns in schoolchildren questionnaire were promising. The detailed description of the methodology employed may prove useful to researchers conducting similar studies in children.

The COSMO-Spain Survey: Three First Rounds of the WHO Behavioral Insights Tool

Objective: To describe changes in knowledge, attitudes and preventive practices (KAP), risk perception, and psychological variables of Spanish population toward the COVID-19 pandemic from July to November 2020.

Methods: Three samples, each of one composed by 1,000+ persons aged 18 years or older, were interviewed online in three rounds, every 2 months, from July to November 2020.

Results: The level of knowledge on COVID-19 was high in the three rounds, with percentages above 95% of correct answers related to ways of contagion and correct use of face masks. The most accepted measure was the mandatory use of face masks (80–86% of agreement in the three rounds, p = 0.001), followed by the night curfew (63% of agreement). Most participants (>80%) consistently reported using face masks, ventilating spaces, and washing or disinfecting hands. However, risk perception and self-efficacy were low. Worry about losing a loved one, the health system overload and people who do not wear face masks was high (>85% of the samples). The percentage of respondents who felt depressed due to COVID-19 increased from round 1 to round 3 (p = 0.044).

Conclusions: Spanish population has a high degree of KAP, but a relatively low risk perception and self-efficacy. These findings can help health authorities to guide containment measures and campaigns addressed to improve preventive practices.

Modelling knowledge, health beliefs, and health-promoting behaviours related to cardiovascular disease prevention among Malaysian university students

Background

Healthy lifestyle habits formed during young adulthood may have a sustaining impact on health across later life. The current study aimed to test the theoretical model of factors (selected demographic variables, knowledge of heart disease, health belief related to cardiovascular disease (CVD), self-efficacy, cues to action, and screening intention) influencing health-promoting behaviours among Malaysian university students.

Methods

In a cross-sectional survey, the undergraduate students in Universiti Sains Malaysia were invited to complete the self-administered questionnaires. Participants were selected using a purposive sampling method. The proposed hypothesised model was analysed using a structural equation modelling with Mplus 7.3 program. A total of 788 (70.7% female) undergraduate students with a mean age of 20.2 (SD = 1.02) participated in the study. The primary outcome of knowledge, health beliefs, and health-promoting behaviours related to CVD were measured by questionnaires namely: Knowledge of Heart Disease, Health Beliefs Related to CVD, and Health Promoting Lifestyle Profiles-II.

Results

The final hypothetical structural model showed a good fit to the data based on several fit indices: with comparative fit index (CFI) at .921, standardised root mean square residual (SRMR) at .037, and root mean square error of approximation (RMSEA) at .044 (90% CI: .032, .054). The final structural model supported 13 significant path estimates. These variables explained 12% of the total variance in health-promoting behaviours. Through perceived benefits, total knowledge had an indirect effect on health-promoting behaviours.

Conclusion

The results suggest that perceived barriers, perceived benefits, family history of CVD, and screening intention enable young adults to engage in health-promoting behaviours.

The Relation between Levels of Media Literacy and Attitudes and Beliefs Concerning Obesity in University Students

The prevalence of obesity in young people around the world. The written and visual media have an important role to play in increasing student awareness in the prevention of obesity. This study was planned with the aim of determining the effect on attitudes and beliefs concerning obesity of the levels of media literacy of university students. This cross-sectional descriptive study was conducted with 300 obese students. The Media Literacy Scale, and the Obesity Health Belief Model Scale were used in the collection of data for the study. The Student t test and the one-way ANOVA test were used in the analysis of the data. A weak, positive statistically significant correlation was found between media literacy and the subscales of perceived severity, perceived barriers, and perceived benefit (p < .05). A weak positive correlation was found between the subscales of possessing knowledge, the ability to analyze and form a response, and the ability to judge and see hidden messages, and the sub-scales of perceived severity, perceived barriers, and perceived benefit (p < .05). It was found in this study that the media literacy of obese students was at a medium level, and that media literacy affected their attitudes and beliefs regarding obesity. It is recommended that the visual media should broadcast short audiovisual educational films at regular intervals on the prevention of obesity.

Applying the Modified Health Belief Model (HBM) to Korean Medical Tourism

The purpose of this study is to investigate how foreigners' health beliefs influence their visiting intentions to Korean medical tourism. This study used an online survey engine (docs.google.com/forms) to collect data from foreigners who are from India, Nepal, Bangladesh, Vietnam, and Mongolia, who are potential Korean medical tourists. Out of 213 questionnaires collected, 200 questionnaires (93.9%) were used for the statistical analysis. The Confirmatory factor analysis (CFA) revealed that six dimensions, "Experience", "Susceptibility", "Severity", "Barrier", "Benefit", and "Visiting Intention", had construct validity; Cronbach's alpha coefficient was tested for item reliability. It is expected that four variables in the health belief model (HBM) that are determined by objective and logical thinking processes will affect the choice of Korean medical tourism. The results showed that Susceptibility, Severity, Barrier, and Benefit had significant effects on Visiting Intention and was a valid measurement to determine "Visiting Intention".

Health belief model for coronavirus infection risk determinants

OBJECTIVE To use the advantages of a ratio scale with verbal anchors in order to measure the risk perception in the novel coronavirus infection, which causes covid-19, in a health belief model-based questionnaire, as well as its validity and reproducibility. METHOD We used the health belief model, which explores four dimensions: perceived susceptibility (five questions), perceived severity (five questions), perceived benefits (five questions), and perceived barriers (five questions). Additionally, we included a fifth dimension, called pro-health motivation (four questions). The questions composed an electronic questionnaire disseminated by social networks for an one-week period. Answers were quantitative values of subjective representations, obtained by a psychophysically constructed scale with verbal anchors ratio (CentiMax ® ). Mean time for total filling was 12 minutes (standard deviation = 1.6). RESULTS We obtained 277 complete responses to the form. One was excluded because it belonged to a participant under 18 years old. Reproducibility measures were significant for 22 of the 24 questions in our questionnaire (Cronbach's α = 0.883). Convergent validity was attested by Spearman-Brown's split half reliability coefficient (r = 0.882). Significant differences among groups were more intense in perceived susceptibility and severity dimensions, and less in perceived benefits and barriers. CONCLUSION Our health belief model-based questionnaire using quantitative measures enabled the confirmation of popular beliefs about covid-19 infection risks. The advantage in our approach lays in the possibility of quickly, directly and quantitatively identifying individual belief profiles for each dimension in the questionnaire, serving as a great ally for communication processes and public health education.

Examining Users' Adoption of Precision Medicine: The Moderating Role of Medical Technical Knowledge

Precision medical technologies have received a great deal of attention, but promoting such technologies remains a problem for enterprises and medical institutions. Adopting the unified theory of acceptance and use of technology (UTAUT) model and the health belief model (HBM), this study investigated the key factors affecting users' willingness to adopt precision medicine (PM) in terms of technical factors and external stimuli. Based on 415 questionnaires, performance expectancy, price value, social influence, and perceived threat of disease were found to significantly increase users willingness to adopt PM; meanwhile, privacy risks had the opposite effect. Knowledge about PM was found to strengthen the positive effect of performance expectancy, price value, social influence, and perceived threat of disease on willingness to adopt PM and weaken the negative effect of privacy risk. This study demonstrates the successful application of UTAUT to the medical field while also providing guidance for the promotion of PM.

Development and validation of a knowledge, attitude, and practice questionnaire on nutrition-related cancer prevention for Iranian women

Background:

Designing cancer prevention programs needs information on knowledge, attitude, and practice of the community. Unfortunately, this information is not available in Iran.

Materials and Methods:

We developed a questionnaire (NUTCANKAPQ) to assess the knowledge, attitude, and practice of Iranian women regarding cancer prevention dietary habits. We recruited women who had referred to public health-care centers in Tehran, Iran. To assess validity, we applied face, content, and construct validity methods. We performed test–retest approaches to assess reliability, and internal consistency of the questionnaire was assessed through Cronbach's alpha and intraclass correlation coefficients (ICCs).

Results:

Qualitative content validity was carried out by an expert panel, and internal consistency was deemed satisfactory (Cronbach's alpha, >0.6). We also observed high reliability in the questionnaire (ICC = 0.85). The mean (± standard deviation) scores for knowledge, attitude, and practice of study participants were 28.3 (±14.1), 67.1 (±18.9), and 53.7 (±8.3), respectively. The result of exploratory factor analysis, Kaiser–Meyer–Olkin (KMO), implied that the model was reasonably fit (KMO > 0.6). The final questionnaire included seventy items.

Conclusion:

NUTCANKAPQ is a valid and reliable tool for the assessment of cancer-related nutrition knowledge, attitude, and practice among the Iranian population. Application of NUTCANKAPQ may provide important clues for policy-making and improvement of cancer prevention programs among the Iranian population.

Assessing the impact of an educational intervention program on sexual abstinence based on the health belief model amongst adolescent girls in Northern Ghana, a cluster randomised control trial

BACKGROUND

Adolescent pregnancy is a worldwide problem because of its health, social, economic and political repercussions on the globe. Even though the rates of adolescent pregnancy have declined over the decade, there is still unacceptably high rates especially in lower and middle-income countries including Ghana. Although the problem has been widely investigated, there is little information on the effectiveness of different methods to improve adolescent sexual abstinence based on theoretical models. This study is aimed to assess an educational intervention program on sexual abstinence based on the Health Belief Model (HBM) among adolescent girls in Northern Ghana.

METHODS

A cluster randomized control trial was conducted in Ghana from April to August 2018. Participants within the ages of 13-19 years were enrolled voluntarily from six randomly selected Senior High Schools (3 for intervention and 3 for control). A total of 363 adolescent were enrolled. A self-structured questionnaire was administered to both groups of participants at baseline and endpoint of the study. Control participants received their normal classes whiles the intervention group additionally received comprehensive sexuality education for 1 month. Qualified midwives conducted the health education program. At least two sessions were conducted for each participating class weekly. The lessons focused on perceived susceptibility, perceived severity of adolescent pregnancy, perceived benefits, perceived barriers to adolescent pregnancy prevention, personal and family values, perceived self-efficacy and knowledge of contraceptives. Educational strategies such as discussions, demonstrations, role-play and problem solving techniques were used to deliver the lessons. Sexual abstinence was the outcome variable of the study and it was measured after 3 months of the intervention. Binary logistic regression was used to assess the impact of the intervention on sexual abstinence practice.

RESULTS

At baseline, there was no difference between control and intervention groups. The mean score of Knowledge and attitude for control were (58.17 and 139.42) and intervention (60.49 and 141.36) respectively. Abstinence practice was 69.4% for control and 71.6% in the intervention group. However, after the intervention, the mean score of knowledge and attitude for control were (87.58 and 194.12) respectively. Sexual abstinence in the control was 84.4% and intervention was 97.3% respectively. The educational interventions resulted in a significant difference in sexual abstinence between intervention and control groups (OR = 13.89, 95% Confidence Interval (2.46-78.18, P < 0.003).

CONCLUSION

Educational intervention, which was guided by HBM, significantly improved sexual abstinence and the knowledge of adolescents on pregnancy prevention among the intervention group. Provision of comprehensive sex education guided by behavioural theories to adolescents at Senior High Schools in Ghana is recommended.

TRIAL REGISTRATION

This trial was retrospectively registered in Protocol Registration and Results System (PRS) with trial number NCT03384251 .

Determinants of nurses' willingness to receive vaccines: Application of the health belief model

AIMS AND OBJECTIVES

To assess the willingness of nurses to receive vaccines as recommended by Taiwan's "Immunization Recommendations for Healthcare Personnel" (IRHCP), as well as the factors associated with their willingness.

BACKGROUND

Immunisation for healthcare personnel (HCP) is a means of reducing pathogen transmission. Also, vaccinating HCP reduces personnel and labour costs during an epidemic.

METHODS

A cross-sectional study was conducted. A self-administered questionnaire survey targeting nurses working in various service units at three hospitals was used. In total, 413 nurses completed the questionnaire. The main outcome measure was the willingness to receive vaccines recommended by the IRHCP, and the variables we assessed included knowledge regarding the IRHCP, individual perceptions (perceived risk of contracting the infection, perceived severity of the infection and perceived transmissibility after disease onset), perceived benefits and barriers to the vaccination, cues to the vaccination and demographics. This study followed the STROBE checklist for reporting this study.

RESULTS

The willingness of nurses to receive vaccines recommended by the IRHCP was high; the highest level of willingness was for the hepatitis B vaccine. The nurses' willingness to receive various vaccines recommended by the IRHCP was predicted by the knowledge regarding the IRHCP and perceived transmissibility after disease onset. Except the diphtheria-tetanus-acellular pertussis vaccine, perceived benefits and perceived barriers were also predictors of the willingness to receive vaccines.

CONCLUSIONS

Our results showed that interventions focusing on increasing the knowledge regarding the IRHCP and perceived transmissibility after disease onset, emphasising the benefits of the vaccination and reducing the perceived barriers to the vaccination are needed to increase nurses' willingness to receive vaccines.

RELEVANCE TO CLINICAL PRACTICE

It is suggested using health education courses and mass media broadcasts at the individual and societal levels to raise awareness regarding the benefits of vaccines and enhance nurse' confidence in vaccination programs.

Perceptions and factors influencing the intention to do regular physical activities for the prevention of osteoporosis among Iranian working women

Purpose

Osteoporosis is a metabolic bone disease and a growing global health problem. It is estimated that about 200m people are suffering from this disease in the world. The purpose of this paper is to investigate the perceptions and factors influencing the intention to do regular physical activities in order to prevent osteoporosis in Iranian Muslim working women.

Design/methodology/approach

The present cross-sectional descriptive study was conducted on 217 women employed in a university in Iran. The tool for data collection was a researcher-made questionnaire that had gone through validity and reliability processes. The data analysis was done using SPSS ver. 19 software as well as statistical descriptive and analytical tests.

Findings

The majority of participants were aged 30–39 (50.7 percent) and the least ones were 40 years old (24.4 percent). In total, 67.7 percent of the participants were married. Also, 77 percent of the participants had religious belief on the duty to do strong physical activities, and 83 percent had intention to do physical activities. The results showed that there was a significant difference in the mean scores of self-efficacy and the mean scores of religious belief between the women with and without having intention to do physical activities (p<0.01).

Originality/value

Regarding the relationship that self-efficacy and religious belief had with the intention to do physical activities in women employees, the need to address this issue through educational programming with the focus on self-efficacy and religious culture seems to find priority.

Effect of Multimedia Education on Nutritional Behaviour for Colorectal Cancer Prevention: An Application of Health Belief Model

Background

Colorectal cancer is a major public health problem. A way to decrease this cancer is through dietary behavioural changes. The aim of this study was to determine the effects of education on dietary behaviour based on the health belief model (HBM) using multimedia.

Methods

In this clinical trial study, 98 participants were randomly allocated to an HBM group (n = 48) and a control group (n = 50). The HBM group received an audiovisual compact disc (CD) that contained information about nutritional behaviour of colorectal cancer (CRC) prevention based on HBM that lasted 45 min. Both groups completed questionnaires regarding demographic factors, knowledge and HBM constructs, and a three-day dietary recall at the beginning of the study, 1 week after, and 3 months after the education. The outcome of this study was measured by the amount of food servings consumed and dietary micronutrient intake.

Results

At the baseline, there were no significant differences between groups regarding demographic factors. Findings showed that self-efficacy (P < 0.001), severity (P < 0.001), and benefits (P < 0.001) were perceived to be higher, and knowledge (P < 0.001) was increased in the HBM group compared to control group 3 months after education. There was a significant increase in fruit and vegetable (P < 0.001) and dairy (P = 0.001) intake and a significant decrease in red meat servings (P = 0.016) in the HBM group compared to the control group. Also, intake of vitamin D (P < 0.001), folate (P < 0.001), calcium (P = 0.008), and dietary fibre (P < 0.001) was increased in the HBM group compared to the control group 3 months after education.

Conclusion

Education plans based on HBM and implemented through multimedia can change nutritional beliefs and behaviours for the prevention of colorectal cancer.

Perceived Benefits and Intakes of Protein, Vitamin C and Iron in Preventing Anemia among Pregnant Women

Introduction: Nutritional adequacy is essential in ensuring the normal growth and development of the fetus. Perceived benefits will be able to strengthen pregnant women to meet optimum nutritional intake to prevent anemia. Adequacy of protein, vitamin C and iron will reduce the risk of iron deficiency anemia in pregnancy. This study aims to examine the association between perceived benefits with protein, vitamin C, and iron intake in preventing pregnancy anemia.Methods: This study used a cross-sectional design and was conducted in August-October 2017 among105 pregnant women. This study used the multistage random sampling method. The population of this study was pregnant women who had antenatal care in four Community Health Centre in Surabaya namely Jagir, MedokanAyu, SidotopoWetan, and Gundih. Results: The average daily protein intake was 76.34 (SD = 35.88) gram/day. There was a significant association between perceived benefits with protein intake (r = 0.272; p = 0.005). The average daily vitamin C intake was 90.67 (SD = 116.54) mg/day. There was no significant association between perceived benefits and vitamin C intake (r = 0.175; p = 0.074). The average daily iron intake was 64.73 (SD = 23.13) mg/day. There was a significant association between perceived benefits and iron intake (r = 0.219; p = 0.025).Conclusion: The knowledge of pregnant women about the benefits of nutrition will affect the adequacy of pregnancy nutrition. Health workers need to provide health education on the importance of nutrition for pregnant women to prevent anemia during pregnancy.

The relationship between frequency of performance and perceived importance of health behaviours

The relationship between performance of health behaviours and their perceived importance was examined among 250 adults. Frequency of performance and perceived importance of 21 health behaviours, self-assessed health and the Big Five personality traits were measured. As expected, importance and performance were positively correlated. Self-assessed health was more strongly associated with performance than importance, and a model wherein importance affects performance, which in turn affects self-assessed health, was superior to a model wherein performance affects importance. The Big Five significantly explained performance, particularly conscientiousness, and importance explained performance beyond this effect. Consequently, importance perceptions should be considered when developing behavioural interventions.

Application of the Health Belief Model to customers' use of menu labels in restaurants

Some countries require the provision of menu labels on restaurant menus to fight the increasing prevalence of obesity and related chronic diseases. This study views customers' use of menu labels as a preventive health behavior and applies the Health Belief Model (HBM) with the aim of determining the health belief factors that influence customers' use of menu labels. A self-administered survey was distributed for data collection. Responses were collected from 335 restaurant customers who experienced menu labels in restaurants within three months prior to the survey. The results of a structural equation model showed that all the HBM variables (perceived threats, perceived benefits, and perceived barriers of using menu labels) positively affected the customers' use of menu labels. Perceived threats were influenced by cues to action and cues to action had an indirect influence on menu label use through perceived threats. In conclusion, health beliefs were good predictors of menu label use on restaurant menus. This study validated the application of the HBM to menu labeling in restaurants, and its findings could offer guidelines for the industry and government in developing strategies to expand the use of menu labels among the public.

Understanding the Experiences of Low-Income Individuals Receiving Farmers’ Market Incentives in the United States: A Qualitative Study

Objective. The objective of this study was to identify benefits and barriers to using a farmers’ market (FM) incentive program among program participants. Design. In qualitative semistructured interviews, participants were asked about their experiences with shopping at FM, using FM incentives, barriers to fruit and vegetable (F&V) intake, and changes in dietary intake. Interviews were recorded and transcribed. Inductive content analysis was used to code, categorize, and develop themes based on the transcriptions. Setting. A FM in Northern Utah. Subjects. A convenience sample of participants ( n = 14) completed a 45- to 60-minute interview after receiving FM incentives for an 8-week intervention period. Results. FM incentives reduced barriers associated with shopping at FM such as cost and accessibility among program participants. Incentives provided participants with greater spending flexibility, allowing parents to provide children with F&V that previously did not fit into their food budget. Participants reported greater family and community involvement when shopping at FM. However, the limited hours and days of operation were factors that reduced the use of FM among participants, even when incentives were provided. Conclusions. The perceived benefits and barriers to shopping at FM and receiving FM incentives should be considered by future programmers and funding agencies.

Toward an Understanding of the Poor Health Status of Indigenous Australian Men

The purpose of this study was to investigate perceptions of health and health behaviors among Indigenous Australian men. Using a participatory action research (PAR) framework, we conducted two focus groups and 40 individual semi-structured interviews with men between the ages of 18 and 35 years in each of three locations across Australia. We used the health beliefs model to provide a framework for the analyses. Participants recognized that their Indigenous status placed them in a vulnerable position with regard to health, and that there might be serious consequences of failing to follow a good diet and engage in appropriate exercise. However, they delineated a number of barriers to engaging in such health behaviors. These perceived barriers require addressing at a range of policy levels within government, with a focus on social structures and institutionalized discrimination, as well as unemployment, poverty, dispossession, and cultural oppression.

Health beliefs and the valence framework in health information seeking behaviors

Purpose

The purpose of this paper is to help understand consumer acceptance of online health information services by integrating the health belief model and extended valence framework.

Design/methodology/approach

A laboratory-based, experimental-scenarios research design is used to collect data, and the structural equation modeling technique is used to test the research model.

Findings

The model explains 47.6 percent of the variance in intentions to use online health information services. Trust appeared to have the strongest effect on acceptance. Perceived risk also had a significant impact on acceptance. Furthermore, health belief variables are confirmed as important factors for consumer acceptance. Self-efficacy was found to moderate the effect of perceived severity on acceptance.

Research limitations/implications

This study helped identify the relative salience of the health belief model and extended valence framework in consumer acceptance of online health information services.

Practical implications

This study can help practitioners better understand the development of trust and the profiles of consumers who may browse their sites. When online health service providers promote their information to encourage potential online health information seekers, they should use countermeasures against risk perceptions.

Originality/value

This study attempted to extend the valence framework to the non-commercial service context. Moreover, health beliefs and the valence framework are two fundamental aspects that health information seekers consider when making decisions about online health services.

Determinants of puberty health among female adolescents residing in boarding welfare centers in Tehran: An application of health belief model

Background: Adolescence is a critical stage of growth and development. That is associated with changes in body shape and appearance. Issues such as irregular menstrual periods, amenorrhea, and menstrual cycle are major issues in women's health. The purpose of this study was to examine the determinants of physical puberty health based on the Health Belief Model (HBM) among female adolescents. Methods: This analytical cross sectional study was conducted in welfare boarding centers in Tehran, Iran. Data were collected in 2011 by a structured and valid questionnaire. Total 61 female adolescents (age range: 12-19 yrs) participated in this study from welfare boarding centers in Iran, Tehran, by using convenience sampling method. The questionnaire consisted of demographic characteristics, health belief model constructs and physical puberty health behaviors gathered by using interview. A series of univariate general linear models were used to assess the relationship between puberty health and health belief model constructs. Results: According to the results of this study there were positive significant relationships between perceived susceptibility, perceived benefits, perceived barriers, cues to action and increased puberty health in female adolescents (p<0.05). Perceived benefits, perceived barriers and cues to action were predictors of physical puberty health behaviors. Conclusion: Based on the results of the study to improve the physical Puberty health behaviors of female adolescents should make them aware of the benefits of health behaviors, and remove or reform the perceived barriers of health behaviors. Also, the appropriate information resources should be introduced for obtaining information about puberty health.

How can hospitals better protect the privacy of electronic medical records? Perspectives from staff members of health information management departments

PURPOSE

The adoption of electronic medical records (EMR) is expected to better improve overall healthcare quality and to offset the financial pressure of excessive administrative burden. However, safeguarding EMR against potentially hostile security breaches from both inside and outside healthcare facilities has created increased patients' privacy concerns from all sides. The aim of our study was to examine the influencing factors of privacy protection for EMR by healthcare professionals.

METHOD

We used survey methodology to collect questionnaire responses from staff members in health information management departments among nine Taiwanese hospitals active in EMR utilisation. A total of 209 valid responses were collected in 2014. We used partial least squares for analysing the collected data.

RESULTS

Perceived benefits, perceived barriers, self-efficacy and cues to action were found to have a significant association with intention to protect EMR privacy, while perceived susceptibility and perceived severity were not.

CONCLUSION

Based on the findings obtained, we suggest that hospitals should provide continuous ethics awareness training to relevant staff and design more effective strategies for improving the protection of EMR privacy in their charge. Further practical and research implications are also discussed.

Trust and online consumer health service success

We examine consumers’ early stage trust beliefs for effects on perceptions of information and system quality, later stage trust, satisfaction and usage intentions in the context of online health services. Using a longitudinal research design, data was collected from a sample of undergraduates during two time periods, approximately five weeks apart. Results show that trust in the website influences trust in the e-service provider at both early and later stages. Perceptions of system and information quality depend on trust, while trust and satisfaction are important to continued usage intentions. Results are important for understanding how trust interacts with IS success factors.

Impact of dining out on nutritional intake and metabolic syndrome risk factors: data from the 2011 Korean National Health and Nutrition Examination Survey

The frequency of dining out has rapidly increased; however, the independent associations between dining out, metabolic syndrome risk factors and nutritional status have not been well characterised. The aim of the present study was to investigate the associations between dining out, nutritional intakes and metabolic syndrome risk factors among Korean adults, using data from the 2011 Korean National Health and Nutrition Examination Survey. Frequency of dining out was significantly associated with intake of nutrients such as energy, water, protein, fat, carbohydrate, Ca, Na, vitamin A and carotene. Especially, the result revealed that Korean adults had insufficient Ca intake compared with the Korean reference intake (700 mg). As the frequency of dining out increased, so did energy intake. In addition, individuals who dined out seven or more times per week experienced a 64 % higher likelihood of blood pressure abnormalities, an 88 % higher likelihood of waist circumference abnormalities, and a 32 % higher likelihood of low HDL-cholesterol levels than those who dined out less than once per week. BMI was not associated with the frequency of dining out. Our findings suggest that strategies to modify dining-out behaviour could reduce metabolic syndrome risk factors via improved nutrition.

Understanding weight management perceptions in first-year college students using the health belief model

OBJECTIVE

To examine weight management barriers, using the Health Belief Model, in first-year college students.

PARTICIPANTS

First-year college students (n = 45), with data collected in April, May, and November 2013.

METHODS

Nominal group technique sessions (n = 8) were conducted.

RESULTS

First-year students recognize benefits to weight management beyond physical attractiveness to quality-of-life domains, including social (eg, bonding opportunities and energy to socially engage) and mental health (eg, stress management). Men believe that weight management is important for career/financial reasons, whereas women voiced that it will allow them to live a full, independent life with a high level of multitasking. Men believed that their barriers were external (eg, campus resources/programs), whereas females perceived their barriers to be internal (eg, poor time management).

CONCLUSIONS

College students are challenged by weight management and want the institution to provide resources, including curriculum, to help them manage their physical activity and nutrition behaviors.