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Angeli M, Hassandra M, Krommidas C, Morres I, Theodorakis Y. Assessing the Impact of a Health Education Anti-Smoking Program for Students: A Follow-Up Investigation. CHILDREN (BASEL, SWITZERLAND) 2024; 11:387. [PMID: 38671604 PMCID: PMC11049245 DOI: 10.3390/children11040387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/16/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
In this follow-up study, we aimed to assess the effectiveness of the "I do not smoke, I exercise" anti-smoking preventive health education program. The program was based on the theory of planned behavior supplemented with life skills teaching and targeted at high school students. The intervention comprised ten one-hour online sessions, administered by physical education instructors. The study cohort comprised 222 students (109 boys, 113 girls) from 11 secondary schools, with an average age of 16.42 ± 1.36 years. Data collection involved pre- and post-intervention self-assessment questionnaires. The examined variables included attitudes towards smoking, intention to smoke, subjective norm, perceived behavioral control (PBC), knowledge about smoking, smoking behavior, exercise behavior, attitudes toward the program's implementation, and satisfaction with the program. A separate paired samples t-test revealed a significant improvement in students' knowledge about smoking (t217 = -5.605, p < 0.001, d = 0.38) and perceived behavioral control (t220 = -2.166, p < 0.05, d = 0.15) following the intervention. However, no significant changes were observed in the remaining variables. In addition, students' overall satisfaction with the implementation of the present health education program was high (M = 5.72 ± 1.39). These findings suggest that the health education smoking prevention intervention incorporates techniques and strategies that influence the perceived behavioral control variable, emphasizing students' strong interest in educationally theorized programs integrating technology into their design. Future studies should consider further examination of tobacco control strategies within the high school context.
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Affiliation(s)
| | | | | | | | - Yannis Theodorakis
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece; (M.A.); (M.H.); (C.K.); (I.M.)
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Kidanu AW, Kidanu TW, Butler J, Dyer TV. A qualitative analysis of Ethiopian and Eritrean Americans' initiation and continuation of hookah smoking. J Ethn Subst Abuse 2023; 22:60-78. [PMID: 33554770 DOI: 10.1080/15332640.2021.1877230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Hookah smoking is emerging as a popular social practice and health behavior risk among Ethiopian and Eritrean Americans. This qualitative study was the second phase of a sequential exploratory mixed methods study and examined factors that enable the initiation and facilitate the continuation of hookah smoking among Ethiopian and Eritrean Americans. Semi-structured interviews were conducted with twenty-five Ethiopian and Eritrean American hookah smokers residing in the Washington, DC Metropolitan Area of the United States. Interview questions were guided by the Theory of Planned Behavior and addressed: (1) initiation of hookah smoking, (2) past and current patterns of hookah smoking, and (3) behavioral, control and normative beliefs toward hookah smoking. Several themes were identified under the core constructs of 'factors influencing hookah smoking initiation' and 'factors influencing hookah smoking continuation' such as curiosity, lack of health knowledge, socio-cultural acceptance, accessibility, flavor, physical dependence, physiological effects and social connections. Based on these findings, it is recommended that future prevention activities (e.g. health messages) be embedded into a comprehensive tobacco prevention approach to address individual misperceptions of harm and addiction, community social norms and environmental access around hookah smoking, which contribute to both initiation and continuation in the Ethiopian and Eritrean American populations.
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Affiliation(s)
| | - Tamnnet W Kidanu
- Carleton College, Office of Health Promotion, Northfield, Minnesota
| | - James Butler
- Behavioral and Community Heath, College Park, Maryland
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Choi Y, Suh KH. Verifying the usefulness of the theory of planned behavior model for predicting illegal use of online content: the role of outcome expectancies and social loafing. BMC Psychol 2022; 10:263. [DOI: 10.1186/s40359-022-00978-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/08/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Currently, laypeople can earn profit by producing content; therefore, it should be noted that the unauthorized use of intellectual creations or possessions can cause legal issues and undermine the producers’ desire to create. This study verified the usefulness of the theory of planned behavior (TPB) model for predicting the illegal use of online content among South Korean college students and examined the roles played by outcome expectancies and social loafing in this model.
Methods
The participants, 369 male and female Korean college students, were aged between 18 and 31 years (M = 22.12, SD = 2.33). We measured the illegal use of online content and the factors of the TPB model, as well as outcome expectancies and social loafing with regard to participants’ illegal use of online content. Correlational analysis, stepwise regression analysis, path analysis for the TPB model, and analyses of the moderated model were performed using SPSS and AMOS.
Results
All TPB factors, outcome expectancies, and social loafing were positively correlated with the illegal use of online content. Stepwise regression analysis showed that intention, social loafing, outcome expectancies, and perceived behavioral control were significant predictors of the illegal use of online content. A TPB model, including a direct path from perceived behavioral control to behavior, was validated to analyze the illegal use of online content. This model was found to be moderated by outcome expectancy.
Conclusion
This study suggests that the TPB is useful for predicting the illegal use of online content and that outcome expectancies and social loafing also play an important role in the illegal use of online content among college students. The findings of this study provide useful information for future research and could aid in preventing illegal online content use among adolescents and young adults.
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The Moderating Power of Impulsivity: A Systematic Literature Review Examining the Theory of Planned Behavior. PHARMACY 2022; 10:pharmacy10040085. [PMID: 35893723 PMCID: PMC9326604 DOI: 10.3390/pharmacy10040085] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/16/2022] [Accepted: 06/23/2022] [Indexed: 01/27/2023] Open
Abstract
The theory of planned behavior (TPB) states that behavioral intention is the best predictor of actual behavior change. However, intention explains only a portion of the variance in behavior. Of specific interest is the question of which moderating or mediating variables can be leveraged to aid health promotion interventions utilizing the tenets of behavioral economics (delay discounting and commitment contracts) in the intention–behavior pathway. Impulsivity has been postulated to fill this role and may be applied to multiple behaviors. We aim to determine if impulsivity moderates the association between intention and actual behavior in the TPB, to discover what other variables may moderate or mediate this association, and to apply the findings to future studies in the field of behavioral economics. To this end, a systematic review was conducted using the PubMed, PsychINFO, and Embase online databases. Eligible studies in peer-reviewed journals published prior to November 2021 were selected. Thirty-three studies were included in the final review, examining physical activity, diet, preventive health, mental health, addiction, and medication adherence behaviors. Three main concepts emerged: (1) impulsivity moderates the association between intention and behavior change; (2) self-efficacy moderates the association between intention and behavior change; and (3) planning and self-efficacy contribute to moderated mediation. This review demonstrates a gap in the literature regarding the application of the TPB to the intention–behavior pathway for health behaviors. Future studies in behavioral economics may leverage the variables of impulsivity, self-efficacy, and planning to predict follow-through in this area and to develop targeted change initiatives.
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Analysing the Influence of Companies’ Green Communication in College Students’ Green Purchase Behaviour: An Application of the Extended Theory of Planned Behaviour Model. ADMINISTRATIVE SCIENCES 2022. [DOI: 10.3390/admsci12030080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
In recent years, there has been a growing concern about the environmental impacts of consumers’ behaviour. As this environmental awareness increases, consumers tend to focus more on green products and how purchasing these products represents an effective way to protect the environment. Through the application of the theory of planned behaviour (TPB), in this research, we studied the influence of some key variables on college students’ green purchasing behaviour, namely perceived behavioural control, subjective norms, green attitudes, and green purchase intentions. The TPB model was extended to the analysis of the influence of the companies’ green communication on students’ green purchase behaviour. To achieve the proposed goal, from March to April of 2021, a survey was conducted among the students of a higher education institution (HEI) in Portugal, allowing us to gather 432 valid responses. The findings suggested that all the variables, except the subjective norms, had a positive influence on the students’ green purchase intentions. Moreover, it was observed that students’ intentions had a positive influence on their green purchase behaviour. This research provides important results not only for policymakers to promote more sustainable behaviours among consumers but also for companies to be more aware of the importance of green communication.
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Wang F, Gao S, Chen B, Liu C, Wu Z, Zhou Y, Sun Y. A Study on the Correlation Between Undergraduate Students’ Exercise Motivation, Exercise Self-Efficacy, and Exercise Behaviour Under the COVID-19 Epidemic Environment. Front Psychol 2022; 13:946896. [PMID: 35859845 PMCID: PMC9292573 DOI: 10.3389/fpsyg.2022.946896] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/13/2022] [Indexed: 11/14/2022] Open
Abstract
The outbreak of COVID-19 epidemic has influenced human beings from various aspects including physical exercise behaviours. This study aims to explore the influence of the COVID-19 epidemic on exercise self-efficacy and exercise behaviour, as well as the intermediary effects of exercise motivation. A sample of 1,115 undergraduate students was investigated using the physical exercise behaviour scale, exercise self-efficacy scale, and exercise motivation scale, combined with the COVID-19 epidemic environment as an influencing factor. SPSS was used for statistical analysis and AMOS for the prediction model building. Logical analysis was undertaken to sort out and analyse the data. The structural equation model reveals that exercise self-efficacy has a positive effect on exercise motivation and exercise behaviour. Meanwhile, the COVID-19 epidemic environment negatively influences exercise behaviour through the intermediary role of exercise self-efficacy and exercise motivation. Moreover, the intermediary effect of exercise self-efficacy is greater than that of exercise self-efficacy and exercise motivation. This study provides both theoretical implications and practical guidelines for society and undergraduate students to improve their exercise behaviour during epidemic.
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Affiliation(s)
- Fang Wang
- School of Physical Education, Sichuan University, Chengdu, China
| | - Shiying Gao
- School of Physical Education, Sichuan University, Chengdu, China
| | - Baoxia Chen
- School of Physical Education, Sichuan University, Chengdu, China
| | - Chenyu Liu
- Department of MA Filmmaking, University for the Creative Arts, Farnham, United Kingdom
| | - Zhusheng Wu
- School of Physical Education, Sichuan University, Chengdu, China
| | - Yan Zhou
- School of Physical Education, Sichuan University, Chengdu, China
| | - Yan Sun
- Cyberspace Institute of Advanced Technology, Guangzhou University, Guangzhou, China
- *Correspondence: Yan Sun,
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Zaheri H, Raziani Y, Khademi N, Moradi Y, Shahriari H, Ghanei‐Gheshlagh R. Prevalence of hookah smoking among Iranian pupils and university students: An updated systematic review and meta‐analysis. THE CLINICAL RESPIRATORY JOURNAL 2022; 16:425-440. [PMID: 35665461 PMCID: PMC9366573 DOI: 10.1111/crj.13511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/12/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Hamid Zaheri
- Student Research Committee Kurdistan University of Medical Sciences Sanandaj Iran
| | - Yosra Raziani
- Nursing Department Komar University of Science and Technology Sulaymaniyah Iraq
| | - Nesa Khademi
- Student Research Committee Lorestan University of Medical Sciences Khorramabad Iran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine Kurdistan University of Medical Sciences Sanandaj Iran
| | - Hossein Shahriari
- Faculty of Para Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Reza Ghanei‐Gheshlagh
- Social Determinants of Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran
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Zareban I, Karimy M, Araban M, Delaney D. Oral self-care behavior and its influencing factors in a sample of school children from Central Iran. ACTA ACUST UNITED AC 2021; 79:175. [PMID: 34635161 PMCID: PMC8507238 DOI: 10.1186/s13690-021-00695-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 09/20/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Oral health is an important part of public health and crucial to health promotion and enhancing the quality of life. This research examined childhood oral self-care behavior and their related factors using extended Theory of Planned Behavior (TPB). METHOD This cross-sectional study was conducted on 368 sixth-grade elementary school students in Saveh city, Iran, in 2019. The students were selected using a random multi-stage sampling method. The instrument included the socio-demographic questions, TPB constructs, and action and coping plan items. Data were analyzed by SPSS software (Version 21) at alpha level p ≤ 0.05. RESULT Overall, 24 (6.6%) students have never used toothbrushes, 222 (62.7%) have never used dental floss, and 298 (82.7%) students have never used mouthwash. The stepwise multiple linear regression analysis results indicated that the TPB with action and coping planning constructs had better predictive power than the original model. In the final model, coping planning (β = .28), intention (β = .24), action planning (β = .23), and perceived behavior control (β = .15) were the most important predictors of oral self-care behavior. CONCLUSION The results indicated that the oral self-care behavior status in Iranian elementary students was not favorable, and the extended model of the TPB with action and coping plan constructs were significant predictors of self-care behavior. Therefore, these findings emphasize the need for expanding educational interventions based on the extended model of the TPB to improve the oral self-care behavior of students.
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Affiliation(s)
- Iraj Zareban
- Health Promotion Research Center, Zahedan of University Medical Sciences, Zahedan, Iran
| | - Mahmood Karimy
- Social Determinants of Health Research Center, Saveh University of medical sciences, Saveh, Iran.
| | - Marzieh Araban
- Department of Health Education and Promotion, Social Determinants of Health Research Center, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Daniel Delaney
- Clinical Psychology Department, PhD. Student University of Rhode Island, New England, USA
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Karimian Z, Sadat Z, Afshar B, Hasani M, Araban M, Kafaei-Atrian M. Predictors of self-medication with herbal remedies during pregnancy based on the theory of planned behavior in Kashan, Iran. BMC Complement Med Ther 2021; 21:211. [PMID: 34404404 PMCID: PMC8369796 DOI: 10.1186/s12906-021-03353-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of application of medicinal herbs during pregnancy has increased significantly among women over the past years; however, the safety and efficacy of medicinal herbs during pregnancy are still unclear. The aim of the present study was to categorize the predictors of self-medication with herbal remedies during pregnancy based on the theory of planned behavior (TPB). METHODS The present descriptive-analytical study was conducted on 300 pregnant women referred to Kashan health center to receive prenatal care services in 2020. The study participants were randomly selected using stratified random sampling with proportional allocation. The data collection tool was a two-part researcher made questionnaire. The first part of the questionnaire included demographic information, midwifery information, and questions related to women's awareness about herbal medicine. The second part of the questionnaire was designed based on the theory of planned behavior including attitudes, perceived behavioral control, subjective norms, intention, and behavior performance. Data were analyzed using descriptive statistics, regression analysis, and SPSS version 18.0. RESULTS The mean age of participants was 28. 7±5.4 years (range, 15-45 years), the majority were housewives (88.3%) and had secondary education (39.3%). A total of 164 women (57. 1%) used medicinal herbs during pregnancy. The individual's attitude towards herbal medicines consumption, subjective norm, and perceived behavioral control was correlated with behavioral intention (P < 0.05). Similarly, subjective norms were the most predictor of using herbal medicine among pregnant women (P < 0.05). CONCLUSION The findings revealed that more than 50 % of pregnant women used medicinal herbs during pregnancy. The present study showed that the individual's attitude towards herbal medicines consumption, subjective norm, and perceived behavioral control was correlated with intention of herbal medicine use among pregnant women. Likewise, subjective norms were the most predictor of herbal medicine use among pregnant women. The TPB should be addressed in planning health education programs and modifying health behaviors, including self-medication, especially during pregnancy.
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Affiliation(s)
- Zahra Karimian
- Department of midwifery, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Zohreh Sadat
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.
| | - Bahareh Afshar
- Ms.c of midwifery counseling, Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Hasani
- Department of midwifery, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Marzieh Araban
- Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahbubeh Kafaei-Atrian
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.,Department of midwifery, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
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Haryanto AN, Noer M, Kusumayati A, Machmud R, Hafizurrachman H, Bachtiar A. Determinant of Smoking Behavior among Elementary Student in Indonesia: A Structure Equation Model. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Initial smoking exposure may occur during early adolescence (aged 10–12 years old), and it increases overtime. Although several factors for smoking behaviors exist among adolescents, there are few studies address determinant of smoking behavior by adding others variables in theory of plan behavior such as smoking refusal skills, self-regulation, parenting, family function, environment, and culture.
AIM: The aim of this study was, therefore, to evaluate the determinant of smoking behavior among elementary student in Indonesia using a structural equation model.
METHODS: A cross-sectional survey was carried out from June to October 2019 in West Java, Indonesia. For each school, students were selected using a systematic random sampling technique. The study included girls and boys ages 10–12. The consent was obtained by the parent or guardian. Structural equation modeling was used for analysis.
RESULTS: The mean age was 10.56 years (SD = 0.37). About 28.6% of them were currently smoking with aged of first use was 10.02 (SD = 0.19). More than half (56%) of their family were currently smoking too and friend smoking was 41.7%. The final model accounted for 27% and 39% of the variance of intention and smoking behavior, respectively, has both direct and indirect effects through empowerment on self-care behaviors toward pregnancy-related complication.
CONCLUSION: The present study was intended to expand the theory of planned behavior by including additional variables in its model: Smoking refusal skills, self-regulation, parenting, family function, environment, and culture. This study also provides a significant contribute for clinical a practice and policy-maker as a basic data to establish future intervention to promote no tobacco use among elementary student to achieve optimal well-being to prevent a fatal disease.
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Maharani DA, Nadira KV, Setiawati F, El Tantawi M. Intention to provide tobacco cessation counseling among Indonesian dental students and association with the theory of planned behavior. BMC Oral Health 2021; 21:23. [PMID: 33413333 PMCID: PMC7790038 DOI: 10.1186/s12903-020-01348-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 11/22/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Use of tobacco is a serious public health problem in Indonesia that requires a multidisciplinary approach by healthcare providers to address it. The study assessed the intentions of undergraduate students in dental schools to provide tobacco cessation counseling (TCC) and their association with the constructs of the theory of planned behavior (TPB). METHODS A cross sectional study was conducted in October 2019 using an electronic survey for dental students in Indonesian dental schools (n = 30). The survey assessed schools and students' characteristics and eleven statements assessed their perspectives toward TCC based on the TPB using a 5-point Likert scale. Principal component analysis (PCA) was used to identify components within the items of perspective. Multilevel linear regression analysis was used to assess the association between intention to provide TCC and the constructs of the TPB as identified in the perspectives' items using TPB controlling for confounders. RESULTS About 1288 students participated from 30 dental schools, 83.3% females with mean age = 21.5 years with average intention to provide TCC = 4.3 out of 5. They had above average positive attitude about provision of TCC being the dentist's role (mean = 3.8 out of 5). PCA identified two components: confidence in their own abilities and perception of favorable environment with average scores = 3.2 and 2.7 out of 5. Intention to provide TCC was significantly associated with more positive attitude recognizing TCC as a dentist's role (B = 0.10, P < 0.0001), greater confidence in skills to provide TCC (B = 0.17, P < 0.0001) and less perception of favorable environment supportive off providing TCC (B = - 0.20, P < 0.0001). CONCLUSIONS Indonesian dental students' intention to provide TCC can be explained by the constructs of the TPB. Development of dental curricula promoting professional responsibility toward TCC should be given attention. Improving students' attitude and confidence potentially may support their patients' efforts to quit smoking.
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Affiliation(s)
- Diah Ayu Maharani
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, Jalan Salemba No. 4, Jakarta, 10430, Indonesia.
| | - Kiarra Vashti Nadira
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, Jalan Salemba No. 4, Jakarta, 10430, Indonesia
| | - Febriana Setiawati
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, Jalan Salemba No. 4, Jakarta, 10430, Indonesia
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Tapera R, Mbongwe B, Mhaka-Mutepfa M, Lord A, Phaladze NA, Zetola NM. The theory of planned behavior as a behavior change model for tobacco control strategies among adolescents in Botswana. PLoS One 2020; 15:e0233462. [PMID: 32502211 PMCID: PMC7274417 DOI: 10.1371/journal.pone.0233462] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 05/05/2020] [Indexed: 12/29/2022] Open
Abstract
Background Behavioral intentions (motivational factors), attitudes, subjective norm (social pressures), and perceived behavioral control promote or discourage smoking behavior among adolescents. Objective To assess students’ behavioral intentions, attitudes, subjective norms and perceived behavioral control on smoking using the Theory of Planned Behavior. The prevalence of smoking among the adolescents is also calculated. Methods In this cross-sectional study, structured self-administered questionnaires were used to collect data from adolescents in primary and secondary schools. Data on demographics, behavioral intentions, attitudes, subjective norms, and perceived behavioral control towards smoking were collected. Pearson product moment correlations and logistic regression models were used to determine factors associated with current smoking. Results A total sample of 2554 (mean age = 15; Range = 12–18 years) students participated in the study. Twenty-nine percent (n = 728) of the students had tried smoking at least once. Smoking was predicted by attitudes, subjective norms, perceived behavioral control and intention.There was a strong association between having a parent or guardian, caregiver or close friend who smoked (p < 0.001) and being a smoker. The majority of students (57%) conveyed that adults talked to them about the harmful effects of cigarette smoking and 50% had discussed smoking concerns with their friends. Students who had positive attitudes towards smoking like “smoking makes you confident” were more likely to be current smokers (OR: 1.63, 95% CI: 1.03–2.59). The feeling or conviction that they could refuse a cigarette if offered was an impediment from smoking (OR: 0.18, 95% CI: 0.13–0.26). Conclusions Attitudes, subjective norms, and perceived behavioral control contributed significantly to the students' smoking. Right attitudes must be cultivated and behavioral control must be strengthened for early effective interventions to curtail smoking among adolescents.
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Affiliation(s)
- Roy Tapera
- Deaprtment of Environmental Health, School of Public Health, University of Botswana, Gaborone, Botswana
- * E-mail:
| | - Bontle Mbongwe
- Deaprtment of Environmental Health, School of Public Health, University of Botswana, Gaborone, Botswana
| | - Magen Mhaka-Mutepfa
- Department of Psychology, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana
| | | | | | - Nicola M. Zetola
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Ngwenya N, Nkosi B, Mchunu LS, Ferguson J, Seeley J, Doyle AM. Behavioural and socio-ecological factors that influence access and utilisation of health services by young people living in rural KwaZulu-Natal, South Africa: Implications for intervention. PLoS One 2020; 15:e0231080. [PMID: 32287276 PMCID: PMC7156071 DOI: 10.1371/journal.pone.0231080] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 03/16/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Young people's health service utilisation (the number accessing a facility) has been the focus of guidelines and health systems strengthening policies. This is due to young people being at an increased health risk because of inequitable access and utilisation of health services, which is more pronounced in rural settings with limited service availability. This is a major concern as globally, youth constitute a considerable and increasing part of the population in Sub-Saharan Africa. OBJECTIVE The objective of this paper is to present a comprehensive approach for the exploration of health service utilisation by young people in rural KwaZulu-Natal, South Africa. We examined barriers and facilitators conceptualised by the constructs of the Theory of Planned Behaviour, framed within a socio-ecological model. METHODS Data were collected in January to June 2017 from two sites using in-depth interviews, spiral transect walks and community mapping with young people (aged 10 to 24 years), primary care health providers, school health professionals, community stakeholders and young people's parents. RESULTS Socio-ecological and behavioural factors influenced young people's intention to use services. Barriers included perceived negative attitudes of health providers and perceived poor staff competencies. Facilitators included an appreciation of receiving health education and assumed improved health. At social and community levels, normative beliefs hindered young people from utilising services as they feared stigmatisation and gossip. At a public policy level, structural elements had a disempowering effect as the physical layout of the clinics hindered utilisation, limited resources influenced staffing, and facility opening times were not convenient for school goers. CONCLUSION We suggest that to fully appreciate the complexity of health service utilisation, it is necessary to not only consider factors and processes relevant to the individual, but also acknowledge and act upon, the disjuncture between community level cultural values, norms and national policies.
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Affiliation(s)
| | - Busisiwe Nkosi
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | | | - Jane Ferguson
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Janet Seeley
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Aoife M. Doyle
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Othman M, Aghamohammadi N, Nik Farid ND. Determinants of shisha use among secondary school students in Sudan. BMC Public Health 2019; 19:1390. [PMID: 31660934 PMCID: PMC6819635 DOI: 10.1186/s12889-019-7748-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/04/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Shisha smoking has re-emerged in the Middle East in the last two decades and has spread rapidly in these communities. Information about shisha smoking in adolescents in Sudan is deficient. Hence, the aim of this study is to estimate the prevalence of shisha smoking among adolescents and determine the associated factors. METHODS This study is a school based cross sectional study among secondary school students in Khartoum State - Sudan that targets both male and female students aged 14-17 years. A total of 3387 students from 29 public and private schools were selected by multi stage random sampling. The participants completed an anonymous self-administered questionnaire which was based on Arabic version of the Global Youth Tobacco Survey (GYTS). RESULTS The response rate was 100% in schools and among participants, 57.3% were females and 51.6% were from public schools. The overall prevalence of those who had ever smoked shisha was 13.4%, and among male students the prevalence was 16.8%, while it was 10.9% in females. The associated factors were poor academic performance OR 2.90 CI 95% (1.21-6.94), friends smoking shisha OR 2.39 CI 95% (1.65-3.45), friends smoking cigarettes OR 2.76 CI 95% (1.90-4.01), peer pressure to smoke shisha OR 13.76 CI 95% (7.86-24.07) and unexpectedly restriction of selling shisha to minors OR 2.21 CI 95% (1.28-3.82). CONCLUSION The prevalence of those who had ever smoked shisha is among the lowest in Middle East region; therefore, regular surveillance system is needed. A well-structured peer based comprehensive tobacco control programmes that are supported by strict and rigorous anti-tobacco regulations which control both commercial and social resources of tobacco are needed to contain this issue among adolescents.
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Affiliation(s)
- Mohammed Othman
- Department of Social and Preventive medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nasrin Aghamohammadi
- Centre for Occupational and Environmental Health, Department of social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Daliana Nik Farid
- Department of Social and Preventive medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Karimy M, Rezaee-Momtaz M, Tavousi M, Montazeri A, Araban M. Risk factors associated with self-medication among women in Iran. BMC Public Health 2019; 19:1033. [PMID: 31370891 PMCID: PMC6676788 DOI: 10.1186/s12889-019-7302-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 07/10/2019] [Indexed: 01/15/2023] Open
Abstract
Background Self-medication is a public health concern that may create several problems such as increase in drug resistance, raise in drug use per capita, and creating side effects. This study was conducted to determine predictors of self-medication based on the theory of planned behavior (TPB) among the Iranian women. Methods This was a cross sectional study. A sample of married women completed a validated, anonymous, self-administered questionnaire. The questionnaire included items on demographic variables, knowledge, and TPB structures, and the checklist of women’s self-medication practices. The study was conducted in six urban health centers of Shush and Zarandieh in Iran during January to July 2016. Data were analyzed using SPSS 23.0 applying t-test and logistic regression. Results A total of 360 women took part in the study. The results showed that 76% of women had a history of self-medication and 98.9% stored drugs at home. The most important reasons for self-medication were perceived self-medication harmless (41%), having history of a disease (35.5%), and availability of medications at home (34%). The most frequent diseases for self-medication were fatigue, weakness, and anxiety (24%), and fever (20%). The results obtained form logistic regression analysis indicated that age, place of residence, education level, health insurance status, as well as all constructs of the TPB were significant predictors for self-medication. Conclusion The findings indicated that the prevalence of self-medication among Iranian women was high. Since women have important role in shaping the family health, the issue of high prevalence among this population should be considered as a serious problem in Iran. In this regard, it is recommended to consider factors affecting self-medication among women to reduce this health threatening factors.
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Affiliation(s)
- Mahmood Karimy
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Majed Rezaee-Momtaz
- Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmoud Tavousi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Ali Montazeri
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Marzieh Araban
- Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. .,Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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About Intentions to Donate for Sustainable Rural Development: An Exploratory Study. SUSTAINABILITY 2019. [DOI: 10.3390/su11030765] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Theory of Planned Behaviour (TPB) was used to investigate factors affecting the intention of citizens to donate money altruistically for sustainable rural development projects in Spain. To achieve this aim, individuals’ attitudes, subjective norms and perceived behavioural control have been considered; also, Azjen’s model was further extended to include additional elements: Moral norms, past behaviour, knowledge and some background factors. Respondents completed an online questionnaire assessing domains elaborated in the extended TPB model. Hierarchical multiple regression analysis revealed support for the model. Attitudes, injunctive norms, perceived behavioural control, moral norms, past behaviour, crowdfunding knowledge, age and employment condition were found to have positive and significant influence on intentions to donate. Theoretical and applied implications of the results are discussed, highlighting important considerations for public policy.
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Extended Theory of Planned Behavior (ETPB): Investigating Customers’ Perception of Restaurants’ Sustainability by Testing a Structural Equation Model. SUSTAINABILITY 2018. [DOI: 10.3390/su10072580] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In the modern competitive scenario, all companies seek to understand how to achieve success. One of the keys to conquer/maintain market shares is sustainability, which is a hot topic of numerous studies that have focused on its use as a solution to obtain social, environmental, economic, and cultural benefits. To this end, the present work aims to identify the variables able to guide consumers towards the choice of sustainable restaurants through the conceptual extension of a theoretical model known in literature as Theory of Planned Behavior (TPB). The authors propose an Extended Theory of Planned Behavior (ETPB), consisting of seven variables: attitude; subjective norm; perceived behavioral control; perceived usefulness; curiosity; behavioral intention; and behavior. The authors used a quantitative approach based on the test of a Structural Equation Model (SEM). Overall, 1023 questionnaires were analyzed. The results of the analysis provided empirical evidence for the hypotheses formulated suggesting that attitude, subjective norm, perceived behavioral control, perceived usefulness, and curiosity affected the consumers’ behavioral intention to prefer sustainable restaurants and that behavioral intention affected their actual behavior. Based on what emerged from the analysis, the work could be understood as a useful tool for scholars and practitioners, suggesting interesting theoretical and managerial implications. In fact, on the one hand, it contributes to the enrichment of scientific literature related to the factors triggering human choices, and, on the other, it helps maximize the success of the restaurants by highlighting the levers to be actioned to improve business performances. However, the paper presents a main limit, linkable to the fact that, whilst the use of questionnaires represents an advantage in terms of sample size, on the other hand, it does not allow us to go deeper in understanding the reasons why people prefer restaurants that adopt sustainable practices.
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Knowledge and Attitudes of University Students Towards Hookah Smoking in Fasa, Iran. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2018. [DOI: 10.5812/ijpbs.11676] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Bashirian S, Barati M, Mohammadi Y, Mostafaei H. Factors Associated with Hookah Use among Male High School Students: The Role of Demographic Characteristics and Hookah User and Non-User Prototypes. J Res Health Sci 2016; 16:217-223. [PMID: 28087855 PMCID: PMC7189923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 11/04/2016] [Accepted: 11/29/2016] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND As students' hookah use has become a widespread problem in the developing countries, it is time to understand the cognitive determinants of students' decisions to do so. This study aimed to investigate the roles of psychological and demographic factors associated with hookah use among male high school students. METHODS This descriptive-analytical study was performed among 601 high school male students, recruited through multistage sampling method in the Kermanshah City, west of Iran in 2016. The data-gathering tool consisted of a self-administered questionnaire with questions about hookah use behavior and demographic, behavioral and psychological variables. Data were analyzed using SPSS-18 software using chi-square and logistic regression. RESULTS 36.1% of the participants reported ever hookah use and 17.1% mentioned using hookah in the past month. Pleasure (28.1%) and sensation seeking (22.5%) were common reasons of hookah use. In comparison to non-users, hookah users evaluated a typical hookah user as more clever, less immature, more popular, more attractive, more self-confident, more independent, and less selfish (P<0.001). CONCLUSIONS The results revealed the importance of psychological factors when examining students' hookah use status. Thus, design and implementation of interventions might be effective in prevention of hookah use among students.
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Affiliation(s)
- Saeed Bashirian
- a Social Determinants of Health Research Center and Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Majid Barati
- b Behavioral Disorders and Substance Abuse Research Center and Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Younes Mohammadi
- c Modeling of Noncommunicable Diseases Research Center and Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Hossein Mostafaei
- d Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
,Correspondence Hossein Mostafaei (MSc)) Tel: +98 81 38380090
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