Does knowledge and concern regarding food supplement safety affect the behavioral intention of consumers? An experimental study on the theory of reasoned action

In recent years, health crises have led consumers to make more frequent purchases of food supplements. The global food supplement market, which reached $61.20 billion in 2020, is estimated to reach $163.12 billion by 2022 and $350.96 billion by 2032. However, many consumers still have concerns about the safety of food supplements. Within the scope of the research, firstly, the health consciousness (HC) level of food supplement consumers was determined. Secondly, food safety knowledge (FSK) and food safety concerns (FSCs) were measured. Thirdly, consumers' attitudes (ATUs), subjective norms (SNs), and behavioral intentions (BIs) toward food supplements were determined within the scope of the theory of reasoned action. The study used a convenient sampling, and 327 participants were included in the sample population. The data for the analysis was collected using the online survey method in the third quarter of 2023. The relationships between hypothesized items in the structural model were tested using the Smart-PLS. The validity and reliability of the measurement model were evaluated at the start of the structural equation modelling approach using confirmatory factor analysis (CFA). Regression analyses were performed in the structural model phase to evaluate overall fit and suggested relationships by way of the Smart-PLS. In light of the findings, it was determined that the interaction between HC and ATU was mediated by FSK, and the interaction between HC and the SN was mediated by FSK. Consequently, this research presents a variety of theoretical and practical implications to give clues for consumers' health regarding food supplement consumption.

Consumers' Preferences and Attitudes towards Plant-Based Milk

Plant-based milk (PBM) has become increasingly popular due to its environmental sustainability, health benefits, ingredient abundance, and unique taste. This study aims to identify the main factors that affect consumer preferences and attitudes towards PBM, and to examine the effect of consumer attitudes including environmental awareness, health consciousness, and food neophobia on WTP. We use the double-bounded dichotomy choice (DBDC) method to calculate consumers' willingness to pay (WTP) for PBM. We find that the appearance, taste, nutritional value, and environmental benefits of PBM significantly increase consumers' WTP for it. Consumers with high environmental awareness are more likely to perceive PBM as environmentally friendly and are willing to pay a higher price for it. Consumers with high health consciousness tend to value the environmental benefits of PBM and prioritize purchase convenience, as it aligns with their health-conscious lifestyle, leading to a higher WTP for PBM. The results of our study can help design effective strategies to market plant-based milk and develop sustainable and healthy food systems.

Exploring factors influencing domestic violence: a comprehensive study on intrafamily dynamics

Introduction

This econometric analysis investigates the nexus between household factors and domestic violence. By considering diverse variables encompassing mood, depression, health consciousness, social media engagement, household chores, density, and religious affiliation, the study aims to comprehend the underlying dynamics influencing domestic violence.

Methods

Employing econometric techniques, this study examined a range of household-related variables for their potential associations with levels of violence within households. Data on mood, depression, health consciousness, social media usage, household chores, density, and religious affiliation were collected and subjected to rigorous statistical analysis.

Results

The findings of this study unveil notable relationships between the aforementioned variables and levels of violence within households. Positive mood emerges as a mitigating factor, displaying a negative correlation with violence. Conversely, depression positively correlates with violence, indicating an elevated propensity for conflict. Increased health consciousness is linked with diminished violence, while engagement with social media demonstrates a moderating influence. Reduction in the time allocated to household chores corresponds with lower violence levels. Household density, however, exhibits a positive association with violence. The effects of religious affiliation on violence manifest diversely, contingent upon household position and gender.

Discussion

The outcomes of this research offer critical insights for policymakers and practitioners working on formulating strategies for preventing and intervening in instances of domestic violence. The findings emphasize the importance of considering various household factors when designing effective interventions. Strategies to bolster positive mood, alleviate depression, encourage health consciousness, and regulate social media use could potentially contribute to reducing domestic violence. Additionally, the nuanced role of religious affiliation underscores the need for tailored approaches based on household dynamics, positioning, and gender.

Validation of the Health Consciousness Scale among the Czech Population

The COVID-19 pandemic has demonstrated the importance of maintaining good health. It became has become apparent that health consciousness is a crucial factor in promoting healthy lifestyles, disease prevention, and the overall well-being of individuals. A higher level of health consciousness is associated with healthy habits, better adherence to medical recommendations, and a higher quality of life. Therefore, health consciousness is a critical construct in health care that reflects the degree to which individuals care about their health. This study, which is based on a representative sample of the adult population (n = 1372), aims to validate the Health Consciousness Scale (HCS) to assess its reliability and validity, and evaluate the factor structure of the translated version of the scale in the Czech language. The validation of the HCS in the Czech context is a significant step forward and provides useful information for healthcare professionals, policymakers, and researchers. The findings of this study contribute to the understanding of health consciousness in the Czech population and provide unique information for the development and evaluation of health interventions aimed at promoting healthy behaviors and attitudes.

Development and Initial Validation of Scores on The Lifestyle Practices and Health Consciousness Inventory-2: Brief Version

We developed and validated scores on the Lifestyle Practices and Health Consciousness Inventory (LPHCI)-2: Brief Version, a short form for measuring global wellness (mental and physical health). Tests of internal structure (EFA, CFA, and higher-order CFA) as well as convergent validity supported the psychometric properties of LPHCI-2: Brief Version scores.

A Psychometric and Relative Importance Evaluation of Health Literacy and Health Consciousness on COVID-19 Preventive Behaviors Among Hispanic Adults

Given the COVID-19 pandemic's disproportionate impact on Hispanic individuals in the United States, research examining modifiable psychosocial correlates of COVID-19 preventive behaviors in this population is warranted. Prior research highlights health literacy and health consciousness as integral for the establishment of health-promoting behaviors. Notwithstanding, very little research has validated theory-based measures for health literacy and health consciousness and no research has investigated their relative importance in explaining behaviors that prevent COVID-19 illness among Hispanic individuals. This information is necessary for informing behavioral interventions seeking to promote the well-being of Hispanic people during the current pandemic and in future ones. This study provides a psychometric evaluation of the General Health Literacy Scale (GHLS) and the Health Consciousness Scale (HCS) and further examines their association with conventional COVID-19 preventive behaviors. Confirmatory factor analyses evaluated the psychometric properties of GHLS and HCS. Four separate hierarchical linear regressions, followed by dominance analyses, estimated the relative importance of health literacy and health consciousness on COVID-19 preventive behaviors, adjusting for sociodemographic characteristics. Both GHLS and HCS achieved adequate psychometric criteria, and holding constant sociodemographic characteristics, positively related to COVID-19 preventive behaviors. Although both health literacy and health consciousness were more important than sociodemographic characteristics in explaining COVID-19 preventive behaviors, health consciousness was most important, exceeding the explanatory power of health literacy in all regressions. COVID-19 public health campaigns that seek to raise health awareness among Hispanic people might prove more effective than campaigns that only seek to improve their health literacy.

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

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

Consumer motivation for organic food consumption: Health consciousness or herd mentality

Whether health awareness is self-awareness or conformity awareness is a question worth discussing. Especially under the current trend of organic food consumption, whether it is driven by health consciousness or herd mentality is worth exploring. This is not only about the government's formulation of health policies for the industry (for example, paying more attention to health standards), but also about the sustainable development of organic food consumption (for example, suppliers highlighting their own health advantages). However, there is still little research in this area. Based on data from 1,658 respondents in four first-tier cities in China, this paper explores whether consumers are consuming organic food under health consciousness or herd mentality. This paper uses a logit model to explore the key causes of health consciousness or herd mentality, and uses a propensity score matching (PSM) method to measure the impact of health consciousness and herd mentality on organic food consumption, comparing the effects across age and education groups. The results show that: (1) Individual characteristics, family characteristics, health status, volition, social trust and market education significantly influenced consumers' health consciousness or herd mentality; (2) The main motivation for organic food consumption is health consciousness, but herd mentality plays a role of amplifying this effect.

"It Will Lead You to Make Better Decisions about Your Health"-A Focus Group and Survey Study on Women's Attitudes towards Risk-Based Breast Cancer Screening and Personalised Risk Assessments

Singapore launched a population-based organised mammography screening (MAM) programme in 2002. However, uptake is low. A better understanding of breast cancer (BC) risk factors has generated interest in shifting from a one-size-fits-all to a risk-based screening approach. However, public acceptability of the change is lacking. Focus group discussions (FGD) were conducted with 54 women (median age 37.5 years) with no BC history. Eight online sessions were transcribed, coded, and thematically analysed. Additionally, we surveyed 993 participants in a risk-based MAM study on how they felt in anticipation of receiving their risk profiles. Attitudes towards MAM (e.g., fear, low perceived risk) have remained unchanged for ~25 years. However, FGD participants reported that they would be more likely to attend routine mammography after having their BC risks assessed, despite uncertainty and concerns about risk-based screening. This insight was reinforced by the survey participants reporting more positive than negative feelings before receiving their risk reports. There is enthusiasm in knowing personal disease risk but concerns about the level of support for individuals learning they are at higher risk for breast cancer. Our results support the empowering of Singaporean women with personal health information to improve MAM uptake.

"Digital Dividend" or "Digital Divide": What Role Does the Internet Play in the Health Inequalities among Chinese Residents?

With the vigorous development of the medical industry in China, residents' health has been significantly improved. However, along with the income gap, urban-rural gap, and healthcare resource gap caused by economic development, health inequality has become a fundamental barrier to the promotion of residents' health. The popularity of the Internet has helped close the gap to some extent, but it also has drawbacks. Using data from the China Family Panel Studies (CFPS) from 2014 to 2018, we evaluated the effects of Internet usage on health disparities among residents using fixed effect models, mediation effect models, and other methodologies. The findings indicate that Internet usage can help to minimize health inequality since it lowers income inequality, promotes health consciousness, and reduces depression. Furthermore, Internet usage plays a greater role on the health improvement of the middle-aged, the elderly, urban residents, and females. Although the Internet has brought "digital dividends" in general, the Internet usage rates among different groups also reveal that there is a clear "digital gap" among rural residents, elderly groups, and low-income groups. These results have significant implications for promoting healthcare equality.

Social Acceptance of Mobile Health among Young Adults in Japan: An Extension of the UTAUT Model

The unprecedented development of information and communication technologies has opened up immense possibilities in the field of health care. Mobile health (mHealth) is gaining increasing attention as an important technology for solving health-related problems. Although a high rate of smartphone usage among young people in Japan has been identified, smartphone usage for health management is not high. As Japanese youth are important potential users of mHealth, it is necessary to explore theories that influence the behavioral intention of Japanese youth to adopt mHealth. This study conducted a questionnaire survey in a Japanese university and collected 233 valuable responses. This study was adapted and extended from the unified theory of acceptance and use of technology (UTAUT) model to measure eight constructs: health consciousness, social influence, facilitation conditions, perceived risk, trust, performance expectancy, effort expectancy, and behavioral intention. Structural equation modeling was used for hypothesis testing. We found that trust, performance expectancy, and effort expectancy directly influenced the behavioral intention to use mHealth. Health consciousness and social influence indirectly influence behavioral intention through trust and performance expectancy. Facilitation conditions indirectly influenced behavioral intention through effort expectancy. This study makes a vital theoretical contribution to policymakers and product developers for the further diffusion of mHealth among young people in Japan.

Impact of COVID-19 anxiety on functional foods consuming intention: role of electronic word of mouth☆

Purpose

The COVID-19 pandemic, which involving mass quarantines in many nations, has affected consumer health consciousness behaviors, including food consumption. This study aimed to investigate the impact of COVID-19 anxiety on functional food consumption within the framework of changes in health concerns and electronic word-of-mouth communication through digital platforms, paying special attention to the moderating effect of trust on eWOM information.

Design

/methodology/approach: This cross-sectional study included 527 participants. The data were analyzed using a structural equation modeling approach. Mediating moderating effects were tested using bootstrapping and multigroup methods.

Findings

Anxiety about the COVID-19 virus has a great impact on individuals’ health concerns, word-of-mouth information seeking, and functional food consumption intention. Mediating effects of health consciousness and eWOM on functional food consumption intention were also observed. The anxiety about the COVID-19 virus and health consciousness triggers eWOM communication, and is a strong driver of intention to purchase functional foods if people trust the eWOM information source.

Originality/value

While scholars have demonstrated the impact of COVID-19 on human behavior, a largely uninvestigated issue is the effect of COVID-19 virus anxiety on health product consumption. This is one of the first studies to examine the interrelationships among COVID-19 anxiety, health consciousness, eWOM, and functional food consumption intention.

This study provides valuable insights into consumer behavior during the COVID-19 pandemic. Future research should consider the effect of COVID-19 virus anxiety on health-related issues and nutritional behavioral consequences. Based on the results, implications for managers and researchers are proposed.

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Covid-19 virus anxiety impact individuals’ concern of health and functional foods consuming intention.

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eWOM communication mediate the effect of anxiety of Covid-19 virus and functional foods consuming intention.

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Trust on eWOM information moderates these relations.

Consumer Attitudes and Purchase Intentions in Relation to Animal Welfare-Friendly Products: Evidence from Taiwan

Animal welfare, environmental sustainability, and food safety have become topics of international concern. With the rise of friendly rearing and green consumption consciousness, consumers can use animal welfare certification labels as references to make purchase decisions. This study adopts the theory of planned behavior (TPB) as its core and incorporates variables, such as moral affection, health consciousness, and trust in certification, to discuss the thoughts of Taiwanese consumers on buying animal welfare-friendly products and the factors that affect their purchase decisions. This study will be conducive in clarifying the consumption behavioral pattern of animal welfare-friendly products, which previous literature has mentioned but not tested, thereby filling this literature gap. This study collects 653 valid questionnaires and uses the partial least square-structural equation modeling to analyze the correlations between various variables. The research findings indicate the following. (1) Consumers' attitudes, subjective norms, and perceived behavioral control have significant and positive influences on the behavioral intention of purchasing fresh milk with animal welfare labels. (2) Moral affection positively influences customers' behavioral intention toward fresh milk with an animal welfare label through attitudes, subjective norms, and perceived behavioral control. (3) Trust in certifications will enhance moral cognition and positive attitudes toward fresh milk with animal welfare labels. According to the research findings of this study, we recommend that businesses strengthen the promotion of dairy products in line with friendly rearing, environmental sustainability, and other ethical consumption concepts to generate market segregation elements.

Research on patients' willingness to conduct online health consultation from the perspective of web trust model

Background and aims

The online health platform becomes an important choice for users to receive health services. While bringing convenience to users, it also provides lots of overloaded information for users and leads them to have trouble in making online medical choice decisions. In order to understand what types of information on the online health platform play key roles in the user's decision choice, this research explores the effects of cognition-based information, affect-based information and institution-based information on patients' willingness to conduct online health consultation from the perspective of Web Trust Model.

Methods

Responses of 412 valid questionnaires were collected via online surveys.

Results

The results showed that: (1) cognition-based information, affect-based information and institution-based information positively predict patients' willingness to conduct online health consultation; (2) online trust significantly mediates the relationship between online health platform information and willingness to conduct online health consultation; (3) health consciousness significantly moderates the mediating effect of online trust in the effect of online health platform information on patients' willingness to conduct online health consultation.

Conclusions

The findings make theoretical contributions by extending the Web Trust Model to the research field of online health service and offers practical implications for how to effectively provide information on the online health platform.

Augmented reality advertising and college students' interest in the extreme sports: Moderating role of innovation resistance and health consciousness

Advertising and promotions are the most utilized types of augmented reality (AR) activations for marketers across all industries. The same is true for the sports industry. This form of augmented reality is meant to bring attention to the organization through a novel technology such as AR. Recently, a lack of interest among students in extreme sports has been attributed to a lack of professional advertising and marketing innovation. This situation requires the attention of researchers, and this study investigates the impact of augmented reality advertising on college students' interest in extreme sports, specifically in China. The article also investigates the moderating role of innovation resistance and health consciousness in the relationship between augmented reality advertising and college students' interest in extreme sports in China. Students actively participating in sports were selected using the purposive sampling technique, and AMOS was used for data analysis. According to the findings, augmented reality advertising positively correlates with interest in extreme sports. The findings also revealed that innovation resistance and health consciousness significantly moderated college students' interest in extreme sports and augmented reality advertising. This research assists regulators in developing regulations to increase interest in extreme sports through augmented reality advertising and innovation adoption.

Chinese Residents' Healthy Eating Intentions and Behaviors: Based on an Extended Health Belief Model

Unhealthy eating is one cause of obesity and some chronic non-communicable diseases. This study introduces self-efficacy and health consciousness to construct an extended health belief model (HBM) to examine the factors influencing healthy eating intentions and behaviors of Chinese residents and explore the moderating effect of perceived barriers and the mediating effect of healthy eating intentions. Through the survey platform “Questionnaire Star”, this study collected quantitative data from 1281 adults, and partial least squares structural equation modeling was used for confirmatory factor analysis, path analysis, importance-performance map analysis, and multi-group analysis. Results showed that perceived susceptibility, perceived severity, perceived benefits, self-efficacy, and health consciousness had a significant positive effect on residents’ healthy eating intentions. Perceived barriers had a significant negative effect on residents’ healthy eating intentions. Healthy eating intentions had a significant positive effect on healthy eating behaviors. Perceived barriers played a significant negative moderating effect between healthy eating intentions and behaviors. Healthy eating intentions had a positive and significant mediating effect. The multi-group analysis showed that extended HBM has relative generalization ability. The extended HBM has good explanatory and predictive power for healthy diet and provides a new framework for understanding the influencing factors of individuals’ healthy eating intentions and behaviors.

Impact of the Threat of COVID-19 Infections on the Perceived Risk to HPV Vaccination

Vaccination rates for human papillomavirus (HPV) in Japan are significantly lower than other countries, and Japanese people are reluctant to be vaccinated. Repeated daily reports of COVID-19 infections and restrictions have made people more health conscious and aware of the danger of infectious diseases. In this study, we used the health belief model (HBM) to examine perceived threats of cancer and infectious diseases and to ascertain whether the new COVID-19 vaccination in addition to these perceived threats would increase vaccination intention against cervical cancer. We conducted a cluster analysis to classify the segmentation regarding the perceived threat, and a logistic regression analysis to predict factors influencing people accepting vaccination. We received 1257 completed surveys during our research. We classified the participants into six clusters, and the logistic regression analysis indicated eight factors significantly associated with the willingness to get the HPV vaccine: reliable information sources such as doctors and social networking sites (SNS), the recognition of COVID-19 symptoms, the awareness of COVID-19 vaccination, the importance of HPV prevention through vaccination, one’s own intention of COVID-19 vaccination, their intention of COVID-19 vaccination toward children, and benefits of HPV vaccination. Further research on HPV and COVID-19 vaccination is encouraged.

The Role of Self-Care Activities (SASS-14) in Depression (PHQ-9): Evidence From Slovakia During the COVID-19 Pandemic

In the ongoing situation, when the world is dominated by coronavirus disease 2019 (COVID-19), the development of self-care programs appears to be insufficient, while their role in mental health may be crucial. The aim of the study was to evaluate the associations between self-care activities and depression in the general Slovak population, but also in its individual gender and age categories. This was achieved by validating the self-care screening instrument, assessing differences, and evaluating the associations using quantile regression analysis. The final research sample consisted of 806 participants [males: 314 (39%), females: 492 (61%)] and data were collected through an online questionnaire from February 12, 2021 to February 23, 2021. Patient Health Questionnaire (PHQ-9) for depression (α = 0.89) and Self-Care Activities Screening Scale (SASS-14) [health consciousness (HC) (α = 0.82), nutrition and physical activity (NPA) (α = 0.75), sleep quality (SLP) (α = 0.82), and interpersonal and intrapersonal coping strategies (IICS) (α = 0.58)] were used as screening measures. Mild depressive symptoms were found in 229 participants (28.41%), moderate depressive symptoms in 154 participants (19.11%), moderately severe depressive symptoms in 60 participants (7.44%) and severe depressive symptoms in 43 participants (5.33%). The main findings revealed the fact that individual self-care activities were associated with depression. This supported the idea that well-practiced self-care activities should be an immediate part of an individual's life in order to reduce depressive symptoms. Sleep quality played an important role, while HC indicated the need for increased attention. Other dimensions of self-care also showed significant results that should not be overlooked. In terms of depression, females and younger individuals need targeted interventions. The supportive educational intervention developed based on the self-care theory can help manage and maintain mental health during a stressful period, such as the COVID-19 pandemic. Health policy leaders should focus on health-promoting preventive self-care interventions, as the demand for them increases even more during the pandemic.

Food Consumption Behavior of Pakistani Students Living in China: The Role of Food Safety and Health Consciousness in the Wake of Coronavirus Disease 2019 Pandemic

The emergence of coronavirus disease 2019 (COVID-19) has considerably changed global food production, processing, and consumption at different levels. Sojourners are among those who have experienced a higher level of food insecurity during the crisis of the COVID-19 outbreak. The current research aimed to investigate the immediate consumption behavioral intentions of the Pakistani international students in the People's Republic of China (PRC) during the wake of COVID-19 pandemic. This study applied the Theory of Planned Behavior (TPB) and background factors of food safety and health consciousness that influence the consumption behavioral intention of Pakistani students toward unfamiliar local food in China. A relational model was analyzed where food safety and health consciousness were hypothesized to serve as background variables associated with TPB components. Moreover, the indirect effects of food safety and health consciousness on behavioral intentions were assessed. The data were collected through convenience samples from 462 Pakistani international students and were analyzed through partial least square structural equation modeling (PLS-SEM). The results confirmed that food safety and health consciousness were positively associated with attitude (ATT), subjective norm (SN), and perceived behavioral control (PBC). However, food safety and health consciousness were indirectly associated with the behavioral intention only through ATT and SN. The results highlighted the role of food safety and health consciousness as important antecedents of classical TPB components that affect intentions and behaviors to avoid unfamiliar local food in a migrated context. The present study provides enlightenment to those who aim to investigate the consumption behavioral intentions of sojourners in the wake of the pandemic situation based on food safety and health consciousness. The findings of the current study are also applicable to general consumption patterns in the food sector.

Validation and Test of Measurement Invariance of the Adapted Health Consciousness Scale (HCS-G)

The objective of this study was the translation and validation of a health consciousness scale in order to provide an economically and empirically confirmed measurement of health consciousness, which is associated with health-related behavior. We evaluated this translation on the basis of psychometric testing in a German convenience sample. A cross-sectional online survey (n = 470) was carried out using a translated version of the health consciousness scale, oriented on the basis of international guidelines. As previous studies have not consistently confirmed the factorial structure of the health consciousness scale, we conducted a Confirmatory Factor Analysis to verify its factorial structure. Furthermore, we cross-validated the questionnaire with other scales in order to verify convergent and discriminant validity. The results indicated a two-factor solution for the Health Consciousness Scale-German (HCS-G). The criterion validity was confirmed on the basis of a significantly positive correlation between the HCS-G and health literacy. Furthermore, strict measurement invariance was able to be verified, indicating that the HCS-G is an applicable measurement, regardless of gender. In practical research, this questionnaire can help to assess health consciousness and its influence on health-related constructs. Future studies should consider possible mediating variables between health consciousness and health outcomes.

Disparity of Cervical Cancer Risk in Young Japanese Women: Bipolarized Status of HPV Vaccination and Cancer Screening

Women born between 1994 and 1999 achieved high vaccination rates for human papillomavirus (HPV); they are now reaching the age of cervical cancer screening programs in Japan. In this study, we aimed to investigate the health awareness of HPV-vaccinated and unvaccinated women and to create tailored leaflets recommending cervical cancer screening for each. Surveys on the cancer screening rates for HPV-vaccinated and unvaccinated women aged 20 and 21 have demonstrated that the rate was significantly higher (p < 0.01) in vaccinated (6.2%) than in unvaccinated women (3.1%). Next, interviews and Internet questionnaires clarified that there was a trend that vaccinated women have a better health consciousness than the unvaccinated ones, and that in unvaccinated women, their willingness to receive cervical cancer screening was significantly enhanced by the fear of developing cancer. Finally, in a prospective study, the increase in the screening rate for both vaccinated and unvaccinated groups after they read tailored leaflets, from 6.4% to 7.4% and from 3.9% to 5.1%, respectively, was not statistically significant compared to the groups provided with a standard reminder letter. Cervical cancer control measures might be enhanced by recommending cervical cancer screening in ways better tailored to HPV vaccination status.

Food Innovation Adoption and Organic Food Consumerism-A Cross National Study between Malaysia and Hungary

In order to meet the rising global demand for food and to ensure food security in line with the United Nation's Sustainable Development Goal 2, technological advances have been introduced in the food production industry. The organic food industry has benefitted from advances in food technology and innovation. However, there remains skepticism regarding organic foods on the part of consumers, specifically on consumers' acceptance of food innovation technologies used in the production of organic foods. This study measured factors that influence consumers' food innovation adoption and subsequently their intention to purchase organic foods. We compared the organic foods purchase behavior of Malaysian and Hungarian consumers to examine differences between Asian and European consumers. The findings show food innovation adoption as the most crucial predictor for the intention to purchase organic foods in Hungary, while social lifestyle factor was the most influential in Malaysia. Other factors such as environmental concerns and health consciousness were also examined in relation to food innovation adoption and organic food consumerism. This paper discusses differences between European and Asian organic foods consumers and provides recommendations for stakeholders.

Addressing elderly loneliness with ICT Use: the role of ICT self-efficacy and health consciousness

With an increasing aging population worldwide, loneliness among elderly individuals has become a salient societal problem. Fortunately, the last decade has also witnessed an upsurge in information and communication technology (ICT), which is ubiquitously deployed and integrated into our daily lives, including the lives of elderly people. This research investigates the potential exploitation of well-developed ICT to mitigate loneliness among the elderly. Specifically, we examined the effects of two dimensions of ICT use: communication use and information use. Moreover, we examined the moderating effects of two relevant features in the elderly population, namely, ICT self-efficacy and health consciousness. We applied structural equation modeling (SEM) to evaluate survey data from mainland China comprising 436 effective responses from the elderly population. We find that ICT use has a positive effect on loneliness among the elderly, and our results support and deepen this understanding, indicating that ICT self-efficacy and health consciousness can moderate the relationship between ICT use and loneliness. Our findings suggest that ICT use plays a significant role in mitigating elderly loneliness. Moreover, it is also suggested that the characteristics of ICT self-efficacy and health consciousness for the elderly can influence the relationship between their ICT use and loneliness. This gives a more accurate description, as compared with the main findings in prior literature, that ICT can help mitigate loneliness in the elderly. Finally, by adopting social cognitive theory, our research explains the moderating effect of ICT self-efficacy and health consciousness between the use of ICT by the elderly and their loneliness.

Exploring the Usage Intentions of Wearable Medical Devices: A Demonstration Study

Background

In the face of an aging society, an immediate and preventive medical system urgently needs to be established, and the application of wearable devices is essential. However, the application of smart medical care in Taiwan is still not widespread, and few studies have explored the related issues of wearable medical device usage. Thus, determining the success of a wearable medical device mainly depends on the degree of user adoption and use.

Objective

The purpose of this study was to examine the factors that influence the intention to use wearable medical devices.

Methods

This study applied the unified theory of acceptance and use of technology (UTAUT) to build a comprehensive model that explains intentions to use wearable medical devices.

Results

The research findings showed that health consciousness and trust were the strongest predictors of intentions to use wearable medical devices.

Conclusions

The results reveal the magnitudes of the impacts of the variables in a well-accepted revised UTAUT model in the context of the medical industry, particularly in the setting of wearable medical devices. Several important implications for academics and industry decision-makers can be formulated from these results.

Integrating health consciousness, self-efficacy, and habituation into the attitude-intention-behavior relationship for physical activity in college students

This study aimed to empirically test the relationship between attitude, behavioral intention, and behavior, which has been asserted by many human behavior theories including those of reasoned action, planned behavior, interpersonal behavior, and self-regulation. In the physical activity context, the study explored (a) how two cognitive constructs - health consciousness and self-efficacy - influence the attitude-intention-behavior relationship, and (b) how the relationship differs depending on habituation to physical activity. A survey of 525 undergraduate students was conducted at a South Korean university. The results of structural equation modeling showed that the attitude-intention-behavior relationship was only significant in the non-habituation group. In the linkage, health consciousness significantly influenced attitude toward physical activity, while self-efficacy had stronger impacts on behavioral intention and behavior than on attitude. Based on the findings, some theoretical implications and practical guidelines are discussed.

The Relationship between Health Consciousness and Home-Based Exercise in China during the COVID-19 Pandemic

During the COVID-19 pandemic, people have reduced the frequency of going out, and need to engage in health behaviors at home. Home-based exercise has aroused people's attention. This paper aims to examine the influencing mechanism of health consciousness on home-based exercise during the COVID-19 pandemic. A questionnaire method was used to select 449 Chinese respondents on an online platform; the questionnaire includes a health consciousness scale, health life goal scale, perceived behavioral control scale, and the home-based exercise scale. A T-test was used to conduct differential analysis. The hierarchical regression analysis method was used to examine the relationship between health consciousness and home-based exercise, and the Hayes' SPSS PROCESS macro was used to test mediating effect. The results show that there are significant differences in home-based exercise with respect to gender, age, and marital status. Health consciousness has a significant positive effect on home-based exercise. Perceived behavioral control acts as the mediator between health consciousness and home-based exercise. Health consciousness can influence home-based exercise through health life goals and perceived behavioral control in turn. This paper takes a home-based exercise survey, and expands the theoretical research of home-based exercise. The findings suggest that people should pay attention to promoting the transformation of health consciousness into home-based exercise. It provides enlightenment for people to adopt health behaviors during the COVID-19 pandemic.

Healthy Eating Determinants: A Study among Malaysian Young Adults

This study aimed to examine the effect of health consciousness, knowledge about healthy food, attitudes toward healthy food, subjective norms, and perceived behavioural control on the intention to consume healthy food, which subsequently affects the consumption of healthy food among Malaysian young adults. The current study also examined the moderating effect of perceived barriers on the association between intention to consume healthy food and the consumption of healthy food. This study adopted a cross-sectional design and collected quantitative data from 1651 Malaysian young adults (between the age of 18 and 40 years) by sharing a Google form link through social media. The findings reveal that health consciousness, knowledge about healthy food, attitude toward healthy food, subjective norms, and perceived behavioural control had a significant positive effect on the intention to consume healthy food. Findings also show that the intention to consume healthy food has a significant positive effect on the consumption of healthy food among Malaysian young adults. Furthermore, the findings reveal the positive and significant mediating effect of the intention to consume healthy food and the significant moderating effect of perceived barriers on the association between the intention to consume healthy food and the consumption of healthy food. The multi-group analysis revealed that the effect of perceived barriers on the consumption of healthy food and the moderating effect of perceived barriers were significantly higher among urban respondents. Health and agriculture policymakers should focus on the attributes of healthy eating practices and their health benefits to promote the mass adoption of healthy food among Malaysian young adults.

Influence of the Business Revenue, Recommendation, and Provider Models on Mobile Health App Adoption: Three-Country Experimental Vignette Study

BACKGROUND

Despite the worldwide growth in mobile health (mHealth) tools and the possible benefits of mHealth for patients and health care providers, scientific research examining factors explaining the adoption level of mHealth tools remains scarce.

OBJECTIVE

We performed an experimental vignette study to investigate how four factors related to the business model of an mHealth app affect its adoption and users' willingness to pay: (1) the revenue model (ie, sharing data with third parties vs accepting advertisements); (2) the data protection model (General Data Protection Regulation [GDPR]-compliant data handling vs nonGDPR-compliant data handling); (3) the recommendation model (ie, doctor vs patient recommendation); and (4) the provider model (ie, pharmaceutical vs medical association provider). In addition, health consciousness, health information orientation, and electronic health literacy were explored as intrapersonal predictors of adoption.

METHODS

We conducted an experimental study in three countries, Spain (N=800), Germany (N=800), and the Netherlands (N=416), to assess the influence of multiple business models and intrapersonal characteristics on the willingness to pay and intention to download a health app.

RESULTS

The revenue model did not affect willingness to pay or intentions to download the app in all three countries. In the Netherlands, data protection increased willingness to pay for the health app (P<.001). Moreover, in all three countries, data protection increased the likelihood of downloading the app (P<.001). In Germany (P=.04) and the Netherlands (P=.007), a doctor recommendation increased both willingness to pay and intention to download the health app. For all three countries, apps manufactured in association with a medical organization were more likely to be downloaded (P<.001). Finally, in all three countries, men, younger individuals, those with higher levels of education, and people with a health information orientation were willing to pay more for adoption of the health app and had a higher intention to download the app.

CONCLUSIONS

The finding that people want their data protected by legislation but are not willing to pay more for data protection suggests that in the context of mHealth, app privacy protection cannot be leveraged as a selling point. However, people do value a doctor recommendation and apps manufactured by a medical association, which particularly influence their intention to download an mHealth app.

Willingness to pay for whole turkey attributes during Thanksgiving holiday shopping in the United States

Although whole turkeys served at Thanksgiving are the ubiquitous kickoffs to the US winter holiday season, much remains unknown about shopping behaviors for holiday food items. Given the once-a-year purchase of the whole turkey for most households, collecting data about demand and preferences necessitated the collection of data during the week before Thanksgiving, while turkey shopping was at the forefront of consumers' minds. Despite a self-reported confidence in cooking turkeys, many respondents indicated they thawed frozen meat using improper methods. Ninety-five percent of respondents indicated that they consumed meat; 89% of respondents who consumed meat or had someone in the household who did, indicated they had purchased turkey products. Positive willingness to pay (WTP) was found for all attributes of whole turkeys studied: free range, fed a vegetarian diet, hormone use not permitted, and antibiotic use not permitted. Mean estimated WTP for free range ranged from $0.37/lb for industry verified free range to $0.74/lb for USDA verified free range; although those 2 estimates were not statistically different from each other, they were both statistically different from zero. The statistically significant estimated mean WTP for hormone use not permitted ranged from $0.85/lb for industry verification to $1.35 for USDA verification but were again not statistically different from each other. Mean WTP estimates, which were statistically significant but not different from one another for antibiotic use not permitted, ranged from $0.62/lb for industry certification to $0.72 for retailer certified. Turkeys certified to be fed a vegetarian diet had a mean WTP estimate of $0.39/lb for retailer verification to $0.60/lb for USDA verification; those mean WTP estimates were not statistically different from each other but were each statistically different from zero. Social desirability bias, which can be defined as the relative over-reporting of one's own goodness, was detected with respect to self-reported holiday eating and healthfulness statements. Relationships were found between social desirability bias, gender, and age for holiday eating statements using a seemingly unrelated regression.

Exploring Patients' Intentions for Continuous Usage of mHealth Services: Elaboration-Likelihood Perspective Study

Background

With the increasingly rapid development of Web 2.0 technologies, the application of mobile health (mHealth) care in the field of health management has become popular. Accordingly, patients are able to access consulting services and effective health information online without temporal and geographical constraints. The elaboration-likelihood model (ELM) is a dual-process persuasion theory that describes the change of attitudes and behavior.

Objective

In this study, we drew on the ELM to investigate patients’ continuous usage intentions regarding mHealth services. In addition, we further examined which route—central or peripheral—has a stronger impact on a patient’s usage of health care management.

Methods

To meet these objectives, five hypotheses were developed and empirically validated using a field survey to test the direct and indirect effects, via attitude, of the two routes on continuous usage intention.

Results

We found that patients’ perceived mHealth information quality and perceived mHealth system quality had a positive effect on their personal attitudes. The results revealed that social media influence had a positive effect on a patient’s attitude toward mHealth services. In particular, our findings suggest that a patient’s health consciousness has a positive effect on the relationship between social media influence and attitude.

Conclusions

This study contributes to the mHealth services literature by introducing the ELM as a referent theory for research, as well as by specifying the moderating role of health consciousness. For practitioners, this study introduces influence processes as policy tools that managers can employ to motivate the uptake of mHealth services within their organizations.

Race/Ethnic Variations in Predictors of Health Consciousness Within the Cancer Prevention Context

PURPOSE

Although the literature establishes a link between health consciousness (HC) and prevention behavior, less explored are the individual, social, and health characteristics that are associated with increased HC. Similarly, underexamined is the influence of race and ethnicity on the relationship of these characteristics to higher levels of HC.

DESIGN

This cross-sectional study aims to identify and assess the relative importance of factors associated with higher levels of HC, highlighting the role of race and ethnicity.

PARTICIPANTS

Participants came from a national research panel survey (N = 1007).

MEASURES

Participants completed a 4-item scale capturing key concepts of HC as well as questionnaires capturing demographic profiles, social support, social networking activities, and health status.

ANALYSIS

A stepwise multiple regression was used to identify significant predictors of HC.

RESULTS

Female and more educated participants report higher levels of HC. African American and Hispanic participants report higher levels of HC compared to white participants. Findings indicate social support, social network participation, education, cancer survivorship, and health status were positively associated with higher HC for the collective sample. However, results revealed variations in factors associated with higher HC when stratified by race/ethnicity.

CONCLUSION

Findings suggest that interventions aiming to motivate cancer prevention behaviors within at-risk communities may find more success by incorporating factors that are aligned with increased HC among culturally diverse populations.

Our health, our planet: a cross-sectional analysis on the association between health consciousness and pro-environmental behavior among health professionals

One possible predictive factor that affects both pro-environmental behavior and health behavior is health consciousness (a psychological state where an individual is aware of and involved in his/her health condition). We examined the relationship between health consciousness and two pro-environmental behaviors (recycling and green purchasing) within health professionals in a Japanese large hospital. Multivariate linear regression analysis revealed a significant association between health consciousness and recycling behavior, while there was no association between health consciousness and green purchasing behavior. We assume that health consciousness can certainly be a factor promoting pro-environmental behavior, but that it may have been insufficient to cause green purchasing, because of the organizational norm of recycling in the Japanese context. Given that there is previous evidence about the relationship between health consciousness and health behavior, health consciousness might be a predictive factor that encourages both health behavior and pro-environmental behavior simultaneously.

How Chinese Consumers' Intentions for Purchasing Eco-Labeled Products Are Influenced by Psychological Factors

This paper studies how consumers’ psychological factors influence their intentional purchasing behavior towards eco-labeled products and investigates why consumers choose eco-labeled products. Based on the Theory of Planned Behavior, we develop an extended model including six constructs. Among these constructs, consumers’ intentional purchasing behavior, attitude towards the behavior, subjective norm, and perceived behavioral control are applied from the original theoretical framework. Health consciousness and environmental awareness are integrated additionally to reflect consumers’ concerns about the natural environment and their health. Next, we conduct and analyze a survey-based empirical study with 336 samples using the Structural Equation Modeling. Our findings show that consumers’ attitude towards the behavior is positively influenced by environmental awareness, but the effects of it on intentional purchasing behavior are insignificant. Also, subjective norm has a positive influence on intentional purchasing behavior, but its effects on attitude towards the behavior are not significant. Moreover, the results also show that the total effects of health consciousness on intentional purchasing behavior are significantly higher than the effects of environmental awareness. Our results can provide a reference for business managers to attract consumers through eco-labeling as well as government policymaking.

Nutritional Knowledge and Health Consciousness: Do They Affect Consumer Wine Choices? Evidence from a Survey in Italy

Wine is one of the few food products not subject to mandatory nutritional labelling, except for alcohol content. As such, health-related characteristics might be inferred by attributes related to production methods and alcohol content. This research focuses on the set of information currently reported on wine bottle labels, investigates the consumer’s use of such labels, and their preferences for information associated with ’naturalness’ such as clean labels and alcohol content. We conducted a survey on Italian consumers of red wine, which included a choice experiment. Results showed that health consciousness is an important driver in the use of wine labels. Estimates from a latent class model suggest that health consciousness, along with age, plays a significant role in defining consumer preference segments: the majority of our sample tended to prefer red wine characterized by ‘clean labels’, but younger and more health-conscious consumers showed a significant disutility for higher alcohol content. More traditional consumers revealed disutility for more unconventional ‘clean labels’, which were instead appreciated by a third group of consumers, called here ‘new clean trend lovers’. Preference for nutritional information such as lower alcohol content and clean labels distinguished the more health-conscious consumers, who belonged to the most likely preference class. Together, the results may suggest that nutritional information currently not mandatory for wine would be appreciated by a significant share of wine consumers.

Some Key Factors Affecting Consumers' Intentions to Purchase Functional Foods: A Case Study of Functional Yogurts in Vietnam

The development of functional foods is key to promoting a healthy diet and preventing certain diseases. This study aims to examine several key factors that affect consumer attitude and intention with respect to purchasing functional foods in an emerging market economy. A research model was developed by extension of the Theory of Reasoned Action (TRA), and then validated through obtaining data from 596 Vietnamese consumers who were interested in functional yogurts using an interviewer-administered questionnaire. Multivariate data analysis reveals that while health consciousness and subjective norm significantly enhance consumers’ attitudes towards purchasing functional yogurts, perceived price of functional yogurts exerts a negative impact on such attitudes. Moreover, subjective norm and attitude appear to be key predictors of consumers’ intentions to buy functional yogurts. These findings extend the extant literature relating to functional food purchase and consumption in emerging markets, and they have several important practical implications for functional yogurt manufacturers, retailers, and policymakers. A major implication is that education and communication programs that aim at increasing consumers’ health consciousness and their awareness of functional foods’ health benefits play an integral role in the success of functional food products such as functional yogurts. Research limitations and future research directions are also presented.

Report of health checkup system for chronic kidney disease in general population in Okayama city: effect of health guidance intervention on chronic kidney disease outcome

BACKGROUND

From 2011, Okayama municipal government started the health checkup follow-up project to find those who were unaware of suffering chronic kidney disease and to prevent from aggravation of CKD stage. In this study, we aimed to evaluate the effect of 2 years' CKD-follow-up project regarding renal function and CKD risks.

PATIENTS AND METHODS

Those who received a health checkup by the national health insurance in Okayama city in 2011 were recruited. The patients with lifestyle-related diseases or metabolic syndrome were excluded. Subjects who had an estimated glomerular filtration rate<50 mL/min/1.73 m2 or urinary protein positive by dipstick test were defined as compromised renal function group. They were recommended to visit a medical institution. Non-compromised renal function participants with two or more risks for CKD (hyperglycemia, higher blood pressure, dyslipidemia, hyperuricemia) were recommended to receive a health guidance (risk group). The change of renal function and CKD risks between 2011 and 2013 in each group was examined.

RESULTS

A total of 28,309 people received a health checkup in 2011. In compromised renal function group, 39.5% (96/243) of the subjects improved their CKD stages in 2013 regardless of the visit of medical institutions or the frequency of receiving health checkup. In risk group, 63.4% (260/410) of the subjects decreased their CKD risks in 2013 independent of the reception of health guidance.

CONCLUSION

In both compromised renal function group and risk group, more than half of subjects kept their kidney function (217/243) and decreased the number of CKD risks (260/410) in 2 years' follow-up. Receiving a health checkup itself and notification of one's own health condition could exert a protective effect on kidney function.

The Role of Health Consciousness, Patient-Physician Trust, and Perceived Physician's Emotional Appraisal on Medical Adherence

Poor adherence to medical recommendations is a well-recognized catalyst for public health consequences worldwide. The literature highlights health consciousness as a likely antecedent to patient-physician trust, which in turn promotes medical adherence. Nevertheless, principles of patient-centered care suggest that patient perceptions of their doctor's appraisal of their emotions may influence the path between trust and medical adherence. Accordingly, this study tested the mediating role of patient-physician trust in the relation between health consciousness and medical adherence and assessed whether patient ratings of their doctor's appraisal of their own and their patients' emotions moderated the mediated relation. Data were collected via self-report questionnaires from two culturally and economically diverse countries: Bosnia-Herzegovina (N = 262) and the United States (N = 314). Participants were young, healthy adults who visited their primary care physician in the past year. The study employed confirmatory factor analysis, mediation, and moderated mediation analyses. The results indicate that health consciousness positively related to patient-physician trust, which was in turn related to higher medical adherence and which mediated 28% of the total effect of health consciousness. Nevertheless, among patients who rated their physicians to have low appraisal for their patients' emotions but high appraisal for their own emotions, the path from trust to adherence was not significant. These results highlight the importance of promoting health consciousness among young individuals, all while training practitioners to be attuned to their patients' emotions and circumstances above their own. However, additional findings indicate that the interrelation between doctors' emotional attributes and adherence is not necessarily one directional and warrants further investigation.

The Response of More Health Focused and Less Health Focused People to a Physical Activity Calorie Equivalent Label on Discretionary Snack Foods

A Physical Activity Calorie Equivalent (PACE) label shows the minutes of physical activity required to burn off the caloric content of a particular food. This study investigated the influence of PACE labelling on liking and consumption of discretionary snack foods in a group of more health focused and less health focused consumers. Participants (n = 97) tasted and rated (i.e., liking, prospective consumption) a range of snack foods with or without a PACE label. Total sampling consumption was also measured. Participants completed a shortened version of the International Physical Activity Questionnaire and the General Health Interest Scale questionnaire. Paired samples t-test, independent samples t-tests, a General Linear Model and Chi-Square tests were used to check for statistical significance. For more health focused participants (n = 57), the PACE label decreased only liking (p = 0.02). The PACE label was not effective in reducing liking (p = 0.49), prospective consumption (defined as the amount of the sample participants thought that they could consume) (p = 0.10) or consumption (p = 0.41) of energy-dense discretionary snack foods for less health focused individuals (n = 40). The level of participants’ physical activity did not facilitate the influence of PACE labelling on liking, consumption or prospective consumption. The PACE label was found to not be effective among less health focused individuals or the overall sample population. Therefore, the PACE label may not be an effective labelling strategy to reduce the liking or consumption of discretionary snack foods.

The Mediating Role of Health Consciousness in the Relation Between Emotional Intelligence and Health Behaviors

The goals of this study were to identify groups of health-related behaviors among young adults (N = 314, Mage = 21.94, SD = 6.53), gauge the relation between emotional intelligence and health behaviors in this population, and assess health consciousness as mediator of said relation. Latent class analysis identified two mutually exclusive health behavior groups, which according to response patterns were labeled as Healthy and Unhealthy. The Healthy group (56%) was composed of individuals who had a healthy diet (i.e., low fat and high fiber), exercised regularly, and who frequently engaged in behaviors that prevent oral and skin-related diseases. In contrast, the Unhealthy group (44%) rarely engaged in these health-promoting behaviors. Using structural equation modeling we found a negative relation between emotional intelligence and unhealthy behaviors relative to health-promoting ones. Mediation analyses indicated that the mechanism explaining said relation was through increments in health consciousness, with large standardized indirect effects ranging between -0.52 and -0.78. As health behaviors during early adulthood are salient predictors of health outcomes in old age, the results have clear implications for the inclusion of emotional intelligence training in programs seeking to raise health awareness and cultivate health promoting behaviors in young adults, in so much as to seek to reduce the risk of chronic ailments later in life.

Health Consciousness and Its Effect on Perceived Knowledge, and Belief in the Purchase Intent of Liquid Milk: Consumer Insights from an Emerging Market

This study is based on the influence of consumers' health consciousness (HC), perceived knowledge (PK) and beliefs affecting the attitude and purchase intent (PI) of the consumers. The outcome of this study is obtained through an exclusive survey conducted on a randomly selected sample of 712 households who purchase liquid milk (LM) in the cities of Dhaka and Chittagong in Bangladesh. A structured questionnaire is used to interview these participants to obtain data which are analysed employing descriptive statistics, Confirmatory Factor Analysis, and Structural Equation Modelling. The results of the analyses corroborate that consumers' health consciousness has a positive impact on perceived knowledge, belief, and attitude, but not on purchase intent. In addition, belief affects both the attitude and PI positively. Although consumers' perceived knowledge is too low to constitute their attitude towards LM, it has a positive, significant impact on the PI. The results also reveal that more than a third of the respondents consume LM several times per month, followed by more than a quarter of the sampled respondents who consume LM several times per week, and these consumption patterns have a positive and significant influence on the PI. Moreover, the monthly income of the family, age, and labelling preference are significantly correlated with PI.

Investigation into Differences in Level of Knowledge about Hypertension between High School Students and Elderly People

As a major chronic non-communicable disease, hypertension is the most important risk factor for cardiovascular disease, chronic kidney disease, stroke and, if not treated appropriately, premature death. A population-based approach aimed at decreasing high blood pressure among the general population is an important component of any comprehensive plan to prevent hypertension. However, few studies have investigated generational differences in knowledge about, and consciousness of, hypertension. Thus, we conducted a questionnaire survey about hypertension, with the aim of clarifying differences of understanding about hypertension between high school students and elderly people. The results of this investigation suggested that there is indeed a generational difference: knowledge about hypertension, and awareness of its relationship with salt intake, was higher in elderly people than in high school students. Furthermore, our study showed that among high school students, salt intake consciousness correlated with a family history of hypertension. By contrast, in elderly people, salt intake consciousness is related to age and to an awareness of recommended daily salt intake. This study strongly showed that knowledge and consciousness of hypertension varied among generations, with the elderly being more aware and conscientious about salt intake. Acknowledgement of this generational diversity is critical to developing an effective overall preventive strategy for hypertension.

Complementarity in dietary supplements and foods: are supplement users vegetable eaters?

Background: The consumption of fruits, vegetables, and dietary supplements correlate. Most previous studies have aimed to identify the determinants of supplement uses or the distinct features of supplement users; this literature lacks a discussion on dietary supplement consumption as a predictor of fruit and vegetable consumption. Objective: This study examines how dietary supplement consumption correlates with fruit and vegetable consumption by combining scanner data and surveys of Korean household grocery shopping. Methods: Propensity score matching (PSM) is used to identify the relationship between dietary supplement consumption and fruit and vegetable consumption in a household. A logit regression using supplement consumption as the dependent variable is used. Then, the supplement takers (the treatment group) are matched with non-takers (the control group) based on the propensity scores estimated in the logit regression. The fruit and vegetable consumption levels of the groups are then compared. Results: We found that dietary supplement use is associated with higher fruit and vegetable consumption. This supports the health consciousness hypothesis based on attention bias, availability heuristics, the focusing effect, and the consumption episode effect. It rejects the health substitute hypothesis based on economic substitutes and mental accounting. Conclusions: Future research on the health benefits of dietary supplements should address the complementary consumption of fruits/vegetables and their health benefits to avoid misstating the health effects of supplements.

Type of milk typically consumed, and stated preference, but not health consciousness affect revealed preferences for fat in milk

Fat is an important source of both pleasure and calories in the diet. Dairy products are a major source of fat in the diet, and understanding preferences for fat in fluid milk can potentially inform efforts to change fat consumption patterns or optimize consumer products. Here, patterns of preference for fat in milk were determined in the laboratory among 100 free living adults using rejection thresholds. Participants also answered questions relating to their health concerns, the type of fluid milk typically consumed, and their declared preference for type of milk (in terms of fat level). When revealed preferences in blind tasting were stratified by these measures, we observed striking differences in the preferred level of fat in milk. These data indicate a non-trivial number of consumers who prefer low-fat milk to full fat milk, a pattern that would have been overshadowed by the use of a group mean. While it is widely assumed and claimed that increasing fat content in fluid milk universally increases palatability, present data demonstrate this is not true for a segment of the population. These results underscore the need to go look beyond group means to understand individual differences in food preference.

Cognitive factors of using health apps: systematic analysis of relationships among health consciousness, health information orientation, eHealth literacy, and health app use efficacy

BACKGROUND

Interest in smartphone health apps has been increasing recently. However, we have little understanding of the cognitive and motivational factors that influence the extent of health-app use.

OBJECTIVE

This study aimed to examine the effects of four cognitive factors-health consciousness, health information orientation, eHealth literacy, and health-app use efficacy-on the extent of health-app use. It also explored the influence of two different use patterns-information and information-behavior use of health apps-with regard to the relationships among the main study variables.

METHODS

We collected and analyzed 765 surveys in South Korea. According to the results, there was a negligible gender difference: males (50.6%, 387/765) and females (49.4%, 378/765). All participants were adults whose ages ranged from 19 to 59. In order to test the proposed hypotheses, we used a path analysis as a specific form of structural equation modeling.

RESULTS

Through a path analysis, we discovered that individuals' health consciousness had a direct effect on their use of health apps. However, unlike the initial expectations, the effects of health information orientation and eHealth literacy on health-app use were mediated by health-app use efficacy.

CONCLUSIONS

The results from the path analysis addressed a significant direct effect of health consciousness as well as strong mediating effects of health-app use efficacy. These findings contribute to widening our comprehension of the new, digital dimensions of health management, particularly those revolving around mobile technology.