Parent Intention to Participate in an Online Intervention to Enhance Health Behavior Change Among Youth Treated with Psychotropic Medication Who are Overweight or Obese: An Application of the Theory of Planned Behavior

Youth with mental health disorders (MHD), particularly those who take psychotropic medications, are at increased risk of being overweight or obese (OW/OB) when compared to typical youth. Parents are important resources for interventions addressing OW/OB. However, parents of youth with MHD may face challenges that require interventions designed to address their needs. Prior to investing research funding in the development of interventions for this group, research is needed to understand factors associated with parents' decisions to enroll in these programs. The theory of planned behavior (TPB) provided a framework for examining parents' salient beliefs, direct attitudes, and intention to enroll in a hypothetical online healthy lifestyle intervention for their youth (ages 11-17) with OW/OB and treated with psychotropic medication. Parents who were enrolled in the study (n = 84) completed demographic questionnaires and a TPB questionnaire which was constructed for this study. A confirmatory factor analysis (CFA) of the direct attitude (i.e., attitude toward the behavior, subjective norm, perceived behavioral control) questions generally supported the three-factor model (i.e., RMSEA = .07, 90% CI .03-.11, p = .18; CFI = .96, SRMR = .06). Results from a multiple regression analysis demonstrated that direct attitudes predicted parent intention to participate in an online healthy lifestyle intervention for this sample of youth accounting for 84% of variance. In this preliminary study, the TPB appears to be a promising framework for understanding direct attitudes associated with parent intentions toward intervention participation in this population of youth. Interventions for parents of youth with OW/OB who are prescribed psychotropic medication should consider addressing these direct attitudes to improve intention.

Increasing Uptake of Prescription Drug Take-Back Boxes: Eliciting Preferences and Applying the Theory of Planned Behavior to Predict Use

This study assesses adults' perceptions of and predictors of intention to use prescription drug take-back boxes. This mixed methods study utilized focus groups and an online survey to examine factors related to intention to use a prescription drug take-back box. This study was conducted in [State] during the spring and summer of 2018. Themes identified in focus group data included the importance of take-back box location, benefits of take-back box use (such as reducing opportunities for medication misuse), and barriers to take-back box use (such as lack of awareness, stigma associated with law enforcement). Survey results indicate that pharmacies are the most preferred take-back box location and that attitudes, subjective norms, and perceived behavioral control are statistically significant predictors of intention to use a take-back box. Results suggest that individuals are open to using take-back boxes in secure, convenient locations, but many are unaware of take-back boxes as an option for safe disposal. These findings have implications for health communication and policy efforts designed to increase the use of take-back boxes for prescription drug disposal.

Patient beliefs associated with medication hesitancy in palliative care: A systematic review using the theory of planned behavior

CONTEXT

The demand of palliative care is increasing due to the aging population and treatment hesitancy or intentional avoidance compromises symptom management.

OBJECTIVES

To identify patient beliefs associated with medication hesitancy by using the theory of planned behavior (TPB) namely, attitudes, subjective norms, behavioral intention, and perceived behavioral control associated with medication hesitancy or intentional noncompliance by avoidance.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was followed to conduct a systematic literature search involving the CINAHL, Embase, MEDLINE, and PsycINFO databases from inception until March 2022. Hand-searched articles from reference lists and gray literature were included. Thematic analysis was conducted on qualitative data and triangulated with quantitative data.

RESULTS

About 554 articles were retrieved from the literature search and 17 articles were included based on the eligibility criteria. Three subthemes that were identified under TPB constructs were attitude: negative attitude toward medications, passive attitude toward illness and inaccurate information about disease or medication; one subtheme was identified under subjective norms: perceived negative opinions from others; and one subtheme was identified under perceived behavioral control: perception of manageable symptoms. Quantitative data provided triangulation of qualitative findings related to fear of addiction and side effects, feelings of hopelessness, unclear direction and information, social stigma, endurable symptoms, and illness as determinants for medication avoidance.

SIGNIFICANCE OF RESULTS

This systematic review highlighted some patient beliefs related to medication hesitancy or avoidance. Clinicians should take patient beliefs and concerns into consideration when creating treatment regimens for people receiving palliative care to optimize medication adherence and the quality of care.

Protecting children from COVID-19: examining U.S. parents motivation and behaviour using an integrated model of self-determination theory and the theory of planned behaviour

OBJECTIVES

This longitudinal study applied the integrated model of self-determination theory (SDT) and the theory of planned behaviour (TPB) to explain COVID-19 preventive behaviours among parents of young children in the United States.

DESIGN

The study adopted a two-wave longitudinal study design. Parents (N = 681) completed self-report questionnaires related to measures of SDT and the TPB constructs and behavioural adherence at baseline and after one month. We used standardised residual change scores to test the structural relationships of the integrated model.

RESULTS

The parameter estimates of the model (CFI > .96, TLI > .86, RMSEA = .05, SRMR = .03) fit acceptably well to the data. Psychological need support was positively and significantly linked to autonomous and controlled motivation and amotivation. Autonomous motivation was positively and significantly correlated with TPB factors, and intention. Intention was a significant and positive predictor of behavioural adherence.

CONCLUSION

The integrated model of SDT and the TPB appeared to be applicable to the explanation of COVID-19 prevention among the U.S. parents. Longitudinal data showed that a psychological need supportive social environment was related to favourable motivation, social cognition beliefs, intention and behavioural adherence to the preventive behaviours of parents protecting their young children from COVID-19.

Effectiveness of two educational interventions based on the theory of planned behavior on oral cancer self-examination in adults: a randomized controlled trial

BACKGROUND

The theory of planned behavior (TPB) is recognized as an effective theory for behavior change. The aim of the present study was to investigate the impact of two TPB-based educational interventions on oral self-examination (OSE) behavior and the related TPB constructs among adults in Tehran, Iran, in 2022.

METHODS

This randomized controlled trial involved 400 healthy individuals recruited from 20 urban comprehensive health centers in the southern part of Tehran, Iran. The health centers were randomly assigned to two control (PowerPoint) and intervention (WhatsApp) groups (200 individuals in each group). In the control group (the recipient of the routine care), participants received a 20-minute lecture through a PowerPoint presentation and a pamphlet. In the intervention group (the recipient of an additional intervention alongside the routine care), participants were educated through messages and images on WhatsApp along with having monthly group discussions. Data was collected at baseline, as well as at 1- and 3-month follow-ups using a structured questionnaire. The outcomes assessed included OSE behavior and the related TPB constructs: intention, attitude, subjective norm, and perceived behavioral control. Linear and logistic generalized estimating equations (GEE) regression models were used to evaluate the impact of the interventions with STATA version 17.

RESULTS

Of the total participants, 151 (37.75%) were men. The mean ± standard deviation (SD) of ages in the PowerPoint and WhatsApp groups were 39.89 ± 13.72 and 39.45 ± 13.90, respectively. OSE and the related TPB constructs showed significant differences between the groups at the 1-month post-intervention assessment. The effect of PowerPoint was more significant in the short-term (one month), while both methods showed similar effectiveness after three months, specifically in relation to OSE and the TPB constructs. At the 3-month post-intervention assessment, there were significant increases in OSE (OR = 28.63), intention (β = 1.47), attitude (β = 0.66), subjective norm (β = 2.82), and perceived behavioral control (β = 1.19) in both groups (p < 0.001).

CONCLUSIONS

The present study provides evidence of the effectiveness of both educational interventions in improving OSE and the TPB constructs after three months. Therefore, both TPB-based educational methods can be recommended for designing and implementing interventions aimed at preventing oral cancer.

TRIAL REGISTRATION

The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).

Comparative effect of physical health training and psychological training of the theory of reasoned action (TRA) model on the life quality of patients with diabetes in Tehran, Iran: utilization of message texting

BACKGROUND AND PURPOSE

Providing physical health and mental health training promotion is necessary for a sustainable change in attitude and lifestyle of diabetic patients. The present study was conducted with the aim of comparing the effect of physical health training and psychological training of the theory of reasoned action (TRA) model on the life quality of patients with type 2 diabetes.

METHODS

This experimental study was conducted in 2022 with two intervention groups and one control group consisting of 129 patients with type 2 diabetes who were referred to Imam Khomeini Hospital in Tehran. Over the course of one month, each individual in intervention group 1 received 15 text messages focusing on physical health, while intervention group 2 received 15 psychological text messages related to the TRA. The control group did not receive any text messages during this period. The data collection tool used was the "Audit of Diabetes-Dependent Quality of Life (ADDQoL)" questionnaire, which was completed by the participants before and after the intervention. The data were analyzed using SPSS version 16 software at a statistical significance level of 0.05.

RESULTS

In the intervention-1 group, the average life quality score was 8.51 units (P < 0.001), while in the intervention-2 group, it was 19.25 units (P < 0.001) higher than the control group. The psychological training group had a 17.62 units (P < 0.05) lower average fasting blood sugar (FBS) and a 10.74 units (P < 0.001) higher average quality of life compared to the physical training group.

CONCLUSION

The results of this study showed that the effectiveness of psychological training of the TRA model in improving life quality and reducing FBS in patients with diabetes is greater than physical health training. It is suggested that policy makers and health managers base future plans on physical health promotion training along with TRA model mental health training for the development of education in patients with diabetes. Specialists and healthcare workers can also act to improve personal health characteristics, especially those related to reducing FBS and increasing the quality of life of patients with diabetes, by using training through mobile phone text messages, particularly with psychological content TRA based.

The factors affecting substance abuse relapse based on theory of planned behavior in male addicts covered by addiction treatment centers in Southern Iran

BACKGROUND

Given the destructive nature of addiction and its relapse after quitting, the present study aimed to investigate the factors affecting substance abuse relapse based on the Theory of Planned Behavior (TPB) in male addicts covered by addiction treatment centers in Shiraz, Iran.

METHODS

This cross-sectional study was conducted on 400 male addicts covered by addiction treatment centers in Shiraz, Iran, in 2021-2022. The data collection tool was a researcher-made questionnaire. Data were analyzed using SPSS-22 software through descriptive statistical methods, linear regression, and binary logistic regression.

RESULTS

190 people (47.50%) were aged 31-40 years, 265 people (66.25%) were married, 224 people (56%) lived with their spouses, and 192 people (48 percent) had their first use at the age of 16-20. The substance respondents used were methamphetamine (59.5%), heroin (53%), opium (48%), and alcohol (40%). 138 people (34.5%) had their first place of consumption at friends' houses (Tables 1 and 2). 342 people (85.5%) had a history of relapse, and 172 people (50.29%) had 1-5 relapses. Marital status, occupation, and income were among the demographic risk factors, and addicted friends and close relatives were among the behavioral risk factors for drug relapse among people with a history of relapse. Personal desire and the insistence of friends were also among the individual and interpersonal factors of drug use among participants. The regression results showed that the constructs of awareness, attitude, subjective norms, perceived behavioral control, and behavioral intention were predictors of drug relapse among addicts (P < 0.05).

CONCLUSION

The current study's findings indicate that among the behavioral risk factors for drug relapse in individuals with a history of relapse are addicted friends and close relatives, while marital status, occupation, and income are among the demographic risk variables. Among the individual and interpersonal factors influencing drug usage among participants were personal desire and friends' insistence. Furthermore, the findings indicated that the TPB's structures might be used to predict drug relapse in addicts.

Towards determining perceived audience intent for multimodal social media posts using the theory of reasoned action

Increasing use of social media has resulted in many detrimental effects in youth. With very little control over multimodal content consumed on these platforms and the false narratives conveyed by these multimodal social media postings, such platforms often impact the mental well-being of the users. To reduce these negative effects of multimodal social media content, an important step is to understand creators' intent behind sharing content and to educate their social network of this intent. Towards this goal, we propose INTENT-O-METER, a perceived human intent prediction model for multimodal (image and text) social media posts. INTENT-O-METER models ideas from psychology and cognitive modeling literature, in addition to using the visual and textual features for an improved perceived intent prediction model. INTENT-O-METER leverages Theory of Reasoned Action (TRA) factoring in (i) the creator's attitude towards sharing a post, and (ii) the social norm or perception towards the multimodal post in determining the creator's intention. We also introduce INTENTGRAM, a dataset of 55K social media posts scraped from public Instagram profiles. We compare INTENT-O-METER with state-of-the-art intent prediction approaches on four perceived intent prediction datasets, Intentonomy, MDID, MET-Meme, and INTENTGRAM. We observe that leveraging TRA in addition to visual and textual features-as opposed to using only the latter-results in improved prediction accuracy by up to 7.5 % in Top-1 accuracy and 8 % in AUC on INTENTGRAM. In summary, we also develop a web browser application mimicking a popular social media platform and show users social media content overlaid with these intent labels. From our analysis, around 70 % users confirmed that tagging posts with intent labels helped them become more aware of the content consumed, and they would be open to experimenting with filtering content based on these labels. However, more extensive user evaluation is required to understand how adding such perceived intent labels mitigate the negative effects of social media.

Investigating COVID-19 Vaccine Uptake Intention Using an Integrated Model of Protection Motivation Theory and an Extended Version of the Theory of Planned Behavior

As global governments continue to inoculate populations in the aftermath of the SARS-CoV-19 epidemic, health protection and related problems such as vaccination reluctance have sparked conflicting emotions and discourses. Stakeholder concerns about vaccination promotion have arisen in this context. Consequently, this research investigates vaccination uptake behavior using an integrated framework that includes protective motivation theory and an extended version of the theory of planned behavior. Except for perceived severity, empirical study results based on the structural equation modeling technique demonstrated a positive relationship between PMT factors (i.e. perceived vulnerability, reaction efficacy, self-efficacy, and cost response) and intention to vaccinate. TPB factors (attitude, perceived behavior control, subjective norm, personal moral norm, and descriptive norm) were also found to have a positive connection with intention. The model's utility and suitability are indicated by the predictive and explanatory potency score (R2 = .415). Study implications for COVID-19 vaccine uptake promotion and ideas for future investigations are explored in light of our findings.

Explaining citizens' plastic reduction behavior with an extended theory of planned behavior model: An empirical study in Switzerland

The growing volume of plastic waste resulting from human activities is suffocating our planet. To combat this escalating issue, this study delves into the formation of plastic reduction behavior among Swiss citizens using an extended theory of planned behavior model. Through an online survey, the study obtained 149 valid responses, which were analyzed using partial least squares-based structural equation modeling. The results indicate a significant and strong relationship between plastic risk perception and attitudes towards plastic reduction and environmental protection. Notably, the cognitive dimension (β = 0.802, p = 0.000) of plastic risk perception exhibits a tighter and stronger association with attitude compared to the emotional dimension (β = 0.406, p = 0.000). Among the three variables in the theory of planned behavior model, perceived behavioral control (β = 0.384, p = 0.000) emerges as the strongest determinant of behavioral willingness for plastic reduction. It is followed by attitude (β = 0.214, p = 0.030). However, no significant relationship is observed between subjective norm and behavioral willingness for plastic reduction (β = 0.07, p = 0.292). Finally, attitude fully mediates the relationship between plastic risk perception and behavioral willingness for plastic reduction. Theoretical and managerial implications are discussed.

Understanding the intention and behavior of psychological help-seeking among Chinese college students using theory of planned behavior: a three-month follow-up study

Underutilization of mental health services is common and associated with substantial suffering, mental disorders and death. The present study aimed to explore factors significantly affecting the professional psychological help-seeking behavior based on the Theory of Planned Behavior (TPB). A sample of 597 Chinese college students recruited online completed the questionnaires, which measured four constructs of TPB including help-seeking intention, attitude, subjective norm and perceived behavioral control in December 2020. Help-seeking behaviors were evaluated three months later in March 2021. A two-step structural equation modeling procedure was used to test the TPB model. Findings show that partially consistent with TPB, more positive attitudes about seeking professional help (Β = .258, p = .001) and higher perceived behavioral control (Β = .504, p < .001) directly predicted higher intention to seek mental health services, and perceived behavioral control (Β = .230, p = .006) directly predicted help-seeking behavior. However, behavioral intention (Β = -.017, p = .830) did not statistically significantly predict help-seeking behavior, while subjective norm (Β = .047, p = .356) did not predict help-seeking intention as well. The model accounted for 49.9% of the variance modeling help-seeking intention and 12.4% of the variance modeling help-seeking behavior. The results revealed the importance of attitude and perceived behavioral control in predicting help-seeking intention and behavior among Chinese college students and indicated that there existed a gap between intention and actual help-seeking behavior.

Understanding the Associations Between Adolescents' Exposure to E-Cigarette Information and Vaping Behavior Through the Theory of Planned Behavior

Adolescents have actively looked for and passively scanned information about electronic cigarettes (e-cigarettes) from a variety of media and interpersonal sources. Despite the evidence that exposure to e-cigarette information is associated with youth's increased vaping intention, there is a paucity of scholarship that differentiates the sources where adolescents obtain e-cigarette information in their investigation, which limits our understanding of the unique association between vaping intention and e-cigarette information acquisition from specific sources. In addition, few studies have systematically examined the mechanism of the aforementioned associations. To fill the gap, an online national survey on a panel of adolescents between 13 to 17 years old was conducted. After controlling for potential confounders, several significant indirect effects were observed. Specifically, adolescents' vaping intention was negatively associated with e-cigarette information seeking from health professionals but positively with e-cigarette information exposure from family and friends, outdoors advertisements, social media, and other online channels, with the theory of planned behavior (TPB) constructs mediating these relationships. The findings not only contribute to the body of scholarship on TPB but also provide important suggestions for regulating outdoor and online e-cigarette information and designing persuasive interventions and campaigns.

Student intentions to engage instructors in mental health-related conversations: An application of the theory of planned behavior

OBJECTIVE

Considering that college students experience mental health issues and college counseling centers are overwhelmed, this study identifies instructors as a potential mental health resource for students. This study utilizes the theory of planned behavior to investigate the relationship between students' attitudes, injunctive and descriptive norms, perceived behavioral control, and their intentions to engage their instructors in mental health conversations.

PARTICIPANTS

Participants were 311 undergraduate students at a small, private university in Southern California.

METHODS

Participants were recruited through a Communication subject pool and completed an online survey about engaging instructors in these conversations.

RESULTS

Results of a regression analysis indicate that all theoretical constructs positively predict students' intentions to discuss mental health with an instructor.

CONCLUSIONS

By providing insight into students' intentions to utilize instructors as mental health resources on campus, these findings yield practical implications for better preparing universities and their faculty to engage in students' mental health.

Exploring the impact of college graduates' place attachment on entrepreneurial intention upon returning to hometowns: A study based on the theory of planned behavior

The issue of the continuing decline of rural areas caused by urbanization has become a global concern. Encouraging college graduates to return to their hometowns to start businesses is an important initiative for countries to achieve sustainable rural development. Drawing from the Theory of Planned Behavior (TPB), this study introduces two additional variables: place attachment and entrepreneurial self-efficacy. Through a series of three model refinements, a comprehensive theoretical framework has been formulated to elucidate Chinese college graduates' hometown-based entrepreneurial intention and behavior. The samples for this study were 1151 college graduates selected from diverse universities across China. This study aims to explore the influence of college graduates' hometown-based entrepreneurial intention using Structural Equation Modelling. This analytical approach illuminates how variables such as college graduates' place attachment, entrepreneurial self-efficacy, subjective norm for hometown-based entrepreneurship, and attitude towards hometown-based entrepreneurship affected their hometown-based entrepreneurial intention. The research findings reveal the following insights: (1) The overall levels of college graduates' place attachment and hometown-based entrepreneurial intention were relatively low. (2) College graduates' place attachment, entrepreneurial self-efficacy, subjective norm for hometown-based entrepreneurship, and attitude towards hometown-based entrepreneurship, had a positive impact on their hometown-based entrepreneurial intention. (3) College graduates' place attachment and subjective norm for hometown-based entrepreneurship had a significant impact on their hometown-based entrepreneurial intention through the mediating variable of entrepreneurial self-efficacy. This study then makes policy recommendations from theoretical and managerial aspects.

Influencing factors of health screening among retirees: an extended TPB approach

Background

Health screenings are promoted worldwide as they help detect and prevent overall health issues. Despite expanding coverage, the participation rate among the retired population has not significantly increased. Given the special role of health screenings in promoting health and healthy aging, understanding the behavioral intentions, and influencing factors of retirees' voluntary participation in health screenings is crucial. This study aims to explore the participation intentions in health screenings among the Chinese retired population by integrating the Theory of Planned Behavior (TPB) and Self-Efficacy (SE).

Methods

This study used a cross-sectional design to conduct an online questionnaire among 311 retirees in 2023. The questionnaire, tailored for the Chinese retired population, combines the TPB theory and Self-Efficacy theory, including demographic structure, the basic structure of TPB, and SE.

Results

A Structural Equation Modeling (SEM) approach was used to identify factors related to health screening behaviors. Of the respondents, 311 completed the survey (88.9% response rate). The most crucial determinant of health examination behavior was behavioral intention, with a correlation score of (1.524, p < 0.001). Significant correlates of behavioral intention included Subjective Norms (SN) and Self-Efficacy (SE), followed by Perceived Behavioral Control (PBC) and Attitude (AT), with correlation scores of (0.401, p < 0.001), (0.339, p < 0.001), (0.082, p < 0.001), and (0.060, p < 0.05), respectively.

Conclusion

This study provides insights for enhancing the willingness and behavior of retirees to participate in health screenings.

Different types of mobile phone use while driving and influencing factors on intention and behavior: Insights from an expanded theory of planned behavior

Mobile phone use while driving (MPUWD) is a significant concern due to its negative impact on road safety. This cross-sectional study aimed to assess different types of MPUWD and identify factors influencing intention and behavior among drivers in Zahedan. A total of 392 participants provided information on demographic and driving characteristics, as well as constructs derived from the Theory of Planned Behavior (TPB) augmented with moral norms. Findings revealed that a majority of drivers (86.4%) engaged in MPUWD, primarily involving calling, using applications, and texting. However, most participants did not intend to use their phones while driving in the following week. Multiple regression analysis identified age, receiving driving fines, subjective norm, and perceived behavior control as significant predictors of intention for MPUWD. Additionally, factors such as age, receiving driving fines, driving hours, car gearbox type, attitude, perceived behavior control, behavioral intention, and moral norm were significant predictors of actual MPUWD. Older participants demonstrated better behavior in various mobile phone activities while driving. Overall, the study emphasized that the main TPB constructs and moral norms have a greater influence compared to other variables in predicting MPUWD. Perceived behavioral control was the most important predictor of the intention and behavior of MPUWD. Understanding these factors can guide efforts to discourage MPUWD through targeted interventions and strategies to promote safer driving practices.

Factors affecting intent to perpetrate violence against nurses: Theory of Planned Behavior approach

BACKGROUND

The Theory of Planned Behavior (TPB) has been found to predict target behaviors. The literature examining this model lacks attention to violence toward nurses.

PURPOSE

To explore the association between the public's exposure to violence and intention to employ violence toward nurses, under the TPB framework.

METHODS

A cross-sectional study (705 participants) employed a self-report questionnaire. Path analysis assessed TPB variables' mediation between prior exposure to violence and violent intent toward nurses.

DISCUSSION

The TPB variables, that is attitudes, subjective norms, and perceived control, mediated only the association between exposure to physical violence and intention to act violently. Subjective norms were the strongest mediator. The explained variance was 31%.

CONCLUSION

When addressing violence against nurses, policymakers must consider attitudes, subjective norms, and perceived control among patients and their attendants. Violence directed at nurses and health care workers reflects societal violence and the "upstream approaches" needed to mitigate violence in health care settings.

Using the theory of planned behaviour to predict pre-service teachers' preferences for scientific sources

BACKGROUND

Despite the growing emphasis on research-based teacher education and calls for evidence-informed practice, teachers tend to prefer experiential over scientific knowledge sources to inform their actions, justify decisions and analyse educational problems. This tendency already occurs as early as during initial teacher education, and it is possibly bolstered by school internships where mentors emphasise the value of practical over scientific knowledge.

AIMS

The present study applied the theory of planned behaviour (TPB) to investigate under what conditions pre-service teachers intend to use and prefer scientific sources from educational research.

METHODS

The study's participants were 343 pre-service teachers in a half-year school internship who indicated their attitudes towards educational research, behavioural control (i.e. self-efficacy), perceived subjective norm, intentions of using research and preference for scientific sources in a survey. Perceived subjective norm was established by measuring whether pre-service teachers believed their mentors considered research-based knowledge.

RESULTS

In line with the predictions of the standard TPB model, structural equation modelling confirmed the effects of positive attitudes, self-efficacy and perceived subjective norm on pre-service teachers' intentions of using research. In turn, intentions and self-efficacy predicted preferences for scientific sources but not the use of scientific sources when planning a lesson in the internship.

CONCLUSIONS

Pre-service teachers' scientific source preferences are shaped not only by personal dispositions but also by the social context of school.

Predicting nurses' safety compliance behaviour in a developing economy, using the theory of planned behaviour: A configurational approach

AIM

The study's main objective was to use a fuzzy set qualitative comparative analysis to identify the configuration of recipes that predict nurses' safety compliance behaviour.

DESIGN

A cross-sectional design.

METHODS

A survey was used where questionnaires were collected from 285 nurses across four primary healthcare hospitals within the Ashanti Region, Ghana. The data collection happened between June 1 to August 2, 2022. A fuzzy set qualitative comparative analysis was used to identify the recipes of psychological factors that determine nurses' safety compliance behaviour.

RESULTS

Results from the study suggest that the necessary configurations that explained nurses' safety compliance behaviour came from the presence of subjective norm, attitude, perceived behavioural control, perceived organizational support and negation of intention. The result highlights the need for safety protocols to be conscious of the interplay between nurses' assessment of self, social clues and perception of management care and support since such psychological factors must be considered concurrently to achieve the optimal safety compliance behaviour among nurses.

CONCLUSION

A health and safety protocol that fails to recognize the importance of psychological antecedents on subordinates' safety compliance behaviour could limit the safety policy's usefulness in bringing the appropriate behavioural change in nurses.

IMPACT

To date, no study has combined the antecedents of theory planned behaviour with perceived organizational support and cue to action to assess how they collectively predict nurses' safety compliance behaviour. Findings from the study suggest that nurses in primary health facilities inform their safety compliance behaviour by assessing self-capabilities, social signals from superiors and colleagues and perception of management support. Hospital administrators and nursing managers in sub-Saharan Africa may rely on these psychological forces to persuade nurses to develop positive safety compliance behaviour at the health facility.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Digital Dating Abuse: An Application of the Theory of Planned Behavior

Social media and other technologies are being increasingly adopted as mechanisms to perpetrate abuse against dating partners. Using Ajzen's theory of planned behavior as a framework, a sample of 352 emerging adults completed a questionnaire that assessed the core constructs of the theory of planned behavior (i.e., attitudes, subjective norms, perceived behavioral control), as well as intentions to commit three types of digital dating abuse in the near future: digital monitoring and control, digital direct aggression, and digital sexual coercion. The models explained 44%, 34%, and 44% of the variance in intentions to commit digitally facilitated monitoring and control, direct aggression, and sexual coercion, respectively. Attitudes and subjective norms significantly predicted intentions, whereas perceived behavioral control did not. Given the increasing prevalence of digital dating abuse, prevention efforts should target attitudes toward digital dating abuse-related behaviors and perceptions of social acceptability and engagement.

A qualitative exploration of exercise motivation among colorectal cancer survivors: an application of the theory of planned behavior

PURPOSE

The purpose of this qualitative study was to use semi-structured interviews and thematic analysis to elicit key influencing factors (i.e., behavioral, normative, and control beliefs) related to physical activity and exercise in colorectal cancer survivors.

METHODS

Colorectal cancer survivors (N = 17) were recruited from exercise programs designed for colorectal cancer survivors at the Yonsei Cancer Center, Seoul, South Korea. A purposive sampling method was used. Interview questions were informed by the theory of planned behavior (TPB). Semi-structured face-to-face interviews were conducted, and open-ended questions addressed the research question. Interviews were transcribed verbatim and analyzed using thematic analysis.

RESULTS

Participants were on average 2.2 years post-treatment. The mean age of the sample was 55.9 years. Key behavioral, normative, and control beliefs emerged in the data. For behavioral beliefs, colorectal cancer survivors believed that exercise would result in physical and psychological improvements, and improve their bowel problems. For normative beliefs, most colorectal cancer survivors wanted their oncologists' approval for participation of exercise. Family members, more specifically the spouse, were also influencing factors for colorectal cancer survivors adopting physical activity. The most frequently mentioned control belief was that supervised exercise with an exercise specialist made exercise participation easier.

CONCLUSIONS AND IMPLICATIONS

Beliefs identified in this study can inform TPB-based physical activity interventions tailored for colorectal cancer survivors. While information alone may not lead to behavior change, integrating these beliefs with other influential factors can potentially enhance intervention efficacy and promote physical activity in this population.

Determinants of HPV vaccine uptake intentions in Chinese clinical interns: an extended theory of planned behavior approach

Background

This study aims to utilize the extended Theory of Planned Behavior (TPB) model to examine the intentions of clinical interns in China towards Human papillomaviruses (HPV) vaccination. It also fills a significant gap in the literature concerning vaccine acceptance in this specific population.

Methods

This cross-sectional study was carried out with clinical interns in Shandong Province, China, with a total of 1,619 participants. Data were collected through self-reported questionnaires, including demographic characteristics, TPB variables, and HPV-related health knowledge. Hierarchical regression analysis was employed to identify key factors influencing vaccination intentions, and Structural Equation Modeling (SEM) was used to analyze the interrelationships between these factors.

Results

This study initially identified key predictors affecting clinical interns' intentions to receive the HPV vaccine through hierarchical regression analysis. The preliminary model, which accounted for demographic factors, revealed foundational impacts of household income and HPV-related clinical experience on intentions. After integrating TPB variables-attitude, subjective norm, perceived behavioral control, and HPV-related health knowledge-the model's explanatory power was enhanced to 37.30%. SEM analysis focused on the interplay among TPB constructs and extended variables, confirming their significance in forming vaccination intentions, with subjective norm having the most substantial impact (β = 0.375, p < 0.001). The extended TPB model explained over half of the variance in vaccination intentions, substantiating the hypotheses and revealing the psychological determinants behind clinical interns' decision-making for HPV vaccination.

Conclusion

The extended TPB model from this study effectively explains the vaccination intentions among clinical interns for HPV, offering theoretical support for public health strategies and educational interventions targeting this group. These findings are of significant importance for public health practice and future health promotion strategies.

Using the Theory of Planned Behavior to determine COVID-19 vaccination intentions and behavior among international and domestic college students in the United States

Vaccination is the most effective strategy for preventing infectious diseases such as COVID-19. College students are important targets for COVID-19 vaccines given this population's lower intentions to be vaccinated; however, limited research has focused on international college students' vaccination status. This study explored how psychosocial factors from the Theory of Planned Behavior (TPB; attitudes, perceived behavioral control, subjective norms, and behavioral intentions) related to students' receipt of the full course of COVID-19 vaccines and their plans to receive a booster. Students were recruited via Amazon mTurk and the Office of the Registrar at a U.S. state university. We used binary logistic regression to examine associations between students' psychosocial factors and full COVID-19 vaccination status. Hierarchical multiple regression was employed to evaluate relationships between these factors and students' intentions to receive a booster. The majority of students in our sample (81% of international students and 55% of domestic students) received the complete vaccination series. Attitudes were significantly associated with all students' full vaccination status, while perceived behavioral control was significantly associated with domestic students' status. Students' intentions to receive COVID-19 vaccines were significantly correlated with their intentions to receive a booster, with international students scoring higher on booster intentions. Among the combined college student population, attitudes, intentions to receive COVID-19 vaccines, and subjective norms were significantly related to students' intentions to receive a booster. Findings support the TPB's potential utility in evidence-based interventions to enhance college students' COVID-19 vaccination rates. Implications for stakeholders and future research directions are discussed.

Integrating the theory of planned behavior and the self-determination theory to promote Mediterranean diet adherence: A randomized controlled trial

The Mediterranean diet (MD) is one of the healthiest and most sustainable food regimes. Nevertheless, MD diffusion is still limited, emphasizing the need to understand the psychosocial factors that could predict and promote its adoption. Starting from an integrated model of Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT), the present randomized controlled trial investigated the effect of manipulating motivation (autonomous vs. controlled) on intention and MD adherence behavior. Participants included 726 Italian adults randomly allocated to one of three conditions: autonomous motivation manipulation, controlled motivation manipulation, and control group. TPB variables were measured immediately after manipulation (T1), while MD adherence was evaluated 2 weeks later (T2). Results from multivariate analyses of variance highlighted that participants in the autonomous motivation condition reported higher intention and a more favorable cognitive attitude than control group participants. However, no change in behavior was found. Moreover, a path analysis with mediation effect showed that the impact of autonomous motivation condition versus control group on intention was mediated by cognitive attitude. Findings support the integration of TPB and SDT to encourage intention to adhere to the MD, also suggesting that prompting autonomous motivation may help to promote a greater diffusion of this healthy and sustainable dietary pattern.

Examining the moderating effect of perceived risk from particulate matter on outdoor sports participants: a theory of planned behavior perspective

Purpose

This study, drawing from the theoretical framework of the Theory of Planned Behavior (TPB), examines the structural relationship among attitudes, subjective norms, perceived behavioral control (PBC), and behavioral intention. The study focuses on investigating how the perceived risk associated with particulate matter moderates the relationships between "attitudes and behavioral intention," "subjective norms and behavioral intention," and "PBC and behavioral intention" within the context of individuals engaged in outdoor sports.

Design/methodology/approach

The data were collected from outdoor sports gatherings facilitated through a popular South Korean sports meetup application. Confirmatory factor analysis was employed to establish the construct validity of the measurement scale, assess factor loadings, averaged variance extracted (AVE), and construct reliability (CR). We also ensured the reliability of the measurement scale through Cronbach's α analysis. To achieve our research objectives, we utilized structural equation modeling with maximum likelihood estimation to examine the positive relationships under investigation. Additionally, we performed moderation analysis using the statistical software Jamovi.

Findings

The findings demonstrate the significant impacts of attitudes, subjective norms, and PBC on behavioral intention and reveal that perceived risk acts as a moderator, influencing the relationship between PBC and behavioral intention.

Application of Bayesian structural equation modeling in construction and demolition waste management studies: Development of an extended theory of planned behavior

Sustainable construction and demolition waste management relies heavily on the attitudes and actions of its constituents; nevertheless, deep analysis for introducing the best estimator is rarely attained. The main objective of this study is to perform a comparison analysis among different approaches of Structural Equation Modeling (SEM) in Construction and Demolition Waste Management (C&DWM) modeling based on an Extended Theory of Planned Behaviour (Extended TPB). The introduced research model includes twelve latent variables, six independent variables, one mediator, three control variables, and one dependent variable. Maximum likelihood (ML), partial least square (PLS), and Bayesian estimators were considered in this study. The output of SEM with the Bayesian estimator was 85.8%, and among effectiveness of six main variables on C&DWM Behavioral (Depenmalaydent variables), five of them have significant relations. Meanwhile, the variation based on SEM with ML estimator was equal to 78.2%, and four correlations with dependent variable have significant relationship. At the conclusion, the R-square of SEM with the PLS estimator was equivalent to 73.4% and three correlations with the dependent variable had significant relationships. At the same time, the values of the three statistical indices include root mean square error (RMSE), mean absolute percentage error (MPE), and mean absolute error (MSE) with involving Bayesian estimator are lower than both ML and PLS estimators. Therefore, compared to both PLS and ML, the predicted values of the Bayesian estimator are closer to the observed values. The lower values of MPE, RMSE, and MSE and the higher values of R-square will generate better goodness of fit for SEM with a Bayesian estimator. Moreover, the SEM with a Bayesian estimator revealed better data fit than both the PLS and ML estimators. The pattern shows that the relationship between research variables can change with different estimators. Hence, researchers using the SEM technique must carefully consider the primary estimator for their data analysis. The precaution is necessary because higher error means different regression coefficients in the research model.

Evaluation of an Educational Intervention Based on Theory of Planned Behavior to Reduce Suicidal Ideation and Attempts in Drug Addicts Receiving Methadone: A Quasi-Experimental Study

BACKGROUND

Drug addiction can lead to suicidal ideation or suicide attempt so that half of those who attempt suicide have a history of substance abuse. The purpose of this study was to investigate the effect of educational intervention based on Theory of Planned Behavior (TPB) on reducing suicidal ideation and suicide attempt of addicts.

METHODS

A longitudinal quasi-experimental educational intervention was conducted on 200 methadone-treated addicts with suicidal ideation under the auspices of government addiction centers of Shiraz city from 2021 to 2022. Baseline data on demographic characteristics, suicidal ideation, and TPB questionnaire were collected from two groups at the beginning of the study and then three months after the intervention. The experiment group received educational intervention including sessions of individual and group counseling, training and organizational supports. The questionnaire was completed by both the experimental and control groups before the educational intervention and three months after the educational intervention. Data were analyzed using SPSS 22 software through independent t-test, Chi-square and paired t-test (p = 0.05).

RESULTS

The mean age of addicts in the experimental and control groups was 38.80 ± 11.64 and 39.41 ± 11.18 years, respectively (p = 0.206). 22% of the experimental group and 18% of the control group had a history of suicide. According to the results, there was no significant difference between the experimental and control groups in terms of knowledge, attitude, subjective norms and perceived behavioral control before the educational intervention, however, the mentioned variables increased significantly in the experimental group three months after the educational intervention. There was no significant difference in suicide attempt and suicidal ideation between the experimental and control groups before the educational intervention, however, there was a significant change in the experimental group after the educational intervention.

CONCLUSION

The results of the present study showed the effect of educational intervention on the knowledge, attitude, subjective norms, perceived behavioral control, suicidal ideation and suicidal attempt of addicts, thus confirming the effectiveness of the TPB-based intervention on reducing suicide of addicts.

Theory of Planned Behavior applied to the choice of food with preservatives by owners and for their dogs

Many pet owners make food choices for their pets that are similar to those they make for themselves, and food characteristics such as the presence of preservatives can influence this decision. The Theory of Planned Behavior (TPB) is a tool used to predict intentions and behavior and can be an important indicator for the pet food industry. The aim of this study was to investigate pet owner behavior regarding food with or without preservatives, based on the behavior prediction of TPB. A questionnaire was distributed with questions related to direct (attitude, subjective norms, and perceived behavioral control) and indirect (behavioral beliefs, normative beliefs, and intentions) measures for the analysis of TPB. For the statistical analysis the structural equation modeling (SEM) was used. The correlation between owner behavior and the behavior imposed on their dog's diet was evaluated by paired T test or paired Wilcoxon test according to variables' adherence or not to normality, respectively. A total of 1,021 answers were evaluated after the inclusion and exclusion criteria were applied. The results indicated that TPB was effective in predicting the intentions (r2 = 0.58 for dogs and r2 = 0.59 for owners) and behavior (r2 = 0.58 for dogs and r2 = 0.57 for owners) regarding the intake of diets without preservatives. It was observed that owners are more concerned with the diet of their dogs than their own and they believe that the intake of preservatives can be prejudicial to the health of their dogs (p<0.001). However, owners trust more in pet food manufacturers than human food manufacturers (p<0.001). Therefore, it can be concluded that TPB can be an important tool to understand consumer behavior towards their dog food, and that the industry should intensify its approach on safety of preservatives in pet food, since many owners still believe they can be prejudicial to dogs.

Effects of educational interventions based on the theory of planned behavior on oral cancer-related knowledge and tobacco smoking in adults: a cluster randomized controlled trial

BACKGROUND

The theory of planned behavior (TPB) is an effective model for facilitating behavioral change. The aim of the present study was to evaluate the impact of TPB-based educational interventions on oral cancer-related knowledge and tobacco smoking behavior in an Iranian adult population in 2022.

METHODS

In this randomized controlled trial, a total of 400 healthy individuals were enrolled. The study was implemented in 20 urban health centers in the south of Tehran, Iran. The health centers were randomly allocated into two intervention groups. In group PowerPoint (PP), the participants received education through a 20-minute PowerPoint presentation complemented by a pamphlet. Group WhatsApp (WA) was educated via WhatsApp messages and images. Data was collected using a structured questionnaire at baseline, and at one- and three-month follow-ups. The outcomes were evaluated in terms of knowledge, tobacco smoking behavior, and the related model constructs i.e. intention, attitude, subjective norm, and perceived behavioral control. Generalized estimating equations (GEE) regression models were applied to assess the effect of interventions on repeated measurements of the outcomes. All analyses were conducted using STATA Software Version 17.

RESULTS

Out of all the participants, 249 (62%) were women. The mean and standard deviation (SD) of age were 39.67 and 13.80 years. Overall, group PP had a significantly higher score of knowledge compared to group WA (β = 0.43, p = 0.005). No significant differences were found between the groups with regard to tobacco smoking and the related TPB constructs, except for attitude with a higher score in group PP compared to group WA (β = 0.50, p = 0.004). At the three-month follow-up, both interventions had significant effects on increasing knowledge (β = 4.41), decreasing tobacco smoking (OR = 0.54), and increasing intention (β = 1.11), attitude (β = 1.22), subjective norm (β = 1.37), and perceived behavioral control (β = 1.08) (P < 0.001).

CONCLUSIONS

Both interventions were effective in improving knowledge, tobacco smoking, and the TPB constructs after three months. Therefore, the application of both methods could be considered in the design and implementation of oral cancer prevention programs.

TRIAL REGISTRATION

The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).

Effect of nutrition education integrating the health belief model and theory of planned behavior on dietary diversity of pregnant women in Southeast Ethiopia: a cluster randomized controlled trial

BACKGROUND

Maternal anemia, miscarriage, low birth weight (LBW), preterm birth (PTB), intrauterine growth restriction (IUGR), prenatal and infant mortality, morbidity, and the risk of chronic disease later in life are all increased by a lack of dietary diversity during pregnancy. However, evidence for the effect of nutrition education on the dietary diversity score (DDS) among pregnant women was sparse in Ethiopia, particularly in the study areas. This study aimed to assess the effect of nutrition education on dietary diversity among pregnant women in urban settings in Southeast Ethiopia.

METHODS

A community-based two-arm parallel cluster randomized controlled trial was conducted among 447 randomly selected pregnant women attending antenatal care (224 intervention group and 223 control group) at health facilities from February to December 2021. A multistage cluster sampling technique, followed by systematic sampling, was used to select the pregnant women. Pregnant women who participated in the interventions were given nutrition education starting at 16 weeks of gestation and continuing for 6 months. We used a pre-tested, interviewer-administered, structured questionnaire to collect the data. A 24-hour qualitative dietary recall was used to calculate the dietary diversity score (DDS). A multivariable generalized estimating equation (GEE) model was conducted to evaluate the intervention effect.

RESULTS

After the intervention, the proportion of adequate dietary diversity was 14.15% higher in the intervention arm compared to the control group (45.09% versus 30.94%, P = 0.002). The overall difference in adequate dietary diversity between the two groups was 8.5%. After adjusting for background characteristics, the multivariable GEE binary logistic model revealed that having received intervention [(AOR = 1.89, 95% CI: 1.27, 2.79)], being literate [(AOR = 3.41, 95% CI: 1.13, 10.23)], and having high wealth [(AOR = 1.60, 95% CI: 1.09, 2.35)] significantly improved adequate dietary diversity.

CONCLUSION

The findings indicated that having received the intervention, being literate, and having a high level of wealth significantly improved maternal dietary diversity. Efforts should be made to increase nutrition education using the health belief model (HBM) and the theory of planned behavior (TPB). Moreover, there is a need to improve literacy and economic empowerment through income-generating activities to enhance adequate dietary diversification during pregnancy.

TRIAL REGISTRATION

Clinicaltrials.gov (PACTR202201731802989, Retrospectively registered on 24 January 2022).

Theory of planned behavior and college student 24-hour dietary recalls

Objective: The transition to college is marked by poorer eating behaviors, making emerging adulthood a particularly salient intervention point for improving lifelong health. The present study aims to better understand what psychosocial factors predict eating behaviors of college students using the Theory of Planned Behavior (TPB). Participants & Methods: Dietary recalls were analyzed the Healthy Eating Index (HEI)-2015 scoring system for 67 university students between the ages of 18 and 25 (70.1% female; 49.3% White, 20.9% Black/African American, 13.4% Asian). Results: Haye's PROCESS Model 6 was used. The full model accounted for a significant amount of variance in HEI-2015 scores (F[3, 63] = 3.09, p = .033, R2 = .12). The final model suggested a significant indirect effect of PBC on the relation between ATT and HEI-2015 (β = .859, SE = .637, 95% CI [.009, 2.482]). Conclusions: Although some college students might have favorable attitudes, only those who believe this is within their control actually ate a (somewhat) healthier diet.

Factors influencing nurses' intent to provide care involved in coronavirus disease 2019: Theory of planned behaviour perspectives

AIMS AND OBJECTIVES

To identify the factors influencing the intent to provide care among nurses involved in coronavirus disease 2019 (COVID-19) care.

BACKGROUND

COVID-19 was first reported in Wuhan, China, in 2019. In 2020, the World Health Organisation declared it a pandemic, leading to 5,827,104 deaths and 421,203,495 confirmed cases as of 19 February 2022. The high transmissibility of COVID-19 has prolonged the pandemic for over 2 years, resulting in deleterious effects on nurses' physical and mental health. The fear of infection and isolation may lead to negative experiences and perceptions among COVID-19 frontline nurses, which may ultimately degrade the quality of patient care. Thus, it is essential to identify factors influencing of nurses' intent to provide care.

DESIGN

Cross-sectional study.

METHODS

Data were collected from 169 nurses involved in direct COVID-19 care at a hospital designated for infectious disease care in Korea from August to September 2021 using an online questionnaire. STROBE checklist was followed.

RESULTS

Nurses' intent to provide care significantly differed based on whether they lived with parents and had adequate availability of personal protection equipment. The correlation analysis indicated that the intent to provide care was significantly positively correlated with normative beliefs, control beliefs, attitude towards the behaviour, subjective norms and perceived behavioural control. Perceived behavioural control, control beliefs and attitude towards the behaviour were significant factors influencing nurses' intent to provide COVID-19 care.

CONCLUSION

This study showed that nurses perceived behavioural control and positive behaviour towards providing COVID-19 care fundamentally influenced their intent to provide care.

RELEVANCE TO CLINICAL PRACTICE

In clinical practice, the safety and rights of individual nurses who participated in COVID-19-related patient care are promoted, and ultimately, the quality of patient care is improved. Furthermore, active support at the organisation and government level is needed to strengthen the capabilities necessary for nursing patients with infectious diseases.

Extending the theory of planned behavior to examine the role of meat-eater identity: The case of dry-aged beef

Dry-aged beef provides superior qualities and a unique taste experience due to its exceptional sensory attributes, including tenderness, juiciness, and flavor, compared to traditional beef. Our study focused on the factors that impact consumers' intention to consume and willingness to pay for dry-aged beef. We implemented an extended version of the Theory of Planned Behavior (TPB) model that contains a measure of meat-eater identity to analyze the intention to consume and the willingness to pay a premium for dry-aged beef steak that has undergone 21-30 days of aging. An online survey was conducted with a stratified sample of Italian respondents (n = 944). The data were analyzed using partial least squares structural equation modeling (PLS-SEM). The TPB's effectiveness was enhanced by adding the meat-eater identity construct to the model. Specifically, it was found that the participants' meat-eater identity significantly influenced their intention to consume. The results also revealed that the most critical impact of identity comes from the mediated influence of attitudes, subjective norms, and perceived behavioral control. Finally, the intention to consume strongly influenced the willingness to pay for a dry-aged beef steak.

Predictive modeling of consumer purchase behavior on social media: Integrating theory of planned behavior and machine learning for actionable insights

In recent times, it has been observed that social media exerts a favorable influence on consumer purchasing behavior. Many organizations are adopting the utilization of social media platforms as a means to promote products and services. Hence, it is crucial for enterprises to understand the consumer buying behavior in order to thrive. This article presents a novel approach that combines the theory of planned behavior (TPB) with machine learning techniques to develop accurate predictive models for consumer purchase behavior. This study examines three distinct factors of the theory of planned behavior (attitude, social norm, and perceived behavioral control) that provide insights into the primary determinants influencing online purchasing behavior. A total of eight machine learning algorithms, namely K-nearest neighbor, Decision Tree, Random Forest, Logistic Regression, Naive Bayes, Support Vector Machine, AdaBoost, and Gradient Boosting, were utilized in order to forecast consumer purchasing behavior. Empirical findings indicate that gradient boosting demonstrates superior performance in predicting customer buying behavior, with an accuracy rate of 0.91 and a macro F1 score of 0.91. This holds true when all factors, namely attitude (ATTD), social norm (SN), and perceived behavioral control (PBC), are included in the analysis. Furthermore, we incorporated Explainable AI (XAI), specifically LIME (Local Interpretable Model-Agnostic Explanations), to elucidate how the best machine learning model (i.e. gradient boosting) makes its prediction. The findings indicate that LIME has demonstrated a high level of confidence in accurately predicting the influence of low and high behavior. The outcome presented in this article has several implications. For instance, this article presents a novel way to combine the theory of planned behavior with machine learning techniques in order to predict consumer purchase behavior. This integration allows for a comprehensive analysis of factors influencing online purchasing decisions. Also, the incorporation of Explainable AI enhances the transparency and interpretability of the model. This feature is valuable for organizations seeking insights into factors driving predictions and the reasons behind certain outcomes. Moreover, these observations have the potential to offer valuable insights for businesses in customizing their marketing strategies to align with these influential factors.

Integrating health belief model and theory of planned behavior to assess COVID-19 vaccine acceptance among urban slum people in Bangladesh

INTRODUCTION

The vaccination against coronavirus disease 2019 (COVID-19) has been identified as a promising strategy to reduce the severity of the pandemic. Despite the safe and effective COVID-19 vaccines, bringing socioeconomically disadvantaged people under vaccination coverage has been challenging for developing countries like Bangladesh. Therefore, this study explored the determinants of vaccine acceptance among urban slum residents of Bangladesh using the Health Belief Model (HBM) and Theory of Planned Behavior (TPB).

METHODS

A face-to-face survey of 400 urban slum dwellers in two large cities in Bangladesh was conducted between July 5 to August 5, 2021. The questionnaire included vaccine acceptance, socio-demographics, health-related characteristics, trust in health authorities, reasons for vaccine hesitancy, and dimensions of HBM and TPB frameworks. Hierarchical logistic regression was performed to evaluate the association between these characteristics and vaccination acceptance.

RESULTS

Around 82% (n = 327) of respondents were willing to accept the COVID-19 vaccine. In a fully adjusted model, respondents with secondary level education had higher intention (OR = 46.93, 95%CI = 1.21-1807.90, p < 0. 05) to accept COVID-19 vaccine. Respondents with bad (OR = 0.11, 95%CI = 0.01-0.35, p<0.05) or very bad (OR = 0.01, 95%CI = 0.01-0.35, p<0.05) health conditions were less interested in the COVID-19 vaccination. In regard to HBM dimensions, greater perceived susceptibility (OR = 1.75, 95% CI = 1.12-2.75, p < 0.05), and perceived benefits (OR = 3.28, 95% CI = 1.17-6.00, p < 0.001) were associated with a greater willingness to get vaccinated. In regard to TPB, higher self-efficacy in preventing illness without the vaccine increased the desire to get vaccinated (OR = 1.55, 95% CI = 1.02-2.37, p < 0.05). Fear of unknown side effects, religious beliefs, contraindications to vaccination, and insufficient information on the vaccine were the main reasons for vaccine hesitancy.

CONCLUSIONS

These findings offer valuable insights for policymakers in Bangladesh to design targeted interventions that address vaccine hesitancy and increase vaccination acceptability among socially disadvantaged individuals in urban areas. Strategies should focus on providing accurate and accessible information about the vaccine, communicating its positive impact effectively, engaging with religious leaders to address misconceptions, and tailoring vaccination campaigns to meet the unique needs of different demographic groups.

Mothers' intention to vaccinate their daughters against human papillomavirus in NorthWest Ethiopia, using the theory of planned behavior

Human papillomavirus (HPV) is the second most common cause of cancer worldwide among females. HPV vaccination is highly protective against HPV infection and can reduce 56% of HPV infections. Therefore, the study aims to assess mothers' intention to vaccinate their daughters aged 9-14 years old against human papillomavirus in Debre Tabor town, Northwest Ethiopia, using the theory of planned behavior. A community-based cross-sectional study design was employed using the theory of planned behavior from November 1 to 30, 2022, in Northwest Ethiopia. A total sample of 449 study participants was enrolled. The study participants were selected using a multi-stage random sampling technique. Data was collected using an interview-administered questionnaire. The data was entered into EPI data version 4.6 and then, exported to SPSS version 23 for analysis. Those variables with a p-value <.05 with 95% CI were considered significant predictors. Mothers' positive intention to vaccinate their daughters aged 9-14 years against HPV was 67.5%. Attitude, perceived behavioral control, and subjective norm were significant predictors with (AOR = 10.09, 95% CI = 6.23-16.32), (AOR = 4.12, 95% CI = 2.71-6.26), and (AOR = 16.397, 95% CI = 9.69-27.748), respectively. Only two-thirds of mothers have a positive intention to vaccinate their daughters against human papillomavirus. Attitude, perceived behavioral control, and subjective norm were predictors. Therefore, it is better to do community mobilization toward the advantage of HPV vaccination.

Intention and practice on personal preventive measures against COVID-19 among older adults in the Kingdom of Saudi Arabia: an epidemiological study using the Theory of Planned Behaviour

Introduction

Older adults aged 65 years and above are among the most vulnerable to adverse outcomes and death following a COVID-19 infection. The weekly epidemiological updates by the World Health Organisation show that the continued emergence of concerning subtypes of the virus indicates that the pandemic remains a public health concern and the public should continue to comply with personal preventive measures (PPMs). This study applies the Theory of Planned Behaviour (TPB) which is rooted in the field of Public Health, Epidemiology, and Preventive Medicine to Saudi older adults to predict their health behaviour.

Methods

This behavioural epidemiological study recruited older adult participants aged 65 years of age and above. A tool which consisted of sociodemographic and health-related questions, as well as questions regarding the components of the TPB, namely, Attitude, Subjective Norm, Perceived Behavioural Control was used. Bivariate analyses, followed by unadjusted and adjusted multivariable logistic regression analyses were performed to derive odds ratios and 95% confidence intervals.

Results

The total number of participants was 502. The mean age was 70.34 years, with similar distributions between males and females. In total, 52.2% intended to practice PPMs, whereas only 48% had a good practice. Also, 56% had a favourable Attitude towards PPMs, 61.4% had a positive Subjective Norm and 39.8% had perceived they had a high control over their behaviour. Females, and high educational status were predictors for high intention to practice PPMs (OR = 1.59, 95% CI = 1.01-2.52 and OR = 2.72, 95% CI = 1.44-5.16 respectively). Further predictors included Attitudes, Subjective Norm and Perceived Behavioural Control. Results also show that intention to practice was significantly associated with a lower odd of practicing PPMs (OR = 0.06, 95% CI = 0.04-0.10).

Conclusion

Current findings highlight the need to continue with public health efforts targeting vulnerable older adults. Also, the fact that intention negatively predicted practice highlights the need for further behavioural epidemiological studies addressing the intention-behaviour gap.

Application of the extended theory of planned behavior to predict dentist intention and behavior in providing caries preventive care for preschool children

BACKGROUND

Various studies show a gap between evidence-based recommendations and the preventive practice of dentists. This study aimed to create and assess an extended Theory of Planned Behavior (TPB) model on dentists' intentions to do caries preventive measures and related barriers experienced by dentists.

METHODS

A total of 362 general dentists from 34 Indonesian provinces were included in this study. A self-administered online questionnaire consisted of three sections: dentist characteristics and practice pattern, TPB questionnaire, and dentist perceived behavior regarding preventive care for pediatric patients. The questionnaire was distributed and the data was analyzed through structural equation modeling.

RESULTS

TPB's extended version is a fit and relevant model, explaining 55.3% of dentists' intentions to undertake preventive procedures and 17.8% of preventive practices. Perceived behavioral control was the most powerful predictor of intention (44.2%) and practice (8.8%), while parental barriers were the most significant barrier to provide preventive care (18.9%).

CONCLUSION

Extending the TPB by taking barriers from multiple stakeholders as a consideration has a higher predictive level for preventive practices. Each barrier should be addressed through oral health programs and policies, and dentists must be taught to overcome these barriers (through formal or continuing education) in order to maximize caries prevention strategies.

A model of purchase intention of complementary and alternative medicines: the role of social media influencers' endorsements

BACKGROUND

Social Media Influencers (SMIs) are a fashionable way of marketing products by creating electronic word-of-mouth (e-WOM) on social media. The marketing of complementary and alternative medicines (CAMs) by SMIs is becoming increasingly popular and gaining credibility within consumers on social media platforms. Nonetheless, advising about healthcare products on social media should be examined as it is different from endorsing other kinds of commercial products. The aim of this study is to develop a model that provides the underlying mechanisms of the stimuli of SMIs on social media towards consumers' purchase intention of CAMs.

METHODS

This study used best fit framework synthesis methods to develop the model. A priori theory selection was conducted by identifying a BeHEMoTh strategy (Behavior of Interest, Health context, Exclusions and Models or Theories) to systematically approach identifying relevant models and theories relative to the research aim. Further evidence derived from primary research studies that describe the behavior identified is coded against selected a priori theory to develop the model.

RESULTS

This study presents a novel model for understanding the purchase behavior of CAMs using SMIs as a marketing strategy. The model included two well-known theories (theory of planned behaviour theory and source credibility theory) as well as extensive existing research from a multidisciplinary perspective. The model is exclusively designed to help identify elements affecting perceived source credibility and factors that have an influence over consumers' preferences to purchase CAMs by taking into consideration SMIs' endorsements.

CONCLUSIONS

This study provides unique insights introducing new research areas to health literature and offers, new roles for healthcare professionals in this digital era by gaining new skills and competencies required to provide more credible and accurate information about CAMs. The study also highlights the new marketing era of online health-related product endorsements and recommends that policymakers and researchers carefully evaluate the impact of SMI's on the use of CAMs, as well as to regulate the content of these promotional materials.

Understanding the perceptions of sedentary college students' engagement in physical activity: application of the theory of planned behavior

OBJECTIVE

To understand salient beliefs related to physical activity (PA) in sedentary college students.

PARTICIPANTS

Thirty-seven students from a large research university participating in a larger research project were subsequently invited to participate in small focus groups.

METHODS

Using the Theory of Planned Behavior as a framework, semi-structured focus groups were conducted to understand the perceptions of using mobile technology as a tool to increase PA.

RESULTS

A grounded theory approach revealed that students generally had positive attitudes about PA and relied heavily on social support as a facilitator of PA behavior change. The structured exercise program delivered via the mobile app increased perceived behavioral control. Other key findings include academic barriers, desire to avoid chronic disease, and inconsistent efficacy of the mobile application among this population.

CONCLUSIONS

Interventions designed to increase PA in this population should focus on structured activity, increased self-monitoring, positive outcome expectancies, and social support.

Application of the Theory of Planned Behaviour to inform development of a Dissemination and Implementation science training for nutrition practitioners

OBJECTIVE

To determine nutrition practitioners' attitudes, behavioural control and normative beliefs to best inform the development and formulation of a nutrition-specific Dissemination and Implementation (D&I) science training.

DESIGN

A cross-sectional survey aimed to assess Theory of Planned Behaviour (TPB) constructs and intention to use D&I science. A validated TPB questionnaire assessed constructs including perceived behavioural control, subjective, injunctive and descriptive normative beliefs, attitudes and intention to use D&I science. For analysis, Spearman's ρ, Kruskal-Wallis and Steel-Dwass tests were conducted for quantitative variables.

SETTING

Online, 26-item Qualtrics survey.

PARTICIPANTS

Cross-sectional sample of members (n 70) affiliated with the Society for Nutrition Education and Behaviour listserv.

RESULTS

The major finding from this study was a significant positive correlation between perceived behavioural control score and intention (r = 0·315, P = 0·0119).

CONCLUSIONS

D&I training interventions could formulate learning and teaching strategies to target perceived behavioural control (self-efficacy, knowledge and ability) to enhance intention. For example, application and experience-based learning techniques trainings could be strategies to increase knowledge and abilities.

Effects of safety interventions toward workers' behaviors using the theory of planned behavior in the rubber wood processing industry

Objectives. Rubberwood manufacturing has a wide range of occupational safety hazards. Workers' safety behaviors are substandard. This quasi-experimental study aimed to determine the factors affecting safety behaviors using the theory of planned behavior (TPB) and compare the effects of safety intervention programs on workers' behaviors. Methods. The sample comprised workers from a rubberwood processing factory. Exploratory and confirmatory factor analyses were performed to validate the TPB constructs. The constructs were also analyzed before and after the interventions using structural equation modeling to confirm the observed variables. The interventions included conducting job safety analysis, establishing safety standard operation procedures and launching a behavioral promotion campaign. A t test was used to compare the constructs' intervention effects. Results. The structural equation model adequately fit the data and confirmed that the constructs were aligned with the TPB. Most path coefficients were statistically significant after the interventions were implemented. 'Attitude' and 'perceived behavioral control' directly and significantly affected 'intention'. 'Intention' was an essential mediator to 'behaviors'. The improvement in workers' behaviors was evident. Conclusions. According to the TPB, safety program interventions helped enhance workers' behaviors. Hence, based on participatory approaches, sustainable safety interventions should be maintained for all levels of personnel in the organization.

The Theory of Planned Behaviour doesn't reveal 'attitude-behaviour' gap? Contrasting the effects of moral norms vs. idealism and relativism in predicting pro-environmental behaviours

The inconsistency between pro-environmental attitudes and behaviours called the 'attitude-behaviour' gap, has been reported in many scenarios relating to sustainable actions. However, the reasons for it are not entirely clear. It has been proposed that the 'attitude-behaviour' gap is driven by the moral dimension whereby moral attitudes fail to translate into subsequent moral behaviours. If so, the lacking integration of moral dimension into the environmental domain serves as a generalisable factor to improve the accuracy of predicting pro-environmental behaviours. Hence, we aimed to explore (i) whether the addition of a moral element to the Theory of Planned Behaviour (TPB) shows the 'attitude-behaviour' gap and (ii) whether the ethics position questionnaire (EPQ) is a more suitable measure of morality within the TPB framework, as compared to that of moral norms. The results from 181 US MTurk participants disclosed that the addition of the moral element to the TPB framework did not reveal the presence of the 'attitude-behaviour' gap, despite both moral norms and idealism significantly predicting pro-environmental attitudes. The findings do not indicate whether moral norms or idealism should be used as a more accurate measure of morality within the TPB framework, although relativism was found to have no significant effects. Further investigation of why the moral element does not reveal the 'attitude-behaviour' gap within the TPB framework predicting pro-environmental behaviours would help understand the reasons why rational choice models tend to overestimate theoretical vs. real-life engagement with sustainability.

Effects of virtual interventions based on the theory of planned behavior to improve obesity-preventive lifestyle among girls, during COVID-19 pandemic

BACKGROUND

Adolescence is a critical period for the spread of obesity and overweight. This research was conducted with the aim of determining the effect of an educational intervention based on the theory of planned behavior on promoting obesity-related behaviors in overweight female students in Gachsaran.

METHODS

this quasi-experimental study was conducted on 90 female students of the first secondary school in the form of two intervention and control groups. Information related to nutritional status and the structures of the theory of planned behavior were collected using a researcher-made questionnaire whose validity and reliability have been confirmed. The educational intervention was carried out during five virtual training sessions. The data obtained three months after the intervention were analyzed using SPSS statistical software, version 20, using independent t-tests, paired t-tests, and equivalent non-parametric tests.

RESULTS

The present study showed that the scores of the constructs of awareness, perceived behavior control, subjective norms, intention, and nutritional behaviors were significantly improved after the intervention (p < 0.001). The results of the Mann-Whitney test showed that the two intervention and control groups did not have a significant difference in terms of the average overall physical activity score after the intervention (p = 0.078).

CONCLUSION

The results of the present study showed that training based on the theory of planned behavior in the conditions of COVID-19 disease and in a virtual form had an effect on nutritional behavior but could not increase physical activity behavior in adolescents with weight loss.

Determination of loyalty among high school students to retain in the same university for higher education: An integration of Self-Determination Theory and Extended Theory of Planned Behavior

Student loyalty generally refers to the formed bond between the student and a university. This relationship between a university and its students proves essential in a university's success in the competitive field of higher education institutions. The aim of this study was to determine the factors affecting students' loyalty among high school students to pursue their college or higher education in their current universities by utilizing Self-Determination Theory and Extended Theory of Planned Behavior. A total of 1224 high school students voluntarily participated and answered an online questionnaire that consist of 80 questions. Structural Equation Modeling (SEM) showed that competency had the highest direct significant effect on perceived behavioral control which subsequently led to student satisfaction, followed by relatedness and empathy. In addition, student satisfaction had the highest direct effect significant effect on student loyalty, followed by university image and effectiveness. Interestingly, university ranking, programs offered, and kinship patronage also had significant indirect effects on student loyalty. This new framework may be a theoretical foundation for universities to enhance student loyalty and student recruitment. Considering students as customers, the satisfaction of students would result in an increase in the application which would present an increase in population, sales, marketability, and profitability of the university.

A planned behavior theory-based explanatory model of protective behavior against COVID-19, with an age perspective

In this study, an explanatory model of protective behaviors against COVID-19 transmission based on the theory of planned behavior is tested using a sample of 904 individuals by adding two relevant variables in the COVID-19 context: skepticism and responsibility toward COVID-19 transmission. Responsibility and the intention to behave in a protective way act as mediators in predicting protective behaviors. The model is invariant between younger and older people, although some path differences were found: the perception that individuals have about the extent to which their reference group adopts protective behaviors directly influences individual protective behavior for younger but not older people, for whom subjective social norms were only indirect predictors of such behavior. Additionally, the rates in all the variables showed that the group under 35 took more risks in the context of protective behaviors against COVID-19: they exhibited more skepticism, lower behavioral control, perceived fewer positive social norms regarding protective behaviors, felt less responsible for spreading the disease, had less intention to behave in a protective way, and finally adopted fewer protective behaviors. Developers of intervention strategies and campaigns should contemplate such variables and focus on differences according to age.

Understanding the Sociocognitive Determinants Underlying Intentions to Exercise for Postconcussion Symptom Relief: An Application of the Theory of Planned Behavior

CONTEXT

This study investigated individual sociocognitive factors from the theory of planned behavior and their relationship to exercise for postconcussion recovery.

DESIGN AND METHODS

Four hundred and fifty-nine Australian adults, two-thirds of whom had no concussion history (66%), completed an online survey of their beliefs and attitudes toward exercise for postconcussion recovery. Secondary questions evaluated program design features that could affect engagement (eg, session frequency).

RESULTS

Structured equation modeling found that subjective norms were the strongest significant predictor of intention to participate in exercise for postconcussion recovery. Perceived behavioral control was also a significant predictor of intention to participate but to a lesser extent. Attitude did not predict participation intention. The design features identified as key were personalization and being supervised during the program.

CONCLUSIONS

This study found that people's intention to participate in a program of exercise postconcussion recovery is shaped by individual psychological factors and identified program design features that could be adjusted for increased engagement. Program success could be maximized through strategies such as supporting individuals to have a stronger sense of control over their participation through the choice of session timing or frequency and harnessing the influence of significant others via supportive messaging from key professionals.

A Study on the effect of lifestyle educational intervention based on the theory of planned behavior on promoting quality of life of middle-aged women

The present study aimed to determine the effect of lifestyle educational intervention based on the theory of planned behavior on promoting the quality of life of middle-aged women. The present quasi-experimental study examined 80 middle-aged women and randomly divided them into two groups (intervention and control). Data collection tools included the demographic information questionnaire, the Health Promoting Lifestyle Profile-II (HPLP-II), the 12-Item Short-Form Health Survey (SF-12), and the author-developed questionnaire based on constructs of the theory of planned behavior. Data were collected via WhatsApp twice (before and three months after the educational intervention). Five 45-minute training sessions were held for the intervention group and a 60-minute session for a family member regarding physical activity and spiritual growth over two months via WhatsApp. Data were analyzed using SPSS, and the results were considered significant at a statistical level (p < .05). The implementation of the educational intervention significantly increased the mean scores of quality of life, physical activity and spiritual growth, knowledge regarding physical activity and spiritual growth, attitude toward physical activity and spiritual growth, subjective norms toward spiritual growth, perceived behavioral control for physical activity, and behavioral intention to perform physical activity and spiritual growth in the intervention group in comparison with the control group. The educational intervention, which was designed based on constructs of the theory of planned behavior, was influential in promoting the lifestyles and quality of life of middle-aged women. Therefore, it is suggested to use the educational program of the present study in addition to other middle-age health care.

Nurses' behavioural intentions towards intravenous fluid administration for pediatric patients: Application of the theory of planned behaviour

BACKGROUND

For pediatric patients, the demand for quality and safe Intravenous Fluid (IVF) therapy is huge. This is because, compared to adults, children have a lower tolerance for IVF therapy errors and present devastating physiological responses to errors. Nurses play a vital role in IVF administration; therefore, adequate knowledge, positive attitudes, positive perceived behavioural control, and good behavioural intentions are required to achieve effective and successful therapy, patient safety and prevention of complications, and overall positive patient outcomes. This study sought to assess the behaviour of nurses towards IVF administration for pediatric patients.

METHOD

A cross-sectional facility-based study was designed and randomly recruited 112 nurses. The theory of planned behaviour was used as a conceptual framework to assess nurses' behavioural intentions towards IVF administration for pediatric patients. Mean scores and their respective standard deviations, reliability tests, exploratory factor analysis, and linear logistic regression were all performed using SPSS version 27, with the level of significance set at 0.05.

RESULTS

Nurses' behavioural intentions for IVF administration for pediatric patients were influenced by their knowledge of standards and protocols for IVF use (β = 0.320; p = 0.01), attitudes (β = 0.339; p = 0.006) subjective norms (β 0.240; p = 0.003) and perceived behavioural control (β = 0.26; p = 0.001).

CONCLUSION

Nurses' behavioural intentions for IVF administration were significantly influenced by their knowledge of procedures and standards for IVF administration. Additionally, the nurses' subjective norms, perceived behavioural control, and attitude towards IVF administration have a significant effect on their behavioural intentions to administer IVFs to pediatric patients. For nurses to administer IVF effectively, safely, and successfully to pediatric patients, there is a need to enhance their knowledge of standards and guidelines for IVF administration. The nurses need to have good attitudes and positive support and influence from all others to be able to administer IVFs safely and successfully to their pediatric patients.

Cell phone-related driver distraction: Habits predict behavior over and above the theory of planned behavior variables

INTRODUCTION

Habits have often been overlooked in studies investigating cell phone-related driver distractions. This paper examines the association between habits and cell phone-related driver distractions within a mediation model based on the Theory of Planned Behavior (TPB). Additionally, it explores potential differences in behaviors across urban and rural driving environments and between males and females.

METHOD

We conducted an online survey in China with 1,016 respondents, measuring attitudes, subjective norms, perceived behavioral control, self-reported behavior, and habits associated with cell phone use while driving.

RESULTS

Data was analyzed using a two-stage structural equation modeling approach. Results indicate that the measurement model provided a good fit to the data and was invariant across urban and rural driving environments, as well as across genders. The latent path model investigating mediation also demonstrated a good fit and revealed that TPB variables (attitudes, subjective norms, and perceived behavioral control) partially mediated the relationship between cell phone-related habits and cell phone use while driving. The structural model was invariant across driving environments but not across genders, for which the extent of the differences were limited. Moreover, habits were strongly associated with subjective norms and perceived behavioral control, emerging as the strongest predictor of cell phone-related distractions.

CONCLUSIONS

The findings suggest that habits should be considered in research on phone-related distracted driving behaviors and in the development of intervention designs.