Health Belief Model Research Articles

Psychometric properties of a modified health belief model for cervical cancer and visual inspection with acetic acid among healthcare professionals in Ethiopia.

Evidence supports that the Health Belief Model (HBM) can explain and predicts certain health behaviors, including participation in cervical cancer (CC) screening. The purpose of this study was to evaluate the psychometric properties of a modified HBM for CC and visual inspection with acetic acid (VIA) in female healthcare professionals in Addis Ababa, Ethiopia, 2020. Psychometric properties related to CC and VIA were tested using 42-item modified HBM self-administered questionnaire and a cross-sectional study design with simple random sampling. Kaiser-Meyer-Olkin and Bartlett's sphericity test indicated that data sampling adequacy for exploratory factor analysis was 0.792 (χ2 = 3189.95, df = 351, p < .001). Items with cross-loading and factor loadings ≥ 0.5 were retained. Confirmatory factor analysis (CFA) was conducted to determine model fit. The final analysis included 194 women, (mean age 30±4.34). Twelve items with ≤ 0.5 were removed and 30 retained items loaded into 6 factors; (benefits of VIA, perceived seriousness of CC, barrier (fear of negative outcome), self-efficacy, susceptibility to CC, and barriers (health system delivery)) explained 65% of the total variance. Cronbach's alpha for the total instrument was 0.8 and reliability for the 6 subscales was 0.76-0.92. Composite reliability and average variance extracted indicated good internal consistency and convergent validity. CFA identified 6 additional items to be removed with high residual covariance. The final 24 items of the modified HBM had an acceptable model fit (goodness-of-fit index (GFI) = 0.861, adjusted GFI = 0.823, comparative fit index = 0.937, root mean square error of approximation = 0.059). The modified HBM for CC and VIA with 24 items had adequate psychometric properties and may be used by Ethiopian healthcare professionals for research or clinical purposes. To support external validity the updated 24 items tool is suggested for application in further study in different populations in Ethiopia.

Acceptability of COVID-19 booster vaccine in malaysia: a cross-sectional study

Despite the high efficacy and safety demonstrated in clinical trials, COVID-19 booster vaccination rates in Malaysia remain below 50% among the general public. This study explores the factors influencing public acceptance of the COVID-19 booster vaccine among the Malaysian population. The questionnaire included variables on sociodemographics, knowledge, and the Health Belief Model (HBM) constructs. Based on the Chi-squared test of contingencies, a t-test and multivariate logistic regression analysis on 411 collected responses, the findings revealed that older participants, individuals of Chinese ethnicity, and those with higher education levels and incomes were more willing to accept booster vaccinations. The analysis further identified perceived susceptibility, perceived severity and perceived barriers as significant predictors influencing booster vaccination acceptance rates. Healthcare policymakers may consider targeting interventions to diminish the obstacles associated with booster vaccinations. These intervention strategies include implementing health intervention programmes, such as public health awareness initiatives, to raise awareness of the risks and severity of COVID-19, ultimately encouraging higher uptake of booster vaccines.

Understanding the Impact of Psychological Distance on Medical Tourism Intention: The Health Belief Model Perspective

ABSTRACT This study advances the Health Belief Model (HBM) within the context of medical tourism, exploring the intricate interplay between destination image, health beliefs, psychological distance, and the behavioral intentions of potential medical tourists. Our investigation reveals that destination image significantly influences perceived barriers and severity of risks, which, along with perceived susceptibility and benefits, strongly predicts tourists’ visitation intentions. Notably, the study revealed the dual roles of psychological distance: as a mediator between destination image and tourist preferences, and as a moderator affecting the impact of destination image on perceived risks. These findings underscore the importance of psychological factors in medical tourism decisions, suggesting that addressing psychological distance can enhance marketing strategies and improve patient outcomes.

A systematic review of the association between history of sexually transmitted infections and subsequent condom use in adolescents.

Sexually transmitted infections (STIs) are common among adolescents. According to the Health Belief Model, cues to action influence preventive behaviors. Cues to action can include health experiences such as being diagnosed with an STI. The impact of a history of STIs on subsequent condom use among adolescents remains largely unexamined, despite high rates of recurrence and their health impacts. This project aimed to systematically review the literature on the association between curable STIs and subsequent condom use among adolescents. The systematic review, reported following PRISMA guidelines, was conducted using the Joanna Briggs Institute method. Eligible studies, in the form of cohort studies, case-control studies, or cross-sectional studies, targeted adolescents aged 10 to 24, with or without a history of curable STIs; the outcome was subsequent condom use. MEDLINE (Ovid), Embase (Elsevier), and Web of Science were searched from January 2012 to December 2022 with the assistance of an information specialist. Two reviewers independently selected articles and extracted data. Risk of bias analysis was performed using ROBINS-E. The review explores results, with tables, based on population characteristics, exposure, and outcome, and addresses the influence of gender, ethnicity, and age. Of 3088 articles identified, seven studies were retained. Almost all the studies focused on African-American, Nigerian, or Rwandan adolescents, and several included only girls. Among girls, a history of STI increased subsequent condom use in combination with other contraceptive methods (n = 4). Among boys and older adolescents of both genders, a history of STI was associated with a decrease in condom use (n = 3). No study distinguished between different STIs. While all the studies (n = 7) presented a high risk of bias, six did not present a threat to conclusion validity. All the studies indicated that a history of STI could influence subsequent protective behaviors, possibly by acting as a cue to action, as posited by the Health Belief Model. This information enhances our understanding of factors leading to the adoption of preventive health measures among adolescents and could apply to other infectious experiences.Registration The protocol is registered in PROSPERO (CRD42023397443).

The predictors of voluntary participation in pulmonary tuberculosis screening program: a study in a suburban community of southern Thailand

BackgroundThe health belief model (HBM), baseline health condition, and sociocultural factors impact the decision to participate in a tuberculosis screening program.MethodsThis cross-sectional and descriptive study was carried out among the “Kao Taew” community dwellers aged 18 years and above, who voluntarily underwent the provided pulmonary tuberculosis (PTB) screening by chest radiographs (CXRs). The level of individual HBM domain perception, attitudes toward PTB prevention, and regularity of PTB prevention practices by the participants were evaluated. The significantly associated or correlated factors such as demographic characteristics, individual HBM domain perception, and attitudes toward PTB prevention with the regularity of PTB prevention practices from the univariate analysis were further analyzed by multiple linear regression (p &amp;lt; 0.05) to determine the independent significant predictors of PTB prevention practices.ResultsAmong 311 participants comprising 65% women, 57.9% aged ≥ 65 years and 67.2% had an underlying disease. The study participants had a high level of perception of HBM domains but a low level of perception of the barrier. In addition, a high level of attitudes toward PTB prevention and a high regularity of PTB prevention practices were found. A multiple linear regression analysis revealed that the perceived benefits of PTB screening [Beta = 0.20 (0.04, 0.36) p = 0.016] and acquiring underlying diseases [Beta = 1.06 (0.38, 1.73), p = 0.002] were significant predictors for PTB prevention practices, while belief in Islam was a reverse predictor [Beta = −0.84 (−1.47, −0.21), p = 0.010].ConclusionsThe level of perception of the individual domain of HBM, health status, and religious belief significantly predicted voluntary participation in PTB screening programs. Careful consideration by integration of the relevant health psychology, physical, and sociocultural factors is crucial for planning a health screening program.

Effectiveness of a Health Belief Model-Based Education Program on Self-Efficacy and Preparedness for Infectious Disasters in Rural Populations.

Health education programs can enhance self-efficacy and disaster preparedness. However, research incorporating the Health Belief Model (HBM) in education for infectious disasters is lacking. Examine the effectiveness of an HBM-based education program on self-reported self-efficacy and self-reported preparedness for infectious disasters in rural populations. In total, 109 eligible participants were allocated to two groups: participants who received HBM-based education (n = 55) or regular education (n = 54), presented at in-person meetings, with individual follow-up conducted on WhatsApp. Self-reported self-efficacy and preparedness for infectious disasters in both groups were measured at 4 and 8 weeks. Participants showed a significant interaction between groups and in time to increase in self-reported self-efficacy and self-reported preparedness to deal with infectious disasters. After 4 and 8 weeks, the groups had statistically significant differences (p≤.001) in all outcome measures. HBM-based education was associated with increased self-reported self-efficacy and self-reported infectious disaster preparedness among the rural population. Follow-up by nurses is essential to implementing continuing health belief education programs to enhance rural populations' self-efficacy and infectious disaster preparedness.

Factors associated with health behaviours among stroke survivors: A mixed-methods study using COM-B model.

To identify factors associated with health behaviours among stroke survivors, through a multi-centre study. A sequential mixed methods design. In the quantitative research phase, a total of 350 participants were recruited through multi-stage sampling from December 2022 to June 2023. General information questionnaires, The Stroke Prevention Knowledge Questionnaire (SPKQ), Short Form Health Belief Model Scale (SF-HBMS), Health Promoting Lifestyle Profile (HPLPII), and the WHOQOL-BREF (World Health Organization Quality of Life Questionnaire, Brief Version) were distributed across five tertiary hospitals in Henan province, China. For the qualitative research component, semi-structured interviews were conducted to explore the barriers and facilitators of health behaviour. This study adheres to the GRAMMS guidelines. A total of 315 participants (90.0%) completed the survey. Identified barriers to health behaviour included residing in rural areas, higher scores on the Charlson Comorbidity Index (CCI) and mRS, as well as lower scores on SPKQ, SF-HBMS and WHOQOL-BREF. Twenty-four individuals participated in qualitative interviews. Twenty-eight themes were identified and categorised by frequency, covering areas such as knowledge, skills, intentions, social influences, social/professional role and identity, environmental context and resources, beliefs about capabilities, beliefs about consequences and behavioural regulation. Both quantitative and qualitative data suggested that health behaviour among stroke survivors is at a moderate level, and the identified barrier factors can be mapped into the COM-B model (Capability, Opportunity, Motivation and Behaviour). The study indicates that key barriers to health behaviour among stroke survivors align with the COM-B model. These identified factors should be carefully considered in the planning of future systematic interventions aimed at improving health behaviours among stroke survivors. Patients were invited to completed questionnaires in the study and semi-structured interviews. The investigators provided explanation of this study' content, purpose and addressed issues during the data collection.

Factors associated with pregnant women’s willingness to receive maternal pertussis vaccination in Guizhou Province, China: An exploratory cross-sectional study

ABSTRACT The rise in pertussis incidence among infants in Guizhou, China underscores the need for maternal acellular pertussis vaccine (aP) immunization, a key strategy in protecting infants from severe health consequences. However, the willingness of pregnant women in Guizhou to receive this vaccine is not well-understood. This study aimed to explore pregnant women’s intentions toward maternal pertussis vaccination in Guizhou and identify the associated factors. A questionnaire based on the health belief model, was administered in an exploratory cross-sectional study from January to February 2022. Data from 564 participants were collected and analyzed. The chi-square test, Mann-Whitney U test, and Poisson regression were used to identify potential factors associated with vaccination intentions. Participants’ median age was 27 y (interquartile range (IQR): 24–31), and the median number of children per participant was one. The study found that only 36.0% of the participants intended to receive the aP vaccine while 64.0% were uncertain or negative in this regard. Significant factors associated with intentions to vaccinate included perceived barriers and cues for action and perceived benefits. The major barriers for low vaccination intentions were safety concerns for both the fetus and the mother, and family members’ negative attitudes. Free vaccines, perceiving preventive benefits, observing other pregnant women getting vaccinated, and healthcare provider recommendations may facilitate vaccination intentions. Multiple immune strategies should be developed or optimized to cope with the resurgence of pertussis.

Predicting individuals’ preventive practices against Radon indoor exposure in Saudi Arabia: a cross sectional study

Radon, a naturally occurring radioactive gas, poses a significant public health risk. This study aimed to assess indoor radon exposure in Saudi Arabia using the health belief model (HBM) as a framework for understanding and influencing public behaviour regarding the prevention on indoor radon exposure.A cross-sectional analytical study was conducted involving 803 participants from diverse backgrounds recruited through convenience sampling. The online questionnaire assessed sociodemographics, risk factors, and HBM constructs (perceived susceptibility, barriers, benefits, seriousness, and self-efficacy). Statistical analysis was conducted using SPSS.Most participants showed neutral perceptions towards susceptibility, severity (82.7% each), benefits (85.2%), and barriers (59.7%) to preventive practices. Only 31.6% had high self-efficacy, with 16.4% practicing good prevention and 44.3% fair. Preventive practices correlated positively with perceived severity, benefits, and self-efficacy, but negatively with risk score and perceived barriers.The study highlights the need for improved radon prevention practices in Saudi Arabia, focusing on educational campaigns, self-efficacy enhancement, policy support for renters, and better risk communication. These measures are crucial for mitigating radon exposure risks across the population.

Evaluating smokers' opinions on smoking and customized cessation in a Thailand University context: A qualitative study.

In Thailand, smoking cessation services have been developed to reach smokers who want to quit. However, in universities, smoking cessation services are still limited. This study aimed to identify smokers' opinions on smoking and customized cessation, and to synthesize a cessation model in the university context using the Health Belief Model. A qualitative research method was designed. In-depth interviews with semi-structured questions following the Health Belief Model framework were conducted with students, teachers, and supporting staff who were current smokers. The study was conducted from January to March 2022 at a Thai public university comprising schools of health sciences. Purposive sampling and a snowball technique were applied until data saturation was reached. Interview questions were constructed and validated for content. Verbatim transcriptions were used to perform thematic analysis with investigator triangulation. Forty-three participants were included in this study. Of six main themes and 19 subthemes, most subthemes were consistent between groups except in economic-related themes and customized cessation services. Perceptions of harm showed positive awareness of self-harm and harm to others. Barriers included addiction, being around smokers, social norms, not trusting the counseling services, and having no information about the services. Self-efficacy to quit smoking was found in a few participants. Customized cessation services varied among groups and included convenient services with 24/7 services, services units, generous counselors, communication with an application, online counseling, and medications for cessation. Moreover, the cessation services in a university were mentioned including a quit-smoking community, more activity areas, fewer smoking areas, alliance counselors from schools, and more public relations for cessation units. The perception and self-awareness of harm ranged from relaxed to being serious. Because of barriers, smoking cessation was hard to achieve, and it was hard to reach smokers. Strategies to support cessation were suggested by providing health education programs, promoting facilities and activities on campus, and designing easily accessible and customized cessation services.

Health susceptibility perceptions among Iranian, Afghan and Tajik minorities in three Nordic countries

Purpose This research paper aims to delve into the perceptions of health susceptibility among Iranian, Afghan and Tajik individuals hailing from asylum-seeking or refused asylum-seeking backgrounds currently residing in Finland, Norway and Sweden. Design/methodology/approach Semi-structured interviews were conducted between May and October 2022 involving a sample size of 27 participants. An adapted framework based on the health belief model along with previous studies served as a guide for formulating interview questions. Findings Notably influenced by cultural background, religious beliefs, psychological states and past traumatic experiences during migration journeys – before arrival in these countries till settling down – subjects’ perception of health concerns emerged significantly shaped. Additionally impacting perspectives were social standing, occupational status, personal/family medical history, lifestyle choices and dietary preferences nurtured over time, leading to varying degrees of influence upon individuals’ interpretation about their own wellness or illness. Practical implications Insights garnered throughout the authors’ analysis hold paramount significance when it comes to developing targeted strategies catering culturally sensitive health-care provisions, alongside framing policies better aligned with primary care services tailored explicitly around singular demands posed by these specific communities dwelling within respective territories. Originality/value This investigation represents one among few pioneering initiatives assessing perceptions regarding both physical and mental well-being within minority groups under examination across Nordic nations, unveiling complexities arising through intersecting factors like individual attributes mingling intricately with socio-cultural environments, thereby forming unique viewpoints towards health-care belief systems prevalent among such population segments.

Impact of virtual education based on health belief model on cervical cancer screening behavior in middle-aged women: A quasi-experimental study.

Cervical cancer is one of the most common cancers in women worldwide and a cause of high mortality among people. Pap smear screening is an appropriate method to prevent cervical cancer and reduce its mortality. This study aimed to determine the effect of web-based education based on the Health Belief Model (HBM) on cervical cancer screening behavior in middle-aged women. This study is a quasi-experimental interventional research that was conducted on 240 middle-aged women aged 40-59 years in Isfahan, Iran, in 2022. An online educational intervention based on the constructs of the Health Belief Model was conducted for the intervention group using the Triple-B platform. The information on the intervention and control groups was collected before, immediately after the intervention, and 2 months later using a valid questionnaire. The gathered Data was analyzed using ANOVA and LSD post-hoc, independent samples t test, chi-square, and MANCOVA statistical tests in SPSS 26 software. After the intervention, the mean scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, self-efficacy, and internal cues to action in the intervention group increased and the mean score of perceived barriers decreased (p < .001). The mean score of the external cues to action did not show a significant difference between the intervention and control groups before, immediately, and 2 months after the intervention. Two months after the intervention, 32 women (26.2%) in the intervention group and two women (1.7%) in the control group performed the Pap smear test. Web-based educational intervention based on HBM using different strategies such as question and answer, presentation of infographics, lectures, brainstorming, showing videos and numerous educational images can be an effective way for increasing knowledge and cognitive variables of women and doing Pap smear test.

“I know now that it's something that you can do something about”: Deductive thematic analysis of experiences of an arts-based dementia risk reduction exhibit

Dementia is one of the leading global health crises. Despite the devastating impacts of the illness, general population knowledge pertaining to risk reduction is still limited. Previous research on the impact of dementia risk reduction campaigns has largely focused on awareness rather than behaviour change. Our research introduced an arts-based exhibit to address dementia modifiability, aiming to enhance effectiveness by providing an immersive experience for altering adults’ perceptions and lifestyle behaviours. Interviews were conducted with adults (n = 38 [13 male, 25 female]) who attended an interactive dementia awareness and risk reduction exhibit. Data was analysed using deductive thematic analysis within the Health Belief Model framework to determine key mechanisms of behaviour change. Four key themes encompassing exhibit significance and factors underlying behaviour change were identified. Participants recounted positive experiences, particularly being engaged by the artistic aspects of the exhibit, and recorded heightened engagement in behaviours supporting dementia risk reduction post-exhibit. Areas for improvement included the need for a take-home summary and variation in formats. Prior experience with dementia and age were described as playing roles in dementia risk reduction behaviour, with younger participants reporting lesser engagement with risk reduction information. Our research found that arts-based educational initiatives have the potential to advance public understanding and promote behavioural changes for dementia risk reduction. Our study recommends enhancing the impact of future interventions by employing innovative formats and tailoring them to varied audiences, with a specific emphasis on engaging younger individuals.

Complete Basic Immunization Status of 12 Months Babies at West Wonggeduku Health Center Based on the Health Belief Model

Introduction: From the initial interviews conducted by three mothers, they said that health workers had never conducted outreach to the public about the importance of immunization and the negative impact on the baby's condition if they were not fully immunized, so each region needed to study the factors that influence this. Implementation of immunizations including in the West Wonggeduku Community Health Center area.&#x0D; Method: The type of research sample in this study is quantitative research using a cross sectional study approach which aims to determine the relationship between the complete basic immunization status of 12 Month old babies based on the health belief model theory at the West Wonggeduku Community Health Center in 2022. The population is 120 people, with a sample of 92 people. The sampling technique in this research used the Simple Random Sampling technique, using the Chi-Square Statistical test.&#x0D; Results: Research shows that there is a relationship between perception susceptibility to the completeness of complete basic immunization status X2 count = 34.389, X2 table value = 3.841, and Phi value = 0.611&#x0D; Conclusion: The results of this research are that there is a relationship between perception susceptibility and completeness of immunization in 12 Month old babies

Association between sociodemographic factors and health beliefs related to breast cancer screening behavior among Northern Thai women: a hospital-based study

Early diagnosis of breast cancer is crucial for reducing mortality rates. The purpose of this study is to determine the impact of demographics/social determinants of health on beliefs about the practice of self-breast examination, using mammogram and ultrasound in the context of breast cancer screening among Thai women in a hospital-based setting for implying program planning and future research. A cross-sectional study was conducted in two health centers in Chiang Mai Province from August 2021 to December 2021, involving 130 Thai women ages 40 to 70 years. Data were collected by a survey using a questionnaire to gather sociodemographic information, and health beliefs about breast cancer and screening behavior utilizing the modified Thai version of Champion's Health Belief Model Scale (MT-CHBMS). Descriptive statistics, t-tests, ANOVA, and linear regression models were employed for examining association between sociodemographic factors and health beliefs about the practice of self-breast examination (BSE), using mammogram (MG) and ultrasound (UTS). Health insurance schemes were associated with Benefit-MG, Barrier-BSE, Barrier-MG and Barrier-UTS subscales. Additionally, monthly income was associated with Barrier-MG and Barrier-UTS subscales. The most common barriers reported were “embarrassment”, “worry”, and “takes too much time”. To enhance breast cancer screening in Thailand, program planning and future research should focus on health insurance schemes, especially women with social security schemes, as they may be the most appropriate target group for intervention.

RESEARCH ON THE SUSTAINED USAGE INTENTION OF USERS ON ONLINE FITNESS PLATFORMS: A PERSPECTIVE BASED ON THE HEALTH BELIEF MODEL (HBM)

This study focuses on the online fitness industry, exploring the motives and sustained usage behavior of users on online fitness platforms within the online network environment. The research background is rooted in the health issues arising from insufficient physical activity in real-world society, especially exacerbated by the COVID-19 pandemic. The study uses ideas from the Flow Theory and the Health Belief Model (HBM) to build a research framework to look into how platform incentives, content quality, subjective norms, perceived usefulness, flow experiences, exercise self-efficacy, health awareness, and other things affect users' plans to keep using the platform. Through the collection of 606 valid questionnaires and employing SPSS and AMOS software for differential analysis, regression analysis, and path analysis, all research hypotheses are successfully validated. Results indicate that content quality, platform incentives, and subjective norms significantly positively influence users' perceived usefulness and flow experiences. Furthermore, perceived usefulness and flow experiences have a significant positive impact on users' sustained usage intentions, playing crucial mediating roles in users' sustained behavior. The study also reveals that exercise self-efficacy positively moderates the relationship between users' perceived usefulness and sustained usage intentions, and health awareness serves as a positive moderator in the relationship between users' flow experiences and sustained usage intentions.

THE COMPARISON OF HEALTH EDUCATION THROUGH TELEHEALTH (WHATSAPP) AND BOOKLET ON HIV/AIDS PREVENTION BEHAVIOR IN PROSPECTIVE BRIDES BASED ON THE HEALTH BELIEF MODEL

Background : HIV/AIDS is a sexually transmitted disease that is currently a disease with a high prevalence in Indonesia with the majority of sufferers in the age range of 25-49 years old. Health education is one of the primary prevention efforts in suppressing the incidence of HIV / AIDS. Currently, there are many media that can be used in delivering health education such as booklets and telehealth. Objectives : The purpose of this study was to determine the most effective media in providing health education on HIV/AIDS prevention behavior in prospective brides based on the health belief model. Methods : The study method used a type of quantitative study with a quasy-experiment. This study has a total sample of 54 respondents with accidental sampling technique. This study instrument used AHBS (AIDS Health Belief Scale) as a questionnaire. Result : There is a significant difference between health education through telehealth and booklets on HIV / AIDS prevention behavior in prospective brides based on the health belief model through the Mann Whitney statistical test obtained the results of p value (0.000 &lt;0.05). Conclusions : It can be concluded that telehealth media is a fairly effective tool with the resulting N-gain score of 59.8% in delivering health education. Through this research, it is hoped that Religious Affairs Office Cimahi can use telehealth (whatsapp) and booklets as a media for HIV/AIDS health education for prospective brides

Unveiling the dynamics of social distancing intentions in India: a comprehensive analysis integrating health belief and planned behavior models

Purpose The COVID-19 outbreak reached a critical stage when it became imperative for public health systems to act decisively and design potential behavioral operational strategies aimed at containing the pandemic. Isolation through social distancing played a key role in achieving this objective. This research study examines the factors affecting the intention of individuals toward social distancing in India. Design/methodology/approach A correlation study was conducted on residents from across Indian states (N = 499). Online questionnaires were floated, consisting of health belief model and theory of planned behavior model, with respect to social distancing behavior initially. Finally, structural equation modeling was used to test the hypotheses. Findings The results show that perceived susceptibility (PS), facilitating conditions (FC) and subjective norms are the major predictors of attitude toward social distancing, with the effect size of 0.277, 0.132 and 0.551, respectively. The result also confirms that the attitude toward social distancing, perceived usefulness of social distancing and subjective norms significantly predict the Intention of individuals to use social distancing with the effect size of 0.355, 0.197 and 0.385, respectively. The nonsignificant association of PS with social distancing intention (IN) (H1b) is rendering the fact that attitude (AT) mediates the relationship between PS and IN; similarly, the nonsignificant association of FC with IN (H5) renders the fact that AT mediates the relationship between FC and IN. Practical implications The results of the study are helpful to policymakers to handle operations management of nudges like social distancing. Originality/value The research is one of its kind that explores the behavioral aspects of handling social nudges through FC.

A Scale Development Study: The Vitamin D Health Belief Scale According to The Health Belief Model

Objective: This study was conducted to develop Vitamin D Health Belief Scale based on the health belief model in adult women and determine its validity and reliability.&#x0D; Methods: The sample of the study consisted of 404 women who were aged between 18 and 65, volunteered to participate in the study, and met study criteria. The theoretical framework of the scale was based on the health belief model. During the scale development stage, exploratory factor analysis and index values were evaluated by using confirmatory factor analysis, item-total correlation, and mean scores.&#x0D; Results: The content validity index of the scale was found as 91.52%. As a result of the factor analysis, the variables were gathered under 6 factors with a total explained variance of 58.22%. Cronbach’s alpha value of the scale was determined as.884.&#x0D; Conclusion: As a result of all analyses, a 5-point Likert-type scale that consisted of 31 items was developed. Six factors were obtained from the scale: perceived sensitivity, caring, health motivation, perceived benefits, perceived barriers, and self-efficacy. The total score of the scale gives the Vitamin D Health Belief score. The lowest and highest scores on the scale which consists of 31items are 31 and 155&#x0D; respectively. It is recommended to use this scale to determine vitamin D health beliefs in adult women.

Self-protective behaviors of Thai village health volunteers in community engagement during a COVID-19 outbreak: interpretation using the health belief model

BackgroundVillage health volunteers (VHVs) engaging in community-based COVID-19 prevention and control measures played a key role in mitigating effects of the COVID-19 pandemic in Thailand. We conducted a cross-sectional questionnaire survey study to investigate factors affecting VHVs’ COVID-19 self-protective behaviors and social distancing in Songkhla Province during the first COVID-19 outbreak. Such information may help to understand how to support VHVs in future pandemics.MethodsA total of 152 VHVs from 13 sub-districts participated in the study, completing a 54-item questionnaire based on the Health Belief Model (HBM). The questionnaire included items assessing susceptibility, severity, benefits, barriers, self-efficacy, social distancing, and self-protective behavior. Stepwise multiple regression analysis determined which aspects of the HBM could explain VHVs’ self-protective behavior.ResultsThe VHV population sampled broadly reflected the main demographic characteristics of the local population, although VHVs were predominantly female. Self-protective behavior was significantly associated with VHVs’ role (higher perceived compliance for village leaders than non-leaders) but not with other demographic characteristics. Most VHVs reported high levels of self-efficacy (80.5%), adherence to social distancing measures (70.9%), and engagement in self-protective behavior (72.8%) against COVID-19. However, compliance with hand hygiene appeared to be suboptimal, suggesting room for improvement. Self-efficacy and perceived social distancing showed strong and moderate correlations with self-protective behavior against COVID-19 (r = 0.917, β = 0.819; and r = 0.561, β = 0.173 respectively; p < 0.001). The final HBM-based regression model accounted for 87.2% of the variance in VHVs’ self-protective behavior.ConclusionsThis study highlights the importance of VHVs’ self-efficacy for achieving self-protective behavior during a COVID-19 outbreak, and suggests that self-efficacy may help to overcome barriers that might otherwise hinder behaviors to mitigate against COVID-19. Policies that support self-efficacy should be implemented in any future pandemic, and steps to support VHVs with hand hygiene compliance and empower non-leaders to increase their self-protective behavior may also be helpful. Whilst the HBM provided a useful framework for interpretation, the final model was driven mainly by self-efficacy.