Despite the well-documented benefits of Therapeutic Patient Education (TPE), patient uptake remains low. This study examined whether patients' health beliefs, as described by the Health Belief Model (HBM), predict TPE participation. In this prospective cohort study, 351 adult patients from a French university hospital were followed for six months after being offered TPE for various chronic diseases. At baseline, they completed questionnaires assessing their perceptions of the benefits of and barriers to TPE, disease threat, control over their condition, and the empathy displayed by the healthcare professional (HCP) who recommended TPE. Contextual variables were also recorded. Logistic regressions were used. High perceived benefits significantly predicted TPE participation among patients who perceived high barriers (OR = 3.66, 95% CI [1.72-7.78]). Patients were also more likely to participate if TPE was proposed during a change in the treatment of their disease (OR = 2.91, 95% CI [1.32-6.42]). Finally, their baseline intention to participate (rated from 0 to 100) was predictive of uptake (OR for a 10-unit increase = 1.33, 95% CI [1.17-1.51]). Conversely, neither the perceived threat nor control over the disease predicted uptake. HCP empathy, time since diagnosis, and the type of professional recommending TPE had no significant impact. The HBM displayed some explanatory power in relation to TPE uptake, with perceived benefits and barriers playing a key role. Emphasizing the benefits of TPE while addressing barriers may boost participation, and a change in treatment could serve as a meaningful opportunity to engage patients in TPE. Conversely, highlighting the potential worsening of the disease may be ineffective. Finally, HCPs could tailor their communication strategies based on patients' expressed intention.

Redefining transition: Self-efficacy in urologic care.

Recent enough to matter: Perceived temporal proximity, anxiety, and COVID-19 vaccine intent.

Effectiveness of a nurse-led health belief model-based educational intervention for reducing smartphone addiction in adolescents: A randomized controlled trial.

"To move or not to move"exercise adherence in home-based cardiac rehabilitation after coronary artery bypass graft surgery: A qualitative study.

This study examines the predictive power of constructs from the health belief model (HBM) and theory of planned behaviour (TPB) in explaining malaria vaccine acceptance in Ghana in the post-COVID-19 era, while also assessing the reliability of these constructs within this context. A cross-sectional survey of 622 adults was conducted in two Ghanaian municipalities representing high- and low-malaria endemicity. Constructs from HBM and TPB, alongside contextual factors such as religiosity and traditional medicine use, were measured. Partial Least Squares Structural Equation Modelling (PLS-SEM) was used to assess construct validity and estimate their predictive relationships with vaccine intention. All constructs demonstrated strong reliability (Cronbach's α = 0.894-0.985) and convergent validity (AVE = 0.797-0.971). The model demonstrated strong predictive power, explaining 67.6% of the variance in vaccine intentions (R2 = 0.676). Attitudes (β = 0.578, p < 0.001) and perceived benefits (β = 0.531, p < 0.001) were the strongest predictors of acceptance. Perceived behavioural control had a marginal effect (β = 0.124, p = 0.064). Perceived disease vulnerability negatively predicted intention (β = -0.330, p = 0.006), while perceived severity and subjective norms were non-significant. HBM and TPB constructs are reliable and valid in predicting malaria vaccine acceptance in Ghana. Interventions should focus on strengthening positive attitudes and highlighting the benefits of vaccination, while addressing misconceptions among those who perceive themselves as most vulnerable. This study provides novel evidence on malaria vaccine acceptance in a post-pandemic context and underscores the utility of combining HBM and TPB for predicting preventive health behaviours in sub-Saharan Africa.

Unused and expired Pharmaceuticals and Personal Care Products (PPCPs) are emerging environmental contaminants that may pose serious risks to human health and the environment. In Nepal, household and pharmacy level waste disposal behaviors remain poorly documented. A cross-sectional survey was conducted in Tokha municipality among 298 households and 53 pharmacy retailers. Structured questionnaires included data on: (i) demographic features, (ii) usage and storage patterns of PPCPs, and (iii) their disposal practices. This study was based on the Health Belief Model (HBM) constructs. Data were analyzed using descriptive statistics, chi-square tests, Spearman's correlation analysis, and partial least squares structural equation modeling (PLS-SEM). Unsafe storage and improper disposal practices being common among households and pharmacy retailers. About 41.6% of the households stored unused or expired pharmaceuticals, primarily analgesics and skincare products that accounted 63.1% and 77.5%, respectively. Expired PPCPs were mostly disposed of in household garbage containers (88.9%) or burned (12.8%), while only 4.7% were returned to pharmacies. Of the HBM constructs, self-efficacy was the strongest predictor of response to cues for safe disposal behaviors (β = 0.184). Of all pharmacy retailers, only 17% were aware of disposal regulations and facilities. Major challenges included the lack of take-back systems (37.8%) and limited disposal facilities (24.5%). The study highlighted significant challenges in the management of unused and expired PPCPs among households and pharmacy retailers in Tokha municipality. Households and pharmacy retailers reported unsatisfactory waste disposal practices. Community-based awareness drives and pharmaceutical waste management modules boost self-efficacy by giving people the knowledge and confidence to safely handle and manage unused and expired PPCPs. In a case there are accessible municipal collection systems, pharmacy- or municipal-level take-back points, and clear regulatory mechanisms in the country, it becomes easier for individuals to accelerate that confidence into safety practices to reduce environmental deterioration and protect public health in Nepal.

Health literacy is a key determinant of health behaviours, including vaccination. Despite the proven benefits of immunization, vaccine hesitancy remains a global challenge, shaped by cultural, social, and individual factors. The aim of this study was to investigate the relationship between parents' health literacy and vaccine attitudes according to the health belief model among different ethnic groups. This study is expected to highlight the role of cultural differences in achieving public health objectives, while also contributing to improved health literacy and the development of more inclusive policies in child health and immunization. This descriptive cross-sectional study was conducted with 908 parents (Turkish: 249; Kurdish: 217; Arab: 245; Assyrian: 197) living in Mardin, Turkey, between January and July 2025. Data were collected through face-to-face interviews using a sociodemographic form, the Public Attitude Towards Vaccination Scale-Health Belief Model, and the Turkey Health Literacy Scale-32. Data were analysed using descriptive statistics, chi-square tests, one-way ANOVA, and generalized linear model analyses. Health literacy and vaccination attitudes differed significantly according to ethnic group (p< .001). Arab parents had the lowest general health literacy scores and the most negative vaccination attitudes, including the highest perceived barriers to vaccination (24.04 ± 3.98). In contrast, Assyrian parents had the highest scores for sensitivity and severity, awareness of importance, belief in vaccine benefits, and health responsibility. Higher health literacy was positively associated with more favourable vaccination attitudes among Turkish, Kurdish, and Assyrian parents. However, among Arab parents, higher health literacy was associated with lower awareness of importance, lower belief in vaccine benefits, lower health responsibility, and greater perceived barriers. Significant interaction effects between ethnicity and health literacy were found for awareness of importance, belief in vaccine benefits, and health responsibility. Health literacy is an important factor influencing vaccination attitudes, but its effect varies according to ethnic background and cultural context. In some groups, higher health literacy supports more positive vaccination attitudes, whereas in others it may not lead to greater vaccine acceptance. Public health interventions should therefore use culturally sensitive and trust-based approaches to improve vaccination attitudes among diverse populations.

ABSTRACT Motorcycle-related crashes represent a major public health concern in Thailand, where motorcyclists account for approximately 74% of road traffic fatalities, highlighting their increased vulnerability due to interactions with larger vehicles. To address this issue, exclusive motorcycle lanes (EMLs) have been proposed as a potential solution. Therefore, this study aims to investigate the psychological factors influencing riders’ intentions to use EMLs. The study gathered data from 951 motorcycle riders across three main regions of Thailand. The Structural Equation Model results revealed a significant association between the Health Belief Model and riders’ intentions to utilize EMLs for reducing the risk of road crashes. The results indicate that perceived susceptibility is the most influential determinant across all regions, while perceived barriers exhibit context-dependent effects, particularly in industrial areas. Regional differences highlight the importance of tailoring infrastructure and policy strategies to local traffic environments and offer insights for relevant authorities for enhancing safety measures.

Introduction: Tick-borne-disease (TBD) risk is high along the Appalachian Trail (AT), yet little is known about how long-distance hikers practice recommended prevention behaviors. Because their prolonged outdoor exposure limits the feasibility of standard guidelines, understanding their behaviors and the beliefs shaping them is essential. This study examines TBD prevalence and prevention behaviors using the health belief model (HBM). Methods: A self-administered Qualtrics survey, pilot-tested for clarity, assessed demographics, AT hiking experience, diagnosis of TBD, prevention behaviors, and HBM constructs. Participants were ≥18 years old with AT experience. Recruitment occurred through in-person sampling, online forums, and snowball sampling. Prevention behaviors and HBM variables were analyzed using descriptive statistics and multiple regression models. Results: A total of 202 responses were analyzed. Over one-fifth of participants reported a previous TBD, most commonly Lyme disease. Prevention behaviors varied, with carrying tick removal devices, conducting daily tick checks, and using permethrin being the most frequently practiced. Regression models indicated that perceived barriers consistently predicted all prevention behaviors, while perceived benefits, susceptibility, and cues to action were significant in select models. Conclusions: Long-distance hikers demonstrated high TBD prevalence and inconsistent prevention practices. Tick checks, removal tools, and permethrin use were common prevention behaviors. Perceived barriers and perceived benefits were the strongest behavioral predictors, underscoring the need for interventions that reduce barriers and strengthen perceptions of effectiveness. Findings highlight opportunities to improve prevention strategies for hikers in high-risk environments.

This research assumes that conversation quality in Antenatal Care (ANC) counseling determines whether clinical messages stay as knowledge or become daily behavior. It maps how pregnant women interpret message content, delivery, and closure so that recommendations feel relevant and actionable at home. A qualitative design used semi-structured face-to-face interviews with three pregnant women who received ANC counseling in the last three months. The interview guide combined key ANC message themes, Communication Accommodation Theory (CAT), and the Health Belief Model (HBM). Data were audio-recorded, transcribed verbatim, member-checked, and analyzed using reflexive thematic analysis. Findings show that mothers recall core advice on nutritious eating, light activity, and clinic visits, but operational details such as concrete portions, how to take iron tablets, and prioritized danger signs are not consistently conveyed. Counselors generally use everyday language and a comfortable pace, but message structure is uneven across topics. Home follow-up uses simple cues such as alarms, notes in the maternal and child health book, and family members who act as natural reminders. The study concludes that counseling effectiveness depends on content completeness and how conversations are structured and closed, and recommends a four-step micro-SOP with teach-back closure so ANC messages are understood, remembered, and practiced.

Chest pain is a common symptom with causes ranging from harmless to potentially life-threatening. Interpreting its seriousness and deciding whether to seek care can be challenging for individuals. While research has focused on patients with confirmed cardiac diagnoses, less is known about how people experience and evaluate chest pain in general, and how they decide to seek care. To explore the considerations of people experiencing chest pain and identify the barriers and facilitators influencing their decision to seek medical care. Qualitative study using semi-structured focus groups and individual interviews with adults who had experienced chest pain in primary care. Two focus groups (n=3 each) and nine individual interviews were conducted. Interviews were guided by the Health Belief Model (HBM) and explored barriers and facilitators to care-seeking. Transcripts were analysed thematically. Data collection continued until no new themes emerged. All HBM components shaped help-seeking, often changing as symptoms progressed. Decisions to seek care were influenced by multiple, interacting factors. Barriers included fear of exaggerating symptoms, prior non-cardiac explanations, downplaying symptoms, and practical considerations. Facilitators included severe or persistent symptoms, prior recognition, social support, and positive relationships with healthcare providers. Expectations also influenced decisions, including seeking reassurance about serious illness or advice for non-cardiac or persistent symptoms. Decisions to seek medical care for chest pain are influenced by symptom interpretation, expectations, social support, and trust in healthcare providers. Clear communication, strong doctor-patient relationships, and accessible, reliable information may support timely and appropriate care-seeking.

Factors associated with COVID-19 vaccination among breastfeeding and pregnant people: Application of the health belief model.

Social media discourse surrounding obesity management medications (OMMs) has generated significant public attention, driven largely by celebrities and influencers sharing narratives about their use. However, much of this influencer-generated content remains underexamined, raising concerns about how health beliefs are communicated within sociocultural narratives. This study examines how medical and patient influencers communicate health beliefs about OMMs through signals embedded in their content. Using a qualitative content analysis informed by netnographic principles, 213 YouTube video transcripts by medical and patient influencers were analyzed. Drawing on the health belief model and signaling theory, the study identifies key communicative signals within influencer discourse. Findings reveal that medical influencers emphasize evidence-based signals, while patient influencers foreground experience-based ones. The analysis also uncovers paradoxical signals, including boomerang effects, commercial intent, and contradictory empowerment. This study integrates the health belief model and signaling theory to advance understanding of credibility and persuasion in online health communication.

Asian elephants (Elephas maximus) are poached for an illegal trade in their skins, which are used in traditional medicine in Africa and Asia. We explored whether messages about the legal and health risks of using elephant skin for medicinal purposes (stomach illness) could reduce such consumption. We conducted a randomized controlled trial intervention experiment based on a health belief model. We showed 1673 residents at China's Yunnan-Myanmar border comic strips that portrayed these risks (legal-risk and health-risk treatments and control). Respondents were then asked for their perception of benefits and risks of using elephant skin and their consumption intentions for treating stomach illness (i.e., seek elephant skin, seek animal-based traditional medicine, visit informal market, and visit hospitals). We used structural equation models to examine whether and how different messages affect consumption intentions. Compared with the control group (n=580), the comics that showed the legal risks of use of elephant skin (n=529) significantly reduced respondents' intentions to seek elephant skin by 24% compared with the control group, particularly when the message conveyed that its use is not a cure. The health-risk treatment (n=564) increased respondents' intentions to go to the hospital when suffering from stomach illness and, unexpectedly, increased the intention of urban residents who had never heard of elephant skin as a treatment to look for it by 40% compared with those of urban residents in the control group. Our results revealed that interventions tailored to specific audience segments are necessary to prevent unintended, negative consequences of public messaging conservation interventions.

This study assessed Chinese cancer patients' willingness to participate in phase III clinical trials of new anti-cancer drugs and examined influencing factors using the Health Belief Model (HBM) and social support. A cross-sectional survey recruited 480 patients from an online community through convenience sampling. Data included demographics, disease and treatment status, HBM constructs (including perceived severity, perceived benefit, perceived barrier, cue to action, self-efficacy), social support (including family's, friends', and others' support), and willingness to participate. Statistical analyses involved factor analysis, reliability testing, correlations, and hierarchical regression. The mean willingness score was 2.883 (range = 1-5). Willingness varied significantly by living arrangements, employment, income, and treatments. Demographics explained 9.8% of the variance, disease and treatment status 12%, and social support 22.4%, with family support as a significant predictor (β = 0.202, p < .001). Incorporating HBM constructs raised the explained variance to 48.2%. Key positive predictors included cues to action (β = 0.251), self-efficacy (β = 0.281), and perceived severity (β = 0.151), while perceived barriers reduced willingness (β = -0.114). Findings suggest Chinese cancer patients show limited willingness to join phase III trials, although it should be generalized cautiously, considering the non-representative nature of the online sample. Enhancing family support and targeting self-efficacy and external motivators may improve engagement, supporting the utility of the HBM framework.

The public transportation system is a high-risk medium for respiratory infectious disease (RID) transmission. Health awareness videos are integral to disseminating knowledge, elevating health-risk perceptions, and enhancing attitudes toward precautionary measures against RID, as per the Health Belief Model and Cognitive Dissonance theory. This study aimed to produce and evaluate an evidence-based health awareness video on precautionary measures against RID among public transportation drivers (PTDs) in Lebanon. This is a multistage project executed over 2 fiscal years. In stage 1, a scoping review study identifies articles on RID among PTDs. Search strategy follows a combination of concepts (influenza, COVID-19, and public transportation) using PubMed, CINAHL Complete, and other databases up to September 2025. Studies that reported the characteristics of PTDs, their knowledge, perceptions, and compliance with precautionary measures against RIDs are reviewed. In stage 2, based on the scoping review, a script for a health-awareness video is drafted. Using a classic Delphi technique, the script is revised and approved by 8 experts in public health, infection control, psychology, and filmmaking, using the Patient Education Materials Assessment Tool for audiovisuals (PEMAT-AV), and DISCERN. PEMAT-AV (13-items) systematically evaluates the understandability and actionability of educational materials. DISCERN tool (16-items) evaluates the quality of consumer health information. In stage 3, a nonblinded, randomized, 2-arm controlled trial is conducted on 387 drivers from different regions. Using a simple randomization technique, the experimental group watches the new video. The control group watches a neutral video on traffic signs. To evaluate the effectiveness of the video, participants' knowledge, risk perceptions, attitudes, and cognitive dissonance are measured using infection control guidelines, Health Belief Model tool, Vaccination Attitudes Examination scale, and dissonance thermometer. Using IBM SPSS, between-group analysis is performed with Student t test, ANOVA, and Pearson correlation, followed by forward-stepwise linear regression analyses (2-sided α=.025). In stage 1, 20 relevant studies were identified. Studies from Lebanon described the sociodemographics, health- and work-related characteristics, and life challenges of the target population. Other studies reported influenza or COVID-19 vaccine hesitancy, low vaccine uptake, inadequate cleaning or disinfection of vehicles, and elevated risk perceptions among computers. The prevalence and impact of RIDs and determinants of precautionary measures against RIDs were identified. In stages 2 and 3, the video will be revised by experts (projected 5 months), produced (projected 6 months), and tested (projected 2 months). The study has not been funded yet. Findings from the scoping review study inspired the writing of the script (characters and dialogue), making it evidence-based and tailored toward the target viewers. A health awareness video on precautionary measures against RIDs contributes to a safer public transportation system and higher service usage. It aligns with the global mission to control the spread of RID and to lessen the disease burden.

The growing visibility of social media influencers has increased interest in their role in shaping health beliefs and behaviors. While prior research has largely focused on message characteristics or direct behavioral outcomes, less attention has been given to the conditions under which influencer-based health messages are interpreted and translated into action. This study conceptualizes influencer-based health communication not as a direct persuasive force, but as a conditional communication process. Drawing on Uses and Gratifications Theory and the Health Belief Model as interpretive frameworks, it examines how individuals engage with health-related influencer content, how such engagement relates to health perceptions, and how digital health literacy shapes message interpretation. Survey data from social media users were analyzed using Firth’s penalized logistic regression to address the rarity of influencer-driven health behavior. Findings indicate that, despite high levels of exposure to influencer-based health content, the translation of such exposure into health-related action remains limited. Exposure to health content significantly increases the likelihood of influencer-driven behavior, whereas higher digital health literacy reduces this likelihood, suggesting a protective effect. Additionally, perceived commercial intent decreases the probability that influencer recommendations lead to action. By distinguishing between engagement and behavioral change, this study reframes influencer effects as conditional outcomes shaped by motivations, perceptions, and interpretive competencies. It contributes to health communication literature by moving beyond linear persuasion models and highlighting the critical role of digital health literacy. The findings also offer practical implications for strengthening individuals’ ability to critically evaluate health information in digital environments.

Background. Human papillomavirus (HPV) is a prevalent sexually transmitted infection and major cause of cervical and anogenital cancers. This study aimed to assess parental knowledge, vaccine hesitancy, and health beliefs concerning HPV infection and vaccination. Methods. This cross-sectional study was conducted using convenience sampling among parents of adolescents aged 9-18 attending outpatient clinics at a tertiary hospital. The study collected sociodemographic characteristics and used the Health Belief Model Scale for HPV Infection and Vaccination to assess health beliefs, in order to identify factors associated with parental perceptions and vaccination attitudes. Results. A total of 320 parents participated in the study; 82.8% were mothers. Self-reported HPV infection was low (1.9%), and only 3.4% of parents and 2.8% of their children had been vaccinated. Awareness about HPV infection was 75%, and that of the HPV vaccine was 67.2%. However, only 30% of parents were willing to vaccinate their children, while 47.5% were uncertain. The most commonly reported barriers were lack of awareness (33.9%) and concerns about side effects (26.4%). Higher parental education, family income, and prior HPV knowledge were positively associated with both awareness and willingness to vaccinate children, whereas having multiple adolescents was associated with increased vaccine hesitancy. Conclusion. Parental awareness of HPV infection and vaccination was 75% and 67.2%, respectively, while vaccination rates among adolescents were very low. Higher parental education, income, and prior HPV knowledge were associated with favorable perceptions of vaccination. Addressing knowledge gaps and reducing perceived barriers through educational interventions may help increase HPV vaccination uptake among adolescents.

Identifying the factors that affect behaviours related to reducing dental plaque can help decrease oral and dental health problems. Therefore, the aim of this study was to determine the predictors of behaviours related to reducing dental plaque based on the Health Belief Model constructs among sixth-grade students. In this cross-sectional study, 401 sixth-grade students from Urmia City were selected using a multi-stage sampling method. The data collection tool was a researcher-made questionnaire that included two parts. The first part gathered demographic information, while the second part consisted of questions designed based on the Health Belief Model constructs, as well as knowledge about dental plaque and behaviours related to reducing it. The data obtained were analysed using SPSS software, version 16. Constructs of perceived self-efficacy (β = 0.455, p < 0.001), perceived barriers (β = -0.100, p = 0.018) and cues to action (β = 0.100, p = 0.043) were significant predictors of behaviours associated with reducing dental plaque. The constructs of the Health Belief Model, along with knowledge, explained approximately 40.2% of the variance in behaviours related to reducing dental plaque among sixth-grade students in Urmia City. Constructs of perceived self-efficacy, perceived barriers and cues to action were significant predictors of behaviours related to reducing dental plaque among sixth-grade students. Therefore, it is recommended that these constructs be integrated into all educational interventions that are designed and implemented with the aim of promoting behaviours related to reducing dental plaque among sixth-grade students.