Modified Health Belief Model Research Articles

The health information management professionals' role in supporting individuals considering genetic testing: An exploratory study.

Background: An increasing number of people are exploring their genetic predisposition to many diseases, allowing them to make healthcare decisions with improved knowledge. Objectives: The aim of this study was to identify factors that influence individuals to consider genetic testing utilising a modified health belief model (HBM). Method: The authors tested the modified HBM using a convenience sample of individuals from across the United States after a pilot study was used to test the validity and reliability of the constructs. Using SmartPLS, the researchers determined that the modified HBM explains the decision-making process used to determine what influences individuals to consider genetic testing. Results: Results suggested that perceived susceptibility, perceived benefits, cues to action, self-efficacy, e-health literacy and normative belief all play a role in an individual's decision to test their genetics. Conclusion: By conducting genetic testing, individuals may benefit from knowing they are predisposed to certain cancers and other diseases. Yet, research results have indicated that most individuals are unaware of resources available online that will help them in understanding genetic test results and associated diseases. Implications: Since healthcare literacy is an issue reported by these individuals, health information management professionals are well qualified to support them in e-health literacy by assisting them to evaluate the trustworthiness of available resources, and to educate them about privacy rights regarding access to and protection of their genetic information.

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.

Knowledge regarding Disposal of Kitchen Garbage among Housewives: A Descriptive Design

Background: A descriptive study was conducted to assess the knowledge regarding the disposal of kitchen garbage among housewives in selected community areas, in Kanakapura, Bangalore, Karnataka. A total sample of 100 housewives was selected using the non-probability purposive sampling technique. The objectives of the study were to assess the knowledge regarding the disposal of kitchen garbage among housewives. The final objective was to find out the association between knowledge regarding the disposal of kitchen garbage and selected demographic variables. Materials and Methods: A descriptive design was used to conduct the study. A sample comprising 100 housewives was enrolled using a non-probability purposive sampling technique. The conceptual framework used in the study was based on the Modified Health Belief Model by Becker and Rosenstock (1974). Results: Data analysis was done using descriptive and inferential statistics. The findings of the study revealed that the knowledge score about the disposal of kitchen garbage was 46.89% and the mean knowledge score regarding disposal of kitchen garbage among housewives was 13.13±1.52. A significant association at 0.05 levels was observed between knowledge about educational status. Conclusion: The findings of the study confirmed that the knowledge regarding disposal of kitchen garbage is average among housewives.

The use of Health Belief Model (HBM) to explain factors underlying people to take the COVID-19 vaccine in Indonesia

BackgroundSARS-COV-2 (COVID-19) has severely impacted people's health worldwide. Vaccines are one of the health measures taken to reduce the impact of COVID-19, but recent reports have revealed that some people are reluctant to be vaccinated against COVID-19. Understanding the factors underlying an individual’s decision to take the COVID-19 vaccine is critical to designing an immunisation programme. This study examines factors that influence the intention to take a COVID-19 vaccine using the modified Health Belief Model (HBM) framework and analysing demographic factors. MethodA cross-sectional online survey was conducted from 10 January to 20 January 2021. Five hundred thirty-seven respondents above 17 years old and residing in Indonesia voluntarily completed an online survey. Survey questions addressed sociodemographic factors; perception of susceptibility, severity, benefits and barriers; cues to action; and intention to take the COVID-19 vaccine. A Structural Equation Modelling (SEM) approach with SmartPLS software was used to analyse the measurements and model construct. FindingsThe results showed that the perception of susceptibility, severity, benefits and barriers, as well as cues to action, predicted people’s intention to take a COVID-19 vaccine. Model structure explained a large proportion of variance in people’s intention to be vaccinated against COVID-19 (R2 = 66.8 %). Some demographic factors affected the key variables of the HBM. People with low and middle income negatively influence feeling severity, beneficial and barrier in intending to take vaccine. Other demographic factors such as sex, age, marriage and living areas did not affect the components of the HBM, except for females influencing severity and people living in urban areas associated with benefits variable. These findings imply that COVID-19 vaccination programmes should focus on providing accurate information about the severity of COVID-19 and the benefits of taking the vaccine. Building people’s confidence in their ability to eliminate barriers to taking the vaccine and involving family members and community and religious leaders will increase COVID-19 vaccine uptake. ConclusionDespite limitations to the study, such as respondent demographics that are unrepresentative of the wider Indonesian population, inadequate survey timing and an exclusive focus on vaccine intention as the outcome variable, the present study contributes to explaining individuals’ intentions to take a COVID-19 vaccine in a Eastern country context. This study is valuable to providing public health policy recommendations that focus on effectively designing immunisation programme interventions.

COVID-19 Vaccine Hesitancy in an Underrepresented Minority Community.

To assess factors influencing acceptability of COVID-19 vaccine in a population of predominantly indigent, minority, pregnant and non-pregnant people of reproductive age. Cross-sectional survey using a modified Health Belief model administered between January 2021 and January 2022 at four hospitals in Brooklyn. Participants included English-speaking reproductive aged persons attending clinics at the participating sites. Descriptive and univariate data analyses were used for analysis. 283 eligible reproductive persons were approached of whom 272 completed the survey (96%). Three quarters said they would take the vaccine under certain circumstances ("as soon as it is ready" [28.6%], "when my doctor recommends it" [21.3%] or "when enough people have received it to know if it works" [25%]), while 25% said they would never take the vaccine. When comparing persons that would take it under certain circumstances to those that never would, the "never" group was significantly more likely to note that, "they would not trust any COVID vaccine" (71.4% vs. 28.5%; p ≤ 0.0001). This greater level of distrust extended to greater distrust of doctors, government, family, newspapers, and media. However, 36% said they would be influenced by their doctor's recommendation. Pregnant participants were significantly more likely to wait until their doctor recommended it (17.6% of pregnant persons compared to 3.7% of non-pregnant p < 0.0001). Despite mistrust and other discouraging factors, many persons, under appropriate circumstances (e.g., reassurance about vaccine safety) may be motivated to take the vaccine. Even those who claimed that they wouldn't take the vaccine under any circumstance may be influenced by their health care providers.

Math Phobia among School Students: A Comparative Design

Background: A Comparative study was conducted to assess the level of Math Phobia (Mathematical Anxiety) among high School students in selected Government and Private Schools, Kollam, Kerala. A total sample of 60, High school students were selected using convenience sampling technique. The objectives of the study were to assess the level of Math Phobia/Mathematical Anxiety among Government and Private High School students and to compare the level of Math Phobia/Mathematical Anxiety among Government and Private High School students. The final objective was to find out the association between level of Math Phobia/Mathematical Anxiety and selected Socio-demographic variables. Materials and Methods: A Descriptive Comparative design was used to conduct the study. A sample comprising of 60 High School students (30 Government and 30 Private) from 10th Standard were enrolled using non-probability convenience sampling technique. The conceptual framework of the study was based on Modified Health Belief Model by Becker and Rosenstock (1974). Tools used for data collection were Demographic Performa and Modified Abbreviated Mathematics Anxiety Rating Scale. Results: Data analysis was done using Descriptive and Inferential statistics. Findings of the study revealed that the mean Mathematical anxiety among Government High School students was 33.83±9.80 and the mean Mathematical anxiety among Private High School students were 45.87±17. The comparison of the mean Mathematical Anxiety scores among the Government and Private High School students were done using the ‘Student t-test’. The computed ‘t-value’ at 3.27** (df = 58) was statistically significant at p &lt; 0.01. No significant association was observed between the level of Math Phobia and selected Socio-demographic variables among both Government and Private School students (P &gt; 0.05). Conclusion: The findings of the study confirmed that the level of Math Phobia/Mathematical Anxiety among the Private High School students were significantly higher than the Government High school students.

Assessing the effectiveness of public health interventions for Covid-19 in Greece and Cyprus.

In this article, we statistically examine the effectiveness of non‐pharmaceutical interventions (NPIs) implemented by the national governments of Greece and Cyprus during 2020 to (a) limit the spread of the SARS‐CoV‐2 virus, and (b) mitigate the economic fallout brought about by the Covid‐19 pandemic. Applying a modified health belief model, we hypothesize that behavioral outcomes at the policy level are a function of NPIs, perceived severity, and social context. We employ a Prais‐Winsten estimation in 2‐week averages and report panel‐corrected standard errors to find that NPIs have clear, yet differential, effects on public health and the economy in terms of statistical significance and time lags. The study provides a critical framework to inform future interventions during emerging pandemics.

Beliefs about influenza and avoidance of free influenza immunization among people with chronic diseases.

People with chronic diseases may have poor influenza-related outcomes. The study objective was to examine the association between the dimensions of the Health Belief model and noncompliance with influenza immunization. study participants were community-dwelliing individuals from the Foča region (Republic of Srpska, Bosnia and Herzegovina) listed to receive free influenza immunization for the season 2017/2018 due to chronic diseases. After vaccination season was completed, we included all nonvaccinated people and the corresponding number of vaccinated people. The data collection lasted from April to December 2018 using a sociodemographic questionnaire and modified Health Belief model Applied to Influenza. The study sample consisted of 295 people of which 149 (50.5%) were immunized against influenza in the past season. Adjusted logistic regression model suggested that people who scored lower on domains of Seriousness (odds ratio [OR] = .79, 95% confidence interval [CI] [.69, .91]), Benefits (OR = .83, 95% CI [.76, .91]) and Cue to action (OR = .79, 95% CI [.73, .86]), but higher the Barriers domain (OR = 1.10, 95% CI [1.03, 1.17]), were less likely to receive vaccination in the past season. People who did not receive recommendation from a health care worker and who were never vaccinated against influenza did not comply with influenza vaccination across all models (p < .01). Perceiving influenza as less serious, less beneficial, having fewer cues to action, and perceiving more barriers to influenza vaccination were associated with skipping influenza immunization. Not receiving health care worker recommendation and never being vaccinated against influenza were also associated with avoidance of vaccination. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Factors related to parents\u2019 adherence to childhood immunization

BackgroundImmunizations protect children from deadly infectious diseases. Yet, there is still insufficient understanding of the factors associated with parents’ non-adherence to immunizations in contexts outside of Western countries. The aim of this study is twofold: (a) to investigate non-adherence to immunizations for children aged 6 months to 6 years in Saudi Arabia based on the number of immunizations missing or delayed by more than one month; and (b) to examine the underlying factors that predict the extent of non-adherence based on the Health Belief Model framework.MethodsA cross-sectional study was carried out in 22 randomly selected primary health care centers. Structured interviews were also conducted to collect data using the modified Health Belief Model questionnaire. Multiple regression analysis was used to assess the predictors of the extent of non-adherence.ResultsBased on data from 220 participants, 51.8% of parents did not adhere with childhood immunizations. There was no significant relationship between parents’ sociodemographic characteristics and the extent of their hesitancy about children’s immunizations. The linear combination of perception of infectious disease severity, perception of their children’s susceptibility, perception of immunization benefits, perception of fewer barriers to obtaining immunizations, cues to action related to immunizations, and self-efficacy predicted the extent of non-adherence to immunizations (F (11.220) = 2.595, p < 0.001) and explained 12% of its variance. Yet, only perceived children’s susceptibility, perceived barriers, and self-efficacy independently predicted parents’ non-adherence.ConclusionSaudi Arabia’s high proportion of non-adherence to childhood immunizations should be addressed. For instance, a health education program could be developed to increase parents’ awareness that their children are susceptible to health risks. Paying a special attention to existing barriers in accessing and receiving the immunizations is crucial. In addition, building parents’ self-efficacy, which is confident in making healthy decisions, such as keeping their children’s immunizations up to date, is important.

Assessing Community Acceptance of Maternal Immunisation in Rural KwaZulu-Natal, South Africa: A Qualitative Investigation.

Despite the significant benefits of maternal immunisation, uptake remains low in many parts of the world. In this qualitative study, we aimed to assess the factors that influence pregnant women’s decision to engage with maternal immunisation in rural KwaZulu-Natal, South Africa. We conducted in-depth interviews with a total of 28 purposively sampled pregnant women and key informants using semi-structured topic guides. Data analysis was conducted using a modified Health Belief Model framework that included constructs of barriers to action, modifying factors of cue to action and perceived social norms. The findings show that traditional customs and institutional barriers such as low-quality health service delivery, long queues, and distance to the health facilities, immunisation vaccine stockouts and low levels of maternal knowledge influence the choice and decision to engage with maternal immunisation. Understanding health-related behaviours and addressing barriers to care is important in facilitating vaccination uptake. This study contributes to the understanding of maternal immunisation uptake in low-resource settings.

What drives small-scale farmers to vaccinate their multiple livestock species animals against common infectious diseases in Myanmar?

Livestock rearing is an important income source for small-scale farmers in Myanmar, but Foot and Mouth Disease (FMD) and Newcastle disease (ND) are major constraints to livestock production. A study was conducted to identify perceptions of farmers about FMD and ND disease risks and perceptions about vaccination practices by using the modified health belief model. The majority of livestock farmers (>70%) reported that they were aware of the risk and impact of FMD and ND and were willing to vaccinate their livestock (>60%). Focusing on three main livestock farmer groups, about 17.0% of cattle, 15.4% of village chicken, but only 2.3% of small ruminant owners, indicated that the non-availability of vaccinations in the villages was the major constraint to vaccinations (p<0.001), while in contrast twice as many small ruminant farmers compared to cattle and village chicken farmers indicated they had no knowledge about vaccinations and no funds to conduct vaccinations. Limited accessibility to vaccines and vaccinators was related to size of villages (p = 0.001 for cattle; p = 0.027 for small ruminants; p = 0.005 for village chicken). Willingness to vaccinate small ruminants against FMD was associated with the perceived impact of the disease on sales and accessibility of information about vaccination. Accessibility to information about ND vaccination influenced the willingness of village chicken farmers to conduct vaccinations. In addition, beliefs in the effectiveness of vaccinations played a major role in the willingness to carry out vaccinations on both, cattle (β = 0.3, p = 0.018) and village chicken farms (β = 0.5, p<0.001). Our study highlights that policies that increase the accessibility of vaccines and the dissemination of information about disease prevention and vaccination practices in villages of all sizes, have the potential to increase FMD and ND vaccination rates and thereby reduce outbreak occurrence in Myanmar. On the other hand, indirect factors, such as village size strongly influenced the availability of vaccinations.

A Study to assess the Prevalence of Menopausal Symptoms and Effectiveness of Structured Teaching programme on Knowledge and Attitude regarding Menopausal symptoms and its management among women at selected wards of Kadapra Grama Panchayat in Pathanamthitta District

A quantitative study was to assess the prevalance of menopausal symptoms and effectiveness of structured teaching programme on knowledge and attitude of menopausal symptoms among women at selected wards of Kadapra Grama Panchayat, Pathanamthitta district. The objectives of the study was to assess the prevalance of menopausal symptoms, to assess the pretest level knowledge and attitude regarding menopausal symptoms and its management, to find out the effectiveness of structured teaching programme on knowledge and attitude regarding menopausal symptoms and its management and association of pretest level of knowledge with selected demographic variables. Non-probability purposive sampling was used to select 100 Sample. The conceptual framework developed based on Rosenstock’s modified health belief model. Modified menopausal symptoms checklist is used to assess prevalance of menopausal symptoms. A structured knowledge questionnaire and attitude scale is used to assess the knowledge and attitude of sample regarding menopausal symptoms and its management. The collected data were analysed using descriptive and inferential statistics. The post-test was done 7 days after pretest using same tool. The result revealed that paired t test value of knowledge was 29.34 and that of attitude was 32.50. It was concluded that structured teaching programme was effective in increasing knowledge and change in attitude. Chi square was used to find out association of pretest level of knowledge with selected demographic variables. The results showed that there is no association with pretest level knowledge and selected demographic variables.

Applying the Modified Health Belief Model (HBM) to Korean Medical Tourism.

The purpose of this study is to investigate how foreigners’ health beliefs influence their visiting intentions to Korean medical tourism. This study used an online survey engine (docs.google.com/forms) to collect data from foreigners who are from India, Nepal, Bangladesh, Vietnam, and Mongolia, who are potential Korean medical tourists. Out of 213 questionnaires collected, 200 questionnaires (93.9%) were used for the statistical analysis. The Confirmatory factor analysis (CFA) revealed that six dimensions, “Experience”, “Susceptibility”, “Severity”, “Barrier”, “Benefit”, and “Visiting Intention”, had construct validity; Cronbach’s alpha coefficient was tested for item reliability. It is expected that four variables in the health belief model (HBM) that are determined by objective and logical thinking processes will affect the choice of Korean medical tourism. The results showed that Susceptibility, Severity, Barrier, and Benefit had significant effects on Visiting Intention and was a valid measurement to determine “Visiting Intention”.

Predictors of caring behaviors of mothers of premature infants based on the health belief model

Objective: To investigate predictors of caring behaviors of mothers of premature infants based on the health belief model. Methods: This cross-sectional study was conducted by using the structural equation modeling on 168 mothers of premature infants, who were selected by convenience sampling method from October 2017 to February 2018 in Iran. Data were collected by using a standard scale. Validity and reliability of all data collection tools were approved. Data were analyzed by using SPSS V.16 and Mplus6 software. Results: The structural equation modeling of the initial health belief model did not have a good fit, but the fitness of model 2 obtaining from the modified initial model was confirmed by changes in locations of constructs. None of constructs of model 2 had a significant positive association with the caring behavior of mothers of premature infants and only 2.8% of variance of caring behaviors in mothers could be predicted by the sum of variables of demographic characteristics and the modified health belief model constructs. Conclusions: Given that the findings do not approve the use of the health belief model in predicting determinants of caring behavior of mothers of premature infants, it is suggested to apply this model to investigate the effect of educational intervention based on the health belief model on the caring behavior of mothers.

Likelihood of healthy eating among adolescents based on the health belief model

Introduction Maintaining appropriate eating habits is one of the key components of good health. It is especially difficult during adolescence, a critical period in life because of the increased autonomy and the intention to take risks. Investigating the theoretical background of adolescents’ eating behaviour is therefore a worthwhile line of research. We applied the widely used health belief model to explore adolescents’ likelihood of healthy eating. Materials and methods A sample of adolescents (Szeged, Hungary; N = 400, age = 14–19 years; mean age = 16.01 years, SD = 1.18 years; 37% males) participated in the study. Data were collected through online, self-administered/anonymous questionnaires. Based on bidirectional correlations of the variables, we used a path analysis to examine relationships between elements of a modified health belief model. Results Our modified model showed the direct impacts of cues to action, benefits, barriers, and self-efficacy, and the indirect impacts of perceived severity and susceptibility-via-cues-to-action on the likelihood of healthy eating. Discussion and conclusions Elements of the health belief model play a decisive role in estimating adolescents’ healthy eating behaviour. We suggest that the model can serve as a useful theoretical background in planning and evaluating prevention programs to reduce obesity and promote healthy eating.

Factors Associated With the Management of Adverse Drug Reactions Among Community Pharmacists in South Korea.

Community pharmacists dispensed 68.4% of all drugs used in Korea, but reported only 2.0% of adverse drug reactions (ADRs) in 2011. This study compared community pharmacists' understanding of the importance of ADR management and their actual practice of it, and identified relevant factors related to their management of ADR. With the use of a modified health belief model (HBM), 800 community pharmacists were surveyed via social network service messaging. A total of 200 usable responses were obtained for an effective response rate of 25.0%. Descriptive analysis was used to quantify the differences between community pharmacists' understanding of the importance of ADR prevention and their practice. A hierarchical regression was performed with the following predictors: (1) demographic factors, (2) social impact of ADR prevention, (3) importance of social support, and (4) cognition about the importance of ADR prevention. Although community pharmacists clearly recognized the importance of ADR management, their performance was very low. The disparity between cognition and performance was more pronounced for ADR reporting than for patient counseling. Social support was the most powerful predictor of ADR prevention practice, explaining 18.5% of the variance in ADR prevention practice. Social impact of ADR prevention, demographic factors, and cognition about the importance of ADR prevention explained 12.6%, 6.2%, and 1.8% of the variance, respectively. Strengthening community pharmacists' performance of population-based ADR management should be prioritized over patient-oriented ADR management. To improve public health, community pharmacists should make an effort at ADR reporting. This can be done with appropriate government support, such as incentives to community pharmacists, public awareness campaigns, education, and establishment of feedback systems.

Effectiveness of modified health belief model-based intervention to reduce body mass index for age in overweight junior high school students in Thailand

PurposeThe purpose of this paper is to determine the effectiveness of a modified HBM-based intervention to reduce body mass index (BMI) for age in overweight junior high school students.Design/methodology/approachA cluster-randomized controlled trial was conducted in the first and second years of a junior high school in the center of Thailand. In total, 24 classrooms were randomly assigned to a modified health belief model intervention arm (HBMIA), and 24 classrooms were randomly assigned to a traditional school health education arm (control). In total, 479 students who were overweight (BMI forage = median +1 SD, aged 12–15 years) participated in the study. The HBMIA used the health belief model (HBM) as a motivator for behavioral strategies that included modifying diet and participating in physical activity. BMI, health knowledge and behavior for preventing obesity were recorded at baseline and at six months. A multilevel regression model was performed to calculate mean difference between HBMIA and control group.FindingsThe students who participated in the HBMIA showed a decrease in BMI of 1.76 kg/m2, while those who participated in the control showed an increase in BMI of 1.13 kg/m2, with a mean difference of –2.88 kg/m2(95% CI =–3.01 to –2.75), an improvement in health knowledge (mean difference 27.28; 95% CI =26.15–28.41) and an improvement in health behavior (mean difference 23.54; 95% CI =22.60–24.48).Originality/valueA modified HBM-based intervention to reduce BMI for age is effective in overweight junior high school students.

Beliefs, attitudes and perceptions to sun-tanning behaviour in the Norwegian population: a\xa0cross-sectional study using the health belief model

BackgroundNorway has one of the highest incidences of melanoma in the world. It has been suggested that the majority of all skin cancers could be prevented by changes related to sun-tanning behaviour. This study explores the sun-tanning behaviour of the Norwegian population using a modified Health Belief Model (HBM). Increased knowledge about beliefs, attitudes and sun-tanning behaviour can provide information which may be useful for future sun protection interventions.MethodsIn 2017, 1004 members of the Norwegian population completed cross-sectional online surveys. People who seek the sun for tanning purposes was the eligibility criterion for this study, reducing the study population to 569. With the aid of the constructs from the HBM, predictive factors explaining sun-tanning behaviour were determined using multivariate linear regression adjusted for demographics (gender, age, education and income). Furthermore, the predictor variables, empowerment and benefits of tanning, were added to the model.ResultsFive of the constructs in the modified HBM showed significant correlation with sun-tanning behaviour using bivariate analysis. The strongest correlation was perceived barriers of sun protection (0.42), with the next strongest being the benefits of tanning (0.30). The modified model explained 31% of the variation in sun-tanning behaviour using multivariate analysis. Significant predictors from the HBM to sun-tanning behaviour were perceived barriers to sun protection (Beta = 0.36, p < 0.001) and the severity of melanoma (Beta = − 0.20, p < 0.001). In addition, empowerment (Beta = 0.05, p = 0.05) and the benefits of tanning (Beta = 0.28, p < 0.001) proved to be variables with significant effect on sun-tanning behaviour. The demographic factors age, education and income were also associated with sun-tanning behaviour (p < 0.05).ConclusionBased on the results of this study, several factors in the modified HBM had a significant impact on Norwegians’ sun-tanning behaviour. The results indicate that future sun protection interventions should focus on reducing barriers in relation to sun protection behaviour, as well as emphasizing the severity of adverse tanning behaviour and melanoma. Efforts to alter the perceptions of the beneficial factors of tanning behaviour can also be appropriate in health promotion campaigns and interventions. Finally, implementing empowerment strategies could have a positive effect on promoting healthy sun-tanning behaviour.

Sociodemographic and psychological determinants of influenza vaccine intention among recipients of autologous and allogeneic haematopoietic stem cell transplant: a cross-sectional survey of UK transplant recipients using a modified health belief model

ObjectivesStudies exploring vaccination rates among haematopoietic stem cell transplant (HSCT) recipients have focused on physician factors that limit uptake. Understanding the patient factors that determine vaccination intention is crucial to...

Barriers Influencing Linkage to Hypertension Care in Kenya: Qualitative Analysis from the LARK Hypertension Study.

Hypertension, the leading global risk factor for mortality, is characterized by low treatment and control rates in low- and middle-income countries. Poor linkage to hypertension care contributes to poor outcomes for patients. However, specific factors influencing linkage to hypertension care are not well known. To evaluate factors influencing linkage to hypertension care in rural western Kenya. Qualitative research study using a modified Health Belief Model that incorporates the impact of emotional and environmental factors on behavior. Mabaraza (traditional community assembly) participants (n = 242) responded to an open invitation to residents in their respective communities. Focus groups, formed by purposive sampling, consisted of hypertensive individuals, at-large community members, and community health workers (n = 169). We performed content analysis of the transcripts with NVivo 10 software, using both deductive and inductive codes. We used a two-round Delphi method to rank the barriers identified in the content analysis. We selected factors using triangulation of frequency of codes and themes from the transcripts, in addition to the results of the Delphi exercise. Sociodemographic characteristics of participants were summarized using descriptive statistics. We identified 27 barriers to linkage to hypertension care, grouped into individual (cognitive and emotional) and environmental factors. Cognitive factors included the asymptomatic nature of hypertension and limited information. Emotional factors included fear of being a burden to the family and fear of being screened for stigmatized diseases such as HIV. Environmental factors were divided into physical (e.g. distance), socioeconomic (e.g. poverty), and health system factors (e.g. popularity of alternative therapies). The Delphi results were generally consistent with the findings from the content analysis. Individual and environmental factors are barriers to linkage to hypertension care in rural western Kenya. Our analysis provides new insights and methodological approaches that may be relevant to other low-resource settings worldwide.