Perceived Health Risks Research Articles

Decisional trade-offs towards doping and their association with moral attitudes and health risk perceptions: A mixed methods study

ABSTRACT The objective of the present research was to examine doping-related decisional trade-offs, and their relationship with health risk perceptions towards doping and moral attitudes in sport. A mixed methods sequential-explanatory design was used. In Study 1,249, Mixed Martial Arts (MMA) athletes from 16 countries completed anonymous online questionnaires on decisional trade-offs related to doping, health risk beliefs towards doping, moral attitudes in sport, and socio-demographic variables. The results showed that almost 1 in 10 athletes would trade their life for sporting success, independently of the moral implications of their choice. When mortal threat was absent, 31.5% of the athletes would trade morality for sporting success. Decisional trade-off choices differentiated scores in moral attitudes, such as acceptance of cheating and keeping winning in proportion. In Study 2, 11 British competitive MMA athletes were interviewed about decisional trade-offs involving moral violations or mortal threats. Thematic analysis corroborated the Study 1 findings, with most athletes dismissing the doping choice involving a mortal threat but endorsing the one where the mortal threat was absent. Anti-doping education in MMA athletes should target the decision-making process underlying doping, with an emphasis on moral values and the adverse health risk effects of doping.

Work-Related Hazards and Perceived Confined-Space Health Risk : Understanding the Correlation with Mental Workload Among Farmers in Northern Thailand’s Shallow Wells

ABSTRACT Objectives This study examined factors related to perceived health risks in confined spaces (PCSHR) and their correlation with the mental workload among farmers managing agricultural wells in northern Thailand. Methods A cross-sectional, multi-stage sample of 356 farmers was selected from four rural districts’ agricultural areas. Data were collected through interviews conducted from August to December 2022, using a self-administered structured questionnaire. The five-part questionnaire gathered demographic data, information on experiences and operations in agricultural wells, knowledge of confined spaces, PCSHR, and the six-dimension NASA Task Load Index (TLX) mental workload. Linear regression and multi-variable analyses were used to investigate factors associated with PCSHR, while Pearson correlations tested the association between PCSHR and mental workload variables. Results Most farmers were male (92.4%), worked in wells to install pumping systems (81.7%) and maintain equipment (73.3%), averaging 3.80 times per year, with an average duration of 25.81 minutes. Physical symptoms reported included difficulty breathing (72.8%), feeling swelteringly hot (55.9%), and sweating excessively (27.8%), as well as accidents such as being struck by falling soil or objects (20.2%), and falling into the well while climbing down (14.9%). Farmers’ perceived risk scores were high when working while physically exhausted or unprepared and when assisting an unconscious worker without knowing the gas concentration. In addition, the maximal mental workload scores were mental demand and effort subscale. Factors significantly associated with PCSHR (adj.R 2 = 60.6%, p < .05) encompassed education higher than lower secondary level, current alcohol consumption, smaller well width, assisted operations, number of physical symptoms experienced, absence of environmental accidents, and confined space knowledge, while increased PCSHR was positively associated with mental workload (Overall r = 0.711, p < .01). Conclusion Comprehensive education about potential hazards can improve farmers’ risk perception, potentially reducing mental workload and preventing fatal accidents. Field studies are recommended to develop community-specific work protocols and accurate measuring instruments suitable for rural settings are needed.

Breaking Conventional Eating Habits: Perception and Acceptance of 3D-Printed Food among Taiwanese University Students.

Considering the prevalent strain on environmental resources imparted by existing food systems, prioritizing environmental sustainability is an imperative course of action. Subsequently, the shift towards sustainable production and consumption patterns engenders an escalating demand for environmentally conscious food systems. Thus, 3D-printed food technology surfaces are a promising solution noted for their efficacy in curtailing food waste, bolstering environmental sustainability, and imparting innovative strategies to the food supply chain. Herein, we amalgamate the theory of planned behavior (TPB) framework with several variables, namely 'sensory appeal', 'food neophobia', 'perceived health risk', and 'environmental friendliness' to probe the behavioral intentions of Taiwanese university students' perceptions about 3D-printed food. Employing the snowball sampling method, 370 questionnaires were disseminated, out of which 319, constituting an effective retrieval rate of 86.2%, were deemed valid. Statistical analysis produced intriguing findings. Consumers' inclination to purchase 3D-printed food is substantially determined by their attitudes, subjective norms, sensory appeal, food neophobia, perceived health risks, and environmental friendliness. Contrary to our initial hypothesis, perceived behavioral control did not exhibit a significant impact on consumers' propensity to purchase 3D-printed food. Therefore, businesses should focus on magnifying the sensory appeal of 3D-printed food, coupled with precise nutritional labeling, to bolster consumer interest, enhance acceptance, and augment behavioral intentions. This study sheds light on the potential for the development of 3D-printed food in Taiwan, providing an indispensable reference for future endeavors in Taiwan's 3D-printed food industry.

Risk perceptions and behaviors concerning rural tourism and economic-political drivers of COVID-19 policy in 2020.

When COVID-19 was first introduced to the United States, state and local governments enacted a variety of policies intended to mitigate the virulence of the epidemic. At the time, the most effective measures to prevent the spread of COVID-19 included stay-at-home orders, closing of nonessential businesses, and mask mandates. Although it was well known that regions with high population density and cold climates were at the highest risk for disease spread, rural counties that are economically reliant on tourism were incentivized to enact fewer precautions against COVID-19. The uncertainty of the COVID-19 pandemic, the multiple policies to reduce transmission, and the changes in outdoor recreation behavior had a significant impact on rural tourism destinations and management of protected spaces. We utilize fine-scale incidence and demographic data to study the relationship between local economic and political concerns, COVID-19 mitigation measures, and the subsequent severity of outbreaks throughout the continental United States. We also present results from an online survey that measured travel behavior, health risk perceptions, knowledge and experience with COVID-19, and evaluation of destination attributes by 407 out-of-state visitors who traveled to Maine from 2020 to 2021. We synthesize this research to present a narrative on how perceptions of COVID-19 risk and public perceptions of rural tourism put certain communities at greater risk of illness throughout 2020. This research could inform future rural destination management and public health policies to help reduce negative socioeconomic, health and environmental impacts of pandemic-derived changes in travel and outdoor recreation behavior.

Air pollution, perceived health risk, and trip decision-making: Environmental justice considerations

This study evaluates the impacts of air pollution on trip decision-making and the determinants associated with perceived health risk from air pollution, socioeconomic status, and trip routine. To analyze its impacts based on a comprehensive mechanism, we developed a conceptual framework for trip decision-making process via perceived health risk from air pollution through an extensive literature review. We conducted a survey about trip plan changes due to poor air quality in South Korea, and used an integrated choice and latent variable model to verify the hypotheses in the framework. The result reveals that high perceived health risk encourages people to seek related information, which induces more trip plan changes under poor air quality. People with greater perceived risk tend to make more drastic trip-related decisions by changing or even canceling trip schedules. Moreover, higher-income groups generally perceive greater health risks and eventually seek relevant information more. The findings imply that the gap caused by socioeconomic status brings more frequent exposure of socially disadvantaged groups to polluted air, which can connect to environmental justice problems in society. This study provides noteworthy knowledge of the relationship between air quality and travel behavior to make healthy cities for everyone through environmental justice in transportation.

The relationships between citizens’ perceptions of corporate political activity and their health risk perception

Risk perception is a pertinent issue in the situation of constant risks associated with the biological, climatic, or technological factors that affect citizens’ lives today. The context in which a risk-generating situation arises can influence the way citizens perceive it. Among other factors, it is important to take the political context into account in risk perception research. In this vein, a wide variety of firms try to influence political decisions made by public authorities through the implementation of corporate political activity (CPA) strategies. In the case of polluting industrial complexes, residents who live close to them may perceive higher health risks when they become aware of the implementation of CPA strategies by firms. However, this reality has been neglected in the academic literature. To help fill this gap our research is based on institutional and attribution theories and the social risk perspective. The aim of the paper is to provide empirical evidence on the relationships between perceived CPA strategies, namely information and financial incentives, and health risk perception. For this purpose, the study focuses on residents who live near a polluting industrial complex. The results are obtained using structural equation models, and they show that each CPA strategy influences citizens’ health risk perception in a different way. Finally, we offer theoretical and practical implications of citizens’ health risk perception in a context with corporate political involvement.

Promoting new users’ online health consultation services usage behavior strategically

Online consultation services have the potential to reduce the workload of healthcare staff, provide timely care to patients, and improve doctor-patient relationships. The COVID-19 pandemic has accelerated the development of these services and platforms, but it remains to be seen whether the general public will continue to use them after the pandemic is under control. This research proposes a framework to examine the factors contributing to UK adults’ continued usage of online healthcare consultation services after COVID-19 restrictions have been lifted. A total of 430 new users completed surveys, and the results indicate that expectation confirmation, system quality, and information quality can positively impact users’ self-efficacy toward using online consultation services. This, in turn, can influence their continued usage behavior. Furthermore, the results suggest that participants’ perception of health risks can moderate the relationship between self-efficacy and continued usage behavior. The strategic implications of these findings are discussed.

How health risk of COVID-19 resurgence may trigger individual tendencies regarding COVID-19-related cyberchondria: Investigating the I-PACE model

Cyberchondria during the COVID-19 pandemic has posed significant challenges to public well-being. Previous lstudies have implicated perceived health risk in COVID-19-related cyberchondria. However, the effect of perceived COVID-19 health risk on cyberchondria and potential underlying mechanisms remains unclear. In this study, we developed a model based on the general addictive behavior framework of the I-PACE (Interaction-Person-Affect-Cognition-Execution) model to describe how induction of health risk of COVID-19 resurgence may influence individual tendencies regarding COVID-19-related cyberchondria. Through a scenario-based experiment, we tested this model with a balanced sample of 984 participants from China. The results revealed that the effect of induction of health risk of COVID-19 resurgence on tendencies regarding COVID-19-related cyberchondria was fully mediated by individual's risk perception and health information craving. Additionally, moderation analysis showed that an individual's general inhibitory control did not moderate the development of cyberchondria. Theoretical and practical implications are provided.

Support for a hypothetical sugar-sweetened beverage tax in Taiwan.

Sugar-sweetened beverages (SSBs) are drinks that contain added sugar or sweeteners and provide calories with no additional nutrients, and some countries have imposed additional taxes on the SSBs to reduce consumption, which is considered an SSB tax policy. This study used a cross-sectional online survey to examine the patterns of public support for an SSB tax in Taiwan. The sample included 1617 adults aged ≥ 20 years, who answered the survey questionnaire between May 2020 and April 2021. The respondents were recruited using convenience sampling, but sampling weights were applied to represent the Taiwanese population. Generalized ordered logit models with sampling weights were used to examine the correlates of public support for an SSB tax. Results showed that ~60% of the respondents supported the SSB tax and 47% perceived the tax to be effective. The respondents who were aware of the perceived health risks of SSBs or those who believed that one should be partly responsible for the health impact of SSBs were more likely to show support for the SSB tax. In adjusted regression models, both one's perceived risk and perceived responsibility of SSBs were positively associated with the perceived effectiveness of the SSB tax after sociodemographic characteristics were controlled. These research findings show evidence that there is public support for implementing an SSB tax to reduce SSB consumption in Taiwan.

IJCM_314A: Risk perceptions of heat related illnesses, assessing vulnerability and adaptive capacity of brick- kiln workers in a rural Puducherry: A Cross-Sectional Study

Background: Heat is one of the physical hazards that can cause health problems in the workplace, Brick field workers are widely exposed to risk factors for heat-related illnesses. Knowledge, attitudes, and practices (KAP) are three of the most important means of preventing such illnesses. Objectives: To determine the predictors of risk perception and to assess the vulnerability and adaptive capacity regarding heat-related illness among brick field workers in Rural Puducherry. Methodology: A cross-sectional study was conducted from March to June (2023). A total of 280 Brickfield workers were recruited from five rural commune areas of Puducherry, using the Multistage random sampling method. The data was collected on demographic characteristics, risk perception and spontaneous adaptation behaviours through KAP scores using structured questionnaires. Chi-square tests, correlation matrix and Linear Multiple regression models were employed to analyze the data. Results: 15.4% of the subjects suffered from HRIs, and 68.2% never received health education about HRIs. The mean for knowledge (K-score) was 13.5 (SD = 6.008) for attitudes (A-score) 4.21 (SD = 2.167) for practices (P-score) 4.23 (SD = 1.988). There were noticeable differences in KAP-score with respect to educational level (P &lt; 0.05), income level (P &lt; 0.05) and work relevant experience (P &lt; 0.05). Eventually, higher educational achievements, higher income status and relevant years of work experience were positive predictors for higher risk perception. Conclusion: There is a large room for improving health risk perception and adaptation capacity to heat waves among the brickfield workers. It will be very important to develop health educational programmes and enrich systematic educational resources to raise awareness.

Predicting The Customer Purchase Intention Based on Perception of Risk Using Machine Learning Techniques

Online shopping has become an indispensable aspect of modern life. Nevertheless, this convenience is not without its risks. Potential pitfalls include fraudulent activity, subpar product quality, and the security of personal and financial information. The purpose of this research paper is to predict how individuals react in terms of online purchase intention, guided by their unique risk perceptions. It also aims to explore important risks and sociodemographic factors influencing the levels of perceived risk. This investigation was conducted through a survey questionnaire administered to a sample of 308 participants from India. Various machine learning models were applied to predict the customer purchase intention based on the various risks. The results revealed that the CatBoost Classifier outperformed the other methods. Following closely, Random Forest and Gradient Boost Classifier also demonstrated strong performance. By utilizing Random Forest's feature importance, factors such as financial risk, delivery risk, perceived health risk, time loss risk, and cultural risk significantly impact purchase intention. Additionally, among demographic factors, occupation has the most significant influence. This prediction model will offer practical insights for e-commerce platforms, marketers, and policymakers, enabling them to tailor strategies.

Artemisia spp. Essential Oils: From Their Ethnobotanical Use to Unraveling the Microbiota Modulation Potential.

The 2015 Nobel Prize in Medicine, awarded for the discovery of artemisinin in Artemisia annua, reignited interest in aromatic plants, including Artemisia absinthium L. This article delves into the historical, ethnopharmacological and medicinal significance of A. absinthium, examining its bitter taste noted since ancient Greek times and its association with medicinal properties throughout history. Despite being banned in the 20th century due to perceived health risks; recent research has led to the reconsideration of A. absinthium's potential applications. This study focuses on the prebiotic efficacy of essential oils (EOs) from two Artemisia species: A. absinthium and A. annua. A broth microdilution test, growth curve test and in vivo models were used to study the impact of low doses (from 0.5% v/v to 0.00048 v/v) of Artemisia spp-EO on the three probiotic strains (Lactobacillus, Lactobacillus casei and Saccharomyces boulardii). These essential oils, when used in minimal concentrations (lower than 0.06% v/v), are safe and exhibit prebiotic effects on major probiotic strains, supporting the traditional culinary use of Artemisia spp. This research opens avenues for potential applications in the food industry, emphasizing the need for further exploration into the prebiotic properties of Artemisia spp-EOs and their influence on the microbiota.

Can a health warning label diminish the persuasive effects of health-oriented nutrition advertising on ready-to-drink alcohol product packaging? A randomized experiment.

A health warning label (HWL) cautioning about the link between alcohol and cancer may be able to communicate alcohol risks to consumers and potentially counter health-oriented nutrition advertising on ready-to-drink alcoholic beverages. This study aimed to examine the independent and combined effects of nutrient content claims (e.g. 0g sugar) and a HWL on perceived product characteristics and intentions to consume, and whether these effects differed by gender and age. A between-subjects randomized experiment. Participants were randomized to view one of six experimental label conditions: nutrient content claims plus nutrition declaration (NCC + ND), ND only, NCC + ND + HWL, ND + HWL, HWL only and no NCC, ND or HWL, all on a ready-to-drink (RTD) vodka-based soda container. Alcohol consumers (n = 5063; 52% women) in Canada aged 18-64 recruited through a national online panel. Participants completed ratings of perceived product characteristics, perceived product health risks, and intentions to try, buy, binge and drink the product. Compared with the reference condition NCC + ND (current policy scenario in Canada), the other five experimental label conditions were associated with lower ratings for perceiving the product as healthy. All experimental conditions with a HWL were associated with lower product appeal, higher risk perceptions and reduced intentions to try, buy and binge. The experimental condition with a HWL only was associated with intentions to consume fewer cans in the next 7days (β = -0.72, 95% confidence interval [CI] = -1.37,-0.08) versus the reference. Few interactions were observed, suggesting that label effects on outcomes were similar by gender and age. Health warning labels on alcohol packaging appear to be associated with lower product appeal, higher perceived health risks and reduced consumption intentions, even in the presence of nutrient content claims.

Optimal self-protection and health risk perceptions: Exploring connections between risk theory and the Health Belief Model.

In this contribution to the longstanding risk theory debate on optimal self-protection, we aim to enrich the microeconomic modeling of self-protection, in the wake of Ehrlich and Becker (1972), by exploring the representation of risk perception at the core of the Health Belief Model (HBM), a conceptual framework extremely influential in Public Health studies (Janz and Becker, 1984). In our two-period model, we highlight the crucial role of risk perception in the individual decision to adopt a preventive behavior toward a generic health risk. We discuss the optimal prevention effort engaged by an agent displaying either imperfect knowledge of the susceptibility (probability of occurrence) or the severity (magnitude of the loss) of a health hazard, or facing uncertainty on these risk components. We assess the impact of risk aversion and prudence on the optimal level of self-protection, a critical issue in the risk and insurance economic literature, yet often overlooked in HBM studies. Our results pave the way for the design of efficient information instruments to improve health prevention when risk perceptions are biased.

Gender Differences in the Co-Use of Tranquilizers, Sedatives, Sleeping Pills and Alcohol among Spanish Adolescents: A Nationwide Population-Based Study.

Adolescence is a critical developmental stage for the initiation of substance use worldwide, which is one of the main risk-taking behaviors that may impact adolescents' physical and mental well-being. The aims of this study were to (1) assess the prevalence of the co-use of tranquilizers, sedatives, and sleeping pills with alcohol (TSSp&AC) by gender in the Spanish adolescent population in 2018 and (2) identify the variables associated with TSSp&AC. An observational cross-sectional study following STROBE guidelines was conducted. We analyzed data from 38,010 adolescents aged 14 to 18 years old (18,579 males and 19,431 females) who participated in ESTUDES (Survey on Drug Use in Secondary Education in Spain) 2018. Female adolescents reported a higher prevalence of TSSp&AC than males (p < 0.001). The factors associated with female co-use were being 16-18 years of age (OR 1.65); the consumption of tobacco (OR 1.73), cocaine (OR 1.84), other illicit psychoactive drugs (OR 1.89); and novel illicit psychoactive drugs (OR 1.74); no perceived health risk from the consumption of TSSps (OR 2.45); and the perceived availability of TSSps (OR 2.23) and alcohol (OR 2.09). There are several factors associated with TSSp&AC in Spanish female adolescents with potential implications for healthcare providers.

An overview of the Be Well Home Health Navigator Program to reduce contaminants in well water: Design and methods

BackgroundThe Be Well Home Health Navigator Program is a prospective, randomized controlled trial (RCT) implemented to compare a community health navigator program to usual care program to reduce contaminants in drinking water. Design and settingThis 4-year two-armed RCT will involve well owners in Oregon that have private drinking water wells that contain arsenic, nitrate, or lead above maximum contaminant levels. InterventionThe intervention leverages the trusted relationship between Cooperative Extension Service (CES) Community Educators and rural well owners to educate, assist and motivate to make decisions and set actionable steps to mitigate water contamination. In this study, CES will serve as home health navigators to deliver: 1) individualized feedback, 2) positive reinforcement, 3) teach-back moments, 4) decision-making skills, 5) navigation to resources, 6) self-management, and 7) repeated contact for shaping and maintenance of behaviors. Usual care includes information only with no access to individual meetings with CES. Measurable outcomesPre-specified primary outcomes include 1) adoption of treatment to reduce exposure to arsenic, nitrate, or lead in water which may include switching to bottled water and 2) engagement with well stewardship behaviors assessed at baseline, and post-6 and 12 months follow-up. Water quality will be measured at baseline and 12-month through household water tests. Secondary outcomes include increased health literacy scores and risk perception assessed at baseline and 6-month surveys. ImplicationsThe results will demonstrate the efficacy of a domestic well water safety program to disseminate to other CES organizations.Trial registration number: NCT05395663

Mental and Physical Symptoms and Perceived Health Risks of Pregnant and Postpartum Women following the Significant Shift in COVID-19 Management in China: A Cross-Sectional Survey

Background. There was a remarkable downgrade in China’s COVID-19 response strategies in January 2023. The COVID-19 infection rate grew rapidly in the early stages following the management policy shift. This study attempted to explore the associations between SARS-CoV-2 infection and mental or physical health status in pregnant and postpartum women and the role of perceived health risks and family members’ SARS-CoV-2 infection status on these associations by capturing the impact of policy shifts in a short period of time. Methods. This cross-sectional study with a random sample from a convenience sample of hospitals was conducted in pregnant and postpartum women in January 2023. Standardized assessment tools were employed to assess anxiety, depressive and physical symptoms, and feelings of hopelessness. Hierarchical multiple logistic regressions were conducted to examine the mechanisms of associations of interests by including a range of sociodemographic factors, self-perceived health, SARS-CoV-2 infection status, and perceived health risks as covariates. Results. Of the 1,013 pregnant and postpartum women aged 32.0 ± 0.3 years, 58.2% (n = 590) were diagnosed with COVID-19, and 49.4% (n = 500) had family members who were infected with SARS-CoV-2. Nearly 98% of the included participants took measures to prevent SARS-CoV-2 infection. A COVID-19 diagnosis was positively associated with feelings of hopelessness (OR = 1.68, 95% CI: 1.20–2.35), probable anxiety (OR = 6.42, 95% CI: 2.18–24.61), possible depression (OR = 2.56, 95% CI: 1.07–6.70), and physical symptoms (OR = 6.28, 95% CI: 1.63–42.03) after adjusting for sociodemographic and health characteristics, while the associations presented no statistical significance when family members’ SARS-CoV-2 infection status and perceived health risks were introduced into the models. Conclusions. Our results suggested that pregnant and postpartum women may experience physical and mental health challenges when they or their family members contracted COVID-19 in the context of a considerable shift in COVID-19 management. Early detection of poor health status and its risk factors for vulnerable groups during shifts in health policy and administrative practice is very necessary, and health services, including easy access to psychosocial support and obstetric counselling, should be prioritized.

Science-based evidence on pathways and effects of human exposure to micro- and nanoplastics.

Human exposure to plastic particles has raised great concern among all relevant stakeholders involved in the protection of human health due to the contamination of the food chain, surface waters, and even drinking water as well as due to their persistence and bioaccumulation. Now more than ever, it is critical that we understand the biological fate of plastics and their interaction with different biological systems. Because of the ubiquity of plastic materials in the environment and their toxic potential, it is imperative to gain reliable, regulatory-relevant, science-based data on the effects of plastic micro- and nanoparticles (PMNPs) on human health in order to implement reliable risk assessment and management strategies in the circular economy of plastics. This review presents current knowledge of human-relevant PMNP exposure doses, pathways, and toxic effects. It addresses difficulties in properly assessing plastic exposure and current knowledge gaps and proposes steps that can be taken to underpin health risk perception, assessment, and mitigation through rigorous science-based evidence. Based on the existing scientific data on PMNP adverse health effects, this review brings recommendations on the development of PMNP-specific adverse outcome pathways (AOPs) following the AOP Users' Handbook of the Organisation for Economic Cooperation and Development (OECD).

Association of anxiety and depression symptoms with perceived health risk of nicotine vaping products for smoking cessation.

As tobacco smoking prevalence is unacceptably high for the one in five Australians reporting a mental health condition in the past year, multiple cessation supports are needed to reduce tobacco-related disease. Nicotine vaping product (NVP)-facilitated smoking cessation is one option requiring a medical prescription in Australia. Yet, people easily obtain NVPs via non-prescription channels. As mental health impacts quitting intentions and health system engagement, this study examined how presence of anxiety and depression symptoms may be associated with perceived health risk of using NVPs from prescription or non-prescription sources for smoking cessation. We used cross-sectional South Australian (15 years +) 2022 survey data on vaping, smoking, anxiety, and depression. Robust linear regression was used to examine the association of anxiety and depression symptoms and nicotine addiction concern on perceived health risk of using NVPs from prescription or non-prescription sources. For prescription NVPs, vaping was associated with lower perceived health risk (b=-0.732). Higher perceived addiction risk was associated with higher perceived health risk from prescription NVPs (b=0.784). For non-prescription NVPs, vaping (b=-0.661) or smoking (b=-0.310) was associated with lower perceived health risk, and higher perceived addiction risk (b=0.733) was associated with a higher perceived health risk. Although anxiety and depression were not directly associated with NVP health risk perceptions, vaping while having depression symptoms was associated with higher perceived health risk ratings for prescription (b=0.700) but not non-prescription sources. People with depression who vape may see health risk barriers in NVP prescription access for smoking cessation, a smoking cessation support gap.

Development and validation of fall risk perception scale for patients with Parkinson's disease.

Perception assessment plays an important role in fall risk awareness and fall prevention. Parkinson's disease patients with motor dysfunction are at high risk of falling. Currently, no instrument has been explicitly crafted to assess the risk perception of fall in PD patients. The purpose of this study was to develop and validate the fall risk perception scale for PD patients (FRPS-PD), providing healthcare professionals with a effective assessment tool to enhance proactive fall prevention initiatives. Based on the Proactive Health theory and Risk Perception Attitude (RPA) Framework, the questionnaire was developed through literature review, semi-structure interview, expert consultation and pilot testing. A total of 428 patients with PD from Grade A tertiary hospitals in Shanghai, Hangzhou and Anhui from January 2023 to July 2023 were recruited. The items and dimensions in the scale were explored and confirmed using item-analysis, content validity, exploratory factor analytical (EFA), confirmatory factor analytical (CFA), internal consistency and test-retest reliability analysis. A total of 16-items, 2-dimensions structure were identified, including 12 items of risk perception and 4 items of self-efficacy dimension. The cumulative variance of EFA model was 73.669%, further CFA showed that acceptable model fit (χ2/df = 2.226, RMSEA = 0.074, NF = 0.928, TLI = 0.951, CFI = 0.959, GFI = 0.887 and AGFI = 0.848). The content validity index was 0.956. The reliability of the scale was 0.952 using Cronbach's α coefficient method. The test-retest reliability was 0.944. The FRPS-PD is a valid and reliable measurement for evaluating fall risk perception level for individuals with PD in mainland China.