Preventive Health Behaviors Research Articles

Developing a Health Belief Model Scale for Smoking Behaviour During Pregnancy: Validity and Reliability Study

Objective: The Health Belief Model, which is one of the most frequently used models in explaining health behaviours, reveals the determinants of performing preventive health behaviours. Since our perceptions play an active role in changing a behaviour, a measurement tool is needed to evaluate the pregnant woman perceptually within the scope of HBM. Our study was conducted to analyze the perceptions of pregnant women about quitting smoking by developing a scale within the scope of Health Belief Model and analyze the validity and reliability of the scale within Turkish context. Methods: In the methodological study, which was conducted at the gynecology polyclinic of an university hospital between 15.05.2018 - 30.04.2019, the data were collected by applying a questionnaire to pregnant women who smoked at least one cigarette per day. The sample of the study consists of 289 pregnant women who applied to the clinic for routine pregnancy follow-ups. The content validity of the scale was evaluated by taking the opinions of nine experts in the field of public health nursing. Descriptive and confirmatory factor analysis methods were used in the analysis of the data. Results: 24.6% of the participants are high school graduates, 56.7% are not employed, 49.1% have a history of unplanned pregnancy, and 1% have started smoking during their current pregnancy. Cronbach Alpha values of the sub-dimensions of the scale ranged between .90 and .70, respectively. Confirmatory factor analysis fit indices were found as RMSEA = 0.066, CFI = 0.904 and NFI = 0.842. Conclusion: The scale is a valid and reliable measurement tool for measuring perceptions of pregnant women about smoking cessation behavior smoking behaviours. It is recommended to use the assessment of perceptions of smoking cessation behavior among pregnant smokers.

Public Health Evaluation of COVID-19 Vaccine Acceptability and Health Behaviors in South Africa: Past, Current, and Future Implications (2020–2022)

South Africa is facing a high burden of COVID-19 pandemic with low-vaccine coverage in the African Region. We aimed to investigate the temporal changes and impacts in health behaviors on vaccine acceptability in pre-, during-, and post-vaccine roll-out periods. In this cross-sectional study, we used the combined data from the nationally conducted “COVID-19 Vaccine Surveys (CVACS)” (May 2020–February/March 2022). Semiparametric regression models were used to capture the nonlinear association between the vaccine acceptability and health behaviors. Our study provided compelling evidence for a substantial decline in COVID-19 vaccine trust which shifted from 62%–70% to 26%–42% overtime. Participants younger than 40 years of age were less likely to receive the vaccine before it became available. However, this association changed in the postvaccine period with significant uptake in vaccine acceptance in younger groups. South Africans who identified themselves as black were more likely to intend to receive (aORs ranged: 1.93−3.60) and to trust the vaccine’s safety and efficacy (aORs ranged:1.79−1.23) in all time periods. “Mask wearing” and “frequent hand washing” were the most commonly reported behaviors. Given the lower rates of vaccine acceptability and a reduction in preventative health behaviors, monitoring the spread of infections is crucial and may have significant clinical and epidemiological implications.

Understanding and mitigating negative affect in preventive health behaviors: Evidence from the COVID-19 vaccination process.

The study investigated the willingness for vaccine uptake during the COVID-19 pandemic (April-June 2021), and explored the effect of both mindfulness and health education in managing negative affect post-vaccination. In study 1, a sample of 468 Chinese college students completed a one-time survey, assessing loneliness, stress, medical fear, and vaccination likelihood. Results showed that medical fear mediated the relationship between loneliness, stress and vaccination likelihood. In study 2, 70 college students were randomly assigned to one of three intervention conditions (mindfulness, health education, and control) during vaccination. Participants in mindfulness group showed lower negative affect scores than the control group post-intervention (p = 0.019). However, no significant difference was reported between health education with the other two conditions. As such, medical fear would be an important factor to target for improving the likelihood of vaccine uptake. Furthermore, a short mindfulness intervention was effective to improve experience of vaccination through mitigating negative affect.

Optimistic bias: Concept analysis

Purpose: The purpose of this study was to analyze and clarify the concept of ‘optimistic bias.’ Methods: A review of the literature was conducted using several databases. The databases were searched using the following keywords: optimistic bias, optimism bias, and concept analysis. The literature on optimistic bias was reviewed using the framework of Walker and Avant’s conceptual analysis process. Results: Optimistic bias can be defined by the following attributes: 1) underestimation of personal risk, 2) vague confidence, 3) positive future prediction and 4) lack of risk recognition. The antecedents of optimistic bias are as follows: 1) risk perception, 2) self-efficacy, and 3) risk controllability. The consequences of optimistic bias are as follows: 1) reduced anxiety, 2) providing emotional stability, 3) negative consequences for preventive health behavior, 4) lack of attention to risk-related information, and 5) negative consequences for self-protection behavior. Conclusion: The definition and attributes of optimistic bias identified by this study can provide a common understanding of this concept and help to develop a nursing intervention program effective in preventing, protecting, and improving health of subjects in the field of nursing practice.

Adaptation and study protocol for harvest for health together Arizona: A mentored community garden intervention for survivors of cancer

BackgroundCurrent health behavior recommendations for skin cancer prevention, treatment, and survivorship are the same for survivors of other cancers; they include eating a healthy diet, being physically active, maintaining a healthy weight, and minimizing ultraviolet (U.V.) exposure. Few interventions exist to support health behaviors beyond U.V. exposure. We adapted Harvest for Health, a home-based mentored gardening intervention for cancer survivors, for implementation in Arizona as a community-based intervention. MethodsStakeholder-informed adaptations for Harvest for Health Together Arizona (H4H2-AZ) included updating intervention materials to be relevant to the arid desert environment, emphasizing the importance of sun safety in cancer survivorship, and shifting from a home-based to a community-based delivery model. Participants will be enrolled in cohorts aligned with growing seasons (e.g., spring, monsoon, fall) and matched to an individual 30 ft2 community garden plot for two growing seasons (6 months). Original intervention components retained are: 1) Master Gardeners deliver the intervention providing one-to-one mentorship and 2) gardening materials and supplies provided. This pilot six-month single-arm intervention will determine feasibility, acceptability, and appropriateness of an evidence-based adapted mentored community gardening intervention for survivors of skin cancer as primary outcomes. Secondary outcomes are to explore the effects on cancer preventive health behaviors and health-related quality of life. DiscussionThis pilot single-arm intervention will determine feasibility, acceptability, and appropriateness of an evidence-based adapted mentored community gardening intervention for survivors of skin cancer. If successful, the intervention could be widely implemented throughout existing Master Gardener programs and community garden networks for survivors of other cancers. Trial registrationClinicalTrials.gov identifier: NCT05648604. Trial registered on December 13, 2022.

Potential Hepatitis a Analysis: Research on Healthy and Safe Lifestyles in Indonesian Education in Taiwan

Purpose: This research aims to develop a predictive model using the Health Belief Model behavioral theory approach to understand changes in eating habits and physical activity among Indonesian students in Taiwan. Given the historical context of hepatitis A outbreaks in Taiwan and the importance of preventive health behaviors, the study seeks to lay the foundation for further intervention research focused on promoting healthy lifestyles among Indonesian students. Methods: The research employs a basic research approach to develop a predictive model, drawing on the Health Belief Model framework. Data collection involves administering questionnaires to Indonesian students in Taiwan to assess their eating habits, physical activity, knowledge about hepatitis A prevention, and adherence to Clean and Healthy Living Behavior (PHBS) practices. Statistical analysis is conducted to identify factors influencing knowledge and behavior related to hepatitis A prevention. Results and Discussion: Analysis of questionnaire data from 112 Indonesian students reveals that many behaviors do not reflect PHBS practices aimed at preventing hepatitis A transmission. The results indicate that factors such as age, gender, and level of education significantly influence knowledge about hepatitis prevention and healthy hygiene behavior. Specifically, higher levels of knowledge correlate with better preventive behaviors, suggesting the importance of educational interventions in promoting health awareness among students. Implications of the Research: The findings have implications for public health interventions targeting Indonesian students in Taiwan to prevent hepatitis A transmission and promote healthy lifestyles. By identifying factors influencing knowledge and behavior related to hepatitis prevention, the research provides insights for developing targeted interventions and educational campaigns aimed at improving health outcomes among this population. Originality/Value: This research contributes to the literature by applying the Health Belief Model framework to understand and predict changes in eating habits and physical activity among Indonesian students in Taiwan. The study addresses the need for preventive health measures in response to hepatitis outbreaks and underscores the importance of cultural and contextual factors in shaping health behaviors among international student populations. The findings provide a basis for future intervention research and highlight the significance of promoting health awareness and preventive practices in diverse cultural settings.

Abstract P127: Health Literacy and COVID-19 Infection and Vaccination: The C4R-MESA Study

Rationale: Health literacy (HL) is associated with health prevention behaviors and may influence COVID-19 outcomes. Objective: To test associations of HL, risk of COVID-19 infection, and receipt of COVID-19 vaccines in a multi-ethnic US community-based sample. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) assessed participant levels of HL via follow-up phone calls in year 18 (2016-18), as well as the impact of the COVID-19 pandemic via questionnaires designed by the Collaborative Cohort of Cohorts for COVID-19 Research (C4R) Study (2020-23). The 4 HL items asked about difficulty in the ability to read, comprehend, and complete medical materials and understand medical statistics (scales 1-5, low to high difficulty); scores were summed and dichotomized into adequate (≤10) or low (>10) HL. COVID-19 data included infection and vaccination status and time (days) until infection and vaccination (March 2020-February 2023). Unadjusted comparisons of COVID-19 data and HL were assessed by Chi-square and T-tests. Cox proportional hazards models were adjusted for age, sex, race/ethnicity, and then additionally for income and education. Results: Of 3412 participants (mean age 77 years; 54% female; 41% White, 13% Chinese, 26% Black 20% Hispanic), 409 (12%) had low HL and 360 (11%) had incident COVID-19 infections. In the subset with vaccination data (N=1781), 94% were vaccinated. While HL was not significantly associated with incident COVID-19 infection, low (vs adequate) HL was significantly associated with longer time-to-vaccination and lower adjusted hazards of vaccination ( Table ). Conclusions: Our findings suggest that low levels of HL are associated with delayed COVID-19 vaccination, even after accounting for demographic and socioeconomic indicators. Improving health literacy in the population may empower and encourage individuals to engage in disease prevention behaviors, including vaccination. Table: Associations of Health Literacy (HL) with COVID-19 Infection and Vaccination

Ecological validity of common behavioral decision making tasks: evidence across two samples

ABSTRACT Background Clinicians and scholars routinely use behavioral decision tasks to assess real-world decision making capabilities. However, many common behavioral decision making tasks lack data on the extent to which they predict real-world risky behaviors. Across two pre-registered studies, and two timepoints, we assessed decision making abilities using common behavioral tasks and predicted participants’ real-world risky decision making from task performance. Method In Study 1, 918 Mechanical Turk (MTurk) workers completed three decision making tasks in addition to assessments of real-world risk behavior: preventive health behaviors, COVID-19 vaccination status, and virtual social distancing task performance. In Study 2, 221 college student participants completed the Study 1 tasks plus additional assessments of decision making and real world risk and protective behaviors. Results Across both studies, the selected behavioral decision tasks rarely predicted real world behavior and, when they did, the relationship was weak at best. Conclusions These data suggest that these behavioral decision making tasks may not be good predictors of real world risky behavior at present, with some evidence that the specificity of the behavior being assessed matters (i.e. the closer the task was to the specific behavior being predicted), calling for additional ecological validity research, with a greater variety of tasks in the future.

Have the effects of Covid-19 been overcome? Levels of Covid-19 fear, Covid-19 anxiety and hopelessness in young adolescents: A structural equation modeling.

This research aimed to determine the level of fear, anxiety, and hopelessness of Covid-19 in young adolescents' post Covid-19 period. Young adolescents in the 17-24 age group were included in this study, which was conducted in a descriptive-cross-sectional design. Sociodemographic characteristics questionnaire form and Coronavirus (Covid-19) Fear Scale, Coronavirus Anxiety Scale, and Beck Hopelessness Scale were used to collect data. 90.8% of the participants had been vaccinated, 26.9% had previously caught in Covid-19, and 10.3% of those who had been caught in the disease had a severe course. 10.7% of young adolescents had to take medicines, 56.4% had a family history of Covid-19, and 18.7% had lost a relative as a result of Covid-19, was found. The level of fear, anxiety and hopelessness was higher among women, first-grade students, those who did not receive the Covid-19 vaccine, those who have caught in Covid-19 before, and those who have lost a family due to Covid-19. It is thought that the increase in the awareness level of young adolescents about Covid-19 improves preventive health behaviors and enables the development of positive behaviors related to the disease.

Preventive health behaviour differences across racial groups during the early stages of COVID-19.

Throughout the COVID-19 pandemic, the practice of preventative health behaviours had been used disparately across different racial groups. This study seeks to identify any differences in preventative health behaviours across racial groups, controlling for other socio-demographic factors. A US national survey study was electronically conducted from July through November 2020, to measure racial/ethnic differences in health preventive behaviours about COVID-19. We performed 2-part regression models to assess whether preventive health behaviours differed by race and ethnicity. Specifically, we employed generalized logistic regressions for investigating the predictors of the use of complementary or alternative medicine (CAM), or stay-at-home strategy, then performed ordinal logistic regression to examine the predictors of social distancing, face mask wearing, and hand hygiene strategy practice. The results show that non-White respondents were more likely to practice social distancing, mask wearing, and hand hygiene strategy to prevent COVID-19, compared to their White counterparts. Additionally, the findings indicate that individuals who experienced COVID-19-related racial abuse or depression had a higher likelihood of practicing preventive health behaviours. We found ethnicity can be a predictor of health preventive behaviours, in accordance with previous research. The causes of these disparities will require further investigation in order to be addressed.

Online Health Information Seeking and Preventative Health Actions: Cross-Generational Online Survey Study.

The popularity of online health information seeking (OHIS) has increased significantly owing to its accessibility and affordability. To facilitate better health management, it is essential to comprehend the generational differences in OHIS behavior and preventative health actions after seeking online health information (OHI). This study investigates the variations in OHIS and engagement in preventative health actions between 2 generations based on their technology use (digital natives [aged 18-42 years] and digital immigrants [aged ≥43 years]). Additionally, this research explores the mediating role of OHIS types on the generational effect on preventative health actions and the moderating role of OHI search frequency, gender, and the presence of chronic diseases on the generational effect on OHIS types and preventative health actions. A preregistered online survey was conducted on the Prolific online data collection platform using stratified sampling of 2 generations (digital natives and digital immigrants) from the United States in November 2023. Overall, 3 types of OHIS were collected: health wellness information search, health guidance information search, and health management information search. A 1-way analysis of covariance tested the generational differences in types of OHIS and preventative health actions, and a 2-way analysis of covariance tested the moderating role of OHIS search frequency, gender, and the presence of chronic diseases using 7 control variables. The PROCESS Macro Model 4 was used to conduct mediation analyses, testing OHI search types as mediators. Linear regression analyses tested age as a predictor of OHIS and preventative health actions. The analysis of 1137 responses revealed generational differences in OHIS. Digital natives searched for health wellness information more frequently (P<.001), whereas digital immigrants searched for health guidance (P<.001) and health management information (P=.001) more frequently. There were no significant differences between the 2 generations regarding preventative health actions (P=.85). Moreover, all 3 types of OHIS mediated the relationship between generational differences and preventative health actions. Furthermore, as people aged, they searched for significantly less health wellness information (P<.001) and more health guidance (P<.001), and health management information (P=.003). Age was not a significant predictor of preventative health actions (P=.48). The frequency of OHI searches did not moderate the effect of generations on OHIS types and preventative health actions. Gender only moderated the relationship between generation and health guidance information search (P=.02), and chronic diseases only moderated the relationship between generation and health wellness information search (P=.03). To the best of our knowledge, this study is the first to explore how 2 digital generations vary in terms of searching for OHI and preventative health behaviors. As the older adult population grows, it is crucial to understand their OHIS behavior and how they engage in preventative health actions to enhance their quality of life.

Effects of Scanning Health News Headlines on Trust in Science: An Emotional Framing Perspective

ABSTRACT Rooted in the emotions-as-frames model (EFM), this research examines how hope, fear, and annoyance are evoked through health news headline scanning, and how these emotions influence perceptions of news and medical science institutions as well as health behavioral intentions. A sample of U.S. adults (N = 327) were assigned to one of four headline framing conditions expected to associate with different emotions (positive future frame-hope; threat frame-fear/anxiety; reversal frame-annoyance; and control-neutral) and then asked about their emotional states, trust in science and news, and health-related behavioral intentions. Overall, health news headlines generated more hope than any other emotion across all conditions, and positive future-framed headlines evoked more hope than other framed headlines. Felt hope, in turn, generated greater trust in news and science, higher expectations of medical breakthroughs and cures, and greater intention to engage in preventative health behaviors. Felt anxiety had marginal positive benefits whereas felt annoyance negatively impacted the outcomes of interest. Notably, felt emotion mediated the headline frame-outcome relationships in the positive future/hope condition. These findings offer some support for the EFM and demonstrate that scanning headlines imbued with specific emotional frames can influence important health-related outcomes through the emotions they evoke. We discuss both the theoretical and practical implication of these findings.

COVID-19 related health literacy and preventive behaviours of the older person in Perak state, Malaysia: A qualitative study

IntroductionHealth literacy is crucial in controlling the spread of SARS-CoV2 and preventing infection, as well as preparing healthcare systems for situations that require immediate response. The aim of this study was to evaluate older people's health literacy towards disease prevention, as well as the motivators and barriers they experienced when adopting preventative measures. MethodsWe conducted in-depth interviews with 16 participants aged 65 and beyond. Purposive sampling was used to recruit participants, accounting for variability in gender, age and educational level. The transcripts were analysed using thematic analysis methods. The interview guide was developed using Sørensen's conceptual model of health literacy. ResultsFive main themes and 16 sub-themes were identified in this study. Knowledge and perception on preventive measures (with two sub-themes), sources of Covid-19 information (with two sub-themes), appraise the health information (with two sub-themes), perceived practice (with five sub-themes), barriers and motivators (with five sub-themes) were the major themes. This study discovered aspects of SEM may influence preventive measure adoption and the impact of different levels of SEM on seniors' decision-making for preventive measure adoption. ConclusionThis study examined older adults' experiences with CoviD-19-related health literacy (access, comprehend, assess, and apply), as well as their preventative behaviours, barriers, and motivators. Future disease outbreak mitigation measures should consider the SEM approach in order to improve health communication and promote healthy behaviour.

The Untapped Potential of Narrative as a Tool in Aviation Mental Health and Certification.

INTRODUCTION: Work-related stress is common in pilots, with broad implications, including the potential development of mental health symptoms and sometimes even psychiatric disease. This commentary argues for the use of narrative as a tool to promote preventive health behaviors in pilots and combat misinformation about aeromedical certification related to mental health.Hoffman WR, McNeil M, Tvaryanas A. The untapped potential of narrative as a tool in aviation mental health and certification. Aerosp Med Hum Perform. 2024; 95(3):165-166.

Timing of preventive behavior in the case of a new and evolving health risk: the case of COVID-19 vaccination

BackgroundTime preferences for preventive behavior under novel risks and uncertain contexts may differ from timing preferences related to familiar risks. Therefore, it is crucial to examine drivers of preventative health behavior timing in light of new health risks. Using the case of COVID-19, we examine factors affecting vaccination timing plans when vaccines were widely available in the European Union (EU).MethodsWe use data from the Flash Eurobarometer 494 survey (May 21–26, 2021), which collected information on EU residents’ attitudes towards COVID-19 vaccinations. We also use the ‘Our World in Data’ vaccination database for country-level COVID-19 vaccination rates. Probit regressions were conducted to determine how local vaccination rates, trust in information sources, social norms, vaccine safety beliefs, and risk understanding affected the probability of COVID-19 vaccination delay.ResultsOf total participants (n = 26,106), 9,063 (34.7%) were vaccinated, 7,114 (27.3%) wanted to get vaccinated as soon as possible, 5,168 (19.8%) wanted to delay vaccination and 2,962 (11.4%) resisted vaccination. Participants were more likely to delay COVID-19 vaccination if they lived in a country with lower vaccination prevalence, trusted online social networks, family, friends, and colleagues for vaccination information, were eager to follow vaccination-related social norms, expressed vaccine safety concerns, and understood the risk of catching COVID-19 without a vaccine to be lower.ConclusionsResults from the study contribute to understanding important factors that predict timing of vaccination plans. These findings can also contribute to the wider knowledge base about timing of preventive behavior uptake in novel risk contexts.

Explaining differences in self-focused and other-involved public health preventive behaviors between the US and China: the role of self- construal and health locus of control.

This study examined national similarities and differences in people's engagement in health preventive behaviors during a public health crisis, as well as investigated the underlying individual-level psychological mechanisms. A conceptual distinction was made between self-focused and other-involved preventive behaviors in response to public health crises. Two cross-sectional surveys were conducted in the United States (N = 888) and China (N = 844) during the early stage of the COVID-19 pandemic. Hayes' PROCESS was utilized to assess national differences in seven preventive behaviors, along with the mediating effects of self-construal and health locus of control. The results showed that American participants reported greater engagement in self-focused preventive behaviors than Chinese, whereas Chinese participants reported greater engagement in other-involved preventive behaviors than Americans. Chinese participants also engaged more in other-involved than self-focused preventive behaviors. Self-construal and health locus of control partially explained the observed differences in engagement in preventive behaviors. This study introduces a culture-sensitive approach to provide insights for crafting communication interventions that can enhance the effectiveness of health campaigns in the context of a public health crisis.

Race and gender disparities in preventive health activity engagement of older adults in the southeastern United States

A cross-sectional study was conducted to determine preventive-health-activity engagement in community-dwelling older adults participating in student-led health screenings in east Alabama. From 2017-2019, health professions students conducted health screenings at 23 community and independent living sites to assess medical and social needs of adults. Clients’ responses to questions regarding vaccinations (flu/pneumonia/shingles), cancer screenings (colon/sex-specific), and other (dental/vision) screenings were aggregated to create a preventive health behavior (prevmed) score. Chi-square, t-tests, and regression analyses were conducted.Data from 464 adults ages 50-99 (72.9±10.1) years old were analyzed. The sample was 71.3% female, 63.1% Black/African American (BA), and 33.4% rural. Linear regression indicated BA race (p=0.001), currently unmarried (p=0.030), no primary care provider (p<0.001) or insurance (p=0.010), age <65 years (p=0.042) and assessment at a residential site (p=0.037) predicted lower prevmed scores. Social factors predict preventive health activity engagement in community-dwelling adults in east Alabama, indicating several opportunities to improve health outcomes.

Assessment of Factors Related to COVID-19 Preventive Health Behaviours Using a Health Belief Model

Abstract Non-pharmaceutical interventions, including physical distancing, hand hygiene, mask wearing, are some of the most effective public health interventions against COVID-19 spread. Adoption of these measures can vary in different countries and even in different populations within a country. The goal of our study was to investigate factors that influence adoption of these preventive health behaviours in the Latvian population within the Health Belief Model framework, while also expanding on the models cues to action dimension by testing if evaluation of COVID-19-related government actions and belief in COVID-19 related conspiracy theories could be used as such. Our quantitative cross-sectional study that was carried out in Latvia before the second wave of COVID-19 pandemic included two samples of major population language groups (nLatvian = 452; nRussian = 190) and showed differences that could potentially improve adoption of preventive health behaviours in Latvia if regarded in informing and educating the public. It was also found that evaluation of COVID-19-related government actions has statistically significant impact on preventive health behaviour and could be used as cues to action within the HBM, while belief in COVID-19-related conspiracy theories had no association with preventive health behaviour.

Development of Emerging Infectious Diseases Preventive Health Behavior (EID-PHB) Scale and Validation of the Complex Models.

Emerging Infectious Diseases are one of the world's leading causes of death, and preventive measures must be implemented to minimize human casualties. Research on preventive behavior relies on the preventive behavior scale and it has an impact on the findings. This study aimed to develop an Emerging Infectious Diseases Preventive Health Behavior (EID-PHB) Scale and verify the validity and reliability of the complex models. Initial items were generated through a literature review and interviews, based on the proposed conceptual framework of transmission-based precautions. 14 experts reviewed the preliminary items for content validity and 20 adults for face validity. Data were collected online by a research company from April 28 to May 3, 2023. A total of 533 participants completed the survey, and subjects were assigned through simple random sampling. The first sample (n = 330) was used for item analysis and Exploratory Factor Analysis (EFA), and the second sample (n = 203) was used for Confirmatory Factor Analysis (CFA), convergent validity, discriminant validity, criterion validity, and reliability. The test-retest reliability was assessed in 34 adults. The final instrument derived six components (droplet, contact, airborne, bloodborne, environmental prevention, and psychological coping), nine indicators, and 34 items. The CFA indicated that all the complex models had a good fit and the integrated factors were confirmed through validity tests. The Cronbach's alpha for the 34 items was 0.92, and the criterion validity was verified (r = 0.85, p < 0.001). The EID-PHB is a valid and reliable tool that can be used to determine preventive behaviors against emerging infectious diseases. This tool is expected to provide a conceptual framework for future research, contribute to the clinical practice and education, and establish strategies and policies for improving individual and public health.

Determinants of Health Behavior for Effective Treatment and Prevention of Chronic Obstructive Pulmonary Disease: Empirical Advances

Objective: The prime objective of this research is to investigate the impact of health behavior, quitting smoking, access to healthcare, and patients' adherence to healthcare on chronic obstructive pulmonary disease treatment. Methods: A 7-point Likert scale questionnaire was administered to collect the data. A sample size of 471 respondents was used for the determination of results with a structural equation modeling approach. Smart PLS 4 was used for testing the results of the measurement model assessment and structural model assessment. Results: The findings of the current study showed that health behavior, quitting smoking, access to healthcare, and patients' adherence to healthcare are significant antecedents of chronic obstructive pulmonary disease effective treatment. Conclusion: This research reported that the emphasis and support for health behavior improvement, quitting smoking support, access to better healthcare, and patient adherence to healthcare are opportunities useful for chronic obstructive pulmonary disease effective treatment all over the world. The research has reliable theoretical as well as practical implications that are critical to improving the body of knowledge and practices for the improvements in the treatment of chronic obstructive pulmonary disease.