Health beliefs,perceived self-efficacy,and breast self-examination among Thai migrants in Brisbane

BACKGROUND: Women in Thailand have a relatively low risk of developing breast cancer; however, death rates from breast cancer are increasing. Rates in many migrant groups are also known to be on the increase. Little is known about breast cancer screening, particularly breast self-examination (BSE), among Thai migrant women in other countries. In Australia, non-English-speaking-background migrants are known to be low users of preventive health services. AIMS: To investigate, using the health belief model (HBM) and self-efficacy as a theoretical framework, the use of BSE in a recent migrant group, Thai women in Australia, and to identify sociodemographic variables that influence the women's regular use of BSE. METHODS: In 1998, a cross-sectional study was conducted among 145 Thai women in Brisbane recruited through a snowball-sampling method, which used personal contacts and key persons within the Thai community. The study was approved by the University Human Ethics Review Committee. Data were collected through designed closed-ended questions. RESULTS: Only 25% of the women performed BSE regularly. HBM indices were strongly associated with BSE. Beliefs in high personal susceptibility to breast cancer strongly increased the likelihood of BSE. After adjusting for potential confounding factors, cues or triggers to undertake BSE and self-efficacy, or the ability to do BSE were found to be important determinants of regular BSE. Study limitations, including data collection methods, are discussed. CONCLUSION: A low percentage of women practised BSE regularly. The HBM is a useful framework for identifying factors influencing the use of BSE. Strategies that increase the confidence of women to undertake preventive health behaviour or increase self-efficacy are likely to increase their regular screening for breast cancer.     

The influence of spirituality and religiosity on breast cancer screening delay in African American women: application of the Theory of Reasoned Action and Planned Behavior (TRA/TPB).

African American women (AAW) are 25% more likely to present with late stage breast cancer and 20% more likely to die from their disease than Caucasian women. Researchers report that a treatment delay of 3 months is a significant factor in breast cancer mortality. Socioeconomic factors, lack of access and knowledge, spiritual and religious beliefs, fear and fatalism are reported as contributing factors to screening delays. Studies have primarily applied the Health Belief Model (HBM) and modified versions like the Champion HBM to preventive health practices. Neither have significant inclusion of spirituality or religiosity. The TRA/TPB focus on beliefs, intent and attitude as individual determinants of the likelihood of performing a specific behavior; but have not had wide utility in studies related to screening delays among AAW. This paper explores the utility of applying the TRA/TPB as the theoretical framework for determining cultural relevance of spirituality and religiosity to screening delays among AAW.     

ICU护士照护机械通气病人的态度、主观行为规范及其行为意向研究

目的对成都地区三所三级甲等综合医院ICU护士照护机械通气病人的态度、主观行为规范及其行为意向进行研究,为相关的护士培训提供依据。方法应用《护士对照护机械通气病人的行为态度、主观行为规范和行为意向》量表中文修订版对近三个月内照护过机械通气病人的ICU护士进行测评,描述ICU护士照护机械通气病人的态度、主观行为规范和行为意向。结果分别有69．1％、91．3％、95．8％的ICU护士对照护机械通气病人的行为态度、主观行为规范和行为意向为正性。结果绝大多数ICU护士对照护机械通气病人持积极的行为态度、主观行为规范和行为意向。     

成都地区三所三级甲等综合医院ICU与非ICU护士对机械通气病人照护行为意向的研究

目的对成都地区三所三级甲等综合医院ICU与非ICU护士对机械通气病人照护行为意向进行比较,为相关的护士培训提供依据。方法应用《护士对照护机械通气病人的行为态度、主观行为规范和行为意向》量表的中文修订版,对近三个月内照护过机械通气病人的ICU与非ICU护士进行测评,比较两组护士照护机械通气病人的行为态度、主观行为规范和行为意向间的差异。结论ICU与非ICU护士照护机械通气病人的行为态度(P>0.05)和主观行为规范(P>0.05)差异无显著性意义,行为意向(P<0.05)差异有显著性意义,ICU护士的行为意向优于非ICU护士。     

Exploring the dynamics of the theory of planned behavior in the context of blood donation: does donation experience make a difference?

BACKGROUND: This study investigates the influence of different variables from the theory of planned behavior (TPB) on intention within multiple donation categories, covering the entire range of lifetime number of donations (LND). Does the same set of variables predict intention equally strong throughout the donor career? STUDY DESIGN AND METHODS: Measures of intention, self‐efficacy, cognitive and affective attitude, and subjective and moral norms were assessed within a sample of 11,480 whole blood donors. Donors were categorized into 65 donation classes using their LND; for example, all donors with one donation (n = 483) in the first donation class, all donors with two donations (n = 447) in the second donation class, and so on. For each donation class, separately for men and women, linear multiple regression models for intention were fitted using self‐efficacy, cognitive attitude, affective attitude, subjective norm, and moral norm as predictor variables. RESULTS: During all stages of the donor career, self‐efficacy is the main predictor of intention, with a relatively constant beta (β = 0.64, p < 0.001). Cognitive attitude (β = 0.11, p < 0.001) and moral norm (β = 0.10, p < 0.001) contributed marginally to the prediction. Several sex effects were observed; self‐efficacy is a stronger predictor of intention in women, whereas subjective norm predicts intention in men only. CONCLUSION: Regardless of the number of lifetime donations, the same set of TPB variables, both in composition and in relative strength, predicts intention. A feeling of self‐efficacy remains equally important for all donors. It is worthwhile to study whether directed intervention strategies are necessary to target self‐efficacy within donor groups with different levels of donation experience.     

Predicting blood donation intentions and behavior among Australian blood donors: testing an extended theory of planned behavior model

BACKGROUND: Donor retention poses a significant problem to blood collection agencies around the world. Previous research using an augmented theory of planned behavior (TPB) approach has demonstrated that attitude, subjective norm, self-efficacy, moral norm, anticipated regret, donation anxiety from prior blood donations, and self-identity as a blood donor predicts experienced donors' intentions and that intentions, self-efficacy, moral norm, and anticipated regret may impact upon people's actual blood donation behavior.
STUDY DESIGN AND METHODS: Established blood donors (n = 263) completed questionnaires assessing standard TPB constructs, anticipated regret, moral norm, donation anxiety, and self-identity as a blood donor. Three months later, a second questionnaire assessing blood donation behavior in the intervening 3 months was mailed and returned by 182 donors.
RESULTS: With structural equation modeling, the final augmented TPB model provided an excellent fit to the data and included a direct path from intention to behavior and indirect paths to behavior through intention for attitude, self-efficacy, and anticipated regret. Moral norm, donation anxiety, and donor identity indirectly predicted intention through attitude. In total, 51 percent of the variance in donors' attitudes, 86 percent of variance in donors' intentions, and 70 percent of the variance in donors' behavior were accounted for in the final model.
CONCLUSION: An augmented TPB framework proved efficacious in determining the predictors of the intentions and behavior of established blood donors. Further, this framework highlighted the importance of considering in the future how donors' motivations for donating blood may evolve as a function of the number of prior donations.     

A path analysis of intention to redonate among experienced blood donors: an extension of the theory of planned behavior

BACKGROUND: The need for blood products is constant and unremitting, yet only a small percentage of eligible individuals answer the appeal to donate. Further, most new donors never return to provide a repeat donation. The ongoing need to attract and retain new donors has led to the examination of psychosocial factors that may predict the likelihood of blood donation behavior. By use of regression techniques, prior studies have established that elements of the Theory of Planned Behavior (e.g., attitude, subjective norm, personal moral norm, and perceived control or self-efficacy) can predict intention to donate among nondonors. STUDY DESIGN AND METHODS: Path analysis was used to further examine the utility of the Theory of Planned Behavior in predicting donation intention in a sample of 227 experienced donors who completed an online survey. Experiential measures relating to previous donations, including the experience of vasovagal reactions and overall donor satisfaction, were added to the model. RESULTS: The final model, which provided an excellent fit to the data, characterized 1) three direct pathways from attitude, subjective norm, and self-efficacy to donation intention and 2) four indirect pathways, wherein self-efficacy, personal moral norm, vasovagal reactions, and overall donor satisfaction influence donation intention through attitude. In total, 65 percent of the variance in donation intention and 50 percent of the variance in attitude is accounted for in this model. CONCLUSION: The Theory of Planned Behavior can be used to predict donation intentions among experienced donors. Further, the model's predictive utility is improved by considering the influence of previous donation experiences on donor attitudes.     

Can we explain running-related injury preventive behavior? A path analysis

BackgroundBehavioral and social science theories/models have been gaining attention in sports injury prevention.ObjectiveTo investigate the potential of the Theory of Planned Behavior in explaining running-related injury preventive behavior.MethodsSix-month prospective cohort study based on data gathered from a randomized controlled trial. From a total of 1512 invited trail runners, 232 were included in this study. Preventive behaviors and their determinants were assessed at baseline and two and six months after baseline. Five-point Likert scales were used to assess the determinants of preventive behavior. A Bayesian path analysis was conducted applying mixed models and mediation analysis.ResultsA 1-point increase in intention, attitude, subjective norm, and perceived behavioral control predicted an increase of 54% (95% Bayesian credible interval [BCI]: 38, 71) in the rate of performing running-related injury preventive behavior, explaining 49% (R² 0.49; 95% BCI: 0.41, 0.56) of the variance around preventive behavior. Intention and perceived behavioral control predicted running-related injury preventive behavior directly, while 40% (95% BCI: 21, 61) and 44% (95% BCI: 20, 69) of the total effect of attitude was mediated by intention and perceived behavioral control, respectively. Attitude, subjective norm, and perceived behavioral control predicted intention.ConclusionsThe Theory of Planned Behavior may have the potential to explain half of the variance around running-related injury preventive behavior and intention. Therefore, such theory may be considered a relevant and useful tool in developing, investigating, and/or implementing programs aimed at preventing running-related injuries.     

Predicting donation among an Irish sample of donors and nondonors: extending the theory of planned behavior

BACKGROUND: Research has indicated the ability of the Theory of Planned Behavior to predict blood donation. This study tested an extended version of the Theory of Planned Behavior (attitude, subjective norm, and perceived behavioral control with the addition of past behavior, moral norm, self-identity, and anticipated regret) in predicting donation intention and behavior among donors and nondonors and if forming implementation intentions improved attendance at a mobile blood donation clinic. STUDY DESIGN AND METHODS: This study used a cross-sectional follow-up design. A questionnaire was distributed to 600 staff and students at the National University of Ireland, Galway, before the arrival of a mobile clinic to Galway city. Half of these participants were invited to make implementation intentions specifying how, where, and when they planned to donate blood. A second questionnaire measuring reported attendance at the clinic was distributed 2 weeks after the first questionnaire. RESULTS: A total of 172 eligible donors returned questionnaires (29% response rate). The extended Theory of Planned Behavior accounted for 51 percent of the variance in intention to donate in the future: anticipated regret, attitude, perceived behavioral control, self-identity, and subjective norm significantly predicted intention. Donors differed from nondonors: they possessed more favorable attitudes toward blood donation, had a greater sense of donor identity, and believed more strongly in a moral obligation to donate blood than nondonors. Those who made implementation intentions were no more likely to donate that those who had not. CONCLUSION: Owing to the different factors influencing the donation decision for donors and nondonors, separate strategies to promote donation should be designed for these subgroups, targeting the elements most pertinent to each group.     

Developing a new model for cross-cultural research: synthesizing the Health Belief Model and the Theory of Reasoned Action

This article discusses the development of a new model representing the synthesis of two models that are often used to study health behaviors: the Health Belief Model and the Theory of Reasoned Action. The new model was developed as the theoretic framework for an investigation of the factors affecting participation by Mexican migrant workers in tuberculosis screening. Development of the synthesized model evolved from the concern that models used to investigate health-seeking behaviors of mainstream Anglo groups in the United States might not be appropriate for studying migrant workers or persons from other cultural backgrounds.     

Predictors of prostate cancer screening intention among older men in Jordan

Intention to prostate cancer screening (PCS) is one of the major factors affecting the long‐term success of population‐based PCS programmes. The aim of this study is to explore strong factors linked to intention to PCS among older Jordanian adults using the Health Belief Model (HBM). Data were obtained from Jordanian older adults, aged 40 years and over, who visited a comprehensive health care centre within a ministry of health. A pilot test was conducted to investigate the internal consistency of the Champion Health Belief Model Scale for PCS and the clarity of survey questions. Sample characteristics and rates of participation in PCS were examined using means and frequencies. Important factors associated with intention to PCS were examined using bivariate correlation and standard multiple linear regression analysis. About 13% of the respondents were adherent to PCS over the prior decade. Four out of the seven HBM‐driven factors (perceived susceptibility, benefits and barriers to prostate‐specific antigen (PSA) test, and health motivation) were statistically significant. Those with greater levels of susceptibility, benefits of PSA test and health motivation and lower levels of barriers to PSA testing were having more intention to participate in PCS. Family history, presence of urinary symptoms, age and knowledge about prostate cancer significantly predicted the intention to PCS. Intervention programmes, which lower perceived barriers to PSA testing and increase susceptibility, benefits of PSA testing and health motivation, should be developed and implemented.     

Prerequisites to providing culturally competent care to Mexican migrant farmworkers: a Delphi study

The purpose of this study was to identify prerequisites to providing culturally competent care to Mexican migrant farmworkers. A national sample of nurse experts who worked with Mexican migrant farmworkers (N = 93 [50.2%] in round 1; and N = 142 [54.8%] in round 2) participated during the period of August 1998 to April 1999. Using a two-round modified Delphi method, a list of 89 items was generated. The nurse experts agreed that the 89 items identified were prerequisites to cultural competence, showing consensus rates of 85.4% in round 1 and 88.8% in round 2. The prerequisites to culturally competent care identified by participants encompassed caring, cultural sensitivity, cultural knowledge (general/specific), cultural abilities/skills, and others (bi-cultural status; cultural and learning experiences).     

基于计划行为理论的护理专业学生课程出勤意向研究

目的分析和探讨护理专业学生的课程出勤意向与态度、主观规范、感知行为控制之间的关系。方法采用问卷调查法,对239名护理专业学生不同课程的出勤率、出勤意向等进行调查。结果经多元逐步回归分析显示,学生的出勤态度、主观规范、感知行为控制进入出勤意向的回归方程,其决定系数为0.81。结论护理专业学生课程出勤意向与态度、主观规范、感知行为控制有关,可以通过提高教师素质、改变教学方法、完善考勤制度、合理安排课程等方法提高护理专业学生的出勤意向。     

Determinants of exercise intention and behavior in survivors of breast and prostate cancer: an application of the theory of planned behavior

The purpose of this study was to evaluate the theory of planned behavior as a framework for understanding exercise intention and behavior in survivors of breast and prostate cancer. Participants were 83 survivors of breast and 46 survivors of prostate cancer who were diagnosed within the previous 4 years and had completed treatment. Each participant completed a mailed self-administered questionnaire that assessed exercise during the previous week, demographic and medical variables, and the theory of planned behavior. For survivors of breast cancer, regression analyses indicated that attitude, subjective norm, and perceived behavioral control explained 45% of the variance in exercise intention with attitude, subjective norm, and perceived behavioral control each uniquely contributing to intention. Furthermore, exercise intention explained 30% of the variance in exercise behavior; however, perceived behavioral control added no unique variance. For survivors of prostate cancer, attitudes, subjective norm, and perceived behavioral control explained 36% of the variance in exercise intention, but only perceived behavioral control made a significant unique contribution. Furthermore, intention explained 36% of the variance in exercise behavior; however, perceived behavioral control added no unique variance. Results suggest that nurses may use the theory of planned behavior as a model for understanding the determinants of exercise intentions and behavior in survivors of breast and prostate cancer.     

A pilot study to validate measures of the theory of reasoned action for organ donation behavior

The present study aimed at taking the first attempt in validating the measures generated based on the theory of reasoned action (TRA). A total of 211 university students participated in the study, 95 were included in the exploratory factor analysis and 116 were included in the confirmatory factor analysis. The TRA measurements were established with adequate psychometric properties, internal consistency, and construct validity. Findings also suggested that attitude toward organ donation has both a cognitive and affective nature, while the subjective norm of the family seems to be important to students’ views on organ donation.     

Exercise among blue-collar workers: application of the theory of planned behavior.

The purpose of this study was to identify cognitive predictors of blue-collar workers' (N = 468) intention to exercise and their self-reported exercise behavior. The theory of planned behavior (TPB) provided the framework for the study. A cross-sectional sample of skilled and unskilled workers from the physical facilities department of a large, Midwestern state university completed a questionnaire containing measures of attitude, subjective norm, perceived behavioral control, intention, and self-reported leisure exercise behavior. Structural equation modeling demonstrated that workers' attitude toward exercise and perceived behavioral control explained 61.7% of the variance of intention, whereas intention and perceived behavioral control explained 51.3% of the variance of exercise behavior. Subjective norm was not a significant predictor of intention to exercise. The findings support the use of the TPB in identifying cognitive factors that explain exercise behavior and suggest that interventions to promote exercise behavior in blue-collar workers should address their attitude toward exercise and their perceptions of behavioral control.     

The relationship of attitude, subjective norm, and behavioral intent to the documentation behavior of nurses

Ajzen and Fishbein's theory of reasoned action was used to assess the relationship of nurses' attitude, subjective norm, and behavioral intention to their documentation behavior. Attitudes, subjective norms, and behavioral intentions toward documentation were elicited from 108 staff nurses. Documentation behavior was based on what should be documented in any hospitalized patient's chart during a shift. This exploratory model was analyzed with LISREL VI. The overall fit of the final model to the data was good, as judged by a chi-square (df = 7, p = .845). The total coefficient of determination for the structural equation was .461. Attitude toward documentation did not relate significantly to intention to document optimally. Subjective norm did have a significant effect on behavioral intent. Attitude and subjective norm accounted for 46.1% of the variance in behavioral intent. Behavioral intent had a significant effect on documentation behavior, accounting for 15.2% of the variance. It appears that subjective norm, which is the influence of others, is what directs the intention to document and thus relates to subsequent documentation. Recommendations for practice include the communication of high ideals and expectations of important others to the staff nurse in order to improve the quality of documentation.     

Predicting breast self-examination using the theory of reasoned action

The personal and normative influences on breast self-examination (BSE) behavior in older women were examined using the Theory of Reasoned Action. The sample consists of 93 volunteers ranging in age from 52 to 90 years. A structured questionnaire was used for data collection. Direct and indirect measures of attitude and social norm were used to predict intention to perform BSE and BSE frequency. Contrary to the model assumptions, indirect measures accounted for more variance in both intention and behavior, and explained actual behavior better than intention to perform. Both the indirect and direct measures of attitude and social norm explained a significant amount of the variance in intention and BSE frequency. There were significant differences on all the model components (direct and indirect measures of attitude, social norm, and intention) between frequent and infrequent BSE performance groups. Discriminant analysis using the indirect measures of attitude and social norm correctly classified 76% of the women into frequent and infrequent performance groups.     

Attitudes, subjective norm, perceived behavioral control, and intentions related to adult smoking cessation after coronary artery bypass graft surgery

The purpose of this study was to examine the relationships between intention, attitudes, subjective norm, and perceived behavioral control related to smoking cessation in adults after initial coronary artery bypass graft surgery (CABG). The theoretical framework for the study was derived from Ajzen's Theory of Planned Behavior. Intention, the global and belief-based measures of attitude, subjective norm, and perceived behavioral control were measured with the Determinants of Adult Smoking Cessation (DOASC) Questionnaire developed by the investigator. Thirty-two adult smokers completed the questionnaire 2 to 3 weeks following hospital discharge. Four weeks after the questionnaire completion, a follow-up telephone call was used to determine the participants' current smoking status. The study results indicated that there was a statistically significant relationship between the intention to quit smoking after CABG and the global measure of attitude, and perceived behavioral control. This study highlights some of the beliefs about the outcomes of quitting smoking permanently after CABG which may underlie attitudes, subjective norm, and perceived behavioral control in this population. Implications for theory, practice, and research are discussed.