The Health Belief Model in predicting healthcare workers' intention for influenza vaccine uptake in Jordan

BackgroundTheories of health behavior change are being inadequately adopted to understand the reasons behind low influenza vaccination rates among healthcare workers (HCWs). The Theory of Planned Behavior (TPB) is being used to predict intention-behavior relationship while the Health Belief Model (HBM) is being employed to predict actual behavior. The purpose of this study was to test a conceptual model based on the HBM’s constructs to predict Jordanian HCWs’ intentions for influenza vaccine uptake as an alternative to the TPB.MethodA cross-sectional questionnaire-based study was conducted in 2016 in a tertiary teaching hospital in Amman-Jordan including a convenience sample of 477 HCWs with direct patient contact. The study instrument was tested for validity and reliability. A conceptual regression model was proposed incorporating the constructs of the primary HBM with some modifications in the threat construct as well as an additional variable about explicit past vaccination behavior (in the past year and/or any previous history of influenza vaccine uptake).ResultsAlmost all the constructs of the HBM demonstrated significant differences between participants intending and those who did not intend to vaccinate against influenza. After adjusting for the confounding variables in the final conceptual regression model, past vaccination behavior (OR= 4.50, 95%Confidence Interval 3.38–6.00, P< 0.0005) and the perceived benefit scale (OR= 1.19, 95% Confidence Interval 1.11–1.28, P< 0.0005) were the only significant predictors of intentions to vaccinate against influenza in the next season.ConclusionTaking into consideration the altruistic beliefs of HCWs and their explicit past vaccination history augments the utility of the original HBM tool in predicting HCWs’ intentions to vaccinate against influenza in a way that is consistent with the predictive ability of the Theory of Planned Behavior.     

Mise à jour des croyances et congruence à l'humeur dans le trouble dépressif

Depressive disorder is characterized by a polymorphic symptomatology associating emotional, cognitive and behavioral disturbances. One of the most specific symptoms is negative beliefs, called congruent to mood. Despite the importance of these beliefs in the development, the maintenance, and the recurrence of depressive episodes, little is known about the processes underlying the generation of depressive beliefs. In this paper, we detail the link between belief updating mechanisms and the genesis of depressive beliefs. We show how depression alters information processing, generating cognitive immunization when processing positive information, affective updating bias related to the valence of belief and prediction error, and difficultie to disengage from negative information. We suggest that disruption of belief-updating mechanisms forms the basis of belief-mood congruence in depression.     

Articulation of Asthma and Its Care Among Low-Income Emergency Care Recipients

Low-income minority patients from East St. Louis, Illinois, a depressed midwestern urban city, who had visited acute care settings with asthma symptoms, participated in a focus group. Questions were constructed around the Health Belief Model to characterize participants' experiences in receiving asthma care, their confidence in long-term asthma self-management, barriers they perceived to managing their asthma, and recommendations they would make for improving asthma care in their community. Analysis of comments suggests an appreciable understanding of asthma triggers, limited coping behaviors for asthma symptoms, very limited practice of active asthma management, perception of the health care system as frequently insensitive to their needs or their knowledge of their own care, exchange of well-articulated information regarding how to deal with the system, and an apparent lack of awareness of any potential contribution of patient education or support system.     

洛阳市某企业职业健康教育调查

[目的]了解洛阳市某企业有害作业人群有关《职业病防治法》的知识、信念、行为情况,为进一步开展企业的健康教育提供参考。[方法]2005年根据《职业病防治法》相关内容,采用问卷方式,调查接触职业病危害因素1年以上的职工。[结果]调查325人,对有关知识的知晓率为5.2%~82.8%,具有有关信念的占78.1%~89.2%,有关行为形成率为38.8%~95.4%。有关知识得分,36~55岁为(15.78±3.68)分,19~35岁为(17.54±3.77)分(P<0.05);有关知识、信念、行为得分,工龄10年及以上者均高于工龄不足10年者(P<0.01);有关知识、信念与行为得分大专以上学历者较高(P<0.01)。[结论]某企业职工的职业卫生知识、信念与行为均不够理想。     

Effectiveness of Community Intervention in Improving Bone Health Behaviors in Older Adults

An 8-week, bone-health community program addressed risks/lifestyle changes within the Health Belief Model and Theory of Reasoned Action frameworks in a randomized format (treatment group n = 35; control group n = 34). Median week 1 values for calcium (control, 963 mg; treatment, 1023 mg) and vitamin D (81 IU both groups) were below recommendations, increasing throughout the program for both control (1023 mg calcium, 128 IU vitamin D) and treatment (1005 mg calcium, 122 IU vitamin D) groups. There was limited response to the exercise outcome variables, with many not participating in that section of the program. Psychosocial variables were positive for both control and treatment groups at week 1, with no significant difference at postintervention. Regression analysis indicated that those with a positive attitude about calcium intake and belief that they could choose calcium-fortified foods were more likely to have higher calcium intake. Intention to exercise was modified by peer and family support. Community-based programs can translate and use clinical trial key topics and outcomes, but participation bias makes impact results difficult to interpret the effectiveness of the program.     

La psychopathologie nous aide-t-elle à penser les théories du complot ? Trois modèles cliniques d’un imaginaire collectif

ObjectivesConspiracy theories appear today as a specific collective imaginary. Belief in conspiracy theories seems to have clearly increased during the last decades, partly due to their elaboration and diffusion via social media. A lot of empirical research about conspiracy theories are designed in social and cognitive psychology, but only a few studies adopt a clinical point of view. One reason is that such a clinical approach carries the risk of abusively applying some psychopathological notions to a wide range of the general population, and to a social – and not only individual – construct. This paper aims to promote a psychodynamic approach to conspiracy theories. We argue that this approach allows to studying them as subjective and collective constructs, leaving aside any attempt to make a diagnosis on people believing in conspiracy theories, and any dichotomy between the normal and the pathological.Materials and methodsWe discuss three clinical ways to represent the psychological functions of conspiracy theories: paranoid ideation, perverse uses, and reaction to traumatic events. As a matter of fact, these clinical notions are often explicitly referred to, or implicitly implied, when psychological motives or functions of belief in conspiracy theories are discussed. We seek to point out the implications of these three clinical notions and their ability to shed light on conspiracy theories. This leads to discuss their relevance for a differential clinic of the belief in conspiracy theories, allowing to identify the various dimensions of conspiracy theories, and of their subjective uses and functions.ResultsThrough a psychodynamic understanding of clinical entities, conspiracy theories can be studied as both subjective and collective constructs. In this way, we argue that a psychodynamic approach can avoid the risk of a diagnostical and pathological use of clinical concepts stemming from a binary distribution between the normal and the pathological. It rather leads to question along a continuum the various dimensions of conspiracy theories and of the belief in their content.ConclusionsThe phenomenon of conspiracy theories seems to emerge from a wide range of heterogeneous and distinctive constructs, uses and attitudes. Belief in conspiracy theories can provide several kinds of psychological benefits, implying various subjective functions and psychic mechanisms. Moreover, in terms of psychological attitudes, we have to clearly distinguish different phenomena: some spontaneous and collective elaborations of conspiracy theories, belief in conspiracy theories, the process of their diffusion, and their political, social and psychological intentional uses. These heterogeneous dimensions raise the risk of undermining any study of this phenomenon considering it as a unidimensional and a unified construct. In this way, we argue that a differential clinic of this conspiracy phenomenon is a methodological need, prior to the design of empirical clinical studies and to the reflection about preventive actions.     

Assessment of GPs' beliefs relating to the care of people with intellectual disabilities: A Taiwan-based,opportunity-guided approach

Purpose. This study was designed to investigate general practitioners' (GPs) beliefs about the perceived importance of their role in, and their satisfaction with, providing healthcare to people with intellectual disabilities. The identification of healthcare issues with potential for improvement was assessed using gap analysis and an opportunity-guided method.

Method. A cross-sectional census survey by a mail-structured questionnaire recruited 331 GPs (response rate = 16%) who provided information on healthcare for people with intellectual disabilities in 2006 in Taiwan.

Results. The results indicated that GPs considered their role in providing healthcare for people with intellectual disabilities to be important (mean score 7.2 – 8.3). However, the respondents generally did not feel satisfied (mean score 4.6 – 5.5) with their achievements in treating patients with intellectual disabilities. We found that the gender and educational level of the respondents were statistically correlated to the perceived importance they considered their work to have, while the factors of age, medical practice setting and training experience in intellectual disability were statistically correlated to GPs' perceived satisfaction in providing healthcare to people with intellectual disabilities (p < 0.05). Those healthcare issues of ‘training and experience in intellectual disability’, ‘multi-disciplinary and multi-sectoral cooperation’, ‘adequate competence in disability diagnosis’, ‘genetic consulting services’, ‘duty of disease prevention and health promotion’, and ‘adequate medical consultation time’ were the five most promising areas to be improved in healthcare for people with intellectual disabilities according to the opportunity-guided analysis.

Conclusions. This study highlights that health professionals need to examine carefully healthcare issues pertaining to people with ID, and that much more effort is required to develop appropriate healthcare policies based on the opportunity-guided health issues identified here.     

Behavioral intention to prevent cervical cancer and related factors among female high school students in Japan

Aim

This study aimed to examine female high school students’ behavioral intention to prevent cervical cancer and related factors.

Methods

The participants were 2158 female high school students at 16 high schools in A prefecture in the Tohoku region in Japan. A self‐administered questionnaire was carried out that was developed based on a conceptual framework comprising the Health Belief Model and Theory of Reasoned Action.

Results

The responses were obtained from 2072 students (96.0%). Of these, the answers of 2028 respondents were analyzed after excluding those participants who did not complete the behavioral intention item (effective response rate: 97.0%). A factor analysis and covariance structure analysis yielded a model with strong goodness‐of‐fit that explained the behavioral intentions based on an “Awareness of the importance and effectiveness of cervical cancer screening,” “Obstacles to cervical cancer prevention behavior,” “Subjective norms for adopting cervical cancer prevention behavior,” and “The behavior of someone close that encourages cervical cancer prevention behavior.”

Conclusion

The statistical analysis yielded a model with strong goodness‐of‐fit that explained female high school students’ behavioral intentions, which were related to four factors, including “the awareness of the importance and effectiveness of cervical cancer screening.”

     

Prevalence and associated factors of seasonal influenza vaccination among 24- to 59-month-old children in Hong Kong

BackgroundInfluenza results in severe complications among 24- to 59-month-old children, who are recommended by the WHO to take up influenza vaccination (IV) annually. Health promotion is warranted. Yet, there is a dearth of studies on IV prevalence and associated factors in this age group.MethodsA random population-based telephone survey interviewed 540 parents of Chinese children aged 24–59 months in Hong Kong during March through June, 2011. Constructs of the Health Belief Model (HBM) and subjective norm formed basis for assessing parental perceptions on influenza and IV. For data analysis, adjusted, and stepwise multiple logistic regression models were fit.ResultsThe prevalence of having taken up at least one dose and two doses of IV among children aged 24–59 months was 58.9 and 42.4%, respectively. Significant associated factors included family members’ IV experience (ORu = 5.37, 95% CI: 3.48, 8.29), variables related to the HBM constructs (except perceived severity) [perceived susceptibility of seasonal influenza (ORu = 2.03, 95% CI: 1.39, 2.95), perceived benefits of IV (ORu = 3.11, 95% CI: 2.05, 4.71), perceived barriers (ORu = 0.49, 95% CI: 0.25, 0.96) of IV, and cue to action (ORu = 4.79, 95% CI: 2.87, 7.99)], supportive subjective norm (ORu = 4.26, 95% CI: 2.91, 6.25), and level of fear felt during the H1N1 pandemic (ORu = 1.97, 95% CI: 1.01, 3.87). Adjusted for the child's age, the same significant factors were found. Exposure to related media messages was statistically non-significant.ConclusionThe reported IV prevalence was higher than that of 24- to 59-month-old children reported in other studies. There is room for improvement through health promotion, which should modify parental cognitions related to HBM (except perceived severity and self-efficacy) and involve family members to create subjective norm. Media campaigns may be inadequate for promotion of IV; use of the setting approach may be considered.