Understanding users of online energy efficiency counseling: comparison to representative samples in Norway.

Introduction: To achieve substantial energy efficiency improvements in the privately owned building stock, it is important to communicate with potential renovators at the right point in time and provide them with targeted information to strengthen their renovation ambitions. The European Union recommends using one-stop-shops (OSSs), which provide information and support throughout the whole process, from planning to acquisition of funding, implementation, and evaluation as a measure to remove unnecessary barriers. Methods: For this paper, we invited visitors of two Norwegian websites with OSS characteristics to answer an online survey about their renovation plans and energy efficiency ambitions. The participants visited the websites out of their own interest; no recruitment for the websites was conducted as part of the study (N = 437). They also rated a range of psychological drivers, facilitators, and barriers to including energy upgrades in a renovation project. Their answers were then compared to existing data from representative samples of Norwegian households regarding home renovation in 2014, 2018, and 2023, as well as data from a sample of people who were engaged in renovation projects in 2014, which was collected by the research team with a similar online survey. Furthermore, 78 visitors completed a brief follow-up online survey one year later to report the implemented measures. Results: We found that visitors of the websites are involved in more comprehensive renovation projects and have substantially higher ambitions for the upgrade of energy efficiency compared to the representative samples. They also perceive stronger personal and social norms, as well as have a different profile of facilitators and barriers. Discussion: The findings suggest to policymakers that OSSs should be marketed especially to people motivated to upgrade energy efficiency but lack information and are unable to implement their plans alone. Also, the construction industry might refer interested people to such low-threshold online solutions to assist informed and more ambitious decisions.

The influence of life transitions on Danish adults' physical activity beliefs and behaviour: A qualitative study.

Using a qualitative design, we explored how life transitions influence Danish adults' physical activity beliefs and behaviour adopting the Theory of Planned Behaviour as a guiding framework. Life story interviews with 42 participants revealed 6 salient life transition periods which affected physical activity behaviour, either in a disruptive way resulting in decreased activity levels or in a facilitative manner, providing opportunities for increased activity engagement. The identified life transition periods uniquely influenced individuals' attitudes, subjective norms and perceived behavioural control (PBC) beliefs, thus affecting motivations toward physical activity. Specifically, starting primary school or a career, forming a romantic relationship, and having a child primarily shaped subjective norm and PBC, while leaving home was especially influential on PBC and retirement on attitudes and PBC. Consistent themes across the transition periods included time constraints and opportunities to be active, supportive social contexts, access to facilities and having a need to be active.

Would you bet on the vet? Influences on dairy farmers' vaccination choices, with a spotlight on the Veterinarian impact.

Ensuring effective vaccination is crucial for epidemic control, particularly in voluntary vaccination scenarios. Though highly important for planning voluntary vaccination programs, we lack insights into the effectiveness of veterinarian communication and the impact of disease-specific traits on farmer vaccination intentions. To fill this void, our study compared five diseases affecting Israeli dairy cattle (Botulism, Bovine Ephemeral Fever (BEF), Brucellosis, Lumpy Skin Disease (LSD), and Rabies). Using questionnaires grounded in the theory of planned behavior, we surveyed 340 Israeli dairy farmers to understand their vaccination intentions for each disease.Simultaneously, veterinarians overseeing these farms provided insights into their opinions and perceived influence on vaccination decisions. Results revealed varying levels of farmer vaccination intention, with Botulism showing the highest and BEF the lowest. Social pressure significantly influenced farmers' vaccination intentions, with distinct patterns across diseases. Veterinarian opinions had the highest influence only for LSD, while other factors played crucial roles in different diseases. Intriguingly, there was no correlation between veterinarians' recommendations and farmers' perceptions of these recommendations. In conclusion, the optimization of voluntary vaccination programs necessitates tailoring interventions to the unique characteristics of each disease. Additionally, improving communication between veterinarians and farmers is essential, with an emphasis on effective risk communication training.

Diagnosing and managing prescription opioid use disorder in patients prescribed opioids for chronic pain in Australian general practice settings: a qualitative study using the theory of Planned Behaviour.

BACKGROUND: Chronic pain is a debilitating and common health issue. General Practitioners (GPs) often prescribe opioids to treat chronic pain, despite limited evidence of benefit and increasing evidence of harms, including prescription Opioid Use Disorder (pOUD). Australian GPs are worried about the harms of long-term opioids, but few are involved in the treatment of pOUD. There is little research on GPs' experiences diagnosing and managing pOUD in their chronic pain patients. METHODS: This qualitative research used semi-structured interviews and a case study to investigate GPs' experiences through the lens of the Theory of Planned Behaviour (TPB). TPB describes three factors, an individual's perceived beliefs/attitudes, perceived social norms and perceived behavioural controls. Participants were interviewed via an online video conferencing platform. Interviews were transcribed verbatim and thematically analysed. RESULTS: Twenty-four GPs took part. Participants were aware of the complex presentations for chronic pain patients and concerned about long-term opioid use. Their approach was holistic, but they had limited understanding of pOUD diagnosis and suggested that pOUD had only one treatment: Opioid Agonist Treatment (OAT). Participants felt uncomfortable prescribing opioids and were fearful of difficult, conflictual conversations with patients about the possibility of pOUD. This led to avoidance and negative attitudes towards diagnosing pOUD. There were few positive social norms, few colleagues diagnosed or managed pOUD. Participants reported that their colleagues only offered positive support as this would allow them to avoid managing pOUD themselves, while patients and other staff were often unsupportive. Negative behavioural controls were common with low levels of knowledge, skill, professional supports, inadequate time and remuneration described by many participants. They felt OAT was not core general practice and required specialist management. This dichotomous approach was reflected in their views that the health system only supported treatment for chronic pain or pOUD, not both conditions. CONCLUSIONS: Negative beliefs, negative social norms and negative behavioural controls decreased individual behavioural intention for this group of GPs. Diagnosing and managing pOUD in chronic pain patients prescribed opioids was perceived as difficult and unsupported. Interventions to change behaviour must address negative perceptions in order to lead to more positive intentions to engage in the management of pOUD.

A theoretical framework for identifying sociocultural factors that influence nurses' compliance with early warning systems for acute clinical deterioration: A cross-sectional survey.

BACKGROUND: Systematic adoption of early warning systems in healthcare settings is dependent on the optimal and reliable application by the user. Psychosocial issues and hospital culture influence clinicians' patient safety behaviours. OBJECTIVE: (i) To examine the sociocultural factors that influence nurses' EWS compliance behaviours, using a theory driven behavioural model and (ii) to propose a conceptual model of sociocultural factors for EWS compliance behaviour. DESIGN: A cross-sectional survey. SETTING: Nurses employed in public hospitals across Queensland, Australia. PARTICIPANTS: Using convenience and snowball sampling techniques eligible nurses accessed a dedicated web site and survey containing closed and open-ended questions. 291 nurses from 60 hospitals completed the survey. METHODS: Quantitative data were analysed using ANOVA or t-tests to test differences in means. A series of path models based on the theory were conducted to develop a new model. Directed or theory driven content analysis informed qualitative data analysis. RESULTS: Nurses report high levels of previous compliance behaviour and strong intentions to continue complying in the future (M=4.7; SD 0.48). Individual compliance attitudes (ß 0.29, p<.05), perceived value of escalation (ß 0.24, p<.05) and perceived ease or difficulty complying with documentation (ß -0.31, p<.05) were statistically significant, predicting 24% of variation in compliance behaviour. Positive personal charting beliefs (ß 0.14, p<.05) and subjective norms both explain higher behavioural intent indirectly through personal attitudes. High ratings of peer charting beliefs indirectly explain attitudes through subjective norms (ß 0.20, p<.05). Perceptions of control over one's clinical actions (ß -0.24, p<.05) and early warning system training (ß -0.17, p<.05) directly contributed to fewer difficulties complying with documentation requirements. Prior difficulties when escalating care (ß -0.31, p<.05) directly influenced the perceived value of escalating. CONCLUSIONS: The developed theory-based conceptual model identified sociocultural variables that inform compliance behaviour (documenting and escalation protocols). The model highlights areas of clinical judgement, education, interprofessional trust, workplace norms and cultural factors that directly or indirectly influence nurses' intention to comply with EWS protocols. Extending our understanding of the sociocultural and system wide factors that hamper nurses' use of EWSs and professional accountability has the potential to improve the compliance behaviour of staff and subsequently enhance the safety climate attitudes of hospitals. TWEETABLE ABSTRACT: A newly developed model reports nurse's personal attitudes, peer influence, perceived difficulties encountered documenting and escalation beliefs all predict early warning system compliance behaviour.

Stakeholder perspectives on the barriers and facilitators of engagement in healthy lifestyle behaviours in underrepresented adolescents: a focus group study from the European SEEDS project.

BACKGROUND: Obesity in adolescence has increased in the last decades. Adolescents fail to meet the recommended guidelines for physical activity (PA) and healthy diet. Adolescents with a low socioeconomic status (SES) particularly seem to have fewer healthy lifestyle behaviours. The European Science Engagement to Empower aDolescentS (SEEDS) project used an extreme citizen science approach to develop and implement healthy lifestyle behaviour interventions in high schools. As part of this project, key stakeholders were invited to reflect on the intentions of adolescents to engage in healthy lifestyle behaviours. The aim of this study was to gain stakeholder insights into the barriers and facilitators to healthy lifestyle behaviours of adolescents from low SES areas and on the possible role of these stakeholders in facilitating healthy lifestyle behaviours. METHODS: Six semi-structured focus groups were conducted in four European countries with 28 stakeholders from different settings (schools, community, and government), like teachers, policy advisors and youth workers. The theoretical framework of focus groups was based on the Theory of Planned Behaviour. The main questions of the focus groups were centred on PA and healthy diet. The focus groups were qualitatively analysed in NVivo using thematic analysis to identify topics and themes. RESULTS: According to stakeholders, adolescents have sufficient understanding of the importance of PA and a healthy diet, but nevertheless engage in unhealthy behaviour. Parents were mentioned as important facilitators for engaging adolescents in healthy lifestyle behaviours. Stakeholders listed lack of knowledge, time, and financial resources as barriers for adolescents from low SES families to engage in healthy lifestyle behaviours. The school environment was listed as an important facilitator of adolescents' healthy lifestyle changes, but stakeholders acknowledged that current school days, curriculum and buildings are not designed to promote healthy lifestyle behaviours. External support and collaboration with community and governmental stakeholders was seen as potentially beneficial to improve healthy lifestyle behaviours. CONCLUSIONS: This study shows the variety of barriers adolescents from low SES areas face, and the need for a broader collaboration between key stakeholders to facilitate healthy lifestyle behaviours. Schools are regarded specifically as important facilitators. Currently, the school environment entails various barriers. However, when addressing those, schools can increase opportunities for healthy lifestyle behaviours of adolescents from low SES areas. TRIAL REGISTRATION: This study is registered in ClinicalTrials.gov on 12/08/2021: NCT05002049.

Mental health nurses' attitudes towards consumers with co-existing mental health and drug and alcohol problems: Adescriptive study.

WHAT IS KNOWN ON THE SUBJECT?: Dual diagnosis is one of the leading causes of disability globally. There is limited evidence on mental health nurses' attitudes towards consumers with dual diagnosis. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Mental health nurses have positive attitudes towards consumers with dual diagnosis. A positive attitude at work is influenced by various factors, including feeling that one's role is appropriate and legitimate. This also includes receiving support in that role, being motivated to work, having confidence in completing tasks and feeling satisfied with one's job. ABSTRACT: BACKGROUND: Dual diagnosis is a global health concern. This descriptive research assessed mental health nurses' attitudes towards consumers with dual diagnosis in Australian mental health settings. The research question was: What is the attitude of mental health nurses towards consumers with co-existing mental health and drug and alcohol problems? MATERIALS AND METHODS: This cross-sectional survey included 103 mental health nurses who work with consumers with dual diagnosis. Participants were recruited from various mental health settings through convenience sampling. The Comorbidity Problems Perceptions Questionnaire was used to assess attitudes. Descriptive data and multiple regression analyses were conducted. We utilized the consensus-based checklist for reporting results of this study. RESULTS: Mental health nurses positively perceived consumers with dual diagnosis. Factors associated with a positive attitude were a higher level of work experience, feeling that one's role is adequate, perceiving one's role as legitimate, receiving increased support in one's position, having high work motivation, possessing high task-specific self-esteem and experiencing higher levels of work satisfaction. Work experience predicted role adequacy. Position predicted role support. The work sector predicted role-related self-esteem. CONCLUSIONS: As mental health nurses gain work experience; they develop positive attitudes that boost their self-esteem and sense of importance towards consumers with dual diagnosis. This constructive mindset also positively affects their work motivation and job satisfaction towards consumers with dual diagnosis. Conducting interventional studies is necessary to examine how clinical experiences, work environments, and job positions can impact attitudes, aiming to improve mental health nursing interventions towards consumers with dual diagnosis. IMPLICATIONS TO PRACTICE: The study found that mental health nurses' positive attitudes towards consumers with dual-diagnosis are influenced by their experience and knowledge. Moreover, mental health nurses who feel supported, motivated and confident in their roles are more likely to provide high-quality care to consumers with dual diagnosis. Mental health nurses could provide better care and support if they took a proactive approach and addressed the challenges associated with this consumer population. To be successful in their roles, mental health nurses require access to resources and support from healthcare organizations. As a result, their job satisfaction and attitudes towards consumers with dual diagnosis will be enhanced. In this way, consumers as well as healthcare organizations will benefit.

Identifying key beliefs underlying QR code check-in and compliance behaviours in the COVID-19 pandemic.

ISSUE ADDRESSED: The implementation of quick response (QR) code check-in compliance behaviour during the COVID-19 pandemic featured in infection control strategies in several global jurisdictions, but was of particular interest in the Australian context, where it became mandated on a nationwide scale. We aimed to identify the salient beliefs people hold toward complying with the QR code check-in using a Theory of Planned Behaviour belief-based framework. METHODS: An elicitation study using open-ended questions (Queensland; N = 93, Mage = 4.77 years, SD = 13.62 and Victoria; N = 76, Mage = 44.92 years, SD = 11.63) and a prospective correlational study using a two-wave online survey (Queensland; N = 290, Mage = 38.99, 46.6% female and Victoria; N = 290, Mage = 38.27, 53.4% female) were conducted. RESULTS: Qualitative data were coded through an iterative content analysis, while quantitative data were analysed using linear multiple regression. Behavioural, normative and control beliefs were associated with intention and behaviour in both samples. Variation in beliefs across the states also were observed. CONCLUSIONS: Across both samples, beliefs in positive outcomes consistently exhibited stronger associations with both intention and behaviour than the reported negative outcomes. Distinct differences emerged between the two samples in terms of regression effects. SO WHAT?: Results indicate individual experience may affect the beliefs which guide behaviour, supporting the potential efficacy of health promotion campaigns tapping into context specific beliefs and experiences if QR code check-in is to be implemented as an infection control measure in future.

Perception towards reducing natural gas consumption and imports in Europe: A theoretical and empirical investigation.

The European energy system is undergoing a drastic change, focusing on reducing natural gas consumption and import. European households, which are responsible for 25 % of final energy consumption, mainly based on natural gas, could play a significant role in such a transition. Therefore, the study aims to understand the perception towards natural gas consumption reduction and imports. An online questionnaire was designed based on an extended version of the theory of planned behaviour, which 257 highly educated respondents filled out. The results delineated the respondents' positive perception of reducing natural gas consumption. Specific attributes (i.e., environmental concerns, national sustainable and efficient energy system, and national energy independence) and personal moral norms (i.e., moral responsibility) significantly impact the willingness and effort to reduce natural gas consumption. The lack of control is the largest perceived control behaviour in reducing the respondents' natural gas consumption compared to available knowledge and affordability. Finally, the respondents care significantly and want to know about natural gas import sources, and they are highly against natural gas imports from Russia, the United States, the Middle Eastern, and Arab countries. Based on the insights, the study provides detailed recommendations. The study provides concrete recommendations for policy-makers to include environmental, humanitarian and energy-independence concerns in their decision-making processes related to natural gas imports and consumption. It also emphasises informing and involving individual households in such decision-making processes.

Exploring the factors influencing evidence-based approaches to advanced chronic kidney disease: a qualitative study involving nurses and physicians.

BACKGROUND: Advanced chronic kidney disease (ACKD) is associated with a high risk of adverse cardiovascular and renal events and has a significant impact on quality of life and life expectancy. Several studies have identified areas for improvement in their management in primary care. Some professional and environmental factors can act as key barriers to appropriate care. OBJECTIVE: To analyse attitudes, subjective norms, and perceived behavioural control among primary care professionals related to the implementation of an evidence-based approach for individuals with ACKD in primary care. METHODOLOGY: This was a qualitative study using an interpretative phenomenological approach based on the theory of planned behaviour. Two aspects of the evidence-based approach were explored: the implementation of clinical practice guidelines and the utilisation of electronic kidney disease records within the scope of this study. Primary care nurses and physicians participated in a previous pilot interview and five focus groups. Subsequently, a thematic analysis of the gathered data was conducted. FINDINGS: Thirty-three primary care professionals participated. The emerging themes included: experiences in the management of ACKD (highlighting a distinct profile of older, frail patients with comorbidities masking CKD and a CKD follow-up primarily focused on analytical monitoring and drug adjustment); factors in the professional environment influencing the use of scientific evidence (such as time constraints, excessive electronic health records, and unfamiliar reference guidelines); attitudes towards the application of recommendations on ACKD (recognising limitations of computer systems despite considering them as guidance); and capacities to implement evidence-based recommendations (acknowledging formative needs and challenges in coordinating care with nephrology services). CONCLUSIONS: Several psychological elements identified through the TBP hinder the adequate implementation of an evidence-based approach for individuals with CKD. Attitudes have been identified as factors modulating the use of standardised electronic records. Instead, subjective norms (influences from the professional environment) and perceived behavioral control (perception of capabilities) acted as barriers to the proper application of clinical practice guidelines and standardised records. IMPLICATIONS FOR PRACTICE: Strategies aimed at optimising the management of people with ACKD should focus not only on training but also on improving attitudes, organisational structures, IT systems and coordination between primary care and nephrology.

Consumer knowledge, attitudes, and behaviour regarding food safety - A perspective from Laos.

Primary research data on food chain safety at consumer level is needed to help policymakers to decrease the risk of foodborne infections in the Lao People's Democratic Republic. Therefore, the objectives of this study are to 1) determine Lao people's food safety knowledge, attitudes, and intentions and identify the most influential factors that shape their food safety behaviour, and 2) to support the government in the development of more efficient risk communication programmes. A paper-based consumer survey was implemented to collect quantitative data on the selected topics about Laotian consumers, as well as on the equipment of households regarding the conditions and tools necessary for safe food preparation and storage. A model was developed based on the extended Theory of Planned Behaviour (TPB), and partial least squares structural equation modelling (PLS-SEM) was applied to analyse the factors that affect food safety behaviour. The elements of Knowledge and Perceived Behavioural Control positively influence behaviours, such as using separate chopping boards for raw and ready-to-eat foods. According to the model, only 10 % of the Intentions would be translated into Behaviours, which gap can be explained by the lack of a hygienic environment. Although the survey indicated that Laotian people intend to follow food safety guidelines, participants felt they lacked sufficient knowledge. This perception was validated by the knowledge test and behavioural part of the study. In the light of these findings, it is essential to raise awareness and promote food safety knowledge and interventions, such as enhancing food safety education in childhood. This would help to facilitate and encourage adopting safe practices to improve overall food safety at the consumer level, delivering positive impacts also to the food business sector.

Factors influencing midwives' intentions to facilitate normal physiological birth: A qualitative study.

BACKGROUND: Whilst most women desire to birth vaginally, research highlights reducing rates of normal physiological birth worldwide. Previous studies have focussed largely on clinical practices associated with vaginal birth however health care professionals' intentions are also known to effect behaviour; a factor not well understood within the context of midwifery and normal physiological birth. QUESTION/AIM: To explore factors influencing midwives' intentions to facilitate normal physiological birth. METHODS: A qualitative study using individual interviews was conducted. The Theory of Planned Behaviour was used to develop a semi-structured interview guide to gather perceptions, thoughts, knowledge, and experience of normal physiological birth from participants. Data were analysed thematically within the theoretical constructs: attitudes, subjective norms, and perceived behavioural control. FINDINGS: Fourteen midwives from various practice settings, models, and locations in Australia were interviewed. Major factors influencing midwives' intentions to facilitate normal physiological birth were influenced by workplace culture, values and influence of leaders, the need to prioritise collaborative interdisciplinary relationships and support autonomy in midwifery. DISCUSSION: Factors influencing the midwives' intentions of facilitating normal physiological birth were multifaceted. Some influences are more obvious and observable through practice, while others were rooted in underlying beliefs and attitudes that were hidden in the subconscious of those involved. However, all contributing influences ultimately shape midwives' intentions and the way in which they facilitate normal physiological birth. CONCLUSIONS: Midwives intend to support normal physiological birth; however multiple factors influence their intentions over time. Prioritising collaborative interdisciplinary relationships and supporting autonomy in midwifery could address known barriers.

Utility of the Theory of Planned Behaviour for predicting parents' intentions to vaccinate their children against COVID-19.

Vaccination is a crucial form of primary prevention, and it is important to understand the factors that influence parents' decisions to vaccinate their children. The current study examines the utility of the Theory of Planned Behaviour (TPB) and anticipated affect for explaining parents' intentions to vaccinate their children against COVID-19. Parents (N = 843) living in the United States completed an online survey. The TPB variables explained 65% of the variability in parents' intentions. In addition to all three of the TPB antecedents predicting vaccine intentions, both anticipated regret of not vaccinating and anticipated positive emotions of vaccinating were associated with parent intentions. Contrary to predictions, subjective norms were a stronger predictor of intentions when perceived behavioural control was lower compared to higher. These findings help further our understanding of parent-for-child vaccine decisions in the context of novel health threats and inform intervention efforts aimed at encouraging this behaviour.

Attitudes, subjective norms and perceived behavioural control factors influencing Canadian secondary school students' milk and milk alternatives consumption.

OBJECTIVE: The research objectives were to evaluate factors that influence Canadian secondary school students' milk and milk alternatives (MMA) consumption and to explore associations through age and gender lenses. DESIGN: A qualitative design was used, consisting of semi-structured interviews and photo-elicitation methods. Analysis was guided by the Theory of Planned Behaviour (TPB). Deductive and inductive thematic analyses were used to generate themes, charting data based on attributes such as gender and age. SETTING: Interviews were held virtually or via telephone. PARTICIPANTS: Participants were twenty-eight high school students from Ontario, Canada, diverse in terms of gender and age. RESULTS: Both desirable and undesirable beliefs about the health outcomes of consuming MMA were commonly discussed. These included health benefits such as strong bones, muscular strength, and growth, and health consequences like unwanted skin conditions, weight gain, and diseases. While boys and girls associated MMA consumption with muscular strength, boys predominantly considered this favourable, while girls discussed outcomes like unwanted skin conditions and weight gain more often. Adolescents' perspectives on taste/perceived enjoyment, environmentally friendly choices and animal welfare also influenced their MMA preferences. Parental influences were most cited among social factors, which appeared to be stronger during early adolescence. Factors involving cost, time and accessibility affected adolescents' beliefs about how difficult it was to consume MMA. CONCLUSIONS: Recommendations for shifting attitudes towards MMA are provided to address unfavourable beliefs towards these products. Interventions to increase MMA consumption among adolescents should include parents and address cost barriers.

Behavioural Factors Influencing the Intention to Adopt Sheep Scab Control Measures in Northern Ireland.

Sheep scab, caused by infestation with the ectoparasitic mite Psoroptes ovis, is an endemic disease in the Northern Ireland (NI) sheep flock and constitutes significant economic and welfare burdens for the NI farming industry. Despite its endemic nature, historically, little research has been undertaken to support the control of the disease in NI. This study offers the first attempt to analyse the psychological and behavioural factors influencing farmers' intentions to implement effective sheep scab control measures in NI. To achieve our objective, quantitative data from a sample of 126 sheep farmers were statistically analysed using an extended theory of planned behaviour approach in an ordered logistic regression modelling framework. Our analyses showed that sheep scab remains an issue of concern in Northern Ireland. The attitudes of the farmers, as well as perceived behavioural control, emotional effect, membership of Business Development Groups (BDGs), and higher education qualifications, were found to be statistically significant factors influencing farmers' intentions to adopt sheep scab control measures. This study provides a solid foundation for how to promote behavioural changes among sheep farmers to improve their ability to implement effective disease control measures, helping to tackle this challenging disease in a more sustainable way in the future.

Autonomy and factors affecting dental health care seeking behaviour in women: An application of theory of planned behaviour.

Background: Understanding oral health care seeking behaviour and it's determinants is essential in improving oral health. The health care utilization in women was found to be influenced by their autonomy. A socio-cognitive model that can explain variance in dental attendance behaviour in women including autonomy has yet to be validated. The Theory of Planned Behaviour (TPB), which takes into account women's autonomy, attitude, subjective norms, and perceived behavioural control, is empirically tested in this study with regard to self-reported dental visiting intentions and dental health seeking behaviour. Method: Cross sectional study using self-administered questionnaires was conducted to assess socio-demographic factors, autonomy, dental visiting behaviors as well as constructs of TPB model in 400 women aged 18 years or older in Bangalore city selected via stratified cluster sampling method. Two-stage structural equation modelling (SEM) was used to test the hypothesized TPB model. Results: The proposed correlated 5-factor measurement model was confirmed through confirmatory factor analysis (CFA). In SEM subjective norm (ß = 0.17), perceived behavioural control (ß = -0.27) and autonomy (ß = 0.49) significantly predicted dental visiting intentions in women. Intention (ß = 0.56) and autonomy (ß = 0.25) explained dental visiting behaviour. It also revealed indirect effect of autonomy and perceived behaviour control on dental visiting behaviour through intentions. The hypothesized model predicted 27.6 % and 23.8% of the variance in intention and dental visiting behaviour respectively. Conclusion: The hypothesized model was successful in predicting intention and dental visiting behaviour in women. This could explain the multidimensional nature of dental care utilization in women which in turn might be helpful in improving access to dental care among them in future.

Does the purchase intention of green consumers align with their zero-waste buying behaviour? An empirical study on a proactive approach towards embracing waste-free consumption.

In recent years, emerging retail markets in cosmetics have transformed into green markets, as consumers demand more eco-friendly products. However, in scholarly literature, limited studies are available where researchers discuss green consumers' purchase intentions towards eco-friendly products and their relationship with zero-waste buying behaviour. This study is conducted to address the existing gap in current literature. An empirical investigation is carried out, focusing on individuals who use cosmetic products and are active followers of zero-waste beauty influencers on social media. Responses are gathered for data analysis with the help of partial least squares structural equation modelling (PLS-SEM). The results indicate that eco-friendly packaging, pro-environmental belief, and para-social interaction positively impact the altruistic motivation and purchase intention of consumers. Ultimately, these factors collectively contribute to the purchase of zero-waste cosmetic products. The findings of this study can provide valuable insights for policymakers and brand managers in the field of herbal cosmetic formulations. These insights can help in understanding the fundamental reasons that drive consumers to buy zero-waste cosmetic items, potentially leading to a decrease in ecological impact. Additionally, the study contributes to the theory of planned behaviour (TPB) by investigating consumers' purchase intention towards eco-friendly products and their zero-waste buying behaviour.

Testing an extended theory of planned behaviour in predicting Covid-19 vaccination intention over the course of the pandemic: A three-wave repeated cross-sectional study.

Background: Mass vaccination against Covid-19 has been recognised as the most effective strategy for overcoming the pandemic emergency and remains crucial in the ongoing efforts to mitigate the impact of the virus. The present study aimed to test the efficacy of an extended Theory of Planned Behaviour (TPB) model in predicting vaccination intention in three different phases of the pandemic. Understanding how psychological drivers of vaccine acceptance may have changed throughout the pandemic is essential for informing public health strategies and addressing vaccine hesitancy, even in the current post-pandemic context. Methods: Using a repeated cross-sectional survey, we tested the hypothesised extended TPB model (intention, attitude, subjective norms, perceived behavioural control, anticipated affective reactions, risk perception, trust in science, trust in institutions and religiosity) across three independent samples: before (T1: November-December 2020; N = 657), during (T2: March-May 2021; N = 818), and after (T3: February-March 2022; N = 605) the start of the vaccination campaign in Italy. Results: Results indicated significant differences between the time points in all investigated variables, pointing to a general trend of improvement in vaccine acceptability levels at T2 compared to T1, and a worsening at T3 compared to the other two time points. Interestingly, net of these differences, a multi-group Structural Equation Modeling analysis supported the invariance, across time, of the structural relationships examined within the extended TPB. Conclusion: Findings demonstrated the efficacy of the TPB in predicting Covid-19 vaccination intention at different stages of the pandemic, suggesting that the model, in its extended version, represents a valuable framework for designing interventions aimed at promoting vaccine acceptance.

Municipal solid waste management instruments that influence the use of the refuse as fuel in developing countries: A critical review.

Landfills are the destination of most of the refuse generated whereas composting, material recycling, and Waste-to-Energy (WtE) technologies are not commonly employed in developing countries. However, the destination for energy purposes could be supplied with this refuse, improving the viability of energy use. Thus, this article raises some questions to identify aspects that could encourage its use as refuse-derived fuel (RDF) in these countries. Among them, does environmental education affect the municipal solid waste (MSW) source separation with emphasis on a destination? Can selective collection and extended producer responsibility (EPR) affect the MSW for energy recovery? Is there competition between the recycling market and the energy market for RDF? A systematic review of the literature was conducted to gather data and provide answers to such questions. This enabled to observe that EPR, selective collect expansion and source separation influence the quantity and quality of waste sent for energy use. Both internal and external factors impact on source separation. Additionally, there is evidence to support that despite several studies showing their technical, economic, environmental and social viability, the methods of energy usage of the refuse still need to improve their deployment in developing countries. In addition to identifying the main research gaps to be filled in future studies, the article also identified the instruments of MSW management that are to be applied in developing countries to divert recyclable and organic waste from landfill.

"Let's talk about sleep health": Patient perspectives on willingness to engage in psychological interventions for insomnia.

BACKGROUND: Cognitive behavioural therapy for insomnia (CBT-I) is recommended as the first-line treatment yet remains underutilised in general practice. Understanding patient motivations and barriers to engaging in psychological interventions for insomnia is critical. Theoretical frameworks, such as the Theory of Planned Behaviour, are needed to identify variables related to intentions and behaviour change. AIM: To explore key influences that motivate individuals' intention to engage with psychological interventions for insomnia. DESIGN AND SETTING: An online survey and interviews with 20 community-dwelling participants with insomnia, aged 26-75 years. METHOD: Guided by the Theory of Planned Behaviour, reflexive thematic analysis was used to identify factors influencing participants' intention to engage with psychological interventions for insomnia. RESULTS: Participants reported positive attitudes towards psychological interventions for insomnia, stemming from negative beliefs about pharmacological sleep aids and the perceived benefits of a structured and evidence-based intervention. Important others positively influenced participants' intention to engage, however the GP influence was less consistent and often indirect. Participants believed in the efficacy of psychological interventions, but several barriers hampered their ability to benefit from them. Accessibility was identified as a key facilitator, whilst lack of knowledge and clear referral pathways were the main barriers impacting uptake. CONCLUSION: This study highlights key factors influencing patients' intention to engage in psychological interventions for insomnia as well as opportunities for GPs to support uptake and engagement. Routine conversations about sleep health are essential to reduce the burden of untreated insomnia in the community, and active promotion of evidence-based psychological interventions are needed.