Impact of vascular screening interventions on perceived threat, efficacy beliefs and behavioural intentions: a systematic narrative review.

Health-related behaviours contribute to the global burden of cardiovascular disease (CVD). Cardiovascular imaging can be used to screen asymptomatic individuals for increased risk of CVD to enable earlier interventions to promote health-related behaviours to prevent or reduce CVD risk. Some theories of behaviour and behaviour change assume that engagement in a given behaviour is a function of individual threat appraisals, beliefs regarding the performance of behaviour, self-efficacy for performing the desired behaviour and/or dispositions to act (e.g. behavioural intentions). To date, little is known about the impact of cardiovascular imaging interventions on these constructs. This article summarises evidence related to perceived threat, efficacy beliefs, and behavioural intentions after CVD screening. We identified 10 studies (2 RCTs and 8 non-randomised studies, n = 2498) through a combination of screening citations from published systematic reviews and meta-analyses and searching electronic databases. Of these, 7 measured behavioural intentions and perceived susceptibility and 3 measured efficacy beliefs. Findings showed largely encouraging effects of screening interventions on bolstering self-efficacy beliefs and strengthening behavioural intentions. Imaging results that suggest the presence of coronary or carotid artery disease also increased perceived susceptibility to CVD. However, the review also identified some gaps in the literature, such as a lack of guiding theoretical frameworks and assessments of critical determinants of health-related behaviours. By carefully considering the key issues highlighted in this review, we can make significant strides towards reducing CVD risks and improving population health.

This systematic narrative review sought to comprehensively report evidence related to individual responses to cardiovascular screening interventions. Theoretically, the study builds upon theories based on the cognitive perspective (e.g. Health Belief Model, Protection Motivation Theory), which supports the examination of individual perceptions of negative health-related outcomes or health risk, beliefs regarding the performance of a behaviour or outcome expectancies (e.g. perceived benefits of behavioural performance), personal control or capacity to perform a behaviour and/or willingness to invest the effort to engage in behaviour after behavioural intervention delivery. These concepts are considered key predictors of health-related behaviours and have been examined in several public health interventions. Using a variety of search strategies, studies that reported outcomes of interest were identified. Some studies showed that cardiovascular screening interventions may help people form the desired intention to engage in health-related behaviours. We also observed (largely) encouraging effects of cardiovascular screening interventions on individual confidence to engage in health-related behaviours and understanding of personal health risks. However, we identified some limitations in the design, delivery and outcomes assessed in the studies included. For future research, key recommendations to inform the design and delivery of health behaviour interventions are provided.

Predicting behavioural intentions towards medication safety among student and new graduate nurses across four countries.

AIMS AND OBJECTIVES: To identify final-year undergraduate students and new graduate nurses' behavioural intentions towards medication safety across four countries. BACKGROUND: Medication errors are a common and avoidable occurrence, being costly for not only patients but also for health systems and society. DESIGN: A multi-site cross-sectional study. METHODS: A self-administered survey was distributed to students and new graduate nurses in South Africa, India, Turkey and Australia. Descriptive statistics were calculated for all survey items. Multiple linear regressions were performed to predict behavioural intentions using the three Theory of Planned Behaviour constructs: attitudes, behavioural control and subjective norms. This study adheres to the STROBE guidelines. RESULTS: Data were analysed for 432 students and 576 new graduate nurses. Across all countries, new graduate nurses reported significantly higher scores on all the TPB variables compared with student nurses. Attitudes towards medication management were found significantly and positively related to intention to practice safe medication management for both student and new graduate nurses. Total perceived behavioural control was significantly and negatively related to intention to practice safe medication management for students. CONCLUSION: Student and new graduate nurses showed favourable attitude, subjective norm, perceived behaviour control and intention in practising medication safety. However, differences in countries require further exploration on the factors influencing attitudes towards medication safety among student nurses and new nurse graduates. RELEVANCE TO CLINICAL PRACTICE: Understanding student and new graduate nurses' medication administration practices is important to inform strategies aimed at improving patient safety. The findings of this study highlight the need for an internationally coordinated approach to ensure safe medication administration by student and new graduate nurses.

Nurses' behavioural intentions towards intravenous fluid administration for pediatric patients: Application of the theory of planned behaviour.

BACKGROUND: For pediatric patients, the demand for quality and safe Intravenous Fluid (IVF) therapy is huge. This is because, compared to adults, children have a lower tolerance for IVF therapy errors and present devastating physiological responses to errors. Nurses play a vital role in IVF administration; therefore, adequate knowledge, positive attitudes, positive perceived behavioural control, and good behavioural intentions are required to achieve effective and successful therapy, patient safety and prevention of complications, and overall positive patient outcomes. This study sought to assess the behaviour of nurses towards IVF administration for pediatric patients. METHOD: A cross-sectional facility-based study was designed and randomly recruited 112 nurses. The theory of planned behaviour was used as a conceptual framework to assess nurses' behavioural intentions towards IVF administration for pediatric patients. Mean scores and their respective standard deviations, reliability tests, exploratory factor analysis, and linear logistic regression were all performed using SPSS version 27, with the level of significance set at 0.05. RESULTS: Nurses' behavioural intentions for IVF administration for pediatric patients were influenced by their knowledge of standards and protocols for IVF use (ß = 0.320; p = 0.01), attitudes (ß = 0.339; p = 0.006) subjective norms (ß 0.240; p = 0.003) and perceived behavioural control (ß = 0.26; p = 0.001). CONCLUSION: Nurses' behavioural intentions for IVF administration were significantly influenced by their knowledge of procedures and standards for IVF administration. Additionally, the nurses' subjective norms, perceived behavioural control, and attitude towards IVF administration have a significant effect on their behavioural intentions to administer IVFs to pediatric patients. For nurses to administer IVF effectively, safely, and successfully to pediatric patients, there is a need to enhance their knowledge of standards and guidelines for IVF administration. The nurses need to have good attitudes and positive support and influence from all others to be able to administer IVFs safely and successfully to their pediatric patients.

Factors associated with using the internet for medical information based on the doctor-patient trust model: a cross-sectional study.

BACKGROUND: Internet medical care has been advancing steadily, especially during the coronavirus disease 2019 pandemic, the development momentum of Internet medical care in China is more vigorous. This study aimed to explore the factors associated with using the Internet for medical information, to examine the popularisation and implementation of Internet medical treatment and feasible strategies, and promote the further development of Internet medical treatment. METHODS: A cross-sectional study was conducted on 408 medical patients who had used online medical services. The one-way analysis of variance or independent samples t-test was used to compare the differences in the influence of demographic characteristics on behavioural intentions of different people seeking medical care. Pearson's correlation was used to evaluate the correlation between different measurement variables. A mediation regression analysis was used to explore the mediating role of trust in Internet medical care. RESULTS: The difference in the influence of Internet medical use frequency on the behavioural intention of different participants was statistically significant (F = 3.311, P = 0.038). Among the influencing factors, personal trust propensity (r = 0.387, P < 0.01), website credibility (r = 0.662, P < 0.01), hospital credibility (r = 0.629, P < 0.01), doctor's credibility (r = 0.746, P < 0.01), and online patient trust (r = 0.874, P < 0.01) were positively correlated with patients' behavioural intentions. In the analysis of intermediary factors, the total effect of the credibility of the diagnosis and treatment website on the behavioural intention of patients was 0.344. The total effect of the credibility of the diagnosis and treatment hospital on the behavioural intention of patients was 0.312; the total effect of the service doctor's credibility on the patient's behavioural intention was 0.385; the total effect of the personal trust tendency on the patient's behavioural intention was 0.296. CONCLUSIONS: This study found defects in various factors that produce distrust in Internet medical treatment. It also reveals the positive effect of trust factors on the development and implementation of Internet medical treatment and provides some ideas for improving the use of Internet medical treatment by the masses.

Does message framing affect changes in behavioural intentions in people with psoriasis? A randomized exploratory study examining health risk communication.

Message framing is important in health communication research to encourage behaviour change. Psoriasis, a long-term inflammatory skin condition, has additional comorbidities including high levels of anxiety and cardiovascular disease (CVD), making message framing particularly important. This experimental study aimed to: (1) identify whether health messages about psoriasis presented as either gain- or loss-framed were more effective for prompting changes in behavioural intentions (BI), (2) examine whether BI were driven by a desire to improve psoriasis or reduce CVD risk; (3) examine emotional reactions to message frame; and (4) examine predictors of BI. A two by two experiment examined the effects on BI of message frame (loss vs. gain) and message focus (psoriasis symptom reduction vs. CVD risk reduction). Participants with psoriasis (n = 217) were randomly allocated to one of four evidence-based health messages related to either smoking, alcohol, diet or physical activity, using an online questionnaire. BI was the primary outcome. Analysis of variance tests and hierarchical multiple regression analyses were conducted. A significant frame by focus interaction was found for BI to reduce alcohol intake (p = .023); loss-framed messages were more effective for CVD risk reduction information, whilst gain-framed messages were more effective for psoriasis symptom reduction information. Message framing effects were not found for BI for increased physical activity and improving diet. High CVD risk was a significant predictor  of increased BI for both alcohol reduction (ß = .290, p < .01) and increased physical activity (ß = -.231, p < .001). Message framing may be an important factor to consider depending on the health benefit emphasised (disease symptom reduction or CVD risk reduction) and patient-stated priorities. Condition-specific health messages in psoriasis populations may increase the likelihood of message effectiveness for alcohol reduction.

Food insecurity, overweight and obesity among low-income African-American families in Baltimore City: associations with food-related perceptions.

OBJECTIVE: To examine associations between food insecurity, excess body weight, psychosocial factors and food behaviours among low-income African-American families. DESIGN: Cross-sectional survey of participants in the baseline evaluation of the B'More Healthy Communities for Kids (BHCK) obesity prevention trial. We collected data on socio-economic factors, food source destinations, acquiring food, preparation methods, psychosocial factors, beliefs and attitudes, participation in food assistance programmes, anthropometry and food security. We used principal component analysis to identify patterns of food source destinations and logistic regression to examine associations. SETTING: Fourteen low-income, predominantly African-American neighbourhoods in Baltimore City, MD, USA. SUBJECTS: Two hundred and ninety-eight adult caregiver-child (10-14 years old) dyads. RESULTS: Of households, 41·6 % had some level of food insecurity and 12·4 % experienced some level of hunger. Food-insecure participants with hunger were significantly more likely to be unemployed and to have lower incomes. We found high rates of excess body weight (overweight and obesity) among adults and children (82·8 % and 37·9 % among food insecure without hunger, 89·2 % and 45·9 % among food insecure with hunger, respectively), although there were no significant differences by food security status. Food source usage patterns, food acquisition, preparation, knowledge, self-efficacy and intentions did not differ by food security. Food security was associated with perceptions that healthy foods are affordable and convenient. Greater caregiver body satisfaction was associated with food insecurity and excess body weight. CONCLUSIONS: In this setting, obesity and food insecurity are major problems. For many food-insecure families, perceptions of healthy foods may serve as additional barriers to their purchase and consumption.

Emphasizing the losses or the gains: Comparing situational and individual moderators of framed messages to promote fruit and vegetable intake.

Health messages are a commonly used way to promote changes in dietary habits but their efficacy could be enhanced by strategies such as the way in which the presented arguments are framed. This study aimed to test the effectiveness of framed messages (gain vs. loss) on behavioural intention and fruit and vegetable (FV) intake, comparing predictions based on prominent theoretical perspectives on message framing (function of the health behaviour and recipients' motivational orientation) and by further exploring the role of baseline intentions as a potential moderator of the framing effects. Undergraduate students (N = 180) completed the three assessment points in time. At baseline, individual moderators (motivational orientation and intentions) and fruit and vegetable intake were assessed. One week later, participants were randomly assigned to the loss or gain-framed message and indicated their intentions for FV intake the following week. A week later, FV intake over the previous week was assessed. The gain-frame was not conducive, per se, to higher intentions or behaviour. Having intention as the outcome, only baseline intentions moderated the effects of message frame. When considering FV intake as the outcome, both motivational orientation and baseline intentions moderated the effects of message frame, with the loss-frame promoting higher FV intake among individuals who were prevention-oriented and had higher baseline intentions. Findings suggest that the success of framed messages for FV intake depends upon the recipient's characteristics, such as motivational orientation, baseline intentions, and cultural background, with implications for health communication interventions.

The Influence of Muslim and Christian Destinations on Tourists' Behavioural Intentions and Risk Perceptions.

This paper studies the factors that influence tourists' risk perceptions of various destinations with different attributes and sociocultural profiles. Factor analysis is utilised to investigate the determinants of risk perceptions, finding that they are influenced both by the type of risk (delinquency, health, accident, environment and catastrophe) and by the characteristics of the destination regarding the management of risk. Structural equations modelling is conducted to study the relationships between risk perceptions, destination image and visiting intentions across destinations. Multi-group analysis across different destinations proves that tourists' risk perceptions have different influences on destination image and visiting intentions. The results show that there are significant differences according to the predominant religion at the destinations, i.e., Muslin and Christian. The implication is that different dimensions of perceived risks and destination socio-culture contexts have different influences on the behaviour of tourists.

Young Adults' Knowledge and Perceptions of Permanent Noise-Induced Tinnitus and its Influence on Behavioural Intentions.

Objective: Young adults' music-listening behaviours may put them at risk of developing permanent hearing loss and tinnitus. This study aimed to assess knowledge of permanent tinnitus and whether this knowledge may influence listening behaviours to a greater degree than knowledge of hearing loss. Materials and Methods: A two-group (between subjects), randomised post-test only, single-factor experimental design was used to determine the effects of health message focus (permanent tinnitus vs. permanent hearing loss) on the main outcome measure of protective behavioural intention. The sample included 109 male and 287 female adults, aged 18 to 25 years, living in the United Kingdom. The young adults' existing knowledge of either permanent hearing loss or permanent tinnitus was measured, and after exposure to a health message, their perceptions and resultant behavioural intentions were assessed and compared. The pooled data were used to test a proposed model of factors influencing hearing protective behavioural intention using path analysis. Results: Whilst 83% knew about the link with hearing loss, only 75% knew that loud music may cause permanent tinnitus. The participants viewed tinnitus as closer temporally than hearing loss, perceived themselves as equally susceptible to both, but perceived hearing loss as more severe. There was no significant difference in behavioural intention between the groups. Conclusion: Perceived susceptibility and severity have a positive effect on behavioural intentions. In light of these results, recommendations for future noise-damage prevention campaigns are made.

Personal experience with Covid-19 is associated with increased environmental concern and pro-environmental behavioral intentions.

Climate change attributable to human activities has created a global threat to humanity and the natural world. However, there is a tendency for people to view climate change as a threat primarily affecting those in far-away places and there is reluctance to engage in pro-environmental action, which is often costly. It is therefore crucial to understand the factors that shape willingness to engage in pro-environmental behavior. Existing research suggests that personal experience with the consequences of climate change may increase pro-environmental action, however it is unknown whether personal experiences in other non-environmental domains may have similar effects. The circumstances of the Covid-19 pandemic allowed us to conduct a quasi-natural experiment to examine the effects of personal experience with a different global threat, namely Covid-19, on environmental responses. Across two studies conducted among UK and US participants, we found that personal experience of Covid-19 was associated with pro-environmental behavioral intentions, and that this relationship was mediated by increased environmental concern. We found that personal experience with Covid-19 was associated with stronger self-transcendence values of universalism and benevolence, which played a further mediating role between personal experience with the virus and environmental concern. These findings suggest that personal experience with at least some global threats, even when not directly related to climate change, may increase concern for distant others and also sensitize people to environmental issues and motivate pro-environmental action.

Evaluating the Public Climate School-A School-Based Programme to Promote Climate Awareness and Action in Students: Protocol of a Cluster-Controlled Pilot Study.

Introduction: School-based programmes may promote knowledge and skills required to address climate change and better health and well-being in adolescents, yet evidence of their effectiveness is limited. In preparation for evaluating the Public Climate School, a school-based intervention to promote climate awareness and action in adolescents, we conduct a pilot study intended to assess procedures for participant recruitment, retention, and data collection, data quality issues and to provide preliminary parameter estimates to guide sample size calculations. Methods and analysis: This unblinded, cluster-controlled pilot study targets students in twelve classes from grades seven to thirteen in German public schools. Seven and five classes were allocated to the intervention and waitlist control arms, respectively. The intervention consisted of (1) live lessons on YouTube, (2) climate-related challenges of the day, (3) workshops and (4) peer exchange sessions. Waitlist control classes participated three weeks later. Measures included the proportion of students completing baseline and follow-up surveys, a comparison of baseline characteristics between students in the retained subsample and those lost to follow-up, proportions of students completing online and paper-pencil-based surveys and problems during data collection based on information reported by teachers. Data quality was assessed as proportions of missing data, associations between missingness and sociodemographic measures using logistic regression models and basic psychometric properties of scales including ceiling effects and internal consistency. Intentions to reduce one's ecological footprint, the primary outcome, and all secondary outcomes for effect estimation were assessed one week pre- and post-intervention from November to December 2021 using items adapted from internationally used instruments and will be investigated using generalised linear mixed models and intention-to-treat analyses. Conclusions: The pilot study will lay the methodological groundwork for a large-scale cluster-randomised effectiveness and process evaluation of the Public Climate School. If proven effective and rolled out more broadly, the Public Climate School has the potential to contribute meaningfully to national climate mitigation and adaptation efforts by reaching a substantial share of adolescents in public schools, including those traditionally less involved in climate action.

Experience or attribution? Exploring the relationship between personal experience, political affiliation, and subjective attributions with mitigation behavioural intentions and COVID-19 recovery policy support.

Scholars argue that personal experience with climate change related impacts can increase public engagement, with mixed empirical evidence. Previous studies have almost exclusively focussed on individuals' experience with extreme weather events, even as scientific research on health impacts of climate change is burgeoning. This article extends previous research in the domain of public perceptions about climate-related public health impacts. Results from a nationally representative sample survey in New Zealand indicates that subjective attribution of infectious disease outbreaks to climate change and to human impact on the environment is positively associated with mitigation behavioural intentions and climate-focussed COVID-19 economic recovery policies. In contrast, knowledge about COVID-19 and self-reported economic impact due to COVID-19 is not associated with policy support. Moreover, significant interaction between political affiliation and subjective attribution to climate change on policy support indicate that learning about the links between health and climate change will particularly help increase mitigation engagement among right-leaning individuals. Subjective attribution may be the key to help translate personal experience to personal engagement.

Exploring the relationship between mastitis risk perceptions and farmers' readiness to engage in milk recording.

The need to move towards Selective Dry Cow Therapy (SDCT) has become increasingly pertinent as a means to reduce the use of antibiotics in the dairy sector. With the EU 2022 ban on prophylactic antibiotics at drying off, practices on some farms will need to drastically change. In Ireland, one particular challenge to the sector-wide transition to SDCT is the lack of widespread uptake of milk recording across dairy farms, a decision support tool which can support mastitis control and help identify cows to select for SDCT. The current study examined readiness to engage in milk recording amongst Irish dairy farmers, and specifically investigated the role of mastitis risk perceptions in shaping farmers' readiness. The study explores the multifaceted nature of risk perception as a construct shaping farmers' attitudes. An online survey was carried out with 197 Irish dairy farmers exploring their attitudes towards mastitis and milk recording. A cluster analysis classified farmers according to their mastitis risk perceptions, with 3 segments identified with differing risk perception profiles. Elevated mastitis risk perceptions were linked to an increased readiness to milk record. However, this relationship was not universal across all farmers. One segment of farmers in the current study maintain low mastitis risk perceptions and remain unmotivated to engage in milk recording. The study concludes that targeted risk communication strategies related to mastitis and milk recording are needed to encourage the move towards SDCT and reduced AMR. Results suggest that the types of risk communication strategies - message framing and two-way risk communication - should reflect farmers' types of mastitis risk perceptions to have the most effective impact on milk recording uptake.

Understanding Our Peers with Pablo: Exploring the Merit of an Autism Spectrum Disorder De-stigmatisation Programme Targeting Peers in Irish Early Education Mainstream Settings.

The political drive for inclusion means there are increasing numbers of children with autism spectrum disorder (ASD) being educated alongside their neurotypical peers. Pervasive victimisation has prompted the development of peer interventions targeting stigma. This study evaluated the 'Understanding Our Peers with Pablo' programme for effects on knowledge, attitudes and behavioural intentions of infant schoolchildren (N = 222) towards autistic peers. Classes were randomly assigned to an intervention or waitlist control condition. Change over time in knowledge of autism and attitudes and behavioural intentions towards familiar and unfamiliar peers was analysed using mixed analyses of variance. The intervention condition showed gains in knowledge and increased positive attitudes towards unfamiliar autistic peers (maintained over three-months). There were significant improvements in attitudes towards familiar autistic peers, and time-limited decreases in behavioural intentions across both conditions. Overall, results support the use of this programme in early-years education.

Data on corona-virus readiness strategies influencing customer satisfaction and customer behavioural intentions in South African retail stores.

This article presents raw inferential statistical data that determined the coronavirus readiness strategies at retail stores in South Africa and their consequences for consumer behavioural intentions. The data was collected from customers within the metropolitan area of Bloemfontein. The data were analysed using a quantitative approach. Structured questionnaires were provided to customers throughout South Africa's Bloemfontein metropolitan area. Reliability and validity were confirmed. The data was presented using Structural Equation modelling (SEM) using the Smart PLS program. The analysis of the SEM path shows estimates of the interconnectivity of the major constructs in the data. The findings from this dataset show that sanitised retail entrances, sanitised retail counters and sanitised retail shelves had a statistically significant effect on customer satisfaction with covid-19 readiness in retail stores. Furthermore, the data reveals that retail social distancing and senior citizens shopping hours had a statistically insignificant effect on customer satisfaction with covid-19 readiness. Moreover, the data reveals that customer satisfaction with covid-19 readiness strategies of retail stores also had a positive and statistically significant effect on customer behavioural intentions.

Development of a questionnaire to measure consumers' perceptions of service quality in community pharmacies.

BACKGROUND: Recent changes within community pharmacy have seen a shift towards some pharmacies providing "value-added" services. However, providing high levels of service is resource intensive yet revenues from dispensing are declining. Of significance therefore, is how consumers perceive service quality (SQ). However, at present there are no validated and reliable instruments to measure consumers' perceptions of SQ in Australian community pharmacies. OBJECTIVES: The aim of this study was to build a theory-grounded model of service quality (SQ) in community pharmacies and to create a valid survey instrument to measure consumers' perceptions of service quality. METHODS: Stage 1 dealt with item generation using theory, prior research and qualitative interviews with pharmacy consumers. Selected items were then subjected to content validity and face validity. Stages 2 and 3 included psychometric testing among English-speaking adult consumers of Australian pharmacies. Exploratory factor analysis was used for item reduction and to explain the domains of SQ. RESULTS: In stage 1, item generation for SQ initially generated 113 items which were then refined, through content and face validity, down to 61 items. In stage 2, after subjecting the questionnaire to psychometric testing on the data from the first pharmacy (n = 374), the use of the primary dimensions of SQ was abandoned leaving 32 items representing 5 domains of SQ. In stage 3, the questionnaire was subject to further testing and item reduction in 3 other pharmacies (n = 320). SQ was best described using 23 items representing 6 domains: 'health and medicines advice', 'relationship quality', 'technical quality', 'environmental quality', 'non-prescription service', and 'health outcomes'. CONCLUSION: This research presents a theoretically-grounded and robust measurement scale developed for consumer perceptions of SQ in a community pharmacy.

Gender and age differences in pre-schoolers' weight bias beliefs and behavioural intentions.

Weight bias is present in children as young as 3 years old; however, research regarding gender differences is mixed. This study examined gender and age differences in weight bias attitudes in a sample of 3- to 5-year-old pre-schoolers. Children assigned positive or negative adjectives to thin, average, or large targets and selected one of these targets as their best friend. Girls showed a larger weight bias than boys in both tasks, and weight bias increased with age in the adjective attribution task. Findings clarify previously mixed gender results and demonstrate that while weight bias beliefs strengthen during the pre-school years, weight bias behavioural intentions do not. The results highlight the importance of continued efforts to address weight bias in young children. Statement of contribution What is already known on this subject? Weight bias is linked to negative consequences in young children. Children as young as 3 years old demonstrate weight bias. Findings regarding gender differences in weight bias in pre-schoolers are mixed. What does this study add? Girls demonstrated higher weight bias than boys in an adjective attribution and best friend selection task. Weight bias increased with age in the adjective attribution task but not in the friend selection task. Weight bias beliefs strengthen during the pre-school years; however, weight bias behavioural intentions do not.

Age Group Differences in Household Accident Risk Perceptions and Intentions to Reduce Hazards.

Very little is known about the extent to which seemingly vulnerable younger and older adults appraise household risks and relatedly whether safety information focused on raising risk awareness influences intentions to reduce hazards in the home. The present study assessed age differences in accident experience, risk attitudes, household accident risk perceptions, comparative optimism, personal control, efficacy judgements, and intentions to remove household hazards. It also examined the predictors of these intentions. Thirty-eight younger adults (aged 18 to 25) and forty older adults (aged 65 to 87) completed study booklets containing all measures. There were significant age group differences for all accident experience and risk-related variables. Younger adults experienced more accidents, had riskier attitudes, and had significantly lower cognitive risk perceptions (i.e., they were less likely to be injured due to a household accident). They also had lower affective risk perceptions (i.e., they were less worried) about their accident risk and perceived more personal control over the risk compared with older adults. Young adults were comparatively optimistic about their risk while older adults were pessimistic. Older adults had higher response efficacy and intentions to reduce hazards in the home. Only worry, response efficacy, and risk attitudes predicted intention, however, these relationships were not moderated by age or efficacy appraisal. Although tentative theoretical and practical implications are presented, further research is required in order to better understand the objective and subjective risk associated with household accidents, and to determine the factors that may improve safety, particularly for those most vulnerable.

Relationships among perceived quality of healthcare services, satisfaction and behavioural intentions of international students in Kuala Lumpur, Malaysia: a cross-sectional study.

OBJECTIVE: The current study aimed to investigate the relationships among the perceived quality of healthcare services, satisfaction and behavioural intentions among international students in Kuala Lumpur, Malaysia. SETTING: A cross-sectional study on public universities in Kuala Lumpur, Malaysia. PARTICIPANTS: All participants in this study were international students joining public universities in Kuala Lumpur, Malaysia. PRIMARY INDEPENDENT VARIABLE: Perceived quality of healthcare services measured on a SERVQUAL scale. PRIMARY DEPENDENT VARIABLE: Participants' satisfaction of healthcare services assessed using five items. SECONDARY DEPENDENT VARIABLE: Behavioural intentions measured on six items. RESULTS: Of the 556 international students, 500 (90%) completed the survey. The study used structural equation modelling (SEM) through the AMOS (Analysis of Moment Structures) software to analyse the data. SEM analyses showed that the perceived quality of healthcare services significantly and directly affected satisfaction, with a value of 89% and an effect size of 0.78. It also had a significant indirect impact on the behavioural intentions (0.78) of international students. The results indicated that participants' satisfaction had a statistically significant impact on their behavioural intentions (0.77). CONCLUSION: Perceived quality of care is an important driver of international students' satisfaction and their behavioural intention with healthcare services. Such relations of effects among the three investigated factors were also positive and significant.

Positive and negative behavioural intentions towards refugees in Turkey: The roles of national identification, threat, and humanitarian concern.

The present research investigated positive and negative behavioural intentions towards Syrian refugees in Turkey. The behavioural intentions were examined in relation to national identification, perception of threat, and humanitarian concerns. A questionnaire was conducted among Turkish participants (n = 605) and the results showed that respondents made a distinction between negative and positive behavioural intentions towards Syrian refugees. Further, higher national identification was associated with more negative and less positive behavioural intentions, and perception of threat was responsible for these associations. In addition, humanitarian concern was associated with more positive behavioural intentions and less negative ones. Additionally, stronger humanitarian concern weakened the association between threat perceptions and negative behavioural intentions but also strengthened the association between higher threat and lower positive behavioural intentions.