Application of the theory of planned behavior to model the intention and behavior of tomato growers in pesticide exposure.

Widespread and indiscriminate use of pesticides has become one of the most important environmental and public health problems around the world. This study was conducted with the aim of applying the theory of planned behavior model to investigate the knowledge, attitude, and behavior of tomato growers in the face of pesticides in agricultural lands located in Kurdistan province, western Iran. We included 300 tomato growers in this study and they filled up a standard TPB questionnaire containing questions about basic information, knowledge, attitude and behavior about pesticides and their actions for disposing of the residual spray solution, washing place of pesticide sprayer, and the disposal of water from washing the equipment. Most of the respondents, 86.7 %, had not participated in promotional classes on how to dispose of the residual solution. Approximately 46.15, 38.46, and 15.39 % of pesticides contained moderately toxic, slightly toxic and practically non-toxic compounds, respectively. More than two-thirds (89 %) of the tomato growers stated that they leave the water from washing the equipment in the field. In addition, among the three variables of TPB, attitudes had the highest score (3.38), which indicated the positive to relatively neutral attitude of farmers towards the safe use of pesticides. These findings can be useful for planners and environmental organizations to make effective interventions to reduce environmental pollution caused by pesticides. Since the incorrect use of pesticides is one of the important environmental and health factors, education and awareness programs can help farmers to consider the correct use of pesticides and environmental protection more.

Do two-wheeler riders propel towards autonomous driving? A path-based probabilistic study in Indian context.

Regardless of the rational benefits of autonomous vehicle adoption towards mitigating mobility goals in urban and sub-urban areas of middle-income countries, adoption of such technology remains thought-provoking. Two wheeled vehicles are often utilized extensively all over the world for short distance trips in sub-urban areas. The present study investigates perceived risks of using four wheeled autonomous vehicles by captive two-wheeler riders for long and short distance trips in densely populated Indian cities. Theoretical autonomous vehicle technology acceptance models were modified considering Indian perceptions in this study. Offline stated preference responses were collected from various universities, open public spaces and governmental organizations of various cities within India. Structural equation models (SEM) and Random Forest (RF) were employed to generate meaningful insights from the surveys conducted. Random Forest (RF) analysis concluded that bicycle riders show medium to low levels of trust towards behavioural adoption intention of autonomous vehicles. According to proposed structural equation models, interest to adopt or willingness to buy autonomous vehicles for two wheeled vehicle users is mostly influenced by perceived trust and risk rather than perceived concerns/benefits for middle and old age groups in India. Perceived ease of use has the most significant marginal effects on two-wheeler riders' perceived risks towards autonomous vehicle adoption, which accounted for more than 20 % of unexplained variance. Results from this research may offer insightful diversity of attitudes towards adoption of autonomous vehicle technologies in India through the means of increased efficiency and reduced travel time and costs along with riders' risks towards privacy and safety.

Hindrance stressors and turnover intentions among preschool teachers: The mediating role of work engagement and the moderating effect of meaningful work.

Background: Teacher turnover in preschool settings poses significant challenges to educational quality and stability. Understanding the factors that influence turnover intentions is crucial for developing effective retention strategies. Objective: This study aims to explore the relationships between hindrance stressors and turnover intentions among preschool teachers, with a particular focus on the mediating role of work engagement and the moderating effect of meaningful work. Methods: Participants were recruited from Shanghai, China. The study involved 220 preschool teachers, with a mean age of 32.35 years, the majority of whom were female. All participants completed the Hindrance Stressors Scale, the Turnover Intention Scale, the Work and Meaning Inventory, and the Utrecht Work Engagement Scale. Results: Findings indicate a positive association between hindrance stressors and turnover intentions, partially mediated by decreased work engagement. Additionally, meaningful work was found to moderate the relationship between hindrance stressors and work engagement; it can mitigate the adverse effects of hindrance stressors on work engagement. Conclusion: Addressing hindrance stressors and fostering work engagement and meaningful work are essential for mitigating turnover intentions. These insights offer valuable guidance for educational administrators in enhancing teacher retention and improving workplace well-being.

Effect of label elements in bottled water: Impact on consumer preferences, purchase intentions and health perception through affective sensory tests.

Bottled water has become a popular beverage choice worldwide, with consumers increasingly seeking healthier options. However, label elements can significantly influence consumer perception and purchasing decisions. The research aimed to assess how label elements affect the liking, purchase intention, preference and concept of healthy bottled water. Two stages involved 180 and 100 participants aged between 18 and 40, provided sociodemographic information. The first stage used a hedonic scale and ranking test to perception of nine labels with different elements. The second stage selected a consensus label from prior tests. Four labels were designed, differing in brand color and nutritional information placement. In this last stage, the acceptability, preference ranking and concept of healthy were re-evaluated and eye tracking via the Pupil Lab program. Findings showed varied responses in acceptability and purchase intention among consumers. However, significant differences were observed in preferences and healthiness perceptions based on label characteristics. The label with the highest preference and perceived healthiness featured a sky-blue design with nutritional information on the right side. Combining sensory testing and eye tracking offers valuable insights for designing labels that positively impact consumer perception. The results provide important implications for bottled water manufacturers and marketers in developing effective labeling strategies to meet consumer preferences and promote healthier choices.

Classroom intervention to improve behavioral intention toward regular physical activity among adolescents.

Background: During adolescence, a critical phase in human life, the groundwork for a healthful future is established. Physical inactivity poses a significant risk factor for non-communicable diseases (NCDs) and related mortality worldwide. To assess adolescents' behavioral intentions regarding regular physical activity, the Theory of Planned Behavior (TPB) examines 'Attitude,' 'Subjective norm,' and 'Perceived behavioral control.' Utilizing TPB, this study focuses on evaluating the impact of a school-based health promotion intervention on behavioral intentions toward physical activity among urban adolescents in West Bengal, India. Methods: A school-based nonrandomized controlled interventional study with parallel group design was conducted among adolescents aged between 12 and 16 years. Behavioral intention towards performing regular physical activity was determined with the measurements of the constructs from the TPB. Cluster analysis was conducted using measurements from both the intervention and control groups. Participants with higher mean scores in the constructs were classified as intenders, while the rest were considered non-intenders. The intervention's impact was evaluated by calculating the Relative Risk (RR) through a generalized linear model with robust standard error estimates, to ascertain the probability of belonging to the higher intention cluster. Result: Following the intervention, construct-wise scores improved significantly, particularly the perceived behavioral control mean score in the intervention group. The Relative Risk (RR) of becoming an intender for regular physical activity in the intervention group was 1.24 (95% CI: 1.04-1.48) when compared to the control group. Conclusion: Health Promoting Schools has been recognized as a strategic and cost-effective vehicle to promote positive development and healthful living, and the current evidence suggests they can effectively reduce the emergence of significant NCD risk factor like physical inactivity. Schools must establish strong partnerships with diverse stakeholders to address barriers beyond the school environment and enhance their control over critical issues.

Choice intention for the national volume-based procurement drug and its associated factors: a cross-sectional study on patients with late-life depression in China.

BACKGROUND: The national volume-based procurement (NVBP) policy has significantly decreased prices and increased the accessibility of NVBP drugs. Nevertheless, issues such as heightened adverse reactions and suboptimal efficacy have arisen. Concerns regarding the quality of low-cost medications and the absence of long-term research have been widely recognized. This has led to caution among patients with late-life depression (LLD) due to their delicate health and the severity of their condition. This study evaluated the choice intention for NVBP drugs and associated factors in older patients with LLD. METHODS: A weighted sample of 408 participants between December 2022 and March 2023 were included. Data were collected via face-to-face interviews and questionnaires. To identify significant associated factors of choice intention, a multilevel logistic regression model was employed. RESULTS: Over half (53.68%) of older patients with LLD intended to choose NVBP drugs. Associated factors included self-assessed poor economy, higher out-of-pocket expenses, monthly household income exceeding CNY 6000, absence of other non-communicable chronic diseases, ordinary registration, urban employee medical insurance, no requirements for brand-name drugs, adverse reactions after using NVBP drugs, and rejection of physicians' recommendation for NVBP drugs. The interaction effect between the real economic condition and patients self-assessed economy significantly influences choice intention for NVBP drugs. Among 124 patients with self-assessed poor economy, 75 showed a higher intention to use NVBP drugs. In these patients, age, medical insurance reimbursement, and brand awareness were significantly associated with choice intention. CONCLUSION: Economic factors, physical conditions, medical needs, and physician recommendations significantly influenced the choice intention for NVBP drugs. The choice intention can be improved by strengthening physician-patient communication, increasing the scope and proportion of medical insurance reimbursement, improving substitution studies, and conducting post-marketing re-evaluations of NVBP drugs.

Correlates of burnout and dropout intentions in medical students: A cross-sectional study.

BACKGROUND: Burnout is a pervasive issue among medical students, exhibiting a high prevalence that jeopardizes their academic success and may also predispose them to more severe affective disorders such as depression. This study aims to explore the complex relationships between psychological capital (PsyCap), general social support, educational satisfaction, and burnout, and how these factors collectively influence dropout intentions. METHODS: A non-probabilistic convenience sample was collected through an online survey from first- and second-year medical students at a Faculty of Medicine in Portugal. The survey employed psychometric instruments to measure burnout (BAT-12), social support (F-SozU K-6), PsyCap (CPC-12R), satisfaction with education, and dropout intentions (Screening Instrument for Students At-Risk of Dropping Out). Structural equation modeling was applied to analyze the data from 351 participants. RESULTS: The model demonstrated a significant positive association between burnout and dropout intentions (ß̂ = 0.37; p < 0.001), underscoring burnout as a direct correlate of dropout intentions alongside educational satisfaction (ß̂ = -0.25; p = 0.003) and PsyCap (ß̂ = -0.22; p = 0.005). Higher social support is associated with reduced burnout (ß̂ = -0.28; p < 0.001) and increased educational satisfaction (ß̂ = 0.22; p = 0.002). LIMITATIONS: The non-probabilistic sampling method prevents the generalization of the findings. The cross-sectional data do not permit the inference of temporal relationships between the studied variables. CONCLUSIONS: These findings emphasize the importance that burnout may have on dropout intentions, and contribute to the understanding of affective syndromes such as burnout in educational settings.

Continuous Insulin Therapy to Prevent Post-Transplant Diabetes Mellitus: A Randomized Controlled Trial.

Rationale & Objectives: Hyperglycemia is frequently observed early after transplantation and associated with development of post-transplant diabetes mellitus (PTDM). Here, we assessed continuous subcutaneous insulin infusion (CSII) targeting afternoon hyperglycemia. Study Design: Open-label randomized parallel 3-arm design. Settings & Participants: In total, 85 kidney transplant recipients without previous diabetes diagnosis were randomized to postoperative CSII therapy, basal insulin, or control. Interventions: Insulin was to be initiated at afternoon capillary blood glucose level of ≥140 mg/dL (7.8 mmol/L; CSII and basal insulin) or fasting plasma glucose level of ≥200 mg/dL (11.1 mmol/L; control). Outcomes: Hemoglobin A1c (HbA1c) levels at 3 months post-transplant (primary endpoint). PTDM assessed using oral glucose tolerance test at 12 and 24 months. Results: CSII therapy lasted until median day 18 and maximum day 88. The median HbA1c value at month 3 was 5.6% (38 mmol/mol) in the CSII group versus 5.7% (39 mmol/mol) in the control group (P = 0.70) and 5.4% (36 mmol/mol) in the basal insulin group (P = 0.02). At months 12 and 24, the odds for PTDM were similar compared with the control group (odds ratios [95% confidence intervals], 0.80 [0.18-3.49] and 0.71 [0.15-3.16], respectively) and the basal insulin group (0.96 [0.18-5.68] and 1.51 [0.24-12.84], respectively). Mild hypoglycemia events occurred in the CSII and the basal insulin groups. Limitations: This study is limited by outdated insulin pump technology, frequent discontinuations of CSII, a complex protocol, and concerns regarding reliability of HbA1c measurements. Conclusions: CSII therapy was not superior at reducing HbA1c levels at month 3 or PTDM prevalence at months 12 and 24 compared with the control or basal insulin group.

An initial assessment of an opinion leader-informed intervention to improve concussion-related outcomes among middle school parents: a randomized controlled trial.

INTRODUCTION: There is a need for evidence-based prevention programming that can reduce head impacts and increase reporting and disclosure of concussion. This study assessed an intervention to decrease concussion risk and improve concussion management through improving concussion-related knowledge, attitudes, intentions, and self-efficacy among parents in the middle school (MS) sport setting. PATIENTS AND METHODS: This randomized controlled trial (NCT04841473) examined parents of MS-aged children. Participants were randomized into one of two study arms: (1) CDC, which completed an education training module that compiled concussion education from the Centers for Disease Control and Prevention (CDC); and (2) TRAIN + CDC, which completed the CDC training module and an additional TRAIN educational module that provided strategies (originating from the Popular Opinion Leader framework) on communicating such information with one's personal peer networks and children. Validated measures of concussion-related knowledge, attitudes, intentions, and self-efficacy were collected before completing the training modules and one week following completion. Linear mixed model analyses examined differences in outcomes between study arms. RESULTS: Overall, 103 parents completed the training modules and had valid pre- and post-intervention data (TRAIN + CDC n = 49; CDC n = 54). Analyses found that the study arms did not differ in the change scores from pre- to post-intervention across concussion-related outcomes. However, scores from pre- to post-intervention improved across both study arms for knowledge metrics, such as 'Concussions are less likely to happen when athletes play by the rules of the sport' (p < 0.001), and self-efficacy metrics, such as feeling confident in one's knowledge and recognition of concussion symptoms (p < 0.001 and p = 0.001, respectively). CONCLUSIONS: Although study arms did not differ in change scores from pre- to post-intervention, beneficial increases were nonetheless found across both knowledge and self-efficacy. Additional research is needed to further examine the beneficial manners in which concussion education can be best delivered and the most effective.

How online pro-environmental games affect users' pro-environmental behavioural intentions? - Insights from Ant Forest.

Information technology has created new ways for people to participate in environmental protection. Ant Forest, a pro-environmental game that actively encourages users to take part in offline environmental activities through online gaming content, has gained great popularity. However, research in this area is still limited, and the effect of playing such games on users' pro-environmental intentions in real life and the underlying mechanisms are unknown. Therefore, this research draws from Persuasive Systems Design model and value theory and examines the relationships between design features of Ant Forest, users' values and their pro-environmental behavioural intentions. The research model is empirically tested by survey data from 428 Ant Forest users. Results indicate that users' self-enhancement values, including utilitarian, hedonic and social values, and self-transcendence values, including altruistic and biospheric values, all positively affect their continued gameplay intentions and therefore affect their pro-environmental behavioural intentions. Additionally, the primary task support, social support, dialogue support, and system credibility of Ant Forest have varying positive effects on users' perceived values.

Moral resilience and intention to leave: Mediating effect of moral distress.

AIMS: This study aims to examine the mediating effect of moral distress on the relationship between moral resilience and the intention to leave. BACKGROUND: Moral distress is a phenomenon that negatively impacts healthcare workers, healthcare institutions, and recipients. To eliminate or minimize the negative effects of moral distress, it is necessary to increase the moral resilience of nurses. Moral resilience is important in protecting against the negative effects of moral distress, such as burnout and turnover intention. In this direction, it is necessary to increase the moral resilience of nurses to reduce negative situations such as turnover intention in nurses. METHODS: It is a descriptive-predictive study. Sociodemographic Information Form, Measure of Moral Distress - Healthcare Professionals, and Rushton Moral Resilience Scale were used to collect data from the nurses. A total of 220 clinical nurses were recruited. ETHICAL CONSIDERATIONS: Approval was obtained from the university's non-interventional ethics committee, and informed consent was obtained from the participants. RESULTS: The study found a total moral distress score of 6.39 ± 0.3.12 and moral resilience score of 2.69 ± 0.48. A moderate and weak negative correlation was found between moral distress and moral resilience. Moral distress has a moderating effect on the intention to leave nursing (ß = -0.158, p = .010) and the intention to leave the current position (ß = -0.174, p = .000). Individual's moral resilience directly affects the intention to leave. The presence of moral distress eliminates the direct effect of moral resilience and affects the intention to leave together with moral resilience. CONCLUSIONS: Moral resilience leads to decreased intention to leave, and moral distress mediates this situation. An increase in moral distress decreases moral resilience and increases intention to leave. It can be assumed that if moral distress is not controlled, increasing moral resilience will not affect the intention to leave the job.

The impact of deep learning based- psychological capital with ideological and political education on entrepreneurial intentions.

The aim of this study is to investigate the influence of psychological capital on college students' entrepreneurial intentions. Through a combination of relevant analysis and linear regression, the primary focus is on exploring the relationship between psychological capital and its four dimensions with entrepreneurial intentions. Firstly, the items in the psychological capital questionnaire were revised to align more closely with entrepreneurial contexts. Subsequently, the average deviations and standard deviations of each dimension of psychological capital were analyzed. Then, the correlation between psychological capital and entrepreneurial intentions was examined to explore the extent of their relationship. Finally, regression analysis was conducted on both psychological capital and entrepreneurial intentions, and utilizing a recurrent neural network model, the covariant relationship between entrepreneurial psychological capital and intentions was explored. The results indicated that the average scores for entrepreneurial self-efficacy, optimism, hope, and resilience were 3.91, 4.27, 4.19, and 4.15, respectively. The average value of psychological capital was 4.13, indicating a moderately high level. The correlation analysis between psychological capital and entrepreneurial intentions yielded a result of 0.562, indicating a moderate degree of correlation. The correlation coefficients of the four dimensions with entrepreneurial intentions were 0.390, 0.494, 0.531, and 0.467, respectively. The standardized coefficients for psychological capital and its four dimensions were 0.564, 0.382, 0.510, 0.536, and 0.468, all of which were statistically significant. Overall, psychological capital exhibited better predictive power for entrepreneurial intentions than its individual dimensions. The results from the deep learning model similarly demonstrated the positive role of psychological capital in entrepreneurial intentions, though the influence of ideological and political education (IPE) factors was relatively weaker. In conclusion, both psychological capital and IPE have a promotive effect on entrepreneurial intentions. This study provides a reference for the accurate evaluation of college students' entrepreneurial intentions.

Vaccine literacy, vaccination intention, and their correlation among adults in Mainland China: a cross-sectional study.

BACKGROUND: Vaccination is one of the most economic and effective strategies for preventing infectious diseases. However, public intention to be vaccinated is, to a certain degree, influenced by issues related to vaccine hesitancy, anti-vaccine movement, and public concerns about safety and adverse effects. Vaccine literacy is considered as a positive factor in improving vaccination intention, however, the correlation between vaccine literacy and vaccination intention has not been thoroughly investigated in mainland China. This study aims to (1) explore the correlation between vaccine literacy and vaccination intention among adults in mainland China; (2) investigate whether participants could seek out vaccine information on their own initiative and whether they knew basic information of common vaccines. METHODS: An online cross-sectional survey was conducted on 614 adult participants from 27 May to 8 June 2023 by a convenience sampling. Data were collected by using the questionnaire of demographic characteristics, vaccine literacy, vaccination intention, initiative of seeking out vaccine information, and basic vaccine quiz about common vaccines. Data were analyzed by using IBM SPSS version 24.0 at a significance level of 0.05. RESULTS: The mean scores of functional, and interactive-critical vaccine literacy were 2.97 ± 0.70 and 2.73 ± 0.66; the vaccination intentions of influenza, hepatitis B, COVID-19 and HPV were 58.5%, 80.0%, 71.3% and 62.9% respectively; interactive-critical vaccine literacy was significantly and positively associated with vaccination intention. The results also showed: 71.4% of the participants could seek out vaccine information on their own initiative, however, a certain proportion of the participants merely knew vaccine names and did not know basic information of common vaccines, especially influenza vaccine and hepatitis B vaccine. CONCLUSIONS: There is still room for improvement in vaccine literacy, vaccination intention of influenza and HPV vaccines, and basic vaccine information. Based on the significantly positive correlation between interactive-critical vaccine literacy and vaccination intention, it is advisable to harness vaccine literacy to boost vaccination intention by communicating and learning basic information of common vaccines.

The relationship between nurses' burnout status and their intention to leave during the COVID-19 pandemic process.

AIM: The aim of this research is to determine the relationship between nurses' burnout status and their intention to leave the job during the COVID-19 pandemic. MATERIALS AND METHODS: The population of the descriptive study, which seeks a relationship, consists of nurses working in State Hospital, the sample consists of 213 nurses who agreed to participate in the research between April 2021 and August 2021. Data were collected using the 'Personal Data Collection Form', 'Burnout Scale' and 'Intention to Leave Scale'. Ethics committee approval was obtained for the study. RESULTS: Of the participants, 75.6% were women, 91.1% cared for patients with a diagnosis of COVID-19. The participants' Burnout Scale mean score was 4.34 ± 1.10, and the Intention to Leave Scale mean score was 2.94 ± 1.04. The relationship between burnout and age, gender, marital status, income status, unit of work, professional experience, choosing the profession voluntarily, being happy to do the job and caring for a patient with COVID-19 was found to be statistically significant (p < 0.05). It has been concluded that age, income status, unit of work, professional experience, choosing the profession willingly and being happy to do the job affect the intention to leave the job. A positive and significant relationship was found between the mean scores of the Burnout Scale and the mean scores of the Intention to Leave Scale. CONCLUSION: This study determined that as nurses' burnout level increased, their intention to quit their jobs increased.

Exploring the influence of live streaming on consumer purchase intention: A structural equation modeling approach in the Chinese E-commerce sector.

The e-commerce landscape is evolving rapidly, and businesses seek novel ways to enhance their competitive edge. In this context, understanding consumers' purchase intentions becomes crucial. Drawing from the Stimulus-Organism-Response (SOR) theory, we propose a conceptual framework investigating the factors influencing purchase intention in e-commerce live-streaming marketing. The research adopts Structural Equation Modeling (SEM), Confirmatory Factor Analysis (CFA), and hypothesis testing to evaluate the relationships. The findings revealed that the attributes of live streaming, including the live streamer, the product, and the field, as well as trust and impulsiveness, positively influence purchase intention. This study provides a novel perspective on live streaming e-commerce with evidence on how e-commerce live streaming drives purchase intentions, enriches the content of live streaming e-commerce literature, and explores the practical implications for marketing managers who are looking for marketing by live streaming.

Factors influencing recommendation intentions for autonomous vehicles: A path analysis in a pilot study.

Over the past decade, the rapid development of artificial intelligence has propelled the transition of autonomous vehicles from laboratories to real-world applications. However, autonomous vehicles are a long way from fully integrating into most people's lives. Previous studies indicate that the word-of-mouth effect is often used by consumers to determine the quality of innovative technologies. Word-of-mouth recommendation can not only increase the income of enterprises by attracting new customers, but also greatly reduce the promotion and publicity expenses of enterprises. Through the word-of-mouth effect, the intention to recommend can contribute to the growth of the autonomous driving market. Therefore, current research explores the mechanisms among the perceived risk of privacy safety, perceived defect, perceived behavioral control, intention to use, and intention to recommend through path analysis. Our findings, based on 433 online questionnaires, indicate that the perceived risk of privacy safety, perceived defects, and perceived behavioral control influence the intention to recommend. Notably, perceived risk of privacy safety and perceived defect directly affects the intention to recommend and also correlates with perceived behavioral control. These findings provide some empirical evidence for the recommendation of autonomous vehicles and the expansion of consumer groups.

COVID-19 Impact on Refugees Mask-Wearing Behaviors and Intentions.

COVID-19 challenged countries in addressing population and raising awareness about mask-wearing during pandemic; Lebanon is a refugee hotspot, with humanitarian responsibility for their protection. The goal of this study is to emphasize the need of raising awareness among vulnerable populations and studying their mask-wearing behavior and intentions. This research draws on findings from a survey characterized by refugees' representatives from NGO, focusing on the behaviors and implications of refugees' mask-wearing. To address the study question, a customized survey based on Theory of Interpersonal Behavior was undertaken, in which the behavior of refugees was impacted by their desire to engage in an activity. The findings show that refugees are influenced by other people's mask-wearing behavior; they view masks as providing protection and aim to use them in the future provided all enabling conditions are met. Artificial intelligence might be a better monitor for this behavior in the future.

Understanding the predictors of health professionals' intention to use electronic health record system: extend and apply UTAUT3 model.

BACKGROUND: The implementation of Electronic Health Record (EHR) systems is a critical challenge, particularly in low-income countries, where behavioral intention plays a crucial role. To address this issue, we conducted a study to extend and apply the Unified Theory of Acceptance and Use of Technology 3 (UTAUT3) model in predicting health professionals' behavioral intention to use EHR systems. METHODS: A quantitative research approach was employed among 423 health professionals in Southwest Ethiopia. We assessed the validity of the proposed model through measurement and structural model statistics. Analysis was done using SPSS AMOS version 23. Hypotheses were tested using structural equation modeling (SEM) analysis, and mediation and moderation effects were evaluated. The associations between exogenous and endogenous variables were examined using standardized regression coefficients (ß), 95% confidence intervals, and p-values, with a significance level of p-value < 0.05. RESULTS: The proposed model outperformed previous UTAUT models, explaining 84.5% (squared multiple correlations (R2) = 0.845) of the variance in behavioral intention to use EHR systems. Personal innovativeness (ß = 0.215, p-value < 0.018), performance expectancy (ß = 0.245, p-value < 0.001), and attitude (ß = 0.611, p-value < 0.001) showed significant associations to use EHR systems. Mediation analysis revealed that performance expectancy, hedonic motivation, and technology anxiety had significant indirect effects on behavioral intention. Furthermore, moderation analysis indicated that gender moderated the association between social influence, personal innovativeness, and behavioral intention. CONCLUSION: The extended UTAUT3 model accurately predicts health professionals' intention to use EHR systems and provides a valuable framework for understanding technology acceptance in healthcare. We recommend that digital health implementers and concerned bodies consider the comprehensive range of direct, indirect, and moderating effects. By addressing personal innovativeness, performance expectancy, attitude, hedonic motivation, technology anxiety, and the gender-specific impact of social influence, interventions can effectively enhance behavioral intention toward EHR systems. It is crucial to design gender-specific interventions that address the differences in social influence and personal innovativeness between males and females.

Why Are Healthcare Providers Leaving Their Jobs? A Convergent Mixed-Methods Investigation of Turnover Intention among Canadian Healthcare Providers during the COVID-19 Pandemic.

BACKGROUND: Staffing shortages across the healthcare sector pose a threat to the continuity of the Canadian healthcare system in the post-COVID-19 pandemic era. We sought to understand factors associated with turnover intention as well as Canadian healthcare providers' (HCPs) perspectives and experiences with turnover intention as related to both organizational and professional turnover. METHOD: A convergent questionnaire mixed-methods design was employed. Descriptive statistics and ordinal logistic regressions were used to analyze quantitative data and ascertain factors associated with turnover intention. Thematic analysis was used to analyze qualitative open-field textbox data and understand HCPs' perspectives and experiences with turnover intention. RESULTS: Quantitative analyses revealed that 78.6% of HCPs surveyed (N = 398) reported at least a 25% turnover likelihood regarding their organization, with 67.5% reporting at least a 25% turnover likelihood regarding their profession. Whereas regression models revealed the significant impact of years worked, burnout, and organizational support on turnover likelihood for organizations, age, sex, burnout, and organizational support contributed to the likelihood of leaving a profession. Patterns of meaning drawn from participants' qualitative responses were organized according to the following four themes: (1) Content to stay, (2) Drowning and no one cares, (3) Moral stressors, and (4) Wrestling with the costs and benefits. CONCLUSIONS: Many HCPs described weighing the costs and benefits of leaving their organization or profession during the COVID-19 pandemic. Although challenging working conditions, moral stressors, and burnout may play a significant role in HCPs' experiences of turnover intention, there is ample room to intervene with organizational support.

COVID-19 Vaccination Hesitancy among the General Population: A Gender-Based Review and Bibliometric Analysis.

December 2019 was momentous since it experienced the trajectory of another novel pathogenic HCoV recognized as 2019-nCoV in Wuhan, China, which further unfurled to all countries on the entire globe at lightning speed. The Majority of COVID-19 vaccines are being manufactured using protein subunits, viral vectors, inactivated viruses, as well as DNA and mRNA vaccine platforms. This study aimed to conduct a gender-based review of COVID-19 vaccine hesitancy among the general population and bibliometric analysis. Various articles related to COVID-19 vaccine hesitancy, either based on their title, abstract, or keywords in the search strategy, were reviewed. For COVID-19 vaccine hesitancy, we used the definition of "Reluctance to receive safe and recommended available vaccines". Accordingly, 408 articles were included in the complete evaluation and the bibliometric analysis. Data Analysis was done using the Vos viewer Software. The strength of co-cited publications showed strong contributors from the American and Asian continents. The words with the maximum weightage based on their occurrences were female, health personnel, acceptance, social media, socio-economic factors, and ethnic groups, as covered in the red cluster. On the other hand, the Overlay Visualization on the right side, based on the total link strength of MeSH items, showed the largest clusters with items such as females, attitude to health, trust, cross-sectional studies, the acceptance of healthcare, rural population, public health, and parents, which were toward the center. The terms toward the periphery, which had less weightage, need more analysis. Greater perceived susceptibility, risk perception, benefits, and low levels of barriers and self-efficacy were the prime reasons for getting vaccinated, more specifically among females. In most instances, the female being the decision-maker of the family needs to be attended to first as she can further change the mindset of the entire family and carry the future forward.