Changing the Conversation: Empowering Community Pharmacists to Address Pneumococcal Vaccine Hesitancy.

BACKGROUND: Although pneumococcal vaccine is recommended for everyone 65 years of age and older, only 58% of Canadians in this age group have been vaccinated, well below the Public Health Agency of Canada's target of 80%. To improve uptake, a stepped-wedge cluster randomized trial testing the effectiveness of a community pharmacist intervention was developed. OBJECTIVE: This pre-specified sub-study aimed to uncover and quantify factors contributing to vaccine hesitancy by exploring the nature of patient-pharmacist conversations about pneumococcal vaccine. METHODS: Beginning each month (April to August 2023), participating pharmacies were randomly selected to receive an education package designed to enhance pharmacists' knowledge, skills, and abilities in promoting pneumococcal vaccination. Pharmacists provided usual care (control stage) until they received the educational package and transitioned to the intervention stage. Weekly scorecards tracked patient-pharmacist conversations about pneumococcal vaccination. Chi-squared tests compared time taken for each conversation and patient-reported reason(s) for refusal between control and intervention stages. RESULTS: Thirteen pharmacies from across Alberta were included in the analysis, reporting 656 patient-pharmacist conversations (control stage n=271, intervention stage n=385). Time taken for pneumococcal vaccine conversations decreased after pharmacies received the education package (65% of conversations resulting in vaccination took <20 minutes in the control stage, compared to 88% in the intervention stage (p=0.004)). The most common patient-reported reason for refusal, needing more time to think about the vaccine, remained similar between stages (p=0.23). However, during the intervention stage, fewer patients refused vaccination due to lack of time to receive it today (p=0.016) and perceived lack of benefit (p=0.035), but more patients refused vaccination due to cost barriers (p=0.026). CONCLUSION: The education provided in this study changed the reasons for refusing vaccines, suggesting the nature of patient-pharmacist conversations became more efficient and informed. Similar interventions could be adopted across Canada and the US to help combat vaccine hesitancy.

"Are you OK doctor?" An expanded health belief model exploration of doctors' experiences and perspectives of on-shift health behaviour.

PURPOSE: Understanding doctors' health beliefs is essential for developing effective and competent healthcare practices that benefit doctors and their patients. This study aimed to qualitatively explore doctors' perceptions of on-shift health-protective behaviours and their perceived effects on competence. METHODS: The research applied theoretically driven Expanded Health Belief Model (EHBM) enquiry methods to explore beliefs and experiences through an occupational context survey, 14 individual depth interviews, and two focus groups. Semantic and deductive themes associated with EHBM domains were examined, and an inductive thematic analysis of the interviews was conducted. RESULTS: Doctors' beliefs were strongly imbued by their perceived identity within the systemic context; they expressed impaired self-efficacy in reacting to their health needs on shift, and several disclosed harm to themselves and patients. Dominant themes included the psychosocial effects of the systemic culture and the influence of the situational occupational context in impacting health-protective behavioural action. The context and implications of experiences during the COVID-19 pandemic are discussed. CONCLUSIONS: This study presents key belief-oriented factors influencing doctors' health-protective behaviour at work and its implications for competent practice. Further doctor-led guidance on focus points for evidence-based theoretically driven health improvement solutions is provided regarding operational practice, formulating policies, developing interventions and further research.

Development and acceptability of a gestational diabetes mellitus prevention system (Better pregnancy) based on a user-centered approach: A clinical feasibility study.

Background: Gestational diabetes mellitus (GDM) can increase the risk of adverse outcomes for both mothers and infants. Preventive interventions can effectively assist pregnant women suffering from GDM. At present, pregnant women are unaware of the importance of preventing GDM, and they possess a low level of self-management ability. Recently, mHealth technology has been used worldwide. Therefore, developing a mobile health app for GDM prevention could potentially help pregnant women reduce the risk of GDM. Objective: To design and develop a mobile application, evaluate its acceptance, and understand the users'using experience and suggestions, thus providing a valid tool to assist pregnant women at risk of GDM in enhancing their self-management ability and preventing GDM. Methods: An evidence-based GDM prevent app (Better pregnancy) was developed using user-centered design methods, following the health belief model, and incorporating GDM risk prediction. A convenient sampling method was employed from June to August 2022 to select 102 pregnant women at risk of GDM for the pilot study. After a week, the app's acceptability was evaluated using an application acceptance questionnaire, and we updated the app based on the feedback from the women. We used SPSS 26.0 for data analysis. Results: The application offers various functionalities, including GDM risk prediction, health management plan, behavior management, health information, personalized guidance and consultation, peer support, family support, and other functions. In total, 102 pregnant women consented to participate in the study, achieving a retention rate of 98%; however, 2% (n = 2) withdrew. The Better pregnancy app's average acceptability score is 4.07 out of 5. Additionally, participants offered several suggestions aimed at enhancing the application. Conclusions: The Better pregnancy app developed in this study can serve as an auxiliary management tool for the prevention of GDM, providing a foundation for subsequent randomized controlled trials.

Exploring the Relationship Between Psychological Constructs and Decision-Making Preferences in Psychiatric Outpatients.

Objective: This study aimed to elucidate the relationships among health locus of control, psychological reactance, attitudes toward psychiatric treatment, and patient decision-making preferences within a psychiatric outpatient population. Methods: A total of 200 consecutive psychiatric outpatients from a community mental health center in Tenerife, Spain, were approached for participation between September 2023 and March 2024. Of these, 151 patients consented to participate in this cross-sectional study. Participants were selected based on their willingness to participate and were provided with informed consent forms. Data were collected using the Patient's Health Belief Questionnaire on Psychiatric Treatment (PHBQPT) and the Control Preferences Scale (CPS). The PHBQPT evaluates health beliefs impacting adherence to psychiatric treatment, while the CPS assesses the preferred level of involvement in medical decision-making. Sociodemographic data were also collected to contextualize the findings. Results: Significant correlations were found between patients' control preferences and their attitudes towards medication, compliance with psychiatric advice, and perceptions of treatment control. A collaborative control preference was notably associated with positive attitudes toward medication and trust in the psychiatrist. These findings suggest that tailored treatment approaches prioritizing patient involvement could enhance adherence and outcomes. Conclusion:  The study underscores the importance of considering psychological constructs in psychiatric care to foster a holistic, patient-centered approach. Recognizing and integrating patients' control preferences, attitudes towards medication, and psychological reactance can improve the therapeutic relationship and treatment adherence. Future research should explore longitudinal and interventional studies to further understand the impact of aligning treatment approaches with patient preferences and psychological profiles.

In today's fast-paced world, understanding how we can better cater to the needs of psychiatric patients is more important than ever. This study, conducted in Tenerife, Spain, with 151 participants, shines a light on the intricate relationship between a patient's psychological mindset and their involvement in psychiatric care. Researchers explored how patients' beliefs about health control, their resistance or openness to psychiatric advice, and their preferences in treatment decisions intertwine to affect their approach to psychiatric treatment. The core findings reveal a fascinating tapestry of patient attitudes and behaviors. For example, patients who prefer a joint approach with their psychiatrists toward managing their treatment tend to have a more positive outlook on medication and a deeper trust in their doctors. This suggests that when patients feel they are part of the decision-making process, they are more likely to follow through with treatment plans, leading to better outcomes. What does this mean in everyday terms? Essentially, the study highlights the power of listening and integrating patients' viewpoints into their care plans. When patients see their insights and preferences reflected in their treatment, their engagement and adherence to medication improve. This not only fosters a more supportive environment for healing but also paves the way for more personalized, effective psychiatric care. In essence, this research is a call to action for healthcare providers to delve deeper into understanding each patient's unique psychological makeup. By doing so, they can tailor treatments that resonate more closely with the patient's own beliefs and preferences, ultimately leading to a more positive healthcare experience for everyone involved.

Structural equation modeling analysis of health belief model-based determinants of COVID-19 preventive behavior of academic staff: a cross-sectional study.

INTRODUCTION: Despite COVID-19 being highly contagious and spreading to several countries, the university community has overlooked prevention measures. For more than five decades, the Health Belief Model (HBM) has been a widely used conceptual framework in health behavior. structural equation modeling(SEM) analysis is an advanced statistical method capable of rectifying failures of the basic models and showing complex relations Thus this study aimed to determine the magnitude of COVID-19 prevention behavior and identify its associated factors using HBM and SEM analysis. METHOD: An institutional-based cross-sectional study was conducted among academic staff of the University of Gondar in Ethiopia from April 10 to May 10/2021. Daniel Soper's sample size calculator was used to determine the sample size. Proportional allocation to each campus followed by a simple random sampling technique was employed to select study subjects. A pre-tested, structured questionnaire was used to collect the data. Structural equation modeling analysis was employed to show the relationship between health belief model constructs and their effect on preventive behavior. RESULT: A total of 602 academic staff participated. The magnitude of good COVID-19 preventive behavior was 24.8%. The HBM explained 55% of the variance in preventive behavior. Perceived barriers (ß = -0.37, p < 0.05), self-efficacy (ß = 0.32, p < 0.05), perceived susceptibility (ß = 0.23, p < 0.05), and perceived benefit (ß = 0.16, p < 0.05) were the direct significant predictors of COVID 19 prevention behavior. CONCLUSION: only a quarter of the academic staff have good COVID-19 preventive behavior. The HBM explained a great amount of variance in preventive behavior and Perceived barriers, benefits, susceptibility, and self-efficacy significantly associated with prevention behavior. Carefully planned intervention that considers those significant perceptions should be designed and implemented to raise COVID-19 prevention behavior.

Predicting COVID-19 vaccine uptake: Comparing the health belief model and theory of planned behavior.

The COVID-19 outbreak has had a significant impact on the global health landscape, underscoring the crucial role that vaccinations play in achieving herd immunity and reducing the effects of pandemics. Given the importance of this issue, it is imperative to gain a deeper understanding of the various factors that influence individuals' decisions to seek vaccination. This study aimed to compare the prediction level of the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and a combined model in explaining the intention of adults to receive COVID-19 immunization. A cross-sectional online survey was conducted among adults (n = 505) in Saudi Arabia. The survey contained variables related to the HBM and TPB. The prediction level of the two models as well as a combined model were evaluated utilizing Structural Equation Modeling (SEM). Among the recruited 505 participants, 88% fell within the 18 to 30 age range, and 54.5% were male. The proposed HBM model accounted for 68% of the variation in intention, whereas the TPB model explained 78.2% of the variation in COVID-19 vaccination intention. The combined model showed greater explanatory power (82%). The variables of susceptibility (ß = 0.20, p < .001), severity (ß = 0.49, p < .001), advantages (ß = 0.63, p < .001), and obstacles (ß = - 0.24, p < .001), perceptions of behavioral control (ß = 1.58, p < .001) and attitudes (ß = 0.44, p < .001) were found to significantly predict increased vaccination intentions in the combined model. However, the subjective norm construct did not significantly predict vaccination intentions (ß = 0.06, p = .34). The TPB has greater explanatory power than the HBM in predicting the intention to obtain COVID-19 vaccination. However, the combined model showed a greater prediction level. Understanding and identifying people's perceived health beliefs and practices is critical for developing successful COVID-19 intervention methods.

Why did I participate in an HIV vaccine study? Experiences of participation in the first phase II HIV vaccine trial in Mozambique: An ancillary study using a mixed-method approach.

Introduction: This study recognized the lack of information regarding recruitment and retention factors associated with implementing HIV vaccine trials from the perspective of de facto participants. It aimed to describe the motives and experiences of 31 young adults who participated in a phase II HIV vaccine clinical trial conducted in Maputo, Mozambique. Methods: This was an ancillary study with a mixed-method approach that employed a convergent design, combining both quantitative and qualitative methodologies. Data collection involved questionnaire surveys, in-depth interviews, and focus group discussions. Participants were assessed before and after learning whether they received the experimental vaccine or placebo. Thematic analysis was used for qualitative data, while descriptive analysis and statistical tests such as Fischer's test and McNemar's exact test were applied to quantitative data. The study also utilized the Health Belief Model to understand the decision-making process of participating in an HIV vaccine study. Results: Most of our participants were young females, single, with limited financial resources. Participants joined the trial with the belief that they had a unique opportunity to help the fight against HIV and contribute to the research for the discovery of an HIV vaccine. Positive experiences related to trial participation include gaining knowledge about HIV and personal health and receiving risk reduction counseling. Participants reported blood collection as a negative experience and that they suffered social harm because of trial participation. Participants felt abandoned after the trial ended. Conclusion: Preventive HIV vaccine trials should integrate a social-behavioral component to assess reasons for participation and refusal in real-time. Providing ongoing personal attention is crucial for young individuals who have committed 1-2 years to trial participation, extending beyond the trial period. Implementing tailored strategies for HIV risk assessment and reduction during and after the trial is essential. Addressing these factors can enhance preventive HIV vaccine trial implementation.

Enhancing COVID-19 booster vaccination among the elderly through text message reminders.

The BOOST (Booster promotion for older outpatients using SMS text reminders) program at Taipei Veterans General Hospital assessed the effectiveness of text message reminders in enhancing COVID-19 booster vaccination rates among the elderly, guided by the Health Belief Model (HBM). Targeting patients aged 65 and above, eligible yet unvaccinated for a COVID-19 booster, this cohort study sent personalized reminders a week prior to their scheduled appointments between April 18, 2022, and May 12, 2022, acting as cues to action to enhance vaccination uptake by overcoming perceived barriers and raising awareness of benefits. Over 5 weeks, the study observed a 38% increase in vaccination rate among 3,500 eligible patients, markedly surpassing the concurrent national rate increase of 4% for the same demographic. The majority of vaccinations occurred within two weeks after the reminder, illustrating the effectiveness of the strategy. Cox regression analysis identified age and time since last vaccination as significant predictors of responsiveness, with those aged 65-74 and 75-84 showing higher uptake, particularly when reminders were sent within 4 months after the last dose. A single reminder proved to be effective. The findings of this study demonstrate the potential of SMS reminders to promote COVID-19 vaccination among the elderly through the strategic use of HBM principles, suggesting a feasible and effective approach to public health communication.

Determinants of intended prevention behaviour against mosquitoes and mosquito-borne viruses in the Netherlands and Spain using the MosquitoWise survey: cross-sectional study.

BACKGROUND: Recently, Europe has seen an emergence of mosquito-borne viruses (MBVs). Understanding citizens' perceptions of and behaviours towards mosquitoes and MBVs is crucial to reduce disease risk. We investigated and compared perceptions, knowledge, and determinants of citizens' behavioural intentions related to mosquitoes and MBVs in the Netherlands and Spain, to help improve public health interventions. METHODS: Using the validated MosquitoWise survey, data was collected through participant panels in Spain (N = 475) and the Netherlands (N = 438). Health Belief Model scores measuring behavioural intent, knowledge, and information scores were calculated. Confidence Interval-Based Estimation of Relevance was used, together with potential for change indexes, to identify promising determinants for improving prevention measure use. RESULTS: Spanish participants' responses showed slightly higher intent to use prevention measures compared to those of Dutch participants (29.1 and 28.2, respectively, p 0.03). Most participants in Spain (92.2%) and the Netherlands (91.8%) indicated they used at least one prevention measure, but differences were observed in which types they used. More Spanish participants indicated to have received information on mosquitoes and MBVs compared to Dutch participants. Spanish participants preferred health professional information sources, while Dutch participants favoured government websites. Determinants for intent to use prevention measures included "Knowledge", "Reminders to Use Prevention Measures", and "Information" in the Netherlands and Spain. Determinants for repellent use included "Perceived Benefits" and "Cues to Action", with "Perceived Benefits" having a high potential for behavioural change in both countries. "Self-Efficacy" and "Knowledge" were determinants in both countries for breeding site removal. CONCLUSION: This study found differences in knowledge between the Netherlands and Spain but similarities in determinants for intent to use prevention measures, intent to use repellents and intent to remove mosquito breeding sites. Identified determinants can be the focus for future public health interventions to reduce MBV risks.

A new communication approach to encourage lung cancer screening action in rural eligible populations.

Objective: The purpose of this study was to develop an effective communication approach to encourage lung cancer screening action within rural screening-eligible populations. Methods: An iterative research approach using targeted engagement with the priority population was used. Findings were triangulated through multiple methods, including two surveys and concept testing interviews. The Health Belief Model and the Extended Parallel Process Model served as study frameworks. Results: Initial findings suggest that threat levels are high in the priority population and an emphasis on barrier mitigation messaging may drive action. Health campaign posters integrating these findings were developed and tested with the priority population. The new health campaign posters were tested against examples of previously used health campaign posters. Findings suggest that the new health campaign posters were more effective in spurring lung cancer screening motivation and intention to act in the priority population compared to current health campaign poster examples. Conclusion: Messaging focused on gain-framing, inoculation messaging, and barrier mitigation may be more effective in encouraging lung cancer screening action in rural eligible populations. Innovation: This project outlines a systematic process to developing effective, targeted communication approaches using behavior change and persuasive communication frameworks along with engagement from priority populations.

The Perceived Benefits and Self-Efficacy of an Exercise Intervention on Tobacco Withdrawal Symptoms: A Qualitative Study Based on the Health Belief Model.

Background: This study examined the effectiveness of an exercise programme as an adjunct to smoking cessation treatments. The effects of exercise on smoking habits and tobacco withdrawal symptoms (TWS) were evaluated among smokers who were in the pre-contemplation and contemplation stages. Methods: This was a case study with convenience sampling techniques. This study lasted approximately 2 years, beginning in February 2016. This study was divided into two phases: an intervention phase followed by an interview. The participants were invited to undergo the 8-week supervised moderate aerobic exercise programme. This qualitative study involved 14 participants selected from the intervention phase. They were interviewed about their experiences using a semi-structured questionnaire guided by the health belief model. Results: This study involved 14 participants who were aged between 26 years old and 40 years old and smoked from 11 to 20 cigarettes per day. Most participants perceived benefits and self-efficacy regarding smoking habits and tobacco withdrawal symptoms (TWS) following the exercise intervention. Conclusion: This study demonstrated that moderate exercise might be helpful in increasing self-efficacy in smoking cessation and the findings encourage further research on exercise programmes as an adjunct to smoking cessation treatments in Malaysia.

Predictive ability of the health belief model in HIV testing and counselling uptake among youth aged 15-24 in La-Nkwantanang-Madina Municipality, Ghana.

BACKGROUND: Majority of new Human Immunodeficiency Virus (HIV)-positive persons in Ghana are aged 15-24. HIV prevalence among persons aged 15-24 years, a proxy for new infections, remained stable at 1.5% for 2017 and 2018, making it a significant public health concern. Yet only 26.4% of females and 8.6% of males aged 15-24 years know their HIV status. This study determined the predictive ability of the Health Belief Model (HBM) in HIV testing and counselling (HTC) uptake among youth (15-24 years) in the La-Nkwantanang Madina Municipality, Ghana. METHODS: A cross-sectional design was adopted for the study, using a multistage sampling method to select 415 youth aged 15-24. Data were collected using a structured interviewer-administered questionnaire, and analysed using binomial logistic regression with STATA software version 16.0 at p < 0.05 significance level and at 95% confidence interval. RESULTS: HTC uptake was 29.2%. Perceived susceptibility, perceived barriers, and perceived self-efficacy predicted HTC uptake. Youths with a high-risk perception for contracting HIV [OR = 3.03; 95% CI = 1.46, 6.30, p = 0.003], who perceived that they can contract HIV if not protected [OR = 3.69; 95% CI = 1.47, 9.22, p = 0.005], and worry about getting HIV [OR = 3.03, 95% CI = 1.61, 5.69, p < 0.001] (perceived susceptibility) were more likely to uptake HTC. Youths who had no trust issues with health workers [OR = 3.53; 95% CI = 1.46, 8.53, p = 0.005] and those who were not afraid of positive HIV test results [OR = 5.29; 95% CI = 2.66, 10.51, p,0.001] (perceived barriers) were more likely to uptake HTC. Youths who had no difficulties in turning up for appointments (perceived self-efficacy) had higher odds of HTC uptake [OR = 11.89, 95% CI = 6.73, 20.98, P < 0.001]. For the modifying factors, being married [OR = 2.96; 95% CI = 1.65-5.33], and having knowledge of HTC [OR = 9.10; 95% CI = 2.16-38.3], significantly influenced HTC uptake. CONCLUSION: Health promotion interventions to increase HTC uptake should focus on heightening the perception of susceptibility to HIV, reducing the barriers to HTC uptake, and increasing the self-efficacy for HTC uptake. The interventions should also target the significant modifying factors.

Determinants of Intention to Uptake COVID-19 Vaccination Among Saudi Adults: Application of the Health Belief Model.

Introduction: The pandemic caused by COVID-19 has had a profound effect on global health. Due to its potential impact on the efficacy of pandemic control measures, vaccine hesitancy (VH) in relation to COVID-19 has emerged as a significant concern. The attainment of herd immunity is contingent on the rate of COVID-19 vaccine adoption. Despite this, there have been reports of reluctance toward the COVID-19 vaccine. This study seeks to investigate the effect of constructs that influence adults' intentions to receive COVID-19 vaccination using the Health Belief Model (HBM). Methods: A cross-sectional study was conducted by recruiting Saudi Arabian adults as participants. Using Structural Equation Modeling (SEM), the proposed HBM model was evaluated. A total of 505 individuals replied to the survey. Results: The suggested HBM model explained 68% of the variation in intention to get COVID-19 immunization. I found all HBM variables namely perceived susceptibility, greater levels of perceived behavioral control, severity, benefits, and barriers to be significant predictors of vaccination intentions. Among demographic variables, only married status had a significant relationship with the intention to obtain COVID-19 immunization. Discussion: The findings of this study indicate that the HBM can be utilized effectively to obtain insight into the factors that influence COVID-19 prevention measure adherence. Understanding and recognizing individuals' perceived health beliefs and practices is essential for the development of effective COVID-19 intervention strategies.

Health Belief Model Predicts Likelihood of Eating Nutrient-Rich Foods among U.S. Adults.

Despite decades of messaging, most Americans still consume excess fats and sugars, but inadequate fiber, potassium, and calcium. Nutrient-rich foods (NRFs) have a high density of favorable nutrients related to calories. Choosing NRFs could lower risk of nutrition-related chronic diseases and aid in their control. We hypothesized that having greater knowledge of NRFs, the presence of a nutrition-related chronic disease or risk factor, and positive Health Belief Model (HBM) views would be predictive of the likelihood of eating NRFs. Through a national online survey panel, 976 adults aged 18-80 completed demographic, health, NRF knowledge, attitudes, and HBM construct questions. Participants were 77% White, 52% women, and 55% had a nutrition-related disease or risk factor. Multivariable HBM scales were generated by theory, principal components, and reliability analysis. NRF knowledge was significantly higher for women, Whites, households without children, and persons without a nutrition-related disease (all p ≤ 0.015). 'Likelihood of eating NRFs' was significantly higher for persons with a nutrition-related disease, Whites, married participants, main food shoppers, and households with children (all p ≤ 0.022). Regressing demographic and HBM constructs on the 'likelihood of eating NRFs' resulted in R2 of 0.435. Nutrition-related disease and HBM constructs of self-efficacy, perceived benefits, and cues to action were predictive of the likelihood of eating NRFs, but higher NRF knowledge was negatively associated.

Exploring Perceptions and Barriers: A Health Belief Model-Based Analysis of Seasonal Influenza Vaccination among High-Risk Healthcare Workers in China.

The annual seasonal influenza vaccination rate among high-risk healthcare workers (HCWs) has fallen below expectations, underscoring the importance of exploring the impact of perception on vaccination behavior. An online survey, grounded in the Health Belief Model (HBM), was administered to high-risk healthcare workers at West China Hospital. The data analysis encompassed descriptive statistics, logistic regression for univariate analysis, and path regression for multivariate analysis. A total of 1845 healthcare workers completed the survey, with an acceptance rate of 83.90% (95% CI, 82.20-85.60%). Path analysis revealed significant correlations between vaccination acceptance and perceived susceptibility (ß = 0.142), perceived benefits (ß = 0.129), perceived barriers (ß = 0.075), exposure to vaccination advertisements (ß = 0.115), and knowledge about seasonal influenza (ß = 0.051). Vaccination education efforts should prioritize elucidating the risks associated with the disease and emphasizing the benefits of vaccination. Furthermore, leveraging advertising proves to be an effective strategy for promotion.

Climate Change and Health Risk Perceptions of Arkansas Small Farmers through the Application of the Health Belief Model.

Climate change poses health risks to Arkansas small farmers. Farmers face an increased risk of heat-related illnesses (e.g., heat exhaustion, cerebral vascular accidents, and cardiovascular issues) and work-related injuries, death, and mental health conditions due to climate change. This cross-sectional survey employed the health belief model (HBM) as its theoretical framework. This study aimed to assess the health status of small farmers, climate change beliefs, adaptive agricultural practices, and the perceived effects of climate change on health. Study data were collected using non-probability sampling methods from small farmers (n = 72) with a gross farm income of < USD 250,000. The study findings show that 93% of participants reported good-excellent health, 69% believe the climate is changing and getting warmer, 58.3% believe people are responsible for the changes in our climate, and 75% believe the changing climate impacts farmers. Among the HBM predictive variables, participants reported self-efficacy (50%), perceived susceptibility (48.6%), and perceived severity (43%). Only 16.7% of farmers reported believing they have all the information needed to prepare for climate-related health impacts. This study suggests small farmers have protective factors and adaptive capacity, including health status, income, and education levels, but believe they lack the information necessary to protect their health from climate change.

Development and Psychometric Properties of the Health Belief Model Scale for Premature Birth Prevention (HBM-PBP) for Women of Childbearing Age.

Purpose: This study aimed to develop the Health Belief Model scale for premature birth prevention (HBM-PBP) and evaluated its psychometric properties in women of childbearing age. Methods: This study employed a cross-sectional design and included 724 women of childbearing age with intentions of future childbirth or in their first trimester of pregnancy. An item pool was formulated from the literature and in-depth interviews based on the health belief model. Content validation was conducted by experts and through cognitive interviews with women of childbearing age. Construct and concurrent validity and reliability were evaluated using factor analysis, Pearson's correlation analysis, and Cronbach's alpha. Results: The HBM-PBP consisted of 96 items, including perceived susceptibility (21 items, 5 subscales), severity (26 items, 5 subscales), benefits (27 items, 5 subscales), and barriers (22 items, 5 subscales). Convergent and discriminant validity were supported. The Cronbach's alpha coefficient of the domains ranged from 0.87 to 0.94. Conclusion: The HBM-PBP is a valid and reliable measurement scale with good psychometric properties. It can be used to measure health beliefs in women, either as a whole or in individual domains. Health professionals can leverage the HBM-PBP to discern women's health beliefs on premature birth, facilitating tailored interventions and educational efforts.

Exploring COVID-19 Vaccine Intentions, Perceptions, and Uptake Among the Saudi Population.

Background The widespread hesitancy, delays in acceptance, or outright refusal to receive vaccinations, even when readily available, present a notable global challenge. This is particularly pertinent in the context of COVID-19 vaccine hesitancy, where research shows considerable variability in hesitancy rates worldwide. The primary aim of this study is to investigate COVID-19 vaccine intentions among the Saudi population using behavioral theories as a framework. Methodology A descriptive cross-sectional study was conducted in the Kingdom of Saudi Arabia from January 2022 to December 2022. An online self-administered survey was distributed via social media to reach the targeted participants. Both men and women aged >18 years were included, while non-Saudi individuals and people who are less than 18 years old were excluded. A total of 1,139 participants were included. Results The study found that about 96% of respondents were willing to receive a COVID-19 vaccination. Analyzing sociodemographic and COVID-19-related factors with vaccine intention showed that those previously diagnosed with COVID-19 were less likely to refuse vaccination (P = 0.015). Univariate analyses revealed significant differences in the health belief model (HBM) and theory of planned behavior (TPB) dimensions between willing and unwilling participants. Willing individuals perceived greater infection severity (P = 0.543), higher vaccination benefits (P < 0.01), fewer barriers (P < 0.01), more cues to action (P < 0.01), and lower infection prevention self-efficacy (P < 0.01) compared to the unwilling group. TPB dimensions also differed, with willing individuals having more favorable vaccine attitudes (P < 0.01) and stronger vaccination social norms (P < 0.01). A multivariate logistic regression indicated that having COVID-19 increased vaccine willingness likelihood (odds ratio [OR] = 2.11, 95% confidence interval [CI] 1.14-3.91). Perceived barriers (OR = 0.61, 95% CI 0.44-0.85), self-efficacy (OR = 1.96, 95% CI 1.16-3.32) from HBM, and favorable vaccine attitudes (OR = 1.55, 95% CI 1.02-2.35) from TPB were significant predictors of vaccine willingness. Conclusions The TPB highlighted the importance of attitudes and perceived norms in vaccination acceptance, suggesting their value in vaccination promotion strategies. However, further research, including prospective and interventional studies drawing from a wider array of psychological theories, is needed to develop effective interventions for promoting vaccination.

Using health belief model constructs to understand the role of perceived disease threat and resilience in responding to COVID-19 among people who use drugs: a cluster analysis.

Introduction: The Health Belief Model (HBM) has been successfully applied to understanding adherence to COVID-19 prevention practices. It has not, however, been used to understand behavior in people who use drugs (PWUD). The aim of this study was to use the HBM to better understand COVID-19 perceptions among PWUD and understand how resiliency affects those perceptions. Materials and methods: A cross-sectional survey was completed from September to December 2021 with PWUD (n = 75) who utilize services at a large harm reduction organization in Philadelphia. Segmentation analysis was done using a k-means clustering approach. Two clusters emerged based on perceived COVID-19 personal impact and resiliency (Less COVID impact/High resilience (NoCOV/HR) and High COVID impact/Low resilience (COV/LR). Differences in responses by cluster to perceptions of COVID-19 and individual pandemic response grouped by HBM constructs were assessed using Student's t-test and chi squares. Results: Significant differences in HBM constructs were seen between clusters. Those in the COV/LR cluster were more likely to think they were susceptible to getting COVID-19 and less likely to believe they knew how to protect themselves. The NoCOV/HR cluster believed they were able to protect themselves from COVID-19 and that they were able to easily understand messages about protecting themselves. Conclusion: Understanding how PWUD conceptualize disease threat and using HBM can better inform interventions to improve future pandemic response. Findings suggest that resilience is key to protecting PWUD from future infectious disease outbreaks. Interventions aimed at increasing resiliency among PWUD may improve preventative behavior and decrease disease burden in this vulnerable population.

Behavior Change Theories and Models Within Health Belief Model Research: A Five-Decade Holistic Bibliometric Analysis.

The health belief model (HBM) has gained significant scholarly attention over the past five decades. This study aims to provide a comprehensive bibliometric analysis of the HBM research landscape to reveal its evolving trends and impact. The analysis utilized data from the Scopus database to explore publication patterns, influential sources and researchers, international collaborations, and thematic trends in the HBM-related literature. The findings demonstrate a substantial growth in HBM publications, with a peak of more than 11% in 2022-2023. The United States, Iran, China, the United Kingdom, and Australia are the most productive countries, and prominent HBM researchers include Lau JTF, Champion VL, and Jeihooni AK. Thematic analysis reveals a shift from broader topics of HBM to more specific areas, such as COVID-19, health behavior, and digital health interventions. The current study highlights the sustained and growing interest in HBM, its diverse applications, and the collaborative efforts of researchers worldwide to develop and refine this influential theoretical framework in public health and behavioral science.