Health Belief Model to Assess Mpox Knowledge, Attitudes, and Practices among Residents and Staff, Cook County Jail, Illinois, USA, July-August 2022.

In summer 2022, a case of mpox was confirmed in a resident at the Cook County Jail (CCJ) in Chicago, Illinois, USA. We conducted in-depth interviews with CCJ residents and staff to assess mpox knowledge, attitudes, and practices; hygiene and cleaning practices; and risk behaviors. We characterized findings by using health belief model constructs. CCJ residents and staff perceived increased mpox susceptibility but were unsure about infection severity; they were motivated to protect themselves but reported limited mpox knowledge as a barrier and desired clear communication to inform preventive actions. Residents expressed low self-efficacy to protect themselves because of contextual factors, including perceived limited access to cleaning, disinfecting, and hygiene items. Our findings suggest correctional facilities can support disease prevention by providing actionable and tailored messages; educating residents and staff about risk and vaccination options; and ensuring access to and training for hygiene, cleaning, and disinfecting supplies.

Impact of virtual education based on health belief model on cervical cancer screening behavior in middle-aged women: A quasi-experimental study.

BACKGROUND: Cervical cancer is one of the most common cancers in women worldwide and a cause of high mortality among people. Pap smear screening is an appropriate method to prevent cervical cancer and reduce its mortality. AIM: This study aimed to determine the effect of web-based education based on the Health Belief Model (HBM) on cervical cancer screening behavior in middle-aged women. METHODS AND RESULTS: This study is a quasi-experimental interventional research that was conducted on 240 middle-aged women aged 40-59 years in Isfahan, Iran, in 2022. An online educational intervention based on the constructs of the Health Belief Model was conducted for the intervention group using the Triple-B platform. The information on the intervention and control groups was collected before, immediately after the intervention, and 2 months later using a valid questionnaire. The gathered Data was analyzed using ANOVA and LSD post-hoc, independent samples t test, chi-square, and MANCOVA statistical tests in SPSS 26 software. After the intervention, the mean scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, self-efficacy, and internal cues to action in the intervention group increased and the mean score of perceived barriers decreased (p < .001). The mean score of the external cues to action did not show a significant difference between the intervention and control groups before, immediately, and 2 months after the intervention. Two months after the intervention, 32 women (26.2%) in the intervention group and two women (1.7%) in the control group performed the Pap smear test. CONCLUSION: Web-based educational intervention based on HBM using different strategies such as question and answer, presentation of infographics, lectures, brainstorming, showing videos and numerous educational images can be an effective way for increasing knowledge and cognitive variables of women and doing Pap smear test.

Psychometric properties of a modified health belief model for cervical cancer and visual inspection with acetic acid among healthcare professionals in Ethiopia.

PURPOSE: Evidence supports that the Health Belief Model (HBM) can explain and predicts certain health behaviors, including participation in cervical cancer (CC) screening. The purpose of this study was to evaluate the psychometric properties of a modified HBM for CC and visual inspection with acetic acid (VIA) in female healthcare professionals in Addis Ababa, Ethiopia, 2020. METHODS: Psychometric properties related to CC and VIA were tested using 42-item modified HBM self-administered questionnaire and a cross-sectional study design with simple random sampling. Kaiser-Meyer-Olkin and Bartlett's sphericity test indicated that data sampling adequacy for exploratory factor analysis was 0.792 (χ2 = 3189.95, df = 351, p < .001). Items with cross-loading and factor loadings ≥ 0.5 were retained. Confirmatory factor analysis (CFA) was conducted to determine model fit. RESULTS: The final analysis included 194 women, (mean age 30±4.34). Twelve items with ≤ 0.5 were removed and 30 retained items loaded into 6 factors; (benefits of VIA, perceived seriousness of CC, barrier (fear of negative outcome), self-efficacy, susceptibility to CC, and barriers (health system delivery)) explained 65% of the total variance. Cronbach's alpha for the total instrument was 0.8 and reliability for the 6 subscales was 0.76-0.92. Composite reliability and average variance extracted indicated good internal consistency and convergent validity. CFA identified 6 additional items to be removed with high residual covariance. The final 24 items of the modified HBM had an acceptable model fit (goodness-of-fit index (GFI) = 0.861, adjusted GFI = 0.823, comparative fit index = 0.937, root mean square error of approximation = 0.059). CONCLUSION: The modified HBM for CC and VIA with 24 items had adequate psychometric properties and may be used by Ethiopian healthcare professionals for research or clinical purposes. To support external validity the updated 24 items tool is suggested for application in further study in different populations in Ethiopia.

Effects of a Planned Web-Based Educational Intervention Based on the Health Belief Model for Patients With Ischemic Stroke in Promoting Secondary Prevention During the COVID-19 Lockdown in China: Quasi-Experimental Study.

Background: Some common modified vascular risk factors remain poorly controlled among stroke survivors, and educational programs may help improve these conditions. Objective: This study aimed to evaluate the effect of a planned web-based educational intervention based on the health belief model (HBM) in promoting secondary prevention among patients with ischemic stroke. Methods: An evaluation-blinded quasi-experimental trial with a historical control group was conducted. Patients admitted from March to June 2020 were assigned to the historical control group, and patients admitted from July to October 2020 were assigned to the intervention group. The control group received routine health management. The intervention group received 6 additional sessions based on the HBM via Tencent Meeting, an audio and video conferencing application, within 3 months after discharge. Sessions were held every 2 weeks, with each session lasting approximately 40 minutes. These sessions were conducted in small groups, with about 8 to 10 people in each group. The primary outcomes were changes in blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), hemoglobin A1c (HbA1c), and the proportion of patients achieving the treatment target. The secondary outcomes were medication adherence, assessed with the Morisky Medicine Adherence Scale (MMAS), and disability, assessed with the modified Rankin scale. Results: In total, 315 patients experiencing their first-ever stroke were analyzed. More patients in the intervention group had controlled BP (41.9% vs 28.4%; adjusted odds ratio [aOR] 1.93; P=.01), LDL-C (83.1% vs 67.7%; aOR 2.66; P=.001), and HbA1c (91.9% vs 83.9%; aOR: 3.37; P=.04) levels as well as a significant postintervention decrease in the systolic BP (adjusted ß -3.94; P=.02), LDL-C (adjusted ß -0.21; P=.008), and HbA1c (adjusted ß -0.27; P<.001), compared with control groups. Significant between-group differences were observed in medication adherence (79.4% vs 63.2%; aOR 2.31; P=.002) but not in favorable functional outcomes. Conclusions: A web-based education program based on the HBM may be more effective than current methods used to educate patients having strokes on optimal vascular risk factors and medication adherence.

The predictors of voluntary participation in pulmonary tuberculosis screening program: a study in a suburban community of southern Thailand.

Background: The health belief model (HBM), baseline health condition, and sociocultural factors impact the decision to participate in a tuberculosis screening program. Methods: This cross-sectional and descriptive study was carried out among the "Kao Taew" community dwellers aged 18 years and above, who voluntarily underwent the provided pulmonary tuberculosis (PTB) screening by chest radiographs (CXRs). The level of individual HBM domain perception, attitudes toward PTB prevention, and regularity of PTB prevention practices by the participants were evaluated. The significantly associated or correlated factors such as demographic characteristics, individual HBM domain perception, and attitudes toward PTB prevention with the regularity of PTB prevention practices from the univariate analysis were further analyzed by multiple linear regression (p < 0.05) to determine the independent significant predictors of PTB prevention practices. Results: Among 311 participants comprising 65% women, 57.9% aged ≥ 65 years and 67.2% had an underlying disease. The study participants had a high level of perception of HBM domains but a low level of perception of the barrier. In addition, a high level of attitudes toward PTB prevention and a high regularity of PTB prevention practices were found. A multiple linear regression analysis revealed that the perceived benefits of PTB screening [Beta = 0.20 (0.04, 0.36) p = 0.016] and acquiring underlying diseases [Beta = 1.06 (0.38, 1.73), p = 0.002] were significant predictors for PTB prevention practices, while belief in Islam was a reverse predictor [Beta = -0.84 (-1.47, -0.21), p = 0.010]. Conclusions: The level of perception of the individual domain of HBM, health status, and religious belief significantly predicted voluntary participation in PTB screening programs. Careful consideration by integration of the relevant health psychology, physical, and sociocultural factors is crucial for planning a health screening program.

Factors associated with health behaviours among stroke survivors: A mixed-methods study using COM-B model.

AIMS: To identify factors associated with health behaviours among stroke survivors, through a multi-centre study. DESIGN: A sequential mixed methods design. METHODS: In the quantitative research phase, a total of 350 participants were recruited through multi-stage sampling from December 2022 to June 2023. General information questionnaires, The Stroke Prevention Knowledge Questionnaire (SPKQ), Short Form Health Belief Model Scale (SF-HBMS), Health Promoting Lifestyle Profile (HPLPII), and the WHOQOL-BREF (World Health Organization Quality of Life Questionnaire, Brief Version) were distributed across five tertiary hospitals in Henan province, China. For the qualitative research component, semi-structured interviews were conducted to explore the barriers and facilitators of health behaviour. This study adheres to the GRAMMS guidelines. RESULTS: A total of 315 participants (90.0%) completed the survey. Identified barriers to health behaviour included residing in rural areas, higher scores on the Charlson Comorbidity Index (CCI) and mRS, as well as lower scores on SPKQ, SF-HBMS and WHOQOL-BREF. Twenty-four individuals participated in qualitative interviews. Twenty-eight themes were identified and categorised by frequency, covering areas such as knowledge, skills, intentions, social influences, social/professional role and identity, environmental context and resources, beliefs about capabilities, beliefs about consequences and behavioural regulation. Both quantitative and qualitative data suggested that health behaviour among stroke survivors is at a moderate level, and the identified barrier factors can be mapped into the COM-B model (Capability, Opportunity, Motivation and Behaviour). CONCLUSION: The study indicates that key barriers to health behaviour among stroke survivors align with the COM-B model. These identified factors should be carefully considered in the planning of future systematic interventions aimed at improving health behaviours among stroke survivors. PATIENT OR PUBLIC CONTRIBUTION: Patients were invited to completed questionnaires in the study and semi-structured interviews. The investigators provided explanation of this study' content, purpose and addressed issues during the data collection.

Self-protective behaviors of Thai village health volunteers in community engagement during a COVID-19 outbreak: interpretation using the health belief model.

BACKGROUND: Village health volunteers (VHVs) engaging in community-based COVID-19 prevention and control measures played a key role in mitigating effects of the COVID-19 pandemic in Thailand. We conducted a cross-sectional questionnaire survey study to investigate factors affecting VHVs' COVID-19 self-protective behaviors and social distancing in Songkhla Province during the first COVID-19 outbreak. Such information may help to understand how to support VHVs in future pandemics. METHODS: A total of 152 VHVs from 13 sub-districts participated in the study, completing a 54-item questionnaire based on the Health Belief Model (HBM). The questionnaire included items assessing susceptibility, severity, benefits, barriers, self-efficacy, social distancing, and self-protective behavior. Stepwise multiple regression analysis determined which aspects of the HBM could explain VHVs' self-protective behavior. RESULTS: The VHV population sampled broadly reflected the main demographic characteristics of the local population, although VHVs were predominantly female. Self-protective behavior was significantly associated with VHVs' role (higher perceived compliance for village leaders than non-leaders) but not with other demographic characteristics. Most VHVs reported high levels of self-efficacy (80.5%), adherence to social distancing measures (70.9%), and engagement in self-protective behavior (72.8%) against COVID-19. However, compliance with hand hygiene appeared to be suboptimal, suggesting room for improvement. Self-efficacy and perceived social distancing showed strong and moderate correlations with self-protective behavior against COVID-19 (r = 0.917, ß = 0.819; and r = 0.561, ß = 0.173 respectively; p < 0.001). The final HBM-based regression model accounted for 87.2% of the variance in VHVs' self-protective behavior. CONCLUSIONS: This study highlights the importance of VHVs' self-efficacy for achieving self-protective behavior during a COVID-19 outbreak, and suggests that self-efficacy may help to overcome barriers that might otherwise hinder behaviors to mitigate against COVID-19. Policies that support self-efficacy should be implemented in any future pandemic, and steps to support VHVs with hand hygiene compliance and empower non-leaders to increase their self-protective behavior may also be helpful. Whilst the HBM provided a useful framework for interpretation, the final model was driven mainly by self-efficacy.

Effect of health belief model-based educational intervention on prostate cancer prevention; knowledge, practices, and intentions.

BACKGROUND: Prostate cancer screening is a crucial preventive element for improving the survival rates of prostate cancer. Therefore, our research objective was to investigate the effect of health belief model-based education on prostate cancer knowledge, health beliefs, and preventive health practices among adult and older adult males. METHODS: A one-group pre-test/post-test quasi-experimental study design was carried out at the one-day outpatient clinics affiliated to General Alexandria Main University Hospital. We enrolled 110 men aged 45-75 years old in a health belief model-based educational intervention program. Various questionnaires were utilized to gather data before, immediately after, and three months following the intervention. These questionnaires included the socio-demographic questionnaire, Prostate Cancer Knowledge Questionnaire (PCKQ), Prostate Cancer Screening-Health Belief Model Scale (HBM-PCS), Prostate Cancer Preventive Practices Questionnaire (PCPPQ), and one question regarding the intention to undergo PC screening. RESULTS: Participants' knowledge about prostate cancer screening improved significantly immediately after the program and this positive change was maintained at the follow-up (p = 0.000). Furthermore, participants' perceptions and preventive practices towards prostate cancer screening had changed significantly after program completion and at follow-up (p = 0.000). After program completion, many of the participants (92.7%) expressed their intention to undergo prostate cancer screening within the coming six months (p = 0.000). The younger age group (45-49 years) showed higher scores in their perception of prostate screening (p = 0.001). Higher education and income were significantly associated with higher scores in the three scales (p = 0.000 in all scales). CONCLUSION: The study findings emphasized the effectiveness of the designed health educational program based on the HBM on PC preventive behaviors, through significantly improving participants' knowledge level, perceptions, practices, and intentions to PC screening. The program is highly recommended for prostate cancer preventive health practices among both adult and older adult males.

Establishing the feasibility and preliminary efficacy of a health belief model based educational training program on health belief perceptions and dementia-preventive behaviors in people with type 2 diabetes.

This quasi-experimental study evaluated feasibility and preliminary efficacy of dementia-preventive educational training intervention program based on the health belief model for improving perceived health beliefs and dementia-preventive behaviors among people with type 2 diabetes mellitus. Two community hospitals with 72 eligible participants were chosen from 12 local institutions using simple random sampling method. One hospital (22 patients) was allocated to dementia-preventive educational training intervention, and the other hospital (23 patients) was allocated to control intervention (using simple random sampling). Primary study outcome was feasibility, and secondary outcomes were changes in dementia prevention behaviors and health belief perceptions. Recruitment rate was 62.5% (45/72) and 22 patients in each group totally completed outcome measures and attended sessions, indicating feasibility of the intervention and study design. There were no significant differences between groups at baseline. After training, participants in the intervention group had significantly higher scores than control group in prevention behaviors and perceptions of health beliefs. The intervention group experienced significant with-group changes in outcomes. Results show that conducting a subsequent fully powered experimental study is feasible, and the intervention has promising efficacy.

Effect of health belief model-based training and social support on the physical activity of overweight middle-aged women: a randomized controlled trial.

Introduction: The highest incidence of overweight among adults is found among women, predominantly middle-aged women. While it has been demonstrated that being overweight increases mortality by compromising physical and mental health, it also imposes substantial costs on the healthcare system. Lack of physical activity is a primary contributing factor to becoming overweight. The majority of inactive adults are women, particularly middle-aged women. Consequently, this study investigated the training program for overweight women based on the health belief model (HBM) and social support approach. Methods: A randomized, controlled trial involving 73 overweight middle-aged women (control group: 37, intervention group: 36) was conducted using simple random sampling. The intervention group participated in six 120-min sessions per week for 6 weeks of a training program based on HBM and social support through physical activity, group discussion, role play, and media. Data were collected using the Physical Activity Questionnaire (IPAQ), Bandura's Exercise Self-Efficacy Scale (Bandura's ESE), and a researcher-made questionnaire before and 4 weeks after the training. The collected data were analyzed using descriptive and inferential statistics via SPSS 27 software. p-values <0.05 were considered statistically significant. Results: A training program based on HBM and social support led to improved perceived benefits (p < 0.001), cues to action (p = 0.03), and self-efficacy (p < 0.001) of physical activity; decreased perceived barriers (p = 0.001); increased social support (p = 0.001); and increased physical activity (p < 0.001). In addition, the BMI of the intervention group decreased after the training program (p = 0.01). Conclusion: The findings of the study demonstrate the efficacy of the training program based on HBM and the social support approach in improving social support and physical activity of women. In addition, the study evaluates the long-term outcome in populations with varying social, economic, and cultural standings. Clinical Trials Registration: https://clinicaltrials.gov/, (IRCT201706236261N17).

Enhancing Testicular Cancer Prevention Among University Students: A Health Belief Model and Social Support Intervention.

BACKGROUND AND OBJECTIVE: Testicular cancer poses a significant health concern for young adults, particularly university students, who often lack tailored interventions. Drawing on the Health Belief Model and a social support strategy, this study implemented an innovative educational program to empower male university students with knowledge and promote proactive engagement in testicular cancer self-examination practices. MATERIAL AND METHOD: A quasi-experimental research design was utilized in this study. The study participants consisted of 350 male individuals aged 18-25, corresponding to the final academic year (fourth year). The educational intervention for the post-test phase group consisted of seven 50 to 60-minute training and education sessions designed to enhance knowledge and promote preventive behaviors related to testicular cancer. Various statistical tests, such as Chi-square tests, independent t-tests, Mann-Whitney tests, and Repeated Measurement ANOVA, were systematically employed to unravel meaningful insights and determine the statistical significance of observed trends. RESULTS: The findings showed significant improvements post-intervention in knowledge, perceived susceptibility, severity, benefits, self-efficacy, cues to action, social support, and testicular self-examination performance. CONCLUSION: The study underscores the effectiveness of the intervention in promoting preventive behaviours against testicular cancer among university students, laying the groundwork for future educational initiatives. 
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Examination of Nursing Staffs' Perceptions of the COVID-19 Vaccine Using the Health Belief Model.

BACKGROUND: The coronavirus (COVID-19) pandemic profoundly impacted patient care across the United States. OBJECTIVE: To examine nursing staffs' perceptions of the COVID-19 vaccine using the Health Belief Model (HBM) as a theoretical framework. METHODS: A cross-sectional, anonymous, web-based survey was completed by practicing nursing staffs throughout the United States. Analyses involved descriptive and comparative statistics. RESULTS: Of the 294 nursing staff who completed surveys, 50% were between 18 and 37 years of age, and 73.1% were registered nurses, with 49.3% employed in a hospital setting. Nursing staff reported their primary reason for vaccination was concern for others (mean: 84.44; SD: 28.26), vaccine prevents spread (mean: 81.85; SD: 28.94), and own health (mean: 79.63; SD: 30.0). Influencing factors that predicted vaccination included age, Wilks' Λ = 0.76, F(32, 919.86) = 2.20, p < .001, η2partial = 0.066, and the vaccine mandate, Wilks' Λ = 0.63, F(8, 249) = 18.61, p < .001, η2partial = 0.374. CONCLUSION: Nursing staffs' perceptions using the HBM as a theoretical framework provided insight into their decisions to receive the COVID-19 vaccine. Further research is warranted to examine nurses' attitudes and factors that influence their decision-making regarding vaccination.

The Use of the Health Belief Model in the Context of Heatwaves Research: A Rapid Review.

As heatwaves increase and intensify worldwide, so has the research aimed at outlining strategies to protect individuals from their impact. Interventions that promote adaptive measures to heatwaves are encouraged, but evidence on how to develop such interventions is still scarce. Although the Health Belief Model is one of the leading frameworks guiding behavioral change interventions, the evidence of its use in heatwave research is limited. This rapid review aims to identify and describe the main themes and key findings in the literature regarding the use of the Health Belief Model in heatwaves research. It also highlights important research gaps and future research priorities. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 10 articles were included, with a geographic distribution as follows: United States (n = 1), Australia (n = 1), Pakistan (n = 1), and China (n = 1), as well as Malaysia (n = 2), Germany (n = 1), and Austria (n = 1). Results showed a lack of research using the Health Belief Model to study heatwaves induced by climate change. Half of the studies assessed heatwave risk perception, with the 2 most frequently used constructs being Perceived Susceptibility and Perceived Severity. The Self-efficacy construct was instead used less often. Most of the research was conducted in urban communities. This review underscores the need for further research using the Health Belief Model.

The application of behavioral change theories in addressing vaccine hesitancy: A Literature Review.

Vaccination is vital in combating infectious diseases, including COVID-19. Nevertheless, vaccine hesitancy poses a substantial obstacle to achieving high vaccination rates. This study investigated the determinants of vaccine hesitancy using behavioral change theories and proposes a comprehensive conceptual framework to address this challenge.The paper conducted a review of several behavior change theories relevant to understanding vaccine hesitancy. The health belief model (HBM) highlighted the importance of individuals' perceptions of the effectiveness of health behaviors and their perceived susceptibility to illness. The social cognitive model (SCT) underscored the role of personal experiences, environmental factors, and social support in shaping health behaviors. The theory of reasoned action and planned behavior (TRA) suggested that attitudes and subjective norms are crucial in determining behavioral intentions. The transtheoretical model (TTM) outlined stages of behavior change, while the socio-ecological model (SEM) considered factors at individual, relationship, community, and societal levels. Comprehending vaccine hesitancy is essential for developing effective strategies to promote vaccine acceptance. This study, which examined vaccine hesitancy through various behavior change theories, sought to shed light on the factors influencing vaccine hesitancy among Filipinos. The resulting conceptual framework offers guidance for future interventions aimed at addressing vaccine hesitancy and ultimately improving vaccination rates.

Effectiveness of education intervention, with regards to physical activity level and a healthy diet, among Middle Eastern adolescents in Malaysia: A study protocol for a randomized control trial, based on a health belief model.

BACKGROUND: Among the most urgent public health challenges, of the twenty-first century, is obesity. This can be attributed to its relationship with several non-communicable diseases (NCDs), as well as premature mortality. Being overweight or obese is a major concern not only in high-income countries, but also in low-income and middle-income countries, particularly in urban areas. Several studies have highlighted the prevalence of obesity, among Middle Eastern-descent adolescents, studying in Arabic secondary schools, located in Malaysia. Intervention studies, directed at Middle Eastern adolescents in Malaysia, are limited. This paper, describes the protocol, for an integrated health education intervention process. Titled 'Healthy lifestyle', it is a primary prevention process, aimed at curbing obesity and disordered eating, among Middle Eastern secondary school adolescents, aged 13-14 years old, residing in Malaysia. METHODS AND ANTICIPATED RESULTS: A cluster randomized controlled study will be conducted, involving 250 Middle Eastern adolescents, in Arabic schools in Malaysia. The participants will be randomly assigned to the intervention and control groups. While the intervention group participates in six weeks of fortnightly six sessions (45 minutes per session), the control group will carry on with their regular curriculums, and normal physical activity routines. The variables which will be evaluated include anthropometric measurements, knowledge, attitude, daily routines, physical activity, sedentary behaviour, food assessment, eating attitudes test-26, and a structured questionnaire based on the HBM. Data will be collected from the intervention and control groups at baseline, post-intervention, and two months following the intervention. Data analysis will be performed by way of the SPSS Statistics software version 26. The generalized estimating equation (GEE) will be used, to test the effect of the intervention program, with regards to the selected variables (outcomes), between and within-group at baseline, as well as six weeks and two months following intervention, after adjusting for clustering. Outcomes will be assessed at each time point, along with a derived average over all three-time points; thus, ensuring that both the cumulative and overall effects are determined. CONCLUSIONS: This trial will provide useful information for improving the knowledge, attitude, and practices of Middle Eastern adolescents, with regards to body weight status, physical activity level, nutrition status (BMI and dietary intake), and disordered eating. This will go a long way, towards ensuring their adherence to appropriate physical activities, and a healthy diet, to keep non-communicable diseases at bay. TRIAL REGISTRATION: This study is registered at NCT: NCT05694143.

Effect of nutrition education integrating the health belief model and theory of planned behavior on dietary diversity of pregnant women in Southeast Ethiopia: a cluster randomized controlled trial.

BACKGROUND: Maternal anemia, miscarriage, low birth weight (LBW), preterm birth (PTB), intrauterine growth restriction (IUGR), prenatal and infant mortality, morbidity, and the risk of chronic disease later in life are all increased by a lack of dietary diversity during pregnancy. However, evidence for the effect of nutrition education on the dietary diversity score (DDS) among pregnant women was sparse in Ethiopia, particularly in the study areas. This study aimed to assess the effect of nutrition education on dietary diversity among pregnant women in urban settings in Southeast Ethiopia. METHODS: A community-based two-arm parallel cluster randomized controlled trial was conducted among 447 randomly selected pregnant women attending antenatal care (224 intervention group and 223 control group) at health facilities from February to December 2021. A multistage cluster sampling technique, followed by systematic sampling, was used to select the pregnant women. Pregnant women who participated in the interventions were given nutrition education starting at 16 weeks of gestation and continuing for 6 months. We used a pre-tested, interviewer-administered, structured questionnaire to collect the data. A 24-hour qualitative dietary recall was used to calculate the dietary diversity score (DDS). A multivariable generalized estimating equation (GEE) model was conducted to evaluate the intervention effect. RESULTS: After the intervention, the proportion of adequate dietary diversity was 14.15% higher in the intervention arm compared to the control group (45.09% versus 30.94%, P = 0.002). The overall difference in adequate dietary diversity between the two groups was 8.5%. After adjusting for background characteristics, the multivariable GEE binary logistic model revealed that having received intervention [(AOR = 1.89, 95% CI: 1.27, 2.79)], being literate [(AOR = 3.41, 95% CI: 1.13, 10.23)], and having high wealth [(AOR = 1.60, 95% CI: 1.09, 2.35)] significantly improved adequate dietary diversity. CONCLUSION: The findings indicated that having received the intervention, being literate, and having a high level of wealth significantly improved maternal dietary diversity. Efforts should be made to increase nutrition education using the health belief model (HBM) and the theory of planned behavior (TPB). Moreover, there is a need to improve literacy and economic empowerment through income-generating activities to enhance adequate dietary diversification during pregnancy. TRIAL REGISTRATION: Clinicaltrials.gov (PACTR202201731802989, Retrospectively registered on 24 January 2022).

Exploring factors influencing outpatient radiology attendance based on Health Belief Model (HBM): A qualitative study.

INTRODUCTION: Non-attendance for radiology outpatient appointments is a global issue and is associated with adverse clinical outcomes and operational inefficiencies. This paper aims to understand the underlying factors influencing outpatient radiology attendances based on the Health Belief Model (HBM). METHODS: Purposive sampling was used to recruit patients (n=30) for in-depth semi-structured telephone interviews. Inclusion criteria comprised participants who were above 21 years old and fluent in English, while participants reliant on third-party assistance (e.g., nursing homes and prison services), to attend the appointment were excluded. The interviews were recorded and transcribed verbatim. The COREQ (Consolidated Criteria for Reporting Qualitative Research) was utilised to guide the reporting of this study. The data analysis involved a hybrid thematic analysis approach using NVivo. RESULTS: Six key themes associated with appointment adherence in radiology were identified. These themes included: 1) prioritising health and acceptance of current medical conditions; 2) the impact of perceived severity on non-attendance; 3) perceived benefits of attending appointments; 4) perceived barriers to attendance; 5) influential prompts; and 6) confidence in attendance. CONCLUSION: This is the first study of its kind to utilise the HBM to examine factors influencing attendance adherence among radiology outpatients in Singapore. Costs, prompts, and the perceived severity of the condition play pivotal roles in shaping the health-seeking behaviours of these outpatients while professionalism of healthcare staff and barriers to attendance present opportunities for providers to address patients' lack of interest towards their appointments. IMPLICATIONS FOR PRACTICE: Findings of this study will contribute to the development of personalised, targeted interventions for improving patient engagement and attendance in radiology settings.

The Effect of an Educational Intervention Based on the Health Belief Model (HBM) on Nutritional Performance Related to Gastric Cancer in Rural Women in Northern Regions of Iran.

Gastric cancer is a common cause of cancer death in the world. This study examined 120 rural women. The educational program included four sessions for each group based on the health belief model. The mean age of the women was 34.51 ± 9.16. The mean score of the perceived barriers significantly decreased in the experimental group (11.08 ± 0.37) compared to the control group (14.92 ± 0.42) (P < .001), and the mean score of knowledge, performance and HBM constructs, increased significantly 2 months after the education (P < .001).It is recommended that educational interventions be designed by HBM to improve nutritional behaviors related to GC in the female population.

Understanding Physical Distancing and Face Mask Use Across High-Risk African American Subgroups During the COVID-19 Pandemic: Application of Health Belief Model.

Physical distancing and face masks remain frontline prevention strategies due to suboptimal vaccine uptake and the highly infectious COVID-19 variants. Communities of color are disproportionately impacted by a chronic disease burden that places them at higher risk of severe COVID-19 disease. Therefore, they can greatly benefit from face mask use and physical distancing, especially if the individual(s) have not received the vaccine. We applied the Health Belief Model to explore barriers and motivators influencing physical distancing and face mask use among high-risk, Black American subgroups during the early COVID-19 pandemic stages. We conducted 62 semi-structured interviews among four Black American subgroups: young adults, individuals with underlying medical conditions, essential workers, and parents. Thematic analysis, guided by the Health Belief Model, yielded six themes: (1) Knowledge on Face Mask Use and Physical Distancing, (2) Perceived Susceptibility and Severity Varies by Subgroup, (3) Experience with and Perceived Self-Efficacy to Engage in Preventive Behavior, (4) Perceived Benefits to engaging in preventive behaviors, (5) Perceived Barriers to engage in preventive behaviors, and (6) Cues to action to increase participation. Each subgroup's unique experience informed multilevel, tailored approaches that can be used by health promotion practitioners to improve face mask use and physical distancing among uniquely vulnerable Black American subgroups in the current and future pandemic.

Análise qualitativa das percepções de mães residentes de Francisco Morato sobre a vacinação infantil contra a poliomielite e a hepatite A / Qualitative analysis of the perceptions of mothers living in Francisco Morato regarding childhood vaccination against polio and hepatitis A

Introdução: Segundo um epidemiologista, "O ingrediente mais importante em todas as vacinas é a confiança", que a sociedade deposita nessa medida profilática, bem como nas instituições públicas que a recomendam. Segundo o Ministério da Saúde, tem sido observada uma redução de cerca de 10 a 20% na cobertura vacinal anual nacional para diversas doenças infantis. Francisco Morato tem registrado quedas na cobertura vacinal infantil, sendo uma preocupação para os gestores. Objetivos: O presente estudo quali-quantitativo teve como objetivo descrever as percepções e atitudes de mães de crianças de 0 a 4 anos de idade sobre a vacina contra a poliomielite e contra a hepatite A. Justificativa: Segundo o Sistema Estadual de Análise de Dados, cerca de 62,2% dos residentes de Francisco Morato estão nas faixas alta e muito alta de vulnerabilidade social, destacando a necessidade de se conhecer a realidade local. Os resultados deste trabalho podem contribuir para o planejamento de ações em educação e comunicação em saúde sobre a vacinação infantil. Material e Métodos: Foram realizadas entrevistas em profundidade, submetidas à Análise de Conteúdo (etapas: Organização, Codificação e Categorização), com categorias apriorísticas e não apriorísticas. O roteiro das entrevistas foi baseado nos constructos do Modelo de Crenças em Saúde, "Severidade percebida", "Suscetibilidade percebida", "Benefícios percebidos" e "Barreiras percebidas". Resultados: Cinco mulheres foram entrevistadas, nenhuma demonstrou ser contrária à vacinação. A análise utilizou a seguinte classificação: (1) Categoria: adesão à vacinação infantil; subcategorias: posicionamento (a favor, contra, contradições), argumentos (percepção de risco, medo). (2) Categoria: COVID-19; subcategorias: não é o momento; reação à vacina; influência religiosa. (3) Categoria: forças impulsoras e restritivas à vacinação infantil; subcategoria: argumentos (Deslocamento, UBS). (4) Relatos e/ou críticas que elas fazem sobre o comportamento de conhecidos; subcategorias: fonte (vizinhos, membros da igreja, amigos). Conclusões: Considerando-se as respostas às entrevistas, as participantes do estudo têm uma atitude positiva em relação à vacinação contra a poliomielite e contra a hepatite A, porém apresentam preocupações em relação a outros imunobiológicos, como a vacinação contra a COVID-19. Estudos quantitativos e que analisem os comportamentos podem contribuir para a análise do problema.