Information-Motivation-Behavioral Skills Model Supplemented With the Moderated-Mediation Path: A Framework for Interpreting Patients' Online Medical Services Utilization.

PURPOSE: This study aimed to explore the internal determinants affecting patients' utilization of online medical services (OMS) based on the information-motivation-behavioral skills model from a behavioral perspective. DESIGN: A cross-sectional study. SETTING: This study was conducted in three medical institutions in Jiangsu Province, China. SUBJECTS: 470 internet users were enrolled from patients who came to the outpatient clinics. MEASURES: A self-administered questionnaire with feasible reliability and validity was used to investigate the demographic characteristics and OMS utilization-related information, motivation, behavioral skills, intention, and behavior. ANALYSIS: According to the constructed framework, structural equation modeling was used to test the relationships between those factors and OMS utilization behaviors. RESULTS: All direct paths are established except the path between information and intention. Information and motivation positively affected OMS utilization behavior through behavioral skills and intention (P < .001). Motivation and behavioral skills could positively influence OMS utilization behavior through intention (P < .01). Motivation was found to be the largest predictor of OMS utilization behavior. Moreover, gender played a moderating role in the interpretation of the behavior. CONCLUSIONS: Interventions should be conducted regarding information, motivation, and behavioral skills to promote patients' use of OMS. At the same time, the impact of gender on intervention effectiveness should also be considered.

Empirical validation of the information-motivation-behavioral skills model of gestational weight management behavior: a framework for intervention.

BACKGROUND: Unhealthy gestational weight gain is a modifiable risk factor for adverse maternal and child health. Appropriate and effective intervention strategies that focus on behavioral change or maintenance are critical in weight management during pregnancy. Our aim was to uncover the influencing factors and psychosocial mechanisms of gestational weight control behavior, and to construct a behavioral model suitable for intervention based on Information-Motivation-Behavioral skills (IMB) model. METHODS: A sample of 559 pregnant women from a municipal maternal and child healthcare facility in Jiangsu Province, China was enrolled in this cross-sectional empirical study. Partial least square structural equation modelling was used to verify the hypothesized model, and post hoc analyses was used to test the effect of parity and pre-pregnancy BMI on the model. RESULTS: The IMB model elements can predict gestational weight management (GWM) behavior well, with information being the most influential factor. As predicted, information affects GWM directly (ß = 0.325, p < 0.05) and indirectly (ß = 0.054, p < 0.05) through behavioral skills. Likewise, motivation has direct (ß = 0.461, p < 0.05) effects on GWM, and has indirect (ß = 0.071, p < 0.05) effects through behavioral skills. Behavioral skills have a direct impact (ß = 0.154, p < 0.05). The model had a goodness of fit (GOF = 0.421) and was robust when tested in subgroups of different parity or pre-pregnancy BMI. CONCLUSION: Findings from this study supported the predictions of the IMB model for GWM behavior, and identified its modifiable determinants. The tested behavior model for GWM can serve as a new validated intervention strategy in weight management among pregnant women.

[Temporal-spatial distribution and ecological evaluation of macroinvertebrate functional feeding groups in Yongding River Basin]. / æ°¸å®šæ²³æµåŸŸå¤§åž‹åº•æ –åŠ¨ç‰©åŠŸèƒ½æ‘„é£Ÿç±»ç¾¤æ—¶ç©ºåˆ†å¸ƒåŠç”Ÿæ€è¯„ä»·.

We investigated community structure of macroinvertebrate, water environment factors, hydrological factors at 23 sampling sites of the Yongding River basin from spring 2017 (April) to autumn 2017 (November). We analyzed the composition, spatial and temporal distribution of the macroinvertebrate functional feeding groups, as well as their responses to changes in riverine habitat. A total of 78 macroinvertebrate species were identified, with 52, 50 and 53 macroinvertebrate species in spring, summer and autumn respectively. The dominant functional feeding groups were gather-collectors, followed by predators, while the proportion of scrapers, filter-collectors and shredders were extremely low. Dominant species in the three seasons were all gather-collectors, including Orthocladius, Rheotanytarsus, Cricotopus in spring, Glyptotendipes in summer, and Polypedilum, Chironomus, Orthocladius in autumn. Results of redundancy analysis showed that the functional feeding groups of macroinvertebrate community structure were mainly influenced by water temperature, flow velocity, salinity, and total phosphorus in spring, by total phosphorus, dissolved oxygen, conductivity and flow capacity in summer, and by total phosphorus and dissolved oxygen in autumn. Total phosphorus had positive correlation with gather-collectors in all three seasons, indicating that the functional feeding groups of macroinvertebrates were affected by water pollution. The evaluation based on the metrics of functional feeding groups showed that: 1) in terms of material cycle, primary productivity of Guishui River were significantly higher than other regions, and that in autumn were significantly higher than other seasons. The secondary productivity and decomposition capacity of Yanghe River were significantly higher than other regions, and those in spring were significantly higher than other seasons. The autotrophy/heterotrophy of Yanghe River was significantly lower than other regions, and that in spring were significantly higher than other seasons. 2) The longitudinal transport capacity of Sanggan River was significantly higher than other regions, and that in autumn was significantly higher than other seasons. 3) The lateral input capacity of Guishui River was significantly higher than other regions, and that in summer was significantly higher than other seasons.

Vaccine Acceptance and Its Influencing Factors: An Online Cross-Sectional Study among International College Students Studying in China.

BACKGROUND: With the continuous large-scale development of the COVID-19 vaccine, the acceptance of vaccination and its influencing factors at the individual level have become crucial to stemming the pandemic. This study aims to explore the factors that influence the acceptance of the COVID-19 vaccine among international college students. METHODS: The target population constituted international students pursuing various degrees in Jiangsu Province through an online cross-sectional study. A cluster random sampling was performed using a self-administered questionnaire. The Health Belief Model and Knowledge, Attitude/Beliefs, and Practice Theory served as the underlying theories to understanding the factors that influence vaccine acceptance. RESULTS: We received 330 responses. About 36.4% intended to accept the vaccine. The acceptance varied across respondents' place of residence, program of study, continent of origin, knowledge, susceptibility, severity, benefits, and cues to action (p < 0.05). A multivariable logistics regression revealed cues to action (p < 0.001), the perception of COVID-19 vaccination benefits (p = 0.002), and the perception of barriers (p < 0.001) that were associated with vaccine acceptance. CONCLUSIONS: The acceptance of the COVID-19 vaccine was low among international students. The correct and comprehensive beliefs of the target groups regarding the benefits and barriers of the vaccination must be raised. Various effective social strategies must be adopted to trigger the intention of COVID-19 vaccination. The study findings will inform the decisions of public health campaigners, aimed at reducing vaccine hesitation when the COVID-19 vaccine is widely available.

Online medical services utilization evaluated through the lens of socioecological theory and the information-motivation-behavioral skills model: evidence from China.

Online medical services (OMS) have become increasingly advantageous, but there are still several barriers to utilization among patients. This study aims to explore the factors influencing OMS utilization (OMSU) for patients in micro-, meso-, and macrosystems based on socioecological theory (SET) and from the perspective of the information-motivation-behavioral skills (IMB) model. We selected 1065 participants through multistage stratified cluster random sampling in Jiangsu, China. In microsystems, information and behavioral skills were positively associated with intention (ß = 0.84; ß = 3.21) and actual utilization (OR = 1.69; OR = 1.69). Education level (ß = 0.83) and personal motivation (ß = 1.68) were positively related to intention. Chronic diseases (OR = 2.03) had a positive relationship with actual use. In mesosystems, recommendations from people around the patients (ß = 1.14; OR = 1.99), provision of OMS in the nearest primary medical facility (ß = 0.98; OR = 3.60), and provision of instructional information by medical institutions (ß = 1.01; OR = 1.65) were related to OMSU. The average monthly household income (ß = 0.54) was related to intention. Patients who had information about the OMSU experiences of people around them (OR = 1.73) correlated with actual utilization. In macrosystems, the social medical insurance type (OR = 0.66) was associated with OMSU. This study supports the applicability of the SET and IMB model to interpret patients' OMSU.

Accommodations Use Patterns in High School and Postsecondary Settings for Students Who Are d/Deaf or Hard of Hearing.

Using data from the second National Longitudinal Transition Study (Newman et al., 2011), the authors investigated longitudinal patterns of educational accommodations use in secondary and, later, postsecondary settings by students who are d/Deaf or hard of hearing (SDHH). The study focused on language and communication (LC) accommodations used primarily by SDHH, plus non-LC accommodations typically used by a broad range of students. Both LC accommodations for standardized testing and instruction showed decreased use in postsecondary settings compared with high school. After student demographic characteristics were controlled for, no relationships were found between types of accommodations students used in high school and those they later used in postsecondary settings. Student accommodations use in postsecondary settings was not significantly predictive of retention or degree completion. However, several student- and parent-level demographic characteristics were predictive of accommodations use in postsecondary settings. Implications and future research directions are discussed.

Alignment of single-case design (SCD) research with individuals who are deaf or hard of hearing with the what Works Clearinghouse standards for SCD research.

The authors assessed the quality of single-case design (SCD) studies that assess the impact of interventions on outcomes for individuals who are deaf or hard-of-hearing (DHH). More specifically, the What Works Clearinghouse (WWC) standards for SCD research were used to assess design quality and the strength of evidence of peer-reviewed studies available in the peer-reviewed, published literature. The analysis yielded four studies that met the WWC standards for design quality, of which two demonstrated moderate to strong evidence for efficacy of the studied intervention. Results of this review are discussed in light of the benefits and the challenges to applying the WWC design standards to research with DHH individuals and other diverse, low-incidence populations.