Using the theory of planned behavior to predict parents' disclosure of donor conception to their children: a longitudinal study.

STUDY QUESTION: Can the application of the theory of planned behavior (TPB) help predict heterosexual parents' disclosure of donor conception to their children? SUMMARY ANSWER: Parents with a stronger will to act in accordance with social norms favoring disclosure were more likely to start the disclosure process within the next 5-9 years. WHAT IS KNOWN ALREADY: In contrast to single mothers by choice and same-sex couples, heterosexual couples need to make an active decision to disclose their use of donor conception to their child. While disclosure at an early age is encouraged by international guidelines, many heterosexual-couple parents struggle with this. A previous study has found an association between parental scores of TPB factors and disclosure intention, but so far, no study has applied the TPB to predict parents' disclosure behavior. STUDY DESIGN, SIZE, DURATION: The present study is based on the fourth and fifth waves of data collection (T4 and T5) in a nation-wide longitudinal study. Participating parents had conceived through identity-release oocyte donation (n = 68, response rate 65%) and sperm donation (n = 62, response rate 56%) as part of a heterosexual couple. PARTICIPANTS/MATERIALS, SETTING, METHODS: The present study is part of the prospective longitudinal Swedish Study on Gamete Donation (SSGD). Consecutive recruitment of couples starting oocyte or sperm donation treatment was conducted at all seven fertility clinics providing gamete donation in Sweden during a 3-year period (2005-2008). Participants were requested to complete postal surveys at five time points. The present study includes heterosexual-couple parents following oocyte or sperm donation who participated at the two latest time points when their children were 7-8 years old (T4), and 13-17 years old (T5). At T4, participants completed the study-specific TPB Disclosure Questionnaire (TPB-DQ) measuring attitudes and intentions to disclose the donor conception to the child, and disclosure behavior was assessed at both T4 and T5. Data from those participants who had not yet disclosed at T4 were analyzed using survival analysis with Cox regressions. MAIN RESULTS AND THE ROLE OF CHANCE: Forty participants had not disclosed the donor conception to their children at T4 and, out of these, 13 had still not disclosed at T5. We found a significant association between scores of the TPB factor Subjective norms at T4 and their subsequent disclosure behavior at T5 (HR = 2.019; 95% CI: 1.36-3.01). None of the other factors were significantly associated with disclosure behavior. LIMITATIONS, REASONS FOR CAUTION: The present study concerns heterosexual-couple parents with children conceived following treatment with gametes from open-identity donors, which limits the generalizability of our findings to other groups and contexts. Other limitations include the risk of systematic attrition due to the longitudinal study design and decreased statistical power due to few participants. WIDER IMPLICATIONS OF THE FINDINGS: Our findings highlight the importance of perceived subjective norms for parents' disclosure behavior and indicate that the co-parent's opinion about disclosure is of particular relevance in this regard. Counselors should focus on supporting prospective parents to initiate and maintain a healthy and open dialogue about concerns around building a family with donor conception. STUDY FUNDING/COMPETING INTEREST(S): The study was funded by the Swedish Research Council. The authors have no competing interests to declare. TRIAL REGISTRATION NUMBER: N/A.

Effects of educational interventions based on the theory of planned behavior on oral cancer-related knowledge and tobacco smoking in adults: a cluster randomized controlled trial.

BACKGROUND: The theory of planned behavior (TPB) is an effective model for facilitating behavioral change. The aim of the present study was to evaluate the impact of TPB-based educational interventions on oral cancer-related knowledge and tobacco smoking behavior in an Iranian adult population in 2022. METHODS: In this randomized controlled trial, a total of 400 healthy individuals were enrolled. The study was implemented in 20 urban health centers in the south of Tehran, Iran. The health centers were randomly allocated into two intervention groups. In group PowerPoint (PP), the participants received education through a 20-minute PowerPoint presentation complemented by a pamphlet. Group WhatsApp (WA) was educated via WhatsApp messages and images. Data was collected using a structured questionnaire at baseline, and at one- and three-month follow-ups. The outcomes were evaluated in terms of knowledge, tobacco smoking behavior, and the related model constructs i.e. intention, attitude, subjective norm, and perceived behavioral control. Generalized estimating equations (GEE) regression models were applied to assess the effect of interventions on repeated measurements of the outcomes. All analyses were conducted using STATA Software Version 17. RESULTS: Out of all the participants, 249 (62%) were women. The mean and standard deviation (SD) of age were 39.67 and 13.80 years. Overall, group PP had a significantly higher score of knowledge compared to group WA (ß = 0.43, p = 0.005). No significant differences were found between the groups with regard to tobacco smoking and the related TPB constructs, except for attitude with a higher score in group PP compared to group WA (ß = 0.50, p = 0.004). At the three-month follow-up, both interventions had significant effects on increasing knowledge (ß = 4.41), decreasing tobacco smoking (OR = 0.54), and increasing intention (ß = 1.11), attitude (ß = 1.22), subjective norm (ß = 1.37), and perceived behavioral control (ß = 1.08) (P < 0.001). CONCLUSIONS: Both interventions were effective in improving knowledge, tobacco smoking, and the TPB constructs after three months. Therefore, the application of both methods could be considered in the design and implementation of oral cancer prevention programs. TRIAL REGISTRATION: The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).

Disparity in cognitive factors related to cancer screening uptake based on the theory of planned behavior.

INTRODUCTION: Early detection of cancer is a highly effective way to decrease cancer-related deaths. The purpose of this study was to determine the disparity in cognitive factors related to cancer screening uptake based on the theory of planned behavior (TPB). METHODS: In this cross-sectional study, conducted in Kermanshah County, the west of Iran, during 2019, a total of 1760 people aged 30 to 75 years old, were randomly selected to participate voluntarily in the study. Participants filled out a questionnaire including the socio demographic variables, socioeconomic status (SES), TPB variables, and cancer screening uptake behaviors. RESULTS: The mean age of respondents was 45.28. 44.96% of the participants had undergone cancer screening at least once. Socioeconomic status (SES) and gender had the most significant impact on the disparity in cancer screening uptake, with contributions of 74.64% and 22.25% respectively. Women were 8.63 times more likely to be screened than men. Participants with a family history of cancer had a 2.84 times higher chance of being screened. Single individuals were significantly less likely to be screened compared to married individuals. The concentration index for attitude, subjective norms (SN), perceived behavior control (PBC), behavior intention, and cancer screening uptake was 0.0735, 0.113, 0.333, 0.067, and 0.132 respectively. Intention (Beta = 0.225 and P: < 0.001) is a significant predictor of cancer screening behaviors. CONCLUSION: The findings of this study are highly valuable for health policymakers in Iran. They emphasize the significance of creating, executing, and assessing campaigns that promote intention, PBC and SN, particularly among disadvantaged individuals. By doing so, we can effectively decrease the disparity in cancer screening rates. It is crucial to prioritize men, single individuals, and disadvantaged groups in cancer screening promotion programs. This knowledge can be utilized to develop an intervention that is guided by theory and supported by evidence, with the aim of increasing cancer screening rates and minimizing disparities.

The Effect of an Educational Intervention on Breast Cancer Screening of Rural Women: Application of the Theory of Planned Behavior.

BACKGROUND: Early diagnosis of breast cancer is a key factor affecting patient survival, so screening can reduce the burden of this disease. The present study aimed to investigate the effect of education based on the theory of planned behavior (TPB) on breast cancer screening in rural women. METHODS: In this quasi-experimental study, 480 women referring to the health care centers in the cities of Fasa and Shiraz were divided into two groups, intervention (n = 240) and control (n = 240), using cluster random sampling method, in 2021-2022. We randomly selected two health care centers in Shiraz and Fasa and invited them to participate in the study. The demographic information questionnaire and a researcher-made questionnaire based on the TPB were used to collect the data. The intervention included 50-minute sessions on topics such as breast cancer basics, screening methods, barriers to mammography, and the role of peer groups. Data were collected before and 4 months after the intervention. RESULTS: The results showed no difference between the two groups in awareness, attitude, perceived behavioral control, subjective norms, behavioral intention, and breast cancer screening performance before the intervention. Four months after the intervention, a significant increase was found in the intervention group in awareness (7.46 ± 1.50 to 18.54 ± 1.20), attitude (28.55 ± 4.62 to 58.69 ± 4.35), perceived behavioral control (22.52 ± 3.32 to 40.88 ± 3.84), and subjective norms (20.37 ± 3.34 to 21.99 ± 3.38). Instead, no significant difference in the mentioned constructs (P < 0.05) was observed in the control group. CONCLUSION: This study demonstrated that TPB-based education enhanced awareness, attitude, perceived behavioral control, subjective norms, and behavioral intention towards breast cancer screening. The TPB empowers women in rural communities to prioritize their health and seek timely breast cancer screening. Continued efforts and improved access to screening services are crucial for improved outcomes.

Comparative effect of physical health training and psychological training of the theory of reasoned action (TRA) model on the life quality of patients with diabetes in Tehran, Iran: utilization of message texting.

BACKGROUND AND PURPOSE: Providing physical health and mental health training promotion is necessary for a sustainable change in attitude and lifestyle of diabetic patients. The present study was conducted with the aim of comparing the effect of physical health training and psychological training of the theory of reasoned action (TRA) model on the life quality of patients with type 2 diabetes. METHODS: This experimental study was conducted in 2022 with two intervention groups and one control group consisting of 129 patients with type 2 diabetes who were referred to Imam Khomeini Hospital in Tehran. Over the course of one month, each individual in intervention group 1 received 15 text messages focusing on physical health, while intervention group 2 received 15 psychological text messages related to the TRA. The control group did not receive any text messages during this period. The data collection tool used was the "Audit of Diabetes-Dependent Quality of Life (ADDQoL)" questionnaire, which was completed by the participants before and after the intervention. The data were analyzed using SPSS version 16 software at a statistical significance level of 0.05. RESULTS: In the intervention-1 group, the average life quality score was 8.51 units (P < 0.001), while in the intervention-2 group, it was 19.25 units (P < 0.001) higher than the control group. The psychological training group had a 17.62 units (P < 0.05) lower average fasting blood sugar (FBS) and a 10.74 units (P < 0.001) higher average quality of life compared to the physical training group. CONCLUSION: The results of this study showed that the effectiveness of psychological training of the TRA model in improving life quality and reducing FBS in patients with diabetes is greater than physical health training. It is suggested that policy makers and health managers base future plans on physical health promotion training along with TRA model mental health training for the development of education in patients with diabetes. Specialists and healthcare workers can also act to improve personal health characteristics, especially those related to reducing FBS and increasing the quality of life of patients with diabetes, by using training through mobile phone text messages, particularly with psychological content TRA based.

A qualitative exploration of exercise motivation among colorectal cancer survivors: an application of the theory of planned behavior.

PURPOSE: The purpose of this qualitative study was to use semi-structured interviews and thematic analysis to elicit key influencing factors (i.e., behavioral, normative, and control beliefs) related to physical activity and exercise in colorectal cancer survivors. METHODS: Colorectal cancer survivors (N = 17) were recruited from exercise programs designed for colorectal cancer survivors at the Yonsei Cancer Center, Seoul, South Korea. A purposive sampling method was used. Interview questions were informed by the theory of planned behavior (TPB). Semi-structured face-to-face interviews were conducted, and open-ended questions addressed the research question. Interviews were transcribed verbatim and analyzed using thematic analysis. RESULTS: Participants were on average 2.2 years post-treatment. The mean age of the sample was 55.9 years. Key behavioral, normative, and control beliefs emerged in the data. For behavioral beliefs, colorectal cancer survivors believed that exercise would result in physical and psychological improvements, and improve their bowel problems. For normative beliefs, most colorectal cancer survivors wanted their oncologists' approval for participation of exercise. Family members, more specifically the spouse, were also influencing factors for colorectal cancer survivors adopting physical activity. The most frequently mentioned control belief was that supervised exercise with an exercise specialist made exercise participation easier. CONCLUSIONS AND IMPLICATIONS: Beliefs identified in this study can inform TPB-based physical activity interventions tailored for colorectal cancer survivors. While information alone may not lead to behavior change, integrating these beliefs with other influential factors can potentially enhance intervention efficacy and promote physical activity in this population.

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).

Determining behavioral intention and its predictors toward preconception care use among reproductive age women in Arba Minch town, Southern Ethiopia, 2022: a cross-sectional study based on the theory of planned behavior.

BACKGROUND: Preconception care is a highly effective, evidence-based intervention aimed at promoting the health of reproductive-age women and reducing adverse pregnancy-related outcomes. The Ethiopian Ministry of Health plans to integrate preconception care services into the country's existing healthcare system. However, women's preferences may be influenced by their values and customs. Therefore, this study used the theory of planned behavior to assess women's intention toward preconception care use and its predictors among reproductive-age women in Arba Minch town, southern Ethiopia. METHODS: A community-based cross-sectional study was conducted in Arba Minch town from May 1 to 30, 2022. A simple random sampling technique was employed to select 415 study participants for data collection. Data were collected through a face-to-face interview using a pretested, structured questionnaire. Epi Data version 4.6 and SPSS version 26 were used for the entry and analysis of data, respectively. Multiple linear regression was performed to identify independent predictors of intention to use preconception care. The standardized ß-coefficient was used as a measure of association. A P value of less than 0.05 was used to declare statistical significance. RESULTS: This study had 415 participants, giving a response rate of 98.3%. The mean age of the participants was 28.4 (SD 5.18). The mean intention to use preconception care was 21.43 (SD 2.47). Direct perceived behavioral control (ß = 0.263, p < 0.001), direct attitude (ß = 0.201, p = 0.001), direct subjective norm (ß = 0.158, p = 0.006), and age (ß=-0.115, p = 0.023) were significant predictors of women's behavioral intention to use preconception care. CONCLUSION: The study identified perceived behavioral control as the strongest predictor, followed by attitude and subjective norms, influencing the intention to use preconception care. These findings underscore the importance of integrating these predictors into health intervention programs aimed at promoting the implementation of preconception care services.

The factors affecting substance abuse relapse based on theory of planned behavior in male addicts covered by addiction treatment centers in Southern Iran.

BACKGROUND: Given the destructive nature of addiction and its relapse after quitting, the present study aimed to investigate the factors affecting substance abuse relapse based on the Theory of Planned Behavior (TPB) in male addicts covered by addiction treatment centers in Shiraz, Iran. METHODS: This cross-sectional study was conducted on 400 male addicts covered by addiction treatment centers in Shiraz, Iran, in 2021-2022. The data collection tool was a researcher-made questionnaire. Data were analyzed using SPSS-22 software through descriptive statistical methods, linear regression, and binary logistic regression. RESULTS: 190 people (47.50%) were aged 31-40 years, 265 people (66.25%) were married, 224 people (56%) lived with their spouses, and 192 people (48 percent) had their first use at the age of 16-20. The substance respondents used were methamphetamine (59.5%), heroin (53%), opium (48%), and alcohol (40%). 138 people (34.5%) had their first place of consumption at friends' houses (Tables 1 and 2). 342 people (85.5%) had a history of relapse, and 172 people (50.29%) had 1-5 relapses. Marital status, occupation, and income were among the demographic risk factors, and addicted friends and close relatives were among the behavioral risk factors for drug relapse among people with a history of relapse. Personal desire and the insistence of friends were also among the individual and interpersonal factors of drug use among participants. The regression results showed that the constructs of awareness, attitude, subjective norms, perceived behavioral control, and behavioral intention were predictors of drug relapse among addicts (P < 0.05). CONCLUSION: The current study's findings indicate that among the behavioral risk factors for drug relapse in individuals with a history of relapse are addicted friends and close relatives, while marital status, occupation, and income are among the demographic risk variables. Among the individual and interpersonal factors influencing drug usage among participants were personal desire and friends' insistence. Furthermore, the findings indicated that the TPB's structures might be used to predict drug relapse in addicts.

Knowledge level and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers attending Mkonze health center, Dodoma Region, Tanzania.

BACKGROUND: Unsafe abortion is now a global agenda because 45% of all global abortions are unsafe, and 97% are occurring in developing countries. In Tanzania, one million reproductive-aged women face unplanned pregnancies per year, and 39% end up with abortion. About 16% of maternal deaths are reported per year in Tanzania, and unsafe abortion takes the second position. There are several efforts to prevent and intervene unsafe abortions, such as equipping healthcare facilities across all levels of healthcare, approval of Misoprostol use, establishment of comprehensive post-abortion care (PAC), revising policy guidelines and standards, provision of emergency contraceptives, and capacity building of healthcare providers. There is little documentation about how the constructs of the theory of planned behaviour, knowledge, and sociodemographics influence the practice of abortion. OBJECTIVES: To assess the association of knowledge level, sociodemographic characteristics, and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers at Mkonze Health Center in the Dodoma region. METHODOLOGY: It is an analytical cross-sectional study design conducted in Dodoma-Tanzania and involved 206 postnatal women. A validated questionnaire was used and analysis was performed in the Statistical Package for the Social Sciences (SPSS), through descriptive and inferential statistics. RESULTS: The practice of unsafe abortion in the current study is 28/206 (13.6%), influenced bytheir lower educational level and being single women. It was found that the majority had adequate knowledge of unsafe abortion 129 (62.6%), positive attitude 130 (63.1%), good subjective norms 113 (54.9%), and positive perceived behavioral control111 (53.9%). Knowledge, attitude, subjective norms, and perceived behavioral control were not significantly associated with the practice of unsafe abortion. CONCLUSION: The majority of the respondents had high knowledge, attitudes, subjective norms, and perceived behavior control on unsafe abortion. This is an indicator that the implemented initiatives are effective. Maintaining the ongoing effort and improving strategies are promising to mitigate the burden of unsafe abortion. Future research needs to find out hidden factors associated with attitude and how health beliefs might influence someone's attitude towards unsafe abortion.

Effect of sexual health education on sexual function and satisfaction of menopausal migrant women: an application of the theory of planned behavior.

OBJECTIVES: This study investigated the effect of an intervention based on the theory of planned behavior on sexual function and satisfaction of migrant women during menopause in Iran. METHODS: This quasi-experimental study was conducted on 88 migrant and menopausal women in Iran. Sampling was performed using the multistage methods in four health care centers. The educational program based on the theory of planned behavior was held in 4 sessions of 90 min for 4 weeks in the intervention group. The final evaluation of the intervention was performed immediately, and the follow-up stage (3 months after the intervention) by completing questionnaires in two groups. The data was analyzed with SPSS 20 software with statistical tests of mean and standard deviation, Manwitney, Frideman, Generalized Estimating Equations. RESULTS: The results showed that after the intervention, the mean score of sexual function in the intervention group increased from 16.53 ± 2.68 before to 17.52 ± 2.90 immediately and 17.38 ± 2.81 in follow up stage (p < 0.05). But in the control group, this score was not statistically significant during the study stages (p > 0.05). CONCLUSION: The results indicate that the intervention based on the theory of planned behavior is effective in sexual function and satisfaction with the married life of migrant women during menopause. but to change the sexual function, studies with a longer duration and also the use of other educational models are suggested.

Information literacy and intention to adopt e-pharmacy: a study based on trust and the theory of reasoned action.

BACKGROUND: E-pharmacy has gained popularity as an increasingly utilized platform for accessing healthcare services online. However, its adoption exhibits regional variations and necessitates improvement in certain aspects. Guided by the Theory of Reasoned Action (TRA) and Trust theory, this research explores the pivotal role of information literacy in influencing attitudes, perceived control, word of mouth, and trust. The overarching aim is to understand how these factors collectively impact the adoption of E-pharmacy services. METHODS: The study employed Structural Equation Modeling to assess data collected from 473 participants in Nigeria. This methodology allowed for a comprehensive evaluation of the intricate relationships between information literacy, attitudes, perceived control, word of mouth, trust, and E-pharmacy adoption. By utilizing statistical tests within this framework, the research sought to provide a robust analysis of the data and derive meaningful insights. RESULTS: The findings of the research underscore the significance of information literacy in shaping individuals' attitudes towards E-pharmacy. Higher information literacy levels were associated with more positive attitudes, an enhanced sense of perceived control, and increased positive word-of-mouth regarding the use of E-pharmacy services. Additionally, the study revealed that trust plays a crucial intermediary role between word-of-mouth communication and the actual adoption of E-pharmacy. CONCLUSIONS: In summary, this research offers a novel and comprehensive explanation of the relationship between information literacy and the adoption of E-pharmacy services. The study's outcomes contribute valuable insights to the ongoing discourse on E-pharmacy adoption, emphasizing its potential to enhance healthcare accessibility and efficiency within the evolving landscape of digital healthcare. The implications of the findings extend to policymakers, healthcare providers, and other stakeholders interested in optimizing the adoption and integration of E-pharmacy services.

Evaluation of an Educational Intervention Based on Theory of Planned Behavior to Reduce Suicidal Ideation and Attempts in Drug Addicts Receiving Methadone: A Quasi-Experimental Study.

BACKGROUND: Drug addiction can lead to suicidal ideation or suicide attempt so that half of those who attempt suicide have a history of substance abuse. The purpose of this study was to investigate the effect of educational intervention based on Theory of Planned Behavior (TPB) on reducing suicidal ideation and suicide attempt of addicts. METHODS: A longitudinal quasi-experimental educational intervention was conducted on 200 methadone-treated addicts with suicidal ideation under the auspices of government addiction centers of Shiraz city from 2021 to 2022. Baseline data on demographic characteristics, suicidal ideation, and TPB questionnaire were collected from two groups at the beginning of the study and then three months after the intervention. The experiment group received educational intervention including sessions of individual and group counseling, training and organizational supports. The questionnaire was completed by both the experimental and control groups before the educational intervention and three months after the educational intervention. Data were analyzed using SPSS 22 software through independent t-test, Chi-square and paired t-test (p = 0.05). RESULTS: The mean age of addicts in the experimental and control groups was 38.80 ± 11.64 and 39.41 ± 11.18 years, respectively (p = 0.206). 22% of the experimental group and 18% of the control group had a history of suicide. According to the results, there was no significant difference between the experimental and control groups in terms of knowledge, attitude, subjective norms and perceived behavioral control before the educational intervention, however, the mentioned variables increased significantly in the experimental group three months after the educational intervention. There was no significant difference in suicide attempt and suicidal ideation between the experimental and control groups before the educational intervention, however, there was a significant change in the experimental group after the educational intervention. CONCLUSION: The results of the present study showed the effect of educational intervention on the knowledge, attitude, subjective norms, perceived behavioral control, suicidal ideation and suicidal attempt of addicts, thus confirming the effectiveness of the TPB-based intervention on reducing suicide of addicts.

Changing the High-Risk Behaviors of Injecting Drug Users in Iran: Application Theory of Planned Behavior.

Background: Injection risk behavior is a major predictor of HIV infection. The present study was conducted to survey the effect of educational intervention based on the theory of planned behavior on changing high-risk behaviors (the high-risk behaviors of injecting and behaviors of transmitting blood diseases to others) of injecting drug users under the coverage of addiction harm reduction centers. Methods: This study is an experimental research on 120 drug addicts in 2021-2022. Two addiction harm reduction centers in Fasa City, Iran, were chosen randomly (one as the test group and the other as the control group). The data collection tool is made up of two parts. The first part is a questionnaire on demographics. The second part is a questionnaire based on the theory of planned behavior, which was made using information from different sources and studies. The training program was set up based on the pretest results and the theory of planned behavior for the test group. Before and six months after the educational intervention, the experimental and control groups filled out the questionnaire. With a significance level of 0.05, the independent t, chi-square, and paired t statistical tests were used to examine the data using the SPSS 22 program. Results: In the test group, the average age of addicts was 37.42 ± 10.55 years, while in the control group, the average age was 38.36 ± 10.09 years (p=0.244). Six months after the educational intervention, all TPB theory's constructs (knowledge, attitude, subjective norms and perceived behavioral control, behavioral intention, and behavior of injecting drug users) were higher in the test group than in the control group (p=0.001). Conclusion: The results show the effect of this educational intervention in reducing high-risk behaviors related to injection in injection drug addicts, so it is suggested as a useful method to reduce high-risk injection behaviors in these people.

Residents' willingness to engage in carbon generalized system of preferences - A personality insight study based on the extended theory of planned behavior.

In the context of China's dual carbon target, reducing personal carbon emissions has been identified as a crucial strategy to achieve the target. The 2022 Digital China Development Report emphasizes the significance of implementing the Carbon Generalized System of Preferences (CGSP) in driving individual carbon reduction efforts in China. However, the psychological factors influencing public participation in CGSP are still unknown. Based on the Extended Theory of Planned Behavior (TPB), this study explored the psychological factors of different personality trait groups' participation in the CGSP and categorized 712 respondents into Compatible, Positive, Responsible, and Susceptible based on the MINI-IPIP scale and the K-means method. The results show that the strength of willingness to engage (WTE) in CGSP was ranked as: Compatible > Positive > Responsible > Susceptible and the WTE of compatible groups is more influenced by attitude, while Perceived Behavioral Control (PBC) plays a more crucial role in other groups. Personal Norms (PN) and Policy Awareness (PA) were significant for all specific personality groups except the Susceptible group. Surprisingly subjective norms had little to do with WTE. We believe that policymakers should consider the impact of PBC on WTE when formulating policies and raise the expectation of residents in terms of the value they can obtain from participating in CGSP. Additionally, promotional activities related to PN and PA in connection with CGSP should be conducted. These efforts may help individuals better engage in CGSP.

Explaining citizens' plastic reduction behavior with an extended theory of planned behavior model: An empirical study in Switzerland.

The growing volume of plastic waste resulting from human activities is suffocating our planet. To combat this escalating issue, this study delves into the formation of plastic reduction behavior among Swiss citizens using an extended theory of planned behavior model. Through an online survey, the study obtained 149 valid responses, which were analyzed using partial least squares-based structural equation modeling. The results indicate a significant and strong relationship between plastic risk perception and attitudes towards plastic reduction and environmental protection. Notably, the cognitive dimension (ß = 0.802, p = 0.000) of plastic risk perception exhibits a tighter and stronger association with attitude compared to the emotional dimension (ß = 0.406, p = 0.000). Among the three variables in the theory of planned behavior model, perceived behavioral control (ß = 0.384, p = 0.000) emerges as the strongest determinant of behavioral willingness for plastic reduction. It is followed by attitude (ß = 0.214, p = 0.030). However, no significant relationship is observed between subjective norm and behavioral willingness for plastic reduction (ß = 0.07, p = 0.292). Finally, attitude fully mediates the relationship between plastic risk perception and behavioral willingness for plastic reduction. Theoretical and managerial implications are discussed.

Factors affecting intent to perpetrate violence against nurses: Theory of Planned Behavior approach.

BACKGROUND: The Theory of Planned Behavior (TPB) has been found to predict target behaviors. The literature examining this model lacks attention to violence toward nurses. PURPOSE: To explore the association between the public's exposure to violence and intention to employ violence toward nurses, under the TPB framework. METHODS: A cross-sectional study (705 participants) employed a self-report questionnaire. Path analysis assessed TPB variables' mediation between prior exposure to violence and violent intent toward nurses. DISCUSSION: The TPB variables, that is attitudes, subjective norms, and perceived control, mediated only the association between exposure to physical violence and intention to act violently. Subjective norms were the strongest mediator. The explained variance was 31%. CONCLUSION: When addressing violence against nurses, policymakers must consider attitudes, subjective norms, and perceived control among patients and their attendants. Violence directed at nurses and health care workers reflects societal violence and the "upstream approaches" needed to mitigate violence in health care settings.

Effectiveness of two educational interventions based on the theory of planned behavior on oral cancer self-examination in adults: a randomized controlled trial.

BACKGROUND: The theory of planned behavior (TPB) is recognized as an effective theory for behavior change. The aim of the present study was to investigate the impact of two TPB-based educational interventions on oral self-examination (OSE) behavior and the related TPB constructs among adults in Tehran, Iran, in 2022. METHODS: This randomized controlled trial involved 400 healthy individuals recruited from 20 urban comprehensive health centers in the southern part of Tehran, Iran. The health centers were randomly assigned to two control (PowerPoint) and intervention (WhatsApp) groups (200 individuals in each group). In the control group (the recipient of the routine care), participants received a 20-minute lecture through a PowerPoint presentation and a pamphlet. In the intervention group (the recipient of an additional intervention alongside the routine care), participants were educated through messages and images on WhatsApp along with having monthly group discussions. Data was collected at baseline, as well as at 1- and 3-month follow-ups using a structured questionnaire. The outcomes assessed included OSE behavior and the related TPB constructs: intention, attitude, subjective norm, and perceived behavioral control. Linear and logistic generalized estimating equations (GEE) regression models were used to evaluate the impact of the interventions with STATA version 17. RESULTS: Of the total participants, 151 (37.75%) were men. The mean ± standard deviation (SD) of ages in the PowerPoint and WhatsApp groups were 39.89 ± 13.72 and 39.45 ± 13.90, respectively. OSE and the related TPB constructs showed significant differences between the groups at the 1-month post-intervention assessment. The effect of PowerPoint was more significant in the short-term (one month), while both methods showed similar effectiveness after three months, specifically in relation to OSE and the TPB constructs. At the 3-month post-intervention assessment, there were significant increases in OSE (OR = 28.63), intention (ß = 1.47), attitude (ß = 0.66), subjective norm (ß = 2.82), and perceived behavioral control (ß = 1.19) in both groups (p < 0.001). CONCLUSIONS: The present study provides evidence of the effectiveness of both educational interventions in improving OSE and the TPB constructs after three months. Therefore, both TPB-based educational methods can be recommended for designing and implementing interventions aimed at preventing oral cancer. TRIAL REGISTRATION: The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).

Adaptation and validation of the Physical Restraint-Theory of Planned Behaviour Questionnaire to the paediatric context.

BACKGROUND: Physical restraint is applied in pediatric intensive care units to carry out certain painful procedures and to ensure the maintenance and continuity of life support devices. There is a need to analyse the factors that influence the behaviour or intention to use physical restraint. AIM: To create and test psychometrically a paediatric version of the Physical Restraint-Theory of Planned Behaviour Questionnaire to assess paediatric critical care nurses' intention to use physical restraint. STUDY DESIGN: A psychometric study. Five medical-surgical Paeditric Intensive care Units from five hospitals in Spain. The study took place in three phases. In phase 1, the questionnaire was adapted. In phase 2, the content validity of each item was determined, and a pilot test was conducted. In phase 3, we administered the questionnaire and determined its psychometric properties. RESULTS: The assessment of the intention to use physical restraint was extended to all critical paediatric patients, two items were eliminated from the initial questionnaire, four new items were included, and the clinical scenarios of the intention subscale were expanded from three to six. Overall content validity index for the full instrument of 0.96 out of 1. The Paediatric Physical Restraint-Theory of Planned Behaviour Questionnaire is made up of four subscales (attitude, subjective norms (SN), perceived behavioural control (PBC), and intention) subdivided into 7 factors and 51 items. The internal consistency for the attitude subscale obtained a Cronbach's Alpha of 0.80 to 0.73, for the SN it was 0.72 to 0.89, for the PBC it was from 0.80 to 0.73 and for the intention subscale it was 0.75. CONCLUSIONS: The Paediatric Physical Restraint-Theory of Planned Behaviour Questionnaire is an instrument composed of seven factors and 51 items that validly and reliably assesses the intention of paediatric nurses to apply PR in PICUs. RELEVANCE FOR CLINICAL PRACTICE: Having this instrument will help health centres move towards restraint-free care by allowing managers to assess professionals' attitudes, beliefs, and intentions around the use of PR in PICUs.

Predicting Food Waste Avoidance: Analysis of an Extended Model of the Theory of Planned Behavior and of Relevant Beliefs.

This research adopted the Theory of Planned Behavior (TPB) to predict intention and behavior to avoid food waste. In a pilot study, behavioral, normative, and control beliefs were identified. In the main study, a TPB model extended with descriptive and moral norms was assessed using a two-wave design and applying SEM. The associations between beliefs and TPB constructs were analyzed by MIMIC models. Attitude, descriptive and moral norms, and perceived behavioral control were associated with intention to avoid food waste, which predicted behavior. Considering the most important beliefs in forming intentions has important implications for designing food waste prevention interventions.