Testing the Effectiveness of the Health Belief Model in Predicting Preventive Behavior During the COVID-19 Pandemic: The Case of Romania and Italy

We use a cultural psychology approach to examine the relevance of the Health Belief Model (HBM) for predicting a variety of behaviors that had been recommended by health officials during the initial stages of the COVID-19 lockdown for containing the spread of the virus and not overburdening the health system in Europe. Our study is grounded in the assumption that health behavior is activated based on locally relevant perceptions of threats, susceptibility and benefits in engaging in protective behavior, which requires careful attention to how these perceptions might be structured and activated. We assess the validity of the HBM in two European countries that have been relatively understudied, using simultaneous measurements during acute periods of infection in Romania and Italy. An online questionnaire provided a total of (N = 1863) valid answers from both countries. First, to understand individual difference patterns within and across populations, we fit a General Linear Model in which endorsement was predicted by behavior, country, their interaction, and a random effect for participants. Second, we assess the effect of demographics and health beliefs on prevention behaviors by fitting a multi-group path model across countries, in which each behavior was predicted by the observed health belief variables and demographics. Health beliefs showed stronger relationships with the recommended behaviors than demographics. Confirming previously reported relationships, self-efficacy, perceived severity, and perceived benefits were consistently related to the greater adoption of individual behaviors, whereas greater perceived barriers were related to lower adoption of health behaviors. However, we also point to important location specific effects that suggest that local norms shape protective behavior in highly contextualized ways.

Impact of Health Perception and Knowledge on Genetic Testing Decisions Using the Health Belief Model

PURPOSE Early detection of cancer risk is essential as it is associated with a higher chance of survival, more successful treatment, and improved quality of life. Genetic testing helps at-risk patients estimate the likelihood of developing cancer in a lifetime. This study aims to indentify the factors (perceived susceptibility, severity, benefits, and self-efficacy) that impact one's decision to take the genetic test. METHODS We examined the impacts of different factors of the health belief model on the engagement of patients in genetic testing using data from the National Cancer Institute's 2020 cross-sectional nationally representative data published in 2021. Complete surveys were answered by 3,865 participants (weighted population size = 253,815,197). All estimates were weighted to be nationally representative of the US population using the jackknife weighting method for parameter estimation. We used multivariable logistic regression to test our hypotheses for patients who have taken the genetic test for cancer risk detection. We adjusted the multivariate model for age, education, income, race, sex, cancer history, familial cancer history, and education. RESULTS We tested five hypotheses using the health belief model. Respondents who had genetic testing were more likely to rely on their health care providers and genetic counselors to make their decisions. Respondents who had genetic tests also reported less reliability on other sources than doctors: for the internet and social media (odds ratio = 0.33; P < .001) and for journals and magazines (odds ratio = 0.48; P = .007). CONCLUSION The findings show that patients generally rely on suggestions from their health care providers and counselors in genetic testing decisions. These findings also indicate that health care providers play a critical role in helping patients decide whether to use genetic testing to detect cancer risk in the early stages.

Assessing knowledge and self-report intention from COVID-19 symptoms based on the Health Belief Model among international students in Heilongjiang, China: a cross-sectional study

BackgroundA COVID-19 outbreak has been contained in China through effective prevention measures with the collaboration of the citizens. However, there is resistance to self-reported symptoms as required in the international student community. This study explored knowledge level and symptoms reporting behaviours toward COVID-19 among international students.MethodsAn online cross-sectional investigation was conducted among 119 international students across Heilongjiang province and questionnaires implemented through WeChat between 1 and 25 March 2020. The results were explained using descriptive Χ2 test and binary logistic regression analysis using SPSS V.20.ResultsIn total, 119 international students participated, with a response rate of 90.16%. Of the 119 respondents, 96 (80.7%) knew COVID-19 symptoms, 109 (91.6%) took cognisance of questions on the importance of the maintenance of wearing masks and 113 (95%) on questions regarding hand hygiene in the prevention of disease transmission. However, results show that there were still large gaps in knowledge about questions regarding the virus and the treatment methods (many participants incorrectly believed that the virus could be kill by drinking alcohol or smoking). In addition, more than half of the participants declared compliance with positive health behaviours, however 27.7% did not agree with vaccination (if any), and 31.1% did not agree to be quarantined after being diagnosed with COVID-19. Furthermore, 20 participants (16, 80%) expressed an inclination to deliberately withhold symptoms. Variables in the Health Belief Model showed a significant association with behavioural change.ConclusionFrom our study, we found that there is evident knowledge about COVID-19 among international students, although orientation and sensitisation are still required. Those who were aware of the benefits of reporting, the severity of COVID-19 and the legal consequences of deliberately concealing information showed a greater willingness to report; conversely, those who believed reporting is very inconvenient and feared being quarantined after reporting showed less willingness to report. A study focusing on international students’ knowledge and behaviour amid the pandemic will provide information for countries to cut off the chain of disease transmission of all variants of COVID-19.

Exploring the Effects of Product Knowledge, Trust, and Distrust in the Health Belief Model to Predict Attitude Toward Dietary Supplements

Although the health belief model (HBM) has been widely applied in health behavior research, it cannot fully account for dietary supplement (DS) consumption. This study proposed a second-stage moderation model to empirically examine the mediating role of product knowledge and the moderating effects of trust and distrust in the HBM. Surveys were conducted both online and offline in first-tier Chinese cities; 768 effective samples were collected. Structural equation modeling was employed to test the hypotheses. The findings indicated that perceived susceptibility was a better predictor of attitude toward DS products. Second, perceived susceptibility’s effect on product attitude occurred through product knowledge. Third, trust in manufacturers positively affected product knowledge’s effect on product attitude. Based on these findings, to promote DS consumption, marketers can leverage consumers’ perceived susceptibility to illness, associate the benefits and efficacy of DSs with consumers’ health knowledge, and emphasize their production of high-quality DSs.

Use of Focus Groups to Identify Food Safety Risks for Older Adults in the U.S.

Older adults are vulnerable to foodborne illness; however, many do not follow safe food handling guidelines that would reduce their risk of infection. Virtual focus groups were used to explore older adults’ food handling and consumption practices and to understand how to apply the health belief model for food safety research with respect to older adults. Thirty-nine adults between the ages of 56 and 80 participated in the study. Most participants reported eating poultry and eggs, whereas few reported eating precut fruit or raw sprouts. The majority were not using a cooking thermometer for all types of poultry and did report washing raw poultry. Participants were generally resistant to the idea of heating deli meats. Most focus group participants did not perceive themselves as being personally susceptible to foodborne illness. They did, however, express food safety concerns related to specific foods, such as melons and bagged salads, and they reported taking precautions to limit health risks from these foods. Regarding the Health Belief Model, our results indicate that the construct of perceived susceptibility could be expanded to include perceived risk, which refers to an individual’s belief about the likelihood that a food might be contaminated with a foodborne pathogen. These results should be confirmed among a nationally representative sample of older adults.

An Assessment of an Educational Intervention Program Based on the Health Belief Model for Safer Sex Among Female Sex Workers in Selected Districts of Northern Region of Malawi

Background: Pregnant women are at risk of pregnancy if they have unprotected sex, do not use or poorly use contraceptives in the context of penile-vaginal sex. We therefore developed an educational toolkit based on the Health Belief Model (HBM) to assist FSWs to make informed sexual and reproductive decision for safer sex before and/or after heterosexual encounter with their clients. We evaluated the educational intervention programme among FSWs and other stakeholders (nurses and clinicians).Methods:This was a qualitative operational research. We developed an educational tool kit based on the HBM to aid FSWs to make informed decision for safer sex behaviour. We conducted 10 in-depth interviews (IDIs) to identify the components of the educational tool kit, 5 IDIs for modification and refining the tool, and consequently two Focus Group Discussions (FGDs) for consensus building. This process was done in Mzimba North. After the intervention we conducted 6 FGDs with FSWs and 10 IDIs with nurses and clinicians to evaluate the applicability and feasibility of the intervention among female sex workers (FSWs) in Mzimba North, and Nkhata Bay located in Northern region of Malawi.Results:We observed mixed opinions on the components of the educational toolkit. Female sex workers were eager to understand misinformation and misconceptions on contraceptives, right to justice, effectiveness of contraceptives. Female sex workers requested the inclusion of STIs and HIV prevention and economic empowerment in the toolkit. Overall the toolkit and the educational intervention were relevant, feasible, and applicable among the study participants. Conclusion:While several strategies can be used to facilitate the implementation of the evidence based intervention to improve health, our educational intervention program based on the Health Belief Model for safer sex behaviour among female sex workers was found to be feasible and applicable in our study settings. We believe that the intervention may be helpful to address sexual and reproductive health challenges encountered by FSWs in the study sites and elsewhere.

Indonesian Adaptation of New Norms during The Early Phase of The Pandemic Against COVID-19

Background: The COVID-19 pandemic has spread dramatically since March 2020. At the end of May 2020, the Indonesian government stated that Indonesia would soon enter a new phase facing COVID-19. This phase forced people to adopt new living norms to suppress the spread of COVID-19. This study attempted to analyze how the society in Indonesia adapted to new norms and their relation with perceived susceptibility, severity, benefits, and barriers experienced using the Health Belief Model theory.Method: This cross-sectional study voluntarily involved 948 participants across the island of Java through an online survey conducted between June 30 to July 9 2020, with Google Forms. The indicators measured in the study were: healthy living practices, changes in healthy behaviour, perceptions of susceptibility, severity, benefits, and barriers to the COVID-19 pandemic.Results: The study found that more than half of the respondents practised a healthy lifestyle during the COVID-19 pandemic. Most of them admitted that their health behaviour was better than before the pandemic. People with positive perceptions of the benefits and barriers to COVID-19 practiced a healthy lifestyle during the pandemic better (AOR = 1.72; 95% CI = 1.20-2.48 and AOR = 2.24; 95% CI = 1.60-3.14, respectively). People who had positive perceptions of susceptibility and severity about COVID-19 problems had a higher chance of improving previous preventive behaviour (AOR = 2.06; 95% CI = 1.37-3.09 and AOR = 1.79; 95% CI = 1.20-2.69, respectively). Thus, the conclusion was Indonesian people have positive practices and perceptions about the susceptibility and severity of COVID-19, which are useful for enforcing COVID-19 preventive behaviour.