Factors associated with pregnant women's willingness to receive maternal pertussis vaccination in Guizhou Province, China: An exploratory cross-sectional study

The rise in pertussis incidence among infants in Guizhou, China underscores the need for maternal acellular pertussis vaccine (aP) immunization, a key strategy in protecting infants from severe health consequences. However, the willingness of pregnant women in Guizhou to receive this vaccine is not well-understood. This study aimed to explore pregnant women's intentions toward maternal pertussis vaccination in Guizhou and identify the associated factors. A questionnaire based on the health belief model, was administered in an exploratory cross-sectional study from January to February 2022. Data from 564 participants were collected and analyzed. The chi-square test, Mann-Whitney U test, and Poisson regression were used to identify potential factors associated with vaccination intentions. Participants' median age was 27 y (interquartile range (IQR): 24-31), and the median number of children per participant was one. The study found that only 36.0% of the participants intended to receive the aP vaccine while 64.0% were uncertain or negative in this regard. Significant factors associated with intentions to vaccinate included perceived barriers and cues for action and perceived benefits. The major barriers for low vaccination intentions were safety concerns for both the fetus and the mother, and family members' negative attitudes. Free vaccines, perceiving preventive benefits, observing other pregnant women getting vaccinated, and healthcare provider recommendations may facilitate vaccination intentions. Multiple immune strategies should be developed or optimized to cope with the resurgence of pertussis.

Using an extended information-motivation-behavioral skills model to explain HPV vaccination intention among men who have sex with men only and men who have sex with men and women

Men who have sex with men and women (MSMW) have been reported to differ in psychosocial and sexual behavior patterns from men who have sex with men only (MSMO). However, results regarding the differences in HPV vaccination intention/behavior were inconclusive. We compared HPV vaccination intention between MSMO and MSMW and analyzed the differences in potentially associated factors in China. MSM participants were recruited online using a snowball sampling method. Cross-sectional data were collected via a questionnaire based on the extended information-motivation-behavioral skills model. Structural equation modeling was conducted to examine the relationship between the variables, followed by multi-group analysis to test differences between groups. Of 914 MSM, 77.68% were MSMO and 22.32% were MSMW. MSMW had a higher rate of reluctance to vaccinate than MSMO (23.53% vs. 16.20%, p = .016). Differences between the two groups were statistically significant in risky sexual behavior, behavioral skills, and promotional attitude. In both groups, promotional attitude was the most significant predictor of vaccination intention. Vaccination intention was directly influenced by motivation and indirectly by risky sexual behavior in MSMO, but not significantly in MSMW. Additionally, the direct effect of information on behavioral skills in MSMW was significantly greater than that in MSMO, but we did not find any effect of behavioral skills on vaccination intention. MSMW had lower vaccination intention than MSMO. MSMO may be influenced by risky sexual behavior and motivation, positively impacting their vaccination intention, unlike MSMW. Targeted strategies could help promote HPV vaccination, especially in MSMW.

Assessing preconception health in Australia to support better outcomes in the first 2000 days - A critical need for building a core indicator framework

In 2021, the Preconception Health Network Australia co-developed preconception health core indicators identified as critical to ensuring optimal maternal and child outcomes following conception. We conducted an audit of perinatal databases across each state and territory to identify whether preconception core indicator data were available. Seven health domains co-developed by the Preconception Health Network were mapped against the data collected in the perinatal databases. Indicator data were lacking across all seven health domains, with data missing for social determinants of health indicators. Better data linkage and developing a national evidence-based framework would allow ongoing monitoring of women's preconception health nationally.

Factors Impacting Chinese Older Adults' Intention to Prevent COVID-19 in the Post-COVID-19 Pandemic Era: Survey Study

BACKGROUND

Understanding the factors influencing individuals' health decisions is a dynamic research question. Particularly, after China announced the deregulation of the COVID-19 epidemic, health risks escalated rapidly. The convergence of "no longer controlled" viruses and the infodemic has created a distinctive social period during which multiple factors may have influenced people's decision-making. Among these factors, the precautionary intentions of older individuals, as a susceptible health group, deserve special attention.

OBJECTIVE

This study aims to examine the intention of older adults to engage in preventive behaviors and the influencing factors, including social, media, and individual factors, within the context of the postepidemic era. Drawing upon the structural influence model of communication, this study tests the potential mediating roles of 3 different types of media exposure between cognitive and structural social capital and protective behavior intention, as well as the moderating role of negative emotions between social capital and media exposure.

METHODS

In this study, a web survey was used to collect self-reported quantitative data on social capital, media exposure, negative emotions, and the intention to prevent COVID-19 among older adults aged ≥60 years (N=399) in China.

RESULTS

The results indicate that cognitive social capital significantly influenced protective behavior intention (P<.001), with cell phone exposure playing an additional impactful role (P<.001). By contrast, newspaper and radio exposure and television exposure mediated the influence of structural social capital on protective behavior intention (P<.001). Furthermore, negative emotions played a moderating role in the relationship between cognitive social capital and cell phone exposure (P<.001).

CONCLUSIONS

This study suggests that using tailored communication strategies across various media channels can effectively raise health awareness among older adults dealing with major pandemics in China, considering their diverse social capital characteristics and emotional states.

Understanding Adolescents' Experiences With Menstrual Pain to Inform the User-Centered Design of a Mindfulness-Based App: Mixed Methods Investigation Study

BACKGROUND

Digital interventions are increasingly popular for the provision of nonpharmacological pain interventions, but few exist for adolescents with menstrual pain. User-centered design involves incorporating users across phases of digital health intervention design, development, and implementation and leads to improved user engagement and outcomes. A needs assessment is the first step of this approach.

OBJECTIVE

The goal of this study was to conduct a needs assessment to understand menstrual pain management needs and preferences and mindfulness experiences, preferences, and knowledge of adolescents with menstrual pain to inform the future development of an app for managing menstrual pain.

METHODS

We used an explanatory sequential mixed method design that included a survey followed by focus groups. Adolescents aged 13-17 years completed a survey (n=111) and participated in focus groups (n=16). Data were analyzed using descriptive statistics and thematic content analysis and synthesized to provide specific recommendations based on adolescent responses.

RESULTS

Adolescents (n=111) who completed the survey reported a moderate understanding of mindfulness and menstrual pain. Over three-quarters (n=87, 78%) of participants practiced some form of mindfulness and 87% (n=97) of survey participants used nonpharmacological pain management strategies. Teens had a moderate perception that mindfulness could help their menstrual pain (mean 4.51/10, SD 2.45, with higher scores suggesting more interest). Themes were generated related to mindfulness experiences, menstrual pain knowledge and experiences, and app functionality. These themes underscored adolescents' need for continued support and flexible access to mindfulness activities; their awareness of multiple influences to pain, with potential for further education in this area; and the need for menstrual pain-specific content, along with content relevant to typical day-to-day experiences of adolescents.

CONCLUSIONS

Adolescents with menstrual pain have an interest in using a mindfulness app for pain but have unique needs that need to be addressed to ensure app engagement and relevance for this population. Concrete recommendations for future app development are provided.

The Older Adults' Intention to Use Silver Diamine Fluoride for Dental Caries Treatment

Purpose

This study aimed to determine the intention of older adults to use silver diamine fluoride (SDF) for treating tooth decay.

Patients and Methods

A group of Thai-speaking individuals between the ages of 60 and 90 were asked to participate in the study. They were provided with information about SDF and then asked to complete a questionnaire based on the Theory of Reason Action (TRA). The questionnaire consisted of 23 questions divided into seven constructs aimed at determining the determinants of the intention to use SDF. These constructs were behavioral belief, evaluation of behavioral outcome, normative belief, motivation to comply, attitude towards behavior, subjective norm, and intention. The responses were rated on a 4-point Likert scale ranging from 1 (Strongly disagree) to 4 (Strongly agree). The characteristics and TRA scores of the participants were analyzed and compared based on their intention to use SDF, using the Chi-square test and t-test. Multiple logistic regression was employed to determine the determinants of the intention to use SDF.

Results

The study involved 588 participants, with an average age of 65.3 years (SD= 5.53). Of the participants, 52.7% were women, 58.1% were unemployed or retired, 80.8% lived with family, 63.4% had less than sixth-grade education, 62.9% had a monthly family income of less than 10,000 baht, and 63.6% had underlying diseases. The study found that 82.7% of the participants intended to use SDF for dental caries treatment, with an average score of 2.86 out of 4. The study also found that age, family income, underlying diseases, dental health problems, and fear of the dentist significantly affected their intention. Behavioral beliefs and evaluations of behavioral outcomes significantly affected the intention to use SDF treatment.

Conclusion

Most older adults in the study intended to use SDF for dental caries treatment.

Understanding the intention and behavior of psychological help-seeking among Chinese college students using theory of planned behavior: a three-month follow-up study

Underutilization of mental health services is common and associated with substantial suffering, mental disorders and death. The present study aimed to explore factors significantly affecting the professional psychological help-seeking behavior based on the Theory of Planned Behavior (TPB). A sample of 597 Chinese college students recruited online completed the questionnaires, which measured four constructs of TPB including help-seeking intention, attitude, subjective norm and perceived behavioral control in December 2020. Help-seeking behaviors were evaluated three months later in March 2021. A two-step structural equation modeling procedure was used to test the TPB model. Findings show that partially consistent with TPB, more positive attitudes about seeking professional help (Β = .258, p = .001) and higher perceived behavioral control (Β = .504, p < .001) directly predicted higher intention to seek mental health services, and perceived behavioral control (Β = .230, p = .006) directly predicted help-seeking behavior. However, behavioral intention (Β = -.017, p = .830) did not statistically significantly predict help-seeking behavior, while subjective norm (Β = .047, p = .356) did not predict help-seeking intention as well. The model accounted for 49.9% of the variance modeling help-seeking intention and 12.4% of the variance modeling help-seeking behavior. The results revealed the importance of attitude and perceived behavioral control in predicting help-seeking intention and behavior among Chinese college students and indicated that there existed a gap between intention and actual help-seeking behavior.

Cooking at Home: Correlates of Frequency and Intention in Fifth Graders

Cooking at home is associated with health benefits, and 10- and 11-year-old children are capable of participating in meal preparation. However, opportunities for children to cook at home have declined. This study aimed to identify determinants of the frequency and the intention to cook at home in fifth graders using the Theory of Planned Behavior as a framework with quantitative methodology. A total of 241 participants across five elementary schools of the Chaudière-Appalaches region (Quebec, Canada) took part in this correlational study. Data were collected via a self-administered questionnaire based on the Theory of Planned Behavior. Regression analyses led to the identification of determinants of frequency and intention to cook at home. More than two-thirds of participants (69%) declared having cooked at home in the past 7 days. Intention was the only significant variable explaining 18% of the variance for frequency. Intention was determined by perceived behavioral control, attitude, descriptive norms, subjective norms, perceived barriers, being a girl, and normative beliefs, which explain 74% of the variance. Whereas other studies aiming at better understanding children's involvement in meal preparation at home focused on self-efficacy for cooking, this study highlights other behavioral determinants. For example, support from parents appears to be crucial to promote this behavior in this age group. Future research and interventions should be oriented toward determinants such as subjective norms and normative beliefs, and focus on children's autonomy.

Impact of a Nationwide Medication History Sharing Program on the Care Process and End-User Experience in a Tertiary Teaching Hospital: Cohort Study and Cross-Sectional Study

Background

Timely and comprehensive collection of a patient's medication history in the emergency department (ED) is crucial for optimizing health care delivery. The implementation of a medication history sharing program, titled "Patient's In-home Medications at a Glance," in a tertiary teaching hospital aimed to efficiently collect and display nationwide medication histories for patients' initial hospital visits.

Objective

As an evaluation was necessary to provide a balanced picture of the program, we aimed to evaluate both care process outcomes and humanistic outcomes encompassing end-user experience of physicians and pharmacists.

Methods

We conducted a cohort study and a cross-sectional study to evaluate both outcomes. To evaluate the care process, we measured the time from the first ED assessment to urgent percutaneous coronary intervention (PCI) initiation from electronic health records. To assess end-user experience, we developed a 22-item questionnaire using a 5-point Likert scale, including 5 domains: information quality, system quality, service quality, user satisfaction, and intention to reuse. This questionnaire was validated and distributed to physicians and pharmacists. The Mann-Whiteny U test was used to analyze the PCI initiation time, and structural equation modeling was used to assess factors affecting end-user experience.

Results

The time from the first ED assessment to urgent PCI initiation at the ED was significantly decreased using the patient medication history program (mean rank 42.14 min vs 28.72 min; Mann-Whitney U=346; P=.03). A total of 112 physicians and pharmacists participated in the survey. Among the 5 domains, "intention to reuse" received the highest score (mean 4.77, SD 0.37), followed by "user satisfaction" (mean 4.56, SD 0.49), while "service quality" received the lowest score (mean 3.87, SD 0.79). "User satisfaction" was significantly associated with "information quality" and "intention to reuse."

Conclusions

Timely and complete retrieval using a medication history-sharing program led to an improved care process by expediting critical decision-making in the ED, thereby contributing to value-based health care delivery in a real-world setting. The experiences of end users, including physicians and pharmacists, indicated satisfaction with the program regarding information quality and their intention to reuse.

Work characteristics, job satisfaction and intention to leave: a cross-sectional survey of advanced nurse practitioners

BACKGROUND

Advanced Nurse Practitioners (ANPs) are highly skilled health care professionals with the potential to play a major role in improving the quality and accessibility of health care services. However, there is emerging evidence of disquiet among nurse practitioners who often work in suboptimal work environments. Therefore, it is important to understand the elements that contribute to ANPs' job satisfaction and retention in healthcare services.

AIM

To examine the effects of commitment to the workplace, work engagement, and influence at work on job satisfaction and intention to leave of ANPs.

METHODS

A total of 153 ANP's on the advanced practice section of the Nursing and Midwifery Board of Ireland register completed a web survey between July and August 2020. Independent variables (commitment to the workplace, work engagement, and influence at work) were measured using the Copenhagen Psychosocial Questionnaire (COPSOQ). Multivariable logistic regression models were used to investigate the association between dependent and independent variables.

RESULTS

Participants who reported higher levels of influence at work and higher levels of commitment to the workplace were also satisfied in their job (OR 1.05, 95% CI 1.01-1.09, p = 0.025), (OR 1.10, 95% CI 1.06-1.14, p < 0.001) respectively. Additionally, ANPs with higher levels of commitment to work were significantly less likely to leave their role (OR 0.94, 95% CI .92-.96, p < 0.001).

CONCLUSION

Healthcare organisations can improve job satisfaction and decrease intention to leave by creating environments in which ANPs are supported by their colleagues and supervisors, and facilitate their practice to the full extent of their capabilities.

Pandemic fatigue, behavioral intention and predictors of COVID-19 vaccination among individuals living with HIV in Bench Sheko Zone, in Southern Ethiopia, application of TBP: a facility based cross sectional study

Introduction

People living with HIV often face inequalities and negative outcomes, which make them vulnerable. To protect this population and achieve herd immunity, it is crucial for COVID-19 vaccination efforts to prioritize and encourage vaccination among people living with HIV (PLWH). However, in Ethiopia, there is a lack of motivation in this regard. To tackle this issue, a study was conducted in the Bench Sheko Zone of Southwest Ethiopia. The study aimed to assess pandemic fatigue, behavioral intention to get vaccinated, and factors influencing COVID-19 vaccine acceptance among PLWH in that region.

Methods

A facility-based cross-sectional study was conducted among individuals living with HIV who were over 18 years old in Bench-Sheko Zone, located in Southwest Ethiopia. The study included a total of 590 participants from four ART healthcare facilities within the zone. The researchers utilized the Theory of Planned Behavior to examine the predictors of intention to use preconception care. Multiple linear regression analysis was employed to determine these predictors, with a p-value of less than 0.05 considered as indicative of a significant association. The final analysis of the study involved the use of linear regression analysis, and the measure of association was presented as the standardized B coefficient following a multivariable logistic regression analysis.

Result

In the conducted study, the response rate was an impressive 98%. The researchers aimed to investigate the behavioral intention toward the COVID-19 vaccine, which was found to be 55.7%. The average age of the participants in the study was 34.65 ± 6.67. The study was the assessment of pandemic fatigue, which had a mean value of 17.22 ± 5.28. During the multivariate linear regression analysis, four predictor variables were identified. Among these, three variables, namely subjective norm, pandemic fatigue, and age, positively influenced the behavioral intention toward the COVID-19 vaccine. Comprehending these factors can assist healthcare professionals and policymakers in formulating precise interventions and strategies aimed at enhancing the acceptance and adoption of vaccines.

Conclusion

The study indicates that individuals living with HIV have shown lower vaccine intention compared to previous research. The study identifies subjective norm, pandemic control measures, income, and age as predictors of individuals' intention to receive the COVID-19 vaccine.

Theory of Planned Behavior and alcohol use in adolescents in Ecuador. Structural linear regression analysis

The general aim is to identify the explanatory potential of Alcohol use intentions in drinking behaviors in a sample of adolescents in Ecuador. The method consists of a descriptive, explanatory and cross-sectional study using SEM techniques. The participants were 384 adolescents (57% male and 43% female), aged among 14 and 18 years (M= 16.51; SD= 2.64), who are students attending between the 1st and 3rd year of high school in a public educational institution in Ambato, Ecuador. Like principal results, the presence of Alcohol use intention is moderate; the practice of alcohol use is low and mostly does not represent a risk, although 3.9% of the participants could report significant problems with consumption. Intentionality and drinking covary positively with low and moderate intensity. Drinking intentionality explained 15.3% the variance of drinking. We conclude that the Alcohol use intentions are a predictor of adolescent drinking behaviors.

The Association between Message Framing and Intention to Vaccinate Predictive of Hepatitis A Vaccine Uptake

As ongoing, sporadic outbreaks of hepatitis A virus (HAV) infections present public health challenges, it is critical to understand public perceptions about HAV, especially regarding vaccination. This study examines whether message framing changes the intention to vaccinate against HAV and self-reported vaccine behavior. Using a randomized controlled trial (N = 472) in February 2019 via Amazon Mechanical Turk, participants were randomized to one of four HAV vaccination message groups or a no-message control group. The message groups varied in their emphasis on the nature of outcomes (gain versus loss) and for whom (individual versus collective). The message frames were compared by intention to vaccinate, differences in message characteristics, and behavioral determinants. There was no difference in intention to vaccinate between gain- versus loss-framed messages (MD = 0.1, 95% CI = -0.1, 0.3) and individual- versus collective-framed messages (MD = 0.1, 95% CI = -0.1, 0.3). The intention to vaccinate against HAV in the no-message control group was very similar to that in the message groups. However, gain-framed messages were rated more positively in valence than loss-framed messages (MD = -0.5, 95% CI = -0.7, -0.3), which may be helpful for cultivating a positive public perception of HAV vaccination. The study also highlights the importance of comparing message frames to a no-message control in designing health communication messaging promoting HAV vaccination.

Differences in Attitudes and Barriers Towards Advance Care Planning Amongst Ischemic Heart Disease Patients: A Cross-Sectional Study

OBJECTIVES

Perceptions towards advanced care planning (ACP) amongst individuals with Ischemic Heart Disease before or after a life-threatening Acute Myocardial Infarction event is underexamined and could impact the appropriate timing for ACP advocacy. This cross-sectional study assessed awareness and intentions regarding ACP in individuals with Ischemic Heart Disease, both before and after an Acute Myocardial Infarction, and explored the motivating effect of a near-fatal Acute Myocardial Infarction event on its engagement.

METHODS

This study was conducted from 24 August 2021 through 13 March 2023, whereby patients were administered a one-time questionnaire with no follow-up required. Patients with either chronic Ischemic Heart Disease (group A) or a recent Acute Myocardial Infarction event (group B) were recruited from the outpatient National University Heart Centre, Singapore.

RESULTS

101 patients (n = 51 for Group A, n = 50 for Group B) were recruited. Mean age (SD) was 59 (10.5) years and 84 were male (83.2%). Between both groups, patients in group B reported significantly higher scores on 'Lack of information' and 'Self-efficacy' domains, and had no ACP awareness nor plans of doing an ACP compared to group A. ACP awareness was the sole significant predictor of intentions of doing an ACP in the final regression model (P < .05).

CONCLUSIONS

Interestingly, this study suggests that surviving a potentially life-threatening heart condition did not result in higher intention of doing an ACP. Thus, advocacy of ACP in the community should simply start by raising awareness levels widely and may not need to be focused on individuals' state of health.

Predictors of Human Papillomavirus Vaccine Intention and Uptake Among US Hispanic Parents: A Cross-Sectional Study

Introduction: This study explored the influence of the Theory of Planned Behavior constructs on human papillomavirus (HPV) vaccine (HPVV) intentions and uptake among Hispanic parents in South Florida for their children aged 9-21. Method: A descriptive exploratory analysis was conducted using 39 surveys completed by Hispanic parents. These surveys encompassed demographic data and questions about HPVV uptake, intention, attitudes, subjective norms, knowledge, self-efficacy, and awareness. Results: Most participants were uninsured (77%), unemployed (59%), and had low Americanism acculturation (74%). A little over half were aware of the HPVV (54%), yet most had high positive HPVV attitudes (95%) and self-efficacy (85%). HPVV intentions within the year were also high (82%); however, HPVV uptake (45%) and HPVV knowledge (40%) were low at the time of the study. Most parents reported physicians (72%) and nurses/nurse practitioners (59%) as the most influential individuals in their decision-making. A statistically significant relationship between HPVV intention and HPVV attitude (X_Wald^2 (1) = 5.71, p = 0.02., OR = 5.11) and between HPVV uptake and HPVV awareness (X_Wald^2 (1) = 4.63, p = 0.03., OR = 12) were observed. Conclusion: This study recommends further research and targeted interventions to improve HPVV awareness among Hispanic communities. The participants' highly positive attitudes and self-efficacy provide a hopeful outlook for future vaccination efforts within this demographic.

Endovascular Brain-Computer Interfaces in Poststroke Paralysis

Stroke is a leading cause of paralysis, most frequently affecting the upper limbs and vocal folds. Despite recent advances in care, stroke recovery invariably reaches a plateau, after which there are permanent neurological impairments. Implantable brain-computer interface devices offer the potential to bypass permanent neurological lesions. They function by (1) recording neural activity, (2) decoding the neural signal occurring in response to volitional motor intentions, and (3) generating digital control signals that may be used to control external devices. While brain-computer interface technology has the potential to revolutionize neurological care, clinical translation has been limited. Endovascular arrays present a novel form of minimally invasive brain-computer interface devices that have been deployed in human subjects during early feasibility studies. This article provides an overview of endovascular brain-computer interface devices and critically evaluates the patient with stroke as an implant candidate. Future opportunities are mapped, along with the challenges arising when decoding neural activity following infarction. Limitations arise when considering intracerebral hemorrhage and motor cortex lesions; however, future directions are outlined that aim to address these challenges.

Do both anticipated relief and anticipated regret predict decisions about influenza vaccination?

OBJECTIVE

Anticipated regret has been found to predict vaccination intentions and behaviours. We examined whether anticipated relief also predicts seasonal influenza vaccination intentions and behaviour. Given claims about differences in their antecedents and function, we distinguished between counterfactual relief (relief that a worse outcome did not obtain) and temporal relief (relief that an unpleasant experience is over).

DESIGN

Cross-sectional.

METHODS

Unvaccinated participants (N = 295) were recruited online in November 2020. Participants completed measures of anticipated regret, anticipated counterfactual relief, and anticipated temporal relief and measures of theory of planned behaviour constructs (attitudes, norms, perceived control, and intentions). One month later, the same participants were re-surveyed and asked to report their vaccination status.

RESULTS

Although all anticipated emotion measures were associated with intentions and behaviour, only anticipated counterfactual relief and regret independently predicted vaccination intentions in regression analyses. Mediation analysis showed both anticipated counterfactual relief and regret were indirectly, via intentions, associated with behaviour.

CONCLUSIONS

Results suggest that, regardless of valence, counterfactual emotions predict vaccination intention and, indirectly, behaviour. Furthermore, participants may differ in their sensitivity to the anticipation of positive versus negative counterfactual emotions. These findings may permit more precise targeting of interventions to increase vaccine uptake.

Knowledge, Attitudes and Intention to Donate Organs among the Public, Health Sciences Students and Health Personnel: A Scoping Review with a Systematic Review of Malaysian Studies

Background

Various barriers lead to a shortage of organs for transplantation in Malaysia. One drive to improve the organ donation rate operates through future healthcare practitioners and practitioner advocacy. This scoping review was carried out to establish and summarise findings about organ donation-related articles among the public, health sciences students and health personnel. A further aim was to synthesise the latest data on knowledge and attitudes towards organ donation in the Malaysian population.

Methods

PubMed, Scopus, Google Scholar and the Malaysian Medical Repository (MyMedR) were used for a search conducted up to May 2022. Relevant search terms included 'Organ donation' and 'Malaysia'. Journal articles related to knowledge, attitudes and intention were grouped under the general public and health science. Students and health personnel were included. Eligible studies were reviewed by two independent reviewers. Any disagreements were resolved by consensus with a third reviewer.

Results

The 31 included articles revealed an increased level of awareness among the public regarding organ donation. The analysis identified that nonrecognition of brainstem death (38.5%), no knowledge of how to contact the Organ Transplant Coordinator (82.3%) and never approaching the families of a potential donor (63.9%) led to a lack of confidence among healthcare practitioners to promote organ donation.

Conclusion

The shortage of organ donors is the result of the failure to identify the expected donor, obtain consent and procure the organs due to the passivity of Malaysian health professionals in promoting the organ donation process.

Nursing Students' Perceptions of Factors Influencing Nursing Intentions toward COVID-19 Patients

Coronavirus disease (COVID-19) is a pandemic to which nursing students are particularly susceptible. This study aims to comprehensively examine nursing students' knowledge, attitudes, risk perceptions, preventive behaviors related to COVID-19, and nursing intentions toward patients with the virus. A questionnaire was administered to 149 nursing students from two universities. Data on the respondents' general characteristics, knowledge levels, attitudes, perceived risk, preventive behaviors toward COVID-19, and nursing intentions toward COVID-19 patients were collected. The collected data were statistically analyzed using SPSS software (version 26.0). This involved descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analyses. The analyses of the factors affecting nursing students' nursing intentions for COVID-19 patients showed that the most predictive factor was perceived risk (β = -0.38, p < 0.001), followed by attitudes (β = 0.29, p < 0.001) and preventive behaviors (β = 0.17, p = 0.017), which explained 26% of the variance in nursing intentions. Lowering the perceived risk of infectious diseases and cultivating positive attitudes and preventive behaviors can increase nursing students' intentions toward COVID-19 patients. Finally, infection management education programs and research on interventions for nursing students are necessary to enhance the quality of nursing care provided to patients with novel infectious diseases.

Factors affecting childbearing intention in women employees in Birjand: Application of the theory of planned behavior

BACKGROUND

Childbearing is one of the most important determinants of population fluctuations. Identifying factors affecting childbearing is necessary for the proper implementation of population programs. This study aimed to determine the factors affecting childbearing intention among women employees in Birjand based on the theory of planned behavior.

MATERIALS AND METHODS

In this descriptive-correlational study, 405 women employees in the offices of Birjand city in 2022 were selected by stratified random sampling and completed a two-part questionnaire including demographic information and questions related to the theory of planned behavior. The data were analyzed using SPSS v19 and Pearson's correlation, logistic regression, independent t-test, and ANOVA.

RESULTS

The mean age of the participants in the study was 37.82 ± 6.39 years and the mean number of current children was 1.77 ± 0.92. The mean score of childbearing intention was 8.80 ± 3.06, the attitude was 66.04 ± 11.50, the subjective norm was 27.03 ± 6.95, and perceived behavioral control was 32.90 ± 7.80. Also, there was a significant negative and direct relationship between all the constructs of the theory of planned behavior and childbearing intention (P < 0.01). The variables of age, the number of current children, and the ideal number of children were predictors of childbearing intention. According to the standardized beta coefficients, the strongest predictor of intention was the number of current children (β = -0.464).

CONCLUSION

The findings showed that various demographic factors are efficient in childbearing intention. The findings of this study can provide a picture of the current situation of factors affecting childbearing intention in society and be used as a guide for policymakers in fertility planning.

Intentions at the End of Life: Continuous Deep Sedation and France's Claeys-Leonetti law

In 2016, France passed a major law that is unique in giving terminally ill and suffering patients the right to the controversial procedure of continuous deep sedation until death (CDS). In so doing, the law identifies CDS as a sui generis clinical practice, distinct from other forms of palliative sedation therapy, as well as from euthanasia. As such, it reconfigures the ethical debate over CDS in interesting ways. This paper addresses one aspect of this reconfiguration and its implications for the intentions at work in this complex time at the end of life. The concept of intention is often considered central to the ethics of end-of-life care, but its role is recognized to be problematic, with charges of elusiveness and ambiguity. I aim to show that consideration of the French law affords a new understanding of the intentionality of CDS, and that in addition to the obvious importance of this for clarifying the ethics of the practice, it may suggest new ways of addressing the wider problem of ambiguous clinical intentions at end of life.

Knowledge, attitude, and practices regarding human papilloma virus vaccination among physicians in Qatar

BACKGROUND

The human papilloma virus is a global problem that affects sexually active women and men, with cervical cancer being the most serious associated disease. Most cervical cancer cases can be prevented by vaccination against the human papilloma virus early in life. The objective of this study was to assess the knowledge, attitudes, and practices among physicians working in Qatar, regarding the human papilloma virus, infection, and prevention using vaccines.

STUDY-DESIGN

This was a cross-sectional study using quantitative data collection.

METHODOLOGY

An online survey targeting physicians working in Qatar was conducted, using a web-based pretested questionnaire. The questionnaire comprised four sections capturing a few demographic details, 33 questions in the Knowledge Section, 12 questions eliciting the attitude, and 14 practice-related questions. Mean knowledge score was calculated and those with a score more than the mean score were considered to have sufficient knowledge. Association between knowledge and attitude/practices/independent variables were looked for using bivariate and multivariate analysis. Logistic regression was used to identify the predictors for recommending human papilloma virus vaccines.

RESULTS

Of the 557 physicians who participated, 83.7% had sufficient knowledge, but only 69.1% knew that human papilloma virus vaccines were available in Qatar. The majority (89.4%) knew that human papilloma virus infection could be asymptomatic and 96.1% knew at least one symptom; 77% believed the human papilloma virus vaccine would substantially decrease the chances of human papilloma virus infection and related cancers and 46.5% felt physicians were less motivated to promote the human papilloma virus vaccine. The perceived barriers to community acceptance of the human papilloma virus vaccine were lack of awareness regarding the relationship between human papilloma virus and cervical cancer (61.6%), doubts regarding efficacy (32.5%), fear regarding safety (26.9%), concern that the human papilloma virus vaccination may encourage risky sexual behavior (26.8%), and perceived low-risk (23.3%) and cost (24.6%). Only 21.5% commonly discussed sexual health with their clients. More than one-third were not interested in recommending the human papilloma virus vaccine. Bivariate analysis showed nationality, specialization, discussing with patients, and recommending vaccine to be significantly associated with knowledge. Bivariate and regression analysis identified that female gender and physician's religion were significant predictors to recommend the human papilloma virus vaccine.

CONCLUSION

Most physicians have good knowledge. Less than one-fourth commonly discussed sexual health with their clients. More than one-third were not interested in recommending the human papilloma virus vaccine. This issue might affect the human papilloma virus vaccination program implementation if not well addressed.

Breastfeeding Intention, Knowledge, and Attitude of Pregnant Women in Treatment for Opioid Use Disorder

OBJECTIVE

 The objective of this study was to describe breastfeeding intention, knowledge, and attitude, and sources of infant feeding information during the prenatal period among a cohort of pregnant women in treatment for opioid use disorder (OUD).

STUDY DESIGN

 Pregnant women who were receiving treatment for OUD and in the third trimester completed a questionnaire that measured demographic characteristics, infant feeding intentions, breastfeeding beliefs and attitudes, and sources of breastfeeding information. Frequency counts and percentages and means and standard deviations were used to describe data.

RESULTS

 Sixty-five women completed the survey. Three-fourths reported some intention to breastfeeding. While attitudes around breastfeeding were generally positive, less than half of respondents knew the recommendations and infant health benefits of breastfeeding.

CONCLUSION

 Prenatal programs for women in treatment for OUD should consider addressing patient-reported concerns and gaps in knowledge regarding the benefits of and recommendation for breastfeeding.

KEY POINTS

· Breastfeeding has unique benefits for mother-infant dyads affected by maternal OUD.. · Breastfeeding decisions are influenced by maternal psychosocial factors (e.g., knowledge and attitudes), however, such factors have not been previously assessed in women in treatment for OUD.. · Results indicate that attitudes around breastfeeding are positive but knowledge gaps exist..

Envisaging the intention and adoption of electronic health applications among middle-aged and older adults: Evidence from an emerging economy

Technology plays a substantial role in our daily lives, and the spread of COVID-19 paves the way for the use of healthcare technologies to manage health in the comfort of our homes. Middle-aged and older adults face health issues and require instant healthcare advice and support. Electronic healthcare (EH) applications have emerged to facilitate middle-aged and older adults receiving healthcare support instantly while remaining in their homes. The present study empirically evaluates the intention and adoption of electronic health applications with the technological attributes of perceived compatibility, cost, product value, technology accuracy, privacy issues and health motivation among middle-aged and older adults from Malaysia. Moreover, this research examines the mediating effect of the intention to adopt EH applications between technology attributes and the adoption of EH applications. This study uses a cross-sectional method and employs an online survey to assemble quantitative data from 298 middle-aged and older Malaysian adults. It utilizes partial least squares structural equation modelling for data analysis. The data analysis reveals that perceived compatibility, cost, privacy, product value and health motivation significantly influenced the intention to use EH apps. Furthermore, the analysis shows that the intention to adopt EH apps significantly mediates the relationship between the perception of cost, personal privacy, product value, health motivation and adoption of EH apps. However, the intention to use EH apps insignificantly instigates their adoption. Finally, the study presents its implications, limitations and future research directions.

The Development and Efficacy of a High School Athlete Education Program for Safe Nutritional Supplement Use

Many high school athletes report using nutritional supplements. Due to a lack of education at the high school level, the use of safe for sports third-party tested nutritional supplements may be limited. To determine the impact of a short online nutritional supplement education program on safe dietary supplement behavior a cross-sectional repeated measures design was used. Therefore, a convenience sample of 106 high school athletes (14-19 years old) was recruited to measure pre-post education difference for nutritional supplement use and third-party tested (TPT) supplements. Additionally, it was analyzed if nutritional supplement related Theory of Planned Behavior (TPB) constructs were associated with athlete choices. The most popular supplements included protein powder (65%), caffeine from beverages (45%), and different types of vitamins (ranging from 38-44%). Consistent use of (safe) third-party tested individual supplements was low, ranging from 35-77% for the most frequently reported supplements. The combined TPB determinants explained 26% of the variance of the intention to use safe supplements (F3, 102 = 13.03, p < 0.001, Adj R2 = 0.26). The self-reported intention to use third-party tested supplements increased significantly (+7%-36% per individual supplement) after following the education program (Z = -3.288, p = 0.001) resulting in an intentional use of 54-94% TPT supplements. In conclusion, education resulted in more high school athletes reporting future third-party tested supplements use, and TPB construct scores did not change over time but could explain a substantial part of the variance of safe supplement use intentions.

Exploring the Decision-Making Process behind Illicit Drug Use at Music Festivals

Background: Illicit substance use is common at music festivals. One could question whether festival attendees deliberately plan to take drugs at such events or whether their illicit (poly)drug use is provoked by specific circumstances, such as the presence of peers or a general belief that others are using drugs at the festival. Objectives: The present study implemented the prototype willingness model, which is a model that assesses whether illicit drug use at music festivals is rather a rational or a more spontaneous decision-making process. Results: A three-wave panel survey was conducted, questioning festival attendees before (n = 304, 60.86% males), during, and after music festival visits. In total, 186 people (59.68% males) between 18 and 55 years (M = 27.80 years; SD = 8.19) completed all three surveys, of which 62.9% had taken one or more different illicit substances at the festival. Positive attitudes toward illicit drug consumption were most firmly related to attendees' intentions to take drugs at festivals. Additionally, the more festival visitors identified themselves with the prototype of an attendee using drugs, the more likely they were to be willing to use them. The perceived presence of illicit substances at such events was also strongly related to the actual behavior. Conclusion: The findings suggest that illicit drug use at music festivals relates to both a rational choice and an unplanned one.

Salient Beliefs Associated with Unsanctioned Adult Cannabis Use in an Evolving Socio-Political Environment

Background: The changing cannabis legal climate in the United States has been associated with increased prevalence of use, more favorable general attitudes, and cultural norms toward its use among young adults. The purpose of this study was to conceptualize salient beliefs governing illicit cannabis use within a state where medical use is legal and adult use remains illegal. Methods: Following an initial qualitative pilot, a prospective study (baseline and a 30-day follow-up) that utilized an electronic survey design was conducted. Students at a large US university (N = 514) completed a baseline assessment of cannabis use and Theory of Planned Behavior (TPB) constructs, and 169 completed the follow-up assessing actual behavior. Results: Roughly 60% reported illicit cannabis use. Attitude and subjective norms accounted for 57% of the variation in intention for cannabis use in the next 30 days, while intention and perceived behavioral control (PBC) explained 51% of the variation in prospective use. The majority of salient beliefs identified exhibited moderate to strong correlations with intention and behavior among the larger sample. Close friends and partners were identified as important referents, outcome expectations of relaxation, improved social functioning, and more enjoyment, as well as environmental factors, such as proximity to use, safe utilization location, and continued illegality of adult use exhibited strong associations to intention and behavior. Conclusions: The practical utility of the salient belief measures identified herein presents a useful foundation for interventions aimed at reducing illicit cannabis utilization among young adults.

Intention to Use Postpartum Contraceptive and Its Determinants in Sub-Saharan Africa: Systematic Review and Meta-Analysis

Background

The postpartum period is a critical moment for the delivery of family planning services. However, the utilization of family planning among women in sub-Saharan Africa is not optimal. Therefore, the current study aims to assess the intention to use postpartum contraception and its related determinants in the sub-Saharan African setting.

Methods

This study utilized a comprehensive search strategy that involved searching several databases, including PubMed, Scopus, EMBASE, Science Direct, Google Scholar, and online research institutional repository homes. Data extraction was performed using Microsoft Excel, and statistical analysis was conducted using STATA software (version 14). To assess publication bias, a forest plot, Begg's rank test, and Egger's regression test were employed. Heterogeneity was evaluated using the I2 statistic, and an overall estimated analysis was conducted. In addition, sensitivity analysis was performed to examine the impact of each study on the overall estimate. Meta-regression analysis was conducted to identify potential sources of heterogeneity. Finally, the pooled odds ratio (OR) for associated factors was calculated.

Result

After reviewing 1,321 articles, 14 studies were deemed eligible for inclusion in this meta-analysis. The final analysis comprised a total of 39,936 study participants. The overall intention to use postpartum contraception in sub-Saharan Africa was found to be 62.21% (95% confidence interval [CI]: 55.532-68.875). In subgroup analysis, the highest prevalence of intention was observed in Ethiopia (66.71%; 95% CI: 50.36-83.05), while the lowest prevalence was reported in Ghana (59.39%; 95% CI: 50.22-68.57). The intention to use contraception was found to be 67.22% (95% CI: 62.37-72.07) and 54.53% (95% CI: 46.61-62.45) for institutional and community-based studies, respectively. Maternal educational status (OR = 1.22; 95% CI: 1.09-1.38) and husbands' approval of contraceptive use (OR = 2.395; 95% CI: 1.256-4.567) were identified as predictors of intention to use postpartum contraception.

Conclusion

In conclusion, the results of our study show a comparatively low intention toward the use of postpartum contraception, in contrast to findings reported in other countries. As such, we recommend that stakeholders prioritize maternal education and encourage male partner involvement in family planning decisions.

Mothers' intention to vaccinate their daughters against human papillomavirus in NorthWest Ethiopia, using the theory of planned behavior

Human papillomavirus (HPV) is the second most common cause of cancer worldwide among females. HPV vaccination is highly protective against HPV infection and can reduce 56% of HPV infections. Therefore, the study aims to assess mothers' intention to vaccinate their daughters aged 9-14 years old against human papillomavirus in Debre Tabor town, Northwest Ethiopia, using the theory of planned behavior. A community-based cross-sectional study design was employed using the theory of planned behavior from November 1 to 30, 2022, in Northwest Ethiopia. A total sample of 449 study participants was enrolled. The study participants were selected using a multi-stage random sampling technique. Data was collected using an interview-administered questionnaire. The data was entered into EPI data version 4.6 and then, exported to SPSS version 23 for analysis. Those variables with a p-value <.05 with 95% CI were considered significant predictors. Mothers' positive intention to vaccinate their daughters aged 9-14 years against HPV was 67.5%. Attitude, perceived behavioral control, and subjective norm were significant predictors with (AOR = 10.09, 95% CI = 6.23-16.32), (AOR = 4.12, 95% CI = 2.71-6.26), and (AOR = 16.397, 95% CI = 9.69-27.748), respectively. Only two-thirds of mothers have a positive intention to vaccinate their daughters against human papillomavirus. Attitude, perceived behavioral control, and subjective norm were predictors. Therefore, it is better to do community mobilization toward the advantage of HPV vaccination.

Examining acute environmental effects on affective state, expectancy, and intention in sport climbing

Introduction

Psychological research has shown that, among other variables, affective state, expectancy, and behavioral intention influence whether or not a (physically active) behavior is performed. Environmental effects during physical activity on affective state have been well studied; however, research regarding environmental effects on expectancy or intention is limited. Sport climbing is a form of physical activity that is performed both indoors and outdoors and is therefore considered as suitable to study environmental effects. Therefore, the aim of the present study was to investigate environmental effects during sport climbing on affective state, expectancy, and intention. The nature of the relationship between some of these parameters should also be explored.

Methods

Using a within-subjects design, 48 participants were to climb both once indoors in a climbing gym and once outdoors at a crag. The design included questionnaire-based surveys at multiple time points. Affective state, expectancy, and behavioral intention were measured at different test time points.

Results

Two-factor repeated-measures ANOVAs revealed significant main effects of the factors environment (indoor - outdoor) and time (T1 - T2 - T3) for affective state, indicating more positive affective state during outdoor climbing. No environment*time interactions were found. Furthermore, significantly higher intention (d = 0.32; p = 0.032) was measured after the outdoor condition (M = 32.5, SD = 4.1) compared to the indoor condition (M = 31.2, SD = 4.7). Multiple linear regressions revealed that expectancies (measured before and after the session) significantly predicted post-climbing intention only indoors.

Conclusion

The results at least partly suggest environmental effects on behaviorally relevant variables during climbing. Outdoor climbing might provide more favorable characteristics for physically active behavior compared to indoor climbing. Health psychologists or public health professionals who focus on increasing physical activity for their clients could recommend outdoor climbing over indoor climbing.

Understanding caregivers' decision to vaccinate childhood cancer survivors against COVID-19

BACKGROUND

Vaccination against COVID-19 is recommended for childhood cancer survivors (CCS). This study aimed to identify antecedents contributing to caregivers' decisions to vaccinate CCS aged 5-17 years against COVID-19 by applying the Theory of Planned Behavior.

METHODS

Participants in this cross-sectional study completed an online survey assessing caregiver attitudes, subjective norms, perceived behavioral control, intention to vaccinate CCS, CCS vaccination status, COVID-19 health literacy, and frequency of COVID-19 information-seeking. Surveys were completed between May and June 2022 following approval for the emergency use of COVID-19 vaccines among children aged ≥5 years in the U.S. Data were analyzed using unadjusted linear regressions and structural equation modeling.

RESULTS

Participants were caregivers (n = 160, 87.5% biological mothers, 75.6% white/non-Hispanic) of CCS (n = 160, 44.4% female, mean (M) = 12.5 years old, M = 8.0 years off treatment). 70.0% (n = 112) of caregivers and 53.8% (n = 86) of CCS received a COVID-19 vaccine. Over one-third (37.5%) of caregivers reported disagreement or indecision about future COVID-19 vaccination for the CCS. Caregivers' intention (β = 0.962; standard error [S.E.] = 0.028; p < 0.001) was highly related to CCS vaccination status. Attitudes (β = 0.568; S.E. = 0.078; p < 0.001) and subjective norms (β = 0.322; S.E. = 0.062; p < 0.001) were associated with intention. Higher frequency of COVID-19 information-seeking (β = 0.313; S.E. = 0.063; p < 0.001) and COVID-19 health literacy (β = 0.234; S.E. = 0.059; p < 0.001) had a positive indirect effect on intention through attitudes and subjective norms.

CONCLUSIONS

Caregivers' vaccination intentions for minor CCS are highly related to vaccination behavior and shaped by attitudes, subjective norms, COVID-19 health literacy, and frequency of COVID-19 information-seeking. Promoting tailored communication with caregivers of CCS and encouraging them to review reputable sources of information can address their vaccine hesitancy.

Can temporal self-regulation theory and its constructs predict medication adherence? A systematic review and meta-analysis

The relationships between temporal self-regulation theory (TST) constructs (intention, behavioural prepotency and self-regulatory capacity) and medication adherence should be established before further applying the theory to adherence. Searches of PsychINFO, Medline, EMBASE, CINAHL and Web of Science were conducted in 2019 (updated November 2021). Studies had to be original quantitative research, assessed the relationship between one of the constructs and adherence in one illness, and used an adult population. The risk of bias was assessed using the NHLBI Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Three meta-analyses were conducted using R. Moderation analyses were also conducted. A total of 57 articles (60 studies) with 13,995 participants were included, with 7 studies included in more than one analysis. Results identified significant correlations between intention (r = .369, [95% CI: .25, .48]), behavioural prepotency (r = .332, [95% CI: .18, .48]), self-regulatory capacity (r = .213, [95% CI: .10, .32]) and adherence. There was some evidence of publication bias and no significant moderators. No studies explored the interactions in the theory, so whilst the constructs adequately predict adherence, future research should apply the theory to adherence in a specific illness to assess these relationships. Pre-registered on Prospero: CRD42019141395.

Parental Vaccine Literacy: Attitudes towards the COVID-19 Vaccines and Intention to Vaccinate Their Children Aged 5-11 Years against COVID-19 in Thailand

BACKGROUND

High rates of population immunity are needed to control the COVID-19 pandemic. This study aimed to assess parents' intention to have their children, aged 5-11 years, vaccinated against COVID-19 and its influencing factors in Thailand.

METHODS

A cross-sectional online survey was conducted before the nationwide COVID-19 vaccine rollout for children aged 5-11 years in Thailand. A sample of 542 parents with children in this age group was recruited online.

RESULTS

In total, 58.8% of parents intended to vaccinate their child against COVID-19. Logistic regression analysis revealed that influencing factors include child age, parents' education, interactive/critical vaccine literacy, attitudes that the COVID-19 vaccine is safe and effective for children, that the vaccine can reduce the severity of COVID-19 in children, that there were other ways to prevent children from contracting COVID-19 superior to vaccination, and that COVID-19 vaccination in children can be fatal. The main reasons for having an intention to vaccinate their children included to reduce the severity of symptoms if infected with COVID-19 and to protect them from contracting COVID-19 when they go to school.

CONCLUSIONS

Our study provides evidence regarding factors influencing parents' intention to vaccinate their children. The findings can be used to design future interventions to promote COVID-19 vaccine uptake in children.

Patient and Physician Perspectives on the Use of a Connected Ecosystem for Diabetes Management: International Cross-Sectional Observational Study

BACKGROUND

Collaboration between people with type 2 diabetes (T2DM) and their health care teams is important for optimal control of the disease and outcomes. Digital technologies could potentially tie together several health care-related devices and platforms into connected ecosystems (CES), but attitudes about CES are unknown.

OBJECTIVE

We surveyed convenience samples of patients and physicians to better understand which patient characteristics are associated with higher likelihoods of (1) participating in a potential CES program, as self-reported by patients with T2DM and (2) clinical benefit from participation in a potential CES program, as reported by physicians.

METHODS

Adults self-reporting a diagnosis of T2DM and current insulin use (n=197), and 33 physicians whose practices included ≥20% of such patients, were enrolled in the United States, France, and Germany. We surveyed both groups about the likelihood of patient participation in a CES. We then examined the associations between patients' clinical and sociodemographic characteristics and this likelihood. We also described characteristics of patients likely to clinically benefit from CES use, according to physicians.

RESULTS

Compared with patients in Germany and France, US patients were younger (mean age 45.3 [SD 11.9] years vs 61.9 [SD 9.2] and 65.8 [SD 9.4] years, respectively), more often female, more highly educated, and more often working full-time. In all, 51 (44.7%) US patients, 16 (36.4%) German patients, and 18 (46.3%) French patients indicated strong interest in a CES program, and 115 (78.7%) reported currently using ≥1 connected device or app. However, physicians believed that only 11.3%-19.2% of their patients were using connected devices or apps to manage their disease. Physicians also reported infrequently recommending or prescribing connected devices to their patients, although ≥80% (n=28) of them thought that a CES could help support their patients in managing their disease. The factors most predictive of patient likelihood of participating in a CES program were cost, inclusion of medication reminders, and linking blood glucose levels to behaviors such as eating and exercise. In all countries, the most common patient expectations for a CES program were that it could help them eat more healthfully, increase their physical activity, increase their understanding of how blood glucose relates to behavior such as exercise and eating, and reduce stress. Physicians thought that newly diagnosed patients, sicker patients-those who had been hospitalized for diabetes, were currently using insulin, or who had any comorbid condition-and patients who were nonadherent to treatment were most likely to benefit from CES use.

CONCLUSIONS

In this study, there was a high degree of interest in the future use of CES, although additional education is needed among both patients with T2DM and their physicians to achieve the full potential of such systems to improve self-management and clinical care for the disease.

A conceptual analysis of public opinion regarding genome research in Japan

In the 20 years since the completion of the Human Genome Project, the gap between scientific development and public understanding of genome research has been widening. While genome research has been increasingly utilized for social and clinical purposes in a multifaceted manner, this has resulted in an increase in the potential risks associated with genomic data. In this context, our study aims to consider the nature of public perceptions of genome research, primarily by using as a case study the results of previous public surveys relevant to donations for social benefits in Japan. We explored certain types of awareness, attitude, and intention (A-A-I) in such surveys and discussed the resultant key findings through the cultural transmission framework. Reframing the public's response toward genome research based on A-A-I analysis and behavioral science may contribute to developing more systematic communication approaches with the public. With a view to establishing such approaches, our perspective suggests some new insights to discuss the science-society gap in genome research internationally.

Within-Person Associations of Accelerometer-Assessed Physical Activity With Time-Varying Determinants in Older Adults: Time-Based Ecological Momentary Assessment Study

BACKGROUND

Despite the availability of physical activity (PA) interventions, many older adults are still not active enough. This might be partially explained by the often-limited effects of PA interventions. In general, health behavior change interventions often do not focus on contextual and time-varying determinants, which may limit their effectiveness. However, before the dynamic tailoring of interventions can be developed, one should know which time-dependent determinants are associated with PA and how strong these associations are.

OBJECTIVE

The aim of this study was to examine within-person associations between multiple determinants of the capability, opportunity, motivation, and behavior framework assessed using Ecological Momentary Assessment (EMA) and accelerometer-assessed light PA, moderate to vigorous PA, and total PA performed at 15, 30, 60, and 120 minutes after the EMA trigger.

METHODS

Observational data were collected from 64 healthy older adults (36/64, 56% men; mean age 72.1, SD 5.6 y). Participants were asked to answer a time-based EMA questionnaire 6 times per day that assessed emotions (ie, relaxation, satisfaction, irritation, and feeling down), the physical complaint fatigue, intention, intention, and self-efficacy. An Axivity AX3 was wrist worn to capture the participants' PA. Multilevel regression analyses in R were performed to examine these within-person associations.

RESULTS

Irritation, feeling down, intention, and self-efficacy were positively associated with subsequent light PA or moderate to vigorous PA at 15, 30, 60, or 120 minutes after the trigger, whereas relaxation, satisfaction, and fatigue were negatively associated.

CONCLUSIONS

Multiple associations were observed in this study. This knowledge in combination with the time dependency of the determinants is valuable information for future interventions so that suggestions to be active can be provided when the older adult is most receptive.

Intention to Donate Kidney and Associated Factors Among Students in Bahir Dar University: Application of Theory of Planned Behavior

Background

Kidney donation is the donation of a kidney from a living or dead person to another living person who requires transplantation. The scarcity of kidneys is a great public health concern worldwide, owing to an increase in end-stage renal failure. There is no sufficient evidence regarding the intention to donate kidneys in Ethiopia.

Objective

To assess the intention to donate kidneys and its associated factors among Bahir Dar University students in Ethiopia in 2023 by the application of theory of planned behavior.

Method and Materials

This institution-based cross-sectional study was conducted from March 7 to April 5, 2023. A multistage sampling technique was used to select 630 participants. Self-administered structured questionnaires were used to collect data. Data were entered into Epi-data version 4.6, and exported to the Statistical Package for the Social Sciences (SPSS) version 25 for analysis. Bivariate and multivariate linear regression analyses were performed. Findings with a p-value <0.05 at the 95% confidence interval were considered statistically significant and interpreted by the unstandardized beta (ß) coefficient.

Results

The mean score of intention to donate the kidney was 12.9 ± 4.1 standard deviation. Direct attitude (B = 0.341, 95% CI = 0.265, 0.416), direct subjective norm (B = 0.088, 95% CI = 0.010, 0.167), direct perceived behavioral control (B = 0.353, 95% CI 0.251, 0.455), knowledge (B = 0.417, 95% CI 0.251, 0.583), and previous experience of blood donation (B = 0.915, 95% CI 0.321, 1.510) were factors associated with intention to kidney donation.

Conclusion

The mean score of intention to donate kidneys was 12.9 ± 4.1 SD. Direct attitude, direct subjective norm, direct perceived behavioral control, experience with blood donation, and knowledge of participants were significant factors for the intention to donate kidneys. Therefore, social and behavioral change communication strategies should address these factors in order to increase kidney donation.

Investigating the dietary intentions of Iranian tourists regarding the consumption of local food

Introduction

Attention to local food among tourists is increasing day by day. However, studies on the behavior and intention of tourists towards consuming these foods are few. Limited studies in this field prompted us to help fill the research gap by doing this research.

Methods

This study aims to use the extended theory of planned behavior (TPB) by adding risk perception (RP) to investigate the tourists' intentions towards local food (TILF) in Iran. The extended model tested 313 tourists visiting local food supplies.

Results

Results show that the extended TPB explains 87.8% of tourist intention variance. Three variables of the original TPB had positive impacts on tourists' intentions. A notable result of this study was the realization of a negative relationship between RP and TILF.

Discussion

This research has provided recommendations to strengthen tourists' intentions toward local foods by influencing their attitudes, mental beliefs, perceived behavioral control, and risk perception.

How Do Two Types of Exercise Habits Predict Physical Activity with Intention?

This manuscript investigates how conscious intention and unconscious exercise habits influence physical activity behavior. While prior research has predominantly focused on conscious decision-making, this study applied a dual-process model to explore the impact of intention and habit on physical activity engagement. Out of the 300 questionnaires distributed to students from one university, 282 questionnaires were utilized for data analysis after excluding insincere responses. Intention was measured using a 7-point scale, while exercise habits were assessed using the Self-Report Behavioral Automaticity Index. In addition, physical activity was measured using the Weekly Leisure-Time Exercise Questionnaire. The validity and reliability of measurement tools were confirmed. Data were analyzed using SPSS and AMOS, including correlation analysis, multiple regression, and moderation analysis. Intention, exercise preparation habit, and exercise performance habit were all found to influence physical activity levels significantly. Intention demonstrated the strongest impact, followed by exercise preparation habit and exercise performance habit. This suggests that the research efforts regarding intention conducted before the emergence of the dual process model, which proposes the importance of unconscious thinking patterns, were not in vain. The analysis revealed a statistically significant moderating effect of exercise preparation habit, but not exercise performance habit, in the relationship between intention and physical activity. Exercise preparation habit was identified as a significant moderator, enhancing the relationship between intention and physical activity. This study underscores the importance of considering both conscious intention and unconscious exercise habits in promoting physical activity. The findings challenge the prevailing emphasis on conscious decision-making and highlight the need for a more comprehensive understanding of unconscious behavior in health behavior interventions. This study is expected to arouse academic interest in the often-neglected area of unconscious behavior.

Association Between Concerns About COVID-19 Infection and Blood Donation Intention: Cross-Sectional Survey Study Through a Mobile Communication Platform

BACKGROUND

The ongoing COVID-19 pandemic has had an unprecedented impact on blood transfusion and collection. At the beginning of the pandemic, most blood transfusion services had a tough challenge in maintaining an optimal blood inventory.

OBJECTIVE

This study aims to understand the public's psychological cognition and intention toward blood donation as well as the factors influencing their worries. We aimed to find a solution for increasing blood donations and provide a scientific reference for policy formulation regarding blood donation during the COVID-19 pandemic and in the future.

METHODS

A random survey with a 14-item scale on worries related to blood donation was conducted from December 31, 2022, to January 3, 2023, among residents aged 18-60 years in Zhejiang province via SMS text messaging. The results of 8 worry items in this study were compared with the survey results of March 2022, during which COVID-19 was not considered as an epidemic in Zhejiang province. Chi-square test and logistic regression analysis were performed to analyze the factors affecting respondents' blood donation intention and concerns. The degree of worry about blood donation was assigned from 1 (completely disagree) to 5 (completely agree), and 2-sided t tests were performed to analyze the differences in blood donation intention and worries about blood donation.

RESULTS

In total, 1254 valid questionnaire responses were obtained. Males accounted for 62.36% (782/1254) of the sample, 78.39% (983/1254) were 18-45 years old, 60.61% (760/1254) had a university education, and 69.06% (866/1254) had no previous blood donation experience. Approximately 36.52% (458/1254) of the public clearly expressed that they had blood donation worries regarding COVID-19. The main concerns of the respondents were temporary physical weakness caused by blood donation, their own physical conditions not meeting the requirements of blood donation, inconvenient location and working hours for blood donation, and family (or friends) worrying about blood donation. Compared with the results in 2022, the results in 2023 regarding the harmful effects of blood donation on health, temporary physical weakness, infection in donated blood, and family (friends) worrying increased significantly (P<.001). The factors influencing blood donation worries regarding COVID-19 were COVID-19 infection status, adverse reactions to the donated blood, family (or friends) worrying, and unsatisfactory blood donation experience. The factors influencing blood donation intention were gender, age, previous blood donation times, blood donation worries regarding COVID-19, harmful effects of blood donation on health, and blood donation anxiety.

CONCLUSIONS

Blood transfusion services should make full use of the recovery phase of COVID-19 infection as an important time point, publicize the blood donation process and operation standardization, reduce the public's concerns about blood donation, correct negative evaluations, and increase perceived behavioral control and subjective norms.

Perspectives of Patients With Chronic Diseases on Future Acceptance of AI-Based Home Care Systems: Cross-Sectional Web-Based Survey Study

BACKGROUND

Artificial intelligence (AI)-based home care systems and devices are being gradually integrated into health care delivery to benefit patients with chronic diseases. However, existing research mainly focuses on the technical and clinical aspects of AI application, with an insufficient investigation of patients' motivation and intention to adopt such systems.

OBJECTIVE

This study aimed to examine the factors that affect the motivation of patients with chronic diseases to adopt AI-based home care systems and provide empirical evidence for the proposed research hypotheses.

METHODS

We conducted a cross-sectional web-based survey with 222 patients with chronic diseases based on a hypothetical scenario.

RESULTS

The results indicated that patients have an overall positive perception of AI-based home care systems. Their attitudes toward the technology, perceived usefulness, and comfortability were found to be significant factors encouraging adoption, with a clear understanding of accountability being a particularly influential factor in shaping patients' attitudes toward their motivation to use these systems. However, privacy concerns persist as an indirect factor, affecting the perceived usefulness and comfortability, hence influencing patients' attitudes.

CONCLUSIONS

This study is one of the first to examine the motivation of patients with chronic diseases to adopt AI-based home care systems, offering practical insights for policy makers, care or technology providers, and patients. This understanding can facilitate effective policy formulation, product design, and informed patient decision-making, potentially improving the overall health status of patients with chronic diseases.

Falling off the screening grid-Predictors for postponed utilization of psycho-oncological support in cancer patients and its implications for distress assessment and management

OBJECTIVE

Distress assessment of cancer patients is considered state-of-the-art. In addition to distress scores, individual care needs are an important factor for the initiation of psycho-oncological interventions. In a mono-centric, observational study, we aimed for characterization of patients indicating a subjective need but declining to utilize support services immediately to facilitate implementation of adapted screenings.

METHODS

This study analyzed retrospective data from routine distress screening and associated data from hospital records. Descriptive, variance and regression analyses were used to assess characteristics of postponed support utilization in patients with mixed cancer diagnoses in different treatment settings.

RESULTS

Of the total sample (N = 1863), 13% indicated a subjective need but postponed support utilization. This subgroup presented as being as burdened by symptoms of depression (p < 0.001), anxiety (p < 0.001) and distress (p < 0.001) as subjectively distressed patients with intent to directly utilize support. Time periods since diagnosis were shorter (p = 0.007) and patients were more often inpatients (p = 0.045).

CONCLUSIONS

Despite high heterogeneity among the subgroups, this study identified distress-related factors and time since diagnosis as possible predictors for postponed utilization of psycho-oncological interventions. Results suggest the necessity for time-individualized support which may improve utilization by distressed patients.

The meta-cognitive role of thought morality in attitude change and behavioural intentions related to doping

Prior research has examined the relationships between morality, attitudes, and intentions related to doping predominantly via correlational studies based on the theoretical frameworks provided by extensions to the theory of planned behaviour, and the social cognitive theory of moral thought and action. In contrast, the present study experimentally analysed a psychological process (i.e., self-validation) through which thought morality can influence attitudes and intentions. Two hundred and forty-two participants (122 males and 120 females) were randomly assigned to read a message either against or in favour of legalising several doping behaviours in sports, then listed their thoughts regarding that proposal. Next, they were randomly assigned to perceive their thoughts as either moral or immoral, then indicated the extent to which they considered their thoughts as valid. Finally, participants reported their attitudes and intentions regarding the legalisation proposal. As hypothesised, the anti-legalisation (vs. pro-legalisation) message produced more unfavourable thoughts and attitudes, as well as lower intentions to support the legalisation proposal and engage in banned behaviours if legalised in sport. Most importantly, the effects of message direction on attitudes and intentions were greater for participants in the moral (vs. immoral) thought condition. Furthermore, changes in attitudes were consistent with a self-validation process.

Gaze-Triggered Communicative Intention Compresses Perceived Temporal Duration

Eye gaze communicates a person's attentional state and intentions toward objects. Here we demonstrate that this important social signal has the potential to distort time perception of gazed-at objects (N = 70 adults). By using a novel gaze-associated learning paradigm combined with the time-discrimination task, we showed that objects previously associated with others' eye gaze were perceived as significantly shorter in duration than the nonassociated counterparts. The time-compression effect cannot be attributed to general attention allocation because it disappeared when objects were associated with nonsocial attention cues (i.e., arrows). Critically, this effect correlated with observers' autistic traits and vanished when the gazing agent's line of sight was blocked by barriers, reflecting the key role of intention processing triggered by gaze in modulating time perception. Our findings support the existence of a special mechanism tuned to social cues, which can shape our perception of the outer world in time domains.

Uptake of and intention to use oral pre-exposure prophylaxis for HIV among pregnant and post-natal women in Eswatini: a cross-sectional survey

Introduction

In Eswatini, HIV incidence among women of childbearing age is 1.45%. Eswatini introduced oral pre-exposure prophylaxis (PrEP) for HIV prevention in 2016 and requires that all HIV-negative pregnant and post-natal women (PPW) visiting health care facilities be offered PrEP.

Methods

Between September-November 2021, we conducted a survey among HIV-negative PPW from 16 purposively selected healthcare facilities in the Hhohho and Shiselweni regions in Eswatini. We interviewed consenting HIV-negative PPW using a structured questionnaire to collect data on PrEP knowledge, attitudes, intentions, and practices, as well as information on partner HIV status and stigma. Multivariate logistic regression was used to determine predictors of PrEP use and intention, adjusted for significant covariates.

Results

Of 1,484 PPW women approached, 1,149 consented and were interviewed, of whom 704 (61.3%) were post-partum and 445 (38.7%) pregnant. The median age was 25 years [Interquartile Range (IQR) = 21-30 years], with 533 (46.4%) 18-24 years old. Among the 1,149 women, 930 (80.7%) had ever heard about PrEP; 635 (55.3%) had knowledge about PrEP; 183 (15.9%) were currently using PrEP; and 285 (24.8%) had ever used PrEP. Increased odds of PrEP use were associated having HIV-positive male partner (aOR:7.76, 95%CI 3.53- 17.04); positive attitudes to PrEP (aOR:1.56, 95%CI: 1.02-2.40); and high self-efficacy (aOR:1.49, 95%CI:1.13-1.98). Among 864 women who never used PrEP, 569 (65.3%) intended to use PrEP in the future. Odds of intention to use PrEP were higher among women with low levels of education (aOR:2.23, 95% CI: 1.32-3.77); who ever heard about PrEP (aOR:1.69, 95%CI: 1.12-2.56); and had high self-efficacy (aOR:1.57, 95%CI: 1.31-1.87). Regarding stigma, among all women, 759 (66%) either agreed or strongly agreed that people would think they have HIV if they were to use PrEP; 658 (57.3%) reported they would be labelled as having multiple sex partners; 468 (40.7%) reported that their partner would think they are having risky sex with other people. Of 102 women who had discontinued PrEP, a majority stopped due to side effects 32 (35.2%).

Conclusion

Only about 50% of women had knowledge of PrEP, and PrEP uptake among PPW was low, though intention to use appeared high. More efforts to reduce stigma and promote PrEP use, including adequate information on side effects, are needed.

Application of Health Belief Model to Assess Predictors of Weight Management Behaviour Intention Among Civil Servants in Ethiopia: A Mixed Method Study

Introduction

This study aims to use the health belief model to identify predictors of weight management behaviour among civil servants in Ethiopia. Predictors include perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy. The study will provide insight into potential factors that civil servants perceive as significant in weight management.

Methods

A sequential explanatory study was conducted from November 15, 2022, to January 20, 2020 among civil servants working in Dessie town, with 423 participants selected through simple random and purposive sampling techniques for the quantitative and qualitative studies, respectively. Self-administered questionnaires were used for the quantitative study, while in-depth interviews were conducted for the qualitative study. Data was verified, entered into Epi Data, and analysed using Stata for multivariable linear regression. ATLAS.ti software version 7 facilitated the qualitative data analysis process. Findings with a p-value <0.05 at a 95% confidence interval were considered statistically significant in the final model.

Results

This study found that several factors were significantly associated with higher behavioural intention for weight management. Females had higher intention than males, and individuals with higher educational levels demonstrated higher intention. Marital status was also a factor, with being divorced associated with lower intention. The absence of an obese family member and lack of prior weight loss experience were also linked to lower intention. Perceived susceptibility and perceived benefits positively influenced intention, while higher perceived barriers were linked to lower intention.

Conclusion

The study found that a stronger inclination towards weight management was linked to being female, having higher education, no obese family member, prior weight loss experience and positive attitudes. Interventions should target those less likely to exhibit these characteristics and address negative attitudes towards weight management.

Effectiveness of a Theory-Based Digital Animated Video Intervention to Reduce Intention and Willingness to Sext Among Diploma Students: Cluster Randomized Controlled Trial

BACKGROUND

Sexting refers to the exchange of sexually explicit digital content in the form of texts, photos, or videos. In recent years, sexting has become a public health concern. Surveys in Malaysia show a high prevalence of young adults engaged in sexting. Given that sexting is associated with sexual risk behavior, cyberbullying, and mental health issues, this behavior needs intervention to alleviate the resulting public health burden. However, there is a scarcity of theory-based intervention programs on the prevention of intention and willingness to sext among young adults.

OBJECTIVE

This study aimed to develop and implement a sexting intervention module guided by the prototype willingness model (PWM), delivered using web-based animated video, and evaluate its effectiveness among diploma students from a public higher educational institution. The primary outcomes were intention and willingness to sext, while the secondary outcomes were knowledge, attitude, perceived norms, and prototype perceptions of sexting.

METHODS

This 2-armed, parallel, single-blinded cluster randomized controlled trial was conducted in a public higher educational institution in the state of Melaka, Malaysia. Diploma students from 12 programs were randomly allocated into intervention and control groups. Both groups answered a self-administered web-based questionnaire assessing the outcomes at the baseline. The intervention group received a newly developed intervention module based on the PWM in the form of 5 animated videos posted on a private YouTube platform, while the control group was put on the waitlist. The intervention group was encouraged to discuss any issues raised with the researchers via WhatsApp private chat after viewing the videos. All participants were observed immediately and 3 months postintervention. Data analysis was performed with SPSS (version 26; IBM Corp). A generalized linear mixed model was used to determine the effectiveness of the intervention.

RESULTS

There were a total of 300 participants with an attrition rate of 8.3% (n=25). After adjusting for age, sex, relationship status, and the amount of time spent on the web, there were significant differences in the intention to sext (β=-.12; P=.002; Cohen d=0.23), willingness to sext (β=-.16; P<.001; Cohen d=0.40), knowledge (β=.12; P<.001; Cohen d=0.39), attitude (β=-.11; P=.001; Cohen d=0.31), perceived norms (β=-.06; P=.04; Cohen d=0.18), and prototype perceptions (β=-.11; P<.001; Cohen d=0.35) between the intervention and control groups over 3 months.

CONCLUSIONS

In this study, the sexting intervention module using the PWM that was delivered via web-based animated videos was effective in reducing intention and willingness to sext as well as in improving knowledge of sexting, attitudes, perceived norms, and prototype perceptions. Therefore, relevant agencies involved in the promotion of sexual and reproductive health among young adults in Malaysia can consider the implementation of this module.

TRIAL REGISTRATION

Thai Clinical Trial Registry TCTR20201010002; https://www.thaiclinicaltrials.org/show/TCTR20201002001.

Development of nutrition label use scale for patients of coronary heart disease and examination of its reliability and validity

Background

A proper evaluation on the intention of using nutrition label in patients with coronary heart disease (CHD) is crucial to design and formulate of behavior-based interventions. A valid and reliable instrument based on theoretical basis is needed to measure individual intention toward nutrition label use and identify underlying socio-cognitive factors.

Object

To develop and test validity and reliability of the theoretically based nutrition label use (NLU) scale and to promote the use of nutrition labels in CHD patients.

Methods

A questionnaire was developed based on the theory of planned behavior (TPB), empirical literatures, expert review and pilot tested. A total of 460 CHD patients in a hospital in Changsha were investigated using this questionnaire from April 2021 to August 2021. The items and dimensions in the scale were explored and confirmed using item-analysis, content validity, exploratory factor analytical (EFA), confirmatory factor analytical (CFA), internal consistency and split-half reliability tests.

Results

A total of 33 items with 4 structural factors were identified, including 10 items of attitude, 6 items of subjective norm, 12 items of perceived behavior control, and 5 items of intention. The total variance explained by the EFA model was 68.563%. The model was further tested with CFA. The measurement model fitted the data well (Ratio of chi-square minimum and degree of freedom (CMIN/DF) =1.743, goodness of fit index (GFI) =0.814, incremental fit index (IFI) =0.946, Tuker-Lewis index (TLI) =0.940, the comparative fit index (CFI) =0.945, the root mean square error of approximation (RMSEA) =0.057). The content validation index (CVI) of the scale was 0.82, and the CVI of the items ranged from 0.8 to 1.00. The reliability of the scale was 0.976 (p < 0 0.001) using Cronbach's alpha and 0.937 (p < 0.001) using the split-half coefficient.

Conclusion

The newly developed Nutrition Label Use Scale can serve as a valid and reliable tool to evaluate the nutrition label use of CHD patients.

Testing Assumptions of the Physical Activity Adoption and Maintenance Model: A Longitudinal Perspective of the Relationships Between Intentions and Habits on Exercise Adherence

In this study, we aimed to examine empirically the Physical Activity Adoption and Maintenance model (PAAM). We collected data on these variables at baseline (T0) and 6-months later (T1). We recruited 119 participants (42 male, 77 female) aged 18-81 years old (Mage = 44.89, SD = 12.95). who reported, at baseline, that they exercised an average of 3.76 days per week (SD = 1.33) in training periods lasting 15-60 minutes (M = 38.69; SD = 23.28). We conducted hierarchical multiple regression analysis to test the association between each determinant (intentions, habits, and frequency) and future exercise adherence. We tested four models by entering blocks of predictors according to PAAM assumptions. The variance change (R2) between the first and fourth models (ΔR2 = .391) was statistically significant, showing that the fourth model accounted for 51.2% of variance for future exercise adherence, F (6, 112) = 21.631, p < .001, R2 = .73, adjusted R2 = .512. Exercise intention at T1 maintained its significant association (p = .021) with exercise frequency at T1 in all tested models. Exercise frequency at T0 was the most significant predictor (p < .01) of future exercise adherence, with past experience the second most significant predictor (p = .013). Interestingly, exercise habits at T1 and T0 did not predict exercise frequency at T1 in the fourth model. Among the variables we studied, having constantly high exercise intentions and high regular exercise frequency are significantly associated with maintaining or increasing regular future exercise behavior.

Fathers attending the birth of their baby: Views, intentions and needs

BACKGROUND

There is limited information about fathers' views, intentions and needs leading up to childbirth.

AIMS

This study explores the factors influencing fathers' intention to attend the birth, and the needs and supports required leading up to childbirth.

METHODS

Cross-sectional survey of 203 prospective fathers attending antenatal appointments at an outer metropolitan public teaching hospital in Brisbane, Australia.

RESULTS

A total of 201/203 (99.0%) participants intended to attend the birth. The reported reasons included: responsibility (99.5%), protectiveness (99.0%), love for their partner (99.0%), the right thing to do (98.0%), desire to see the birth (98.0%), the perception that partners should attend (97.4%), duty (96.4%) and partner preference (91.4%). Some felt pressured by their partner (12.8%), society (10.8%), cultural expectations (9.6%) and family (9.1%), and 10.6% perceived adverse consequences for not attending. Most participants (94.6%) felt well supported, experienced good communication (72.4%), had the opportunity to ask questions (69.8%) and received an explanation of events (66.3%). They were less often supported by antenatal visits (46.7%) and by a plan for future visits (32.2%). Ten per cent of all fathers and 13.8% of experienced fathers requested better mental health support, and 9.0% prefer better clinician communication.

CONCLUSIONS

Most fathers intend to attend childbirth for personal and moral reasons; however, a small proportion feel pressured. Most fathers feel well supported, although potential improvements include planning for future visits, provision of information, mental health support, clinician communication, increased involvement in their partner's care, the opportunity to ask questions and more frequent clinic visits.