The Theory of Planned Behaviour in Medical Tourism: International Comparison in the Young Consumer Segment.
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SUBMITTER: Boguszewicz-Kreft M
PROVIDER: S-EPMC7084921 | biostudies-literature | 2020 Mar
REPOSITORIES: biostudies-literature
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The Theory of Planned Behaviour in Medical Tourism: International Comparison in the Young Consumer Segment.
Boguszewicz-Kreft Monika M Kuczamer-Kłopotowska Sylwia S Kozłowski Arkadiusz A Ayci Ali A Abuhashesh Mohammd M
International journal of environmental research and public health 20200303 5
The Theory of Planned Behaviour (TPB) assumes the possibility of predicting and explaining humans' behaviour by identifying their intentions. The intentions are shaped by three groups of factors: attitudes towards, social norms and perceived behavioural control over the behaviour. The aim of the research is to examine the applicability of the TPB in medical tourism and to check whether there are differences in predicting the intentions of medical tourists from different countries. The study cove ...[more]
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Project description:BACKGROUND:Direct observation of clinical task performance plays a pivotal role in competency-based medical education. Although formal guidelines require supervisors to engage in direct observations, research demonstrates that trainees are infrequently observed. Supervisors may not only experience practical and socio-cultural barriers to direct observations in healthcare settings, they may also question usefulness or have low perceived self-efficacy in performing direct observations. A better understanding of how these multiple factors interact to influence supervisors' intention to perform direct observations may help us to more effectively implement the aforementioned guidelines and increase the frequency of direct observations. METHODS:We conducted an exploratory quantitative study, using the Theory of Planned Behaviour (TPB) as our theoretical framework. In applying the TPB, we transfer a psychological theory to medical education to get insight in the influence of cognitive and emotional processes on intentions to use direct observations in workplace based learning and assessment. We developed an instrument to investigate supervisors intention to perform direct observations. The relationships between the TPB measures of our questionnaire were explored by computing bivariate correlations using Pearson's R tests. Hierarchical regression analysis was performed in order to assess the impact of the respective TPB measures as predictors on the intention to perform direct observations. RESULTS:In our study 82 GP supervisors completed our TPB questionnaire. We found that supervisors had a positive attitude towards direct observations. Our TPB model explained 45% of the variance in supervisors' intentions to perform them. Normative beliefs and past behaviour were significant determinants of this intention. CONCLUSION:Our study suggests that supervisors use their past experiences to form intentions to perform direct observations in a careful, thoughtful manner and, in doing so, also take the preferences of the learner and other stakeholders potentially engaged in direct observations into consideration. These findings have potential implications for research into work-based assessments and the development of training interventions to foster a shared mental model on the use of direct observations.
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Project description:Introduction To promote patients’ referral across healthcare institutions and integrated care delivery, we identified predictors of physicians’ behaviour and intention to refer patients in a county medical consortium in China on the basis of the theory of planned behaviour (TPB). Methods This census-based cross-sectional study was conducted in Yangxi Hospital Group (YHG). All physicians in county hospitals and township health centres were invited to participate. Structural equation modelling was employed to analyse the relationships between referral intention and behaviour and other TPB variables in the group of whole participants and in sub-groups. Results In total, 330 physicians participated in this study. One-third of participants were general practitioners, and half of them were from county hospitals. Referral behaviour of females (χ2 = 20.372, p < 0.001), who had lower education levels (χ2 = 17.859, p = 0.001), lower professional title (χ2 = 14.963, p = 0.005), and lower monthly salary (χ2 = 33.753, p < 0.001) were less frequent than the others. Among them, 116 (35.2%), 108 (32.7%), and 106 (32.1%) respondents reported that they had never referred patients, had referred patients 1–9 times, and had referred patients over 10 times during the past 3 months, respectively. The mean score of referral intention was 4.23/5 (SD = 0.71). In the model with all participants, a stronger referral intention (β = 0.218, 95% CI = 0.080–0.356) was associated with more frequent referral behaviour. The subjective norm (β = 0.703, 95% CI = 0.590–0.817) was the strongest predictor of physicians’ referral intention, followed by perceived behavioural control (β = 0.234, 95% CI = 0.090–0.378). Mediated by referral intention, subjective norms (β = 0.153, p < 0.01) and perceived behavioural control (β = 0.190, p < 0.01) had significant indirect effects on physicians’ referral behaviour. The model with participants in county hospitals showed similar results to the model with all participants. Meanwhile, in the model with participants in township health centres, there were no significant associations between referral behaviour and other TPB constructs. Conclusion Physicians’ referral behaviour was influenced by intention, subjective norms, and perceived behavioural control in Chinese county hospitals.
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Project description:ObjectiveThe use of e-cigarettes among college undergraduates is a prevalent problem across the United States. Guided by the Theory of Planned Behavior (TPB), we examined the relationship between memorable messages and early adulthood e-cigarette use.MethodsWe recruited 159 students to complete a survey at Time 1 and 126 of those students completed the second survey.ResultsStructural equation modeling demonstrated that attitudes and norms are significantly associated with intentions to use e-cigarettes, whereas efficacy is negatively associated with intentions to use. Intentions were positively associated with actual use of e-cigarettes at Time 2.ConclusionsOur findings contribute to understanding young adults' experiences with alternative tobacco products, and demonstrate a need to create health education and promotion campaigns based on TPB constructs.
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Project description:BackgroundFinnish clinical guidelines are evolving toward integration of knowledge modules into the electronic health record in the Evidence-Based Medicine electronic Decision Support project. It therefore became important to study which factors affect professionals' intention to use clinical guidelines generally in their decision-making on patient care. A theory-based approach is a possible solution to explore determinants of professionals' behaviour. The study's aim was to produce baseline information for developers and implementers by using the theory of planned behaviour.MethodsA cross-sectional internet-based survey was carried out in Finnish healthcare organisations within three hospital districts. The target population (n = 2,252) included physicians, nurses, and other professionals, of whom 806 participated. Indicators of the intention to use clinical guidelines were observed by using a theory-based questionnaire. The main data analysis was done by means of multiple linear regressions.ResultsThe results indicated that all theory-based variables--the attitude toward the behaviour, the subjective norm, and the perceived behaviour control--were important factors associated with the professionals' intention to use clinical practice guidelines for their area of specialisation in the decisions they would make on the care of patients in the next three months. In addition, both the nurse and the physician factors had positive (p < 0.01) effects on this intention in comparison to other professionals. In the similar models for all professions, the strongest factor for the physicians was the perceived behaviour control, while the key factor for the nurses and the other professionals was the subjective norm. This means that context- and guideline-based factors either facilitate or hinder the intention to use clinical guidelines among physicians and, correspondingly, normative beliefs related to social pressures do so for nurses and other healthcare professionals.ConclusionsThe results confirm suggestions that the theory of planned behaviour is a suitable theoretical basis for implementing clinical guidelines in healthcare practices. Our new finding was that, in general, profession had an effect on intention to use clinical guidelines in patient care. Therefore, the study reaffirms the general contention that different strategies need to be in place when clinical guidelines are targeted at different professional groups.
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Project description:OBJECTIVES:Dental caries is the most common chronic childhood disease that occurs in a continuum and can be prevented by children and their parents' adherence to recommended oral health behaviors. Theory-driven tools help practitioners to identify the causes for poor adherence and develop effective interventions. This study examined the Expanded Theory of Planned Behaviour (TPB) Model by adding the concept of Sense of Coherence (SOC) to predict parental adherence to preschooler's preventive dental visits. METHODS:Data regarding socio-economic demographics were collected from parents of children aged 2-6 years. Constructs of TPB including parental attitudes, subjective norms (SN), Perceived Behavioural Control (PBC), and intention to attend preventive dental visits for their preschoolers were collected by questionnaire, alongside parents' sense of coherence (SOC). Dental attendance was measured by asking if the child had a regular dental visit during the last year. Structural Equation Modeling Analysis (SEMA) was carried out to identify significant direct and indirect (mediated) pathways in the extended TPB model. RESULTS:Three hundred and seventy-eight mothers (mean age = 34.41 years, range 22-48) participated in the study. The mean age of children was 3.92 years, range: 2-6), and 75.9% had dental insurance. Results of the final model showed that predisposing factors (child's birthplace and mother's birthplace) significantly predicted enabling resources (family monthly income and child's dental insurance status); both predicted the TPB components (PBC, SN, and attitude). TPB components, in turn, predicted behavioural intention. However, contrary to expectation, intention did not significantly predict dental attendance in the past 12 months. Parent's SOC significantly predicted TPB components and dental attendance. Overall, 56% of the variance in dental attendance was explained by the expanded TPB model. CONCLUSIONS:The expanded TPB model explained a great deal of variance in preschooler's dental attendance. These findings suggest that the expanded model could be used as the framework for designing interventions or strategies to enhance dental attendance among preschoolers; in particular, such strategies should focus specifically on enhancing parental SOC including empowerment.
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Project description:Individual energy-saving behaviours are crucial for reducing energy consumption, and research on the determinants of these behaviours has been increasing over the last decade. The aim of this study is to explore the determinants of two specific behaviours: 'switching off non-essential lights' and 'completely switching off electronic devices'. An extended model of the theory of planned behaviour (TPB) has been used as the theoretical research framework. The extension was implemented by considering two components (affective and cognitive) of the attitude towards these behaviours and then adding habit as a new variable. A two-waves study was conducted in which a convenience sample of Italian workers completed a questionnaire measuring the TPB constructs in relation to the two energy-saving behaviours (Time 1). The participants then completed another questionnaire a month later to assess self-reports of these behaviours (Time 2). The inclusion of habit improved the predictive power of the TPB, and the extended model was found to explain 65.5% and 76.1% of the variance in intentions and 16.2% and 22.9% of the variance in behaviours. Cognitive attitude, subjective norm, perceived behavioural control, and habit were significantly related to intentions, and perceived behavioural control was the strongest predictor. Habit moderated some relationships between the TPB constructs and intentions. Behaviours were associated directly only with intentions. The results of this study support the efficacy of the TPB model in predicting target behaviours; they also suggest some strategies that can be followed to promote these energy-saving behaviours.
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