The effect of interventional program underpinned by health belief model on awareness, attitude, and performance of nurses in preventing nosocomial infections: A randomized controlled trial study / Efecto de un programa de intervención basado en el modelo de creencias en salud sobre el conocimiento, la actitud y el desempeño del personal de enfermería en la prevención de las infecciones intrahospitalarias. Ensayo controlado aleatorizado / Efeito de um programa de intervenção baseado no modelo de crenças em saúde no conhecimento, atitude e atuação da equipe de enfermagem na prevenção de infecções hospitalares. Teste controlado e aleatório

Objective. The present study examined the effect of an interventional program underpinned by the Health Belief Model (HBM) on nurses' awareness, attitude, and performance in preventing nosocomialinfections.Methods. This randomized controlled trial study was performed on 60 clinical nurses in lar, Iran. Nurses were selected using the simple random sampling method and assigned to two experimental (n=30) and control (n=30) groups. Data collection tool included the valid and reliable questionnaire was developed by Soleimani et al. The research intervention consisted of five 90-min sessions based on the health belief model in preventing hospital infection for experimental group. Before the intervention, immediately and two months after the intervention, the two groups completed the questionnaire. The control group received no intervention. Results. Data analysis showed that the differences between the two groups was statistically significant immediately and two months after the intervention (p<0.05). In experimental group the changes in the mean score of knowledge, attitude and performance of nurses before, immediately and two months after the intervention were significant (p<0.05), but in the control group, only the changes in the mean score of performance were significant (p<0.05). Conclusion. The results showed that the HBM-based intervention is effective in promoting nurses' knowledge, attitude, and performance in preventing nosocomialinfections. hence, periodical and in-service HBM-based training programs on preventing nosocomialinfections are recommended to be held for nurses.

Objetivo. El presente estudio examinó el efecto de un programa de intervención basado en el modelo de creencias en salud (Health Belief Model -HBM-, en inglés sobre el conocimiento, la actitud y el desempeño de las enfermeras en la prevención de las infecciones intrahospitalarias. Métodos. Este ensayo controlado aleatorizado se realizó en 60 enfermeras clínicas de lar, Irán. Las enfermeras fueron seleccionadas mediante el método de muestreo aleatorio simple y asignadas a dos grupos experimental (n=30) y de control (n=30). La herramienta para la recogida de datos incluyó el cuestionario válido y fiable desarrollado por Soleimani et al.La intervención consistió en cinco sesiones de 90 minutos basadas en el modelo de creencias de salud para prevenir la infección intrahospitalaria en el grupo experimental. Antes de la intervención, inmediatamente y dos meses después de la intervención, los dos grupos completaron el cuestionario. El grupo de control no recibió ninguna intervención. Resultados. El análisis de los datos mostró diferencias estadísticamente significativas entre los dos grupos en los momentos inmediatamente y dos meses después de la intervención (p<0.05). En el grupo experimental, los cambios en la puntuación media de conocimientos, actitudes y rendimiento de las enfermeras se observaron en los momentos de antes, inmediatamente y dos meses después de la intervención (p<0.05); mientras que en el grupo de control solamente los cambios en la puntuación media de desempeño fueron significativos (p<0.05). Conclusión. Los resultados mostraron que la intervención basada en HBM fue eficaz para promover el conocimiento, la actitud y el rendimiento de las enfermeras en la prevención de las infecciones intrahospitalaria, por lo que se recomienda impartir a las enfermeras programas de formación periódicos y en servicio basados en HBM sobre la prevención de las infecciones intrahospitalarias.

Objetivo. Examinar o efeito de um programa de intervenção baseado no Modelo de Crenças em Saúde (MBH) no conhecimento, atitude e desempenho dos enfermeiros na prevenção de infecções hospitalares. Métodos. Este ensaio clínico randomizado foi conduzido em 60 enfermeiras clínicas de lar, Irã. Os enfermeiros foram selecionados pelo método de amostragem aleatória simples e distribuídos em dois grupos experimental (n=30) e controle (n=30). O instrumento de coleta de dados incluiu o questionário válido e confiável desenvolvido por Soleimani et al. A intervenção consistiu em cinco sessões de 90 minutos baseadas no modelo de crenças em saúde para prevenir infecção hospitalar no grupo experimental. Antes, imediatamente e dois meses após a intervenção, ambos os grupos responderam ao questionário. O grupo controle não recebeu nenhuma intervenção. Resultados.A análise dos dados mostrou diferenças estatisticamente significativas entre os dois grupos imediatamente e dois meses após a intervenção (p<0.05). No grupo experimental foram observadas alterações na pontuação média de conhecimentos, atitudes e desempenho dos enfermeiros antes, imediatamente e dois meses após a intervenção (p<0.05); enquanto no grupo controle apenas as alterações na pontuação média de desempenho foram significativas (p<0.05). Conclusão.Os resultados demonstraram que a intervenção baseada no HBM foi eficaz na promoção do conhecimento, atitude e desempenho dos enfermeiros na prevenção de infecções hospitalares, pelo que se recomenda proporcionar aos enfermeiros este tipo de programas de formação em serviço baseados no HBM.

Percepções de mulheres com câncer de mama acerca dos tratamentos / Perceptions of women with breast cancer regarding treatments

O objetivo deste estudo foi compreender a percepção das mulheres com câncer de mama acerca dos tratamentos. Trata-se de um estudo qualitativo, descritivo, transversal, no qual participaram 40 mulheres em quimioterapia para tratamento do câncer mamário em um hospital especializado em oncologia. O instrumento utilizado para coleta de dados foi uma entrevista semiestruturada. Os dados foram analisados mediante Análise de Conteúdo de Bardin e categorizados conforme o Modelo de Crenças em Saúde. Originaram-se quatro categorias: "Suscetibilidade percebida: câncer e COVID-19", "Percepção da gravidade em face do impacto dos tratamentos", "Desafios e barreiras nos tratamentos" e "Benefícios percebidos no tratamento do câncer". Conclui-se que existem diferentes fatores que ressoam na percepção que a mulher tem sobre os tratamentos e que geram repercussões na forma de enfrentá-los. O conhecimento desses fatores pelos profissionais de saúde pode auxiliar na assistência às mulheres para melhor enfrentamento da doença.

The objective of this study was to understand the perception of women with breast cancer about treatments. This is a qualitative, descriptive, cross-sectional study, involving 40 women undergoing chemotherapy for the treatment of breast cancer in a hospital specialized in oncology. The instrument used for data collection was a semi-structured interview. Data was analyzed using Bardin's Content Analysis and categorized according to the Health Belief Model. Four categories emerged: "Perceived susceptibility: cancer and COVID-19", "Perception of severity in view of treatments impact", "Challenges and barriers in treatments" and "Perceived benefits in cancer treatment". It is concluded that there are different factors that resonate in women's perception of treatments and that generate repercussions in the way of facing them. Knowledge of these factors by healthcare professionals can help in providing better assistance to women in facing the disease.

Psycho-Social Drivers of COVID-19 Vaccine Uptake Among University Students

Background: Students play a significant role in delivering effective messages for better uptake of health pro-moting behaviour. Understanding factors that are associated with COVID-19 vaccine uptake among students will help develop promising strategies in vaccine promotion of the pandemic. The present investigation was undertaken to look into psycho-social drivers of COVID-19 uptake among Indian students.Method: 587 students, aged 18-35 years participated in an online survey. Standardized measures targeting socio-demographic details, health anxiety, preventive health behaviour and constructs of health belief model were used for the present study. Results: The results showed that overall vaccine uptake among students was quite high with nearly 74% of the students reported being vaccinated against COVID-19. Factors like COVID-19 contact, level of education, belief in safety and efficacy of vaccine, social distancing, age, health worry and preoccupation were emerged as the significant drivers of COVID-19 vaccination behaviour increase the probability of vaccine uptake among students. Moreover, factors like Interference with life, Reassurance Seeking, irrational belief about preventive health measures and perceived barriers about vaccination had significant negative link with vaccination de-creasing the likelihood of vaccine uptake. Conclusion: Psychological and socio-demographic factors play vital role in the success of public health strate-gies of COVID-19 vaccine promotion in managing the pandemic.

Mitos y creencias sobre la insulinoterapia en pacientes con diabetes mellitus y sus familiares de un hospital del norte del Perú, 2020 / Myths and beliefs about insulin therapy in patients with diabetes mellitus and their family caregivers from a hospital in northern Peru, 2020

Objetivo. Analizar y explorar los mitos y creencias sobre la insulinoterapia en pacientes con diabetes mellitus y sus familiares cuidadores de un hospital general del norte peruano en el 2020. Materiales y métodos. Se realizo un estudio con enfoque cualitativo, paradigma interpretativo y tipo de análisis temático. Se obtuvieron datos sociodemográficos y clínicos de las historias clínicas y se entrevistaron pacientes con diabetes, con uso de algún tipo de insulina por lo menos tres meses antes del estudio, y a sus familiares cuidadores. Los pacientes participaron de un grupo focal y de entrevistas a profundidad; los familiares participaron solo en entrevistas a profundidad. Resultados. Participaron 12 pacientes con diabetes (11 con diabetes mellitus tipo 2); seis en el grupo focal y seis en las entrevistas a profundidad y siete familiares. Luego del análisis se obtuvieron cuatro categorías: 1) creencias relacionadas al inicio de tratamiento con insulina: tratamiento de elección después del fracaso con otros fármacos, cura la diabetes, regula el azúcar, temor a los inyectables; 2) creencias relacionadas al mantenimiento del tratamiento: descompensación por no usar insulina, la insulina es necesaria para vivir; 3) creencias relacionadas a terapias alternativas y costo: uso de terapias alternativas, costo elevado de la insulina; y 4) mitos relacionados al uso de insulina: genera dependencia, dependencia para la administración de insulina, efectos negativos de la insulina. Conclusiones. Las creencias y mitos de los pacientes, en tratamiento con insulina, emergen desde el inicio del tratamiento y se mantienen con la evolución de este, siendo en muchas ocasiones reforzados por la cosmovisión de los familiares.

Objective. To analyze and explore the myths and beliefs about insulin therapy in patients with diabetes mellitus and their family caregivers from a general hospital in northern Peru in 2020. Materials and methods. This qualitative study used a thematic analysis model, following the interpretative paradigm. Sociodemographic and clinical data were obtained from medical records. Patients with diabetes that used some type of insulin for at least three months prior to the study were interviewed, as well as their family caregivers. Patients participated in a focus group and in-depth interviews; family caregivers participated only in in-depth interviews. Results. Twelve patients with diabetes (11 with type 2 diabetes mellitus) were included; six in the focus group and six in the in-depth interviews. Seven family caregivers were included. After analysis, we obtained four categories: 1) beliefs related to starting insulin treatment: treatment of choice after failure of other drugs, cures diabetes, regulates sugar, fear of injectables; 2) beliefs related to treatment adherence: decompensation for not using insulin, insulin is necessary to live; 3) beliefs related to alternative therapies and cost: use of alternative therapies, high cost of insulin; and 4) myths related to the use of insulin: generates dependence, dependence for insulin administration, negative effects of insulin. Conclusions. The beliefs and myths of patients treated with insulin arise from the beginning of treatment, remain throughout the course of treatment, and are often reinforced by the worldview of family members.

Analysis of influencing factors of tuberculosis related health behaviors among college freshmen with health belief model / 中华行为医学与脑科学杂志

Objective:To explore the influencing factors of tuberculosis related health behaviors among college freshmen with health belief model, so as to provide a scientific basis for the intervention of health behaviors among students.Methods:From January to February 2021, the questionnaire survey was conducted among 5 254 college freshmen from 11 universities.The survey included general demographic data, tuberculosis related health behaviors, and tuberculosis related knowledge, disease threat perception and disease policy cognition.The SPSS 23.0 software was used for data analysis, independent sample t-test and one-way ANOVA were used for inter group comparison, and Logistic regression analysis was used to explore the influencing factors of health behavior holding. Results:The total score of tuberculosis related health behaviors among freshmen was 3~12 (11.01±1.10), and the overall holding rate of tuberculosis related health behaviors was higher.Male( B=-0.753, OR(95% CI)=0.471(0.417-0.531)), and tuberculosis history ( B=-1.088, OR(95% CI)=0.337(0.157-0.722)) were risk factors for tuberculosis related health behaviors among freshmen.Birth in city( B=0.117, OR(95% CI)=1.124(0.944-1.338)), father's education level college /undergraduate and above ( B=0.177, OR(95% CI)=1.194(1.024-1.392)), mother's education level high school/secondary school( B=0.356, OR(95% CI)=1.428(1.126-1.810)), college/undergraduate and above( B=0.194, OR(95% CI)=1.214(1.029-1.433)), take the initiative to understand tuberculosis knowledge ( B=0.208, OR(95% CI)=1.231(1.095-1.385)), higher tuberculosis knowledge score ( B=0.088, OR(95% CI)=1.092(1.041-1.145)), higher disease threat perception score ( B=0.082, OR(95% CI)=1.086(1.031-1.144)) and higher disease policy cognition score( B=0.320, OR(95% CI)=1.378(1.265-1.500)) were protective factors for tuberculosis related health behaviors among first-year undergraduates(all P<0.05). Conclusion:The application of health belief model can analyze and explain the influencing factors of tuberculosis-related health behaviors of freshmen, which is helpful to strengthen health education and advocate tuberculosis-related health behaviors.

Relationship between smoking abstinence self-efficacy， smoking rationalization belief and willingness to quit smoking—a questionnaire survey of 336 male smokers in Shanghai / 上海预防医学

ObjectiveTo explore the influencing factors of willingness to quit smoking in smokers， and to provide reference for further smoking cessation intervention. MethodsThrough purposive sampling， smokers were recruited from 4 residential communities and 3 companies in Shanghai for an online questionnaire survey. The survey included general demographic characteristics， willingness to quit smoking， smoking condition， tobacco addiction， awareness of influence of smoking， smoking abstinence self-efficacy， and smoking rationalization belief. T-test， χ2 test and multiple logistic regression were used to analyze the data. ResultsA total of 336 valid questionnaires were collected. The average age of the smokers was （37.1±10.2） years， and most of their education level was college or above （58.3%）. The daily number of cigarette use was （11.46±7.22） and most of smokers were classified as low nicotine dependence （58.3%）. Today 248 smokers planned to quit smoking in the next six months. Compared with smokers with low smoking abstinence self-efficacy， smokers with high self-efficacy were more likely to quit smoking （OR=2.406，95%CI： 1.357‒4.267）； Smokers with low smoking rationalization belief were more likely to quit smoking than those with high rationalization belief （OR=2.112， 95%CI： 1.167‒3.821）. ConclusionSmoking abstinence self-efficacy has a positive impact on willingness to quit smoking， while smoking rationalization belief has a negative impact on the willingness to quit smoking. Efforts to improve smoking abstinence self-efficacy and dispel smoking rationalization beliefs of smokers should be made to promote the intention to quit among smokers.

Construction of a "4M" death education intervention program for advanced cancer caregivers based on the theory of knowledge, belief and practice / 中国实用护理杂志

Objective:To construct a death education intervention program for advanced cancer caregivers to improve the reference for death education for advanced cancer caregivers.Methods:Content analysis, semi-structured interview, Delphi expert consultation method were used to develop a preliminary death education program based on the theory of knowledge, belief, and behavior. From April to May 2022, fifteen experts from palliative care, life and death education, oncology nursing, psychological nursing and other related fields were selected for two rounds of expert consultation, and the contents of the program were revised and improved through preliminary experiments.Results:After two rounds of expert consultation, the results showed that the expert opinions tend to be unanimous. The authoritative coefficient of experts was 0.87, and the Kendall coordination coefficients of feasibility, validity and scientificity of the two rounds of consultation were 0.181, 0.303, 0.363 and 0.249, 0.355, 0.366, respectively (both P<0.05). The preliminary experiments revised and improved the intervention frequency and content, and finally formed a death education intervention program for advanced cancer caregivers which included four-stage progressive death themes: made an appointment with death, made a discussion on death, made an embrace with death and made friends with death. Conclusions:The process of constructing a death education program for advanced cancer caregivers is scientific, and the content is feasible, valid, and scientific. In addition, it is of great significance to promote death education in palliative care.

Just World, Trust in Institutions and Socioeconomic and Political Moderations / Mundo Justo, Confiança nas Instituições e Moderações Socioeconômicas e Políticas

Abstract This study investigates the system justifying role through belief in a just world (BJW), testing whether institutional trust is related to this belief and whether this relationship depends on specific socioeconomic and political factors. A research with 381 university students, aged 18 to 64 years (M = 22.4, SD = 6.25), explored their BJW and their degree of institutional trust. Regression and moderation analyses revealed that BJW relates to institutional trust only in left-wing and with lower income participants. We believe this occurs because they need more an ideology that justifies the system to trust the institutions. This phenomenon can prevent these people from pursuing structural social changes since the system is now seen as fair.

Resumo Este estudo investiga o papel justificador do sistema através da crença no mundo justo (CMJ), testando se a confiança institucional está relacionada com essa crença e se esta relação depende de fatores socioeconômicos e políticos específicos. Uma pesquisa com 381 universitários, com idades de 18 a 64 anos (M = 22,4, DP = 6,25), explorou seus graus de CMJ e confiança institucional. Análises de regressão e moderação revelaram que a CMJ se relaciona com a confiança institucional apenas naqueles de esquerda e menores rendimentos. Acreditamos que isso ocorra porque estas pessoas precisam mais de uma ideologia justificadora do sistema para poder confiar nas instituições. Este fenômeno pode lhes indispor a buscar mudanças sociais estruturais, já que o sistema passa a ser visto como justo.

Crenças em saúde de mulheres lésbicas e bissexuais acerca da realização do teste de Papanicolaou / Lesbian and bisexual women's health beliefs about performing the Papanicolaou's test

RESUMO Objetivo identificar as crenças em saúde de mulheres lésbicas e bissexuais acerca da realização do teste de Papanicolaou. Métodos estudo transversal desenvolvido exclusivamente online, com 55 participantes. Utilizou-se o Google Forms® para coleta de dados, com questões sociodemográficas e econômicas, além de questões relacionadas às práticas, à intenção e às crenças na realização do teste de Papanicolaou. Os dados foram organizados no Google Sheets® e analisados no software SPSS®. Resultados verificou-se que mulheres bissexuais acreditam mais no benefício "quando eu faço o exame preventivo, eu fico aliviada" (p=0,047). Contudo, possuem maior pontuação de vergonha de fazer o exame preventivo (p=0,005). Identificou-se associação significativa entre ter realizado o exame e benefícios percebidos (p=0,040); gravidade percebida e nível de instrução (p=0,006); ter realizado o exame (p=0,039); e ter parceria fixa (p=0,028). Conclusão mulheres bissexuais acreditam que realizar o exame gera alívio, mas o sentimento de vergonha pode prejudicar a adesão ao exame. Mulheres lésbicas e bissexuais sem acesso à educação superior, que nunca realizaram o exame e que possuem múltiplas parcerias sexuais estão mais vulneráveis ao câncer de colo do útero. Contribuições para a prática: refletir sobre esse cenário para que estratégias educativas sejam efetivadas acerca da prevenção do câncer de colo do útero.

ABSTRACT Objective to identify the health beliefs of lesbian and bisexual women about performing the Papanicolaou's test. Methods cross-sectional study developed exclusively online, with fifty-five participants. Google Forms® were used for data collection, with sociodemographic and economic questions, as well as questions related to practices, intention, and beliefs about performing the Papanicolaou's test. Data were organized in Google Sheets® and analyzed in SPSS® software. Results it was found that bisexual women believe more in the benefit "when I do the preventive exam, I am relieved" (p=0.047). However, they have higher scores of ashamed for doing the preventive exam (p=0.005). Significant association was identified between having done the exam and perceived benefits (p=0.040); perceived severity and education level (p=0.006); having done the exam (p=0.039); and having fixed partnership (p=0.028). Conclusion bisexual women believe that performing the exam generates relief, but feelings of shame may hinder adherence to the exam. Lesbian and bisexual women without access to higher education, who never had the exam, and who have multiple sexual partnerships are more vulnerable to cervical cancer. Contributions to practice: reflect on this scenario so that educational strategies are effective for cervical cancer prevention.

Exploring prostate cancer screening among men in Accra using the health belief model

Objective: To explore the prevalence of prostate cancer screening among Ghanaian men and interrogate why some individuals screen for the disease and others do not. Design: A cross-sectional questionnaire survey based on the Health Belief Model was used to collect data from 356 men aged 40 years and above. Data were collected between February and March 2021. Setting: The study was conducted in the Accra metropolitan area of the Greater Accra region of Ghana. Participants: Convenience sampling was used to recruit participants for the study. Results: Although 86% of the respondents had heard about prostate cancer, only 23% had ever screened for it. Logistic regression analysis suggested that knowledge of the disease (OR = 1.19, CI 95% = 1.03 -1.38) and barriers to screening (OR = .87, CI 95% = .83 -.91) were statistically significant predictors of screening behaviour. Conclusion: HBM has limited predictive power as far as our study is concerned. We suggest increasing public education on prostate cancer and its screening methods. The cost of screening should also be made more affordable so as not to become a barrier.

Current situation of myopia among primary school students in Jinhua city and the intervention effect of knowledge, belief and practice / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the current situation of myopia in a primary school in Jinhua city and the intervention effect of knowledge, belief and practice.METHODS: From September to December 2022, a total of 1 482 primary school students who met the inclusion criteria were selected for myopia test and education intervention based on cluster sampling method. The questionnaire was designed based on relevant references. The main contents of the questionnaire include students' general information, low vision and knowledge, belief and practice before and after intervention and prevention of myopia.RESULTS: A total of 1 482 primary school students were investigated and tested, among which myopia was detected out of 657 students, with a myopia rate of 44.33%. Specifically, mild myopia accounted for 54.64%(359); moderate myopia accounted for 23.90%(157); severe myopia accounted for 21.46%(141). A total of 1 468 valid questionnaires were collected before intervention, and 1 457 valid questionnaires were collected after intervention. The overall knowledge rate of myopia prevention and control knowledge before intervention was 62.57%(7348/11744), and it was 81.20%(9465/11656)after intervention, with statistical significance before and after intervention was statistically significant(P&#x003C;0.001). The behavior attendance rate before intervention was 82.48%(9687/11744), and it was 93.73%(10925/11656)after intervention, with statistical significance comparison before and after intervention(P&#x003C;0.001).CONCLUSION: The results of this survey showed that the myopia situation of primary students in Jinhua city was not optimistic, and some students were not aware of prevention knowledge and correct behavior before intervention. After intervention, the knowledge, belief and practice of myopia prevention and control have achieved remarkable results.

Effectiveness of Mobile Application to Improve Adherence to Tuberculosis Treatment: A Study Protocol

@#Introduction: Tuberculosis (TB) is a leading cause of death due to a single infectious agent. The disease is treatable by a minimum of six months of anti-TB drugs. However, prolonged duration of treatment using directly observed therapy (DOT) causes significant inconvenience to patients and is ineffective in improving treatment outcomes. Therefore, incorporating the Health Belief Model into the development of digital technology could help change behaviour and improve adherence. This study aimed to determine the effectiveness of mobile applications in improving TB medication adherence. Methods: This study proposed to conduct a randomized trial among TB patients in the Kota Kinabalu, Penampang, and Putatan districts of Sabah, Malaysia. The eligible sample will be randomly assigned to the mobile application DOT arm and standard DOT arm. The primary outcome is the adherence level calculated by the percentage of medication observed divided by the intended dose taken in two months, with 80% and more successfully observed treatment considered highly adherent. The secondary outcomes are health-related quality of life, satisfaction, and monthly household income. Multiple logistic regression and repeated measures ANCOVA will be used to determine the effectiveness of interventions to achieve primary and secondary outcomes. Discussion: The findings from this study could hopefully provide insight into rethinking TB care delivery to achieve better TB treatment outcomes. Trial Registration: This study protocol has been approved by the Medical Research Ethics Committee (MREC), Ministry of Health Malaysia (NMRR ID-21-01949-73X) and registered with ClinicalTrials. gov (NCT05259254).

Predictors of Adherence to Personal Preventive Behaviors Among Nursing Students Based on Health Belief Model: Cross Sectional Study During the Second Wave of COVID-19 Pandemic in Indonesia

@#Introduction: Personal preventive behaviors was cited as effective strategy to prevent the SARS-CoV-2 transmissions. When vaccine become available, preventive behavior must still be implemented to significantly decreased the COVID-19 infection risk in the emergence of novel SARS-CoV-2 variants of concern with immune escape phenotype. The Health Belief Model (HBM) is the most widely recognized behaviour theory, but its capacity to predict the preventive behaviours have been inconsistent. This study aimed to assess predictors adherence to COVID-19 preventive behaviour among nursing students based on HBM during the second wave of COVID-19 in Indonesia. Methods: An online cross-sectional study was conducted from May to September 2021. Undergraduate nursing students (n=1,413) from 10 universities in Indonesia was recruited using consecutive sampling. Online self-administered questionnaire was used to collect the data. Binary logistic regression was employed to analyse the association between sociodemographic and HBM construct with adherence to preventive behaviors. Results: Most of the students (n=804; 56.9 %) had poor adherence to COVID-19 preventive behaviors, and poor physical distancing identified as the most dominant non-adherence type (n=774; 54.8 %). First year students (AOR=1.313; 95%CI: 1.020-1.690), low perceived susceptibility (AOR=1.530; 95%CI: 1.193-1.962), low perceived severity (AOR= 1.756; 95%CI: 1.337- 2.307), low perceived effectiveness (AOR=1.910; 95%CI: 1.315-2.777), and low self-efficacy (AOR=4.795; 95%CI: 3.566-6.447) significantly associated with poor adherence (p<0.05). Nagelkerke R square value was 0.313 suggesting that the whole model explained 31.3% of variance in adherence. Conclusion: Intervention that targeting health belief model could be useful to increased adherence level to COVID-19 preventive measures among nursing students.

Public health and Christian theism in Africa: An approach to evil and religious belief in the afterlife

Religious beliefs may significantly impact the effectiveness of health policies. In this article, I analyse how Christian theistic beliefs about evil and suffering, in connection with belief in the afterlife, have unreasonable ethical implications in the context of African epistemologies. Further, I contend that such Christian theistic beliefs have a negative impact on health policies, especially during the current pandemic. They prescribe one-size-fits-all approaches, which neglect contextual issues in addressing the pandemic. They also encourage passivity and neglect in the face of suffering. I then offer an alternative inspired by Afro-communitarianism, which I argue is convincing. Given that the theistic view is morally indefensible, I contend that it cannot be a good explanation of the problem of evil.

Effectiveness of the application of an educational program based on the Health Belief Model (HBM) in Adopting Preventive Behaviors from Self-Medication among Women in Iran. A Randomized Controlled Trial / Eficacia de la aplicación de un programa educativo basado en el Modelo de Creencias sobre la Salud en la adopción de conductas preventivas de la automedicación entre las mujeres de Irán. Un ensayo controlado aleatorio / Eficácia da aplicação de um programa educativo baseado no Modelo de Crenças sobre Saúde na adoção de comportamentos preventivos de automedicação entre mulheres no Irã. Um ensaio clínico randomizado

Objective.To evaluate the effectiveness of the application of an educational program based on the Health Belief Model (HBM) in Adopting Preventive Behaviors from Self-Medication among Women in Iran. Methods. Interventional study with pre and post phases. 200 women referring to the health centers of Urmia were selected by simple random sampling, divided into two groups of treatment and control. Data collection instruments were researcher-devised questionnaire including the questionnaire of Knowledge of Self-medication, the Questionnaire of Preventive Behaviors from Self-medication, and the questionnaire of Health Belief Model. The questionnaires were assessed for expert validity and then, were checked for reliability. The educational intervention was conducted for the treatment group during four weeks four 45-minute sessions. Results.The average scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficiency, and post-intervention performance in have increased in treatment group, comparing to the control group, All findings were statistically significant (p<0.05). Furthermore, social media, doctors, and disbelief in self-medication were more effective in increasing awareness and encouraging to have proper medication, also, the highest self-medication was in taking pain-relievers, cold tablets and antibiotics, which showed significant decrease in treatment group after the intervention. Conclusion.The educational program based onHealth Belief Modelwas effective in reducing the self-medication among the studied women. Furthermore, it is recommended to use social media and doctors to improve the awareness and motivation among people. Thus, applying the educational programs and plans according to the Health Belief Model can be influential in reducing the self-medication.

Objetivo. Evaluar la eficacia de la aplicación de un programa educativo basado en el Modelo de Creencias sobre la Salud (MCS) en la adopción de conductas preventivas de la automedicación entre las mujeres de Irán. Métodos. Estudio de intervención con evaluación pre y post. Se seleccionaron 200 mujeres que acudieron a los centros de salud de Urmia, a quienes se asignaron a los dos grupos de estudio (tratamiento y control) mediante un muestreo aleatorio simple. Para la recolección de la información se utilizaron los cuestionarios sobre: Conocimientos acerca de la automedicación, conductas preventivas de la automedicación y el modelo de creencias sobre la salud. Se evaluó la validez de los cuestionarios por parte de los expertos y luego se comprobó su confiabilidad. La intervención educativa se llevó a cabo para el grupo de tratamiento durante cuatro semanas con 1 sesión semanal de 45 minutos de duración.Resultados.Las puntuaciones medias de los conocimientos, la susceptibilidad percibida, la gravedad percibida, los beneficios percibidos, las barreras percibidas, las señales para la acción, la autoeficacia y el rendimiento posterior a la intervención aumentaron en el grupo de tratamiento en comparación con el grupo de control, y todos los resultados fueron estadísticamente significativos (p<0.05). Además, los medios de comunicación social fueron eficaces para aumentar la concienciación y animar a tener una medicación adecuada. La mayor automedicación fue en la toma de analgésicos, pastillas para el resfriado y antibióticos, que mostró una disminución significativa en el grupo de tratamiento después de la intervención. Conclusión. El programa educativo basado en el Modelo de Creencias de Salud fue eficaz para reducir la automedicación entre las mujeres estudiadas. Además, se recomienda utilizar los medios de comunicación social para mejorar la concienciación y la motivación de las personas.

Objetivo. Avaliar a eficácia da aplicação de um programa educativo baseado no Modelo de Crenças em Saúde (HCM) na adoção de comportamentos preventivos de automedicação entre mulheres no Irã. Métodos. Estudo de intervenção com pré e pós avaliação. Duzentas mulheres que frequentavam os centros de saúde de Urmia foram selecionadas e alocadas nos dois grupos de estudo (tratamento e controle) por meio de amostragem aleatória simples. Para a coleta de informações, foram utilizados os questionários sobre: Conhecimento sobre automedicação, comportamentos preventivos de automedicação e o modelo de crenças sobre saúde. A validade dos questionários foi avaliada pelos especialistas e, em seguida, verificada sua confiabilidade. A intervenção educativa foi realizada para o grupo de tratamento durante quatro semanas com 1 sessão semanal com duração de 45 minutos. Resultados.Os escores médios de conhecimento, suscetibilidade percebida, gravidade percebida, benefícios percebidos, barreiras percebidas, pistas para ação, autoeficácia e desempenho pós-intervenção aumentaram no grupo de tratamento em comparação com o grupo de intervenção. controle, e todos os resultados foram estatisticamente significativos (p<0.05). Além disso, as mídias sociais foram eficazes na conscientização e no incentivo à medicação adequada. A maior automedicação foi em uso de analgésicos, antissépticos e antibióticos, que apresentou diminuição significativa no grupo de tratamento após a intervenção. Conclusão.O programa educativo baseado no Modelo de Crenças em Saúde foi eficaz na redução da automedicação entre as mulheres estudadas. Além disso, recomenda-se o uso das mídias sociais para melhorar a conscientização e a motivação das pessoas.

Pain self-efficacy and physical activity during COVID-19-related social distancing: cross-sectional study / Autoeficácia para dor e atividade física durante o distanciamento social relacionado à COVID-19: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: The COVID-19 pandemic has impacted the practice of physical activity in the population with musculoskeletal pain, and one of the ways to increase the performance of physical activity is to stimulate pain self-efficacy. However, to date, no study that brought the association between self-efficacy and physical activity in this population has been observed in the literature. The aim of this study was to analyze the association of the level of pain self-efficacy and physical activity weekly time in the population with pain during social distancing related to the COVID-19 pandemic in the states of Ceará and São Paulo. METHODS: This study is characterized as a cross-sectional study with a quantitative approach. Data collection was performed using an electronic form. To identify the association between pain self-efficacy (Pain Self-Efficacy Questionnaire) and physical activity weekly time (dependent variable) in the population with pain, a multiple linear regression was performed. RESULTS: Self-efficacy showed a direct association (ß = 0.015; p = 0.0016) with the time of physical activity practiced during the pandemic. Other variables were associated with longer time of physical activity, such as lower pain intensity during the pandemic (ß = -0.064; p = 0.0223), lower body mass index (ß = -0.036; p = 0.0004), the male gender (ß = -0.441; p<0.0001) and absence of reported comorbidities (ß = -0.297; p = 0.0116). The history of positive diagnosis for COVID-19 was not associated with the physical activity duration (p = 0.5347) in an alternative model. CONCLUSION: A direct association between pain self-efficacy and time of physical activity in the population with musculoskeletal pain during COVID-19-related social distancing was identified.

RESUMO JUSTIFICATIVA E OBJETIVOS: A pandemia de COVID-19 impactou a prática de atividade física da população com dor musculoesquelética (DME), e um dos modos de ampliar a realização da atividade física é estimulando a autoeficácia para dor. Entretanto, até o momento, não se observou na literatura qualquer estudo que trouxesse a relação entre autoeficácia e atividade física nessa população. O objetivo deste estudo foi analisar a associação do nível de autoeficácia e do tempo semanal de prática de atividade física na população com dor durante o distanciamento social relacionado à pandemia de COVID-19 nos estados do Ceará e São Paulo. MÉTODOS: Este estudo se caracteriza como um estudo transversal com abordagem quantitativa. A coleta de dados foi realizada a partir de um formulário eletrônico. Para identificação da associação entre autoeficácia (Pain Self-Efficacy Questionnaire) e tempo semanal de prática de atividade física (variável dependente) na população com dor, foi realizada uma regressão linear múltipla. RESULTADOS: A autoeficácia apresentou relação direta (ß = 0,015; p = 0,0016) com tempo de atividade física praticada durante a pandemia. Outras variáveis apresentaram associação com maior tempo de prática de atividade física, como menor intensidade de dor durante a pandemia (ß = -0,064; p = 0,0223), menor índice de massa corporal (ß = -0,036; p=0,0004), ser do sexo masculino (ß = -0,441; p<0,0001) e relatar ausência de comorbidades (ß = -0,297; p = 0,0116). O histórico de diagnóstico positivo para COVID-19 não apresentou associação com tempo de atividade física (p = 0,5347). CONCLUSÃO: Identificou-se associação direta entre autoeficácia para dor e tempo de prática de atividade física na população com dor musculoesquelética durante o distanciamento social relacionado à COVID-19.

Uma breve trajetória dos elementos constitutivos do Advocacy Coalition Framework (ACF) / Una breve trayectoria de los elementos constitutivos del Advocacy Coalition Framework (ACF) / A brief trajectory of the constituent elements of the Advocacy Coalition Framework (ACF)

Resumo O trabalho reconstrói a trajetória do Advocacy Coalition Framework (ACF), especialmente seu processo de aprendizado orientado à políticas públicas. Inicialmente, o texto contrasta os elementos contidos em Sabatier e Mazmanian (1980), nos quais são encontrados os primeiros esforços para desenvolver um modelo de análise com os argumentos encontrados em Sabatier (1987, 1988 e 1993). Posteriormente, a trajetória histórica de atualizações e versões do modelo é discutida com base nas análises de Sabatier e Jenkins-Smith (1999), Sabatier e Weible (2007) e Jenkins-Smith et al. (2018). Ao longo de mais de 30 anos de pesquisa, foi possível acompanhar as modificações presentes nas quatro versões do modelo, as principais hipóteses construídas, as críticas e seus desdobramentos Uma lacuna identificada nessa trajetória e consequente proposta para uma futura agenda de pesquisa apontam a influência dos atores internacionais e suas implicações nas modificações de políticas públicas, condição não explicitamente abordada pela ACF em suas diversas versões, conforme destacado por Jenkins-Smith et al. (2018).

Resumen El artículo pretende trazar la trayectoria del Advocacy Coalition Framework (ACF), especialmente su proceso de aprendizaje orientado a políticas públicas. Inicialmente, el texto contrasta los elementos contenidos en Sabatier y Mazmanian (1980), donde se encuentran los primeros esfuerzos por desarrollar un modelo de análisis, con los argumentos encontrados en Sabatier (1987, 1988 y 1993). Posteriormente, se discute la trayectoria histórica de actualizaciones y versiones del modelo a partir de los análisis de Sabatier y Jenkins-Smith (1999), Sabatier y Weible (2007), y Jenkins-Smith et al. (2018). A lo largo de la trayectoria de construcción del ACF, fue posible seguir las modificaciones en las cuatro versiones del modelo, las principales hipótesis construidas, las críticas y sus desdoblamientos. Una laguna identificada en esta trayectoria, y consecuente propuesta de agenda de investigación futura, destaca la influencia de los actores internacionales y sus implicaciones en las modificaciones de las políticas públicas, condición no abordada explícitamente por el ACF en sus variadas versiones, como destacan Jenkins-Smith et al. (2018).

Abstract This paper aims to retrace the trajectory of the Advocacy Coalition Framework (ACF), especially its policy-oriented learning process. Initially, we contrast the elements in Sabatier and Mazmanian (1980), where the first efforts to develop an analysis model are found, with the arguments found in Sabatier (1987, 1988, and 1993). Subsequently, the historical trajectory of updates and versions of the model is discussed based on the analyses in Sabatier and Jenkins-Smith (1999), Sabatier and Weible (2007), and Jenkins-Smith et al. (2018). It was possible to follow the modifications in the model, the main hypotheses built, the criticisms, and their unfoldings. As main findings, it was evident throughout the ACF construction trajectory: four versions of the model over almost 30 years and with the decisive participation of six prominent authors who contributed to its main developments since the first version, present in Sabatier and Jenkins-Smith (1993); and Sabatier and Jenkins-Smith (1999), the model gains greater analytical capacity with the intermediate variables between the external factors and the policy subsystem and analytically refines the categories internal to the subsystem. One gap identified in this trajectory, and consequent proposal for a future research agenda, is the influence of international actors and their implications on policy modifications, a condition not explicitly addressed by the ACF in its varied versions, as highlighted by Jenkins-Smith et al. (2018).

Percepciones de aceptabilidad y reticencia a las vacunas contra la COVID-19 en el Perú / Perceptions of acceptance and reluctance to COVID-19 vaccination in Peru

RESUMEN Objetivos. Explorar los factores que predisponen la aceptabilidad o reticencia a la vacunación contra la COVID-19 utilizando métodos cualitativos. Materiales y métodos. Estudio cualitativo descriptivo realizado entre abril y junio del 2021. Se utilizó una guía de entrevista semiestructurada que exploró las percepciones de los participantes de diferentes regiones del Perú con relación a la aplicación de la vacuna para la COVID-19, tomando como marco teórico el modelo de creencias en salud, cuyas dimensiones son: susceptibilidad, severidad, beneficios, barreras y estímulos asociados para ejecutar la acción. Resultados. Se entrevistó a treinta personas, en su mayoría mujeres. Para los participantes la eficacia de las vacunas se relaciona con el país de procedencia, además, consideran que es importante conocer los efectos a largo plazo en la salud luego de la aplicación de la vacuna. La información recibida por las autoridades gubernamentales y sanitarias puede ser un factor decisivo para la aplicación de la vacuna. Las personas con la intención de no vacunarse sienten que las estrategias de promoción de la vacunación vulneran sus derechos humanos. Conclusiones. Existe un grupo de personas indecisas o inseguras de recibir las vacunas contra la COVID-19 en quienes es necesario fomentar estímulos de acuerdo con sus preocupaciones y necesidades. Las autoridades gubernamentales y sanitarias deben trabajar conjuntamente para mejorar la confianza de la población y brindar mensajes que despejen las principales dudas sobre la eficacia y las reacciones adversas de las vacunas.

ABSTRACT Objectives. To explore factors that influence the acceptance or reluctance to COVID-19 vaccination using qualitative methods. Materials and methods. Descriptive qualitative study conducted between April and June 2021. A semi-structured interview guide was used to explore the perceptions of participants from different regions of Peru regarding COVID-19 vaccination. The Health Belief Model was used as theoretical framework and its dimensions are: susceptibility, severity, benefits, barriers, and cues to action. Results. We interviewed 30 people, mostly were women. For the participants, the efficacy of vaccines is related to the country of origin of the vaccines; in addition, they consider that it is important to know the long-term effects on health after vaccination. The information received by governmental and health authorities can be a decisive factor for vaccination. People with the intention of not being vaccinated feel that vaccination promotion strategies violate their human rights. Conclusions. There is a group of people undecided or unsure about receiving COVID-19 vaccines who need to be encouraged according to their concerns and needs. Governmental and health authorities should work together to improve the confidence of the population and provide messages to clarify doubts about the efficacy and adverse reactions of vaccines.

Parents’ Perception Towards Covid-19 Vaccination for Children in Surat: A Cross Sectional Study

Background: Vaccine hesitancy has been recognized as a public health issue which needs to be ad-dressed urgently. With reopening of school unvaccinated children might become major carriers of COVID-19. An assessment of the determinants of vaccine hesitancy will aid in the acceleration of vaccine administration among children. Objective: This study aims to explore parental COVID-19 vaccine hesitancy in Surat and determine fac-tors associated with it. Methodology: This is a cross sectional study in Surat among 250 participants selected from Rural and Urban field practice area by Systematic Random Sampling. Data collection was done by data collectors in an interview during the month of January and February, 2022. Univariate analysis was done, followed by Chi square test to establish associations. Predictors were determined by Binomial Logistic Regression. Results: Mean age of population was 31.3 + 10.7 years. Vaccine Hesitancy was recorded in 154 (61.6%) participants. Urban address (p=0.013), Full Vaccination status of parents (<0.001) and Perceived Bene-fits of vaccine to the child (p=0.001) were significant predictors of Vaccine Hesitancy. Conclusion: High proportion of Vaccine hesitancy was found in this study. Interventions can be planned on the basis of factors affecting Vaccine Hesitancy.

A Perspective On COVID-19 Vaccine Hesitancy in India

India started vaccination drives in January of 2021. One of the biggest challenges faced by the govern-ment was the hesitancy to get vaccinated. Vaccine hesitancy causes the vaccination process to be de-layed, affecting the process of building herd immunity and allowing the virus to evolve. Certain anthropo-logical factors are responsible for vaccine hesitancy in a community. These factors are broadly catego-rised as personal beliefs, the role of media, and religion. An in-depth analysis of available literature, including the grey literature indicated that these factors influence an individual’s decision-making. Vac-cine hesitancy was largely affected by rumours surrounding it. Contradictory information regarding the vaccines created uncertainty about the consequences of getting vaccinated. A holistic approach is neces-sary to tackle vaccine hesitancy. The interventions from the government need to consider these social and cultural factors to address vaccine hesitancy in the future. Due to the diverse sample size, there is a need for various actors and stakeholders to come together and implement demographic-specific measures to address vaccine hesitancy in India.