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Familial hypercholesterolemia (FH) is vastly underdiagnosed and causes an increased risk for sudden cardiac death. Cardiology providers (CHCPs) are in an ideal position to care for FH patients. This research aimed to understand the practice behaviors of CHCPs in the screening, diagnosis, and management of FH.
Methods:
Adaptation of an existing FH knowledge tool guided survey development. The results of the quantitative survey guided development of the interview protocol. CHCPs were recruited in the Division of Cardiology at Columbia University Irving Medical Center (CUIMC). A review of the educational materials offered by the Division of Cardiology was conducted to identify FH knowledge domains presented.
Results:
CHCPs with MDs, at CUIMC for 6–10 years, in clinical practice for 1–5 years, and in inpatient services had the highest average total knowledge scores. CHCPs with RNs, at CUIMC for less than 1 year, in clinical practice for 6–10 years, and in Cath Lab had the lowest average knowledge scores. Four themes emerged – variability in FH care; issues related to addressing FH at institutional, practice setting, and individual levels; importance of identifying FH early; and intervention approaches to overcome barriers to caring for FH patients in cardiology. CHCPs with MDs or with experiential FH knowledge described FH care beyond screening. The document review revealed that only MDs were provided lectures pertaining to FH.
Conclusions:
Future interventions should increase didactic and experiential FH knowledge incorporating institutional, local, and national FH resources. Improving FH care can reduce FH-related morbidity and mortality, as well as improve FH health outcomes.
The demand of palliative care is increasing due to the aging population and treatment hesitancy or intentional avoidance compromises symptom management.
Objectives
To identify patient beliefs associated with medication hesitancy by using the theory of planned behavior (TPB) namely, attitudes, subjective norms, behavioral intention, and perceived behavioral control associated with medication hesitancy or intentional noncompliance by avoidance.
Methods
The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was followed to conduct a systematic literature search involving the CINAHL, Embase, MEDLINE, and PsycINFO databases from inception until March 2022. Hand-searched articles from reference lists and gray literature were included. Thematic analysis was conducted on qualitative data and triangulated with quantitative data.
Results
About 554 articles were retrieved from the literature search and 17 articles were included based on the eligibility criteria. Three subthemes that were identified under TPB constructs were attitude: negative attitude toward medications, passive attitude toward illness and inaccurate information about disease or medication; one subtheme was identified under subjective norms: perceived negative opinions from others; and one subtheme was identified under perceived behavioral control: perception of manageable symptoms. Quantitative data provided triangulation of qualitative findings related to fear of addiction and side effects, feelings of hopelessness, unclear direction and information, social stigma, endurable symptoms, and illness as determinants for medication avoidance.
Significance of results
This systematic review highlighted some patient beliefs related to medication hesitancy or avoidance. Clinicians should take patient beliefs and concerns into consideration when creating treatment regimens for people receiving palliative care to optimize medication adherence and the quality of care.
This chapter explores conditions that appear to support the emergence of conservation values and identities that take the form of action, looking at current understandings of human behavior and what is known about zoos’ institutional power and capacities. Returning to the relevance and impact of the zoo as a museum with conservation mission goals, we explore theories and evidence relevant to the potential of zoos as activation entities able to shift zoogoers from the process of individual-level conservation values identity work to the active (and hopefully ongoing) pursuit of a conservation agenda.
This study positions perceived organizational culture's (OC) as an important internal contextual factor that influences employee reactions to change. Drawing on the theory of planned behavior (TPB) and organization theory research, we analyze the mechanisms through which employee perceptions of OC generate its effect on employee responses to organizational change. Data from a field study of 171 employees in Kurdistan Region of Iraq's public school teachers showed that employee perceptions of developmental culture were positively and directly related to their change-supportive intentions (CSIs) and, as suggested by the TPB, its effects are simultaneously mediated by change-related attitude (CRA), subjective norm and perceived behavioral control. However, our findings demonstrated that hierarchical culture was only indirectly related to employee CSIs; this relationship was mediated only by CRA and subjective norm. This study is important because it broadens the remit of OC's role as change agent and provides valuable insight into how OC influences employee responses to change efforts in public organizations.
This paper focuses on the effects of entrepreneurial overconfidence at new venture creation. By analyzing Global Entrepreneurship Monitor data and using the theory of planned behavior as a framework, the study provides new evidence on the relative or absolute nature of overconfidence in entrepreneurial skills and the effect of overprecision on new venture creation. Overprecision of supporting beliefs is newly linked to venture creation and it is shown that nascent entrepreneurs’ overconfidence is based on a self-focusing attitude. The results confirm that overconfidence is not a single construct and highlights the differences between the forms of overconfidence habitually confused in the entrepreneurship literature.
Physical and emotional punishment of children is highly prevalent in the Asia-Pacific region. These actions predict a range of physical and emotional harms, prompting a worldwide effort to eliminate them. A key strategy in this effort is to change parental beliefs regarding the acceptability of physical and emotional punishment. The Positive Discipline in Everyday Parenting (PDEP) program was designed to change those beliefs by teaching parents about child development and strengthening their problem-solving skills. A sample of 377 parents in the Asia-Pacific region completed the program: 329 mothers and 47 fathers of children ranging in age from infancy to adolescence. The parents lived in Australia (n = 135), Japan (n = 172) or the Philippines (n = 70). In all three countries, parents’ approval of punishment in general, and physical punishment specifically, declined and they became less likely to attribute typical child behavior to intentional misbehavior. By the end of the program, at least 75% of parents in each country felt better prepared to respond nonviolently to conflict with their children.
Understanding motivating factors for taking soil conservation measures is seen as key to improving on-farm implementation. However, to date only few on-farm conservation measures have been investigated. The objective of this paper is to investigate the influence of farmers’ subjective beliefs on their intention to apply and actual implementation of cover cropping, with the region of Brandenburg (Germany) as a case. An additional objective was to investigate how these insights can contribute to increase farm level implementation of soil conservation measures. Theory of planned behavior provides an approach to understand human behavior by analyzing farmers’ subjective beliefs. Our results, based on a survey of 96 farmers, show that attitudes (ATTs) and perceived difficulty significantly explain variations in intention to apply cover cropping, with ATTs being generally very positive. We discuss that, in this case, the most effective way to increase on-farm implementation is to decrease the farmers’ perception of difficulty. This can be achieved by providing information to farmers on how to overcome barriers to implementation of conservation measures. In-depth insights into belief structures reveal what kind of information is most useful in the case of cover cropping.
This article explores the factors determining whether older adults engage in the Senior Games and related leisure-time physical activity through examining the adults’ salient beliefs. We conducted 10 in-depth interviews with older adults who have participated in the Senior Games. Underpinned by the planned behavior theory’s framework, we explored three types of beliefs: advantages and disadvantages (behavioral beliefs), social support and pressure (normative beliefs), and facilitators and impediments (control beliefs). Interview respondents were found to engage in the Senior Games and related physical activity to the extent that they associated various intangible advantages with the games and valued psychological satisfaction. They viewed their peers and families as supporting and approving of their engagement and recognized the physical capabilities required, and structural constraints necessary, to engage in the games and related activity. With these findings, pertinent beliefs can be combined with interventions designed to encourage leisure-time physical activities by older adults.
Over the past decade, numerous groups of researchers have studied the willingness of health care personnel (HCP) to respond when a disaster threatens the health of a community. Not one of those studies reported that 100% of HCP were willing to work during a public-health event (PHE).
Problem
The objective of this study was to explore factors associated with the intent of HCP to respond to a future PHE.
Methods
The theory of planned behavior (TPB) framed this cross-sectional study. Data were obtained via a web-based survey from 305 HCP. Linear associations between the TPB-based predictor and outcome variables were examined using Pearson's correlations. Differences between two groups of HCP were calculated using independent t tests. A model-generating approach was used to develop and assess a series of TBP-based observed variable structural equation models for prediction of intent to respond to a future PHE and to explore moderating and mediating effects.
Results
The beginning patterns of relationships identified by the correlation matrix and t tests were evident in the final structural equation model, even though the patterns of prediction differed from those posited by the theory. Outcome beliefs had both a significant, direct effect on intention and an indirect effect on intention that was mediated by perceived behavioral control. Control beliefs appeared to influence intention through perceived behavioral control, as posited by the TPB, and unexpectedly through subjective norm. Subjective norm not only mediated the relationship between control beliefs and intention, but also the relationship between referent beliefs and intention. Additionally, professional affiliation seemed to have a moderating effect on intention.
Conclusion
The intention to respond was influenced primarily by normative and control factors. The intent of nurses to respond to a future PHE was influenced most by the control factors, whereas the intent of other HCP was shaped more by the normative factors. Health care educators can bolster the normative and control factors through education by focusing on team building and knowledge related to accessing supplies and support needed to respond when a disaster occurs.
ConnorSB. Factors Associated with the Intention of Health Care Personnel to Respond to a Disaster. Prehosp Disaster Med. 2014;29(6):1-6.
The Theory of Planned Behavior (TPB) is one of the main theoretical models in the study of the different variables, which influence in the practise of physical activity. The aim in this study was to develop a questionnaire based on TPB in physical activity context providing evidence for the validity of the obtained measures. The instrumental project included three independent studies. The first study entailed the construction and qualitative assessment of the items. In the second study, the analysis of factorial structure was performed by means of exploratory measures, and it showed that the reliability of measures was adequate. The third study provided evidence on the dimensionality of the scale. The confirmatory factorial analysis guaranteed the stability of factorial structure proposed by the TPB and provided evidence for the internal validity of the inventory. Moreover, this study provided evidence of its external validity.
The purpose of this study was to test an explanatory model of the relationships between physical self-concept and some healthy habits. A sample of 472 adolescents aged 16 to 20 answered different questionnaires assessing physical self-concept, physical activity, intention to be physically active and consumption of alcohol and tobacco. The results of the structural equation model showed that perceived sport competence positively correlated with current physical activity. Body attractiveness positively correlated with physical activity in boys and negatively in girls. Current physical activity positively correlated with the intention to be physically active in the future and negatively with the consumption of alcohol and tobacco. Nevertheless, this last relationship was only significant in boys. The results are discussed in connection with the promotion of healthy lifestyle guidelines among adolescents. This model shows the importance of physical self-concept for engaging in physical activity in adolescence. It also suggests that physical activity is associated with the intention to continue being physically active and with healthy lifestyle habits.
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