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The waste problem in the U.S. has only intensified in recent years, first due to China's National Sword Policy and then to the COVID-19 pandemic. One solution to this problem is to encourage people to adopt pro-environmental behaviors such as opting for reusables and products with plastic-free alternate packaging. In this study, we employ the value-belief-norm theory to examine whether its proposed causal chain predicts consumers' willingness to use reusables and products with plastic-free alternate packaging. We also explore the moderating role of perceived behavior control, one of the strongest predictors of environmental behaviors. Our research provides support to the value-belief-norm theory in predicting behavioral willingness. The moderating role of perceived behavior control provides additional insight into the theoretical model and furnishes practical implications for strategic communication designed to encourage the adoption of reusables and alternative packaging.

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Casino gaming is considered as an entertainment but it may cause financial and psychological burdens to some individuals and their families. Therefore, casino operators have established and deployed responsible gaming policy and practice to mitigate such negative effects. This study explores whether and how responsible gaming policy and practice influences people's casino gaming intention and behavior. Data were collected from 644 Chinese adults in Macao. Results showed that responsible gaming policy and practice significantly influenced people's attitude towards casino gaming (as a legal activity and hobby), subjective norm (for disapproval of casino gaming), and perceived behavior control (for not engaging in casino gaming). Casino gaming intention was positively affected by attitude and negatively affected by subjective norm and perceived behavior control. Casino gaming behavior was positively affected by intention and negatively affected by perceived behavior control. As a whole, responsible gaming policy and practice had a small, negative but significant indirect effect on casino gaming behavior. Implications of the study were given.

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In the emergence of pandemic Coronavirus Disease (COVID-19), the delivery of education service becomes a global issue, and many traditional higher education institutes are shifting toward digital alternatives methods. E-learning is considered the most appropriate effective method of knowledge delivery to meet the current academic requirements. This study investigates the key determinants which influence the Intentions to use e-learning among students in higher education institutes in Malaysia due to the outbreak of the novel Covid-19 pandemic. The data were collected through structured questionnaires from students. The data were analyzed using the structural equation modeling using partial least squares (SEMPLS). The research findings revealed that Attitude, Subjective Norm, Perceived usefulness, and Perceived behavioral becomes a positive predictor of Intention to use e-learning. However, Subjective norms found no significant effect on Intention to use e-learning in the Malaysian context. It is due to the COVID-19 emergency that an individual must choose for the e-learning method disregarding their perceptions. Perceived ease of use and Perceived usefulness has a significant positive effect on attitude. These findings offer guidelines to educational institutes for the implementation of the e-learning system during unavoidable circumstances for the sustainable education system.

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Due to the effect COVID-19 epidemic, promoting green consumption is now a key marketing strategy in the hospitality and tourism industry. As it is vital green hotels predict their customers' visit intention, this study attempts to discover the factors affecting Taiwan's Z-generation tourists' green hotel visit intention using an extended theory of planned behavior [including personal moral norms (PMN) and environmental concern (EC)]. Data were gathered from 296 Z-generation tourists via an online survey, which was subsequently analyzed using partial least squares structural equation modeling. The results evidence that Z-generation tourists' attitude, subjective norms, (SN) and perceived behavioral control positively and significantly influence their green hotel visit intention, with attitude being the most significant factor. Moreover, the mediation model analysis indicates Z-generation tourists' attitude toward green hotels mediates the relationships between PMN, SN, EC, and visit intention. This study provides new insights into tourists' green hotel visit intention and emphasizes the importance of attitude in the formation of intention.

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The prolonged COVID-19 has caused a global lockdown and greatly impacts the supply chain and consumers' consumption behavior of aquatic products. Specifically, consumers' increasing awareness of environmental protection drives the marine aquaculture enterprises to supply green products and establish empathy with consumers in a bid to achieve sustainable consumption. This paper conducts a study on the international green marketing paths of marine aquatic products through PLS-SEM analysis of the 407 valid samples collected from the questionnaire survey. The findings indicate that empathy marketing has a significant positive effect on consumers' purchase intention; subjective norm has a significant positive effect on consumers' purchase intention. Additionally, perceived behavior control has a significant mediating effect between consumers' subjective norm and purchase intention; the consumption environment has a significant positive moderating effect on individual consumption intention. The study suggests that sustainable development can be further propelled by means of coordinating the consumers' awareness of ecological environment protection and their enhanced consumption intention.

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BACKGROUND: Promoting vaccination and eliminating vaccine hesitancy are key measures for controlling vaccine-preventable diseases. OBJECTIVE: We aimed to understand the beliefs surrounding and drivers of vaccination behavior, and their relationships with and influence on vaccination intention and practices. METHODS: We conducted a web-based survey in 31 provinces in mainland China from May 24, 2021 to June 15, 2021, with questions pertaining to vaccination in 5 dimensions: attitude, subjective norms, perceived behavioral control, intention, and behavior. We performed hierarchical regression analysis and structural equation modeling based on the theory of planned behavior-in which, the variables attitude, subjective norms, and intention each affect the variable intention; the variable intention mediates the relationships of attitude and subjective norms with behavior, and the variable perceived behavioral control moderates the strength of this mediation-to test the validity of the theoretical framework. RESULTS: A total of 9924 participants, aged 18 to 59 years, were included in this study. Vaccination intention mediated the relationships of attitude and subjective norms with vaccination behavior. The indirect effect of attitude on vaccination behavior was 0.164 and that of subjective norms was 0.255, and the difference was statistically significant (P<.001). The moderated mediation analysis further indicated that perceived behavioral control would affect the mediation when used as moderator, and the interaction terms for attitude (ß=-0.052, P<.001) and subjective norms (ß=-0.028, P=.006) with perceived behavioral control were significant. CONCLUSIONS: Subjective norms have stronger positive influences on vaccination practices than attitudes. Perceived behavioral control, as a moderator, has a substitution relationship with attitudes and subjective norms and weakens their positive effects on vaccination behavior.

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Tooth-brushing is one of the most important health behaviors to teach children considering potentially serious ramifications of poor dental health. However, children's tooth-brushing behavior is affected by various developmental factors. The aim of this cross-sectional study was to investigate factors related to the tooth-brushing behavior of children adopting the Theory of Planned Behavior. A preliminary elicitation study with 33 primary school students identified underlying beliefs related to tooth-brushing intentions. This data was analysed, synthesized, and incorporated into the development of survey items for three age-appropriate, closed-ended questionnaires administered to 709 primary public school students. Path analyses using structural equation modelling were used to discover the structural relationships among the direct and indirect determinants of tooth-brushing behaviors, and path estimates and the model fit were calculated. Social recognition, peer influence, self-motivating strategies, and cognitive aspects of tooth-brushing were found to become more influential in facilitating behavioral intention with age. In the path models, the tooth-brushing behavioral intention was significantly related to perceived behavioral control rather than behavioral beliefs and normative beliefs. Subjective norms were found to become more significant as children matured. This result suggests that education to improve children's tooth-brushing behavior needs be appropriate to the developmental stage of children.

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BACKGROUND: Although male involvement enhances obstetric care-seeking behavior, the practice of male involvement in developing countries remains unacceptably low. Male involvement in maternal services utilization can be influenced by the attitude, subjective norm, and perceived behavior control of their female partners. Little is known about factors influencing pregnant women's attitudes, perceived subjective norms, and perceived behavior control towards male involvement in maternal services utilization. METHODS: A baseline community-based cross-sectional study whose target was pregnant women were performed from 1st June until 30th October 2017. A three-stage probability sampling technique was employed to obtain a sample of 546 pregnant women. A structured questionnaire that hinged the Theory of Planned Behavior was used. The questionnaire explored three main determinants of male involvement, which were: attitudes towards male involvement, perceived subjective norms towards male involvement, and perceived behavior control towards male involvement. RESULTS: After adjusting for the confounders, factors influencing positive attitude towards male involvement were age at marriage [19 to 24 yrs.,(AOR = 1.568 at 95% CI =1.044-2.353), more than 24 yrs. (AOR = 2.15 at 95% CI = 1.150-1.159)]; education status [primary school (AOR = 1.713 at 95% CI = 1.137-2.58)] and economic status [earning more than one dollar per day (AOR = 1.547 at 95% CI = 1.026-2.332)]. Factors influencing perceived subjective norms was only age at marriage [19 to 24 yrs., (AOR = 1.447 at 95% CI = 0.970-2.159), more than 24 years, (AOR = 2.331 at 95% CI = 1.261-4.308)]; factors influencing perceived behavior control were age at marriage [more than 24 years (AOR = 2.331 at 95%CI = 1.261-4.308)], and the intention to be accompanied by their male partners (AOR = 1.827 at 95%CI = 1.171-2.849). CONCLUSION: The study revealed that women who were married at an older age were more likely to have a positive attitude, subjective norms, and perceived behavior control towards male involvement in maternal services utilization than those who were married at a young age. Pregnant women who had primary education and earn more than a dollar per day were more likely to have positive attitudes towards male involvement than poor and uneducated pregnant women. The study recommends an interventional study to evaluate the influence attitude, subjective norms, and perceived behavior control on male involvement in maternal services utilization.

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Bicycle-sharing is regarded as a new mode of transportation with low-carbon and low-cost advantages, which could effectively alleviate traffic congestion. Understanding the factors and influence paths that affect users' willingness to adopt bicycle-sharing is of great importance. This study aims to investigate how users' environmental concern affects their willingness to adopt bicycle-sharing through the impacts of attitude, subjective norm, and perceived behavior control. The research model was constructed based on the theory of planned behavior model and validated by empirical data collected from 988 users in China utilizing structural equation modeling technique. The results show that users' environmental concern is positively and significantly related to their attitude (ß = 0.593, p < 0.001), subjective norm (ß = 0.358, p < 0.001), and perceived behavior control (ß = 0.508, p < 0.001) toward adopting bicycle-sharing. In turn, users' attitude (ß = 0.496, p < 0.001), subjective norm (ß = 0.209, p < 0.001), and perceived behavior control (ß = 0.206, p < 0.01) toward adopting bicycle-sharing all positively affect the intention to adopt bicycle-sharing. Based on these results, policy implications for improving the users' acceptance and usage rate of bicycle-sharing and suggestions for future research are discussed.

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This study evaluates the influences on food handlers' intention to conduct safe handling behaviours in food service settings in Brazil and the United Kingdom, focusing on Optimistic bias (OB). Although OB has been identified in food handlers in other studies, this is the first study evaluating the role of OB in determining behavioural intention. Three hundred participants, from the United Kingdom (n = 150) and Brazil (n = 150), completed a Theory of Planned Behaviour - based questionnaire, including additional questions about OB. For Brazilian food handlers, Attitude had a significant influence on Behavioural Intention followed by Subjective Norm, while Perceived Behavioural Control and OB did not significantly influence Behavioural Intention. For the United Kingdom, Perceived Behavioural Control had the largest influence, followed by Attitude, and then OB. Results suggest that cultural differences may influence predictors of behavioural intention, and that OB can contribute to predicting engagement in safe handling behaviours. Results contribute to a better understanding of the influences on food safety related behaviours.

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In Japan, the amount of vegetable intake in young adults, especially at breakfast, is low. We aimed to examine the factors associated with vegetable intake at breakfast among young adults. In 2016, a self-administered questionnaire survey was conducted at a Japanese university. The questionnaire measured the frequency of ≥70 g vegetable intake at breakfast, lifestyle, eating habits, environmental factors, knowledge and attitudes (including the variable "Perceived behavior control (PBC)", from the Theory of Planned Behavior). The data of 1,455 male students who usually ate breakfast were analyzed. They were divided into two groups based on the median of the frequency of vegetable intake and the above factors were compared using a chi-squared test by living condition. The significant factors were subsequently entered into a logistic regression analysis as independent variables. Eating breakfast with family or friends and PBC were positively associated with vegetable intake in students living with their family. Often doing one's own cooking, having knowledge about a well-balanced diet, and PBC were positively associated with vegetable intake in students living alone. Along with PBC, different factors pertaining to an individual's living condition may need to be considered to increase vegetable intake at breakfast.

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This study aimed to explore the factors predicting the intention to quit smoking and the subsequent behavior 6 months later using the theory of planned behavior (TPB). Data were obtained from 145 smokers who attended a smoking cessation clinic in a community hospital. All participants completed a questionnaire which included demographic information, TPB-based items, perceived susceptibility and previous attempts to quit. The actual quitting behavior was obtained by follow-up phone calls 6 months later. The TPB constructs explained 34% of the variance in intention to quit smoking. By adding perceived susceptibility, the explained variance was significantly improved to 40%. The most important predictors were perceived behavior control and perceived susceptibility, followed by attitude. Subjective norm did not contribute to the prediction of intention. Attitude and perceived behavior control contributed to the prediction of actual quitting behavior, but intention, subjective norm and perceived susceptibility did not. Our findings support that the TPB is generally a useful framework to predict the intention to quit smoking in Taiwan. The inclusion of perceived susceptibility improved the prediction of intention. With regards to successfully quitting, attitude and perceived behavior control played more crucial roles than other TPB constructs. Smoking cessation promotion initiatives focusing on reinforcing cessation belief, enhancing a smoker's perception of their capability to quit smoking, and persuading smokers that they can overcome cessation barriers to cessation could make subsequent interventions more effective.

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