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BACKGROUND: Assessment of self-care behaviors in patients with hypertension may provide clinicians and practitioners with important information about how to better control hypertension. Therefore, the present study aimed to explore the predictors of self-care behaviors in patients with hypertension based on an integrated model of theories of planned behavior and protection motivation. MATERIALS AND METHODS: The present cross-sectional study was part of a larger study, conducted in 2022 on 344 hypertensive patients from Khamir County in Hormozgan Province in Iran. The sample was selected through a systematic random sampling. The patients completed a researcher-made questionnaire based on constructs of the theory of planned behavior and protection motivation theory. They also completed, Hypertension Self-Care Activity Level Effects (H-SCALE), Hypertension Knowledge-Level Scale (HK-LS), and a demographic questionnaire. The data were analyzed in SPSS 21 using the Pearson correlation coefficient, independent-samples T test, one-way ANOVA, and linear regression analysis. RESULTS: The participants' mean age was 47.34 ± 13.68 years. Adherence to medication, physical activity, weight management, diet, and nonsmoking scores were 42.7, 27.3, 66.3, 14.2, and 81.1, respectively. The linear regression model showed that behavioral beliefs (ß = 0.366, P < 0.001), perceived rewards (ß = -0.248, P < 0.001), control beliefs (ß = 0.133, P = 0.013), and normative beliefs (ß = 0.143, P = 0.025) were the major predictors of self-care behaviors in patients with hypertension. CONCLUSION: In light of the present findings, it can be concluded that it is crucial to change patients' attitudes toward self-care behaviors and improve the social acceptance of behavior and its development in society, and improve patients' control beliefs through goal-oriented education that develops resistance against the perceived rewards of the unfavorable behavior. Considering these constructs can act as strategies to promote self-care behaviors among patients.

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Due to their inherent properties, biocidal products might pose a risk to human and animal health and the environment. In risk management, there exists uncertainty about private users' comprehension of and willingness-to-adhere to use instructions that mitigate these risks (e.g., limit frequency of use or application area). This study aimed at providing insights into the users' perspective by focusing on their attention, comprehension, and the attitudinal predictors of protection motivation. In the online study (N = 957 participants from Germany) were introduced to a hypothetical purchase scenario featuring an insect spray and a realistic set of use instructions. Next, the participants' attention for the use instruction was measured in self-report and by tracking the time spent on the page with the use instruction, while Likert scale-type questions measured the comprehensibility, protection motivation, and predictors. Participants reported higher protection motivation if they spent more time with the use instruction, perceived it as comprehensible, rated the threat to humans, animals, and the environment as more severe, perceived themselves as responsible (i.e., internal locus of control) and capable (i.e., self-efficacy) of adhering to the use instructions, perceived adherence to the use instructions as effective (i.e., response efficacy) and did not perceive biocidal products as inherently safe (i.e., neutral locus of control). These results offer valuable information for an improved regulation of biocidal products and better management of potential risks associated with their use. They also provide concepts for interventions to ensure users of biocidal products follow the instructions for a safe use and better protection of the environment.

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AIMS: This study aimed to prospectively examine the explanatory value of the protection motivation theory (PMT) for the intention to use manner of drinking protective behavioral strategies (MD PBS) and to explore its invariance across genders. METHOD: A targeted sampling procedure was used to recruit 339 young adults in the community (Mage = 21.1; SD = 2.21; female = 50.7%) who completed baseline and 2-month follow-up measures of the PMT constructs and intentions to use each of the five MD PBS. RESULTS: Regression analyses revealed that the coping appraisal components (response efficacy and self-efficacy) had greater explanatory power for the intention to use MD PBS than the threat appraisal components (perceived vulnerability and perceived severity). Perceived vulnerability to alcohol consequences was not prospectively associated with any specific behavioral intention or with the total MD PBS score. In contrast, perceived severity was prospectively associated with the intention to use three out of five PBS and the total MD score. Regression coefficients revealed gender invariance for all six models. CONCLUSIONS: Our findings suggest that interventions aimed at encouraging young adults to use alcohol MD PBS would be most effective if they included components that enhance self-efficacy in using these strategies and emphasize their perceived usefulness in reducing alcohol-related consequences.

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Objective: This study aimed to employ hypothetical models based on the protection motivation theory (PMT) to identify factors that improve the intention to use antibiotics appropriately (intention) among individuals who take antibiotics or administer them to their children. Methods: Adult Japanese participants, including 600 parents who administer antibiotics to children aged <14 years and 600 adults who take them, completed an online survey. Structural equation modeling (SEM) was conducted on hypothetical models representing intention using 19 questions based on PMT. If the hypothesized model did not fit, SEM was repeated to search for a new model. Results: The hypothesized models did not fit. Two factors were extracted from SEM: "understanding the risk of antimicrobial resistance" and "excessive expectation of antibiotics." In adults, SEM revealed that "excessive expectation of antibiotics" (ß = -0.50, p < 0.001) negatively influenced intention; in children, "excessive expectation of antibiotics" (ß = -0.52, p < 0.001) negatively influenced intention, while "understanding the risk of antimicrobial resistance" (ß = 0.22, p < 0.001) positively influenced intention. Conclusion: Factors influencing intention varied between adult and pediatric antibiotic use. Innovation: Awareness activities for appropriate antibiotic use should be tailored to population characteristics.

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Background: Modifications of behavior can help reduce the risk of transmission by disrupting the parasite life cycle. Behavior intension is a necessary intermediate step in behavior change. This study aimed to explore protection motivation theory (PMT) in predicting likelihood of engagement in protective behavior against infection with Schistosoma. Methods: In China, a questionnaire for data collection was sent to users who followed the WeChat public account from June 2 to 6, 2023. Factors affecting intentional behavior of participants were analyzed using stepwise regression analysis and structural equation modeling. Results: A total of 2,243 valid questionnaires were collected, with a mean age of 30 ± 8.4 years. Approximately 1,395 (62.2%) participants reported that they had been exposed to wild waters in daily work and life. About 51.0 and 50.7% of respondents reported never having been exposed to wild water in the last 3 and 6 months, respectively. Results indicated that prior knowledge of schistosomiasis was associated with the 7 PMT subconstructs, which then influenced future preventative behaviors. Conclusion: Behavior intentionis a complicated and indispensable part of behavior change that is influenced by professional knowledge, socio-economic status, and personal characteristics. The effective dissemination of knowledge regards schistosomiasis should be strengthened to emphasize the effectiveness of protective measures against infection and severe disease.

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Online consultation services have the potential to reduce the workload of healthcare staff, provide timely care to patients, and improve doctor-patient relationships. The COVID-19 pandemic has accelerated the development of these services and platforms, but it remains to be seen whether the general public will continue to use them after the pandemic is under control. This research proposes a framework to examine the factors contributing to UK adults' continued usage of online healthcare consultation services after COVID-19 restrictions have been lifted. A total of 430 new users completed surveys, and the results indicate that expectation confirmation, system quality, and information quality can positively impact users' self-efficacy toward using online consultation services. This, in turn, can influence their continued usage behavior. Furthermore, the results suggest that participants' perception of health risks can moderate the relationship between self-efficacy and continued usage behavior. The strategic implications of these findings are discussed.

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Purpose: Cervical cancer (CC) screening remains challenging, where the motivational focus towards utilizing CC screening services is rarely highlighted. This study aimed to understand the motivation to undergo CC screening from women and healthcare practitioners' perspectives based on Protection Motivation Theory (PMT). Method: This qualitative study used the nominal group technique (NGT) and in-depth interview (IDI), where the NGT participants were healthcare practitioners from various disciplines (n = 12). Nominal group discussions were conducted via Zoom and involved one moderator, facilitator and observer. The IDI was conducted via Google Meet among seven women who had been included based on purposive sampling. All nominal group discussions and interviews were transcribed, verbatim and underwent deductive thematic analysis. Results: Healthcare practitioners emphasized input on CC knowledge of epidemiology, risk, etiology, nature, and outcome to encourage motivation. Women underlined their important role in the family, and reducing the negative perception as a motivational focus. Having living example of witnessing the CC patient dying and fear of stigma of cancer could be the driven force to undergo screening. Emphasis on the important of sufficient knowledge and correct the misconceptions towards screening could impart the motivation among women. Conclusions: The motivational focus was enriched by the differing perspectives of the healthcare practitioners and women. The findings can guide intervention program development towards enhancing CC screening in the future.

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According to official data, the ultra-Orthodox group in Israel had the highest COVID-19 infection rate yet the lowest vaccination rate compared to the general population. The present study aimed to explore the rate of vaccine uptake as well as reported reasons for vaccine avoidance. In addition, we examined whether several protection motivation theory (PMT) components are good predictors of vaccine uptake. The components we addressed were: perceived susceptibility to the threat of COVID-19, perceived severity of the virus, and perceived efficiency and safety of the vaccine (i.e., response efficacy). The sample included 623 individuals (337 men) aged 18 + who were drawn from a database of a survey company specializing in the ultra-Orthodox community. We conducted a cross-sectional online survey between June 22, 2021, and July 7, 2021, approximately six months after the beginning of vaccination distribution. Results revealed that 65.8% of the participants (versus 89% of the general population) were vaccinated. Women were vaccinated at lower rates than men, whereas those in the Misnagdim ultra-Orthodox subgroup were vaccinated at higher rates than other subgroups in that community. The most prominent reasons for vaccine avoidance were perceived immunity based on prior infection by the virus and lack of trust in the vaccine's safety. In support of the PMT model, the perceived severity of the virus and the vaccine high efficacy were significant predictors of vaccine uptake. The study results call for better outreach to this community and specific psycho-education interventions tailored for its women.

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Prevention behaviors are important in mitigating the transmission of COVID-19. The protection motivation theory (PMT) links perceptions of risk and coping ability with the act of adopting prevention behaviors. The goal of this research is to test the application of the PMT in predicting adoption of prevention behaviors during the COVID-19 pandemic. Two research objectives are achieved to explore motivating factors for adopting prevention behaviors. (1) The first objective is to identify variables that are strong predictors of prevention behavior adoption. A data-driven approach is used to train Bayesian belief network (BBN) models using results of a survey of N = 7797 $N=7797$ participants reporting risk perceptions and prevention behaviors during the COVID-19 pandemic. A large set of models are generated and analyzed to identify significant variables. (2) The second objective is to develop models based on the PMT to predict prevention behaviors. BBN models that predict prevention behaviors were developed using two approaches. In the first approach, a data-driven methodology trains models using survey data alone. In the second approach, expert knowledge is used to develop the structure of the BBN using PMT constructs. Results demonstrate that trust and experience with COVID-19 were important predictors for prevention measure adoption. Models that were developed using the PMT confirm relationships between coping appraisal, threat appraisal, and protective behaviors. Data-driven and PMT-based models perform similarly well, confirming the use of PMT in this context. Predicting adoption of social distancing behaviors provides insight for developing policies during pandemics.

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Background and Purpose: The purpose of this study is to describe the process for developing a reliable and valid survey instrument guided by the protection motivation theory (PMT) to evaluate nurses' health behaviors toward an infectious disease such as Ebola. Methods: The instrument was developed and tested through a systematic process that included a literature review, focus group, validity testing, and reliability testing. Results: The outcome variable, protection motivation, contained two elements, determined by principal component analysis. The instrument's internal consistency had a Cronbach's alpha of .80 or greater. Conclusion: The development and testing of an instrument based on PMT constructs as the theoretical framework have demonstrated a relationship between the perceived threat toward the disease and the proposed coping process needed to address the disease.

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Countries worldwide are facing challenges with increasing the COVID-19 vaccination rates for children. This study examined associations between perceived knowledge, coping appraisal, threat appraisal, adaptive response, maladaptive response, and intention, and possible variance across parents (mother or father) and COVID-19-like symptoms experiences regarding parental intentions to vaccinate their children. A total of 836 Iranian parents with children between the ages of 6 and 12 y completed measures assessing perceived knowledge, coping appraisals, threat appraisals, intentions, adaptive responses, and maladaptive responses. Multigroup structural equation modeling revealed that perceived knowledge was positively associated with both coping and threat appraisals, coping appraisals positively associated with adaptive responses, maladaptive responses, and intentions to vaccinate, threat appraisals positively associated with adaptive and maladaptive responses, and adaptive responses positively associated with intentions to vaccinate. The invariance evaluation revealed no differences across parents or COVID-19-like symptoms experiences in parental intentions to get their children vaccinated. The findings suggest that cogent information regarding childhood COVID-19 vaccination may boost parents' knowledge influencing their appraisals, adaptive responses and intentions to vaccinate their children. Specifically, coping appraisals and adaptive responses appeared to be important mediators between knowledge and intentions to vaccinate. Furthermore, intentions to vaccinate children may not be strongly influenced by parental roles or COVID-19-like symptoms experiences. These findings may help multiple stakeholders promote COVID-19 vaccination rates among children, and countries should further examine ways of increasing rates based on their specific needs.

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BACKGROUND: Wildfire smoke contributes substantially to the global disease burden and is a major cause of air pollution in the US states of Oregon and Washington. Climate change is expected to bring more wildfires to this region. Social media is a popular platform for health promotion and a need exists for effective communication about smoke risks and mitigation measures to educate citizens and safeguard public health. METHODS: Using a sample of 1,287 Tweets from 2022, we aimed to analyze temporal Tweeting patterns in relation to potential smoke exposure and evaluate and compare institutions' use of social media communication best practices which include (i) encouraging adoption of smoke-protective actions; (ii) leveraging numeric, verbal, and Air Quality Index risk information; and (iii) promoting community-building. Tweets were characterized using keyword searches and the Linguistic Inquiry and Word Count (LIWC) software. Descriptive and inferential statistics were carried out. RESULTS: 44% of Tweets in our sample were authored between January-August 2022, prior to peak wildfire smoke levels, whereas 54% of Tweets were authored during the two-month peak in smoke (September-October). Institutional accounts used Twitter (or X) to encourage the adoption of smoke-related protective actions (82% of Tweets), more than they used it to disseminate wildfire smoke risk information (25%) or promote community-building (47%). Only 10% of Tweets discussed populations vulnerable to wildfire smoke health effects, and 14% mentioned smoke mitigation measures. Tweets from Washington-based accounts used significantly more verbal and numeric risk information to discuss wildfire smoke than Oregon-based accounts (p = 0.042 and p = 0.003, respectively); however, Tweets from Oregon-based accounts on average contained a higher percentage of words associated with community-building language (p < 0.001). CONCLUSIONS: This research provides practical recommendations for public health practitioners and researchers communicating wildfire smoke risks on social media. As exposures to wildfire smoke rise due to climate change, reducing the environmental disease burden requires health officials to leverage popular communication platforms, distribute necessary health-related messaging rapidly, and get the message right. Timely, evidence-based, and theory-driven messaging is critical for educating and empowering individuals to make informed decisions about protecting themselves from harmful exposures. Thus, proactive and sustained communications about wildfire smoke should be prioritized even during wildfire "off-seasons."

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Background and Aim: During outbreaks of infectious diseases, if healthcare providers do not follow the principles of prevention, the risk of personal infection increases and they become a source of infection spread. This study aimed to determine the factors related to the preventive health behaviors of COVID-19 among Iranian healthcare providers based on protection motivation theory (PMT). Methods: This analytical cross-sectional study included 346 healthcare providers. Data was collected by an online researcher-made questionnaire based on PMT. To analyze the data, independent T tests, analysis of variance (ANOVA), Spearman correlation coefficient, multiple linear regression, and SPSS 22 software were used. α was considered as 0.05. Results: 85.3% of the healthcare providers would always wear masks, 80.7% would always refuse to kiss and touch hands with others, and 34.7% sometimes would exercise at home. The preventive behaviors were significantly correlated with protection motivation (r = 0.84), self-efficacy (r = 0.51), response efficiency (r = 0.43), perceived severity (r = 0.41) Fear (r = 0.21), perceived susceptibility (r = 0.11), response cost (r = -0.14), and reward (r = -0.15). PMT constructs were able to predict 77% of the variance of the behaviors and the protection motivation construct was the strongest predictor (ß = 0.806). Income above 300 Dolars per month was significantly related to the decrease in the mean score of preventive behaviors against COVID-19. The female sex and the individual or family history of infectious diseases were significantly related to increasing the mean score of COVID-19 preventive behaviors. Conclusion: Based on the study results, it is suggested that some educational interventions be designed and implemented with a focus on this construct and the perceived severity construct and that more attention be given to the education of health care providers with high-income levels, male providers, and the individuals without a history of corona infection in themselves or their family members.

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AIM: Mobility applications have the potential to support low-income older adults in facing mobility challenges. However, there is a generally lower uptake of technology in this segment. To understand factors affecting the intention to use a mobility app, we drew upon the Protection Motivation Theory, and tested a model of low-income older adults' technology adoption. METHODS: A cross-sectional survey was conducted across seven states in Malaysia among community-dwelling low-income older adults aged ≥60 years old (n = 282). Measurement items were adapted from pre-validated scales and 7-point Likert Scales were used. Partial least squares structural equation modeling was utilized to assess the hypothesized model. RESULTS: Mobility technology awareness was found to shape an individual's threat and coping appraisals associated with their intention to use a mobility app. The decision of a low-income older adult to adopt a mobility app as a protective action is not a direct function of threat and coping appraisals but is indirect, and mediated by the underlying cost-benefit perceptions of non-adoption and adoption of the mobility app. In terms of technology perceptions, perceived usefulness is a significant predictor, but not perceived ease of use. CONCLUSIONS: This study entails a new model by uncovering the psychological factors encompassing mobility technology awareness, threat-coping appraisals, and cost-benefit perceptions on Technology Acceptance Model studies. These insights have important implications for the development and implementation of a mobility app among low-income older adults. Geriatr Gerontol Int 2024; 24: 342-350.

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Background: COVID-19 vaccine hesitancy has been cited as one of the main obstacles impacting vaccine coverage. However, factors that affect hesitancy may change over time. Understanding these evolving concerns and adapting strategies accordingly are crucial for effectively addressing vaccine hesitancy effectively and promoting public health. We aimed to explore the temporal changes in factors associated with COVID-19 VH during the COVID-19 pandemic and assess the dynamic evolution of VH. Methods: In August 2022 and February 2023, repeated online surveys were undertaken to collect information from 5378 adults across four regions of China. Multiple linear regression models assessed the influencing factors of COVID-19 VH. The association between protective motive theory (PMT) (perceived severity, susceptibility, benefits, barriers, and self-efficacy) and VH was evaluated by structural equation modeling (SEM). Results: Repeated measures showed that 573 (10.7%) and 1598 (29.7%) of the 5378 participants reported COVID-19 VH in the baseline and follow-up surveys, respectively. Educational levels, chronic disease, history of allergy, COVID-19 infection, and trust in medical staff and vaccine developers were positively associated with COVID-19 VH (P＜0.05). The application of SEM revealed that perceived severity, susceptibility, vaccination barriers, and self-efficacy in the PMT directly impacted on VH (P＜0.05). In addition, severity, susceptibility, benefits, and barriers had a significant direct effect on self-efficacy as ß = 0.113, ß = 0.070, ß = 0.722, ß = -0.516 respectively with P < 0.001. Conclusion: The prevalence of COVID-19 VH was relatively low in the baseline survey and much higher in the follow-up survey, with a significant increase in hesitancy rates among mainland Chinese residents. Acknowledging the substantial impact on the shaping of COVID-19 VH, one must consider factors including perceived severity, susceptibility, vaccination barriers, and self-efficacy.

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Context: Long COVID can appear as a severe late consequence (sequela) of a COVID-19 infection, leading to the inability to work or participate in social life for an unknown amount of time. To see friends or family struggling with long COVID might influence people's risk perceptions, vaccine efficacy expectations, and self-efficacy perceptions to prevent COVID-19 and its consequences. Methods: In an online survey in August 2022, n = 989 German-speaking participants indicated whether they knew someone who suffered from long COVID illness. Four dimensions of protection motivation theory (PMT) were assessed afterwards, as well as vaccination intentions. Results: Multiple mediation analysis with participants who knew vs. didn't know someone with long COVID (n = 767) showed that knowing someone with long COVID was associated with higher perceived affective and cognitive risk of long COVID-19 as well as higher perceived vaccine efficacy. Self-efficacy, i.e., the ease to protect oneself against long COVID, was lower in participants who knew long-COVID patients. Indirect positive effects for response efficacy and affective risk suggest that vicarious experience with long COVID is associated with increased intentions to get a COVID-19 vaccine. Conclusion: The protection from long COVID through vaccination are relevant aspects for individual decisions and health communication.

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In 2020, the Food and Drug Administration granted emergency use authorization for two COVID-19 vaccines. Two years later, the Centers for Disease Control and Prevention estimated that more than 250 million individuals had received at least one dose of the vaccine. Despite the large numbers of individuals vaccinated against COVID-19, partisan differences surrounding the COVID-19 vaccine emerged, creating a potential challenge for health communications aimed at increasing vaccine uptake. A better understanding of partisan differences in attitudes and intentions towards vaccination may help guide public health strategies aimed at increasing vaccine uptake. To determine whether a commonly used theory of behavioral intentions used to craft public health messages explains partisan differences in intentions. Data were drawn from a national panel of US adults and collected between February 21, 2022, and March 3, 2022, using an online survey (n = 1845). Among respondents identifying as either Democrat or Republican (n = 1466), path analysis models were estimated to test whether partisan differences in vaccination or booster intentions were explained by the theoretical constructs of protection motivation theory (PMT). PMT accounted for approximately half of the covariate-adjusted mean difference in COVID-19 vaccination intentions between Democrats and Republicans, and nearly all the mean difference in booster intentions. Party affiliation indirectly affected intentions via its association with perceived susceptibility to COVID-19, vaccine/booster efficacy, and perceived costs of getting a COVID-19 vaccine or booster dose. Compared with Democrats, Republicans may be less likely to get vaccinated or receive a booster dose because of beliefs that they are less susceptible to COVID-19, that the vaccine is less effective, and that vaccination comes with disadvantages. Theories of behavioral intentions can help to identify the underlying theoretical determinants driving behavioral differences between political groups.

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Medical data governance and patient privacy protection have become important contents and hot topics in the process of medical informatization,and privacy concerns have gradually become a research focus.By drawing on the Internet Users'Information Privacy Concerns Scale and Protection Motivation Theory,this paper constructed a general model of patient privacy concerns in medical data.Empirical data was collected in the form of a questionnaire survey,and the hypotheses were validated using factor analysis and structural equation models.The results showed that the severity and likelihood of threats had a significant positive impact on privacy concerns,self-efficacy negatively affected privacy concerns,and privacy concerns positively affected behavioral willingness to privacy protection.Based on these,relevant organizations should strengthen privacy data management,improve data transparency,promote the value of data utilization,and strive to achieve a balance between privacy protection and data use.

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The central question of our study is which determinants drive smoke alarm ownership and intention to purchase one, and whether we can increase smoke alarm ownership by addressing these determinants in a communication-based intervention. We first made an inventory of possible determinants for smoke alarm prevention by consulting prominent prevention behavior theories protection motivation theory and Health Belief Model and other relevant literature. We expanded this list of determinants based on interviews (n = 15) and used survey data representative for the Netherlands to decide to focus on smoke alarm ownership (rather than installation or maintenance). We then tested the determinants of smoke alarm ownership and buying intention in a survey (n = 622). Based on these results, we ran an A/B test (n = 310) of two messages to stimulate smoke alarm ownership: one emphasized the determinants we found to be strong predictors in the survey (know-how, social norm, annoyance) and one emphasized typical determinants that are often addressed in campaigns but were poor predictors in the survey (vulnerability, severity, benefits). Results showed that the message based on the strong determinants resulted in a significant increase in smoke alarm ownership (9.1%) compared to the control group (0.9%; p = 0.027), while the message using the typical determinants did not lead to significant effects. Taken together, our results give a promising direction for interventions to increase smoke alarm ownership, and above all, show that a comprehensive problem analysis for a specific target behavior is a necessary step to induce behavioral change.

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Introduction: Numerous smokers are cognizant of the detrimental effects associated with this habit yet exhibit a persistent reluctance to cease their tobacco consumption. Self-exempt beliefs serve as an obstacle to the cessation of this addictive behavior. This research explored the impact of self-exempt beliefs on the readiness to quit smoking based on the Protection Motivation Theory (PMT) model and the mediating roles of threat appraisal and coping appraisal. Methods: Self-exempt beliefs, PMT constructs, and the intention to quit smoking constituted the theoretical model. The questionnaires were collected from 488 Chinese adult male smokers based on snowball sampling. Exploratory Factor Analysis (EFA) was used to examine the underlying factor structure of the pre-designed self-exempt beliefs scale. The reliability, validity, path coefficients, and explanatory power of the model were calculated using Partial Least Squares Structural Equation Modeling (PLS-SEM). Results and discussion: The results showed that : (1) three common factors (skeptic beliefs, bulletproof beliefs, and "worth it" beliefs) with a total of 11 items were retained after EFA; (2) skeptic beliefs and "worth it" beliefs had a significantly negative effect on both threat appraisal and coping appraisal, while bulletproof beliefs did not; (3) bulletproof beliefs had a significantly positive direct impact on intention to quit, "worth it" beliefs had a significantly negative direct impact on intention, while skeptic beliefs had no significantly direct impact on intention; (4) threat appraisal and coping appraisal positively and significantly predicted cessation intention; and (5) threat appraisal and coping appraisal, as two main cognitive processes, acted as full mediations between skeptic beliefs and the intention to quit, as complementary partial mediations between "worth it" beliefs and the intention, and as non-mediation between bulletproof beliefs and the intention. Our findings suggest that efforts to undermine or "prevent" these self-exempt beliefs, particularly "worth it" and skeptic beliefs, may be an effective tactic for health communication interventions for quitting smoking.