A Public Health Model and Framework to Mitigate the Impact of Orphans and Vulnerable Children Due to HIV/AIDS in Cameroon

UNICEF, UNAIDS and USAID developed a global strategic framework to guide responses to care and protect orphans and other vulnerable children in the context of HIV/AIDS. In the developing world, about 132 million people have lost one or both parents due to the AIDS pandemic and 25 million children have been orphaned by HIV/AIDS in 2010. The HIV prevalence in Cameroon is estimated at 5.1%. As of 2010, there were 304,000 deaths due to AIDS in Cameroon. Out of 1,200,000 orphans and vulnerable children in Cameroon in 2010, 300,000 were AIDS orphans. The HIV/AIDS burden impacts child survival, growth and development in the traditional African setting. With so many orphans in the population, along with many vulnerable children, strategies must be developed to respond more effectively to their critical needs. This study provides a model for OVC care and support in Cameroon. The model was developed out of extensive work using a participatory approach involving traditional, administrative and health stakeholders on OVC in Yaounde I and Yaounde VI Councils, Nanga Eboko Health District, Isangelle, Ekondo Titi, and Bafaka-Balue communities in Cameroon. Consultancy services with PLAN Cameroon, the Pan African Institute for Development-West Africa coupled with facilitation of many training workshops on OVC with Save the orphans Foundation, the Ministry of Social Affairs, and the Ministry of Public Health and working with the National AIDS Control Committee. The essential components of a holistic framework for the care of OVC have been identified. A public health model for the care of OVC and a mechanism for their identification and a referral system for testing OVC for HIV are proposed. Through this model, a mechanism for the effective holistic care of OVC and collaboration is enhanced.

Evaluation of the effects of health education interventions for hypertensive patients based on the health belief model

BACKGROUND Hypertension is a major risk factor for cardiovascular disease and stroke,and its prevalence is increasing worldwide.Health education interventions based on the health belief model(HBM)can improve the knowledge,attitudes,and behaviors of patients with hypertension and help them control their blood pressure.AIM To evaluate the effects of health education interventions based on the HBM in patients with hypertension in China.METHODS Between 2021 and 2023,140 patients with hypertension were randomly assigned to either the intervention or control group.The intervention group received health education based on the HBM,including lectures,brochures,videos,and counseling sessions,whereas the control group received routine care.Outcomes were measured at baseline,three months,and six months after the intervention and included blood pressure,medication adherence,self-efficacy,and perceived benefits,barriers,susceptibility,and severity.RESULTS The intervention group had significantly lower systolic blood pressure[mean difference(MD):-8.2 mmHg,P<0.001]and diastolic blood pressure(MD:-5.1 mmHg,P=0.002)compared to the control group at six months.The intervention group also had higher medication adherence(MD:1.8,P<0.001),self-efficacy(MD:12.4,P<0.001),perceived benefits(MD:3.2,P<0.001),lower perceived barriers(MD:-2.6,P=0.001),higher perceived susceptibility(MD:2.8,P=0.002),and higher perceived severity(MD:3.1,P<0.001)than the control group at six months.CONCLUSION Health education interventions based on the HBM effectively improve blood pressure control and health beliefs in patients with hypertension and should be implemented in clinical practice and community settings.

Assessment of public perspectives and barriers towards dengue preventive practices using the Health Belief Model in Puducherry,India:A cross-sectional study

Objective:To assess the perspectives and barriers towards dengue preventive practices among the residents of Puducherry,India.Methods:A cross-sectional survey was conducted in 300 households in Puducherry,using a population-proportionate(7:3)distribution from urban and rural areas by grid sampling.One adult interview per household was conducted and the participants were selected using a KISH grid.A semi-structured questionnaire based on the Health Belief Model(HBM)with additional questions on knowledge assessment was used.Knowledge was assessed based on the correctness of answers and the HBM scores were calculated on a 5-point Likert scale.Participants were categorized based on the median score under each domain.Logistic regression was used for adjusted analysis and models were built to predict the performances in each domain.Results:Four percent of the participants lacked basic knowledge regarding dengue transmission.While 208(69.3%)participants did not consider themselves at risk of contracting dengue within the next year,majority perceived dengue as a disease with low severity.Around 49.3%(148)were skeptical about the benefit of time and money spent on dengue prevention.Inadequate government efforts were stated as the major barrier(47.0%)and frequent reminders(142,47.3%)as the major cue to action.Age above 50 years(aOR 1.78,95%CI 1.04-3.06,P=0.037)and rural locality(aOR 2.68,95%CI 1.52-4.71,P=0.001)were found to be significantly associated with poor knowledge scores.Urban participants had a significantly higher chance to perceive low susceptibility as compared to the rural counterparts(aOR 1.74,95%CI 1.05-2.9,P=0.03).Participants with less than a high school education had low perceived benefits(aOR 2.46,95%CI 1.52-3.96,P<0.001)and low self-efficacy scores(aOR 2.66,95%CI 1.61-4.39,P<0.001).Conclusions:This study identifies key gaps in dengue prevention,including low perceived susceptibility,mild disease perception,limited knowledge of breeding sites,and overreliance on government efforts.Tailoring interventions to community needs,stratified to factors influencing the community perspectives can significantly improve dengue prevention efforts.

Integrating the health belief model into health education programs in a clinical setting

The article demonstrates that health belief model(HBM)-based health education in hypertensive patients effectively improves blood pressure control and medication adherence at 3 months and 6 months.The HBM addresses perceived barriers,benefits,susceptibility,severity,and self-efficacy,leading to better health behaviors.HBM-based education has been effective in various contexts,including managing chronic diseases,promoting cancer screenings,and preventing infectious diseases.However,the model has limitations,such as cultural applicability and addressing complex health behaviors influenced by environmental factors.Future research should integrate HBM with other theories and conduct longitudinal studies to assess long-term impacts.Despite these limitations,HBM-based education significantly improves patient outcomes,highlighting its potential in health education and promotion when appropriately adapted and implemented.This reinforces the model's value in designing effective health interventions and advancing public health.

Osteoporosis knowledge, beliefs, and calcium intake of college students: Utilization of the health belief model

Objective: The purpose of this study was to examine the relationships between osteoporosis knowledge, beliefs and calcium intake among college students. This study also examined perceived susceptibility, severity, benefits, barriers and self-efficacy related to osteoporosis prevention. Participants: Seven hundred and ninety two (n = 792) men and women ages 17 - 31 of all ethnicities at a mid-western regional university in the US participated in the study. Methods: The Osteoporosis Knowledge Test, Osteoporosis Health Belief Scale, and Osteoporosis Preventing Behaviors Survey were utilized. Each of these tools were previously validated and found reliable. Correlation and multiple regression analyses were completed. Results: Participants did not perceive themselves as susceptible to osteoporosis and perceived minimal barriers to calcium intake. Their knowledge was minimal concerning alternate sources of calcium. Conclusions: Prevention programs should aim to increase osteoporosis knowledge of risk factors and osteoprotective behaviors and to decrease high-risk behaviors during college years when behavior changes can have the strongest impact on bone health.

Health beliefs toward lung cancer screening among Chinese American high-risk smokers:Interviews based on Health Belief Model

Objective This study aims to explore health beliefs toward lung cancer screening with low dose computed tomography among Chinese American high-risk smokers.Methods Guided by the Health Belief Model,semi-structured individual interviews were conducted with Chinese American high-risk smokers via phone.Additional questionnaires on demographic information,history of smoking and lung cancer screening were collected via email or phone before the interview,depending on participants’preference.Content analysis was used to extract meaningful and significant themes in the dataset.Constant comparison analysis and process coding were used to categorize and code data.Results Data saturation was reached after interviewing 12 participants.Chinese American high-risk smokers perceived a low susceptibility to lung cancer,since they believed various protective factors of lung cancer(e.g.,doing exercise,healthy diet,etc.)reduced their risk of getting lung cancer.All the participants perceived a high severity of lung cancer.They acknowledged lung cancer would have a huge impact on their life.Perceived benefits of lung cancer screening were accurate in most aspects although minor confusions were still noticed among this population.Perceived barriers varied on participants’,physicians’,and institutional levels.High-risk Chinese American smokers had little confidence to screening for lung cancer.Cues to action for them to screening for lung cancer included recommendations from health care providers,support from family members and friends,and information shared on Chinese-based social media.Conclusions Misconceptions and barriers to screening for lung cancer existed widely among Chinese American high-risk smokers.Intervention programs and targeted health education should be implemented to promote lung cancer screening among this population.

Development and evaluation of the health belief model scale for exercise

Objectives:This study was aimed to develop a health belief model scale for exercise among Chinese residents to describe the relationships between health beliefs and exercise for promoting residents to adopt or maintain exercise programs.Methods:Participants were from two projects,Project 1 with 3833 participants and Project 2 with 7319 participants.A pool of 21 items was developed based on a small-scale qualitative study about health beliefs of exercise and literature.Internal consistency and construct validity of the scale were evaluated with Cronbach'sαcoefficient,exploratory factor analysis(EFA),confirmatory factor analysis(CFA)and second-order confirmatory factor analysis.Results:A final version of 18 items loaded on six factors which could explain 60.30-%of variance was observed after EFA.The internal consistency of the final version with 18 items performed in Project 1 was acceptable(0.609).The reliability of the six subscales was good with Cronbach'sαcoefficient of 0.628,0.713,0.628,0.801,0.676 and 0.838 for perceived benefits,perceived objective barriers,perceived subjective barriers,self-efficacy,perceived severity and cues to action,respectively.CFA and second-order CFA indicated a good fit to data.Conclusions:The Health Belief Model Scale for Exercise(HBMS-E)is a valid and reliable instrument to assess health beliefs of exercise among residents in China.Understanding the health beliefs of exercise will help health professionals to develop effective interventions for health and evaluate the effectiveness.

The Criticism and Amendment for the Dual-Factor Model of Mental Health: From Chinese Psychological Suzhi Research Perspectives

Aiming at the limitations of psychopathology (PTH), the dual-factor model of mental health (DFM) was proposed as a new mental health concept and methodology under the background of positive psychology trend. In this paper we propose giving an overview of DFM, and doubt, criticize, and modify DFM from the perspective of Chinese psychological suzhi research. The available literature from 1983 to 2012 that is related to DFM and concerning psychological suzhi research in the past 20 years has been reviewed. In addition, we also absorbed the idea of positive psychology and Traditional Chinese Medicine (TCM) Constitution theory to develop theoretically the relationship model between psychological suzhi and mental health. The relationship model between psychological suzhi and mental health modifies and transcends PTH and DFM. It will be the new research area of mental health research.

Health Promotion Model: An Integrative Literature Review

Background: The Health Promotion Model (HPM) indicates that each person is a biopsychosocial creature that is partially shaped by the environment, but also seeks to create an environment in which inherent and acquired human potential can be fully expressed. The HPM is proposed as a holistic predictive model of health-promoting behavior for use in research and practice. Purpose: The purpose of this review is to examine how the HPM has been applied in various research studies. Methods: An integrative review was used to find studies that were guided by the HPM. Data search was between 2008 to 2018 using Google Scholar, Scopus, Web of Science, Science Direct, PubMed, Medline, CINAHL, EBSCO, Cochrane, ERIC, Joanna Briggs Institute and EBSCO host. The keywords used were Pender’s and Health Promotion Model. Results: Seventeen studies were reviewed;most of them were quantitative studies. These studies discussed variables from the HPM. Most of the study variables were measured using instruments derived from the HPM. The results of the reviewed studies revealed that the HPM had predictive value in estimating health-promoting behaviors. Conclusion: The HPM was widely established in the nursing community and was implemented in nursing practice, education, and research. In addition, the HPM constructs were used to hypothesize conceptual frameworks in many studies to predict health-promoting behaviors in many chronic diseases.

The Effect of an Educational Program Based on the Health Belief Model on Self-Efficacy among Patients with Type 2 Diabetes Referred to the Iranian Diabetes Association in 2014

Background: Patient self-efficacy is one of the most important factors in treating and overcoming disease. Objective: The aim of this study was to evaluate the effect of an educational program based on the health belief model on self-efficacy among patients with type 2 diabetes referred to the Iranian Diabetes Association in 2014. Method: A randomized controlled clinical trial was conducted. Eighty patients with type 2 diabetes were selected randomly by the double block sample method. They were then divided into two groups of intervention and control (40 patients in each group) by random allocation. Data were collected by a questionnaire based on the Health Belief Model and self-efficacy. The data were gathered two months after the educational program was held. The educational program was designed on the basis of data collected in the pre-test phase. Then, the educational program was executed for the intervention group in 8 sessions (each 30 minutes) using lectures and an educational booklet. Data analysis was done with Chi-square Test, Pearson’s correlation, Independent samples T-test and paired T-test. The significance level was considered at 0.05. Results: Before intervention, no significant difference was detected between the two groups. However, after intervention all variables were significantly different except for perceived threat. Moreover, there were significant linear relationships between Self-efficacy and all Health Belief Model components after the educational intervention in both groups (p < 0.05). Conclusion: The educational program based on the health belief model increased self-efficacy in type 2 diabetes mellitus patients.

The Clinical Study of a New Management Model Using Mobile Health for Senile Hypertension

Objective: To evaluate a new management model using mobile health for senile hypertension. Methods: This medical service combined traditional medical treatment with Mobile Health. We use it to explore a new and effective model of elderly hypertension management and the most effective and lowest cost management crowd. According to the randomized controlled design of trial, 105 old hypertensive patients participated in the study voluntarily in the Qingdao Municipal Hospital were randomly divided into the experimental group (75 cases) and control group (30 cases). Experimental group is divided into geriatric specialist group (25 cases), general practitioner group (25 cases) and nurse group (25 cases). Blood pressure was administered in experimental (with the new model) and control groups (with the traditional model) for 2 months to compare their blood pressure and the decrease of them. Results: Blood pressure was compared between the two groups before and after administration. The systolic blood pressure (SBP) of experimental group is 162.44 ± 13.970 mmHg before administration. SBP of experimental group is 147.69 ± 13.509 mmHg after administration, the difference is statistically significant (P = 0.000). The diastolic blood pressure (DBP) of experimental group is 91.58 ± 10.822 mmHg before administration. DBP of experimental group is 84.64 ± 10.412 mmHg after administration, P = 0.003. SBP of control group is 159.93 ± 15.238 mmHg before administration. The systolic blood pressure of control group is 152.33 ± 14.115 (mmHg) after administration. P is 0.167 (P > 0.05). The difference was not statistically significant. DBP of control group is 94.73 ± 12.401 (mmHg) before administration. DBP of control group is 90.60 ± 11.115 (mmHg) after administration. P is 0.345 (P > 0.05). The difference was not statistically significant. The decrease of SBP of geriatric specialist group, general practitioner group and nurse group is 18.40 ± 11.764 mmHg, 14.47 ± 9.44 mmHg, 10.80 ± 6.026 mmHg. The difference was not statistically significant (P > 0.05). The decrease of DBP of geriatric specialist group, general practitioner group and nurse group is 9.33 ± 7.451 mmHg vs. 5.33 ± 6.287 mmHg vs. 6.13 ± 5.069 mmHg (P > 0.05). Conclusion: The new model is effective and it works well for controlling blood pressure of elderly hypertensive patients. Especially with the doctors and patients’ families, the management effect has been obviously improved. Medical interventions make the new model more scientific. The management of geriatric specialists, general practitioners and nurses is equally valid.

Structural model of factors relating to the health promotion behavior of reproductive health among Indonesian adolescents

Objectives:We aim to explore the factors related to the health promotion behavior of reproductive health(RH)among Indonesian adolescents via structural equation modeling.Methods:A cross-sectional quantitative study was used to measure 108 adolescents aged 12-16 years.We employed a self-administered questionnaire developed from the health promotion model(HPM)and the empowerment model(EM)on the basis of self-efficacy to determine the factors related to health promotion in maintaining RH behavior.Structural equation modeling(SEM)was used to examine re-lationships among the variables.The Analysis of Moment Structures(AMOS)approach was used to evaluate if the proposed model is suitable for the data based on goodness-of-fit indices.Results:The model is appropriate for the data.Three interrelationships emerge among independent variables(P>0.05),namely,personal and cognitive behaviors(r=-0.01),cognitive and health pro-motion behaviors(r=0.09),and affective and health promotion behaviors(r=-0.17).The strongest relationship is between empowerment and health promotion behavior(r=0.72).Affection(interper-sonal and situational influences),immediate competing demands and preferences,and empowerment(participation and control)are directly related to RH behavior maintenance.Meanwhile,willingness of adolescents,prior related behavior,personal factor,and commitment to a plan of action are indirectly related to RH behavior maintenance.The model explains 43.9%of the variance in maintaining RH behavior.Conclusions:The HPM and EM models help determine the factors related to RH behavior maintenance among adolescents.Intervention to promote RH among Indonesian adolescents should begin from the level of child-parent-health care professional encounter for empowering the RH of adolescents.

Predictors of caring behaviors of mothers of premature infants based on the health belief model

Objective:To investigate predictors of caring behaviors of mothers of premature infants based on the health belief model.Methods:This cross-sectional study was conducted by using the structural equation modeling on 168 mothers of premature infants,who were selected by convenience sampling method from October 2017 to February 2018 in Iran.Data were collected by using a standard scale.Validity and reliability of all data collection tools were approved.Data were analyzed by using SPSS V.16 and Mplus6 software.Results:The structural equation modeling of the initial health belief model did not have a good fit,but the fitness of model 2 obtaining from the modified initial model was confirmed by changes in locations of constructs.None of constructs of model 2 had a significant positive association with the caring behavior of mothers of premature infants and only 2.8%of variance of caring behaviors in mothers could be predicted by the sum of variables of demographic characteristics and the modified health belief model constructs.Conclusions:Given that the findings do not approve the use of the health belief model in predicting determinants of caring behavior of mothers of premature infants,it is suggested to apply this model to investigate the effect of educational intervention based on the health belief model on the caring behavior of mothers.

Human Health Risk Assessment Model of Organic Pollution in Groundwater:Shijiazhuang Industrial Zone

In this study, a risk-based management model is developed and applied to an industrial zone. The models proposed by the United States Environmental Protection Agency and Han Bing have been improved by adding a residual ratio of volatile organic compounds （VOC） after boiling and deleting the related parameters in half-life. Using this improved model, an integrated process was used to assess human health risk level in the study area. Compared with water quality analysis, the results highlight the importance of applying an integrated approach for decision making on risk levels and water protection. The results of this study demonstrated that： （1） Compared with these permissible level standards in China （GB 3838-2002） and National Primary Drinking Water Regulations of the United States, the residents＇ daily life had not been affected by the groundwater in this area （except for relative bad water quality of HB3-4 and HB3-6）; （2） The typical detected organic contaminants of all groundwater samples were chloroform, carbon tetrachloride, trichloroethylene and tetrachloroethene, and the pollution sources were mainly industrial sources by preliminary investigations; （3） As for groundwater, the non-carcinogenic risk values of all samples do not exceed the permissible level of 1.0 and the carcinogenic risk values are relatively lower than the permissible level of 1.00E-06 to 1.00E-04; （4） Drinking water pathway of trichloroethylene and tetrachloroethylene mainly contribute to increasing the health risk of residents＇ in study areas; （5） In terms of non-carcinogenic risk and carcinogenic risk, the health risk order for drinking water pathway and dermal contact pathway was： drinking water pathway 〉 dermal contact pathway.

Modeling of forest soil and litter health using disturbance and landscape heterogeneity indicators in northern Iran

This paper focuses on the indicators of soil and litter health, disturbance, and landscape heterogeneity as a tool for prediction of ecosystem sustainability in the northern forests of Iran. The study area was divided into spatial homogenous sites using slope, aspect, and soil humidity classes. Then a range of sites along the disturbance gradient was selected for sampling. Chemical and physical indicators of soil and litter health were measured at random points within these sites. Structural equation modeling(SEM) was applied to link six constructs of landscape heterogeneity, three constructs of disturbance(harvest, livestock, and human accessibility), and soil and litter health. The results showed that with decreasing accessibility, the total N and organic matter content of soil increased and effective bulk density decreased. Harvesting activities increased soil organic matter. Therefore, it is concluded that disturbances through harvesting and accessibility inversely affect the soil health. Unexpectedly, it was found that the litter total C and C:N ratio improved with an increase in the harvest and accessibility disturbances, whereas litter bulk density decreased. Investigation of tree composition revealed that in the climax communities, which are normally affected more by harvesting activities, some species like Fagus orientalis Lipsky with low decomposition rate are dominant. The research results showed that changes in disturbance intensity are reflected in litter and soil indicators, whereas the SEM indicated that landscape heterogeneity has a moderator effect on the disturbance to both litter and soil paths.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

Concept and evaluation of bay health:the role of numerical model in the Yueqing Bay,China

To better evaluate the three-dimensional bay health and predict the dynamic bay health conditions, a concept of numerical bay health was introduced and a method of numerical bay health evaluation（NBHE） was developed.To support the NBHE method, a numerical bay health index（NBHI） system was constructed, which assess the natural and socio-economic effects on the entire bay. Five index groups are combined to formulate the NBHI,including geometry, hydrodynamics and sediment dynamics, bio-ecology, water quality and socio-economy.Each group has different number of indices selected and weighted using AHP method according to their importance. Data were mainly synthesized from a variety of numerical models together with monitoring programs, which provide superior to other approaches in discriminating data integrity and predicting data in future. The NBHE method using NBHI system was applied in the Yueqing Bay during spring tide in April 2007.According to the NBHE results, Sta. A, at the surface level of the estuarine mouth, has a healthy geometry condition, sub-healthy hydrodynamic and sediment dynamic condition, and unhealthy water quality and bioecology conditions. The integrated healthy score at Sta. A indicates its sub-healthy condition.

Development and Evaluation of Innovative Recycling Intervention Program Using the Health Belief Model (HBM)

The purpose of this study was to assess the effectiveness of interventions based on health promotion theories in changing the recycling behavior of the targeted population. The study focused on the development and evaluation of innovative recycling education programs that address energy recovery, recycling, and waste management. The study applied Health Belief Model-(HBM) as an approach to motivate recycling behaviors and to evaluate the impact of the applied approaches on recycling set-out rates and participation. A total of 102 households from a Midwestern city participated in this study. The study was conducted over a period of six months. A Likert scale questionnaire was used to collect data on recycling and environmental knowledge, skills, behavior, and attitudes. The other set of data was the weight of recyclables that was obtained at each participant’s curb four times over the six months period of interventions. Results indicated a significant increase in average set out rates of recyclables among HBM participants (21.34 lbs. pre-test to 59.3 lbs. post-test). It was concluded that HBM educational approaches can be effective in motivating recycling. This study signifies the need for renewed effort in motivating individuals, households or businesses to recycle. Not every community or city significantly participates in recycling. Innovative strategies as well the application of approaches in the theories of behavioral change can positively influence recycling and overall waste reduction behaviors.

Factors associated with intention to undergo specific health guidance among Japanese workers using health belief model

Objectives: To examine the factors associated with the intention to undergo “specific health guidance”. Methods: Self-reported questionnaire data were collected from 4861 health insurance union members of a company in Japan from August to September 2010. The information gathered included the intention to undergo “specific health guidance,” the Health Belief Model (HBM) subcomponents (perceived severity, susceptibility, benefit, and barriers), other factors related to undergoing specific health guidance, sex, and age. Perceived threat and net benefit were the main HBM components. Bivariate and multivariate logistic regression analyses were used to assess the associations between intention and the main HBM components, i.e., perceived threat and net benefit. We used two models with intention as the dependent variable;Model 1 used four HBM subcomponents, and Model 2 used perceived threat and net benefit as independent variables. Results: A total of 3457 individuals answered all variables (response rate;71.1%). Perceived severity (OR: 1.83, 95%CI: 1.59 - 2.10), benefit (OR: 6.91, 95%CI: 5.94 - 8.04), barriers (OR: 0.11, 95%CI: 0.09 - 0.13), perceived threat (OR: 1.52, 95%CI: 1.31 - 1.76), and net benefit (OR: 11.28, 95%CI: 9.60 - 13.25) were related to intention (all p < 0.01). Multivariate analysis showed that net benefit (OR: 11.23, 95%CI: 9.55 - 13.20) had a stronger correlation with intention than did perceived benefit (OR: 4.67, 95%CI: 3.95 - 5.51) and barriers (OR: 0.15, 95%CI: 0.13 - 0.18) (all p < 0.01). Conclusions: The results suggested that the main HBM components may predict health behavior better than the subcomponents. These results may effectively promote the benefits of, and reduce barriers to, programs aiming to increase participation in specific health guidance.

Community effects on public health in India: A hierarchical model

The data on any aspect of public health, including that on infant mortality, has inbuilt hierarchical structure. Using traditional regression approach in data analysis, i.e., ignoring hierarchical structure, either at micro (individual) or at macro (community) level will be avoiding desired assumption related to independence of records. Accordingly, this may result into distortion in the results due to probable underestimation of standard error of the regression coefficients. To be more specific, an irrelevant co-variate may emerge as an important covariate leading to inappropriate public health implications. To overcome this problem, the objective of the present work was to deal with multilevel analysis of the data on infant mortality available under second round of National family Health Survey and notify changes in results under traditional regression analysis that ignores hierarchical structure of data. This method provides more accurate results leading to meaningful public health implications. In addition, estimation of variability at different levels and their covariance are also obtained. The results indicate that the community (e.g., state) level characteristics still have major role regarding infant mortality in India. Further, if computational facilities are available, multilevel analysis may be preferred in dealing with data involving hierarchical structure leading to accurate results having meaningful public health implications.