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Purpose. To review applications of Ajzen's theory of planned behavior in the domain of health and to verify the efficiency of the theory to explain and predict health-related behaviors. Methods. Most material has been drawn from Current Contents (Social and Behavioral Sciences and Clinical Medicine) from 1985 to date, together with all peer-reviewed articles cited in the publications thus identified. Findings. The results indicated that the theory performs very well for the explanation of intention; an averaged R2 of .41 was observed. Attitude toward the action and perceived behavioral control were most often the significant variables responsible for this explained variation in intention. The prediction of behavior yielded an averaged R2 of .34. Intention remained the most important predictor, but in half of the studies reviewed perceived behavioral control significantly added to the prediction. Conclusions. The efficiency of the model seems to be quite good for explaining intention, perceived behavioral control being as important as attitude across health-related behavior categories. The efficiency of the theory, however, varies between health-related behavior categories.

In recent years, the research on human behaviour in relation to waste management has increased at an expo-nential rate. At the same time, the expanding academic literature on this topic makes it more difficult to un-derstand the main areas of interest, the leading institutions and authors, the possible interconnections among different disciplines, and the gaps. This paper maps knowledge domain on recycling behaviour through biblio-metric analysis and text mining in order to identify current trends, research networks and hot topics. 2061 ar-ticles between 1975 and 2020 from three different databases are examined with an interdisciplinary approach. The findings reveal that 60% of papers have been published between 2015 and 2020, and this topic is of global interest. Leading countries are mainly located in Europe, North America and Commonwealth; however, China and Malaysia are also assuming a driving role. Bibliometrics and text mining provide the intellectual configu-ration of the knowledge on recycling behaviour; co-word analysis individuates conceptual sub-domains in food waste, determinants of recycling behaviour, waste management system, waste electrical and electronic equip-ment (WEEE), higher-level education, plastic bags, and local government. Overall, waste management and related human behaviour represent a universal challenge requiring a structured and interdisciplinary approach at all levels (individual, institutions, industry, academia). Lastly, this paper offers some suggestions for future research such as smart city design, sensor network system, consumer responsibilisation, the adoption of a more comprehensive view of the areas of investigation through the holistic analysis of all stakeholders.

Although there has been a steady increase in the number of studies on consumer behaviour in relation to sustainable development, there is limited focus on the product disposal phase. This systematic literature review intends to: (1) clarify how concepts related to pro-environmental consumer behaviour are understood and analysed in the academic literature on waste management; (2) discover any interplay between pro-environmental consumer behaviour and generic consumer behaviour, and the conditions and factors that favour it. A typical systematic literature review methodology was applied to the papers available on Web of Science, Science Direct and EBSCO (Elton Bryson Stephens Company) host between 1975 and 2019, leading to the selection of 699 final papers. The findings reveal that: (1) Although scholars tend to create a variety of pro-environmental consumer behaviour models depending on their specific field of inquiry, all approaches can be traced back to a limited number of reference theories; (2) The overall level of interplay between pro-environmental consumer behaviour and generic consumer behaviour is limited, nevertheless a favourable context or a supportive institutional-legal framework can significantly influence it; (3) A plethora of conditions and factors favour this type of interplay, involving social psychology, laws, economics, institutions and more; (4) Several critical issues appear in the analysed papers, especially some scholars' assumptions to be able to identify all key factors. It follows the need for a more interdisciplinary approach, a deeper analysis of the effectiveness of the intervention measures at the governmental and institutional level, and a clear classification of factors and conditions (as proposed by this review)

Purpose. This study examined whether eating practices and psychosocial factors differed across stages of change for fruit and vegetables. Design. Data were collected using a self-administered written survey among a convenience sample of 739 Dutch adults. Response rate was 92%. Setting. Data were collected as part of the baseline assessment for a nutrition intervention study. Measures. Fruit and vegetable intake was measured as self-reported consumption with a validated eight-item food frequency questionnaire. Psychosocial variables were measured with six items on bipolar seven-point scales and stage-of-change classifications were based on separate four-item algorithms for fruits and vegetables. Differences in psychosocial factors and consumption were analyzed using one-way analysis of variance with Scheffé's multiple-comparison test. Results. Significant differences were found between stages of change in dietary intake, attitudes, self-efficacy, and judgment of one's own intake compared to others. Attitudes were most positive in preparation and action and least positive in precontemplation. Intake and self-efficacy were more positive in action/maintenance than in pre-action stages. Conclusions. The findings suggest that nutrition education aimed at encouraging higher intake of fruits and vegetables might be most effective if it is stage-tailored. Messages to influence attitudes about fruits and vegetables are likely to affect people in precontemplation, and self-efficacy information to increase confidence in overcoming barriers to consumption is likely to be effective with persons in contemplation and preparation stages.

AbstractNowadays the prediction and change of waste-related behaviors represent a key topic for scholars and policy makers. The theoretical mainstays applied to waste separation behavior, such as the Theory of Planned Behavior (TPB), the Norm Activation Model and the Value Belief Norm, do not include the construct of goal in their formulation. Other goal-focused theories, such as the Goal Systems Theory (GST), lack applications on separation behavior. Recently, Ajzen and Kruglanski (2019) have proposed the Theory of Reasoned Goal Pursuit (TRGP) which combines TPB and GST. Considering TRGP has the potential to offer further insights on human behavior and, to our knowledge, there is no application of TRGP to recycling behavior yet, this paper analyses waste separation behavior of households in Maastricht and Zwolle (The Netherlands) under the lens of TRGP. Although waste separation behavior represents a kind of habitual behavior, this paper highlights the influence of goals and motivation on intention to separate waste. Furthermore, it offers some indications to promote behavior change and some suggestions for future research directions.

Gender inequalities still affect the health and well-being of young people worldwide. Given the apprehensions among government and educators in a conservative context like Panama to implement comprehensive sexual education, there is a need for other educational efforts to stimulate healthy and respectful intimate relationships between adolescents. This article examines to what extent a newly developed Social-Emotional Learning (SEL) program, Me and My New World, provides a context in which students can learn to recognize and manage emotions, to care about others and themselves, make responsible decisions, develop social awareness. The program could additionally facilitate behavioral changes of young people towards more gender equality. Specifically, we focused on equal gender roles, equal rights in relationships and nonviolent problem solving, and present the qualitative effect evaluation among adolescents in Panama. The findings suggest that SEL-based lessons might broaden views on how young people experience the process of exploring identity formation, how assumptions of inequalities can be recreated through the lessons, and that SEL can emphasize the significance of choice and decision-making in interpersonal relationships. The perspectives, needs, and limitations highlighted by the adolescents living in a conservative context are highly valuable for improving future learning strategies for the development of healthier relationships

Adolescents in Panama face multiple challenges to their sexual health, rights and well-being such as high rates of teenage pregnancy (∼30% of all pregnancies), increased HIV infections and sexual violence. In the absence of sufficient evidence-based data and an ongoing debate in Panamanian society about how to approach adolescents' health problems, the aim of this qualitative study was to explore the perceptions and attitudes of different societal actors, namely governmental employees, NGO employees, academics, members from religious groups, teachers and parents. We conducted in-depth interviews (N = 34) which focused on the behavioural and environmental factors considered to influence adolescents' decision making with regard to love, friendships and family relations. Furthermore, we explored how these stakeholders viewed the role of the education system, and the potential of including social–emotional learning (SEL) in the curriculum to provide skills and capacities, which could encourage adolescents to make better decisions and improve their well-being, in general but also in the context of sexual behaviours. Analysis revealed five central themes, i.e. perceptions towards gender roles and equality, adolescents' love (sexual) relationships, capacity needs regarding prevention of risk behaviours and the role of education, comprehensive sexuality education in schools and the potentiality of SEL in the education system. The findings of the study can enhance understanding on the views of stakeholders regarding the factors influencing adolescents' decision making, as well as regarding the possibilities of introducing SEL in the Panamanian educational curriculum.

Health Care Services (HCSs) should implement ongoing innovation and continuously improve their quality. However, in evaluating the quality of HCSs, too little attention has been given to the experience of the users concerning the acquired services. This study focused on how the community values the current services in order to improve HCSs in Indonesia, especially in Jakarta. Four focus group discussions were conducted among 45 community members in the Grogol Petamburan sub-district, in Jakarta. Participants were recruited using a convenience sampling and the data were analyzed using a combination of human coding and NVivo-12. Overall, we found that participants had a negative view of the government-mandated Community Health Centers (CHCs) and they preferred to visit private clinics and hospitals over the CHCs. Participants associated CHCs with unfriendly staffs, longer waiting times, shorter opening hours, and crowded visitors. At the same time, participants had a positive view on the affordability of the CHCs. Additionally, we found the reasoning of Jakartans' (i.e., the citizens of Jakarta city) on using self- and traditional treatments before visiting HCSs and they also expressed the need for psychological services at CHCs. The discussion focuses on the results as feedback on how the government and health care providers may facilitate the community's needs in providing HCSs in Indonesia, especially Jakarta. In brief, we recommend the policy-makers to improve the hospitality of the staff members and the quality of the medical equipment; also, to provide psychological services at CHCs. These efforts need to be done while paying more attention to the cultural aspects of medicinal uses.

Understanding the perceptions of health and sickness can help the government, health providers and health promoters encourage individuals to participate in healthy behaviors and to follow a healthy lifestyle. Jakarta, the capital city of Indonesia, is a culturally, socially and financially diverse city, with complex health care needs. As yet, there is no published data available about Jakartans' (i.e., the citizens of Jakarta city) perceptions on health and sickness. This study aimed to describe what health and sickness mean to Jakartans. To this means, we collected data using an open-ended survey about the meanings of health and sickness from 640 Jakartans. Five main themes of health and sickness emerged. The five themes of health were health as a physical condition, a psychological condition, a spiritual condition, a capability to carry out daily activities, and a healthy lifestyle. The themes regarding sickness were sickness as a physical condition, a psychological condition, an abnormal circumstance or bad situations, a spiritual condition, and an inability to carry out daily activities. We discussed how the above-mentioned perceptions might influence the daily health-related behaviors of Jakartans. In contrast to the typical biomedical approach, we found that, in Jakarta, health was not merely seen as a causal effect of the physical world. Further details are discussed.

Adolescents in Panama face multiple challenges to their sexual health, rights and well-being such as high rates of teenage pregnancy (∼30% of all pregnancies), increased HIV infections and sexual violence. In the absence of sufficient evidence-based data and an ongoing debate in Panamanian society about how to approach adolescents' health problems, the aim of this qualitative study was to explore the perceptions and attitudes of different societal actors, namely governmental employees, NGO employees, academics, members from religious groups, teachers and parents. We conducted in-depth interviews (N = 34) which focused on the behavioural and environmental factors considered to influence adolescents' decision making with regard to love, friendships and family relations. Furthermore, we explored how these stakeholders viewed the role of the education system, and the potential of including social–emotional learning (SEL) in the curriculum to provide skills and capacities, which could encourage adolescents to make better decisions and improve their well-being, in general but also in the context of sexual behaviours. Analysis revealed five central themes, i.e. perceptions towards gender roles and equality, adolescents' love (sexual) relationships, capacity needs regarding prevention of risk behaviours and the role of education, comprehensive sexuality education in schools and the potentiality of SEL in the education system. The findings of the study can enhance understanding on the views of stakeholders regarding the factors influencing adolescents' decision making, as well as regarding the possibilities of introducing SEL in the Panamanian educational curriculum.

Threatening communication is a widely applied method in behavior change interventions, which at the same time has been heavily criticized in the psychological literature. The current paper describes a study of the reasons for this persistent wide application of threatening communication. We conducted qualitative interviews with 33 key actors in behavior change intervention development in The Netherlands. Specifically, we interviewed intervention developers, policymakers, politicians, scientists, and advertising professionals. The interviews were transcribed and subsequently coded using NVivo. We found that participants most closely involved with the actual intervention development were generally convinced that threatening information was to be prevented, but often did not understand the exact processes involved. They were often under the impression that rather than a potent efficacy enhancing element, a behavioral suggestion would suffice to prevent threatening communication from backfiring. As participants were further removed from the actual intervention development, they generally tended to be more in favor of threatening communication. The main reasons for use of threatening information were to attract attention or prompt self-reflection through confrontation, because target population members were assumed to like threatening information and respond rationally to increased risk perceptions by changing their behavior, or simply because no alternatives were available. In addition, intervention developers frequently had to deal with supervisors or funders who preferred threatening communication. Thus, when communicating with practitioners, it seems fruitful to provide them with a toolbox of evidence-based behavior change methods that promote adaptive, rather than maladaptive, behavior; to promote basing interventions on the most relevant behavioral determinants as identified by determinant analyses; and to equip intervention developers with the tools to persuade other key stakeholders that fear is a bad ...

Purpose. Present a 10-year update of the ecologic model of health promotion published by Richard et al. in the American Journal of Health Promotion in 1996. Approach. We adapted and simplified the model by leaving out settings, focusing on levels, and incorporating interpersonal and individual levels and agents that are in control of environmental conditions. Setting. Health care facilities, schools, workplaces, living environments, and public environments were represented in program descriptions. Participants. Forty-three program coordinators responsible for 47 programs were interviewed in the United States and The Netherlands. Methods. A systematic interview protocol elicited general program descriptions and relevant aspects of the ecologic approach. Program aspects from written reports were coded by the authors into levels, interventions, targets, and strategies. Results. The programs had 234 strategies and 276 targets, with a mean of 2.15 levels. Twenty-seven distinct intervention strategies were identified, with the most common being modification of an organization to which the at-risk individuals belong, followed by policy and community changes. Conclusion. Our data fit the ecologic model and our adaptations and indicate that over the past decade health promotion practice may have changed to include more multilevel programs. Systematic analysis of program strategies within and across environmental levels allows better understanding of the social ecology of health-related behavior and potential leverage points for change.

From a corporate social responsibility perspective, there are many reasons to promote teleconference use as an alternative to business travel. The present study examines psychosocial and organizational factors relevant to teleconference use. We tested an extended Theory of Planned Behavior model of teleconference use among office workers of four organizations. Results indicate that intention was the strongest direct predictor of teleconference use. Habit and perceived norm, in turn, were the strongest predictors of intention to use teleconference. In contrast, attitude was only weakly predictive and perceived control not predictive at all of intention to use teleconference. We also examined how this model was influenced by the organizational context by comparing organizations from two different regions, and organizations from the private vs. the public sector. Most teleconference-related beliefs differed between regions and organizational sectors. The relevance of specific attitudinal and normative beliefs to the overall attitude and perceived norm also differed between organizational sectors. Implications for practice and future research are discussed.