Applying the Health Belief Model to Analyze Intention to Participate in Preventive Pulmonary Tuberculosis Chest X-Ray Examinations Among Indigenous Nursing Students

Abstract

The purpose of this study was to investigate knowledge, perceptions of tuberculosis (TB) and intent to receive chest X-ray screening among indigenous (Taiwanese of ethnic Malayo-Polynesian descent) nursing students in Taiwan. A convenience sample was chosen from an technical institute in northern Taiwan that maintained admission quotas and provided scholarships for indigenous students. This school had over 150 classes and around 7,000 students, about 20%-25% of whom were ethnically indigenous. A power analysis based on a pilot study showed that a large effect size required a minimum sample of 485. To attain this number, 50 classes from years one through five were randomly selected based on an expected sampling of 20 students per classroom. In all, 1,000 questionnaires were distributed and 865 returned, for a response rate of 86.5%. A cross-sectional study design was used, and this study was run between the months of February and June 2003. Survey responses were self-reported in two questionnaires that gathered information on respondent knowledge and perceptions regarding TB and intent to take chest X-ray tests. Study results showed a moderate level of general knowledge about TB, misunderstandings regarding transmission vectors, and low perceptions regarding susceptibility. The knowledge score was associated with perceived benefits and barriers to preventing TB. Different places of residence influenced perceived barriers to preventing and treating TB. Age was negatively associated with the perceived benefits of receiving a chest X-ray exam for TB. Indigenous nursing students with higher perceptions of susceptibility and severity and lower perception of barriers on preventing TB had a higher level of intent to take the X-ray exam. Nursing schools must address the subject of TB in-depth and design age-specific curricula that incorporate multifaceted strategies for different students. Additionally, health educators should design health education programs targeted to dispel misconceptions and improve both knowledge and levels of awareness of tuberculosis among the indigenous population in order to enhance their willingness and ability to detect TB.

Complex relation among Health Belief Model components in TB prevention and care

“…Similar with Chang's study, applying the Health Belief Model to analyze intention to participate in preventive p u b l i c h e a l t h x x x ( 2 0 1 5 ) 1 e9 pulmonary tuberculosis chest X-ray examinations among indigenous nursing students, nursing students' score of general TB knowledge, perception of the benefits of TB preventive behavior, and perceived barriers are related to the adoption of behavior. 17 This study also shows that age and immigrant time are the demographic factors which should get more attention. The rates of TB preventative behavior are negatively related to the increasing age and the longer immigrant time.…”

“…Chang applied the Health Belief Model to analyze intention to participate in preventive pulmonary tuberculosis chest X-ray examinations among indigenous nursing students in Taiwan. 17 Poss studied the participation in tuberculosis screening of Mexican migrant farmworkers. 18,19 Rodríguez-Reimann investigated gender and acculturation differences in TB-specific Health Belief Model constructs, and the applicability of the HBM's traditional configuration to Mexican Americans.…”

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