International Journal of Behavioral Medicine最新文献

{"title":"Prediction of Depression and Anxiety Symptoms in Older Adults from Objectively Measured Physical Activity.","authors":"Ken Kurisu, Sungjin Park, Kazuhiro Yoshiuchi, Yukitoshi Aoyagi","doi":"10.1007/s12529-025-10385-8","DOIUrl":"https://doi.org/10.1007/s12529-025-10385-8","url":null,"abstract":"<p><strong>Background: </strong>In the context of global population aging, research on physical activity and mental health in older adults is increasingly warranted. While previous studies revealed cross-sectional associations between objectively measured physical activity and depression in older adults, the longitudinal relationship remains unexplored. This longitudinal study aimed to examine the effects of objectively measured physical activity on future depression and anxiety.</p><p><strong>Methods: </strong>Data were obtained from 477 residents of Nakanojo town who were able to walk independently. Physical activity was measured using an electronic accelerometer, and participants completed the Hospital Anxiety and Depression Scale (HADS) annually. Using these repeated measurements, a longitudinal dataset was constructed by pairing physical activity data with HADS scores measured the following year. Multilevel models were used to predict HADS depression and anxiety scores measured one year after physical activity data collection.</p><p><strong>Results: </strong>For the depression model, based on 1,963 records from 454 participants, longer durations of moderate to vigorous physical activity (MVPA) were associated with lower depression scores the following year (coefficient = -0.44; 95% confidence interval [CI] = -0.59 to -0.28; p < 0.001). Similarly, in the anxiety model, which included 1,938 records from 452 participants, longer MVPA durations were linked to lower anxiety scores in the subsequent year (coefficient = -0.27; 95% CI = -0.41 to -0.13; p < 0.001).</p><p><strong>Conclusions: </strong>These findings suggest that higher levels of physical activity may be associated with reduced future symptoms of depression and anxiety in community-dwelling older adults capable of walking.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intention Setting to Improve Sleep Practices: The Impact on Sleep and Theory of Planned Behaviour Variables; a Randomised Control Trial in Undergraduate Students.","authors":"Jayne Spiller","doi":"10.1007/s12529-025-10381-y","DOIUrl":"https://doi.org/10.1007/s12529-025-10381-y","url":null,"abstract":"<p><strong>Background: </strong>This study investigated whether providing sleep hygiene advice combined with intention setting to improve sleep increased sleep hygiene, sleep period, and advanced bedtime compared with a wellbeing intervention.</p><p><strong>Method: </strong>The intervention for this randomised control trial was delivered in a single online session to undergraduate students. Participants were randomised to either the sleep intervention, an intervention for mental wellbeing, or a control condition. Participants in the sleep and wellbeing conditions watched a video about healthy sleep habits and healthy mental wellbeing, respectively, and set three intentions to improve this outcome. Theory of planned behaviour variables were assessed pre- and post-intervention, and sleep variables were assessed pre-intervention and at 1-week follow-up (n = 128 included at the follow-up).</p><p><strong>Results: </strong>Sleep hygiene scores were significantly lower for the sleep intention setting group compared with the control group post-intervention, reflecting a small effect size (Cohen's d .45). Following the sleep intervention, there was no difference in sleep period or bedtime relative to the control group. Setting intentions did significantly increase participants' intention to use strategies to improve their sleep, but change in intention score was not associated with post-intervention attitude, control belief strength, or power in relation to sleep.</p><p><strong>Conclusion: </strong>Setting intentions to improve sleep results in improved sleep hygiene compared to setting no intentions. However, improved sleep hygiene does not transfer to an increased sleep period or earlier bedtimes, nor does it change attitude and perceived behavioural control. Future studies should consider the moderating role of environmental barriers to intention setting.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Personal-Level Social Networks on Treatment Adherence, Depression, Anxiety, and Perceived Stigma Among Adults with Cystic Fibrosis: An Egocentric Network Analysis.","authors":"Haosen Sun, Heather M Francis, Jennifer Polo, Christine Esposito, Katherine Papia, Jana Yeley, Meagan Brant, Alison Huenger, Janice Wang, Cynthia Brown, Erin Pullen, Melissa J Basile","doi":"10.1007/s12529-025-10382-x","DOIUrl":"https://doi.org/10.1007/s12529-025-10382-x","url":null,"abstract":"<p><strong>Background: </strong>Among people with cystic fibrosis (CF), health behaviors and mental health have been associated with general social support. We used egocentric network analysis to assess the specific impact of social network variables on treatment adherence, depression, anxiety, and perceived stigma among adults with CF. Our goal is to identify the social network factors which may be driving adherence, anxiety, depression, and perceived stigma among adults with CF toward developing targeted network-based interventions.</p><p><strong>Method: </strong>Our primary outcome, adherence to individual-level treatment regimens, was assessed using composite prescription refill history (cMPR), self-reported airway clearance therapy (ACT), and consumption of all prescriptions. Secondary outcomes were assessed via patient completion of the Patient Health Questionnaire-9 (PHQ-9) for depression, the General Anxiety Disorder-7 (GAD-7) for anxiety, and the CF Stigma Scale for perceived stigma. Participants also completed a social network interview to collect data on personal-level networks. Controlling for participant age, sex, race, relationship status, work status, and CF disease severity, we explored the impact of network variables on our primary and secondary outcomes using regression analysis. All models were run twice to assess both core and strong network ties.</p><p><strong>Results: </strong>Regression analysis of 104 participants showed that strong network ties serving as health discussants and health regulators were positively associated with stronger adherence, while financial dependence and network density were associated with decreased adherence. Network alters having higher education levels, strong trust in doctors, and support for daily activities were associated with lower depression, anxiety, and perceived stigma. Participants having a higher proportion of network members who hassled them and had lower trust and/or greater variability in trust in doctors experienced higher depression, anxiety, and perceived stigma.</p><p><strong>Conclusion: </strong>Findings show that network-based variables including close ties to health discussants, network members' education levels, and health beliefs, as well as having network members providing support for daily activities may be driving specific aspects of adherence, symptoms of depression and anxiety, and perceived stigma among adults with CF. These findings may thus allow us to leverage social networks in the development of novel interventions to improve adherence and mental health and reduce perceived stigma for people with CF.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Meta-Analytic Review of the Associations of the Big Five Personality Traits with Subjective Poor Sleep Quality and Insomnia, and Meta-Regression of Some Potential Moderators.","authors":"Habibollah Khazaie, Saeid Komasi, Ali Zakiei, Amirhossein Khazaie, Amir Sharafkhaneh","doi":"10.1007/s12529-025-10384-9","DOIUrl":"https://doi.org/10.1007/s12529-025-10384-9","url":null,"abstract":"<p><strong>Background: </strong>Research on the relationship between personality traits and sleep problems is crucial, as it informs interventions designed to improve mental health and overall well-being. This meta-analytic review aimed to examine the associations between the Big Five personality traits and both subjective sleep quality and insomnia severity. Another objective was to compare the mean scores of personality traits in individuals with insomnia and healthy controls.</p><p><strong>Method: </strong>Three international databases were systematically searched for articles published in English between January 1990 and November 2022 (PROSPERO-CRD42022378352). Due to the observed heterogeneity, pooled estimates of correlations and standardized mean differences were calculated using the random-effects method. Meta-regression and subgroup analyses were performed to identify potential moderators.</p><p><strong>Results: </strong>The estimates derived from 51 studies (involving nearly 31,000 participants from 20 countries) indicated that higher scores of neuroticism and lower scores of extraversion, openness, agreeableness, and conscientiousness were significantly associated with poor sleep quality (r =  - 0.05 to 0.31). With the exception of openness, all other personality traits were significant correlates of insomnia. The meta-regressions revealed that population type, geographic region, age, sample size, sample ratio, quality of study, and year of study served as significant moderators.</p><p><strong>Conclusion: </strong>Despite the significant associations between most personality traits and sleep problems, the heterogeneous estimates were influenced by several moderators. Addressing these moderators can provide researchers with deeper insights into personalized interventions aimed at improving sleep quality across diverse populations. These significant associations also underscore the importance of incorporating personality assessments in clinical settings for individuals experiencing sleep disturbances.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"My Body Is a Ticking Time Bomb\": Associations of Body Mindsets with Psychological Distress in People with Chronic Kidney Disease.","authors":"Emily J Dowling, Tripti Singh, Joseph Chilcot, Alia J Crum, Lauren C Heathcote","doi":"10.1007/s12529-025-10379-6","DOIUrl":"https://doi.org/10.1007/s12529-025-10379-6","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the association between body mindsets-established, but mutable beliefs a person holds about their body-with psychological distress in people with chronic kidney disease (CKD).</p><p><strong>Methods: </strong>A cross-sectional, mixed methods survey was conducted in people with CKD at various stages of treatment. Participants completed the Patient Health Questionnaire-4 (PHQ-4) to capture distress, the Body Mindset Inventory (BMI), and qualitative free-text responses elaborating on their mindsets. Hierarchical regression models explored associations of body mindsets with psychological distress, controlling for demographic variables, treatment modalities, and comorbidities.</p><p><strong>Results: </strong>Two hundred and thirty-two adults with CKD (62% female) completed the survey; 27.6% were receiving dialysis and 34.7% had received a kidney transplant. Those who more strongly endorsed the mindset that their Body is an Adversary reported greater psychological distress, while those who more strongly endorsed the mindsets that their Body is Capable or their Body is Responsive reported less psychological distress. Together, all three mindsets explained 12% unique variance in psychological distress, even after accounting for demographic factors, treatment modalities, and comorbidities. Mixed methods analyses illustrated the range of body mindsets in people with CKD, with some describing their body as \"A ticking time bomb\" and others stating \"My body is a fighter just like me. My body is amazing.\"</p><p><strong>Conclusion: </strong>Mindsets about the body are significantly associated with psychological distress in people with CKD. These cross-sectional data provide a foundation for future longitudinal and interventional studies on the relationship between mindsets and distress outcomes in people living with CKD.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modelling the Associations Between the Physician-Patient Relationship and Patient Outcomes via Self-Determination Theory Variables in Chronic Disease Management.","authors":"Jessica A Eigeland, Robyn L Moffitt, Nicola Sheeran, Natalie Loxton, Liz Jones","doi":"10.1007/s12529-025-10371-0","DOIUrl":"https://doi.org/10.1007/s12529-025-10371-0","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to model the associations between the physician-patient relationship and patient outcomes, considering the mediating role of Self-Determination Theory variables.</p><p><strong>Method: </strong>The current study comprised a sample (N = 226) of Australians with a diagnosed chronic health condition. Path analysis via structural equation modelling was used to model the relationships between patients' self-reported perception of the physician-patient relationship, motivation (autonomous and controlled), basic psychological needs (satisfaction and frustration), and patient outcomes (treatment adherence, mental health, and physical health).</p><p><strong>Results: </strong>Stronger physician-patient relationships indirectly predicted better physical and mental health, as well as greater adherence to treatment. This occurred through serial mediation, whereby stronger physician-patient relationships directly predicted need satisfaction, which in turn predicted autonomous motivation. Conversely, weaker physician-patient relationships indirectly predicted poorer mental health and lower adherence to treatment. This occurred through serial mediation where weaker physician-patient relationships predicted need frustration, which in turn predicted controlled motivation. Weaker physician-patient relationships also directly predicted controlled motivation.</p><p><strong>Conclusion: </strong>Satisfaction of basic psychological needs plays an important role in predicting patient motivation and outcomes. The current findings provide evidence that the physician-patient relationship plays a direct role in facilitating satisfaction and frustration of psychological needs, as well as patient motivation. Attention should be placed on interventions aimed at improving the physician-patient relationship as a means through which to increase need satisfaction, autonomous motivation, and, consequently, patient adherence and outcomes.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Behavioral Sciences to Augment Voluntary Blood Donation in China: A Randomized Control Trial and Latent Class Analysis.","authors":"Bo Li, Caixia Wu, Zhong Liu, Stephen W Pan","doi":"10.1007/s12529-025-10375-w","DOIUrl":"https://doi.org/10.1007/s12529-025-10375-w","url":null,"abstract":"<p><strong>Background: </strong>China is facing a blood shortage crisis and needs to increase its voluntary blood donation rates. Since current programs to promote blood donation may not be sufficient to meet the rising demand, innovative approaches are needed. Behavioral sciences can provide useful insights for developing behavioral interventions to enhance blood donation. However, there have been few empirical studies to evaluate the efficacy of such interventions across different potential and existing donor subgroups.</p><p><strong>Method: </strong>This randomized controlled trial and latent class analysis (LCA) empirically evaluated the effect of online behavioral interventions on blood donation willingness, intention, and behavior on different donor subgroups in China. In 2022, 3280 participants of diverse sociodemographic characteristics in mainland China were recruited through an online survey platform and completed a baseline survey. Participants were randomized to one of five online interventions (stimulating individual standards of fairness, using eye cues to prime individuals, self-imposed penalties for goal failure, presenting blood shortage statistics in China, and a World Health Organization blood donation poster) in the middle of the survey and were provided information on where to donate blood at the end of the survey. To measure post-intervention blood donation, participants were invited to complete a follow-up survey 3 to 4 weeks after the baseline survey. Six donor subgroups were identified using LCA, and differential treatment effects on actual blood donation were assessed using regression analysis based on a classify-analyze approach.</p><p><strong>Results: </strong>Our results showed that presenting blood shortage statistics was the most effective intervention for increasing blood donation among a subgroup of respondents characterized by high educational attainment, while three out of six classes had low donation rates regardless of the intervention.</p><p><strong>Conclusion: </strong>Targeted, online intervention campaigns show promise in efficiently augmenting voluntary blood donation rates in China.</p><p><strong>Trial registration: </strong>ChiCTR2200060481 (Chinese Clinical Trials Registry).</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthy Smiles: An Investigation of Brief Online Interventions to Improve Oral Health among Young People Experiencing Psychological Distress.","authors":"Bonnie A Clough, Emma Walton, Caroline V Robertson, Santosh Tadakamadla, Tanaya Prior, Matt Stainer, Dale Rowland, Amanda J Wheeler","doi":"10.1007/s12529-025-10380-z","DOIUrl":"https://doi.org/10.1007/s12529-025-10380-z","url":null,"abstract":"<p><strong>Background: </strong>Young adults experiencing psychological distress are susceptible to poor oral health through a range of social, cognitive, and biological processes. However, only limited attention has been given to developing interventions to improve oral health behaviours and related factors in this population. This study aimed to compare the efficacy of two brief, online interventions (education and education with motivational interviewing components) to an active control condition.</p><p><strong>Method: </strong>The interventions were informed by co-design and the Theory of Planned Behaviour (TPB), with TPB and related constructs measured pre, post, and one-week following the intervention. Participants were 152 young adults (aged 18-25 years) experiencing moderate or greater psychological distress.</p><p><strong>Results: </strong>Data were analysed using linear mixed-effect modelling, focussing on within groups effects over time and between groups effects at post and follow-up timepoints. Participants in the education intervention reported significantly greater oral health knowledge at post-intervention than pre-intervention (p = .007), with gains maintained at follow-up. Some benefits were also observed for attitudes and oral health values post-intervention, across conditions. The addition of motivational interviewing components did not result in improved intervention effects.</p><p><strong>Conclusion: </strong>Brief online interventions may be appropriate for delivery of educational interventions within this population, but increased support may be needed to improve perceptions of control and behavioural enactment.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Thematic Analysis of Resilient Experiences of People Who Inject Drugs Living with HIV Remaining in HIV Care.","authors":"Julia Lechuga, Gilberto Perez, Valeria Dueñas, Maria Elena Ramos, Luisa Ramos","doi":"10.1007/s12529-025-10377-8","DOIUrl":"https://doi.org/10.1007/s12529-025-10377-8","url":null,"abstract":"<p><strong>Background: </strong>HIV disproportionately affects US Latinos as they account for 30% of all new HIV infections. A subpopulation also disproportionately affected are people who inject drugs (PWID) which account for 1 in 10 HIV diagnoses in the USA. PWID progression through the HIV treatment cascade is inhibited by various barriers. The barriers that PWID experience entering and remaining in HIV care have been documented extensively at the expense of research conducted to understand facilitators. The purpose of this study was to understand the experiences of PWID living with HIV (PWIDLH) in seeking medical treatment and the factors that facilitated remaining in HIV medical care.</p><p><strong>Method: </strong>We employed a resilience framework to analyze the data and interpret findings. The study site was the USA-Mexico border, a region characterized by a confluence of factors that promote forward HIV transmission such as population mixing, violence, sex work, and injection drug use. Participants were 20 PWIDLH (74% male) with a mean age of 43.5 years residing on the USA-Mexico border in the sister cities of Ciudad Juarez, Mexico, and El Paso, TX.</p><p><strong>Results: </strong>Results revealed three themes: resilience as a system of support, resilience as individual-level psychological resources and behavioral skills, and resilience as a transformative process that enables reciprocal determinism.</p><p><strong>Conclusion: </strong>The study findings contribute to the understanding of the role of resilience among Latino PWIDLH residing in a medically underserved setting. Findings have implications for the development of interventions to promote resilience and motivate Latino PWIDLH to enter the HIV treatment cascade sooner and make successful progression.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Framing the Future: How Vaccination Messages Shape Childhood Immunization Beliefs and Intentions Among Urban Low-Income Communities - a Randomized Field Experiment.","authors":"Judy Gichuki, Ben Ngoye, Vicenta Sierra, Francis Wafula","doi":"10.1007/s12529-025-10376-9","DOIUrl":"https://doi.org/10.1007/s12529-025-10376-9","url":null,"abstract":"<p><strong>Background: </strong>Unvaccinated and partially vaccinated children are often found in complex environments, including urban poor settlements. Beyond typical factors affecting vaccination among low-income urban populations, such as affordability, trust remains a critical determinant of caregiver immunization decisions for their children. Drawing on the Theory of Planned Behavior, this study examined the impact of messaging approaches on the interplay across four factors: attitudes, subjective norms, perceived behavioral control, and vaccination intentions.</p><p><strong>Method: </strong>This was an experimental study that employed a between-participants, 2×2×2 design, taking into consideration message content (benefit or cost), message appeal (factual or emotional), and messenger type (layperson or expert). Data were collected from 366 caregivers of children under five residing in randomly selected urban informal settlements. The proposed model was assessed using a partial least squares structural equation model.</p><p><strong>Results: </strong>The study found that caregivers' attitudes toward vaccination (b=0.215, p<0.001, f²=0.087), subjective norms (b=0.086, p=0.03, f²= 0.026), and perceived behavioral control (b=0.199, p<0.001, f²= 0.087) were positively associated with their intentions to vaccinate their children. Structural equation modelling identified varying moderating effects of the messaging, with the inclusion of the moderators leading to an 8% increase in the R². Exposure to benefit-based (b=0.097, p=0.016, f²=0.016) and fact-based messages (b = 0.162, p<0.001, f²=0.031) intensified the influence of attitudes on vaccination intentions. In contrast, emotionally appealing messages strengthened the impact of perceived behavioral control on intentions (b= -0.149, p<0.001, f²=0.033). The use of expert images did not have significant advantages over layperson images.</p><p><strong>Conclusion: </strong>Findings underscore the potential impact of messaging on the efficacy of vaccination promotion efforts. In developing communication strategies, policymakers should consider the interplay between messaging and its moderating influence on relationships between attitudes, subjective norms, and perceived behavioral control with vaccination intentions.</p><p><strong>Trial registration: </strong>Pan African Clinical Trials Registry.</p><p><strong>Trial no: </strong>PACTR202303735426128. Registered on 22/03/2023.</p>","PeriodicalId":54208,"journal":{"name":"International Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}