Health and Land-Use Courses of Action for Education for Sustainable Development in Madagascar: Teacher Perspectives on Possibilities for Implementation

Education for Sustainable Development (ESD) plays a key role in achieving the Sustainable Development Goals. However, the implementation of ESD in education remains a challenge, particularly for countries such as Madagascar. ESD needs to consider regional realities to be relevant to learners. An expert study identified health and land-use courses of action for regionally relevant ESD in northeast Malagasy primary education. However, what about teacher perspectives on the possibilities for implementing such courses of action? The present think-aloud study with 10 Malagasy primary teachers used the Integrated Behavioral Model for Water, Sanitation, and Hygiene (IBM-WASH) to analyze factors that teachers perceive to be relevant for implementing health and also—as an innovation—land-use courses of action. The IBM-WASH model is a tool for identifying opportunities and barriers to a desired health behavior. It turned out that the local school’s surroundings, shared values and attitudes, and existing habits are important for implementing health and land-use courses of action. Therefore, regionally adapted health and land-use teaching should consider community-contextual, community-psychosocial, and habitual-psychosocial factors. Additionally, teachers mentioned the costs and benefits of land-use practices. Thus, land-use teaching should take the individual-technological factor into account. This paper argues for a regionally adapted ESD in teacher and school education.

An Application of the Integrated Behavioral Model for Water, Sanitation and Hygiene to Assess Perceived Community Acceptability and Feasibility of the Biosand Filter among Maasai Pastoralists in Rural Tanzania

In addition to diarrheal disease risk, lack of access to safe water may have other indirect effects throughout one’s life, such as school and workplace absenteeism, leading to less economic productivity. In contexts with scarce resources and unsafe drinking water, household water treatment and safe storage options such as the Biosand filter (BSF) allows households to directly reduce contamination and increase the quality of their drinking water. This study aimed to develop an understanding of perceived community acceptability and feasibility related to pre- and post-implementation of a BSF pilot project in rural Maasai households in the Ngorongoro Conservation Area (NCA), Tanzania. The study was guided by the Integrated Behavioral Model for Water Sanitation and Hygiene interventions (IBM-WASH) to understand the various factors influencing end-user perceptions of the BSF. In-depth interviews, group discussions and think tanks were conducted among a cross-section of community members, stakeholders, and other actors from May 2016 to September 2017. The data were analyzed using a thematic content analysis approach. A range of perceived contextual, technological, and psychosocial factors were found to potentially affect the acceptability and feasibility of BSF adoption in the NCA, highlighting the complex layers of influences in the setting. Whilst the BSF is seemingly an accepted option to treat water within the NCA, the community identified key barriers that may lower BSF adoption. The application of the IBM-WASH model served as a useful framework for evaluating the introduction of the BSF, identifying insights into contextual, technological, and psychosocial community factors.

Predictors of Puberty Health Behaviors Based on Integrated Behavioral Model Among Girl’s High School Students in Birjand in 2020

Background: From the beginning of puberty, girls are exposed to many physical-psychological problems that experience for the first time, so it is very important to pay attention to puberty health. Objectives: The aim of this study was to determine the predictors of puberty health behaviors based on application of the Integrated Behavioral Model (IBM) among girls’ high school students. Methods: This descriptive-analytical study was performed on 265 first grade girls’ high school students in Birjand in 2020 using multi-stags sampling. Data collection tools were a researcher-made questionnaire including demographic information and questions related to IBM constructs that were completed self-administered. Data were analyzed by SPSS 19 software using Pearson correlation coefficient and linear regression analysis. Results: Pearson correlation showed that all IBM constructs except experiential attitude and control belief had a significant correlation with puberty health behaviors (P < 0.04). In total, about 54% of the behavior variance was explained by three variables of intention, self-efficacy, and mother's job, among which intention was the strongest predictor of puberty health behaviors (P = 0.001). Conclusions: The results of the present study indicate the high predictive power of IBM for investigating puberty health behaviors. Therefore, using this model to design educational interventions and improve behaviors in the field of maturity is recommended.

Application of Integrated Behavioral Model (IBM) to measure intention to get early screening and treatment of Sexually Transmitted Infections (STIs) among HIV at- risk sub-populations in Ethiopia

Background: Sexually Transmitted Infections (STIs) increase the risk of contracting Human Immunodeficiency Virus (HIV). Hence, early screening and treatment of STIs as a behavioral practice will reduce the odds of HIV infection among at risk and vulnerable sub-populations. To that end, HIV prevention strategies need to design evidence-based interventions using behavioral models or theories to help at-risk individuals adopt early screening and treatment of STI as preventive health behavior. In this study, commercial sex workers were considered as HIV at-risk sub-populations. Objective: Measuring to what extent that Integrated Behavioral Model constructs explain individuals’ intention to practice early screening and treatment of sexually transmitted infections as healthy behavior of interest in HIV prevention. Design: Integrated Behavioral Model (IBM) measurement survey was conducted using Respondent Driven Sampling (RDS) in six towns located in the main transport corridors of Ethiopia. Respondents’ answers to model construct-based questions and intention to practice the health behavior of interest were measured using Likert Scale. Analysis was done to assess the correlation and level of association of model construct-based questions with intention to practice the preventive health behavior. Results: Respondents’ attitude explained 32%, perceived control 2%, normative influence 21%, and self-efficacy 53 % of their intention to get early screening and treatment of sexually transmitted infections. Conclusion: Self-efficacy explained the variability of respondents’ intention to get early screening and treatment of STIs most, while perceived control was the least. Hence, HIV prevention behavioral interventions targeting early screening and treatment of STIs should give high emphasis to self-efficacy. Keywords: Behavior; integrated behavioral model; sexually transmitted infections; human immunodeficiency virus.

Determinants of Exclusive Breastfeeding Intention in Pregnant Women in Birjand in 2020: Application of Integrated Behavioral Model

Background: Exclusive breastfeeding (EBF) for the first six months of life is the best nutritional option for the growth and development of infants. EBF has a unique biological and emotional effect on the health of the infant and mother. Despite this, the prevalence of EBF is lower than the standard recommended by the World Health Organization (WHO). Objectives: The current study aimed to investigate the determinants of exclusive breastfeeding’ intention based on the Integrated Behavioral Model (IBM) in pregnant women living in Birjand. Methods: Following a descriptive-analytical design, 292 pregnant women referred to health centers of Birjand (Iran) in 2020 were recruited. Sampling was performed using the multistage cluster random technique. Data were collected using a researcher-made questionnaire based on the constructs of IBM. Analyses were conducted by SPSS-19 using Pearson correlation and regression analysis at the significance level of P < 0.05. Results: There was a significant positive correlation between EBF intention and the mean value of different constructs of IBM (P < 0.001). According to the results of regression analysis, perceived self-efficacy, experiential attitude, and injunctive norm could predict EBF intentions (R2 = 0.58). Conclusions: This study demonstrated that a considerable part of the changes relevant to EBF intention could be predicted by the constructs of the integrated behavioral model. Hence, using this model to analyze other health behaviors is a promising option.

Exploring the Role of Media Use Within an Integrated Behavioral Model (IBM) Approach to Vote Likelihood

Political interest is a key predictor of likelihood to vote. We argue that the political interest–vote intention relationship can be explained by well-established theories that predict behavior across domains (e.g., theory of reasoned action, theory of planned behavior). Relying on the integrated behavioral model, we propose a core mediation model with vote likelihood (i.e., behavioral intention) as the dependent variable. Two types of media use (conservative and liberal–moderate) are then assessed in relation to the core model. We explore the ways in which our results contribute to theory and outline a research agenda.

Validation of Family Planning tool in the Pastoralist Community

Background: Pastoralist community, Afar, women felt that they are embedded in strong cultural and religious perspectives which promotes a high number of children, and discourages family planning (FP) use. They are multifaced factors which hinder women not to use FP and it is time to develop a context-based tool to understand the situation at the ground. However, we have a dearth of evidence on a reliable and valid tool. Therefore, this study aims in developing a reliable and valid tool that considers the women's knowledge, male involvement, attitude, and belief about whether most people approve or disapprove of the behavior to use or not use of FP. Methods: A total of 891 married women participated in the study. Reviewing the literature, piloting, pretesting, and collecting the actual data were the steps we used to develop a reliable and valid tool. We used the integrated behavioral model (IBM) as a conceptual framework for developing the tool. The developing tool consists of 1) knowledge 2) perceived male involvement and 3) constructs of integrated behavioral model (IBM); expressional and instrumental attitude, subjective norm, self-efficacy, perceived control and intention to use of FP. The IBM items composed of direct and indirect measurement. In the analysis of the data, exploratory and confirmatory factor analysis was done. Independent t. test with cohen’s d was used to calculate the effect size. The correlation coefficient was carried between the direct and indirect measurements of the items of the integrated behavioral model (IBM). Results: A total of 891 pastoralist married women were included in the analysis of the reliability and validity of the tool. The mean age of the participants was 26.74(±6.45). The KMO value for all items was greater than 0.83 with a Bartlett test of sphericity of (p<0.00). Thirteen items were used to measure the knowledge of the respondent towards FP use. The tool had 64.92 variances explained and Cronbach alpha of 0.85. Acceptable values of the fitness indices were obtained in the confirmatory factor analysis (CFA) The items of knowledge towards FP had normed chi-square of 4.5, RMSEA with 90% CI of 0.064(0.056,.0.071), SRMR of 0.039, CFI of 0.969 and TLI of 0961. All the developed items had a Cohen’s d ranges from 0.5 to 2. Moreover, the correlation test of the IBM ranges from 0.6 to 0.7 which shows a higher correlation between the measurement direct and indirect items.Conclusion: The pastoralist community version of the FP questionnaire is a valid and reliable tool and can be used to measure future family planning use. The indirect measurement of the IBM constructs was a good item to measure FP. However, as a limitation of the study respondents may face difficulty in realizing the difference one item to another especially when items on the scale look so similar to her.