Objectives. Despite a child restraint system (CRS) law in the Kingdom of Saudi Arabia (K.S.A.), compliance has been minimal. We explored the salient behavioral, normative and control beliefs, which may predict intentions of CRS use in K.S.A; identified which of them independently predicted attitude, subjective norms (SN), and perceived behavioral control (PBC); and tested the effect of attitude, SN, and PBC on the intent for CRS use.
Methodology. This study was conducted in two stages. During the qualitative stage two focus groups were conducted (n=25). The identified beliefs were incorporated into a survey following Ajzen's guidelines. 196 pregnant women completed surveys at Dallah Hospital, Riyadh during June, 2013. In a separate observation to measure the CRS usage, two nurses discretely monitored 150 women leaving hospital following maternity stay. Logistic regression was used to determine the association between intent and TPB constructs; and salient beliefs and respective composite belief scores.
Results. Lack of health education and law enforcement, cultural pressure, advice from family, desire to stay close to the child, family size were key factors stated. Logistic regression model with TPB constructs and covariates as predictors of CRS usage intent was statistically significant (χ2=64.986, p<0.0001, df=11) and correctly classified 72.4% of the cases. There was an increase in odds of intent to use CRS for attitudes (31.5%, p<0.05), SN (55.3%, p<0.001), and for PBC (76.9%, p<0.001). The logistic regression models testing the association of the relevant set of composite belief scores were also statistically significant for attitudes (χ2=16.803, p<0.05, df=6), SN (χ2=29.681, p<0.0001, df=5), and PBC (χ2=20.516, p<0.05, df=8). The behavioral observation showed that none of 150 women observed used CRS for their newborn.
Conclusion. Attitude, SN, and PBC were significantly and independently associated with higher intent for CRS usage. Three beliefs were found to be significantly and independently associated with respective TPB constructs. While TPB appears to be useful in identifying beliefs related to CRS usage intentions in K.S.A., the results of the behavioral observation indicate that intentions may not be related to the actual usage of CRS in K.S.A. Further studies are recommended to examine this association.
|Commitee:||Hopp, Joyce W., Marshak, Helen H.|
|School:||Loma Linda University|
|Department:||Health Promotion and Education|
|School Location:||United States -- California|
|Source:||DAI-A 77/01(E), Dissertation Abstracts International|
|Subjects:||Middle Eastern Studies, Health education|
|Keywords:||Car seats, Child restraints, Infant restraints, Saudi Arabia, Theory of planned behavior|
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