Deng Qingwen, Liu Wenbin
Department of Health Management, School of Public Health, Fujian Medical University, Fuzhou, 350122, People's Republic of China.
School of Public Health, Fudan University, Shanghai, 200032, People's Republic of China.
Risk Manag Healthc Policy. 2022 Feb 9;15:179-191. doi: 10.2147/RMHP.S349387. eCollection 2022.
Liver cancer is a globally acknowledged threat to public health, and there is a critical and urgent need to determine factors associated with the use of liver cancer screening and to further promote its use.
To examine whether the extended theory of planned behavior (TPB) incorporating social norms predicts physicians' intentions to use liver cancer screening and to identify the associated factors quantitatively, using contrast-enhanced ultrasound (CEUS) as an example.
A research framework was established by adding social norms to the TPB, based on which the questionnaire for this study was developed. Through multistage random sampling, a cross-sectional questionnaire survey was conducted among 292 physicians in Fujian and Jiangxi provinces. Due to the multicollinearity problem of the data, ridge regression was applied to determine the influencing factors of physicians' intentions to use CEUS.
Most participants (87.30%) reported that they were willing to use liver cancer screening in their clinical practice. The scores of TPB variables were generally higher than those of social norms variables. Ridge regression results indicated that the proposed model was explanatory, which has accounted for 73.5% of the total variance in physicians' intentions. Analyses also illustrated the significant role of TPB variables (attitude and perceived behavioral control) and social norms variables (personal norms, organizational norms, and industrial norms) on physicians' intentions to use CEUS.
The study extended the TPB by including the concepts of social norms, which is not only conducive to expanding the knowledge of factors associated with physicians' intentions to use liver cancer screening, but also provides implications for developing strategies to promote the use of certain health services or products, such as playing the role of core members, holding panel meetings, and establishing information push systems.
肝癌是全球公认的对公众健康的威胁，迫切需要确定与肝癌筛查使用相关的因素，并进一步推广其使用。
以超声造影（CEUS）为例，研究纳入社会规范的扩展计划行为理论（TPB）是否能预测医生使用肝癌筛查的意愿，并定量识别相关因素。
在TPB的基础上增加社会规范，建立研究框架，并据此编制本研究的问卷。通过多阶段随机抽样，对福建和江西两省的292名医生进行横断面问卷调查。由于数据存在多重共线性问题，采用岭回归确定医生使用CEUS意愿的影响因素。
大多数参与者（87.30%）表示愿意在临床实践中使用肝癌筛查。TPB变量的得分普遍高于社会规范变量。岭回归结果表明，所提出的模型具有解释力，解释了医生意愿总方差的73.5%。分析还说明了TPB变量（态度和感知行为控制）和社会规范变量（个人规范、组织规范和行业规范）对医生使用CEUS意愿的重要作用。
本研究通过纳入社会规范的概念扩展了TPB，这不仅有助于拓展与医生使用肝癌筛查意愿相关因素的知识，还为制定促进某些健康服务或产品使用的策略提供了启示，如发挥核心成员的作用、召开小组会议和建立信息推送系统。
