Effects of Health Belief Model Interventions on Preventive Beliefs in Secondhand Smoke Exposure

Effects of Feedback, Education, and Social Media Interventions Based on the Health Belief Model on Preventive Beliefs in Adults Exposed to Secondhand Smoke At Home.

The aim of this study was to compare the effects of feedback, interactive education, and social media interventions based on the health belief model on protective beliefs in adults at risk of exposure to secondhand smoke at home.

Study Overview

• Status: Not yet recruiting
• Conditions: Secondhand Smoke Exposure
• Intervention / Treatment: Behavioral: Exposure feedback; Behavioral: Interactive education; Behavioral: Social media post

Detailed Description

Secondhand smoke (SHS) exposure, also known as environmental tobacco smoke, passive smoke or involuntary smoke, is caused by the burning of cigarettes and other tobacco products and the smoke exhaled by a smoker. Although Turkey is one of the best countries in combating SHS exposure, one in four adults is exposed to SHS at home. One of the most important reasons for this exposure is the lack of deterrent policies for the home environment, which is considered a private area. It is entirely possible for non-smoking individuals to be protected from SHS exposure at home through their own efforts. In this context, the knowledge, behaviors and perceptions of non-smoking adults about exposure are important in preventing or reducing SHS exposure at home. Interventions based on the behavior change model can be effective in developing protective behaviors in adults at risk of SHS exposure at home. Individual and group interventions using multiple educational materials and methods based on the Health Belief Model (HBM) (SHS exposure feedback, interactive group education and social media sharing) can develop protective behaviors in individuals at home.

• Study Type: Interventional
• Enrollment (Estimated): 93
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ercan Asi; Phone Number: +905342087249; Email: ercanasi@akdeniz.edu.tr

Study Locations

• Turkey
  • Konyaaltı
    • Antalya, Konyaaltı, Turkey, 07070
      • Akdeniz University Faculty of Nursing
      • Contact: Ercan Asi; Phone Number: +905342087249; Email: ercanasi@akdeniz.edu.tr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

İnclusion Criteria

• Non-smokers aged 18-64 who live with at least one smoker,
• Literate individuals,
• Individuals who own a smartphone,
• Individuals who voluntarily agree to participate in the study.

Exclusion Criteria:

• Individuals who do not speak Turkish,
• Pregnant individuals,
• Participants who have been living apart from SHS exposure sources in the week leading up to data collection.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Exposure feedback group	Behavioral: Exposure feedback; Determining the actual SHS exposure risk level and providing feedback.; Determining the urinary cotinine test result and providing feedback.; Feedback on the consistency or difference between the perceived SHS exposure risk level and the actual SHS exposure risk level.
Experimental: Interactive education group	Behavioral: Exposure feedback; Determining the actual SHS exposure risk level and providing feedback.; Determining the urinary cotinine test result and providing feedback.; Feedback on the consistency or difference between the perceived SHS exposure risk level and the actual SHS exposure risk level.; Behavioral: Interactive education; Slide presentation, video presentation, Q&A, evaluation of learning and discussion of results
Experimental: Social media group	Behavioral: Exposure feedback; Determining the actual SHS exposure risk level and providing feedback.; Determining the urinary cotinine test result and providing feedback.; Feedback on the consistency or difference between the perceived SHS exposure risk level and the actual SHS exposure risk level.; Behavioral: Social media post; Sharing informational materials such as messages, brochures, and videos related to SHS exposure, including ways to protect yourself from SHS exposure and the adverse health effects of SHS exposure.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Health belief model scale for prevention behaviors of secondhand smoke exposure (HBM-SHS)	The 35-item scale, scored on a five-point Likert scale from "Strongly Disagree (1)" to "Strongly Agree (5)," assesses six subdimensions: "perceived susceptibility," "perceived seriousness," "perceived benefits," "perceived barriers," "self-efficacy," and "behavioral cues." Items on "perceived susceptibility" and "perceived barriers" are reverse coded. Scores range from 35 to 175, with higher scores indicating stronger health beliefs about SHS exposure and greater beliefs in each subdimension.	Baseline and at first month later after intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Secondhand Smoke Exposure Risk Assessment	Risk assessment is conducted through four questions addressing whether there is a smoker in the household, household tobacco use rules, tobacco use in enclosed areas, and the time since the last use. Responses are scored categorically: absence of risk is scored as 0, while the presence and intensity of risk are scored as 1 or more. A score of at least one indicates "risk." SHS exposure risk is scored from 0 to 10, with any score of 1 or above indicating the presence of risk. Total risk assessment scores are represented on a real risk scale of 0-10. According to expert evaluations, the content validity index (CVI) of the questions assessing participants' SHS exposure risk level is 0.86.	Baseline and at first month later after intervention
Actual Risk Assessment	In adults at risk of SHS exposure, urinary cotinine analysis will be conducted using a cotinine urine test kit. The test detects cotinine in the urine, indicating SHS exposure. The strip is dipped into the urine sample for 10 seconds, and the result is read within 5 minutes. In a negative result, both the control (C) and test (T) lines will appear, while in a positive result, only the control line (C) will appear. If neither the C nor T lines are visible, or if only the T line appears, the test is invalid.	Baseline and at first month later after intervention
Perceived SHS Exposure Risk	In adults, SHS exposure risk will be assessed based on the perceived level of risk. Participants' awareness of SHS exposure will be measured by their responses to the question, "How would you describe your risk of being exposed to SHS in your home?" with options such as "No risk at all," "Somewhat at risk," or "At very high risk." Additionally, participants' perceived SHS exposure risk level will be evaluated based on their numerical responses to the question, "What would your risk of SHS exposure in your home be on a scale from 0 to 10?" Each number will represent the participant's perceived (exposure risk probability) risk.	Baseline and at first month later after intervention
ThirdHand Smoke Beliefs Scale (BATHS)	This scale was developed by Haardörfer and colleagues in 2017 to identify beliefs about third-hand smoke (THS). The scale includes 5 items related to the health effects of THS and 4 items regarding its persistence in the environment. The items are rated using a 5-point Likert scale, with the following coding: 5 = Strongly agree, 4 = Agree, 3 = Neutral, 2 = Disagree, 1 = Strongly disagree. The total score of the scale is obtained by dividing the sum of the item scores by the number of items. A score closer to 5 for each item indicates the individual believes in the health and environmental effects of THS, while a score closer to 1 indicates disbelief.	Baseline and at first month later after intervention

Collaborators and Investigators

• Sponsor: Akdeniz University

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2025
• Primary Completion (Estimated): June 10, 2025
• Study Completion (Estimated): December 10, 2025

Study Registration Dates

• First Submitted: November 8, 2024
• First Submitted That Met QC Criteria: November 8, 2024
• First Posted (Actual): November 12, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 12, 2025
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: exposure; secondhand smoke; health belief model
• Other Study ID Numbers: AU-NF-EA-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No