Maternal malnutrition is pervasive throughout the world, notably in sub-Saharan Africa (SSA), including Ethiopia. This study aimed to assess the effect of nutrition education on the nutritional status of pregnant women in urban settings in Southeast Ethiopia. A community-based two-arm parallel cluster randomized controlled trial was conducted among 447 randomly selected pregnant women attending antenatal care (224 intervention and 223 control). We used a multistage cluster sampling technique followed by systematic sampling to select the pregnant women. Pregnant women who participated in the intervention arm received six nutrition education sessions. Women in the control group received standard care. A nonstretchable mid-upper arm circumference (MUAC) tape was used to measure the MUAC. A linear mixed effects model (LMM) was used to evaluate the effect of the intervention on MUAC, accounting for the clustering. The net mean ± standard error of MUAC between the intervention and control groups was 0.59 ± 0.05 (P < 0.0001). The multivariable LMM indicated that having received nutrition education interventions (β = 0.85, 95% CI 0.60, 1.12, P < 0.0001) improved the MUAC measurement of pregnant women. Thus, nutrition education during pregnancy will combat undernutrition among pregnant women.Trial Registration: Clinicaltrials.gov (PACTR202201731802989), retrospectively registered on 24/01/2022.

Widespread and indiscriminate use of pesticides has become one of the most important environmental and public health problems around the world. This study was conducted with the aim of applying the theory of planned behavior model to investigate the knowledge, attitude, and behavior of tomato growers in the face of pesticides in agricultural lands located in Kurdistan province, western Iran. We included 300 tomato growers in this study and they filled up a standard TPB questionnaire containing questions about basic information, knowledge, attitude and behavior about pesticides and their actions for disposing of the residual spray solution, washing place of pesticide sprayer, and the disposal of water from washing the equipment. Most of the respondents, 86.7 %, had not participated in promotional classes on how to dispose of the residual solution. Approximately 46.15, 38.46, and 15.39 % of pesticides contained moderately toxic, slightly toxic and practically non-toxic compounds, respectively. More than two-thirds (89 %) of the tomato growers stated that they leave the water from washing the equipment in the field. In addition, among the three variables of TPB, attitudes had the highest score (3.38), which indicated the positive to relatively neutral attitude of farmers towards the safe use of pesticides. These findings can be useful for planners and environmental organizations to make effective interventions to reduce environmental pollution caused by pesticides. Since the incorrect use of pesticides is one of the important environmental and health factors, education and awareness programs can help farmers to consider the correct use of pesticides and environmental protection more.

Background: Physicians often prescribe original biologic products to patients who have not used them before and are reluctant to switch to biosimilars. Biosimilars are highly similar versions of already-approved biologics, but healthcare professionals typically hesitate to transition patients from the original products to biosimilars. This study aims to investigate the factors that influence U.S. healthcare professionals\' intentions to use biosimilars. Methods: A cross-sectional study was conducted. 510 participants were eligible healthcare professionals (279 physicians and 231 pharmacists). The theory of planned behavior (TPB) is used to identify which factors affect healthcare professionals\' intentions. Descriptive statistics, chi-square, and the logistic regression model tested the TPB constructs as predictors of intentions toward biosimilars. Results: Among 279 physicians, most were aged 61 and above, with high (n = 142) and low (n = 137) intentions. Male physicians constituted 71% of the population. Attending physicians (66.3%) showed consistent perceptions towards biosimilars, primarily in the private sector (76.3%). Pharmacists (n = 231), a higher percentage of females demonstrated higher intentions compared to males (35.5% vs. 28.1%); the majority were community pharmacists. Associations between years of practice and intentions were significant. Positive correlations existed between beliefs and intentions, except for normative beliefs. Conclusions: This study revealed diverse attitudes among healthcare professionals towards biosimilars in the USA. Pharmacists and physicians, especially those with limited experience, require ongoing education on biosimilar manufacturing pathways. This education supports the appropriate use of biosimilars and helps standardize federal and state legislation.

The consumption of edible vegetable oil is an important source of essential fatty acids and vitamin E for the human body. Guiding residents to consume scientifically and reasonably control the intake of edible oils is an important part of promoting the construction of a healthy China. Currently, Chinese residents have an insufficient understanding of the scientific consumption of edible oils, leading to an intake exceeding the dietary recommendations, resulting in excessive fat intake and increasing the risk of chronic diseases such as obesity and cardiovascular diseases. Based on the Theory of Planned Behavior (TPB) and using Structural Equation Modeling (SEM), this study analyzed the cognitive preferences and willingness to pay a premium for edible vegetable oils among urban consumers in China. The survey included 1098 Chinese urban consumers of vegetable oils. The research found that attitudes, health value, monetary value, and environmental endowment of urban residents are the main predicting factors of the intention to purchase high-quality vegetable oils. This study confirms the applicability of the Theory of Planned Behavior in the consumption of high-quality vegetable oils and provides theoretical contributions and insights for Chinese enterprises and policymakers in formulating marketing strategies for vegetable oils.

The purpose of this study is to examine factors affecting green food product purchase intentions and, specifically, to specify the role of past behaviour in shaping purchase intentions for these products and in switching to environmentally friendly food purchases. As for the theoretical framework, the Theory of Planned Behaviour (TPB) was used, with certain modifications proposed; namely, additional constructs were included: past behaviour, knowledge, and trust in green food. Data were collected from 650 green product consumers in Poland. The online survey method was employed. The research revealed that past behaviour is a powerful indicator, which, to the greatest extent, explains purchase behaviours towards green food. This paper explores the fact that attitudes are also strongly linked to green food purchase intentions. Moreover, social norms, trust, and knowledge also have a positive effect on the intention to purchase green food products. Perceived behavioural control is relatively weak but statistically significant. The extended model explains 57% of the variance in green food purchase intentions. By incorporating past behaviour into the TPB, this study gives a new insight into understanding the inconsistency between positive attitudes towards green food and real purchase behaviours. The results of the study provide managers working in the food sector with relevant guidelines for the design of marketing strategies.

UNASSIGNED: Attention to local food among tourists is increasing day by day. However, studies on the behavior and intention of tourists towards consuming these foods are few. Limited studies in this field prompted us to help fill the research gap by doing this research.
UNASSIGNED: This study aims to use the extended theory of planned behavior (TPB) by adding risk perception (RP) to investigate the tourists\' intentions towards local food (TILF) in Iran. The extended model tested 313 tourists visiting local food supplies.
UNASSIGNED: Results show that the extended TPB explains 87.8% of tourist intention variance. Three variables of the original TPB had positive impacts on tourists\' intentions. A notable result of this study was the realization of a negative relationship between RP and TILF.
UNASSIGNED: This research has provided recommendations to strengthen tourists\' intentions toward local foods by influencing their attitudes, mental beliefs, perceived behavioral control, and risk perception.

Consumers\' unsustainable behavior contributes to environmental degradation and impedes sustainability. Using green products is one way to reduce this effect and promote environmental growth. Therefore, this study aims to investigate the green factors that impact young customers\' behavioral intentions regarding green products. For this purpose, the researcher designed a research model based on the expanded theory of planned behavior (TPB). The study adopted a two-stage, hybrid model using partial least square-structural equation modeling (PLS-SEM) and necessary condition analysis (NCA) to evaluate and validate the results. A sample of 382 undergraduate students was gathered using a convenience sampling approach. The results reveal that green TPB perception (GTP), green price sensitivity (GPS), green product trust (GPT), and green product value (GPV) are significantly and positively correlated with green behavioral intention (GBI). This study\'s main contribution is adding a brand-new higher-order construct, GTP, in the environmental and marketing literature and validating its effect on GBI. Again, environmental awareness moderates the association between GPS and GBI. Furthermore, the NCA\'s findings indicated that these variables are necessary to various degrees for students\' GBI. Decision-makers may use the study\'s insights to create successful regulations to better understand young customers and develop appropriate green initiatives for sustainable development.

OBJECTIVE: The diabetics\' lack of knowledge about self-care and incorrect beliefs in this care are the reasons for their admission to hospitals. The present study aimed to examine the impact of education based on the theory of planned behavior (TPB) on intention, self-care behavior, and glycosylated hemoglobin (HbA1c) levels in patients with Type 2 Diabetes.
METHODS: The present study was conducted on 60 diabetic patients who were randomly classified into intervention and control groups. In the intervention group, self-care education based on TPB was held, but the control group only received routine care. The data were collected using a fourpart questionnaire including characteristics, items of patients\' knowledge, items of TPB constructs, and items of diabetes self-care. Data were analyzed in SPSS software.
RESULTS: In intervention group, mean score of self-care behavior and its domains significantly changed from (total: 52.26±14.75, diabetic diet: 22.20±6.05, exercise: 5.17±4.04, blood sugar testing: 5.03 ± 4.15, medication: 5.40±2.28, foot care: 13.47±8.42) into 76.66±8.87, 29.43±5.48, 7.60±2.60, 8.73±2.31, 6.48±1.09, 23.53±3.09, respectively three months after intervention (p<0.01). In this case, these changes were not seen in the control group. The mean level of HbA1c in the intervention group (6.38±0.16) was significantly lower than before the intervention (7.56±1.08) and the control group (8.02±0.25) three months after intervention (p<0.01).
CONCLUSIONS: Education based on the TPB was effective in improving the patients\' self-care behavior and HbA1c index. Therefore, we suggest all medical centers to use the TPB as an effective and low-cost educational approach to improve diabetics\' self-care behavior and health.

Choosing low-carbon transportation is an effective strategy for mitigating carbon emissions. This study utilized the Theory of Planned Behavior (TPB) framework to investigate the influences of proactive personality and perceived consumer effectiveness on low-carbon travel intention. By surveying urban residents, we examined the effects of subjective norm, behavioral attitude, perceived behavioral control, proactive personality, and perceived consumer effectiveness on low-carbon travel intention. The findings indicated that subjective norm, behavioral attitude, perceived behavioral control, proactive personality, and perceived consumer effectiveness have positive impacts on low-carbon travel intention. Notably, subjective norms have the greatest influence on behavioral intention, followed by proactive personality, while perceived consumer effectiveness has the least impact. Furthermore, this study identified attitude and perceived behavioral control as mediating factors between proactive personality, perceived consumer effectiveness, and low-carbon travel intentions. These findings reaffirmed the universal applicability of the TPB in individual decision-making contexts. The results also suggested that to promote low-carbon travel, it is crucial to not only focus on the social aspects of urban residents but also leverage the potential of individuals with a proactive personality.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) was applied as an example, and the Theory of Planned Behavior (TPB) was used as a conceptual model. This study aimed to explore the impact of subjective norms (SNs), attitude towards the behavior (ATT), and perceived behavioral control (PBC) on the intention of the public for regular vaccination during COVID-19. The outcomes can provide certain recommendations for relevant policymakers in developing targeted health education intervention programs in the event of similar events.
METHODS: An online survey was performed between 17 April and 14 May 2021, via the online survey platform \"WENJUANXING\". The multistage stratified cluster sampling was employed, and 2098 participants (1114 males; 53.10%) with a mean age of 31.22 years (SD = 8.29) completed the survey. The survey covered the factors influencing the public\'s intention to receive future regular vaccinations during COVID-19 based on TPB. The effects of different variables on the public\'s vaccination intention were analyzed using hierarchical stepwise regression.
RESULTS: The public\'s intention to receive the COVID-19 vaccine (i.e., behavioral intention) in the future was taken as the dependent variable. Gender, age, marital status, education level, per capita monthly household income, vaccine-related knowledge, whether the COVID-19 vaccine was received, subjective norms (SNs), attitude towards the behavior (ATT), and perceived behavioral control (PBC) were used as independent variables. In this way, a hierarchical stepwise multiple regression model was developed. It can be seen from the final model that gender, age, vaccine-related knowledge, vaccination, attitude, SNs, and PBC were all influential factors in the public\'s intention to get vaccinated in the future, with R2 = 0.399 and adjusted R2 = 0.397 (p < 0.001).
CONCLUSIONS: TPB explains the intention of the public to receive future vaccinations to a large extent, and ATT and SNs are the most important influencing factors. It is suggested that vaccine intervention programs be developed to enhance public awareness and acceptance of vaccination. This can be achieved in three aspects, namely, improving the ATT of the public, SNs, and PBC. Furthermore, the influence of gender, age, vaccine knowledge, and previous vaccination behavior on vaccination intention should be taken into account.