BACKGROUND: Chronic pain is a debilitating and common health issue. General Practitioners (GPs) often prescribe opioids to treat chronic pain, despite limited evidence of benefit and increasing evidence of harms, including prescription Opioid Use Disorder (pOUD). Australian GPs are worried about the harms of long-term opioids, but few are involved in the treatment of pOUD. There is little research on GPs\' experiences diagnosing and managing pOUD in their chronic pain patients.
METHODS: This qualitative research used semi-structured interviews and a case study to investigate GPs\' experiences through the lens of the Theory of Planned Behaviour (TPB). TPB describes three factors, an individual\'s perceived beliefs/attitudes, perceived social norms and perceived behavioural controls. Participants were interviewed via an online video conferencing platform. Interviews were transcribed verbatim and thematically analysed.
RESULTS: Twenty-four GPs took part. Participants were aware of the complex presentations for chronic pain patients and concerned about long-term opioid use. Their approach was holistic, but they had limited understanding of pOUD diagnosis and suggested that pOUD had only one treatment: Opioid Agonist Treatment (OAT). Participants felt uncomfortable prescribing opioids and were fearful of difficult, conflictual conversations with patients about the possibility of pOUD. This led to avoidance and negative attitudes towards diagnosing pOUD. There were few positive social norms, few colleagues diagnosed or managed pOUD. Participants reported that their colleagues only offered positive support as this would allow them to avoid managing pOUD themselves, while patients and other staff were often unsupportive. Negative behavioural controls were common with low levels of knowledge, skill, professional supports, inadequate time and remuneration described by many participants. They felt OAT was not core general practice and required specialist management. This dichotomous approach was reflected in their views that the health system only supported treatment for chronic pain or pOUD, not both conditions.
CONCLUSIONS: Negative beliefs, negative social norms and negative behavioural controls decreased individual behavioural intention for this group of GPs. Diagnosing and managing pOUD in chronic pain patients prescribed opioids was perceived as difficult and unsupported. Interventions to change behaviour must address negative perceptions in order to lead to more positive intentions to engage in the management of pOUD.

BACKGROUND: Although there is evidence of the key role played by focusing on local knowledge in designing appropriate interventions regarding modifiable risk behaviours among patients living with diabetes and hypertension in Mangochi (and Malawi), little is known about local salient beliefs.
OBJECTIVE: With a focus on the theory of planned behaviour as a theoretical lens, this study aimed to identify salient beliefs about modifiable risk behaviours among patients with diabetes, hypertension or both in Mangochi, south-eastern Malawi. Specifically, the objectives were to identify advantages and disadvantages (behavioural salient beliefs), people who approve or disapprove (normative salient beliefs) and enablers and barriers (control salient beliefs) for measures to change modifiable risk behaviours among patients with diabetes, hypertension or both in Mangochi, Malawi.
METHODS: A hypertension diabetes clinic at Mangochi District Hospital, south-eastern Malawi.
METHODS: A formative qualitative study of a quasi-experimental trial was conducted among 25 patients, purposefully sampled, who were living with diabetes, hypertension or both at Mangochi District Hospital in February 2019. Researchers conducted in-depth interviews with patients using an interview guide informed by the theory of planned behaviour\'s elicitation interview guide. Thematic content analysis was used to identify emerging themes.
RESULTS: A total of 25 participants were recruited, of which 12 (48%) were living with diabetes. Five thematic areas emerged from this analysis: physical and psychological fitness, social disconnection, perceived support systems, perceived enablers and perceived barriers to change.
CONCLUSIONS: Appropriate words for each salient belief were identified. Future researchers should use the identified salient beliefs when designing interventions based on the theory of planned behaviour in diabetes and hypertension.Contribution: The paper adds to the body of knowledge informing the use of theory of planned behavior in addressing modifiable risk factors among practitioners, specialists and academics in primary care and Family Medicine in the field of noncommunicable diseases in Mangochi Malawi and beyond.

BACKGROUND: Preconception care is a promising new approach to improve the health of future children through primary intervention. Although most women have a positive attitude towards preconception care, women often do not seek preconception care for themselves.
OBJECTIVE: To explore women\'s hesitancy to seek preconception counselling.
METHODS: An empirical-analytic approach was used to explore women\'s hesitation to seek preconception counselling. In-depth, semi-structured, face-to-face interviews (n = 16) of women desiring to conceive were conducted, and responses were analysed using the determinants \'attitude\' and \'subjective norms\' of the Theory of Planned Behaviour of Ajzen.
RESULTS: The interviewed women expressed a positive attitude towards preconception care in general but were hesitant about seeking preconception care themselves. Women seemed to regard themselves as not being in the target group for preconception care. Additionally, we identified the following four subthemes of subjective norms around the process of becoming pregnant: planning, publicity, information on fertility and artificiality.
CONCLUSIONS: Women do not consider themselves to be part of the target group for preconception care. In some aspects, subjective norms around the process of becoming pregnant may conflict with the current practice of preconception care. Recommendations are provided.