Health Education and Health Promotion

Abstract Aims: This systematic review aims to identify the effectiveness of the COM-B-based intervention model on hypertension management behavior and to explore the barriers and facilitators of COM-B interventions in changing hypertension behavior.
Information & Methods: This systematic review uses the PRISMA guide. The databases of Scopus, PubMed, ProQuest, and Web of Science were searched from January 2015 to April 2025. The search strategy uses keywords and Boolean operators. The selection of articles is based on the research's inclusion and exclusion criteria. This study used the Joanna Briggs Institute Critical Appraisal Checklist to assess the quality of the included studies.
Findings: Twelve studies involving 1,961 participants from China, the United States, Uganda, Nepal, India, and Ghana were included. 5 quantitative articles showed that COM-B-based interventions had clinical significance in terms of blood pressure values and behavioral significance, including blood pressure control, self-management, dietary patterns, and others. 7 qualitative articles report on barriers and facilitators to behavior change, including low health literacy, medical costs, pill fatigue, and social factors. Meanwhile, facilitators of behavior change are family support, interactive education, and treatment facilities such as digital reminders.
Conclusion: The COM-B model is effectively used to evaluate barriers and facilitators to the performance of health behaviors. Identified barriers and facilitators can be used to develop COM-B-based behavior change interventions. Behavioral changes are evident in the results of COM-B-based intervention research, which significantly influence clinical outcomes.

Abstract Aims: Nurturing care during episodes of acute illness is essential to support optimal child development, yet the delivery remains poorly studied in Indonesia. The objective of this study was to determine maternal knowledge, attitudes, and practices related to nurturing care among mothers of acutely ill children under 5 years old in Indonesia.
Instrument & Methods: It is a descriptive, cross-sectional study conducted in November 2024 at Banguntapan II PHC. One hundred and four mother-child pairs were studied using systematic random sampling. Information was gathered through validated questionnaires on knowledge, attitudes, and practices. Descriptive statistics, Pearson correlation, and ANOVA test were performed.
Findings: The knowledge (8.35±1.83) and attitudes (95.64±3.36) of mothers were high regarding nurturing care. Practice scores, however, were significantly lower (58.56±7.19), indicating a significant knowledge-practice disparity. Correlation analysis revealed a moderate positive relationship between knowledge and attitudes (r=0.557), but no significant correlations were found between knowledge-practices or attitudes-practices. Notably, no statistically significant differences were observed across demographic factors, including age, occupation, education level, or family income.
Conclusion: These results highlight key areas for targeted interventions, particularly in nutritional and early stimulation activities and in child safety practices during periods of illness, to support optimal development.

Abstract Aims: Mobile health (mHealth) applications have emerged as an effective approach to supporting maternal breastfeeding health. However, adopting these applications often faces challenges in terms of usability and user satisfaction. This study aimed to adapt and validate the Malay-language version of the Mobile Application Usability Questionnaire (MAUQ) for the Mommy-Be application in Indonesia.
Instrument & Methods: This research uses a descriptive, quantitative design with a Confirmatory Factor Analysis (CFA) to test the instrument's validity. A total of 386 breastfeeding mothers in Makassar City, South Sulawesi, participated in a two-week trial of the application, who were invited via social media applications at each primary health service.
Findings: A CFI value of 0.548 and a TLI of 0.477 indicated a less-than-ideal model fit. After removing items with high Modification Indices (MIs), the second model showed a significant improvement, with a CFI of 0.972, a TLI of 0.966, and an RMSEA of 0.062.
Conclusion: These results highlight the importance of adapting instruments to the local context and technical conditions of the application. The results of this study are expected to support the development of health applications better aligned with local users' needs.

Abstract Aims: Childhood is considered the most appropriate stage for behavioral interventions, as children have not yet established stable behavioral patterns. Implementing educational interventions at this age can instill healthy behaviors and prevent risky behaviors in adulthood. Accordingly, the present study was conducted to implement a campaign to prevent alcohol misuse among parents of children aged 3-7 years in Kerman Province, Iran.
Instrument & Methods: This study was conducted with 500 participants in the pre-test and 497 in the post-test between November 2023 and January 2024 in Kerman. Sampling was conducted randomly. An educational package was uploaded for 10 days on the domestic messaging platform Eitaa. Data were collected before and after the campaign using a researcher-designed questionnaire on knowledge and attitudes. Statistical analyses were performed using SPSS software.
Findings: Most parents were in the 29-59-year age group. After the campaign, the mean knowledge score regarding alcohol misuse in children improved significantly (p<0.001), whereas the attitude score did not.
Conclusion: The intervention increases parental knowledge about alcohol and substance misuse, but doesn’t change their attitudes.

Abstract Aims: Primary health care requires personnel with strong psychological resources to maintain optimal performance. Grounded in the Job Demands-Resources model, this study examines the mediating role of work engagement in the relationship between personal resources—self-efficacy, resilience, and optimism—and healthcare professionals’ performance.
Instrument & Methods: This study employed an explanatory cross-sectional design. Data were collected from 292 primary healthcare professionals using a Likert-scale questionnaire and proportional stratified random sampling. Structural relationships and mediation effects were analysed using Structural Equation Modeling-Partial Least Squares (SEM-PLS) with SmartPLS 4, assessing both measurement and structural models.
Findings: Personal resources significantly influenced work engagement, with optimism (β=0.430), self-efficacy (β=0.318), and resilience (β=0.161) showing positive effects. Work engagement had a strong and significant effect on performance (β=0.699). Direct effects of optimism and resilience on performance were not significant. However, mediation analysis revealed significant indirect effects of optimism (β=0.301), self-efficacy (β=0.222), and resilience (β=0.113) on performance through work engagement.
Conclusion: The findings indicate that personal resources primarily enhance performance through work engagement. Strengthening psychological resources and fostering supportive work environments are essential strategies for improving performance in primary health care settings.

Abstract Aims: Patient experience is a key indicator for assessing hospital service quality. Although Primaya Inco Sorowako Hospital has achieved A-level accreditation with a patient satisfaction rate above 90%, several complaints persist about long waiting times, unclear explanations from staff, and complex administrative procedures. These issues indicate the need to evaluate factors influencing patient experience. To analyze the influence of patient conditions and healthcare service providers on patient experience at Primaya Inco Sorowako Hospital, both directly and through the mediation of healthcare service providers.
Instrument & Methods: This cross-sectional study was conducted among patients who had completed their visit at Primaya Inco Sorowako Hospital, Indonesia, during 2024 (3771 individuals) and were able to provide informative responses. The sample size was calculated to be 349 respondents. Data were collected using a closed-ended questionnaire with a 4-point Likert scale and analyzed using univariate, bivariate, and multivariate methods.
Findings: Patient conditions and healthcare service providers significantly affect patient experience. The most influential factors were healthcare responsiveness and quality, emphasizing the importance of timeliness, effective communication, and provider attentiveness to patient needs.
Conclusion: Patient experience at Inco Sorowako Hospital is influenced by factors in both the Patient and Health Provision dimensions. 

Abstract Aims: This study evaluated the effect of nature-based therapy on treatment adherence and exercise capacity in patients with ischemic heart disease.
Materials & Methods: This randomized controlled clinical trial was conducted on 58 patients who were randomly assigned to the intervention and control group (n=29 per group). The intervention group participated in a structured nature-based educational program that included guided walking, group discussions, relaxation techniques, and exercise sessions conducted in a natural environment. The control group received routine face-to-face education. Treatment adherence was assessed using the eight-item Morisky Medication Adherence Scale, and exercise capacity was evaluated using the six-minute walk test before and after the intervention. Secondary physiological outcomes, including blood pressure, heart rate, respiratory rate, and oxygen saturation, were also measured. Analysis of covariance was used to compare post-intervention outcomes between groups while adjusting for baseline values.
Findings: After adjusting for covariates, treatment adherence was significantly higher in the intervention group than in the control group (p<0.01). Exercise capacity was also significantly greater in the intervention group than in the control group (p<0.001). Furthermore, the intervention group showed significant improvements in physiological parameters, including lower systolic and diastolic blood pressure, reduced heart rate, and improved oxygen saturation compared with the control group (p<0.05).
Conclusion: Nature-based therapy significantly improves treatment adherence, exercise capacity, and physiological outcomes in patients with ischemic heart disease in the short term.

Abstract Aims: Post-traumatic stress disorder is a psychological condition that can affect individuals during large-scale crises, such as the coronavirus pandemic. This study aimed to investigate the effect of COVID-19-related post-traumatic stress disorder on the quality of nurses’ work life. Instrument & Methods: This cross-sectional descriptive-analytical study was conducted between September 2022 and March 2023 among nurses working in hospitals affiliated with Qazvin University of Medical Sciences, located in northwest Iran. Through convenience sampling, 261 nurses were enrolled. Data were collected using the demographic and professional characteristics form, the Post-Traumatic Stress Disorder Symptoms Scale, and the Quality of Nurses’ Work Life (QNWL) questionnaire. Data analysis was performed using SPSS 20, applying descriptive statistics and inferential tests, including the Mann-Whitney U test, Kruskal-Wallis test, analysis of variance, and Spearman’s correlation coefficient. A significance level of p<0.05 was considered. Findings: The mean age of the participants was 35.19±7.75 years. The mean post-traumatic stress disorder score was 45.96±20.21, and the mean quality of nurses’ work life score was 128.17±27.73. Significant relationships were observed between employment status and work shift with the quality of nurses’ work life (p<0.05). Additionally, gender and marital status were significantly associated with post-traumatic stress disorder scores (p<0.05). Conclusion: Both post-traumatic stress disorder symptoms and the quality of nurses’ work life are at moderate levels among the nurses.

Abstract Aims: Heart failure is a major global public health problem. This study aimed to assess the effect of a self-efficacy-based nursing intervention on stress, anxiety, depression, and quality of life in patients with heart failure.
Materials & Methods: This quasi-experimental study was conducted involving 252 participants, with 126 assigned to the intervention group and 126 to the control group, at community cardiology centers in South Sulawesi, Indonesia. The intervention group participated in a twelve-week structured program centered on knowledge, motivation, and self-monitoring, based on Bandura’s self-efficacy theory. Psychological distress, quality of life, and functional independence were evaluated at baseline and during the intervention.
Findings: Participants in the intervention group showed significant reductions in stress (p=0.001), anxiety (p<0.001), and depression (p=0.010) compared to the control group. Quality of life improved in physical (median 63.00), psychological (median=69.00), and social (median=69.00) domains. Functional independence showed a significant increase (p=0.002).
Conclusion: The self-efficacy-based nursing intervention significantly decreases psychological distress and improves quality of life in patients with heart failure.

Abstract Aims: The optimization of services, such as online registration and virtual consultations is hampered by low levels of digital literacy. The purpose of this study was to investigate how digital literacy affects the community health center’s ability to provide quality medical care.
Instrument & Methods: This quantitative and explanatory study was conducted on 224 samples. Purposive sampling was used at the community health center, whereas proportionate random sampling techniques were used at the research location to determine the number of respondents at each community health center. A questionnaire was used to gather data, which was then administered to Kendari City health center officers.
Findings: The effectiveness of healthcare was positively and significantly affected by digital literacy (p=0.0001). Community health center policies had a positive and significant impact on digital literacy (p=0.011), while digital infrastructure had a positive and significant impact (p=0.016).
Conclusion: Digital literacy significantly improves service effectiveness.

Abstract Aims: E-health literacy is correlated with health-related behaviors, suggesting it can act as a mediator in the process by which health-related information leads to changes in health-related behaviors. This study aimed to investigate e-health literacy and examine the relationship between e-health literacy and self-care behaviors in hypertensive patients.
Instrument & Methods: This cross-sectional study was conducted in 2024 among 240 hypertensive patients covered by the healthcare centers of Neyshabur City, Iran. Participants were selected using a stratified random sampling method. Data were gathered using a demographic characteristics questionnaire, the Hypertension Self-Care Profile, and the Electronic Health Literacy Scale. The collected data were analyzed using multiple linear regression with SPSS 22.
Findings: The mean age of the respondents was 41.10±5.69 years. The mean of diabetes self-care activities was 47.1±8.5, and the mean e-health literacy was 21.3±6.6. Most diabetics had low e-health literacy, with 179 (74.6%) falling into this category. After adjusting for having a blood pressure measuring device at home and sleep status, e-health literacy (B=0.313, SE=0.092, p<0.05) was the statistically significant independent factor associated with self-care activities of hypertensive patients.
Conclusion: Implementing educational programs focused on promoting e-health literacy increases the self-care activities of hypertensive patients, thereby enhancing the patient’s overall quality of life.

Abstract Aims: This study aimed to examine the association between fertility knowledge, general health literacy, and reproductive health literacy among female students at Saveh University of Medical Sciences.
Instrument & Methods: This descriptive-analytical cross-sectional study was conducted in 2025 on 208 female medical sciences students. Data collection tools included the Cardiff Fertility Knowledge Scale , the Short Form Health Literacy for Iranian Adults, and the Women’s Reproductive Health Literacy Questionnaire. Data were analyzed using SPSS 24. For inferential analysis, Spearman’s correlation and backward linear regression were employed.
Findings: The mean age of participants was 22.34±3.27 years. The mean fertility knowledge score was 7.68 out of 13, while the mean scores for general health literacy and reproductive health literacy were 74.07 and 73.54 out of 100, respectively. A significant positive correlation was observed between fertility knowledge and both general health literacy (r=0.401, p<0.001) and reproductive health literacy (r=0.386, p<0.001). Regression analysis revealed that general health literacy (P=0.003) and reproductive health literacy (P=0.007) were significant positive predictors of fertility knowledge.
Conclusion: Fertility knowledge among female university students is moderate and influenced by both general and reproductive health literacy.

Abstract Aims: Self-care is essential for improving clinical outcomes among hemodialysis patients. However, limited health literacy often hinders patients’ ability to meet treatment demands. This research aimed to examine the efficacy of the teach-back technique as a health education strategy in promoting self-care behaviors among individuals receiving hemodialysis treatment in Indonesia.
Materials & Methods: This quasi-experimental study was conducted with 158 hemodialysis patients recruited from two tertiary hospitals in 2025. Participants were assigned to the intervention and control groups (79 per group). Data were collected through a researcher-constructed questionnaire assessing sociodemographic and clinical characteristics, along with the established Self-Care Agency Scale (SCAS). Statistical analyses were performed using SPSS 21, applying the Chi-square test, and independent t-tests.
Findings: No notable disparities were observed between the groups at the initial assessment (p > 0.05). Following a two-month period, the experimental group exhibited markedly elevated self-care scores across all domains—namely, medication adherence (p=0.007), self-monitoring (p=0.0001), dietary management (p=0.0001), personal hygiene (p=0.009), and psychological well-being (p=0.0001)—compared with the control group.
Conclusion: The teach-back technique is effective in bolstering self-care abilities among individuals receiving hemodialysis.

Abstract Aims: Pulmonary tuberculosis disproportionately affects the productive age group and has a tendency to spread to household contacts, especially vulnerable populations like children from low socioeconomic backgrounds. This study aimed to develop a life skills education model for tuberculosis patients, employing an effective life skills education strategy to prevent tuberculosis transmission, particularly among household contacts. Materials & Methods: This quantitative quasi-experimental study used a two-group pre-test and post-test design. The study population comprised all tuberculosis patients in the North Sumatra region. The sample included 127 patients from urban areas and 126 patients from rural areas assigned to the intervention and control groups. The non-parametric Friedman test was used to examine changes in knowledge, attitudes, and practices regarding the prevention of tuberculosis transmission among household contacts. Concurrently, the Mann-Whitney test was applied to compare scores between the groups. Findings: Post-intervention analysis revealed significant changes in attitudes for both urban and rural groups (p=0.0001), with no significant difference in the magnitude of these changes between the two areas (p>0.05). While practice scores improved significantly following the intervention (p<0.05), no significant difference in changes in practice scores was found between rural and urban areas when comparing the first and third tests (p>0.05). Conclusion: Health education delivered via the lecture method, incorporating the life skills education module, effectively improves knowledge, attitudes, and actions in both urban and rural settings.

Abstract Aims: This study explored the dynamics of electronic medical records adoption and use in primary healthcare facilities in Indonesia, specifically examining the role of regulatory pressure and perceived technological threats within the framework of mandatory national health policies. Instrument & Methods: This multisite cross-sectional survey was conducted among 688 healthcare workers from 27 community health centers in Bantul Regency, Indonesia. An analytical framework was used to examine regulatory pressure, perceived threat, performance expectancy, effort expectancy, facilitating conditions, behavioral intention, and actual use, with the latter analyzed through structural equation modeling. Findings: Perceptions of utility, ease of use, and organizational support played a vital role in shaping the intention to adopt electronic medical records. Regulatory pressure emerged as a primary driver shaping facility readiness and practitioners’ psychological response, directly strengthening behavioral intention. Notably, actual system usage was driven by the synergy between regulatory mandates and institutional readiness. Conclusion: Successful digital transformation in primary healthcare requires coherence among regulatory enforcement, institutional readiness, and healthcare workers' adaptive responses to technological change.

Abstract Aims: The effective adoption of artificial intelligence in medical academia depends critically on the perspectives of faculty members as the primary stakeholders. Therefore, this study aimed to elucidate faculty perspectives regarding the use of artificial intelligence chatbots in medical education and research. Participants & Methods: This qualitative study employed conventional content analysis. Data were collected through semi-structured interviews with 18 faculty members. Participants were recruited through purposive and snowball sampling until data saturation was reached. Interviews were analyzed using the conventional content analysis method developed by Graneheim & Lundman, and the rigor of the findings was ensured in accordance with Lincoln & Guba’s criteria. Findings: Three main categories were obtained, including “practical application domains of artificial intelligence tools,” which included the sub-categories of content creation and instructional design, academic research support and production, and therapeutic application, “identified benefits and challenges of artificial intelligence tools,” comprising sub-categories of ethical and security concerns, educational and pedagogical concerns regarding student learning, technical and infrastructural limitations, and perceived advantages and opportunities, and prerequisites and enablers for effective artificial intelligence tools use, covering the sub-categories of competency development, foundational attitudes, and systemic support. Conclusion: Faculty members widely utilize chatbots for content creation, article writing, and disease diagnosis, noting that these tools can help accelerate educational and research processes.

Abstract Aims: to analyze whether QWL (Quality of Work Life) consistently mediates organizational commitment, healthy work environment, motivational climate, career development, and health worker job performance in decentralized primary care systems.                
Materials & Methods This paper adopted an explanatory quantitative research study approach, referring to the validated metrics measured organizational commitment, workplace quality, motivation, career progression, QWL, and job performance involved 320 Aceh, Indonesia, local government primary health care workers. Indirect and direct variable links were examined using PLS-SEM.
Findings QWL significantly mediates the effects of inspiring environment and career development on work performance (β = 0.272; p = 0.001), but not organizational commitment or health. Many organizational elements affect work performance without QWL. Finally, QWL cannot explain all organizational and job scenarios. Psychological and structural factors impact decentralized health system employee performance, requiring workforce management beyond QWL growth.
Conclusion: Work-life quality boosts health professionals' performance in decentralized health systems, although its mediating effect varies by organization. QWL selectively mediated motivating environment and career growth on work performance, but not organizational commitment or health.
 

Abstract Objektive: This study evaluated the effectiveness of the JUMINTEN TABAH model in improving anemia prevention knowledge, compliance with IFA consumption, and hemoglobin levels among adolescent girls.
Methods: A quantitative quasi-experimental study with a nonequivalent control group pretest–posttest design was conducted from January to August 2025 in several public senior high schools in Muaro Jambi District, Jambi Province, Indonesia. A total of 100 adolescent girls aged 15–18 years were recruited and allocated into intervention and control groups. The intervention group received the JUMINTEN TABAH model, which consisted of scheduled weekly consumption of IFA tablets every Friday, health education using a pocket book, a Friday calendar as a reminder tool, and peer mentoring and monitoring by Youth Red Cross (PMR) cadres, supported by complementary activities. The control group received routine school health education and IFA distribution. Data were collected using structured questionnaires and hemoglobin measurements. Statistical analyses included paired and independent tests as well as effect size estimation.
Results: The intervention group showed a significant increase in knowledge and compliance behavior after the intervention (p < 0.001), while changes in the control group were not statistically significant. Improvements in knowledge and compliance were significantly higher in the intervention group compared to the control group (p < 0.001), with large effect sizes, indicating a strong impact of the intervention.
Conclusion: The JUMINTEN TABAH model is effective in improving knowledge and compliance with IFA tablet consumption among adolescent girls and has the potential to support anemia prevention programs in school settings.
 

Abstract Aims This study’s objective is to evaluate the current status of dental prosthetics, identify prosthetic needs, and the prevalence of oral frailty within the geriatric population in Egypt.
Instrument & Methods The study recruited 258 community-dwelling adults aged 60 years or older from residential homes in Al-Sharkia Governorate, Egypt. Collected data included demographic information, medical history, oral hygiene, prosthetic status and needs, and scores on the Oral Frailty Index-8 (OFI-8). Statistical analyses, including chi-square tests, t-tests, and multinomial logistic regression, were utilized to evaluate the associations among prosthetic status, prosthetic needs, and oral frailty.
Findings The analysis revealed that a very high percentage (79.8%) of participants were at an elevated risk for oral frailty. More than half the participants needed prosthetic rehabilitation, but many did not have access to suitable dental care. Factors including advanced age, chronic diseases, cigarette smoking, and poor oral hygiene were significantly linked to increased prosthetic needs. In contrast, place of residence and income level were not found to be significant predictors.
Conclusion This study underscores the high prevalence of oral frailty and substantial unmet prosthetic needs among older adults in Egypt. The findings emphasize the need for comprehensive geriatric dental care that incorporates prosthetic treatment. Such interventions are vital for preventing the progression of oral frailty and preserving quality of life in this aging population.
 

Abstract Aims This study aimed to investigate the role of electronic health literacy in adopting health-promoting lifestyle behaviors (HPLB) among students of Qazvin University of Medical Sciences in Iran.
Methods In this cross-sectional study, 376 students were selected in 2023-2024 using proportionate stratified sampling. Participants completed questionnaires on demographic characteristics, eHEALS, and HPLP-II. Data were analyzed using SPSSv22 software, employing descriptive and analytical tests including independent t-tests, Pearson’s correlation and multiple regression analysis, at a significance level of p < 0.05.
Findings Of the 376 participants, 79.78% were under 22 years of age. The mean and standard deviation of the total HPLB and eHealth literacy scores were (127.5 ± 18.8) and (25.04 ± 5.63), respectively. The highest score among the HPLB dimensions was observed in spiritual growth and self-actualization, while the lowest was in physical activity. A significant relationship was found between eHealth literacy and students’ HPLB, indicating that students with higher levels of eHealth literacy were more likely to engage in healthy behaviors. Multiple regression analysis revealed that age, gender, economic status, place of residence, and eHealth literacy together explained 32% of the variance in nutrition (R² = 0.235), 26% in interpersonal relationships (R² = 0.261), 20% in spiritual growth (R² = 0.202), 18% in health responsibility (R² = 0.183), 16% in stress management (R² = 0.162), and 11% in physical activity (R² = 0.115).
Conclusion It is recommended that eHealth literacy concepts be integrated into university curricula to enhance students’ skills in using information technology for adopting health-promoting behaviors.

Abstract Objective: Older adults’ attitudes toward technology are a key determinant of its acceptance or rejection, directly impacting the effectiveness of health interventions. The present study aimed to investigate and measure older adults’ attitudes toward technology and to examine factors associated with these attitudes among individuals attending comprehensive health centers in Iran.
Methods: In this cross-sectional study, 420 participants were selected using multi-stage random sampling. The P.TechPH scale was employed to assess both technophilia and technophobia. Data were analyzed using SPSS version 16.
Results: The mean TechPH score (3.59 ± 0.40) indicated generally positive technophilic attitudes among the participants. Higher levels of technophilia were observed in individuals aged 60–65, those with higher socioeconomic status, employed participants, and those with higher educational attainment. Daily Internet users and individuals with greater proficiency in using phones or tablets also exhibited significantly higher technophilia levels (P < 0.05).
Conclusion: These findings highlight the need for targeted interventions to foster positive attitudes toward technology among older adults, taking into account individual beliefs and relevant sociodemographic factors.

Abstract Aims: Occupational hazards in healthcare settings threaten the safety of medical students, whose protective behaviors during clinical training are vital for their well-being and patient care. This study applied Protection Motivation Theory (PMT) to identify key determinants of protective behaviors among medical students.
Methods: A descriptive–analytical (cross-sectional) study was conducted in 2025 among 420 medical students at Shahid Beheshti University of Medical Sciences, Tehran, Iran, selected through multistage cluster sampling. Data were collected using demographic and PMT-based questionnaires. Pearson correlation and linear regression analyses were performed in SPSS version 18, with a significance level of p < 0.05.
Findings: Participants had a mean age of 22.45 ± 3.9 years; 61% of the participants were female. Regression analysis showed that perceived susceptibility (p = 0.003), intention (p < 0.001), and behavior (p = 0.002) significantly predicted protection motivation. Self-efficacy (p = 0.001), intention (p = 0.001), and protection motivation (p = 0.002) significantly predicted protective behaviors.
Conclusion: Self-efficacy, intention, and protection motivation were the strongest determinants of students’ safety behaviors. PMT-based educational interventions may improve protective practices and reduce occupational risks in clinical environments.