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Browsing by Author "Sharma, Manoj"

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    Conceptualization of college students' COVID-19 related mask-wearing behaviors using the Multi-Theory Model of health behavior change
    (Tabriz University of Medical Sciences, 2021) Davis, Robert E.; Sharma, Manoj; Simon, Kayla E.; Wilkerso, Amanda H.; University of Arkansas Fayetteville; University of Nevada Las Vegas; University of Alabama Tuscaloosa
    Background: Recommendations and policies, regarding the use of face coverings, have been instituted to control transmission of coronavirus disease 2019 (COVID-19). Understanding of psychosocial factors related to the use of face coverings within the context of COVID-19 is needed. This study aimed to conceptualize mask-wearing behavior among students using the Multi-theory Model (MTM) of behavior change. Methods: In October 2020, students (n = 595) enrolled in a large public southeastern US university were recruited to participate in a cross-sectional survey, using a valid and reliable instrument. Univariate, bivariate, and multivariate techniques described mask-wearing behavior and differentiated theoretical drivers of mask-wearing between individuals compliant and noncompliant with guidelines. Results: Compliant individuals reported significantly higher scores (P < 0.05) for initiation and sustenance of mask-wearing, participatory dialogue, behavioral confidence, emotional transformation, practice for change, changes in the social environment, and significantly lower scores for disadvantage. Among multivariable models, all theoretical predictors exhibited significant relationships to their respective outcomes (initiation and sustenance). Specifically, MTM constructs explained approximately 35% of variance in initiation (R-2 = 0.346, F-(3,F-526) = 94.32, P < 0.001) and 33% of variance in sustenance of mask wearing (R-2 = 0.328, F-(3,F-529) = 87.71, P < 0.001) for compliant individuals. Behavioral confidence and emotional transformation exhibited the strongest relationships to initiation (beta = 0.403, P < 0.001) and sustenance (beta = 0.450, P < 0.001), respectively. Conclusion: Findings suggest a need to design educational programming based on the MTM to promote mask-wearing behavior among laggards who defy face mask guidelines, recommendations, and mandates.
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    COVID-19 Vaccine Acceptance among College Students: A Theory-Based Analysis
    (MDPI, 2021) Sharma, Manoj; Davis, Robert E.; Wilkerson, Amanda H.; University of Nevada Las Vegas; University of Arkansas Fayetteville; University of Alabama Tuscaloosa
    The severity and pervasiveness of the COVID-19 pandemic have necessitated the emergency use of COVID-19 vaccines. Three vaccines have been approved in the United States (USA). However, there is still some hesitancy in COVID-19 vaccine acceptability among some subgroups, including college students. While research is limited on vaccine acceptability behavior among college students, preliminary data suggests hesitancy as being high. This study aimed to explain the correlates of COVID-19 vaccine acceptance among college students who reported hesitancy toward the COVID-19 vaccine and those who did not using the initiation component of the multi-theory model (MTM) of health behavior change. Using a cross-sectional study design, data were collected from a Southern USA University (n = 282) utilizing a valid and reliable 27-item questionnaire in February and March 2021. Almost half (47.5%) of participants reported hesitancy to receive the COVID-19 vaccine. The three constructs of MTM's initiation model, behavioral confidence (b = 0.089, p < 0.001), participatory dialogue (b = 0.056, p < 0.001), and changes in the physical environment (b = 0.066, p = 0.001) were significantly associated with COVID-19 vaccine acceptance among those who were not hesitant to take the vaccine and accounted for 54.8% of the variance. Among those who were hesitant to take the COVID-19 vaccine, the MTM construct of behavioral confidence (b = 0.022, p < 0.001) was significant along with Republican Party political affiliation (b = -0.464, p = 0.004), which was negatively associated with vaccine acceptance. The model accounted for 60.6% of the variance in intention to take the COVID-19 vaccine. This study provides evidence for the utility of MTM as a timely intervention to design messages for college students to enhance COVID-19 vaccine acceptability.
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    Explaining Handwashing Behavior in a Sample of College Students during COVID-19 Pandemic Using the Multi-Theory Model (MTM) of Health Behavior Change: A Single Institutional Cross-Sectional Survey
    (MDPI, 2021) Sharma, Manoj; Batra, Kavita; Davis, Robert E.; Wilkerson, Amanda H.; Nevada System of Higher Education (NSHE); University of Nevada Las Vegas; University of Arkansas System; University of Arkansas Fayetteville; University of Alabama Tuscaloosa
    Amidst the COVID-19 pandemic, handwashing offers a simple and effective hygienic measure for disease prevention. Reportedly, a significant proportion of college students did not follow handwashing recommendations provided by the Centers for Disease Control and Prevention (CDC) in the pre-COVID era. The purpose of this cross-sectional study was to explore and explain the handwashing behavior among college students during the COVID-19 pandemic using a contemporary fourth-generation multi-theory model (MTM) of health behavior change. Data were collected from 713 college students at a large public university in the Southern U.S. in October 2020 using a validated 36-item survey. Statistical analyses included independent samples t-tests, Pearson correlation, and hierarchical regression modeling. Among students not following handwashing recommendations, the constructs of participatory dialogue (beta = 0.152; p < 0.05) and behavioral confidence (beta = 0.474; p < 0.0001) were statistically significant and accounted for 27.2% of the variance in the likelihood of initiation of the behavior. Additionally, the constructs of emotional transformation (beta = 0.330; p < 0.0001), practice for change (beta = 0.296; p < 0.0001), and changes in the social environment (beta = 0.180; p < 0.05) were statistically significant and accounted for 45.1% of the variance in the likelihood of sustaining handwashing behavior. This study highlights the applicability and usability of the MTM in designing and testing behavior change interventions and media messaging in campaigns targeting college students.
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    A multi-theory model based analysis of correlates for initiating and sustaining mammography screening behavior among Hispanic American women in the United States
    (Tabriz University of Medical Sciences, 2022) Sharma, Manoj; Batra, Kavita; Wilkerson, Amanda H.; Chirico, Francesco; Raich, Siddharth; University of Nevada Las Vegas; University of Alabama Tuscaloosa; Catholic University of the Sacred Heart; IRCCS Policlinico Gemelli
    Background: Despite the known advantages of mammography, screening rates among Hispanic American women are lower compared to other ethnic groups. Therefore, this cross-sectional study aimed to explore correlates of mammography screening behavior among a sample of Hispanic women aged 45-54 years living in the United States using the multi-theory model (MTM). Methods: A 50-item web-based survey consisting of psychometrically valid tools based on MTM theoretical framework was administered through non-random sampling procedures using Qualtrics. Univariate, bivariate, and multivariate statistics were used to analyze the data. Results: Out of 370 participants, nearly 49% (n = 189) reported not having a mammogram in the past two years. The mean age of the sample was 48.8 +/- 2.8 years. A greater proportion of participants who have had a mammogram reported having health insurance compared to those who have not had a mammogram (93.1% vs. 75.7%, P < 0.001). Results of hierarchical regression suggest that all MTM constructs, including participatory dialogue, behavioral confidence, and changes in the physical environment explained 33.4% of variance in initiating mammography behavior among those who have not had a mammogram. Similarly, practice for change, emotional transformation, and changes in the social environment explained 53% of the variance in sustenance of the behavior change. Conclusion: Along with the MTM subscales, this study points to the important correlates such as health insurance and messaging by healthcare providers to promote the mammography seeking behavior among Hispanic women.
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    Predisposing, enabling and reinforcing factors associated with opioid addiction helping behaviour in tri-state Appalachian counties: application of the PRECEDE-PROCEED model-cross-sectional analysis
    (BMJ, 2023) Wilkerson, Amanda H.; Sharma, Manoj; Davis, Robert E.; Stephens, Philip M.; Kim, Richard W.; Bhati, Deepak; Nahar, Vinayak K.; University of Alabama Tuscaloosa; University of Nevada Las Vegas; University of Arkansas Fayetteville; University of Pittsburgh; Lincoln Memorial University; Columbia University; NewYork-Presbyterian Hospital; Cornell University; Weill Cornell Medicine; University of Mississippi; University of Mississippi Medical Center
    ObjectivesThe overdose epidemic was designated a 'Public Health Emergency' in the USA on 26 October 2017, bringing attention to the severity of this public health problem. The Appalachian region remains substantially impacted by the effects from years of overprescription of opioids, and subsequently opioid non-medical use and addiction. This study aims to examine the utility of the PRECEDE-PROCEED model constructs (ie, predisposing, reinforcing and enabling factors) to explain opioid addiction helping behaviour (ie, helping someone who has an opioid addiction) among members of the public living in tri-state Appalachian counties.DesignCross-sectional study.SettingRural county in the Appalachian region of the USA.ParticipantsA total of 213 participants from a retail mall in a rural Appalachian Kentucky county completed the survey. Most participants were between the ages of 18 and 30 years (n=68; 31.9%) and identified as men (n=139; 65.3%).Primary outcome measureOpioid addiction helping behaviour.ResultsThe regression model was significant (F-(6,F- 180)=26.191, p<0.001) and explained 44.8% of the variance in opioid addiction helping behaviour (R-2=0.448). Attitude towards helping someone with opioid addiction (B=0.335; p<0.001), behavioural skills (B=0.208; p=0.003), reinforcing factors (B=0.190; p=0.015) and enabling factors (B=0.195; p=0.009) were all significantly associated with opioid addiction helping behaviour.ConclusionsPRECEDE-PROCEED model constructs have utility to explain opioid addiction helping behaviour among individuals in a region greatly impacted by the overdose epidemic. This study provides an empirically tested framework for future programmes addressing helping behaviour related to opioid non-medical use.