Study On Hepatitis B Risk Behaviors And Influencing Factors Among Migrant Workers Based On Theory Of Planned Behavior

BackgroundHepatitis B virus(HBV)is mostly transmitted through blood or body fluids of infected individuals,and having sex contact and using contaminated injectors are known as the major routes for HBV infection among adults.Rural-to-urban migrant workers are usually less aware of hepatitis B(HB)prevention and more likely to perform HB risk behaviors.The previous studies on the risk of migrant workers and HB infection are mostly limited to the analysis of the epidemic characteristics of infected people at domestic and foreign,and no research has been found on the risk behaviors and behavioral intention of migrant workers and their influencing factors.ObjectiveTo develop an HBV risk behavior scale,test its validity and reliability,investigate the current status of risk behaviors regarding HB among migrant workers and the influencing factors defined by the Theory of Planned Behavior(TPB).MethodsLiterature reviews,panel discussions,and a plot were performed to initiate the framework of the scale based on TPB,and the scale was analyzed for reliability and validity.Field surveys were carried out from August to December 2017.Participants were selected by two-stage stratified cluster sampling—nine districts of the city area in Chongqing were categorized into three stratifications(very developed,medium developed,and less developed)according to economic background,geographic location and population density,and three districts were then randomly selected from each stratification respectively.Two or more enterprise units were purpose fully selected within each district,including the manufacturing,construction,wholesale and retail industry,the transportation industry,the hotel and catering industry,community services.Unconditional logistic regression analysis was used to analyze the influence factors of HB risk behavior and behavior intention(basic characteristics).and the structural equation model to determine the path of action and efficacy of risk behaviors to HB.Results(1)Scale development results:introducing two dimensions and multiple variables of behavior experience and regret feeling based on TPB,after reliability,validity test and semantic revision.Seven modules including 48 items were eventually retained on the formal scale.The factor loading of items was 0.462~0.928,which explained 75.21%of the overall variance.The confirmatory factor analysis showed a good fitting of the model(c~2/df=1.859,GFI=0.969,AGFI=0.883,CFI=0.900,IFI=0.969,RMSEA=0.039).No correlation was detected between the scale and the Zelaya's Stigma Scale of HIV.The total internal consistency was 0.898.Cronbach'?of each module ranged from 0.648to 0.961.The overall test-retest reliability(ICC)was 0.859,and the ICC of each module ranged from 0.370 to 0.973.(2)A cross-sectional study results:A total of 1692 migrant workers were recruited.Nearby414(24.47%)migrant workers have performed risk behaviors to HBV infection in the last six months,and 1434(84.75%)migrant workers had the risk behavioral intention.Among 1006 migrant workers with sexual activities,more than half(65.81%)never worn a condom.Migrant workers had a low knowledge level of hepatitis B(6.00±1.00).The top three approaches for migrant workers to obtain knowledge about hepatitis B was listening to people around them(53.01%),TV or radio(37.71%),and mobile/Internet(28.78%).Migrant workers who were younger(OR=0.97,95%CI:0.96~0.98),at lower HB knowledge level(OR=0.92,95%CI:0.88~0.96)were more intended to have HB risk behaviors,behavioral towards attitudes(AB),subjective norms(SN),perceived behavior control(PBC),and behavioral experience(EB)had a positive direct significant impact on behavioral intentions BI(?=0.44,P<0.001;?=0.20,P<0.001;?=0.07,P=0.020;?=0.13,P<0.001);Younger age was positively associated with acting HB risk behaviors(OR=0.98,95%CI:0.98~0.99),regret feeling(RF)had a positive direct significant impact on behaviors(?=0.10,P<0.001),and SN had a positive significant indirect impact on behaviors(?=0.05,P<0.001).There were significant associations between AB,SN and EB,between PBC and EB,RF,PBC,SN and AB.ConclusionThe present study is a first try of the scale which test high-risk behavior of hepatitis B among a particular group.The scale has good reliability and validity and could be used as a measurement tool for hepatitis B risk behaviors and the influencing factors of the behaviors among migrant workers.There was a considerable part of migrant workers having had HB risk behaviors and the majority of them were intended to act risk behaviors.The condom was poorly used by migrant workers when having sex.The younger the age,the worse the knowledge situation,the AB the dangerous behavior of HB agrees,the EB is more,the SN and the negative PBC of the migrant workers,the more positive BI of the risk behavior of HB;Migrant workers who agree with their intentions and who do not regret their dangerous behaviors are more likely to have HB dangerous behaviors.The prevention and control of HBV among migrant workers may consider the combination of traditional media and new media,supplemented by peer education,to better analyze the key influencing factors proposed to reduce the risk of HBV to migrant workers in the future.