Search results for: turnover intentions

Authors: Yassamina Berkane, Leila Kloul, Yoann Demoli

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Quality of life, environmental impact, congestion of mobility means, and infrastructures remain significant challenges for urban mobility. Solutions like car sharing, spatial redesign, eCommerce, and autonomous vehicles will likely increase the unit veh-km and the density of cars in urban traffic, thus reducing congestion. However, the impact of such solutions is not clear for researchers. Congestion arises from growing populations that must travel greater distances to arrive at similar locations (e.g., workplaces, schools) during the same time frame (e.g., rush hours). This paper first reviews the research and application cases of urban congestion methods through recent years. Rethinking the question of time, it then investigates people’s willingness and flexibility to adapt their arrival and departure times from workplaces. We use neural networks and methods of supervised learning to apply a new methodology for predicting peoples' intentions from their responses in a questionnaire. We created and distributed a questionnaire to more than 50 companies in the Paris suburb. Obtained results illustrate that our methodology can predict peoples' intentions to reschedule their activities (work, study, commerce, etc.).

Keywords: urban mobility, decongestion, machine learning, neural network

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Authors: Ekta Pandey

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The Indian Pharmaceutical Industry is ranked third largest by volume and fourteenth by value. It thus accounts for 10% of world’s production by volume and 1.5% by value according to Department of Pharmaceuticals, Government of India. The industry has shown phenomenal growth over past few years, moving from US $ 1 billion turnover in 1990 to a turnover of around US $30 billion in 2015. The Indian pharmaceutical sector is ranked seventeenth in terms of export value of active pharmaceutical ingredients and dosage forms to more than 200 countries around the globe. It has shown tremendous changes especially after Trade Related Aspects of Intellectual Property Rights (TRIPS) agreement. Recognizing the immense potential for growth and its direct impact on Indian economy, it is important to look up the industrial policies adopted since Indian independence which turnaround the Indian pharmaceutical industry. A systematic review of changes in market structure of Indian pharmaceutical industry due to shift in policy regimes is done from 1850 to 2015 using secondary peer reviewed published research work. The aim is to understand the impact of anti-trust laws, intellectual property rights, industry competition acts and regulations are quite crucial in determining effective economic policy and have overall lasting effects on international trade and ties. The proposed paper examines the position of Indian domestic firms relative to multinational pharmaceutical firms tries to throw some light on the growth curve of Indian pharmaceutical sector.

Keywords: active pharmaceutical ingredients, competition act, pharmaceutical industry, TRIPS

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Authors: Saira Maqbool, Qaisara Parveen, Muhammad Arshad Dahar

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Improving females' involvement in management and enterprises in Pakistan requires the development of female entrepreneurs as leaders. Entrepreneurial education aims for providing students the knowledge, aptitudes and motivation to energize innovative accomplishment in various settings. Assortments of venture instruction are advertised at all stages of mentoring, from fundamental or discretionary institutes through graduate institutional platforms. The business enterprise will be considered the procedure by which a looming business visionary or business person pursues after openings without respect to the resources they directly regulate. This entails the ability of the business visionary to join every single other generation. This study explores the relationship between developing Women's Leadership skills and Entrepreneurship Education The essential reason for this consider was to analyze the role of Entrepreneurship Edification (EE) towards women's Leadership and develop entrepreneurial intentions among students. The major goal of this study was to foster entrepreneurial attitudes among PMAS Arid Agriculture University undergraduate students concerning their choice to work for themselves. This study focuses on the motivation and interest of female students in the social sciences to build entrepreneurial leadership skills. The quantitative analysis used a true-experimental, pretest-posttest control group research design. Female undergraduate students from PMAS Arid Agriculture University made up the study population. For entrepreneurial activity, a training module has been created. The students underwent a three-week training program at PMAS Arid Agriculture University, where they learned about entrepreneurial leadership abilities. The quantitative data were analyzed using descriptive statistics and T-tests. The findings indicated that students acquired entrepreneurial leadership skills and intentions after training. They have decided to launch their businesses as leaders. It is advised that other PMAS Arid Agriculture University departments use the training module and course outline because the research's usage of them has important results.

Keywords: business, entrepreneurial, intentions, leadership, women

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Authors: Offer E. Edelstein, Iris Vered, Orly Sarid

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Background: Physical activity (PA) is considered as a major factor in bone density preservation and fracture prevention. Yet, gaps in understanding exist regarding how ethnocultural backgrounds might shape attitudes, intentions, and actual PA participation. Based on the theory of planned behavior (TPB) for predicting PA, the aims of the current study were: i) to compare attitudes, subjective norms, perceived control, intentions and knowledge, across two ethnocultural groups; ii) to evaluate the fit of the model across two ethnocultural groups of women: Israeli-born Jews and Ethiopian immigrants. Methods: Two hundred women (one hundred from each group), aged > 65, completed valid and reliable questionnaires assessing knowledge, TPB components, and actual PA. Results: The level of knowledge on osteoporosis was relatively low in both groups. Intention to participate in PA was the only variable that directly predicted actual PA. Intention to participate in PA served as a mediator among attitudes, subjective norms, perceived control, and actual PA. The TPB components mediated the link between knowledge and intention to participate in PA. Conclusion: It is important to understand and augment interventions that enhance PA, in the community, and with sensitivity concerning each ethnocultural group.

Keywords: attitudes, ethnocultural groups, knowledge, physical activity

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Authors: Naheed Malik, Marisa Smith

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This study has been undertaken as an attempt to explore the underlying reasons that cause higher employee turnover rates at the call centers of Pakistan. This research also aimed to examine the relationship among the job related variables such as job satisfaction, organizational commitment, supervisor support, self-esteem, organizational stressors (work overload, role ambiguity and work family conflict) and quitting inclination. A total of 340 call centers respondents filled the survey questionnaire. The data was analyzed through SPSS 19.0. Results reveal the significant relationship among the study variables and stress level contributing more towards employee penchant to leave the job. A significant amount of call centers employee have proclivity to quit from their jobs as soon as they would be able to find some other jobs with attractive compensation. The majority of the respondents were found to be unhappy and dissatisfied due to hectic schedule and imbalance between family and work. This research also highlighted the specific areas in which call centre management needs to emphasize deliberately that affect more sharply on employee leaving aptitude. This study also suggests some useful strategies for the well being of employees that can minimize their tendency of quitting and retention in the long run.

Keywords: call centers, stress, job satisfaction, organizational commitment, supervisor’s support, self esteem, employee turnover, employees’ intention to quit, customer service representative (CSRs)

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Authors: Long Pham, Julia Blanke

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An increasingly popular way of establishing citizen engagement within communities is through ‘city apps’. Currently, most of these mobile applications seem to be extensions of the existing communication media, sometimes merely replicating the information available on the classical city web sites, and therefore provide minimal additional impact on citizen behavior and engagement. In order to overcome this challenge, we propose to use a holistic behavioral model to generate dynamic and contextualized app content based on optimizing well defined city-related performance goals constrained by the proposed behavioral model. In this paper, we will show how the data collected by the CorkCitiEngage project in the Irish city of Cork can be utilized to calibrate aspects of the proposed model enabling the design of a personalized citizen engagement app aiming at positively influencing people’s behavior towards more active participation in their communities. We will focus on the important aspect of intentions to act, which is essential for understanding the reasons behind the common value-action-gap being responsible for the mismatch between good intentions and actual observable behavior, and will discuss how customized app design can be based on a rigorous model of behavior optimized towards maximizing well defined city-related performance goals.

Keywords: city apps, holistic behaviour model, intention to act, value-action-gap, citizen engagement

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Authors: Festus Epetimehin

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Agriculture remains the dominant sector in the rural areas where over 70% of Nigerian reside and it’s still the backbone of our economy. The observed poor performance of farmers in agricultural productivity is due to the nature of risks and uncertainties in agriculture.Agricultural insurance is one of the mechanisms by which farmers can stabilize farm income and investment. The study examined the relationship between agricultural insurance scheme (AIS) and performance of agribusiness in Nigeria. The study adopted exploratory research design which is an ex-ante research approach. One hundred copies of structured questionnaire were administered for the purpose of the study. Correlation analysis and regression analysis were employed for the study. The correlation analysis of the finding revealed that the independent variable; agricultural insurance scheme (AIS) is positively and significantly correlated with the set of dependent variables; where turnover (ABT)=0.582**, profitability (ABP)=0.321**, solvency (ABS)=0.418**and cost of production (ABC)=0.23** respectively. The regression analysis result also revealed the degree of relationship between the independent variable (AIS) and set of dependent variables where one(1%) percent increase in independent variable will lead to 33.9% (ABT), 9.7% (ABP), 17.5%(ABS) and 1.5%(ABC).The study recommended that the Federal Government in collaboration with the participating Agricultural insurers embark on awareness campaign through to the length and breadth of Nigeria on government support and insurance scheme for farmers. Government should also ensure that the loan and insurance scheme should extend beyond the mechanized farmers and include the intensive subsistence farmers in view of the fact that they are the dominants in most of the farm produce markets.

Keywords: agribusiness, agricultural insurance, performance, turnover, solvency, agricultural risks

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Authors: Estela Díaz

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This article aims to make three contributions. First, build on the literature on ethical decision-making literature by exploring factors that influence the intention of adopting veganism. Second, study the superiority of extended models of the Theory of Planned Behavior (TPB) for understanding the process involved in forming the intention of adopting veganism. Third, analyze the moderating effect of gender on TPB given that attitudes and behavior towards animals are gender-sensitive. No study, to our knowledge, has examined these questions. Veganism is not a diet but a political and moral stand that exclude, for moral reasons, the use of animals. Although there is a growing interest in studying veganism, it continues being overlooked in empirical research, especially within the domain of social psychology. TPB has been widely used to study a broad range of human behaviors, including moral issues. Nonetheless, TPB has rarely been applied to examine ethical decisions about animals and, even less, to veganism. Hence, the validity of TPB in predicting the intention of adopting veganism remains unanswered. A total of 476 non-vegan Spanish university students (55.6% female; the mean age was 23.26 years, SD= 6.1) responded to online and pencil-and-paper self-reported questionnaire based on previous studies. TPB extended models incorporated two background factors: ‘general attitudes towards humanlike-attributes ascribed to animals’ (AHA) (capacity for reason/emotions/suffer, moral consideration, and affect-towards-animals); and ‘general attitudes towards 11 uses of animals’ (AUA). SPSS 22 and SmartPLS 3.0 were used for statistical analyses. This study constructed a second-order reflective-formative model and took the multi-group analysis (MGA) approach to study gender effects. Six models of TPB (the standard and five competing) were tested. No a priori hypotheses were formulated. The results gave partial support to TPB. Attitudes (ATTV) (β = .207, p < .001), subjective norms (SNV) (β = .323, p < .001), and perceived control behavior (PCB) (β = .149, p < .001) had a significant direct effect on intentions (INTV). This model accounted for 27,9% of the variance in intention (R2Adj = .275) and had a small predictive relevance (Q2 = .261). However, findings from this study reveal that contrary to what TPB generally proposes, the effect of the background factors on intentions was not fully mediated by the proximal constructs of intentions. For instance, in the final model (Model#6), both factors had significant multiple indirect effect on INTV (β = .074, 95% C = .030, .126 [AHA:INTV]; β = .101, 95% C = .055, .155 [AUA:INTV]) and significant direct effect on INTV (β = .175, p < .001 [AHA:INTV]; β = .100, p = .003 [AUA:INTV]). Furthermore, the addition of direct paths from background factors to intentions improved the explained variance in intention (R2 = .324; R2Adj = .317) and the predictive relevance (Q2 = .300) over the base-model. This supports existing literature on the superiority of enhanced TPB models to predict ethical issues; which suggests that moral behavior may add additional complexity to decision-making. Regarding gender effect, MGA showed that gender only moderated the influence of AHA on ATTV (e.g., βWomen−βMen = .296, p < .001 [Model #6]). However, other observed gender differences (e.g. the explained variance of the model for intentions were always higher for men that for women, for instance, R2Women = .298; R2Men = .394 [Model #6]) deserve further considerations, especially for developing more effective communication strategies.

Keywords: veganism, Theory of Planned Behavior, background factors, gender moderation

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Authors: Jing Yu Pan, Dahai Liu

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Airlines in the US have taken protective measures to battle the COVID-19 pandemic, with a mask mandate being the most important one, especially in the aircraft cabin. As the industry is recovering from the pandemic, mask-wearing will eventually become a personal choice during flight. Nevertheless, COVID-19 will continue to create uncertainty for a long time into the future, making it necessary to understand the attitude and voluntary use of masks by air travelers on airplanes even after masks are no longer mandatory. This study aimed to understand the relationship between demographic characteristics and mask-wearing intention in the US. For age, gender, income, educational, and ethnicity groups, this study examined three factors – subjective norms, risk avoidance, and information seeking and their influence on the mask-wearing intention onboard airplanes during COVID-19 and whether or not attitude toward masks was an important mediator. The results show that all demographic factors except gender could help to explain the group variations in factor impact and the mediating effect in mask-wearing intentions. In particular, Asian travelers had mask-wearing intentions that were not affected by attitude either directly or indirectly. These findings provide useful implications to enhance the health and safety of air travelers, especially in the US, where opposing views toward mask-wearing still widely exist.

Keywords: COVID-19, passenger demographics, aircraft cabin, mask-wearing intention, attitude as mediator

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Authors: Hong Je Kang, Young Chae Choi, Jin Sung Park, Isac Kim

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Purpose: Osteoporotic fractures are an important among postmenopausal women. When osteoporotic distal radial fractures occur, osteoporosis must be treated to prevent the hip and spine fractures. Intravenous injection of Zoledronic acid is expected to improve preventing osteoporotic fractures. Many articles reported the effect of intravenous Zoledronic acid to BMD of the hip and spine fracture or non-fracture patients with low BMD. However, that with distal radial fractures has rarely been reported. Therefore, the authors decided to study the effect of Zoledronic acid in BMD score, bone union, and bone turnover markers in the patients who underwent volar plating due to osteoporotic distal radial fractures. Materials: From April 2018 to May 2022, postmenopausal women aged 55 years or older who had osteoporotic distal radial fractures and who underwent surgical treatment using volar plate fixation were included. Zoledronic acid (5mg) was injected intravenously between 3 and 5 days after surgery. BMD scores after 1 year of operation were compared with the initial scores. Bone turnover markers were measured before surgery, after 3 months, and after 1 year. Radiological follow-up was performed every 2 weeks until the bone union and at 1 year postoperatively. Clinical outcome indicators were measured one year after surgery, and the occurrence of side effects was observed. Result: Total of 23 patients were included, with a lumbar BMD T score of -2.89±0.2 before surgery to -2.27±0.3 one year after surgery (p=0.012) and a femoral neck BMD T score of -2.45±0.3 before surgery to -2.36±0.3 (p=0.041) after one year, and all were statistically significant. Measured as bone resorption markers, serum CTX-1 was 337.43±10.4 pg/mL before surgery, 160.86±8.7 pg/mL (p=0.022) after three months, and 250.12±12.7 pg/mL (p=0.031) after one year. Urinary NTX-1 was 39.24±2.2 ng/mL before surgery, 24.46±1.2 ng/mL (p=0.014) after three months and 30.35±1.6 ng/mL (p=0.042) after one year. Measured as bone formation markers, serum osteocalcin was 13.04±1.1 ng/mL before surgery, 8.84±0.7 ng/mL (p=0.037) after 3 months and 11.1±0.4 ng/mL (p=0.026) after one year. Serum bone-specific ALP was 11.24±0.9 IU/L before surgery, 8.25±0.9 IU/L (p=0.036) after three months, and 10.2±0.9 IU/L (p=0.027) after one year. All were statistically significant. All cases showed bone union within an average of 6.91±0.3 weeks without any signs of failure. Complications were found in 5 out of 23 cases (21.7%), such as headache, nausea, muscle pain, and fever. Conclusion: When Zoledronic acid was used, BMD was improved in both the spine and femoral neck. This may reduce the likelihood and subsequent morbidity of additional osteoporotic fractures. This study is meaningful in that there was no difference in the duration of bone union and radiological characteristics in patients with distal radial fractures administrated with intravenous BP early after the fractures, and improvement in BMD and bone turnover indicators was measured.

Keywords: zeoldreonic acid, BMD, osteoporosis, distal radius

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Authors: Salma Hussein, Hadia Aziz

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Entrepreneurship plays a significant and imperative role in economic and social growth, and therefore, is stimulated and encouraged by governments and academics as a mean of creating job opportunities, innovation, and wealth. Indicative of its importance, it is essential to identify factors that encourage and promote entrepreneurial behavior. This is particularly true for developing countries where the need for entrepreneurial development is high and the resources are scarce, thus, there is a need to maximize the outcomes of investing in entrepreneurial development. Entrepreneurial education has been the center of attention and interest among researchers as it is believed to be one of the most critical factors in promoting entrepreneurship over the long run. Accordingly, the urgency to encourage entrepreneurship education and develop an enterprise culture is now a main concern in Egypt. Researchers have postulated that cognition has the potential to make a significant contribution to the study of entrepreneurship. One such contribution that future studies need to consider in entrepreneurship research is the cognitive processes that occur within the individual such as cognitive style. During the past decade, there has been an increasing interest in cognitive style among researchers and practitioners specifically in innovation and entrepreneurship field. Limited studies pay attention to study the antecedent dynamics that fuel entrepreneurial cognition to better understand its role in entrepreneurship. Moreover, while many studies were conducted on entrepreneurship education, scholars are still hesitant regarding the teachability of entrepreneurship due to the lack of clear evidence of its impact. Furthermore, the relation between cognitive style and entrepreneurial intentions, has yet to be discovered. Hence, this research aims to test the impact of entrepreneurship education on cognitive style and subsequent intention in order to evaluate whether student’s and potential entrepreneur’s cognitive styles are affected by entrepreneurial education and in turn affect their intentions. Understanding the impact of Entrepreneurship Education on ways of thinking and intention is critical for the development of effective education and training in entrepreneurship field. It is proposed that students who are exposed to entrepreneurship education programs will have a more balanced thinking style compared to those students who are not exposed. Moreover, it is hypothesized that students having a balanced cognitive style will exhibit higher levels of entrepreneurial intentions than students having an intuitive or analytical cognitive style. Finally, it is proposed that non-formal entrepreneurship education will be more positively associated with entrepreneurial intentions than will formal entrepreneurship education. The proposed methodology is a pre and post Experimental Design. The sample will include young adults, their age range from 18 till 35 years old including both students enrolled in formal entrepreneurship education programs in private universities as well as young adults who are willing to participate in a Non-Formal entrepreneurship education programs in Egypt. Attention is now given on how far individuals are analytical or intuitive in their cognitive style, to what extent it is possible to have a balanced thinking style and whether or not this can be aided by training or education. Therefore, there is an urge need for further research on entrepreneurial cognition in educational contexts.

Keywords: cognitive style, entrepreneurial intention, entrepreneurship education, experimental design

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Authors: Eranga N. Somaratna, Pradeep Dharmadasa

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In the current competitive environment, the factors leading to organization success are not limited to the investment of capital, labor, and raw material, but in the ability of knowledge innovation from all the members of an organization. However, knowledge on its own cannot provide organizations with its promised benefits unless it is shared, as organizations are increasingly experiencing unsuccessful knowledge sharing efforts. In such a backdrop and due to the dearth of research in this area in the South Asian context, the study set forth to develop an understanding of the factors that influence knowledge-sharing behavior within an organizational framework, using widely accepted social psychology theories. The purpose of the article is to discover the determinants of knowledge-sharing intention and actual knowledge sharing behaviors of bank employees in Sri Lanka using an aggregate model. Knowledge sharing intentions are widely discussed in literature through the application of Ajzen’s Theory of planned behavior (TPB) and Theory of Social Capital (SCT) separately. Both the theories are rich to explain knowledge sharing intention of workers with limitations. The study, therefore, combines the TPB with SCT in developing its conceptual model. Data were collected through a self-administrated paper-based questionnaire of 199 bank managers from 6 public and private banks of Sri Lanka and analyzed the suggested research model using Structural Equation Modelling (SEM). The study supported six of the nine hypotheses, where Attitudes toward Knowledge Sharing Behavior, Perceived Behavioral Control, Trust, Anticipated Reciprocal Relationships and Actual Knowledge Sharing Behavior were supported while Organizational Climate, Sense of Self-Worth and Anticipated Extrinsic Rewards were not, in determining knowledge sharing intentions. Furthermore, the study investigated the effect of demographic factors of bankers (age, gender, position, education, and experiences) to the actual knowledge sharing behavior. However, findings should be confirmed using a larger sample, as well as through cross-sectional studies. The results highlight the need for theoreticians to combined TPB and SCT in understanding knowledge workers’ intentions and actual behavior; and for practitioners to focus on the perceptions and needs of the individual knowledge worker and the need to cultivate a culture of sharing knowledge in the organization for their mutual benefit.

Keywords: banks, employees behavior, knowledge management, knowledge sharing

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Authors: Samuel Alaba Akinwotu

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Effectiveness in communication requires the deployment of pragmatic and rhetorical strategies in religious sermons. In spite of high volume of works in religious discourse, scholars have not adequately accounted for the persuasive and argumentation strategies employed in Christian religious Pentecostal sermons. This study examines communicative intentions and the pragma-rhetorical strategies deployed to maintain balance and effectiveness in selected sermons of Pastor E. A. Adeboye, Bishop D. Oyedepo and Pastor W. F. Kumuyi. Fifteen sermons, delivered orally and transcribed into the written mode, were selected and analysed using Jacob Mey’s theory of pragmeme, Aristotle’s rhetoric and the theory of argumentation by van Eemeren and Grootendorst. Speakers pract stating, encouraging, assuring, warning, condemning, directing, praising, thanking, etc. through rhetorical question, repetition, direct address, direct command and structural parallelism. They assume divine role by speaking authoritatively and they tactically and logically select words to legitimise their ideology. They also categorise and portray individuals and/or issues either as good or bad, sinner/sin or righteous/righteousness, etc. The study provides clearer insight into the pragmatic import and the communicative effectiveness of Christian Pentecostal sermons. Further research can juxtapose the pragma-rhetorical and argumentation strategies of preachers of two clearly differentiated movements within the Christian religion.

Keywords: argumentation, communicative intentions, pentecostal sermons, pragmeme, rhetoric

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Authors: Yvette Reisinger

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Relatively little is known about the Arab travel market, especially the outbound travel market from Arab countries in the Middle East. The Kuwaiti travel market is the smallest yet fastest growing in the Gulf Cooperation Council (GCC) region. The Kuwaiti travel market represents a great potential for the international tourism industry. Kuwaiti nationals have a very high spending power due to the Kuwaiti dinar being the highest-valued currency unit in the world. Although Europe, North America, and Asia/Pacific try to attract the Arab tourist market the number of Kuwaiti travellers attracted to these destinations is very low. The success in attracting the Kuwaiti travel market to Western countries must be guided by an analysis of the factors that affect its travel decisions. The objective of the study is to identify major factors that influence Kuwaiti nationals’ intentions to travel to Western countries. A model is developed and empirically tested on a sample of 343 Kuwaiti nationals. A series of regression analyses are run to determine the effects of different factors on Kuwaiti’s travel decisions. A Herman’s single factor test and Durbin-Watson test are used to assess the validity of the regression model. Analysis is controlled for socio-demographics. The results show that the Muslim friendly amenities and destination cognitive image exert significant effects on Kuwaiti nationals’ intentions to travel to Western countries. The study provides a better understanding of the factors that attract Kuwaiti tourists to Western countries. By knowing what encourages Kuwaitis to travel to Western countries marketers can plan and promote these countries accordingly. The study provides a foundation of future empirical research into the Kuwaiti/Arab travel market.

Keywords: Kuwaiti travel market, travel decisions, Western countries

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Authors: R. K. Yadav, S. Baral, H. R. Paudel, R. Basnet

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The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public healthcare providers in the fight against tuberculosis using international healthcare standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. A total of 20 respondents participated in the study. Barriers to PPM were identified in the following three themes: 1) Obstacles related to TB case detection, 2) Obstacles related to patients, and 3) Obstacles related to the healthcare system. PPM implementation was challenged by following subthemes that included staff turnover, low private sector participation in workshops, a lack of training, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. The study concludes that numerous barriers exist in the way of effective implementation of the PPM approach, including TB cases detection barriers such as knowledge of TB diagnosis and treatment, HW attitude, workload, patient-related barriers such as knowledge of TB, self-medication practice, stigma and discrimination, financial status, and health system-related barriers such as staff turnover and poor engagement of the private sector in workshops, training, recording, and re-evaluation. Government stakeholders must work together with private sector stakeholders to perform joint monitoring and supervision. Private practitioners should receive training and orientation, and presumptive TB patients should be given adequate time and counseling as well as motivation to visit a government health facility.

Keywords: barrier, tuberculosis, case finding, PPM, nepal

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Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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Authors: Shaya Alshahrani

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Perceived risks play a major role in consumer intentions, behaviors, attitudes, and decisions about online shopping in the KSA. This paper investigates the influence of six perceived risk dimensions on Saudi consumers: product risk, information risk, financial risk, privacy and security risk, delivery risk, and terms and conditions risk empirically. To ensure the success of this study, a random survey was distributed to reflect the consumers’ perceived risk and to enable the generalization of the results. Data were collected from 323 respondents in the Kingdom of Saudi Arabia (KSA): 50 who had never shopped online and 273 who had done so. The results indicated that all six risks influenced the respondents’ perceptions of online shopping. The non-online shoppers perceived financial and delivery risks as the most significant barriers to online shopping. This was followed closely by performance, information, and privacy and security risks. Terms and conditions were perceived as less significant. The online consumers considered delivery and performance risks to be the most significant influences on internet shopping. This was followed closely by information and terms and conditions. Financial and privacy and security risks were perceived as less significant. This paper argues that introducing adequate legal solutions to addressing related problems arising from this study is an urgent need. This may enhance consumer trust in the KSA online market, increase consumers’ intentions regarding online shopping, and improve consumer protection.

Keywords: perceived risk, online contracts, Saudi Arabia, consumer protection

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Authors: Hector Liu, Chih-Ming Tsai

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Consumer behaviors in the subscription of over-the-top (OTT) media services have substantially changed because of the COVID-19 pandemic; hence, this study aims to determine the factors affecting subscription intentions. The increased usage of OTT media, particularly in the lockdowns during the COVID-19 pandemic, has intensified the competition between both global and local streaming providers. While studies have discussed antecedents accounting for this change, they have paid limited attention to the psychological factors that shape consumer behavior in using OTT services. Given the changes in consumers’ psychological states during the pandemic, this study seeks to fill the research gap by integrating the expectancy-value model to provide insights into the key gratifications that consumers seek and obtain and that have affected their subscription to OTT services. This study proposes a theoretical model and assesses this framework on data collected from 1,068 OTT service users in Taiwan. The results strengthen the literature by indicating a clear growth in the popularity and subscription of OTT services because of the COVID-19 lockdowns as well as factors such as perceived quality and satisfaction, which influence behavioral intentions for OTT services. Most crucially, however, OTT viewers who acquired a sense of belonging, a sense of being accompanied, and a sense of reduction in anxiety due to being quarantined and in lockdown show a higher tendency to continue their subscriptions to their OTT services of choice during the pandemic. With consumer behavior trends forever changed by the COVID-19 pandemic, the implications from this study provide OTT service platforms with an opportunity to capitalize on their current and potential customers’ changing desires, demands, and factors for a continued subscription.

Keywords: consumer behavior, COVID-19, expectancy-value model, OTT media services

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Authors: Shaun G. Abbott, Rebecca C. Reynolds, John B. F. de Wit

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Low physical activity (PA) levels are a major public health concern in Australia. There is some evidence that PA interventions can increase PA levels via various methods, including online delivery. Low Socioeconomic Status (SES) people participate in less PA than the rest of the population, partly due to poor self-regulation behaviors associated with socioeconomic characteristics. Interventions that involve a particular method of self-regulation, Mental Contrasting with Implementation Intentions (MCII), has regularly achieved healthy behavior change, but few studies focus on PA behavior outcomes and no studies examining the effect of MCII on the PA behaviors of low SES people has been done. In this study, a pilot randomized controlled trial (RCT) will deliver MCII for PA behavior change to individuals of relative disadvantage for the first time. The current pilot study will predict sample size for a future full RCT and test the hypothesis that sedentary participants from areas of relative socioeconomic disadvantage of Sydney, who learn the MCII technique will be more physically active, have improved anthropometry and psychological indicators at the completion of a 12-week intervention compared to baseline and control. Eligible participants of relative socioeconomic disadvantage will be randomly assigned to either the ‘PA Information Plus MCII Intervention Group’ or a ‘PA Information-Only Control Group’. Both groups will attend a baseline and 12-week face-to-face consultation; where PA, anthropometric and psychological data will be gathered. The intervention group will be guided through an MCII session at the baseline appointment to establish a PA goal to aim to achieve over 12 weeks. Other than these baseline and 12-week consultations, all participant interaction will occur online. All participants will receive a ‘Fitbit’ accelerometer to record objectively. PA as a daily step count, along with a PA diary for the duration of the study. PA data will be recorded on a personalized online spreadsheet. Both groups will receive a standard PA information email at weeks 2, 4, and 8. The intervention group will also receive scripted follow-up online appointments to discuss goal progress. The current pilot study is in recruitment stage with findings to be presented at the conference in December if selected.

Keywords: implementation intentions, mental contrasting, motivation, pedometer, physical activity, socioeconomic

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Authors: Sanghoon Shim, Jaehwan Jung, Sung-Ah Kim

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As the digital technology develops, studies on the TUI (Tangible User Interface) that links the physical environment utilizing the human senses with the virtual environment through the computer are actively being conducted. In addition, there has been a tremendous advance in computer design making through the use of computer-aided design techniques, which enable optimized decision-making through comparison with machine learning and parallel comparison of alternatives. However, a complex design that can respond to user requirements or performance can emerge through the intuition of the designer, but it is difficult to actualize the emerged design by the designer's ability alone. Ancillary tools such as Gaudí's Sandbag can be an instrument to reinforce and evolve emerged ideas from designers. With the advent of many commercial tools that support 3D objects, designers' intentions are easily reflected in their designs, but the degree of their reflection reflects their intentions according to the proficiency of design tools. This study embodies the environment in which the form can be implemented by the fingers of the most basic designer in the initial design phase of the complex type building design. Leapmotion is used as a sensor to recognize the hand motions of the designer, and it is converted into digital information to realize an environment that can be linked in real time in virtual reality (VR). In addition, the implemented design can be linked with Rhino™, a 3D authoring tool, and its plug-in Grasshopper™ in real time. As a result, it is possible to design sensibly using TUI, and it can serve as a tool for assisting designer intuition.

Keywords: design environment, digital modeling, hand gesture, TUI, virtual reality

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Authors: Hiromi Takafuji

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Flight attendant:FA is one of popular occupation, especially in Asian countries, and the decision to be hired is made after clearing a high multiplier. On the other hand, immediately after joining the company, they experience unique stress due to the fact that the organization requires them to perform security and customer service duties in a highly specialized and limited space and time. As a result, despite the high level of difficulty in joining the company, many new recruits retire early at a high rate. It is commonly said that 30% of new graduates leave the company within three years in Japan and speculated that Reality Shock:RS is one of the causes of this. RS is that newcomers experience refers to the stress caused by the difference between pre-employment expectations and post-employment reality. The purpose of this study was to elucidate the mechanism by which the expertise required of new FA and the expectation of expertise held by each of them cause reality shock, which affects motivation and the decision to leave. This study identified the professionalism required of new FA and the impact of that expectation for professionalism on RS through an exploratory study of the experiences and psychological processes of FA who left within three years. Semi-structured in-depth interviews were conducted with five FA who left a major Japanese airline at an early stage, and their experiences were categorized, integrated, and classified by qualitative content analysis. They were chosen under a number of controlled conditions. Then two major findings emerged: first, that pre-employment expectations defining RS were hierarchical, and second, that training amplified expectations of professionalism, which strongly influenced early turnover. From these, this study generated a model of RS generative process model of FA that expectations are hierarchical and influential. This could contribute to the prevention of mental health deterioration by reality shock among new FA.

Keywords: reality shock, flight attendant, early turnover, qualitative study

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Authors: Merav Ben Natan, Moran Makhoul Khuri, Haviel Hammer, Maya Yarkoni

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Background: Studies indicate that nursing students often rank hospice nursing among their least preferred career paths. Understanding factors influencing their intent to work in hospice care is essential for improving interest in this field. Aim: This study aimed to explore the relationship between nursing students' intention to pursue a career in hospice care and various factors, including their attitudes towards caring for dying patients, death anxiety, personal or professional experience with dying patients, and the type of nursing program they are enrolled in. Methods: In this cross-sectional study, 200 nursing students completed an online survey using the Frommelt Attitude Toward Care of the Dying Scale and the Turkish Death Anxiety Scale. The survey assessed students' intentions to work in hospice care and related variables. Results: Only 11% of participants expressed an interest in working in hospice care. Students in the accelerated program for non-nursing Bachelor of Arts graduates showed a higher intention to work in hospice care compared to those in the generic program (β = 0.27, P < .001). Conversely, completion of clinical experience in a medical ward was associated with a lower intention to work in hospice care (β = −0.21, P < .01). Conclusions: The findings suggest that nursing students in accelerated programs for non-nursing graduates are more likely to intend to work in hospice care. Enhanced experience and support are recommended to sustain their interest. Clinical experience in medical wards does not effectively substitute for hospice-specific clinical experience.

Keywords: hospice nursing, nursing students, death anxiety, career intentions

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Authors: Benjamin Mugisha Bugingo

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Healthcare staffhas been considered as asignificant pillar to the health care system. However, the contest of human resources for health in terms of the turnover of health workers in Uganda has been more distinct in the latest years. The objective of the paper, therefore, were to investigate the influence Role Human resource management functions in on employeeperformance of professional health workers in public district hospitals in Kampala. The study objectives were: to establish the effect of performance management function, financialincentives, non-financial incentives, participation, and involvement in the decision-making on the employee performance of professional health workers in public district hospitals in Kampala. The study was devised in the social exchange theory and the equity theory. This study adopted a descriptive research design using quantitative approaches. The study used a cross-sectional research design with a mixed-methods approach. With a population of 402 individuals, the study considered a sample of 252 respondents, including doctors, nurses, midwives, pharmacists, and dentists from 3 district hospitals. The study instruments entailed a questionnaire as a quantitative data collection tool and interviews and focus group discussions as qualitative data gathering tools. To analyze quantitative data, descriptive statistics were used to assess the perceived status of Human resource management functions and the magnitude of intentions to stay, and inferential statistics were used to show the effect of predictors on the outcome variable by plotting a multiple linear regression. Qualitative data were analyzed in themes and reported in narrative and verbatim quotes and were used to complement descriptive findings for a better understanding of the magnitude of the study variables. The findings of this study showed a significant and positive effect of performance management function, financialincentives, non-financial incentives, and participation and involvement in decision-making on employee performance of professional health workers in public district hospitals in Kampala. This study is expected to be a major contributor for the improvement of the health system in the country and other similar settings as it has provided the insights for strategic orientation in the area of human resources for health, especially for enhanced employee performance in relation with the integrated human resource management approach

Keywords: human resource functions, employee performance, employee wellness, profecial workers

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Authors: Reza Vakili, Xiaolei Fan, Alex Walton

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The first near ambient pressure (NAP)-XPS study of CO oxidation over Pt nanoparticles (NPs) incorporated into Zr-based UiO (UiO for Universitetet i Oslo) MOFs was carried out. For this purpose, the MOF-based Catalysts were prepared by wetness impregnation (WI-PtNPs@UiO-67) and linker design (LD-PtNPs@UiO-67) methods along with PtNPs@ZrO₂ as the control catalyst. Firstly, the as-synthesized catalysts were reduced in situ prior to the operando XPS analysis. The existence of Pt(II) species was proved in UiO-67 by observing Pt 4f core level peaks at a high binding energy of 72.6 ± 0.1 eV. However, by heating the WI-PtNPs@UiO-67 catalyst in situ to 200 °C under vacuum, the higher BE components disappear, leaving only the metallic Pt 4f doublet, confirming the formation of Pt NPs. The complete reduction of LD-PtNPs@UiO-67 is achieved at 250 °C and 1 mbar H₂. To understand the chemical state of Pt NPs in UiO-67 during catalytic turnover, we analyzed the Pt 4f region using operando NAP-XPS in the temperature-programmed measurements (100-260 °C) with reference to PtNPs@ZrO₂ catalyst. CO conversion during NAP-XPS experiments with the stoichiometric mixture shows that LD-PtNPs@UiO-67 has a better CO turnover frequency (TOF, 0.066 s⁻¹ at 260 °C) than the other two (ca. 0.055 s⁻¹). Pt 4f peaks only show one chemical species present at all temperatures, but the core level BE shifts change as a function of reaction temperature, i.e., Pt 4f peak from 71.8 eV at T < 200 °C to 71.2 eV at T > 200 °C. As this higher BE state of 71.8 eV was not observed after in situ reductions of the catalysts and only once the CO/O₂ mixture was introduced, we attribute it to the surface saturation of Pt NPs with adsorbed CO. In general, the quantitative analysis of Pt 4f data from the operando NAP-XPS experiments shows that the surface chemistry of the Pt active phase in the two PtNPs@UiO-67 catalysts is the same, comparable to that of PtNPs@ZrO₂. The observed difference in the catalytic activity can be attributed to the particle sizes of Pt NPs, as well as the dispersion of active phase in the support, which are different in the three catalysts.

Keywords: CO oxidation, heterogeneous catalysis, MOFs, Metal Organic Frameworks, NAP-XPS, Near Ambient Pressure X-ray Photoelectron Spectroscopy

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Authors: Ehsan Samimi, Mohammaa Ali Shahosseeni, Ali Abasltian, Shahriar Shafaghi

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Background/Objectives: Voluntary turnover and early retirement request by specialists and experienced people in project-based organizations (PBO) has caused many problems in finding suitable experts to execute the projects. Methods/Statistical analysis: The present study is a descriptive and applied research. Research population consists of KWs in oil and gas PBO. The engineers in these organizations were considered as research sample. Interviews and questionnaire were used to gather information. Interviews with experts were used to identify factors and questionnaires were utilized to identify the importance and prioritization. 72 factors were identified and categorized into 9 groups within organizational and HR initiative levels. Results: Results of the research indicate the priority of each group of factors according to the proposed model in the view of KWs in oil, gas and petrochemical industries. On this basis, the following factors have the highest effect ratio based on the respondents’ point of view: 1. knowledge management 2. Performance appraisal system 3. Communication 4.Training and development 5.Job design and analysis 6. Employment policies 7. Career planning 8. Project/organizational factors 9. Salary and rewards. Additionally, in each group the priority of effective sub-factors has been identified as the result of the research .The results support the definitions of KWs and influence of factors examined and specified by similar studies in retention and development of KWs. The high importance of knowledge management and low rank for salary and rewards can be mentioned as example in this regard. Despite the priority of each group of factors the uniqueness of the result is due to identification of effective factors in the specific industry (oil and gas) and type of organization (PBO). Conclusion/Application: The findings of present study can be used to devise plans for retaining and developing KWs in PBO especially in oil and gas industry.

Keywords: project–based organizations, knowledge workers, HR management, turnover, retaining and developing employees

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Authors: Limor Gadot, Orly Sarid

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Integration of young adults with disabilities (YAWD) into workplaces provides an opportunity for social and occupational mobility, enabling them to financial independence. To enhance integration, it is important to understand their occupational preferences as well as the factors that influencing it such as demographic variables, self-assessed health, beliefs about work, subjective norms, and self-efficacy. Planned behavior theory was chosen as a basis for this study. A cross-sectional study, based on preliminary sample of 37 YAWD who have been recognized by the National Insurance Institute and are engaged in a year of national service. The finding shows that most of the participants were single (97%) women (60%); average age was 22(+ 2) years, approximately half were secular. Most of the participants had disabilities resulting from CP (96%). Self-assessed health was correlated positively and significantly with behavioral intentions to work in the free market (r = .33, p = .05), and significant negative correlation with behavioral intentions to work in supported settings (r =.-40, p = .01), and sheltered settings (r =-.36, p = .03): individuals who perceived themselves as having more severe disabilities showed a greater tendency to choose a workplace with more rehabilitative inputs. Furthermore, women showed a greater tendency than men to perceive their disability as impairing their future intention to work: t (36) = 2.23, p < .05. Beliefs about work were positively associated with normative beliefs (r = .308, p = .06). The findings indicate that, especially with women, perceptions of health are related to occupational preferences. Moreover, the findings indicate that the relationship between subjective norms about work and normative beliefs about integrating in a workplace that prevail in the individual's environment affects occupational preferences. The contribution of the study lies in the development of new responses and interventions to encourage adults with disabilities to work.

Keywords: young adults, disabilities, work preferences, occupational preferences

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Authors: Siti Noor Baiti Binti Mustafa

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Energy management studies regarding energy efficiency investments in Malaysia has yet to address the lack of empirical research that examines pro- sustainability behavior of managers in the industrial sector and how it influences energy efficiency investment decision-making. This study adopts the Theory of Planned Behavior (TPB) to examine the relationship between personal attitude, subjective norms, and perceived behavioral control (PBC), the intention of energy efficiency investments, and how perceptions of Non-Energy Benefits (NEB) influence these intentions among managers in the industrial sector in Malaysia. Managers from various sub-sectors in the industrial sector were selected from a sample of companies that are participants of the Government-led program named the Energy Audit Conditional Grant (EACG) that aimed to promote energy efficiency. Data collection was conducted through an online semi-structured, open-ended questionnaire and then later interviewed. The results of this explorative sequential qualitative study showed that perceived behavioral control was a significant predictor of energy efficiency investment intentions as compared to factors such as attitude and subjective norms. The level of awareness and perceptions towards NEB further played a significant factor in influencing energy efficiency investment decision-making as well. Various measures and policy recommendations are provided together with insights on factors that influence decision-makers intention to invest in energy efficiency, whilst new knowledge on NEB perceptions will be useful to enhance the attractiveness of energy-efficient investments.

Keywords: energy efficiency investments, non-energy benefits, theory of planned behavior, personal attitude, subjective norms, perceived behavioral control, Malaysia industrial sector

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Authors: Janell Jayamohan

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A pilot project based on the Theory of Planned Behavior was completed at a single sex female international high school in order to improve the quality of comprehensive sex education in a 12th grade classroom. The student sample is representative of a growing phenomenon of “Third Culture Kids” or global nomads; often in today’s world, culture transcends any one dominant influence and blends values from multiple sources. The Objective was to improve intentions of condom use during the students’ first or next intercourse. A peer-education session which focused on condom attitudes, social norms, and self-efficacy - central tenets of the Theory of Planned Behavior - was added to an existing curriculum in order to achieve this objective. Peer educators were given liberty of creating and executing the lesson to their homeroom, a sample of 23 senior students, with minimal intervention from faculty, the desired outcome being that the students themselves would be the best judge of what is culturally relevant and important to their peers. The school nurse and school counselor acted as faculty facilitators but did not assist in the creation or delivery of the lesson, only checked for medical accuracy. The participating sample of students completed a pre and post-test with validated questions assessing changes in attitudes and overall satisfaction with the peer education lesson. As this intervention was completed during the Covid-19 pandemic, the peer education session was completed in a virtual classroom environment, limiting the modes of information delivery available to the peer educators, but is planned to be replicated in an in-person environment in subsequent cycles.

Keywords: adolescents, condoms, peer education, sex education, theory of planned behavior, third culture kids

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Authors: Rujuta Matapurkar, Shivganesh Bhargava

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This paper discusses work-family enrichment and its relationship with certain antecedents and outcomes while considering effect of mindfulness and organizational pride as moderators. The work-family enrichment has been the topic of interest for researchers as well as practitioners for decades now. It focusses on the positive side of work family interaction rather that the scarcity or balance principle. Research shows that work family enrichment is linked to multiple work place outcomes like job satisfaction, organization citizenship behavior and turnover intention. Enrichment is also linked to life outcomes like life satisfaction, wellbeing. Thus not only the individuals but the organizations too want to engage in the activities resulting in the positive spillover between work and non-work domains. One of the recent focus areas in organization behavior literature has been Mindfulness. Mindfulness is defined as a trait or state in which the mind focuses on the present. It is the conscious attention and awareness of the present thought. The research in the area of mindfulness at work suggests that the same is related to work family balance and job satisfaction. This paper discusses the possibility of mindfulness having effect on the relationship between antecedents of enrichment and enrichment. On the outcome side job embeddedness and job ambivalence are the newest additions to the retention literature. Job ambivalence talks about having strong positive as well as negative feelings about the job. Job ambivalence is the work outcome which is linked to turnover intention. This paper talks about the relationship between enrichment and job ambivalence. Another measure for work place outcomes which is discussed in recent research is job embeddedness. This term talks about the advantages of continuing with the job rather than quitting it. It is described as like a net or a web in which an individual can become stuck and is focused on why people stay rather than on how they leave. The research has have found that establishing or increasing job embeddedness is likely to increase retention, attendance, citizenship and job performance. This paper studies the relationship between enrichment and embeddedness. Lastly this paper studies whether organizational pride has an an effect on the relationship between enrichment and its outcomes. This paper concludes with the direction for future research.

Keywords: work-family enrichment, mindfulness, job ambivalence, job embeddedness, organizational pride

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Authors: Taghrid Asfar, Olusanya J. Oluwole, Michael Schmidt, Alejandra Casas, Zoran Bursac, Wasim Maziak.

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Waterpipe (WP) smoking (a.k.a. hookah) has increased dramatically in the US mainly due to the misperception that it is safer than cigarette smoking. Mounting evidence show that WP smoking is addictive and harmful. Health warning labels (HWLs) are effective in communicating smoking-related risks. Currently, the FDA requires that WP tobacco packages have a textual HWL about nicotine. While this represents a good step, it is inadequate given the established harm of WP smoking beyond addiction and the superior performance of pictorial HWLs over text-only ones. We developed 24 WP pictorial HWLs in a Delphi study among international expert panel. HWLs were grouped into 6 themes: addiction, harm compared to cigarettes, harm to others, health effects, quitting, and specific harms. This study aims to compare the effect of the pictorial HWLs compared to the FDA HWL, and 2) the effect of pictorial HWLs between the 6 themes. A 2x7 between/within subject online factorial experimental study was conducted among a national convenience sample of 300 (50% current WP smokers; 50% nonsmokers) US adults (females 71.1%; mean age of 31.1±3.41 years) in March 2022. The first factor varied WP smoking status (smokers, nonsmokers). The second factor varied the HWL theme and type (text, pictorial). Participants were randomized to view and rate 7 HWLs: 1 FDA text HWL (control) and 6 HWLs, one from each of the 6 themes, all presented in random order. HWLs were rated based on the message impact framework into five categories: attention, reaction (believability, relevance, fear), perceived effectiveness, intentions to quit WP among current smokers, and intention to not initiate WP among nonsmokers. measures were assessed on a 5-point Likert scale (1=not at all to 5=very much) for attention and reaction and on a 7-point Likert scale (1=not at all to 7=very much) for the perceived effectiveness and intentions to quit or not initiate WP smoking. Means and SDs of outcome measures for each HWL type and theme were calculated. Planned comparisons using Friedman test followed by pairwise Wilcoxon signed-rank test for multiple comparisons were used to examine distributional differences of outcomes between the HWL type and themes. Approximately 74.4 % of participants were non-Hispanic Whites, 68.4% had college degrees, and 41.5% were under the poverty level. Participants reported starting WTS on average at 20.3±8.19 years. Compared with the FDA text HWL, pictorial HWLs elicited higher attention (p<0.0001), fear (p<0.0001), harm perception (p<0.0003), perceived effectiveness (p<0.0001), and intentions to quit (p=0.0014) and not initiate WP smoking (p<0.0003). HWLs in theme 3 (harm to others) achieved the highest rating in attention (4.14±1), believability (4.15±0.95), overall perceived effectiveness (7.60±2.35), harm perception (7.53±2.43), and intentions to quit (7.35±2.57). HWLs in theme 2 (WP harm compared to cigarettes) achieved the highest rating in discouraging WP smoking initiation (7.32±2.54). Pictorial HWLs were superior to the FDA text-only for several communication outcomes. Pictorial HWLs related to WP harm to others and WP harm compared to cigarette are promising. These findings provide strong evidence for the potential implementation of WP-specific pictorial HWLs.

Keywords: health communication, waterpipe smoking, factorial experiment, reaction, harm perception, tobacco regulations

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