Social Cognitive Determinants of Betel Quid Chewing among College Students in Southern Taiwan

• Main Authors: Chih-Hung Chang, 張志宏
• Other Authors: Huei-Chen Ko
• Format: Others
• Language: zh-TW
• Published: 2006
• Online Access: http://ndltd.ncl.edu.tw/handle/64202193487478661041

碩士 === 國立成功大學 === 行為醫學研究所 === 94 === Background It has been well documented that the use of betel quid is harmful for health. However, a majority of literature about betel quid focused on its prevalence and oral cancer. It is worth and imperative to understand the psychosocial process of betel quid chewing. In social science, the Attitudes- Social Influence-Self-Efficacy (ASE) model has been applied to explain human behavior widely. According to the ASE model, behaviors are predicted by intention, which is explained by three important social cognitive factors: attitude, social influence, and self efficacy. However, the full model has not been completely supported by empirical data; for example, outcome expectancy would have an indirect impact on the intention to chew and actual betel quid use through refusal self-efficacy. Therefore, this study proposed a revised ASE model and aimed to examine the revised ASE Model in explaining the psychosocial process of betel quid use among Southern Taiwan college students through Structural Equation Modeling. Methods (1).participants: a cluster sampling was used to sample the population of southern Taiwan college students. There were 5,137 college students invited to participate, with a final of 3,741 college students joining the study. After excluding incompletely data, the valid sample included 3,162 students (61.55%). (2). measurements: demographic data, betel quid chewing intention, betel quid chewing behavior, betel quid outcome expectancy, social influence, and betel quid refusal self-efficacy (3).procedure: data were collected in 2003 from 14 colleges in Southern Taiwan. Before the group administration, the purpose and details of the study and their confidentiality were fully explained and obtained their informed consents. (4). statistical analysis: we compared two competing models and examined the relationship among the variables through the Structural Equation Model (SEM) which was carried out by AMOS program (Amos 5.0) Results The prevalence of betel quid use was 7.1% (223/3 162) for all college students, which accounted for 2.1% in females and 13.8% in males. It showed that the revised ASE model accounted for 26.5% of the variance in betel quid use and had a better model-fit evaluation than the original model. Intention to chew affected the use of betel quid, while both social influence and refusal self-efficacy had a direct impact on intention and use as well as an indirect effect on use through intention. Additionally, both positive and negative outcome expectancies predicted intention and betel quid use via refusal self-efficacy. Conclusion and Implication The revised ASE model contributed additional information to the literature which may help researchers understand the psychosocial process of betel quid chewing. Moreover, implications of the revised ASE model were provided with respect to the development of effective prevention programs and clarified the relationships between social cognitive variables, suggesting that more attention should be given towards the development of school-based preventive programs on diminishing social influence and promoting refusal self-efficacy in betel quid use.