基于COM-B模型的大学生幽门螺杆菌筛查意愿影响因素研究OA北大核心CSTPCD

Objective This study aims to investigate the current levels of willingness to participate in Helicobacter pylori(H.pylori)screening among college students in China and the influencing factors,pathways,and mechanisms using the COM-B(Capability-Opportunity-Motivation Behavior)model as the theoretical framework.Suggestions to develop intervention strategies to improve infection screening levels are expected to be proposed.Methods By using a multi-stage stratified sampling method,college students from different regions in China were selected.A questionnaire survey was conducted to investigate their willingness to participate in H.pylori screening and its influencing factors.Analyze statistically the screening willingness of the surveyed individuals.Stratified regression analysis was employed to identify the factors influencing college students'willingness to participate in H.pylori screening from three dimensions:capability,opportunity,and motivation.Additionally,a Structural Equation Modeling framework was constructed to evaluate the overall fit of the model.Mediation analysis was then performed to uncover the specific pathways and mechanisms through which the dimensions of capability,opportunity,and motivation influence the willingness,elucidating their roles in detail.Results A questionnaire survey was conducted among 2 242 college students from 6 cities in Shandong and Shaanxi provinces.The score for college students'willingness to participate in H.pylori screening was(2.90±1.29),indicating a moderate level.Capability factors(health literacy,H.pylori knowledge level),opportunity factors(social norms),and motivation factors(self-efficacy,anticipated regret)had significantly positive and predictive effects on college students'screening willingness(P＜0.001).The structural equation model showed good overall fit.Among them,capability factors(β=0.090)and opportunity factors(β=0.305)indirectly influenced screening willingness through motivation factors,with the last playing a mediating role.Specifically,self-efficacy(β=0.023)and anticipated regret(β=0.020)under the motivation dimension mediated the relationship between capability factors and screening willingness.Self-efficacy(β=0.180)and anticipated regret(β=0.073)also mediated the relationship between opportunity factors and screening willingness.Relationships between these factors were statistically significant(P＜0.05).Conclusions The willingness of college students to participate in H.pylori screening needs to be improved.Capability factors,opportunity factors,and motivation factors significantly and positively predict the willingness to participate in H.pylori screening.Self-efficacy and anticipated regret under the motivation dimension serve as mediating variables between capability factors,opportunity factors,and screening willingness.College students are recommended to participate in H.pylori screening as early as possible.