Inhalation adherence among older males with chronic obstructive pulmonary disease: a structural equation model applying the theory of planned behavior

Saffari, M, Wang, YH, Lee, C-H, Aljaberi, MA, Chen, J-S, Huang, C-M, Griffiths, MD ORCID: https://orcid.org/0000-0001-8880-6524 and Lin, C-Y, 2025. Inhalation adherence among older males with chronic obstructive pulmonary disease: a structural equation model applying the theory of planned behavior. American Journal of Health Behavior, 49 (3), pp. 323-334. ISSN 1087-3244

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Abstract

Objectives: Theoretical frameworks such as the theory of planned behavior (TPB) may provide a basis to study psychological factors associated with inhalation adherence among individuals with chronic obstructive pulmonary disease (COPD). The present study was designed to assess the predictability of TPB constructs for adequate adherence to inhalation therapy among this population.

Methods: Using convenience sampling, 374 Taiwanese males with COPD (mean age: 72.69 years [SD±9.53] completed the Intention of Inhaled Medication Adherence Scale (which is based on TPB constructs), and the Test of Adherence to Inhalers Questionnaire. Structural equation modeling (SEM) was used to assess direct/indirect associations and likely mediating mechanisms.

Results: The SEM model indicated a good fit and demonstrated the direct effects of subjective norms (β=0.254, p=0.003) and attitude (β=0.186, p=0.018) on adherence intention. There was also an indirect association between subjective norms and adherence through behavioral intention (β=0.039; p=0.046).

Conclusions: The TPB appears to be a suitable theoretical framework to assess inhalation adherence among individuals with COPD. Further research is warranted using the theory among individuals with different sociodemographic variables affected by COPD as well as those with other respiratory conditions.

Item Type:	Journal article
Publication Title:	American Journal of Health Behavior
Creators:	Saffari, M., Wang, Y.H., Lee, C.-H., Aljaberi, M.A., Chen, J.-S., Huang, C.-M., Griffiths, M.D. and Lin, C.-Y.
Publisher:	PNG Publications
Date:	1 June 2025
Volume:	49
Number:	3
ISSN:	1087-3244
Identifiers:	Number Type 10.5993/AJHB.49.3.6 DOI 2485049 Other
Rights:	This article is Open Access under the terms of the Creative Commons CC BY-NC-ND licence. https://creativecommons.org/licenses/by-nc-nd/4.0/
Divisions:	Schools > School of Social Sciences
Record created by:	Jonathan Gallacher
Date Added:	14 Aug 2025 16:02
Last Modified:	14 Aug 2025 16:02
URI:	https://irep.ntu.ac.uk/id/eprint/54207

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