β-thalassemia is an autosomal recessive blood disorder caused by gene mutations that affect all aspects of β-globin production. In majority of Asian countries including India, the frequency of β-thalassemia is closely intertwined with social, cultural, and religious issues of the respective country. Several national level screening programs imparted education regarding β-thalassemia, but follow-up evaluation revealed that education was not effective. It has been hypothesized that the beliefs and attitudes, carrier screening, and education among Bhigh risk communities^will have far-reaching implications towards β-thalassemia prevention in the country. The present study is aimed to investigate attitudes, intention, and behavior of β-thalassemia high-and low-risk ethnic groups towards carrier screening and education. A structured questionnaire on knowledge, attitude, and practice regarding β-thalassemia was administered on 926 individuals belong to Arora, a high-risk ethnic group for β-thalassemia (347 rural (AR) and 202 urban (AU)) and 377 cosmopolitan commoners (CC) aged above 18 years of both sexes. To understand the relationship between various questions, Pearson's correlation test and factor analysis was performed. The responses were further categorized into the theory of planned behavior (TPB) constructs with the measures of the main constructs reported as a mean. Various dimensions of knowledge, attitude, and practice reveal that the urban groups (AU and CC) are better aware of the disease Bβ-thalassemiat han the rural group (AR) who witness suffering at close quarters. The AR group is more positive for preventive measures than the urban groups. Significant correlations and factor analysis show Bintentions^for premarital and prenatal screening highly loaded as outcome behaviors. The Ajzen's BTheory of planned behavior^support that the Bintention^and Bperceived behavior control^are better predictors of Boutcome behavior^compared to Battitude^and Bsubjective norm.^As this study is crosssectional and descriptive in nature, the constructs of the theory should be considered as perceptions. However, we believe the patterns observed are indicative of Bpredicting behavior^that has far-reaching implications on health planners and administrators in designing β-thalassemia screening and prevention program.

There are approximately 240 million people across the world who are heterozygous for Beta thalassemia and 200,000 affected homozygous are born annually. Prevention is a big challenge. But the situation in India is different. Social, cultural, and religious issues are found to be closely intertwined with Beta thalassemia prevention. In spite of 10,000 annual Beta thalassemic births, the situation here is not well combated. Social stigma and negative attitude are largely understood to be the bounding factors. The present study examines the prevention issue in the high risk community of India, analyzing their knowledge and perceptions in the light of available health models.