Predictive Social Norms of Physicians’ Intention to Use Liver Cancer Screening: Based on an Extended Theory of Planned Behavior

Abstract

Background: Globally, liver cancer is one of the most malignant tumors and has become a great concern to public health. The serious context of liver cancer prevention and control urges researchers to find more evidence about liver cancer screening and to expand its use. The purpose of this study was to determine the predictors associated with physicians’ intention to use liver cancer screening. Methods: We took contrast-enhanced ultrasound (CEUS) as an example, and developed the research framework by adding socials norms to the Theory of Planned Behavior (TPB). Data was collected via a cross-sectional questionnaire survey on a sample of 292 physicians randomly selected from Fujian and Jiangxi provinces in China with a high and low incidence of liver cancer, respectively. Due to the multicollinearity problem of the data, ridge regression was applied to determine the influencing factors of physicians’ intention to use CEUS. Results: Most of the participants (87.30%) reported that they were willing to use liver cancer screening in their clinical practice. The scores of TPB variables were generally higher than those of social norms variables. Regression results indicated that the proposed model was explanatory, which has accounted for 72.6% of the total variance in physicians’ intention. Analyses also illustrated the significant role of TPB variables (attitude and perceived behavioral control) and social norms variables (personal norms, organizational norms, and industrial norms) on the physicians’ intention to use CEUS. Conclusions: The study extended the Theory of Planned Behavior (TPB) by including the concepts of social norms, which is not only conducive to expanding the knowledge of factors associated with physicians’ intention to use liver cancer screening, but also provide implications for developing strategies to promote the use of certain health services or products, such as playing the roles of core members, holding the panel meeting, and establishing an information push system.