title: Understanding childhood lead poisoning preventive behaviors: the roles of self-efficacy, subjective norms, and perceived benefits.
abstract: BACKGROUND
  Understanding individual and social influences on behaviors commonly recommended to prevent lead poisoning in children can guide more effective educational interventions.
  
  
  METHODS
  In-person interviews were conducted with primary caregivers (n = 380) of American Indian and White children aged 1 to 6 living in or near the Tar Creek Superfund site in northeastern Oklahoma. Caregivers' perceived health benefits, self-efficacy, and subjective norms were assessed for four lead poisoning prevention behaviors (i.e., annual blood lead testing, playing in safe areas, washing hands before eating, and dusting with a damp cloth).
  
  
  RESULTS
  Caregivers spoke with their own mothers, spouses, and other female family members most often when they had concerns or worries about taking care of their children. In multivariate models, subjective norms, perceived benefits, and self-efficacy were positively associated with the hand-washing and damp-dusting behaviors, while only self-efficacy was associated with playing in safe areas. None of the variables were found to have significant influence on the blood lead testing behavior.
  
  
  CONCLUSIONS
  Education programs should address individual level factors such as self-efficacy and perceived health benefits but also consider new strategies that incorporate a normative dimension to lead poisoning prevention.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
authors.forename: Angela D
authors.initials: AD
authors.lastname: Bland
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Kegler
authors.forename: Cam
authors.initials: C
authors.lastname: Escoffery
authors.forename: Lorraine
authors.initials: L
authors.lastname: Halinka Malcoe
mesh_terms: D017028:Caregivers; D002648:Child; D002652:Child Behavior; D002669:Child Welfare; D002675:Child, Preschool; D015331:Cohort Studies; D004782:Environmental Health; D005195:Family Relations; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D007198:Indians, North American; D007855:Lead Poisoning / Q000453:epidemiology / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009825:Oklahoma; D011322:Primary Prevention / Q000193:education*; D011336:Probability; D012016:Reference Values; D012307:Risk Factors; D020377:Self Efficacy