title: Stakeholder reactions toward iodine biofortified foods. An application of protection motivation theory.
abstract: OBJECTIVE
  To use Protection Motivation Theory (PMT) to evaluate stakeholders' intention to adopt iodine biofortified foods as an alternative means to improve children's iodine status and overall school performance.
  
  
  METHODS
  A survey was administered with 360 parents of primary school children and 40 school heads. Protection motivation is measured through matching the cognitive processes they use to evaluate iodine deficiency (threat appraisal), as well as iodine biofortified foods to reduce the threat (coping appraisal). Data were analyzed through Robust (Cluster) regression analysis.
  
  
  RESULTS
  Gender had a significant effect on coping appraisal for school heads, while age, education, occupation, income, household size and knowledge were significant predictors of threat, coping appraisal and/or protection motivation intention among parents. Nevertheless, in the overall protection motivation model, only two coping factors, namely self-efficacy (parents) and response cost (school heads), influenced the intention to adopt iodine biofortified foods.
  
  
  CONCLUSIONS
  School feeding programs incorporating iodine biofortification should strive to increase not only consumer knowledge about iodine but also its association to apparent deficiency disorders, boost self-efficacy and ensure that the costs incurred are not perceived as barriers of adoption. The insignificant threat appraisal effects lend support for targeting future communication on biofortification upon the strategies itself, rather than on the targeted micronutrient deficiency. PMT, and coping factors in particular, seem to be valuable in assessing intentions to adopt healthy foods. Nevertheless, research is needed to improve the impacts of threat appraisal factors.
authors.affiliation: Department of Agricultural Economics, Faculty of Biosciences Engineering, Ghent University, Coupure Links 653, B-9000 Ghent, Belgium. Electronic address: Hans.DeSteur@ugent.be.
authors.forename: Hans
authors.initials: H
authors.lastname: De Steur
authors.affiliation: Department of Agricultural Economics, Faculty of Biosciences Engineering, Ghent University, Coupure Links 653, B-9000 Ghent, Belgium; Department of Nutrition and Dietetics, Faculty of Health Sciences, Mount Kenya University, P.O. Box 342-01000, Thika, Kenya.
authors.forename: Joseph Birundu
authors.initials: JB
authors.lastname: Mogendi
authors.affiliation: Department of Agricultural Economics, Faculty of Biosciences Engineering, Ghent University, Coupure Links 653, B-9000 Ghent, Belgium.
authors.forename: Joshua
authors.initials: J
authors.lastname: Wesana
authors.affiliation: Department of Food Science and Technology/Nutrition, Faculty of Agriculture, Jomo Kenyatta University of Agriculture and Technology, P.O Box 62000-00200, Nairobi, Kenya.
authors.forename: Anselimo
authors.initials: A
authors.lastname: Makokha
authors.affiliation: Department of Agricultural Economics, Faculty of Biosciences Engineering, Ghent University, Coupure Links 653, B-9000 Ghent, Belgium.
authors.forename: Xavier
authors.initials: X
authors.lastname: Gellynck
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D003677:Deficiency Diseases / Q000453:epidemiology / Q000517:prevention & control*; D007887:Fabaceae / Q000737:chemistry*; D005522:Food Services / Q000191:economics; D007722:Health Knowledge, Attitudes, Practice; D006284:Health Plan Implementation / Q000191:economics; D006801:Humans; D007455:Iodine / Q000008:administration & dosage* / Q000009:adverse effects / Q000172:deficiency / Q000627:therapeutic use; D008960:Models, Psychological; D009042:Motivation; D052756:Nutritional Sciences / Q000193:education; D010290:Parents; D015995:Prevalence; D012423:Rural Health / Q000191:economics / Q000193:education; D012574:Schools; D012639:Seeds / Q000737:chemistry*; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology; D000078329:Workforce
chemical_list: D007455:Iodine
keywords: Biofortified foods; Iodine deficiency; Protection motivation theory; School feeding programs; Stakeholder perceptions; Uganda