title: Modelling protection behaviour towards micronutrient deficiencies: Case of iodine biofortified vegetable legumes as health intervention for school-going children.
abstract: OBJECTIVE
  Despite successes recorded in combating iodine deficiency, more than 2 billion people are still at risk of iodine deficiency disorders. Rural landlocked and mountainous areas of developing countries are the hardest hit, hence the need to explore and advance novel strategies such as biofortification.
  
  
  METHODS
  We evaluated adoption, purchase, and consumption of iodine biofortified vegetable legumes (IBVL) using the theory of protection motivations (PMT) integrated with an economic valuation technique. A total of 1,200 participants from three land-locked locations in East Africa were recruited via multi-stage cluster sampling, and data were collected using two, slightly distinct, questionnaires incorporating PMT constructs. The survey also elicited preferences for iodine biofortified foods when offered at a premium or discount. Determinants of protection motivations and preferences for iodine biofortified foods were assessed using path analysis modelling and two-limit Tobit regression, respectively.
  
  
  RESULTS
  Knowledge of iodine, iodine-health link, salt iodization, and biofortification was very low, albeit lower at the household level. Iodine and biofortification were not recognized as nutrient and novel approaches, respectively. On the other hand, severity, fear, occupation, knowledge, iodine status, household composition, and self-efficacy predicted the intention to consume biofortified foods at the household level; only vulnerability, self-efficacy, and location were the most crucial elements at the school level. In addition, results demonstrated a positive willingness-to-pay a premium or acceptance of a lesser discount for biofortification. Furthermore, preference towards iodine biofortified foods was a function of protection motivations, severity, vulnerability, fear, response efficacy, response cost, knowledge, iodine status, gender, age. and household head.
  
  
  CONCLUSIONS
  Results lend support for prevention of iodine deficiency in unprotected populations through biofortification; however 'threat' appraisal and socio-economic predictors are decisive in designing nutrition interventions and stimulating uptake of biofortification. In principle, the contribution is threefold: 1) Successful application of the integrated model to guide policy formulation; 2) Offer guidance to stakeholders to identify and tap niche markets; 3) stimulation of rural economic growth around school feeding programmes.
authors: Department of Agricultural Economics, Faculty of BioSciences Engineering, Ghent University, Coupure Links 653, B-9000 Ghent, Belgium.; Department of Food Science and Technology/Nutrition. Faculty of Agriculture, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
authors: Joseph Birundu
authors: JB
authors: Mogendi
authors: Department of Agricultural Economics, Faculty of BioSciences Engineering, Ghent University, Coupure Links 653, B-9000 Ghent, Belgium.
authors: Hans
authors: H
authors: De Steur
authors: Department of Agricultural Economics, Faculty of BioSciences Engineering, Ghent University, Coupure Links 653, B-9000 Ghent, Belgium.
authors: Xavier
authors: X
authors: Gellynck
authors: Department of Food Science and Technology/Nutrition. Faculty of Agriculture, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
authors: Anselimo
authors: A
authors: Makokha
keywords: Biofortification; food preference; iodine; iodine deficiency; protection motivations