Understanding healthcare workers' green behavioral intentions in Taiwan: an integrated VAB-TPB framework with government policy as a moderator

PURPOSE: This study investigates the psychological determinants of healthcare professionals' support for green hospital transitions by integrating the values-attitude-behavior (VAB) framework with the Theory of Planned Behavior. DESIGN/METHODOLOGY/APPROACH: A survey of 300 Taiwanese healthcare employees was conducted, and the data were analyzed using Covariance-Based Structural Equation Modeling. FINDINGS: Green values (GV) had a significant positive influence on attitudes, subjective norms (SN), and perceived behavioral control (PBC). However, GV did not directly influence behavioral intention. Among the theory constructs, only PBC had a significant positive effect on behavioral intentions (BI). Attitudes and SN did not have significant impacts. Furthermore, government policy (GP) demonstrated a significant positive direct effect on BI, however, analysis found no significant moderating effects on the relationships between attitude, subjective norm, PBC and intention. RESEARCH LIMITATIONS/IMPLICATIONS: The study focused on healthcare workers in Taiwan, future research should include more diverse populations or conduct comparative studies across various regions. PRACTICAL IMPLICATIONS: Hospital managers should prioritize training and resource provision to enhance staff control over environmental practices, while policymakers should maintain clear regulations and incentives to accelerate progress toward carbon-neutral healthcare. SOCIAL IMPLICATIONS: The findings of this study have significant implications for the development of sustainable healthcare practices and the achievement of sustainable development goals. ORIGINALITY/VALUE: Originality lies in the study's integrated VAB-TPB framework, which is uniquely applied to the high-constraint healthcare environment, offering a more nuanced model than prior single-theory applications. This study differs by demonstrating the primacy of PBC over attitudes and norms in a professional context and identifying GP as a direct driver rather than a moderator of intention. Focusing on Taiwan provides a distinctive case study of a high-performing healthcare system facing an urgent, policy-driven sustainability transition, strengthening the study's contribution to the green healthcare field.