[Intention to Participate in Disability Prevention Services Among Older Adults: An Exploration of Gender Differences Using the Health Belief Model].

BACKGROUND: Rates of participation in public initiatives to prevent and delay disability differ by gender, with notably lower participation by males. Identifying gender-specific factors is essential for developing effective strategies to boost participation rates. PURPOSE: In this study, the attitudes toward the preventability of disability and the core constructs of the Health Belief Model (HBM) were considered in terms of their influence on intention to participate in preventive services among community-dwelling older adults. Gender-based differences in the influence of each factor were examined. METHODS: A cross-sectional design was adopted. A total of 200 community-dwelling older adults aged 65 and above were surveyed using a structured questionnaire. Attitudes toward the preventability of disability, core HBM constructs, and intention to participate in services were measured. Data were analyzed using t-tests, chi-square tests, and regression analyses, and mediation effects were examined using the PROCESS model. RESULTS: Compared to their male counterparts, the female participants exhibited more positive attitudes toward preventability (t = -2.856, p < .01), perceived benefits (t = -3.069, p < .01), self-efficacy (t = -2.986, p < .01), and intention to participate (t = -3.405, p < .01). The male participants reported higher perceived barriers (t = -2.542, p < .05). Attitudes toward preventability were found to influence intention to participate indirectly in all participants by enhancing perceived benefits and reducing perceived barriers; for males, this also included an increase in self-efficacy. This indirect effect was stronger in the male (β = 0.61) than female (β = 0.23) group. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Intention to participate in disability prevention services differs by gender. In addition to promoting the benefits of participation and reducing barriers, service providers should place greater emphasis on the preventability of disability and focus on enhancing preventive self-efficacy in promotions targeted at male older adults.