Enhancing behavioral intentions toward body donation through a theory of planned behavior-based, culturally tailored educational intervention: a quasi-experimental study

Abstract

Background: Body donation remains crucial for medical education and research, yet donor shortages persist worldwide, often due to limited awareness and cultural barriers. The Theory of Planned Behavior (TPB) offers a robust framework to understand and influence donation intentions. This study evaluates the efficacy of a culturally sensitive, TPB-based educational intervention aimed at enhancing behavioral determinants related to body donation among adults in India. Methods: A quasi-experimental pre-post design was employed with 163 adult participants. The multi-component intervention included multimedia educational materials, peer discussions, motivational media, and practical guidance on registration. Participants completed a validated, bilingual TPB questionnaire assessing knowledge, attitudes, subjective norms, perceived behavioral control, and behavioral intentions immediately before and after the intervention. Statistical analyses involved paired-sample t-tests to compare pre- and post-intervention scores, multiple linear regression to identify predictors of behavioral intention, and subgroup analyses examining sociodemographic influences. Results: Post-intervention assessments revealed statistically significant improvements across all TPB constructs (all p < 0.001). Knowledge increased markedly from a mean score of 2.7 to 3.8 (on a 0–4 scale), corresponding to a large effect size (Cohen’s d = 1.25). Attitude, subjective norms, and perceived behavioral control all showed medium effect sizes (d = 0.65–0.70). Multiple regression indicated that attitude (β = 0.40, p < 0.001), subjective norms (β = 0.32, p < 0.01), and perceived behavioral control (β = 0.26, p < 0.01) were independent predictors of post-intervention intention, jointly explaining 52% of the variance (R² = 0.52). Notably, willingness or intention to donate increased to 66% post-intervention, with higher readiness observed among participants with prior knowledge, urban residence, male gender, higher education, and older age. Conclusion: The TPB-based, culturally tailored educational intervention effectively enhanced knowledge and psychosocial determinants of body donation intention among Indian adults. These findings underscore the potential of theory-driven, culturally adapted programs to increase readiness for body donation, offering scalable strategies to address donor shortages in diverse cultural contexts globally.