Factors Explaining Respiratory Infection Prevention Behavior Among Late School-Age Children in Public Schools: A Cross-Sectional Study

Abstract

Respiratory infections are a significant cause of morbidity among school-age children. Despite public health efforts, the practice of preventive behaviors, such as handwashing and mask-wearing, remains suboptimal in this age group. This cross-sectional study was conducted in Thailand, where respiratory infections remain a public health concern and the practice of sustained preventive behaviors continues to pose ongoing challenges. The Theory of Reasoned Action posits that behavioral intention, shaped by attitudes and subjective norms, is the most proximal determinant of preventive behavior. The study aimed to examine the extent to which demographic variables, attitudes, subjective norms, and behavioral intention explain respiratory infection prevention behaviors among late school-age children. The participants were 211 late school-age children from public primary schools. Data were collected using a structured questionnaire comprising six parts: Demographics, Knowledge, Attitude, Subjective Norms, Behavioral Intention, and Preventive Behavior. Hierarchical regression was performed. Results revealed that personal characteristics, including gender, age, grade point average, school absenteeism, knowledge, attitude, subjective norms, and behavioral intention, explained 49.9% of the variance in preventive behavior. Behavioral intention emerged as the strongest predictor. Nurses should focus on strengthening intention through attitudes by enhancing educational content that highlights the benefits of respiratory preventive behaviors, and through subjective norms by engaging key influencers such as parents, peer groups, or teachers to promote continuous and sustainable behavior change. However, this intervention should be tested for effectiveness before it can be used in practice.