Understanding childhood lead poisoning preventive behaviors: the roles of self-efficacy, subjective norms, and perceived benefits

Introduction Understanding individual and social influences on behaviors commonly recommended to prevent lead poisoning in children can guide more effective educational interventions. Methods In-person interviews were conducted with primary caregivers (n = 380) of American Indian and White children aged 1 to 6 living in or near the Tar Creek Superfund site in northeastern Oklahoma. Caregiversʹ perceived health benefits, self-efficacy, and subjective norms were assessed for four lead poisoning prevention behaviors (i.e., annual blood lead testing, playing in safe areas, washing hands before eating, and dusting with a damp cloth). Results Caregivers spoke with their own mothers, spouses, and other female family members most often when they had concerns or worries about taking care of their children. In multivariate models, subjective norms, perceived benefits, and self-efficacy were positively associated with the hand-washing and damp-dusting behaviors, while only self-efficacy was associated with playing in safe areas. None of the variables were found to have significant influence on the blood lead testing behavior. Conclusions Education programs should address individual level factors such as self-efficacy and perceived health benefits but also consider new strategies that incorporate a normative dimension to lead poisoning prevention.