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The present study was set up to investigate social-cognitive determinants of HIV-risk precautionary intentions among men who have sex with men (MSM), who meet sex partners on the Internet. Participants were enrolled through the major gay chat room in The Netherlands, www.chatboy.nl, and were asked to complete an online questionnaire. Theory of Planned Behaviour variables attitude, subjective norm, and perceived control explained 55% of the variance in intention to use condoms for anal sex with future e-dates. Adding descriptive norm, personal norm and anticipated regret explained 70%. Sexual fantasies and HIV-status had unique effects on intentions. Differences between high and lower intenders are presented. Limitations of the study are discussed and objectives for an intervention to promote condom use are given. [ABSTRACT FROM AUTHOR]

Objective: To determine the relationship between the need for care and the use of care in the youth care system at neighbourhood level and the relationship with population characteristics, with consideration of the decentralisation of youth care., Design: Descriptive, retrospective study., Method: Data on youth care use, indicators of need for care and population characteristics were gathered from monitors and the records of the municipality, institutions and health insurance companies. Data were grouped on a neighbourhood level (n = 49). For the analyses we used univariate and multivariate regression. We used these to distinguish between neighbourhoods with large and small gaps between youth care use and need for youth care. Differences between these neighbourhoods were analysed with t-tests., Results: A multivariate model showed that the percentage of youths with emotional problems and behavioural problems and the percentage of parents with self-reported need for care were not predictors of youth care use at a neighbourhood level. About two thirds of the variance in youth care use between neighbourhoods could be explained by the population characteristics of a neighbourhood, particularly the percentage of youths originally from non-western countries, the percentage of youths with a low level of education or special training and the percentage of people who received income support. The number of 12-18-year-olds in a neighbourhood was a predictor of youth mental health care, and the percentage of youths in a single-parent family was a predictor of out-patient youth and parenting support. Neighbourhoods with a large gap between the need for and use of youth care were socially more disadvantaged than neighbourhoods with a smaller gap., Conclusion: Population characteristics explain the rate of use of youth care better than the need for youth care in a neighbourhood as measured by municipal monitors. The possible gap between the use of and need for youth care on an individual level in neighbourhoods with many characteristics of disadvantage is an important focus point for future neighbourhood teams.

Unlabelled: Hepatitis B virus (HBV) infections are an important health problem in Turkish migrants in the Netherlands. This study describes the effectiveness of a culturally tailored internet intervention promoting HBV screening in Turkish migrants., Methods: Turkish migrants, aged 16-40 years old, could participate in an online intervention offering either: (i) behaviourally plus culturally tailored (BCT) information; (ii) behaviourally tailored (BT) information or (iii) generic information (GI). Subsequently, free HBV screening was offered., Results: Out of 10.069 invited persons, 1512 (15%) logged in on the website and 623 people were tested. Screening uptake was 44% in the BCT group, 46% in the GI group and 44% in group BT. The BCT group showed favourable intervention effects for scores on determinants of screening when compared with baseline scores and BT., Conclusion: Although BCT did show favourable intervention effects for several determinants addressed in the intervention, we were not able to demonstrate the added value of BCT on screening uptake., Trial Registration: The Netherlands National Trial Register NTR 2394., (© The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: The researchers conducted the current study to explore knowledge and satisfaction with the Hepatitis C Healthy Lives Initiative among a sample of Egyptians. Methods: An exploratory cross-sectional study was carried out among 1,193 clients attending HCV screening sites via consecutive sampling technique. A structured interview questionnaire was used, including three sections: sociodemographic characteristics, satisfaction with the hepatitis C screening program, and HCV-related knowledge. Results: Approximately half of the enrolled participants showed good HCV knowledge. Males had a higher percentage (51.0%) of good knowledge scores (p = 0.029). Individuals with a university degree scored higher (65.9%) than those with other levels of education. More than half of the participants (701, 58.8%) reported high satisfaction with the screening campaign, with patients with no comorbidities showing more satisfaction (p < 0.05). Participants were motivated to be screened to check their health status (94.9%) and were encouraged mostly by family members (65.9%). Regression analysis revealed that higher education level, employment, having no comorbidity, not living in slums, and having no negative family history of HCV were significant factors in predicting a high level of knowledge. Conclusion: The current study revealed that half of the enrolled participants showed good HCV knowledge. The majority of the study participants were satisfied with the screening campaign. The media played a crucial role in raising awareness of the campaign to eliminate HCV, and it is necessary to consider introducing HCV education via mass media. [ABSTRACT FROM AUTHOR]

Climate change communication is an important behavioral manifestation of the public's understanding, expression, and participation in addressing climate change. Social media play an important role in the climate change knowledge communication. Does social media promote climate change communication behavior in the Chinese context? Is its effect stronger than other types of media? Combined with the research context, we divide media into central media, local media, and social media and construct the influence mechanism model of media use on climate change communication behavior. In this study, a questionnaire survey was conducted among the public in China, and 1062 valid questionnaires were empirically tested by methods of hierarchical regression and bootstrapping. According to the findings of the study, different media use has a positive effect on climate change communication behavior. While social media is more likely to be used by the public to obtain climate change-related information than central and local media (with a mean value of 3.84 for social media compared to 3.51 for central media and 3.19 for local media), it is actually the central media that have the greatest effect on climate change communication behavior. This is evident in the total effect value, where the central media have a value of 0.21, which is higher than social media's value of 0.20 and local media's value of 0.12. Risk perception and environmental values play an important mediating role in the influence of media use on climate change communication behavior, among which environmental values have the largest mediating effect. (Specifically, the mediating effects of environmental values were 26.83%, 31.28%, and 38.57% for central media, local media, and social media, respectively.) In addition, risk perception can also positively affect environmental values, thus forming a chain mediating effect between media use and climate change communication behavior (the confidence intervals for the chain mediating effect also exclude the numbers 0). [ABSTRACT FROM AUTHOR]

Intertemporal decisions are crucial to survival, especially when humans are exposed to ecological threats. However, it remains unclear whether and how pandemic threats impact intertemporal choices across cultures. We conducted two studies in two cultural contexts (N = 1180). Study 1a found that Chinese who perceived more pandemic threats showed higher temporal discounting rates (i.e., preferred immediate smaller over delayed larger rewards), and this relationship was mediated by negative emotions. Study 1b, using threat priming, revealed that Chinese participants primed with a high-threat condition (depicting a pandemic threat) showed higher temporal discounting rates compared to those primed with a low-threat condition (describing the flu). Differently, Study 2a revealed that perceived pandemic threat levels of Americans did not directly predict temporal discounting rates. Using similar threat priming, Study 2b further confirmed that Americans in the high-threat priming condition showed no significant differences in temporal discounting rates compared to those in the low-threat priming condition. The current research deepens the understanding of the cultural difference in the impact of pandemic threats on intertemporal decision-making and further informs the development of interventions that promote individual future-oriented thinking in the face of pandemics. [ABSTRACT FROM AUTHOR]

The Hepatitis B virus (HBV) is a prevalent blood-borne illness, posing a significant risk to hemodialysis patients particularly due to their potential immunosuppressed status. This study aimed to address HBV awareness among Jordanian hemodialysis patients, filling a gap in regional research. A descriptive cross-sectional study was conducted at a multicenter governmental hospital in Jordan, with 389 participants. Among them, 61.3% were male, and 80.7% were over 38 years old. While 34% demonstrated a high level of knowledge, Participants with a higher degree of education and those working in the medical field were more informed. Although most participants had an inadequate understanding of HBV symptoms and transmission, they maintained positive attitudes and engaged in infection preventative actions. Enhanced educational efforts are required to raise awareness among hemodialysis patients, and further research is needed to address any reluctance towards preventive practices and seeking treatment. [ABSTRACT FROM AUTHOR]

The perception of health risks can influence people's health behaviors. However, in the context of modern consumer society, few people delve into in-depth discussions on health consumption as a form of health protection behavior. Inspired by the Health Belief Model and Protection Motivation Theory, this study interprets health consumption behavior as a new form of health protection behavior. A survey was conducted on a sample of Chinese youth (N = 885) to explore the mechanisms of action between health risk perception and health consumption behavior using structural equation modeling. The study found that: (1) health risk perception has a significant positive impact on the health consumption behavior of young people; (2) negative emotions and information seeking play mediating roles respectively in the mechanism of the impact of health risk perception on health consumption behavior; and (3) in addition to their individual mediating roles, negative emotions and information seeking behavior collectively play a chained mediation role in this process. Implications of these results, both theoretical and practical, are further discussed. [ABSTRACT FROM AUTHOR]

The paper aims to analyze the consumer joint choice behavior on fresh food purchase channels and terminal delivery services during major public health events, with the purpose of revealing the underlying influencing factors and behavioral characteristics. First, based on random utility maximization theory, the cross-nested logit model is formulated, which takes into account the influence of socioeconomic attribute factors, service attribute factors, risk perception attribute factors and trust perception attribute factors. Second, a questionnaire survey is conducted, and the obtained data are used to estimate the model parameters and perform an elasticity analysis of the utility variables. The parameter estimation results demonstrate that in the context of major public health events, consumers consider adjusting their attitudes toward e-commerce platforms first when the utility variables are altered, and fresh food purchase channels are easily replaced for consumers who choose unmanned equipment home delivery. The elasticity analysis results suggest that consumers are more willing to buy fresh food through community group-buying channels, are more sensitive to the convenience of the purchase process and are less concerned with delivery time. Although person-to-person contact increases the risk of infection, consumers still prefer attended terminal delivery services. Furthermore, consumers least agree with the effectiveness of body temperature detection methods in public places but feel that an effective way to increase consumer trust in enterprises is to strengthen personnel protection measures. [ABSTRACT FROM AUTHOR]

Background: Many studies in infectious diseases struggle to recruit participants. The SARS-CoV-2 infection, transmission dynamics, and household impact in Malawi (SCATHIM) study reported a refusal rate of 57.2%. Adequate publicity can lead to more people participating in studies. This study explored the reasons for participating in the SCATHIM study. Methods: A descriptive qualitative study informed by the theory of reasoned action was conducted in Blantyre between January 2022 and March 2022 to assess factors that influence participation in a COVID-19 study among 10 index cases, 10 caregivers, 10 study decliners, and 5 research staff. The data were collected via in-depth interview guides, audio recorded, transcribed, managed via NVIVO and analysed via a thematic approach. Results: The factors that motivated participation in the study included one's knowledge of COVID-19; potential access to medical services, including free COVID-19 tests for members of the household; financial reimbursements; and the ability to contribute scientific knowledge. The barriers to participation included minimal publicity of the study amidst a novel condition, perceived stigma and discrimination, perceived invasion of privacy, discomfort with the testing procedures, and suboptimal financial reimbursements. Conclusion: Effective publicity and outreach strategies have the potential to decrease refusal rates in study participation, especially if a condition is novel. Studies on infectious diseases should address stigma and discrimination to promote participation and ensure participant safety. [ABSTRACT FROM AUTHOR]

This study focused on vaccine hesitancy and decision regret about the COVID-19 vaccine among nursing students (BScN and MScN) and Registered Nurses (RNs) in Italy. The primary aim was to describe decision regret and vaccine hesitancy among these groups and to understand what influences vaccine hesitancy. Data were collected through an e-survey conducted from March to June 2024. The Decision Regret Scale and the Adult Vaccine Hesitancy Scale were employed to assess regret and hesitancy levels, assessing trust, concerns, and compliance regarding vaccination. Among the participants, 8.64% were not vaccinated. The results indicated moderate to high levels of decision regret and diverse levels of trust, concerns, and compliance with COVID-19 vaccination. Structural equation modeling revealed that decision regret significantly predicted Trust (R2 = 31.3%) and Concerns (R2 = 26.9%), with lower regret associated with higher trust and lower concerns about vaccine safety. The number of COVID-19 vaccine boosters was a significant predictor of Trust and Concerns, with more boosters associated with higher trust and lower concerns. MScN students exhibited higher Compliance compared to RNs (R2 = 2.9%), highlighting the role of advanced education. These findings suggest that addressing decision regret and providing comprehensive vaccine information could enhance trust and compliance. [ABSTRACT FROM AUTHOR]

Cognitive-experiential self-theory is a unique model for exploring restaurant patrons' decision making. Fear and its impact on diners' decision making, particularly related to specific dining contexts (dine-in, takeout, and delivery), are limited in their representation in the literature. The COVID-19 pandemic provided an instance where a single fear could be explored universally for dining patrons. This study explores how fear influences diners' perception of risk, antipathy, and avoidance toward restaurant dining and how these factors impact their intention to dine in a restaurant. Furthermore, it investigates how those constructs influence diner decision making regarding the selection of one of the identified dining contexts. Online survey data (n = 1225) of diners were analyzed using SEM. The research finds that fear impacts dining contexts differentially. Additionally, environmental control is identified as a valuable tool in the mitigation of diners' fear. The pandemic had devastating impacts on the restaurant industry, partly due to the lack of research into fear, particularly in dining contexts. This research helps to fill the important research gap through the findings and theoretical and managerial implications provided. [ABSTRACT FROM AUTHOR]

Background & Aims: Migrants born in countries where hepatitis B is endemic are a risk group for chronic hepatitis B virus (HBV) infection. Treatment options have improved, but due to the asymptomatic nature of chronic HBV infection, the majority of patients remain unidentified., Methods: In 2009, a campaign targeting the Chinese community was held in the city of Rotterdam, The Netherlands. The campaign combined disease awareness activities with free HBV testing at outreach locations. Chronically HBV infected patients were referred to specialist care based on a referral guideline. Before and after the campaign, knowledge of chronic hepatitis B was measured through questionnaires in a convenience sample of the target population (n=285 and n=277)., Results: In a period of 3 months, 13 outreach activities took place and 1090 Chinese migrants were tested for HBV. Forty-nine percent had serological signs of a past or recent HBV infection and 8.5% (n=92) were chronically infected. Thirty-eight percent (n=35) of chronically infected patients were referred for evaluation by a specialist and of these, 15 started antiviral treatment within 1 year of follow-up. Before the campaign, 55% answered correctly to 6 or more out of 10 knowledge items. Knowledge was positively associated with educational level. After the campaign, an increase in knowledge was observed in participants with low levels of education., Conclusions: Chinese migrants could be reached with an outreach campaign, and on-site testing was well accepted. A high prevalence of chronic HBV infection was found and referral to specialist care and initiation of treatment was successful., (Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)

LGBTQ+ media representations that uphold heteronormativity, negativity, and homophobia can lead to perceptions of media as threatening. Drawing on intergroup threat theory, this study measured perceived media threats (in-person/group, realistic/symbolic) among English-speaking LGBTQ+ Filipinos (N = 817). The Perceived Media Threat Scale, developed for this study, showed a unidimensional structure with sound psychometric properties. LGBTQ+ identity challenges were found to be associated with an increased perception of threat from the media. However, perceived media threat was not associated with psychological well-being. The Perceived Media Threat Scale appears to be a sound measure of LGBTQ+ perceptions of media in the Philippines. Results suggest that perceived media threat may impact identity processes such as coming out but does not appear to be related to well-being in the LGBTQ + community. [ABSTRACT FROM AUTHOR]

This article describes the development of ROsafe, an intervention to promote sexually transmitted infection (STI) testing at vocational schools in the Netherlands. Using the planning model of intervention mapping (IM), an educational intervention was designed that consisted of two lessons, an Internet site, and sexual health services at the school sites. IM is a stepwise approach for theory- and evidence-based development and implementation of interventions. It includes six steps: needs assessment, specification of the objectives in matrices, selection of theoretical methods and practical strategies, program design, implementation planning, and evaluation. The processes and outcomes that are performed during Steps 1 to 4 of IM are presented, that is, literature review and qualitative and quantitative research in needs assessment, leading to the definition of the desired behavioral outcomes and objectives. The matrix of change objectives for STI-testing behavior is presented, and then the development of theory into program is described, using examples from the program. Finally, the planning for implementation and evaluation is discussed. The educational intervention used methods that were derived from the social cognitive theory, the elaboration likelihood model, the persuasive communication matrix, and theories about risk communication. Strategies included short movies, discussion, knowledge quiz, and an interactive behavioral self-test through the Internet.

Background: Adolescents are a risk group for acquiring sexually transmitted infections (STIs). In the Netherlands, senior vocational school students are particular at risk. However, STI test rates among adolescents are low and interventions that promote testing are scarce. To enhance voluntary STI testing, an intervention was designed and evaluated in senior vocational schools. The intervention combined classroom health education with sexual health services at the school site. The purpose of this study was to assess the combined and single effects on STI testing of health education and school-based sexual health services., Methods: In a cluster-randomized study the intervention was evaluated in 24 schools, using three experimental conditions: 1) health education, 2) sexual health services; 3) both components; and a control group. STI testing was assessed by self reported behavior and registrations at regional sexual health services. Follow-up measurements were performed at 1, 3, and 6-9 months. Of 1302 students present at baseline, 739 (57%) completed at least 1 follow-up measurement, of these students 472 (64%) were sexually experienced, and considered to be susceptible for the intervention. Multi-level analyses were conducted. To perform analyses according to the principle of intention-to-treat, missing observations at follow-up on the outcome measure were imputed with multiple imputation techniques. Results were compared with the complete cases analysis., Results: Sexually experienced students that received the combined intervention of health education and sexual health services reported more STI testing (29%) than students in the control group (4%) (OR = 4.3, p < 0.05). Test rates in the group that received education or sexual health services only were 5.7% and 19.9%, not reaching statistical significance in multilevel analyses. Female students were more often tested then male students: 21.5% versus 5.4%. The STI-prevalence in the study group was low with 1.4%., Conclusions: Despite a low dose of intervention that was received by the students and a high attrition, we were able to show an intervention effect among sexually experienced students on STI testing. This study confirmed our hypothesis that offering health education to vocational students in combination with sexual health services at school sites is more effective in enhancing STI testing than offering services or education only.

Worldwide, adolescents are at risk for sexually transmitted infections (STI). In The Netherlands, test rates among young heterosexual people are low and knowledge on the behavioral determinants of testing is scarce. In this study, we investigated STI testing in more detail with two independent samples of 16-25 year old vocational school students (n = 756/n = 1302). The aim of this study was to examine risk perceptions in relation to STI testing among lower educated adolescents in order to inform the development of an intervention promoting STI testing. We compared multiple measures of risk perception, fear of testing, self-efficacy for testing, and risk knowledge between groups of adolescents engaging and not engaging in risk behavior. The results show that at least half of the participating students with sexual experience underestimated their susceptibility for STI and showed an optimistic bias. Students with sexual experience also considered STI very severe but lacked self-efficacy for testing. This combination can yield a defensive reaction to the threat of STI that, in turn, results in the underestimation of personal risks. However, self-efficacy did not mediate the relationship between intention to test and perceived relative risk. In conclusion, our findings show underestimation of personal risks by vocational school students, a high perceived severity of STI and low self-efficacy for testing. A low level of knowledge regarding sexual risks and symptoms of STI might have contributed to low risk perceptions. Self-efficacy did not change the relation of intention-to-test to perceived risk.

Background: Research into risk perception and behavioural responses in case of emerging infectious diseases is still relatively new. The aim of this study was to examine perceptions and behaviours of the general public during the early phase of the Influenza A (H1N1) pandemic in the Netherlands., Methods: Two cross-sectional and one follow-up online survey (survey 1, 30 April-4 May; survey 2, 15-19 June; survey 3, 11-20 August 2009). Adults aged 18 years and above participating in a representative Internet panel were invited (survey 1, n = 456; survey 2, n = 478; follow-up survey 3, n = 934). Main outcome measures were 1) time trends in risk perception, feelings of anxiety, and behavioural responses (survey 1-3) and 2) factors associated with taking preventive measures and strong intention to comply with government-advised preventive measures in the future (survey 3)., Results: Between May and August 2009, the level of knowledge regarding Influenza A (H1N1) increased, while perceived severity of the new flu, perceived self-efficacy, and intention to comply with preventive measures decreased. The perceived reliability of information from the government decreased from May to August (62% versus 45%). Feelings of anxiety decreased from May to June, and remained stable afterwards. From June to August 2009, perceived vulnerability increased and more respondents took preventive measures (14% versus 38%). Taking preventive measures was associated with no children in the household, high anxiety, high self-efficacy, more agreement with statements on avoidance, and paying much attention to media information regarding Influenza A (H1N1). Having a strong intention to comply with government-advised preventive measures in the future was associated with higher age, high perceived severity, high anxiety, high perceived efficacy of measures, high self-efficacy, and finding governmental information to be reliable., Conclusions: Decreasing trends over time in perceived severity and anxiety are consistent with the reality: the clinical picture of influenza turned out to be mild in course of time. Although (inter)national health authorities initially overestimated the case fatality rate, the public stayed calm and remained to have a relatively high intention to comply with preventive measures.

Background: Adolescents are at risk for acquiring sexually transmitted infections (STIs). However, test rates among adolescents in the Netherlands are low and effective interventions that encourage STI testing are scarce. Adolescents who attend vocational schools are particularly at risk for STI. The purpose of this study is to inform the development of motivational health promotion messages by identifying the psychosocial correlates of STI testing intention among adolescents with sexual experience attending vocational schools., Methods: This study was conducted among 501 students attending vocational schools aged 16 to 25 years (mean 18.3 years ± 2.1). Data were collected via a web-based survey exploring relationships, sexual behavior and STI testing behavior. Items measuring the psychosocial correlates of testing were derived from Fishbein's Integrative Model. Data were subjected to multiple regression analyses., Results: Students reported substantial sexual risk behavior and low intention to participate in STI testing. The model explained 39% of intention to engage in STI testing. The most important predictor was attitude. Perceived norms, perceived susceptibility and test site characteristics were also significant predictors., Conclusions: The present study provides important and relevant empirical input for the development of health promotion interventions aimed at motivating adolescents at vocational schools in the Netherlands to participate in STI testing. Health promotion interventions developed for this group should aim to change attitudes, address social norms and increase personal risk perception for STI while also promoting the accessibility of testing facilities.

Background: Chronic hepatitis B virus infection (HBV) is an important health problem in the Turkish community in the Netherlands, and promotion of screening for HBV in this risk group is necessary. An individually tailored intervention and a culturally tailored intervention have been developed to promote screening in first generation 16-40 year old Turkish immigrants. This paper describes the design of the randomized controlled trial, which will be used to evaluate the effectiveness of the two tailored internet interventions as compared to generic online information on HBV, and to assess the added value of tailoring on socio-cultural factors., Methods/design: A cluster randomized controlled trial design, in which we invite all Rotterdam registered inhabitants born in Turkey, aged 16-40 (n = 10,000), to visit the intervention website is used. A cluster includes all persons living at one house address. The clusters are randomly assigned to either group A, B or C. On the website, persons eligible for testing will be selected through a series of exclusion questions and will then continue in the randomly assigned intervention group. Group A will receive generic information on HBV. Group B will receive individually tailored information related to social-cognitive determinants of screening. Group C will receive culturally tailored information which, next to social-cognitive factors, addresses cultural factors related to screening. Subsequently, participants may obtain a laboratory form, with which they can be tested free of charge at local health centres. The main outcome of the study is the percentage of eligible persons tested for HBV through to participation in one of the three groups. Measurements of the outcome behaviour and its determinants will be at baseline and five weeks post-intervention., Discussion: This trial will provide information on the effectiveness of a culturally tailored internet intervention promoting HBV-screening in first generation Turkish immigrants in the Netherlands, aged 16-40. The results will contribute to the evidence base for culturally tailored (internet) interventions in ethnic minority populations. An effective intervention will lead to a reduction of the morbidity and mortality due to HBV in this population. This may not only benefit patients, but also help reduce health inequalities in western countries., Trial Registration: The Netherlands National Trial Register NTR 2394.

Background: Hepatitis B virus infection is an important health problem in the Turkish community in the Netherlands. To prevent transmission and progression of the disease in this community, increased screening is necessary. This study aimed to determine 1) the levels of awareness and knowledge regarding hepatitis B, comparing these in tested and non-tested Turkish-Dutch in Rotterdam; 2) the self-reported hepatitis B test status in this population, and how this is related to demographic characteristics, knowledge and awareness., Methods: We conducted a postal survey amongst first and second generation migrants, aged 16 - 40 years., Results: The response rate was 30.2% (n = 355 respondents). Levels of awareness and knowledge regarding hepatitis B were low, as the majority of respondents (73%) never thought about the disease and 58% of the respondents scored 5 or less out of ten knowledge items. Weighted analysis of self-reports showed a test rate of 15%, and a vaccination rate of 3%. Regression analysis showed that having been tested for hepatitis B was related to being married and higher levels of awareness and knowledge., Conclusions: This study shows low levels of hepatitis B awareness and knowledge in the Turkish community in Rotterdam. Self-reported test rates are lower in people who are not currently married, and in those who have low levels of awareness and knowledge. Especially, knowledge about the consequences of hepatitis B, such as liver cancer, was lacking. Therefore, a health promotion intervention should foremost raise awareness, and increase knowledge on the seriousness of this disease.