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Malaysian Youth eHealth Literacy via Healthcare Websites: A Study on Factors Forming Sexual and Reproductive Health Information-seeking Intention

Andrew Jason George and Moniza Waheed

Pertanika Journal of Social Science and Humanities, Volume 29, Issue 1, March 2021

DOI: https://doi.org/10.47836/pjssh.29.1.28

Published: 26 March 2021

Extensive research has been carried out to study the relationship between Malaysian youth and their perceptions of sexual and reproductive health (SRH); ranging from knowledge and awareness levels to lifestyle choices. However, there is insufficient information on youth e-health literacy levels on the subject matter. Therefore, this study examines the factors that influence youth intention towards using healthcare websites to search for SRH information. This study is guided by the Theory of Reasoned Action (TRA) which suggests that the best indicator of behaviour is intention, which is formed by attitude and subjective norms. Participants for the study were 400 youth (from 18 – 40 years of age) based in the Klang Valley area. Data was collected through a self-administered questionnaire where the research instruments were adopted from the TRA framework, namely: Attitude, Subjective Norms, and Intention. Overall, the findings showed that youth who had positive attitudes and adequate social support/pressure towards using healthcare websites to find SRH information were likely to have a high intention to do so. One crucial finding in the context of this study is how subjective norms are a stronger predictor of SRH information-seeking intention compared to attitude. This finding here can add a new dimension to how the TRA framework is utilised, especially in studies revolving around Asian youth intentions and behaviours. Ministries, NGOs, and private institutions that advocate better SRH practices in Malaysia should leverage the influence of new media to improve health literacy levels among youth.

  • Abdullah, F. I., Rahman, N. A. A., Muhammad, N. A., Zainuddin, N. A., & Samsudin, S. (2020). Association between social-cognitive factors and intention towards sexual activity among school-going late adolescents in Kuantan, Malaysia. International Journal of Adolescence and Youth, 25(1), 1-9. https://doi.org/10.1080/02673843.2020.1828111

  • Alagrisamy, R., & Arokiasamy, L. (2019). A study on young female adults’ intention and adoption of emergency contraceptive pill in rural Malaysia. Global Business and Management Research: An International Journal, 11(1), 505-516.

  • Alam, S. S., Musa, R., & Hassan, F. (2009). Corporate customers’ adoption of internet banking: Case of Klang Valley business firm in Malaysia. International Journal of Business and Management, 4(4), 13-21. https://doi.org/10.5539/ijbm.v4n4p13

  • Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Prentice Hall.

  • Ajzen, I. (2013). Theory of planned behavior questionnaire. Measure Instrument Database for the Social Science. http://www.midss.org/sites/default/files/tpb.construction.pdf

  • Albarracín, D., Fishbein, M., Johnson, B. T., & Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: A meta-analysis. Psychological Bulletin, 127(1), 142-161. https://doi.org/10.1037/0033-2909.127.1.142

  • Awang, H., Wong, L. P., Jani, R., & Low, W. Y. (2014). Knowledge of sexually transmitted diseases and sexual behaviours among Malaysian male youths. Journal of Biosocial Science, 46(2), 214-224. https://doi.org/10.1017/s0021932013000114

  • Ayub, S. H., Hamzah, M. R., Azmy, S. N. S., Omar, W. A. W., Abdullah, N. H., Wahab, Z., & Salim, H. (2017). Sexual health communication among youth: A study of knowledge and attitude. Malaysian Journal of Communication, 33(4), 234-248. https://doi.org/10.17576/jkmjc-2017-3304-15

  • Bleakley, A., Khurana, A., Hennessy, M., & Ellithorpe, M. (2018). How patterns of learning about sexual information among adolescents are related to sexual behaviors. Perspectives on Sexual and Reproductive Health, 50(1), 15-23 https://doi.org/10.1363/psrh.12053

  • Breuner, C. C., & Mattson, G. (2016). Sexuality education for children and adolescents. Pediatrics, 138(2), 1-11. https://doi.org/10.1542/peds.2016-1348

  • Bryan, A., Fisher, J. D., & Fisher, W. A. (2002). Tests of the mediational role of preparatory safer sexual behavior in the context of the theory of planned behavior. Health Psychology, 21(1), 71-80. https://doi.org/10.1037/0278-6133.21.1.71

  • Cheah, Y. K., Lim, H. K., Kee, C. C., & Ghazali, S. M. (2016). Factors associated with underage sex in Malaysia: A secondary data analysis of Malaysia Global School-Based Student Health Survey 2012. Journal of Population and Social Studies, 26(4), 305-320. https://doi.org/10.25133/JPSSv26n4.021

  • Centers for Disease Control and Prevention. (2018). How CDC prepares healthy youth for successful futures. https://www.cdc.gov/healthyyouth/about/pdf/DASH_Snapshot.508.pdf

  • Conner, M., Mceachan, R., Lawton, R., & Gardner, P. (2017). Applying the reasoned action approach to understanding health protection and health risk behaviors. Social Science & Medicine, 195, 140-148. https://doi.org/10.1016/j.socscimed.2017.10.022

  • Crook, B., Stephens, K. K., Pastorek, A. E., Mackert, M., & Donovan, E. E. (2016). Sharing health information and influencing behavioral intentions: The role of health literacy, information overload, and the internet in the diffusion of healthy heart information. Health Communication, 31(1), 60-71. https://doi.org/10.1080/10410236.2014.936336

  • Delany-Moretlwe, S., Cowan, F. M., Busza, J., Bolton-Moore, C., Kelley, K., & Fairlie, L. (2015). Adolescent sexual and reproductive health: The global challenges. Journal of the International AIDS Society, 18(2), 29-40. https://doi.org/10.7448/IAS.18.2.19833

  • Department of Statistics Malaysia. (2018). Population by age. http://pqi.stats.gov.my/result.php?token=14dec6447b3c1bb0f570c2b6a3ddab76

  • Dippel, E. A., Hanson, J. D., McMahon, T. R., Griese, E. R., & Kenyon, D. Y. B. (2017). Applying the theory of reasoned action to understanding teen pregnancy with American Indian communities. Maternal and Child Health Journal, 21(7), 1449-1456. https://doi.org/10.1007/s10995-017-2262-7

  • Donoghue, C., Bonillas, C., Moreno, J., Cardoza, O., & Cheung, M. (2017). Young people’s perceptions of advice about sexual risk taking. Sex Education, 17(1), 73-85. https://doi.org/10.1080/14681811.2016.1236016

  • Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Addison-Wesley Pub.

  • Fishbein, M., & Ajzen, I. (2010). Predicting and changing behavior: The reasoned action approach. Psychology Press (Taylor & Francis).

  • Fisher, W. A., Kohut, T., Salisbury, C. M., & Salvadori, M. I. (2013). Understanding Human Papillomavirus vaccination intentions: Comparative utility of the theory of reasoned action and the theory of planned behavior in vaccine target age women and men. The Journal of Sexual Medicine, 10(10), 2455-2464. https://doi.org/10.1111/jsm.1221

  • Freberg, K. (2013). Using the theory of planned behavior to predict intention to comply with a food recall message. Health Communication, 28(4), 359-365. https://doi.org/10.1080/10410236.2012.68865

  • Godin, G., Valois, P., Jobin, J., & Ross, A. (1991). Prediction of intention to exercise of individuals who have suffered from coronary heart disease. Journal of Clinical Psychology, 47(6), 762-772. https://doi.org/c9snr6

  • Greene, K., Hale, J. L., & Rubin, D. L. (1997). A test of the theory of reasoned action in the context of condom use and AIDS. Communication Reports, 10(1), 21-33. https://doi.org/10.1080/08934219709367656

  • Guess, C. D. (2004). Decision making in individualistic and collectivistic cultures. Online Readings in Psychology and Culture, 4(1), 1-18. https://doi.org/10.9707/2307-0919.1032

  • Hamzah, S. R., Suandi, T., & Ishak, N. H. (2016). Association between health literacy and demographic factors among adolescents in Malaysia. International Conference on Youth (ICYOUTH) 2016, Seri Kembangan, Selangor, Malaysia.

  • Haque, A., Mahmud, S., Tarofder A. K., & Ismail, A. (2007). Internet advertisement in Malaysia: A study of attitudinal differences. The Electronic Journal of Information Systems in Developing Countries, 31(9), 1-15. https://doi.org/10.1002/j.1681-4835.2007.tb00218.x

  • Ismail, K., & Hamid, S. R. A. (2016). Communication about sex-reproductive health issues with adolescents: A taboo among Malaysian parents? European Journal of Social Sciences Education and Research, 6(1), 27-41.

  • Jozkowski, K. N., & Geshnizjani, A. (2016). Using a reasoned action approach to examine US college women’s intention to get the HPV vaccine. Health Education Journal, 75(1), 14-26. https://doi.org/10.1177/0017896914561100

  • Khalaf, F. Z., Liow, J. W., Low, W. Y., Ghorbani, B., & Merghati-Khoei, E. (2018). Young women’s experience of sexuality: A battle of pleasure and sexual purity in the context of Malaysian society. Sexuality and Culture, 22(3), 849-864. https://doi.org/10.1007/s12119-018-9496-4

  • Khawaja, Z., Ali, K. I., & Khan, S. (2017). Using Facebook for sexual health social marketing in conservative Asian countries: A systematic examination. Journal of Health Communication, 22(2), 111-123. https://doi.org/10.1080/10810730.2016.1222031

  • Krejcie, R. V., & Morgan, D. W. (1970). Determining sample size for research activities. Educational and Psychological Measurement, 30(3), 607-610.

  • Krimi, M., S., Yusop, Z., & Law, S., H. (2010). Regional development disparities in Malaysia. Journal of American Science, 6(3), 70-78.

  • Lee, R. L., & Kotler, P. (2016). Social marketing: Changing behaviours for good (5th ed.). Sage.

  • Lim, H. M. (2015). Country profile on universal access to sexual and reproductive health: Malaysia. Federation of Reproductive Health Association Malaysia (FRHAM). https://doi.org/10.1080/0144287012000277507

  • Low, W. Y. (2009). Malaysian youth sexuality: Issues and challenges. Journal of Health and Translational Medicine, 12(1), 3-14. https://doi.org/10.22452/jummec.vol12no1.2

  • Manaf, M. R. A., Tahir, M. M., Sidi, H., Midin, M., Jaafar, N. R. N., Das, S., & Malek, A. M. A. (2014). Pre-marital sex and its predicting factors among Malaysian youths. Comprehensive Psychiatry, 55(SUPPL.1), S82-S88. https://doi.org/10.1016/j.comppsych.2013.03.008

  • Manimaran, K. K., Vikneswaran, S., Ng, S. Y., Aisah, M. S., & Chiew, W. L. (2017). Sexual and reproductive health implementation in Malaysia. International Journal of Public Health and Clinical Sciences 4(6), 12-21.

  • Manstead, A. S. R. (2011). The benefits of a critical stance: A reflection on past papers on the theories of reasoned action and planned behavior. British Journal of Social Psychology, 50(3), 366-373. https://doi.org/10.1111/j.2044-8309.2011.02043.x

  • Malaysian Communications and Multimedia Commission. (2018). Internet users survey 2018. https://www.mcmc.gov.my/skmmgovmy/media/General/pdf/Internet-Users-Survey-2018.pdf

  • Mohamad, E. M. W., Kaundan, M. K., Hamzah, M. R., Azlan, A. A., Ayub, S. H., Tham, J. S., & Ahmad, A. L. (2020). Establishing the HLS-M-Q18 short version of the European health literacy survey questionnaire for the Malaysian context. BMC Public Health, 20(580), 1-7. https://doi.org/10.1186/s12889-020-08704-7

  • Mokhtar, M. M., Rosenthal, D. A., Hocking, J. S., & Satar, N. A. (2013). Bridging the gap: Malaysian youths and the pedagogy of school-based sexual health education. Procedia - Social and Behavioral Sciences, 85, 236-245. https://doi.org/10.1016/j.sbspro.2013.08.355

  • Montano, D. E., & Kasprzyk, D. (2008). Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. In K. Glanz, B. K. Reimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (4th ed., pp. 67-96). Jossey-Bass.

  • Muhammad, N. A., Shamsuddin, K., Amin, R. M., Omar, K., & Thurasamy, R. (2017). Questionnaire development and validity to measure sexual intention among youth in Malaysia. BMC Public Health, 17(1), 1-11. https://doi.org/10.1186/s12889-016-3949-1

  • Mittler, J. N., Volmar, K. M., Shaw, B. W. Christianson, J. B., & Scanlon, D. P. (2012). Using websites to engage consumers in managing their health and healthcare. The American Journal of Managed Care, 18(6), 177-184.

  • Müller, P., & Schulz, A. (2019). Facebook or Fakebook? How users’ perceptions of ‘fake news’ are related to their evaluation and verification of news on Facebook. Studies in Communication and Media, 8(4), 547-559. https://doi.org/10.5771/2192-4007-2019-4-547

  • Mustapa, M. C., Ismail, K. H., Mohamad, M. S., & Ibrahim, F. (2015). Knowledge on sexuality and reproductive health of Malaysian adolescents – A short review. Procedia - Social and Behavioral Sciences, 211, 221-225. https://doi.org/10.1016/j.sbspro.2015.11.088

  • Farid. N. D. N., Arshad, M. F. M., Yakub, N. A., Zaki, R. A., Muhamad, H., Aziz, N. A., & Dahlui, M. (2018). Improving Malaysian adolescent sexual and reproductive health: An Intenet-based health promotion programme as a potential intervention. Health Education Journal, 77(7), 837-848. https://doi.org/10.1177/0017896918778071x

  • Ohbuchi, K. I., Fukushima, O., & Tedeschi, J. T. (1999). Cultural values in conflict management: Goal orientation, goal attainment, and tactical decision. Journal of Cross-Cultural Psychology, 30(1), 51-71. https://doi.org/10.1177/0022022199030001003

  • Pecchioni, L. L., & Sparks, L. (2007). Health information sources of individuals with cancer and their family members. Health Communication, 21(2), 143-151. https://doi.org/10.1080/10410230701307162

  • Perumal, I., Abdullah, A., Supramaniam, M., Subramaniam, M., Sinniah, S., & Perumal, G. (2018). Determinants of online purchasing intention of household appliance among Malaysians in Klang Valley. International Journal of Computer Science and Network Security, 18(12), 211-220.

  • Randolph, M. E., Pinkerton, S. D., Somlai, A. M., Kelly, J. A., Mcauliffe, T. L., Gibson, R. H., & Hackl, K. (2009). Seriously mentally ill women’s safer sex behaviors and the theory of reasoned action. Health Education & Behavior, 36(5), 948-958. https://doi.org/10.1177/1090198108324597

  • Reddy, S., & Dunne, M. (2007). Risking it: Young heterosexual femininities in South African context of HIV/AIDS. Sexualities, 10(2), 159-172. https://doi.org/10.1177/1363460707075797

  • Rise, J. (1992). An empirical study of the decision to use condoms among Norwegian adolescents using the theory of reasoned action. Journal of Community & Applied Social Psychology, 2(3), 185-197. https://doi.org/10.1002/casp.2450020303

  • Ross, M. W., & Mclaws, M. L. (1992). Subjective norms s about condoms are better predictors of use and intention to use than attitudes. Health Education Research, 7(3), 335-339. https://doi.org/10.1093/her/7.3.335

  • Rycker, A. D., Yang, L. F., Lee, C. E., & Ponnan, R. (2017). Internet use among urban Malaysians: Network diversity effects. SHS Web of Conferences, 33, 1-7. https://doi.org/10.1051/shsconf/20173300066

  • Sanci, L., Chondros, P., Sawyer, S., Pirkis, J., Ozer, E., Hegarty, K., Yang, F., Grabsch, B., Shiell, A., Cahill, H., Ambresin, A.-E., Patterson, E., & Patton, G. (2015). Responding to young people’s health risks in primary care: A cluster randomised trial of training clinicians in screening and motivational interviewing. PLOS ONE, 10(9), e0137581. https://doi.org/10.1371/journal.pone.0137581

  • Shakir, S. M. M., Wong, L. P., Abdullah, K. L., & Adam, P. (2019). Factors associated with online sexually transmissible infection information seeking among young people in Malaysia: An observational study. Sexual Health, 16(2), 158-171. https://doi.org/10.1071/SH17198

  • Sheeran, P., Norman, P., & Orbell, S. (1999). Evidence that intentions based on attitudes better predict behaviour than intentions based on subjective norms. European Journal of Social Psychology, 29(23), 403-406. https://doi.org/10.1002/(SICI)1099-0992(199903/05)29:2/3<403::AID-EJSP942>3.0.CO;2-A

  • Sheeran, P. (2002). Intention-behavior relations: A conceptual and empirical review. European Review of Social Psychology, 12(1), 1-36. https://doi.org/10.1080/14792772143000003

  • Tabaac, A. R. (2016). Gender and sexual health: Applying gender role theory to men and women’s intention to engage in sexual health information seeking behaviors (Master’s thesis), Virginia Commonwealth University. http://scholarscompass.vcu.edu/etd/4119/

  • Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Allyn & Bacon/Pearson Education.

  • Ujang, F., & Sutan, R. (2018). The effects of short health messages intervention in improving knowledge and attitude on sexual and reproductive health among late adolescents at colleges in Malaysia. Open Journal of Preventive Medicine, 8(8), 207-228. https://doi.org/10.4236/ojpm.2018.88019

  • Vanlandingham, M. J., Suprasert, S., Grandjean, N., & Sittitrai, W. (2014). Two views of risky sexual practices among Northern Thai males: The health belief model and the theory of reasoned action. Journal of Health and Social Behavior, 36(2), 195-212.

  • Widman, L., Choukas-Bradley, S., Helms, S. W., Golin, C. E., & Prinstein, M. J. (2014). Sexual communication between early adolescents and their dating partners, parents, and best friends. Journal of Sex Research, 51(7), 731-741. https://doi.org/10.1080/00224499.2013.843148

  • Widman, L., Choukas-Bradley, S., Noar, S. M., Nesi, J., & Garrett, K. (2016). Parent-adolescent sexual communication and adolescent safer sex behavior: A meta-analysis. JAMA Pediatrics, 170(1), 52-61. https://doi.org/110.1016/j.bbi.2017.04.008

  • Wong, L. P. (2012). An exploration of knowledge, attitudes and behaviours of young multiethnic Muslim- majority society in Malaysia in relation to reproductive and premarital sexual practices. BMC Public Health, 12, 865. https://doi.org/10.1186/1471-2458-12-865

  • Woog, V., Singh, S., Browne, A., & Philbin, J. (2015). Adolescent women’s need for and use of sexual and reproductive health services in developing. Guttmacher Institute. https://www.guttmacher.org/sites/default/files/report_pdf/adolescent-srhs-need-developing-countries.pdf

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e-ISSN 2231-8534

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JSSH-6789-2020

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