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perceived health risks, expected benefits of regular care, and potential barriers such as
cost, convenience, or trust in service quality. While TPB also includes subjective norms
and perceived behavioral control, this study focuses exclusively on attitude for reasons of
parsimony and conceptual clarity. Subjective norms have frequently been found to be
weaker predictors of health-related intentions, while perceived behavioral control
conceptually overlaps with the perceived barriers constructed in HBM. Attitude therefore
provides a coherent mechanism through which health beliefs are translated into intention
in the family doctor service context.
2.2. Hypothesis development
Perceived susceptibility refers to an individual’s belief regarding the likelihood of
experiencing a health problem (Rosenstock, 1974). Prior studies generally suggest that
individuals who perceive themselves as more vulnerable to illness tend to evaluate
preventive health behaviors more positively (Ateş et al., 2021; Singh et al., 2025; Fang et
al., 2025). In Vietnam, the rising prevalence of chronic and lifestyle-related diseases has
increased public exposure to health risks (WHO, 2024). However, routine preventive
check-ups are not consistently practiced, even in urban areas, suggesting that perceived
vulnerability may not always translate into favorable evaluations of preventive services.
Whether perceived susceptibility shapes attitudes toward family doctor services in this
context therefore remains empirically unclear. Drawing on the Health Belief Model, the
following hypothesis is proposed:
H1: Perceived susceptibility has a positive effect on attitude toward health
behavior.
Perceived severity refers to individuals’ beliefs about the seriousness of a health
condition and its potential consequences for quality of life and daily functioning
(Rosenstock, 1974). Prior research indicates that when individuals perceive health
conditions as severe, they are more likely to value preventive healthcare and form
positive evaluations of protective behaviors (Singh et al.,2025; Ateş et al., 2021; Callow et
al., 2020). In Vietnam, concerns about late diagnosis and the long-term consequences of
poorly managed chronic diseases remain prevalent, particularly in primary care settings
(Nguyen et al., 2020). Recognizing the seriousness of such outcomes may therefore
strengthen favorable attitudes toward family doctor services. Accordingly, the following
hypothesis is proposed:
H2: Perceived severity has a positive effect on attitude toward health behavior.
Perceived benefits refer to beliefs about the effectiveness of a health behavior in
reducing health risks or improving health outcomes (Becker, 1974). Extensive empirical
evidence identifies perceived benefits as one of the strongest predictors of positive health
attitudes. Meta-analytic findings demonstrate that perceived benefits consistently show
strong associations with favorable evaluations of preventive health behaviors (Carpenter,
2010). In integrated HBM-TPB models, perceived benefits have also been shown to
significantly enhance positive attitudes toward proactive healthcare engagement (Fang et
al., 2025). In the context of family doctor services, perceived benefits include early
disease detection, continuity of care, personalized treatment, and long-term cost savings.
Despite these advantages, utilization remains limited in Vietnam, suggesting that the
attitudinal role of perceived benefits warrants further examination. Thus, the following
hypothesis is proposed:
H3: Perceived benefits have a positive effect on attitude toward health behavior.
Perceived barriers represent individuals’ assessments of obstacles that hinder

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