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engagement in a healthy behavior, such as financial costs, time constraints,
inconvenience, or distrust in service quality (Rosenstock, 1974). Numerous studies have
identified perceived barriers as the most powerful deterrent to preventive healthcare
adoption (Champion and Skinner, 2008). In healthcare service contexts, higher perceived
barriers have been shown to significantly weaken positive attitudes toward service
utilization (Ong et al., 2023). In Vietnam, despite policy support for family doctor services,
barriers related to accessibility, insurance coverage, convenience, and trust remain
prominent, potentially undermining favorable evaluations. Based on these considerations,
the following hypothesis is proposed:
H4: Perceived barriers have a negative effect on attitude toward health behavior.
Attitude toward a behavior reflects an individual’s overall positive or negative
evaluation of performing that behavior and is a central determinant of intention in the
Theory of Planned Behavior (Ajzen, 1991). Meta-analytic evidence consistently shows that
attitude exhibits a stronger association with behavioral intention than other TPB
components, particularly in health-related contexts (Armitage and Conner, 2001;
Trafimow, 1996). Empirical studies further demonstrate that favorable attitudes toward
preventive or healthcare services significantly predict individuals’ intentions to utilize
those services (Pender and Pender, 1986; Fan et al., 2021; Yusuf et al., 2015). In the
context of family doctor services, individuals who evaluate service use positively are
therefore expected to exhibit stronger intentions to engage in such services. Accordingly,
the following hypothesis is proposed:
H5: Attitude toward the target health behavior is positively associated with the
intention to engage in that behavior.

Figure 1. Research Framework
Source: Research team (2025)
3. Methodology
This study employed a quantitative research approach to examine the relationships
between health beliefs, attitude toward health behavior, and intention to use family
doctor services. Data were collected using a structured questionnaire designed to capture
respondents’ cognitive evaluations and behavioral intentions in a preventive healthcare
context.
Measurement scales were adapted from established studies to ensure content
validity and theoretical consistency. Specifically, perceived susceptibility and perceived
severity were adapted from Fang et al. (2025); perceived benefits were adopted from

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