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6. Conclusion and implications
6.1. Conclusion
This study provides empirical insights into the factors shaping intention to use
family doctor services in Northern Vietnam, a context where preventive primary care is
still developing. By integrating the Health Belief Model with the attitudinal component of
the Theory of Planned Behavior, the study highlights the central role of cognitive
evaluations and practical considerations in forming service use intention.
The findings confirm that attitude is the most proximal and influential predictor of
intention. Health belief constructs contribute to intention indirectly by shaping
individuals’ attitudes toward family doctor services. Among these constructs, perceived
benefits emerged as the strongest positive driver, while perceived barriers exerted a
significant negative effect. In contrast, perceived susceptibility did not demonstrate a
meaningful influence on intention, suggesting that perceived disease risk alone is
insufficient to motivate preventive service use in this context.
These results underscore the importance of evaluative judgments regarding service
value and feasibility over abstract risk perceptions. The study contributes to the health
behavior literature by demonstrating that a parsimonious integration of belief-based and
attitudinal frameworks can effectively explain preventive healthcare intention in a
developing healthcare system. It also reinforces the need to contextualize health behavior
models when applying them beyond disease-specific or treatment-oriented settings.
6.2. Implications
6.2.1. Theoretical implications
From a theoretical perspective, this study supports the complementary integration
of the Health Belief Model and the Theory of Planned Behavior. The findings validate the
role of attitude as a key mediating mechanism linking health beliefs to intention,
reinforcing TPB’s assumption that evaluative judgments are the most immediate
antecedents of behavioral intention.
Additionally, the non-significant role of perceived susceptibility contributes to
ongoing debates regarding the applicability of traditional HBM constructs in preventive
and non-disease-specific contexts. The results suggest that perceived benefits and
barriers carry greater explanatory power than perceived risk in shaping intention toward
family doctor services. This highlights the importance of selectively applying and adapting
health behavior models to better reflect contextual and service-specific characteristics.
6.2.2. Practical implications
For family doctor service providers: Providers should prioritize reducing perceived
barriers, as this factor most strongly influences attitude formation. Efforts should focus on
improving cost transparency, simplifying administrative procedures, enhancing
accessibility, and ensuring service quality. Communication strategies should emphasize
tangible benefits such as continuity of care and early detection, while risk-based
messaging alone is unlikely to be effective.
For policymakers: Policy interventions should target structural and economic
barriers rather than relying primarily on risk awareness campaigns. Given higher intention
among individuals with greater education and income, policies should enhance
affordability and accessibility to prevent inequities. Integrating family doctor services into
insurance schemes and standardizing service quality may help lower perceived barriers
across population groups.
For public health communication and community outreach: Since intention does not

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