Applying the Health Belief Model to Urban Medication Disposal Behaviors: Insights for Public Health Interventions

Abstract

Improper disposal of household pharmaceutical waste (HPW) contributes to environmental contamination and public health risks, yet safe disposal practices remain inconsistent in many communities. This study examined the behavioral intentions of urban Malaysian residents toward safe HPW disposal using the Health Belief Model (HBM). A cross-sectional survey was conducted with 450 stratified pharmacy customers across the Klang Valley. Respondents completed a self-administered digital questionnaire assessing HBM constructs on a 6-point Likert scale. Data was analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The final model explained 63.7% of the variance in behavioral intention (R² = 0.637; adjusted R² = 0.635). Cues to action and self-efficacy were identified as the strongest predictors, while perceived susceptibility and perceived benefits influenced perceived severity. Findings highlight three public health strategies: integrating disposal guidance into routine care, embedding visible cues to action in health care and community settings, and strengthening regulatory frameworks to expand accessible take-back infrastructure.