Content uploaded by Komal Chopra
Author content
All content in this area was uploaded by Komal Chopra on Sep 25, 2021
Content may be subject to copyright.
Maslow’s theory for preventive
healthcare in India –a content
analysis approach
Komal Chopra
Symbiosis Institute of Management Studies, Symbiosis International
(Deemed University), Pune, India
Abstract
Purpose –The purpose of the study was to apply Maslow’s hierarchy of needs to understand consumer
motivation for preventive health care in India using content analysis.
Design/methodology/approach –Content analysis approach which is a qualitative-based approach
was adopted. The responses were collected through semi-structured interviews using purposeful sampling
method, and the responses were analyzed using content analysis approach. Sub themes and main themes
were derived from the data which related to concepts in Maslow’s theory.
Findings –The results indicate the following: healthy food, healthy diet and health supplements are the
basic need; sustainability of health and fitness and health security relate to safety and security need; feeling of
pride in being fit, being a role model of fitness for others and influence of electronic media relate to social and
self-esteem need; freedom from disease and peace of mind fulfill the need for self-actualization.
Research limitations/implications –To strengthen the external validity, a mix of alternate research
methodologies adopting qualitative and quantitative approach need to be adopted.
Practical implications –This study will help to better understand motivation for preventive health care.
It will enable health-care companies to design health-care marketing programs based on Maslow’s theory to
motivate individuals to purchase health products. The public health-care departments can issue guidelines
based on Maslow’s theory to motivate citizens toward preventive health care.
Originality/value –Maslow’s theory was applied in the context of preventive health care.
Keywords India, Content analysis, Health care, Maslow’s theory
Paper type Research paper
Introduction
The World Health Organization declared COVID-19 as a pandemic (Cucinotta and Vanelli,
2020). As a result, the Government of India announced 21-day nationwide lockdown in
response to the COVID-19 crisis which was eased in steps (Barkur and Vibha, 2020). This
realized the need for preventive health care amongst the citizens of the country (Barkur and
Vibha, 2020). India is an emerging market with the world’s second largest population (Saikia
et al., 2020;Arora and Rahman, 2017). Preventive health care relates to all activities done by
individuals to protect themselves from health problems (Burns, 1992). These activities
include yoga, meditation, periodic health checkup, having healthy food, regular exercise, etc.
(Haber, 1983). Preventive health care leads to a feeling of confidence (Veenhoven, 2008).
Research on preventive health care has caught the attention of several researchers
especially during to COVID-19 pandemic crisis. A review of existing literature has
The author expresses gratitude to the Editor and reviewers for providing expert comments which
helped to improve the manuscript at each stage of the review process.
Preventive
health care
Received 9 October2020
Revised 10 May 2021
11 June 2021
Accepted 30 August2021
International Journal of
Pharmaceutical and Healthcare
Marketing
© Emerald Publishing Limited
1750-6123
DOI 10.1108/IJPHM-10-2020-0088
The current issue and full text archive of this journal is available on Emerald Insight at:
https://www.emerald.com/insight/1750-6123.htm
highlighted that protection motivation theory has been more often used to denote preventive
health-care behavior (Bashirian et al., 2020;Mortada et al., 2021). However, the theory is
based on the premise of fear appeals to motivate individuals (Rogers, 1975 cited in Verkijika,
2018). The theory explains that individuals engage in protective behavior by indulging in
preventive health care when they fear vulnerability to a particular disease (Babazadeh et al.,
2017). Another theory is the self-determination theory (Deci and Ryan, 2004). This theory
suffers from the drawback of capturing only the basic motivational need (Ryan and Deci,
2017). There is scant literature that focuses on the role of other motivational factors to
voluntary indulge in preventive health care which is not based on fear or basic need alone.
A very well-known theory of motivation is the Maslow’s hierarchy of needs that has been
widely used in different fields to comprehensively explain different motivational factors
(Maslow, 1943,1958). The theory was developed by Abraham Maslow and explains four
different types of motives, namely, basic motives, safety and security motives, social and
self-esteem motives and the motive to achieve self-actualization (Maslow,1943, 1958).
Maslow’s theory of motivation has been applied in health-care industry but not in the area of
preventive health care. The theory has helped to motivate health-care employees (Benson
and Dundis, 2003). It has also been applied to understand motivation for adoption of health-
care technologies (Thielke et al.,2012). Voluntary indulgence in activities driven by self-
motivation has a greater positive impact on behavior and ensures effective results (Teixeira
et al., 2012). There is a dire need to encourage individuals to undergo preventive health-care
practices to manage the COVID-19 crisis. Hence, it is proposed to apply Maslow’s hierarchy
of needs to motivate individuals for preventive health care. This will help to better
understand self-motivation of individuals and play an important role in designing effective
health-care programs.
A review of current literature on health care also concludes that the Maslow’s theory has
mostly been applied in quantitative research. Hence, it is proposed to apply Maslow’s
hierarchy of needs to motivate consumers for preventive health care using a qualitative
approach. This will help to better understand consumer motivation which is a key benefitof
qualitative approach because it provides deeper insights about the phenomenon under
study (Charmaz, 2020). A widely used qualitative approach in health-care research is content
analysis (Poortaghi et al., 2021). The content analysis approach has distinct advantage over
other theories in terms of application of a theory to better understand a phenomenon
through insights gathered using qualitative method (Krippendorff, 2018;Vespestad and
Clancy, 2020;Charmaz, 2020). Past and current literature has shown that content analysis is
considered an important methodology for human communication based research and is very
relevant in social science research (Krippendorff, 2018;Downe-Wamboldt, 1992;White and
Marsh, 2006). The current research proposes to use content analysis approach to apply the
Maslow’s theory to motivate individuals for preventive health-care practices.
Review of literature
Kelly (2011) defined pandemic as an epidemic that has spread over a large geographic area.
The current pandemic of COVID-19 originated from Wuhan in China and spread across the
globe (Zheng et al.,2020). Pandemics have happened in the past. The H1N1 influenza
pandemic happened in 2009 which spread across the globe (Valleron and Guidet, 2010). The
Zika virus also spread to number of countries (Petersen et al.,2016). Lockdown is seen as
common risk mitigation strategy to prevent the spread of pandemic virus (Musinguzi and
Asamoah, 2020). The restrictions during pandemic created an anxiety amongst individuals
about health prospects and they felt the need to increase immunity toward the disease by
indulging in preventive health care (Fisher et al.,2020). Recent studies have shown that
IJPHM
individuals become more concerned about their health in pandemic situations thereby
focusing on preventive health care (Agarwal et al.,2021).
Preventive health care is a widely researched area. Recent papers on preventive health care
have focused on educating about preventive health-care practices to make it more effective (Lee
et al., 2018). Studies have also focused on different segments of the population. Lebrun-Harris
(2019) has focused on preventive oral care practices amongst children. Graves et al. (2019) have
studied the preventive health-care practices amongst young adults. The predictors of
preventive health-care practices were researched upon by Wu and Raghunathan (2019).
Spencer et al. (2018) emphasized the need for health promotional activities to spread awareness.
Hence the role of health education becomes very important (Wright et al.,2018). Technology
has become a big driver for preventive health care. Wearable technologies are being used for
health care (Gao et al., 2015). Big data analytics is being used in preventive medicine (Razzak
et al., 2020). Prutzman et al. (2021) endorsed the role of digital technology in sensitizing
population about preventive health care. Most of the research in preventive health care has
been on the developed economies. Attention needs to be given to emerging economies like India
which have the second largest population in the world (Maheshwarkar and Raman, 2021).
In the Indian context, limited research has been done in the area of preventive health care.
Anand et al. (2018) studied the preventive health-care practices amongst doctors in India. Shetty
et al. (2018) showed how communication material can be designed to promote preventive health
care in India. Rao and Sheffel (2018) discussed the quality of health-care services in India. Pai
and Alathur (2019) explained the framework for mobile health-care framework in India. Singh
et al. (2018a,2018b) expressed concerns about cost of health care in India. Nadhamuni et al.
(2020) emphasized on the role of technology in preventive health-care practices. Ganapathy and
Reddy (2021) stressed on the need of public private partnership in administering technology
based preventive health-care services in remote areas of India. Reynolds and Childers (2020)
discussed about the disparities in preventive health-care screening.
A review of existing literature indicated the application of different motivational theories
in health care. Ng et al. (2012) studied the role of self-determination theory to understand
health related behaviors of patients. Gomez-Baya and Lucia-Casademunt (2018) studied the
self-determination approach to health and well-being at workplace. Osei-Frimpong (2017)
applied the theory to study participatory behavior of patients. However, the theory does not
take into account factors beyond basic need for health care (Ryan and Deci, 2017). Protection
motivation theory has also been applied in the area of preventive health care (Prentice-Dunn
and Rogers, 1986;Ling et al., 2019;Kowalski and Black, 2021). Bashirian et al. (2020) applied
the theory to study factors associated with preventive health-care behavior during
COVID-19. However, the basis of application of the theory is the fear of vulnerability to the
disease. There could be many other reasons to undertake preventive health care which may
not necessarily be related to fear. Another theory is Maslow’s hierarchy of needs that has
been applied in the area of health care (Shih et al., 2019).
Abraham Maslow’s hierarchy of needs has been referred to by different researchers since
decades (Shaughnessy et al.,2018). These needs form the foundation of human motivation
which is explained in four levels which can be represented in hierarchical form (de Campos,
2012). According to Maslow (1943,1958), the four levels are explained as follows: At the
lowest level of hierarchy is the physiological or basic need which relates to survival of
individuals, i.e. food, shelter and clothing. At the next level is the motivation to remain safe
and secure by protecting oneself from the surrounding environment. The third level relates
to fulfillment of social and self-esteem motives driven by a feeling of belongingness and
accomplishment. The final level of Maslow’s theory is the need for self-actualization driven
by realization of one’s full potential. Recent literature has shown that Maslow’s theory has
Preventive
health care
been used to study needs of patients (Poirier and Devraj, 2019) and also the needs of doctors
(Yang et al.,2019). Wasik (2020) studied the role of nurses in improving quality of health
care. S
,tefan et al. (2020) found that Maslow’s theory can be applied to understand health-
care employee performance. Ryan et al. (2020) studied the Maslow’s hierarchy of needs
integrated with social determinants of health care. Henwood et al. (2015) applied Maslow’s
theory to mental health recovery of adults. Poirier and Devraj (2019) discussed the role of
Maslow’s hierarchy of needs in improving health-care delivery. The review of literature
indicates that Maslow’s theory will comprehensively explain the different levels of
individual motivation for preventive health care which has not been researched earlier.
Hence, Maslow’s approach hasbeen preferred over other theories.
Research question
RQ1. How can Maslow’s hierarchy of needs be applied to understand consumer
motivation for preventive health care in India?
Research methodology
Qualitative research methodology in the form of content analysis has been adopted for the
study (Charmaz, 2020;Krippendorff, 2018). Content analysis adopts an inductive approach
where data can be collected from respondents through semi-structured interviews and
analyzed from which meaningful inferences are derived (Krippendorff, 2018). A similar
approach had been adopted by many researchers in the health-care domain (Bertschy et al.,
2015;Gallagher and Porock, 2010;Mazaheri et al., 2013). Data was collected through semi-
structured interviews using purposeful sampling method (Emmel, 2013;Palinkas et al.,
2015). The participants for the current study were Indian citizens between 20 and 30years
as they account for more than 60% of the population in the country and vulnerable to
COVID-19 virus (Chand, 2018).
Participants for the study were selected from Pune and Mumbai, two cities in India
which are ranked amongst top ten cities with respect to COVID-19 cases in the country
(Kumar and Abdin, 2021). The criteria for selection of participants were purposeful
sampling because the purpose was to target respondents who indulged in preventive health-
care activities (Suri, 2011). The process of data collection and analysis started with the very
first participant and continued till no new insight was forthcoming with additional
interviews which happened with 31 participants and a point of theoretical saturation was
reached (Saunders et al., 2018). Each participant was abbreviated as P. 44% of participants
were males and 56% were females. A total of 24% of the participants worked in retail sector,
28% of the participants were from manufacturing sector, 30% were from delivery services
while 18% were from banking sector. All the participants chosen were concerned with their
health because their work involved physical interaction with customers. The sample size of
31 is supposed to be sufficient for qualitative research because the objective is better
understanding of the concept (Marshall et al.,2013;Saunders et al.,2018;Charmaz, 2020).
According to Sandelowski (1995), having a large sample size in qualitative study may not
give sufficient scope for in-depth analysis. The sample size is considered sufficient keeping
in mind the scope of study and nature of the topic (Morse, 2000). The interviews of
participants were recorded using a video camera so that the expressions of the participants
could be captured and the videos could be re-played multiple times for analyzing the data.
The participants were asked the following questions to understand their motivation for
preventive health care:
IJPHM
Q1. What activities did you undertake for preventive health care during COVID-19
pandemic?
This question will help to understand how individuals maintain their health and fitness
during COVID-19:
Q2. What is the motivation for undergoing preventive health-care activities?
This question will help to understand whether the motivation is particularly related to
COVID-19 situation only or whether it is drivenby other motives:
Q3. How are you maintaining social distancing and ensuring personal hygiene as part
of preventive health care?
This question relates to precautions taken by individuals:
Q4. How has your life changed by undertaking preventive health-careactivities?
This question helps to understand whether preventive health care has led to a change in
lifestyle.
The recorded interviews were initially transcribed. The transcriptions were then
analyzed by a committee of three researchers to understand the context and derive
meaningful interpretations. The interpretations were then related to Maslow’s theory and
abstracted to sub themes. All the similar sub themes were then grouped under the main
themes of Maslow’s hierarchy of needs (Mazaheri et al.,2013). Manual coding was done as it
is advantageous over software based coding. Human ability to recognize and interpret
results is more precise compared to automation driven coding (Belgrave and Seide, 2019;
Nelson et al.,2021).
Results
Analysis of data from Table 1 led to identification of concepts related to Maslow’s hierarchy
of need. The data analysis showed that difference in gender responsewas not discernible.
Basic needs
As per Maslow’s hierarchy of need, the basic need is consumption of health products.
Participant P3 and P5 have propagated consumption of healthy food and having a healthy
diet. Participant P17 has mentioned of consuming health supplements as part of daily
routine to boost immunity (Table 2).
Safety and security needs
The safety and security need relates to steps taken to remain safe and secure from COVID-
19 virus. Many participants were working toward achieving sustained health and fitness.
Participant P2 perceived that in addition to exercise, regular health-care checkup is
important to maintain safety of health. Participant P8 mentioned that developing stamina
will play an important role to develop health and fitness in the long run. Participant P10 was
of the view that regular exercise will also boost immunity toward COVID-19. Participants
P23 and P28 further mentioned about making exercise a habit to remain healthy. Participant
P13 mentioned about social distancing to maintain health and fitness. Participant P15
emphasized the importance of hygiene to ensure safety of health. Participant P16 focused on
Preventive
health care
Table 1.
Data analysis using
content analysis
approach
Coding of participant interviews (P –participant code)
Interview extract Gender Sub theme
Main theme related
to Maslow’s theory
P 1: Fit body makes me look good Male Good personality Boosting Self esteem
P 2: Regular health checkup keeps me healthy Male Sustained fitness Safety of health
P 3: Healthy food keeps me fit all day Female Fitness Basic health need
P4: I can see my good personality by yoga Female Self-pride Esteem need
P5: Healthy diet has given me glowing skin Female Personality Esteem need
P6: Workout at home enables me to work for long
hours
Female Remaining fit Basic need
P7: Preventive health care is the best method to get
freedom from disease
Female Freedom Self-actualization
P8: If I develop stamina, will be able to sustain
fitness in the long run
Male Sustained fitness Safety of health
P9: I’m inspired by celebrities for their fitness and so
I exercise
Male Role model Esteem need
P 10: You can have better immunity if you exercise
regularly
Male Sustained fitness Health security
P11: Healthy diet increases your immunity Male Healthy food Basic health need
P 12: Exercising with kids using social distancing
norms makes me feel young
Female feeling of pride Self esteem
P 13: Social distancing will help to keep me safe Female Sustained health Safety of health
P 14: Seeing social media videos, I’m also motivated
for exercise
Male Influence of electronic
media
Social need
P 15: Wash hand regularly to remain hygiene Male Sustained health Safety of health
P 16: Doing yoga regularly will boost immunity and
create resistance to virus.
Female Sustained health Safety of health
P 17: Herbal products should be part of daily routine Male Health supplements
consumption
Basic need of health
P 18: Healthy lifestyle will make you sustain Female Sustained health Future security need
P 19: Health is wealth Female Security of health Security need
P 20: Discussing health tips with friends through
online platforms is the latest method of socialism
Male Socialization through
electronic platforms
Social need
P 21: I watch television and exercise Female Electronic media
influence
Social need
P 22: Doctor’s advised me to exercise regularly to
remain healthy
Female Sustained fitness Safety need
P 23: Exercise should be a habit to maintain a
healthy body
Female Sustained fitness Security need
P 24 : Others watch me doing yoga so I feel more
motivated and proud
Female Self esteem Esteem need
P25: A gym at home will help to exercise regularly Female Sustained fitness Safety need
P 26: Health insurance is a future investment from
any kind of virus
Male Future investment Security need
P27: Gadgets help to monitor my progress Male Sustained fitness Safety need
P28: I’m very conscious about my health in COVID-
19 crisis so need to exercise
Male Caring of health Safety need
P 29: Exercise reduces stress about current situation Male Caring of health Safety need
P30: Indulging in preventive health care makes me
feel peaceful
Female Peace of mind Self-actualization
P31: I exercise to build my fitness so that I can
impress friends
Female Self-image Esteem need
IJPHM
the need for doing yoga to develop resistance. Participant P18 stressed on the need for a
healthy lifestyle. Participant P22 talked about taking a doctor’s advice periodically while
participant P25 talked about having a gym at home for regular exercise. Participant P27
mentioned about electronic gadgets to monitor health. Participants also considered health as
a security instrument. Participant P19 mentioned that health is wealth which means that
maintaining good health helps to reduce health expenses. P26 was of the opinion that health
insurance was a future investment for health security (Table 3).
Social and self-esteem needs
Social and self-esteem need relates to following of social distancing norms as well as feeling
of pride and being a role model of fitness for others. Participant P4 indulged in yoga to build
a good personality which can be appreciated by others and is a feeling of pride. Participant
P5 followed a healthy diet as it resulted in glowing skin giving a feeling of pride. Participant
P9 was inspired by fitness of celebrities and hence indulged in preventive health-care
activates. The celebrities acted as role models for the participant. Participant P12 preferred
to exercise with kids following social distancing norms as it made the participant feel young
thereby giving a feeling of self-esteem. Participant P14 was motivated to exercise by
watching social media videos and this was another method of fulfilling social need.
Participant P21 too indulged in exercise by watching health related videos on television.
Participant P20 socialized with friends by discussing health tips through online social
platforms. Participant P24 was seen as a role model of fitness by others which was a feeling
of self-esteem and a motivation to exercise. Participant P31 exercised to build fitness so that
friends could be impressed (Table 4).
Table 3.
Safety and security
need
Safety and security need Participant code
Sustained health and fitness
Regular health check - up P2
Developing stamina P8
Regular exercise to build stamina and boost immunity P8, P10
Making exercise a habit P23, P28
Social distancing P13
Maintaining hygiene P15
Doing yoga P16
Healthy lifestyle P18
Periodic doctor’s advice P22
Gym at home for regular exercise P25
Electronic gadgets to monitor health P27
Health security
Good health reduces expenses P19
Health insurance P26
Table 2.
Basic need
Basic needs Participant code
Healthy food P3
Healthy diet P5
Consumption of health supplements P17
Preventive
health care
Self-actualization needs
Self-actualization related to realization of full potential. Participant P7 felt that preventive
health care was the best method to obtain freedom from disease. Participant P30 was of the
view that indulging in preventive health care gave a feeling of peace (Table 5).
Model integration
According to Maslow’s hierarchy of needs, the basic need is healthy food, healthy diet and
health supplements. The next level of Maslow’s hierarchy is safety and security need. The
participants felt that to maintain safety and security of health, they need to carry out
preventive health-care activities such as exercise, workout at home, follow doctor’s advice as
well as be self-conscious about health benefits. Good health also leads to feeling of pride and
self-esteem as it develops a good personality resultingin feeling of pride and a role model for
others. Watching others’doing exercise on electronic media influences the need to follow
them which is the new socialism. Good health also leads to freedom from diseases and peace
of mind which is the property of self-actualization. These needs motivate participants for
preventive health-care activities. The needs can be integrated into a theoretical model
(Figure 1).
Validation of findings
Validation of findings in qualitative research can be done by triangulation method (Lincoln
and Guba, 1985). It is recommended to use a mix of methods for validation (Creswell and
Miller, 2000). Two methods of validation were adopted for the current study (Lincoln and
Guba, 1985):
Validation with existing literature
There is enough literature on adoption of preventive health-care practices to remain healthy.
De Campos (2012) inferred that health was a basic human need which validated that apart
Table 5.
Self-actualization
need
Need for self-actualization Participant code
Freedom from disease P7
Feeling of peace P30
Table 4.
Social and self-
esteem need
Social and self-esteem need Participant code
Feeling of pride
Good personality P4
Glowing skin P5
Feeling of youth P12
Role model
Celebrity as a role model of fitness P9
Self-perception of being a role model for others P24, P31
Electronic media influence
Influence of social media videos P14
Influence of television channels P21
Health discussion with friends on online social platforms P20
IJPHM
from food shelter and clothing, health is a basic human need. Johansson et al. (2006) has
related health to safety and security need. Torres and Fern
andez (1995) showed that good
health boosts self-esteem of individuals which validates the relationship of health with self-
esteem. Doing exercise with others to maintain good health fulfills the social need
(Braveman et al., 2011). Hence, we can conclude that health care has a social and self-esteem
perspective. Miller and Reddin (2021) associate self-actualization with the realization of self-
care to remain healthy.
Participant feedback
Participant checking is the process of getting the findings checked from the participants.
The findings of the current study were sent to participants through mail to review and
confirm. As it was not possible to meet the participants physically due to COVID-19
restrictions, it was agreed upon to discuss the findings in a meeting through video
conferencing on a particular date and at a particular time. A total of 75% of the participants
attended the meeting. Some of the participants wanted a clarification on the interpretation of
results which was resolved after discussion. All the participants then confirmed the
findings. Those who could not attend the meeting had a one to one discussion through
phone call or video call at mutual convenience and confirmed the findings.
Peer debriefing
Peer debriefing is the process of getting the study validated from experts in the form of peer
reviews to provide credibility to the study (Lincoln and Guba, 1985). Two experts, one from
health-care background at a reputed Indian hospital and another, a professor of health-care
management were taken on board to review the study and findings. The experts provided
their guidance throughout the study in the form of criticisms and suggestions based on
which improvements were done. The final version of the draft was sent to them which was
unanimously approved by both the experts.
Figure 1.
Maslow’s theory for
preventive health
care
Preventive
health care
Conclusion and implications
The findings of the study show that Maslow’s hierarchy of needs can be applied to
preventive health-care behavior of individuals. The findings indicate that healthy food,
healthy diet and health supplements are the basic need. Maintaining and sustaining fitness
through preventive health-care activities keeps the body safe through increased immunity.
Being fit also boosts self-esteem and maintains a good personality which can be a role model
for others. Preventive health care also leads to freedom from disease and peace of mind. The
data analysis and results indicate that different individuals have different motivation for
preventive health care.
The study has got several implications from theoretical, practical and policy perspective.
From the theoretical perspective, Maslow’s theory can be applied to individual motivation
for preventive health care. The Maslow’s theory helps to better understand the different
motivational factors of individuals to remain healthy. From the practical perspective, there
are applications for health-care marketing companies. There is a dire need to spread
awareness about preventive health care during the COVID-19 crisis to increase immunity of
citizens. The study can help health-care companies to incorporate Maslow’s theory in health-
care promotional programs for effective marketing of preventive health-care products and
activities. The study also has implications for public health-care policy. Prevention is better
than cure. The public health-care departments can issue guidelines to health-care
institutions and organizations involved in social work to encourage citizens toward self-care
by undertaking preventive health-care activities in different forms so that the population at
large can boost their immunity thereby reducing the number the COVID-19 cases.
Limitations and direction for future research
The current findings are based on qualitative research. Further research could be to
strengthen the external validity by adopting a mix of alternate research methodologies
which could be qualitative and quantitative in nature. This would further strengthen the
external validity. The research could also form the basis of studying individual behavior
toward other diseases and pandemics. Maslow’s theory could also be applied in the area of
health risk management and health-care quality management.
References
Agarwal, A., Ranjan, P., Rohilla, P., Saikaustubh, Y., Sahu, A., Dwivedi, S.N., Baitha, U. and Kumar, A.
(2021), “Development and validation of a questionnaire to assess preventive practices against
COVID-19 pandemic in the general population”,Preventive Medicine Reports, Vol. 22,p. 101339.
Anand, T., Grover, S., Kumar, R., Prabhu, N. and Ingle, G.K. (2018), “Preventive health practices among
doctors in Delhi”,Journal of the Association of Physicians of India, Vol. 66, pp. 48-54.
Arora, B. and Rahman, Z. (2017), “Information technology capability as competitive advantage in
emerging markets: evidence from India”,International Journal of Emerging Markets, Vol. 12
No. 3, pp. 447-463.
Babazadeh, T., Nadrian, H., Banayejeddi, M. and Rezapour, B. (2017), “Determinants of skin cancer
preventive behaviors among rural farmers in Iran: an application of protection motivation
theory”,Journal of Cancer Education, Vol. 32 No. 3, pp.604-612.
Barkur, G. and Vibha, G.B.K. (2020), “Sentiment analysis of nationwide lockdown due to COVID 19
outbreak: evidence from India”,Asian Journal of Psychiatry, Vol. 51, p. 102089.
Bashirian, S., Jenabi, E.,Khazaei, S., Barati, M., Karimi-Shahanjarini, A., Zareian, S., Rezapur-Shahkolai,
F. and Moeini, B. (2020), “Factors associated with preventive behaviours of COVID-19 among
IJPHM
hospital staff in Iran in 2020: an application of the protection motivation theory”,Journal of
Hospital Infection, Vol. 105 No. 3, pp. 430-433.
Belgrave, L. and Seide, K. (2019), “Coding for grounded theory”,The SAGE Handbook of Current
Developments in Grounded Theory, pp. 167-185.
Benson, S.G. and Dundis, S.P. (2003), “Understanding and motivating health care employees:
integrating Maslow’s hierarchy of needs, training and technology”,Journal of Nursing
Management, Vol. 11 No. 5, pp. 315-320.
Bertschy, S., Geyh, S., Pannek, J. and Meyer, T. (2015), “Perceived needs and experiences with
healthcare services of women with spinal cord injury during pregnancy and childbirth –a
qualitative content analysis of focus groups and individual interviews”,BMC Health Services
Research, Vol. 15 No. 1, pp. 1-12.
Braveman, P.A., Egerter, S.A. and Mockenhaupt, R.E. (2011), “Broadening the focus: the need to
address the social determinants of health”,American Journal of Preventive Medicine, Vol. 40
No. 1, pp. 4-18.
Burns, A.C. (1992), “The expanded health belief model as a basis for enlightened preventive health care
practice and research”,Journal of Health Care Marketing, Vol. 12 No. 3, pp. 32-45.
Chand, M. (2018), “Aging in South Asia: challenges and opportunities”,South Asian Journal of Business
Studies, Vol. 7 No. 2, pp. 189-206.
Charmaz, K. (2020), “‘With constructivist grounded theory you can’thide’: social justice research and
critical inquiry in the public sphere”,Qualitative Inquiry, Vol. 26 No. 2, pp. 165-176.
Creswell, J.W. and Miller, D.L. (2000), “Determining validity in qualitative inquiry”,Theory into
Practice, Vol. 39 No. 3, pp. 124-130.
Cucinotta, D. and Vanelli, M. (2020), “WHO declares COVID-19 a pandemic”,Acta Bio Medica: Atenei
Parmensis, Vol. 91 No. 1,pp. 157-160.
de Campos, T.C. (2012), “Health as a basic human need: would this be enough?”,Journal of Law,
Medicine and Ethics, Vol. 40 No. 2, pp. 251-267.
Deci, E.L. and Ryan, R.M. eds. (2004), Handbook of Self-Determination Research, University Rochester Press.
Downe-Wamboldt, B. (1992), “Content analysis: method, applications, and issues”,Health Care for
Women International, Vol. 13 No. 3, pp. 313-321.
Emmel, N. (2013), “Purposeful sampling”,Sampling and Choosing Cases in Qualitative Research: A
Realist Approach, pp. 33-45.
Fisher, J.R., Tran, T.D., Hammarberg, K., Sastry, J., Nguyen, H., Rowe, H., Popplestone, S., Stocker, R.,
Stubber, C. and Kirkman, M. (2020), “Mental health of people in Australia in the first month of
COVID19 restrictions: a national survey”,Medical Journal of Australia, Vol. 213 No. 10,
pp. 458-464.
Gallagher, K. and Porock, D. (2010), “The use of interviews in Q methodology: card content analysis”,
Nursing Research, Vol. 59 No. 4, pp. 295-300.
Ganapathy, K. and Reddy, S. (2021), “Technology enabled remote healthcare in public private
partnership mode: a story from India”,Telemedicine, Telehealth and Telepresence, Springer,
Cham, pp. 197-233.
Gao, Y., Li, H. and Luo, Y. (2015), “An empirical study of wearable technology acceptance in
healthcare”,Industrial Management and Data Systems, Vol. 115 No. 9, pp. 1704-1723.
Gomez-Baya, D. and Lucia-Casademunt, A.M. (2018), “A selfdetermination theory approach to health
and wellbeing in the workplace: results from the sixth European working conditions survey in
Spain”,Journal of Applied Social Psychology, Vol. 48 No. 5, pp. 269-283.
Graves, L., Leung, S., Raghavendran, P. and Mennito, S. (2019), “Transitions of care for healthy young
adults: promoting primary care and preventive health”,Southern Medical Journal, Vol. 112No. 9,
pp. 497-499.
Preventive
health care
Haber, D. (1983), “Yoga as a preventive health care program for white and black elders: an
exploratory study”,The International Journal of Aging and Human Development,Vol.17
No. 3, pp. 169-176.
Henwood, B.F., Derejko, K.S., Couture, J. and Padgett, D.K. (2015), “Maslow and mental health recovery:
a comparative study of homeless programs for adults with serious mental illness”,
Administration and Policy in Mental Health and Mental Health Services Research, Vol. 42 No. 2,
pp. 220-228.
Johansson, A.C., Svedung, I. and Andersson, R. (2006), “Management of risks in societal planning–an
analysis of scope and variety of health, safety and security issues in municipality plan
documents”,Safety Science, Vol. 44 No. 8, pp. 675-688.
Kelly, H. (2011), “The classical definition of a pandemic is not elusive”,Bulletin of the World Health
Organization, Vol. 89 No. 7, pp. 540-541.
Kowalski, R.M. and Black, K.J. (2021), “Protection motivation and the COVID-19 virus”,Health
Communication, Vol. 36 No. 1, pp. 15-22.
Krippendorff, K. (2018), Content Analysis: An Introduction to Its Methodology, Sage publications.
Kumar, R. and Abdin, M.S. (2021), “Impact of epidemics and pandemics on consumption pattern:
evidence from covid-19 pandemic in rural-urban India”,Asian Journal of Economics and
Banking, Vol. 5 No. 1.
Lebrun-Harris, L.A., Canto, M.T. and Vodicka, P. (2019), “Preventive oral health care use and oral
health status among US children: 2016 national survey of children’s health”,The Journal of the
American Dental Association, Vol. 150 No. 4, pp. 246-258.
Lee, Y.H., Chiang, T. and Liu, C.T. (2018), “Residents’educational attainment and preventive care
utilization in China”,International Journal of Health Care Quality Assurance, Vol. 31 No. 1,
pp. 41-51.
Lincoln, Y.S. and Guba, E.G. (1985), Naturalistic Inquiry, Beverly Hills, CA, Sage Publications, Inc.
Ling, M., Kothe, E.J. and Mullan, B.A. (2019), “Predicting intention to receive a seasonal influenza
vaccination using protection motivation theory”,Social Science and Medicine, Vol. 233,
pp. 87-92.
Maheshwarkar, P. and Raman, R.S. (2021), “Population exposure across Central India to PM 2.5 derived
using remotely sensed products in a three-stage statistical model”,Scientific Reports, Vol. 11
No. 1, pp. 1-13.
Marshall, B., Cardon, P., Poddar, A. and Fontenot, R. (2013), “Does sample size matter in qualitative
research? A review of qualitative interviews in is research”,Journal of Computer Information
Systems, Vol. 54 No. 1, pp. 11-22.
Maslow, A.H. (1958), “A dynamic theory of human motivation”, in Stacey, C.L. and DeMartino, M.
(Eds), Understanding Human Motivation, Howard Allen, pp. 26-47.
Maslow, A.H. (1943), “A theory of human motivation”,Psychological Review, Vol. 50 No. 4, p. 370.
Mazaheri, M., Eriksson, L.E., Heikkilä, K., Nasrabadi, A.N., Ekman, S.L. and Sunvisson, H. (2013),
“Experiences of living with dementia: qualitative content analysis of semi-structured
interviews”,Journal of Clinical Nursing, Vol. 22 Nos 21/22, pp. 3032-3041.
Miller, J.J. and Reddin, C., J. (2021), “Self-care among healthcare social workers: the impact of COVID-
19”,Social Work in Health Care, pp. 1-19.
Morse, J.M. (2000), “Determining sample size”,Qualitative Health Research, Vol. 10 No. 1, pp. 3-5.
Mortada, E., Abdel-Azeem, A., Al Showair, A. and Zalat, M.M. (2021), “Preventive behaviors toward
covid-19 pandemic among healthcare providers in Saudi Arabia using the protection motivation
theory”,Risk Management and Healthcare Policy, Vol. 14, p. 685.
Musinguzi, G. and Asamoah, B.O. (2020), “The COVID-19 lockdown trap, how do we get out?”,Journal
of Clinical and Experimental Investigations, Vol. 11 No. 4, pp. 1-5.
IJPHM
Nadhamuni, S., Gupta, G., Mullath, R. and Sridhar, S. (2020), “Leveraging technology to enable effective
preventive screening of NCDs at population scale: initial observations”,Journal of the Indian
Institute of Science, pp. 1-10.
Nelson, L.K., Burk, D., Knudsen, M. and McCall, L. (2021), “The future of coding: a comparison of hand-
coding and three types of computer-assisted text analysis methods”,Sociological Methods and
Research, Vol. 50 No. 1, pp. 202-237.
Ng, J.Y., Ntoumanis, N., Thøgersen-Ntoumani, C., Deci, E.L., Ryan, R.M., Duda, J.L. and Williams, G.C.
(2012), “Self-determination theory applied to health contexts: a Meta-analysis”,Perspectives on
Psychological Science, Vol. 7 No. 4, pp. 325-340.
Osei-Frimpong, K. (2017), “Patient participatory behaviours in healthcare service delivery: self-
determination theory (SDT) perspective”,Journal of Service Theory and Practice, Vol. 27 No. 2,
pp. 453-474.
Pai, R.R. and Alathur, S. (2019), “Mobile health system framework in India”,In Proceedings of the20th
Annual International Conference on Digital Government Research, pp. 186-195.
Palinkas, L.A., Horwitz, S.M., Green, C.A., Wisdom, J.P., Duan, N. and Hoagwood, K. (2015), “Purposeful
sampling for qualitative data collection and analysis in mixed method implementation
research”,Administration and Policy in Mental Health and Mental Health Services Research,
Vol. 42 No. 5, pp. 533-544.
Petersen, E.E., Staples, J.E., Meaney-Delman, D., Fischer, M., Ellington, S.R., Callaghan, W.M. and
Jamieson, D.J. (2016), “Interim guidelines for pregnant women during a Zika virus outbreak –
United States”,Mmwr. Morbidity and Mortality Weekly Report, Vol. 65 No. 2, pp. 30-33.
Poirier, T.I. and Devraj, R. (2019), “Pharmacy in an improved health care delivery model: meeting
Maslow’s hierarchy of needs”,American Journal of Pharmaceutical Education, Vol. 83 No. 8,
pp. 1664-1667.
Poortaghi, S., Shahmari, M. and Ghobadi, A. (2021), “Exploring nursing managers’perceptions of
nursing workforce management during the outbreak of COVID-19: a content analysis study”,
BMC Nursing, Vol. 20 No. 1, pp. 1-10.
Prentice-Dunn, S. and Rogers, R.W. (1986), “Protection motivation theory and preventive health:
beyond the health belief model”,Health Education Research, Vol. 1 No. 3, pp. 153-161.
Prutzman, Y.M., Wiseman, K.P., Grady, M.A., Budenz, A., Grenen, E.G., Vercammen, L.K., Keefe, B.P.
and Bloch, M.H. (2021), “Using digital technologies to reach tobacco users who want to quit:
evidence from the national cancer institute’s smokefree.gov initiative”,American Journal of
Preventive Medicine, Vol. 60 No. 3, pp. 172-184.
Rao, K.D. and Sheffel, A. (2018), “Quality of clinical care and bypassing of primary health centers in
India”,Social Science and Medicine, Vol. 207, pp. 80-88.
Razzak, M.I., Imran, M. and Xu, G. (2020), “Big data analytics for preventive medicine”,Neural
Computing and Applications, Vol. 32 No. 9, pp. 4417-4451.
Reynolds, M.M. and Childers, T.B. (2020), “Preventive health screening disparities among immigrants:
exploring barriers to care”,Journal of Immigrant and Minority Health, Vol. 22 No. 2, pp. 336-344.
Rogers, R.W. (1975), “A protection motivation theory of fear appeals and attitude change”,Journal of
Psychology, Vol. 91 No. 1, pp. 93-114.
Ryan, B.J., Coppola, D., Canyon, D.V., Brickhouse, M. and Swienton, R. (2020), “COVID-19 community
stabilization and sustainability framework: an integration of the Maslow hierarchy of needs and
social determinants of health”,Disaster Medicine and Public Health Preparedness, Vol. 14 No. 5,
pp. 623-629.
Ryan, R.M. and Deci, E.L. (2017), Self-Determination Theory: Basic Psychological Needs in Motivation,
Development, and Wellness, Guilford Publications.
Saikia, M., Das, K.C. and Borbora, S. (2020), “What drives the boom in outward FDI from India?”,
International Journal of Emerging Markets, Vol. 15 No. 5, pp. 899-922.
Preventive
health care
Sandelowski, M. (1995), “Sample size in qualitative research”,Research in Nursing and Health, Vol. 18
No. 2, pp. 179-183.
Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H. and Jinks, C.
(2018), “Saturation in qualitative research: exploring its conceptualization and
operationalization”,Quality and Quantity, Vol.52 No. 4, pp. 1893-1907.
Shaughnessy, M.F., Moffitt, B. and Cordova, M. (2018), “Maslow, basic needs and contemporary teacher
training issues”,Archives of Current Research International, Vol. 14 No. 4, pp. 1-7.
Shetty, A., Purohit, S. and Barve, S. (2018), “Learning from designing communication material for
community based preventive healthcare”,InProceedings of the 9th Indian Conference on
Human Computer Interaction, pp. 85-89.
Shih, C.Y., Huang, C.Y., Huang, M.L., Chen, C.M., Lin, C.C. and Tang, F.I. (2019), “The association of
sociodemographic factors and needs of haemodialysis patients according to Maslow’s hierarchy
of needs”,Journal of Clinical Nursing, Vol. 28 Nos 1/2, pp. 270-278.
Singh, K., Crossan, C., Laba, T.L., Roy, A., Hayes, A., Salam, A. and Patel, A. (2018a), “Cost-
effectiveness of a fixed dose combination (polypill) in secondary prevention of cardiovascular
diseases in India: within-trial cost-effectiveness analysis of the UMPIRE trial”,International
Journal of Cardiology, Vol. 262, pp. 71-78.
Singh, P., RaffinBouchal, S., McClement, S., Hack, T.F., Stajduhar, K., Hagen, N.A. and Sinclair, S.
(2018b), “Healthcare providers’perspectives on perceived barriers and facilitators of
compassion: results from a grounded theory study”,Journal of Clinical Nursing, Vol. 27 Nos 9/10,
pp. 2083-2097.
Spencer, G., Hood, P., Agboola, S. and Pritchard, C. (2018), “Parental engagement in school-based health
promotion and education”,Health Education, Vol. 118 No. 6, pp. 513-527.
S
,tefan, S.C., Popa, S
,C. and Albu, C.F. (2020), “Implications of Maslow’s hierarchy of needs theory on
healthcare employees’performance”,Transylvanian Review of Administrative Sciences, Vol. 16
No. 59 E, pp. 124-143.
Suri, H. (2011), “Purposeful sampling in qualitative research synthesis”,Qualitative Research Journal,
Vol. 11 No. 2, pp. 63-75.
Teixeira, P.J., Silva, M.N., Mata, J., Palmeira, A.L. and Markland, D. (2012), “Motivation, self-
determination, and long-term weight control”,International Journal of Behavioral Nutrition and
Physical Activity, Vol. 9 No. 1, pp. 1-13.
Thielke, S., Harniss, M., Thompson, H., Patel, S., Demiris, G. and Johnson, K. (2012), “Maslow’s
hierarchy of human needs and the adoption of health-related technologies for older adults”,
Ageing International, Vol. 37 No. 4, pp. 470-488.
Torres, R. and Fern
andez, F. (1995), “Self-esteem and value of health as determinants of adolescent
health behavior”,Journal of Adolescent Health, Vol. 16 No. 1, pp. 60-63.
Valleron, A.J. and Guidet, B. (2010), “Realtime comparative monitoring of the a/H1N1 pandemic in
France”,Clinical Microbiology and Infection, Vol. 16 No. 4, pp. 393-396.
Veenhoven, R. (2008), “Healthy happiness: Effects of happiness on physical health and the
consequences for preventive health care”,Journal of Happiness Studies, Vol. 9 No.3, pp. 449-469.
Verkijika, S.F. (2018), “Understanding smartphone security behaviors: an extension of the protection
motivation theory with anticipated regret”,Computers and Security, Vol. 77, pp. 860-870.
Vespestad, M.K. and Clancy, A. (2020), “Exploring the use of content analysis methodology in
consumer research”,Journal of Retailing and Consumer Services, p. 102427.
Wasik, M.A. (2020), “The role of the nurse in improving the quality of healthcare”,Journal of Education,
Health and Sport, Vol. 10 No. 4, pp. 68-74.
White, M.D. and Marsh, E.E. (2006), “Content analysis: a flexible methodology”,Library Trends, Vol. 55
No. 1, pp. 22-45.
IJPHM
Wright, J., O’Flynn, G. and Welch, R. (2018), “In search of the socially critical in health education:
exploring the views of health and physical education preservice teachers in Australia”,Health
Education, Vol. 118 No. 2, pp. 117-130.
Wu, T.Y. and Raghunathan, V. (2019), “Predictors of preventive health practices, chronic disease
burden and health status among underserved Bangladeshi Americans in Michigan”,Journal of
Community Health, Vol. 45 No. 2, pp. 310-318.
Yang, H., Du, H.S., He, W. and Qiao, H. (2019), “Understanding the motivators affecting doctors’
contributions in online healthcare communities: professional status as a moderator”,Behaviour
and Information Technology, pp. 1-15.
Zheng, M., Gao, Y., Wang, G., Song, G., Liu, S., Sun, D., Xu, Y. and Tian, Z. (2020), “Functional
exhaustion of antiviral lymphocytes in COVID-19 patients”,Cellular and Molecular Immunology,
Vol. 17 No. 5, pp. 533-535.
About the author
Dr Komal Chopra is working as an Associate Professor at Symbiosis Institute of Management
Studies, Symbiosis International (Deemed University), Pune, India. He has published research papers
and case studies and is a reviewer for international journals. His research interests include role of
health care in bring about change in consumer behavior. The author has also executed research and
consultancy projects on consumer behavior. Komal Chopra can be contacted at: chopra.k@sims.edu
For instructions on how to order reprints of this article, please visit our website:
www.emeraldgrouppublishing.com/licensing/reprints.htm
Or contact us for further details: permissions@emeraldinsight.com
Preventive
health care
