Anna C. Woloski Wruble

Hebrew University
Israel

Abstract Title: From Intention to Practice: A TPB-Based Randomized Trial in Nursing Education

Biography:

Dr. Anna Woloski-Wruble, EdD, RN, is a senior lecturer (research) at the Faculty of Medicine and a senior member of the Henrietta Szold Hadassah–Hebrew University School of Nursing. As a nurse- midwife and sexual health clinician, her research focuses on sexual and relationship health across the lifespan, sexual health education, and sexual adjustment to illness. She has published extensively, chairs the doctoral program, and mentors graduate student research. She serves on institutional committees including the ethics committee. Her clinical practice includes individuals and couples across the lifespan and health illness continuum and advances culturally sensitive sexuality education initiatives.

Research Interest:

Background: Nursing education is expected to prepare students to conduct comprehensive health assessments that incorporate cultural, social, and lifestyle factors. Despite the recognized importance of holistic care, sexual health assessments (SHA) remain largely absent from nursing curricula. Reported educational interventions have been inconsistent in duration, content, and theoretical grounding, with few based on structured models such as the Theory of Planned Behavior (TPB).

Aim: To evaluate the effectiveness of a TPB-based educational intervention in improving second-year nursing students’ intentions to perform SHAs and their performance three months post-intervention.

Methods: A parallel-group, single-blind randomized controlled trial was conducted among second-year nursing students (N = 76), randomized to an intervention (n = 39) or control group (n = 37). The intervention group received structured SHA training including theoretical instruction and simulation-based practice, while the control group received training in general empathetic communication. TPB components—attitudes, subjective norms, perceived behavioral control, and intention—were assessed pre- and post-intervention employing a questionnaire developed for this study. SHA performance was evaluated three months later using self-reported assignments analyzed with a structured checklist.

Results: Significant group-by-time interactions were found for attitudes (η² = 0.369), perceived behavioral control (η² = 0.324), subjective norms (η² = 0.101), and intention (η² = 0.152) (all p < .05). Attitudes predicted intention at baseline and post-intervention, while perceived behavioral control predicted intention only post-intervention. A combined model of subjective norms and perceived behavioral control explained 63.8% of the variance in intention. At follow-up, the intervention group showed significant improvements in assessing sexual function, addressing changes in sexual activity, and responding to patient concerns (p < .05).

Conclusion: A brief TPB-based intervention effectively enhances nursing students’ readiness and competencies in SHA. Ongoing, theory-driven training is recommended to support sustained integration into clinical practice.

Keywords: sexuality education, TPB, intervention, sexual health assessment