How can the health belief model reveal sufficient and necessary conditions of residential treated greywater adoption? An integrated PLS-SEM and NCA approach

Danesh-Pajooh, S., Tabesh, M., Shahangian, S.A., Yazdanpanah, M., Zobeidi, T., & Zarei, Z. (2026). How can the health belief model reveal sufficient and necessary conditions of residential treated greywater adoption? An integrated PLS-SEM and NCA approach. Environmental Impact Assessment Review 121 e108565. 10.1016/j.eiar.2026.108565.

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Abstract

With freshwater supplies facing increasing pressure, policymakers are seeking non-conventional water resources, like Residential Treated Greywater (RTG), to guarantee urban water security. However, despite technological feasibility, the success of any water reuse initiative depends on public acceptance. Thus, understanding the key mechanisms driving voluntary RTG adoption is essential for formulating more targeted interventional strategies. Applying the Health Belief Model (HBM), this research employed a self-administered online survey to investigate the psychosocial determinants and prerequisites behind the intention to adopt RTG among 375 households in Isfahan, Iran. While previous literature has predominantly emphasized identifying “sufficient” (should-have) factors and neglected to assess the “necessary” (must-have) ones, this study benefited from the integration of Partial Least Squares Structural Equation Modeling (PLS-SEM) and Necessary Condition Analysis (NCA) to distinguish between probabilistically sufficient and necessary conditions for this behavior. The results revealed that: (1) HBM explained 68.9% of the variance in RTG adoption intention; (2) perceived susceptibility and perceived benefits emerged as both sufficient predictors of and necessary conditions for intention, whereas perceived barriers, self-efficacy, and cues to action, though sufficient, were not necessary; (3) although not sufficient, perceived severity was found to be necessary for RTG adoption intention. Building upon the theoretical insights derived from PLS-SEM and NCA, this work also employed a combined Importance-Performance Map Analysis (cIPMA) to prioritize RTG promotion policies and deliver robust practical contributions.

Item Type:	Article
Uncontrolled Keywords:	Wastewater reuse, Public resistance, Environmental psychology, Water conservation, Structural equation modeling, Necessary condition analysis
Research Programs:	Advancing Systems Analysis (ASA) Advancing Systems Analysis (ASA) > Cooperation and Transformative Governance (CAT)
Depositing User:	Luke Kirwan
Date Deposited:	23 Jun 2026 14:31
Last Modified:	23 Jun 2026 14:31
URI:	https://pure.iiasa.ac.at/21672

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