Teacher, Heal Thyself! Exploring Medical Procrastination Among Female Educators – A preliminary pioneering study

Teacher, Heal Thyself! 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Exploring Medical Procrastination Among Female Educators – A preliminary pioneering study Eitan Simon, Yonit Nissim, Adi Sharabi-Nov This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7610944/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This exploratory pioneering study examined sociobehavioral and health-related predictors of medical procrastination among female elementary school teachers in Israel, a group that represents the overwhelming majority of the profession. Medical procrastination, defined as the delay or avoidance of seeking medical care despite recognizing its importance, has rarely been studied among teachers, a profession characterized by high stress and significant health demands. Grounded in procrastination theory and health behavior models, we hypothesized that higher stress levels and higher body mass index (BMI) would positively predict medical procrastination, while healthier lifestyle behaviors and the presence of chronic disease would negatively predict it. A cross-sectional survey was administered to 173 female teachers, including validated measures of stress, lifestyle behaviors, and medical procrastination, along with self-reported BMI and chronic illness status. Linear regression analyzes were conducted to test the hypotheses. Findings revealed that stress was a significant positive predictor, while lifestyle behaviors reduced the likelihood of procrastination. Although limited by its modest sample size, and focus on female teachers, this study provides a first empirical step toward extending procrastination theory into the domain of health-seeking behaviors. The findings suggest that medical procrastination is linked to teachers' health-related behaviors and may have implications for their professional performance or effectiveness. The results underscore the potential value of targeted interventions aimed at reducing stress and medical procrastination to support educators' overall well-being. Although associations between medical procrastination and health behaviors are observed, its direct impact on teachers' physical or mental health, or on professional performance, remains to be tested in future research. Health sciences/Health care Health sciences/Medical research Biological sciences/Psychology Social science/Psychology Health sciences/Risk factors Self-related procrastination stress health behaviors elementary teachers Figures Figure 1 1. Introduction Procrastination, defined as the unnecessary delay of tasks or decisions, is a common behavior with adverse effects on stress, productivity, and well-being (Sirois, 2003 ). It is associated with emotional regulation difficulties, diminished prefrontal activity, and social or cultural factors, and while avoidance may provide temporary relief, it typically increases stress and guilt (Sirois & Pychyl, 2013 ). Chronic procrastination harms physical health by fostering unhealthy lifestyle habits and elevating stress, thereby reducing resilience (Kazemi et al., 2010 ; Steel, 2010 ; Rozental & Carlbring, 2014 ; Badri et al., 2016 ; Koppenborg & Klingsieck, 2022 ). A specific form, health-related procrastination, involves delaying medical or health-promoting activities despite awareness of risks and benefits (Kazemi et al., 2010 ; Steel, 2010 ). This behavior obstructs the management of chronic conditions (Sirois, 2015) and preventive practices such as cancer screening (Azami-Aghdash et al., 2015). Within this domain, medical procrastination—postponing professional healthcare—has been identified as a substantial barrier to health maintenance (Ferrari & Díaz-Morales, 2014). Personality traits like perfectionism may intensify such tendencies, especially in complex decision-making (Rozental & Carlbring, 2014 ). For teachers, the issue is particularly pressing. Their health affects not only personal well-being but also professional effectiveness and the learning environment of students (Day & Gu, 2010). Yet, research on medical procrastination among educators is scarce. Existing studies focus mainly on general populations and view procrastination as an individual psychological tendency, overlooking sociobehavioral, cultural, and systemic influences such as occupational stress, health literacy, financial constraints, and stigma. Addressing these broader factors is critical for understanding the phenomenon in educational contexts. This study applies procrastination theory, which conceptualizes procrastination as a self-regulatory failure involving intention-action gaps (Steel, 2007 ). In health contexts, this aligns with models of health behavior (Ajzen, 1991), emphasizing how stress, lifestyle, and personal characteristics shape decision-making. We propose that stress may mediate avoidance behaviors, while factors such as age and health practices may moderate them. The study focuses on female elementary school teachers, who constitute about 87% of the teaching workforce in Israel (Ministry of Education, 2023). Gender-specific health behaviors, such as breast self-examinations, this underscore the relevance of this population. H1: Mean differences will be found in the various factors and indices between female teachers with chronic diseases vs. those without chronic diseases H2: Stress, chronic diseases, health behaviors and demographic characteristics will predict Medical Procrastination. By integrating procrastination theory and health behavior perspectives, this pioneering study contributes to both theory and practice. Theoretically, it extends procrastination research into the domain of medical help-seeking. Practically, it highlights factors that may inform targeted interventions to support teachers' health and, by extension, their professional functioning. 2. Literature Review Procrastination often arises from the avoidance of discomfort or the lack of immediate rewards (Blunt & Pychyl, 2000 ). While commonly viewed as situational, procrastination is also considered a persistent trait influenced by emotional regulation difficulties, personality traits such as perfectionism, and cognitive overload. Studies indicate its stability over time, with genetic components linked to impulsivity and poor impulse control (Gustavson et al., 2014 ). Procrastination often stems from emotional avoidance, where individuals delay tasks to escape negative feelings such as fear of failure or anxiety. Although this behavior provides temporary relief, it often leads to long-term stress and guilt (Sirois & Pychyl, 2013 ). Moreover, perfectionism exacerbates procrastination by fostering analysis paralysis, as the pursuit of ideal outcomes prevents progress (Sirois, 2014 ). Cognitive overload and decision fatigue, intensified by today's information-rich environment, can overwhelm individuals, prompting delays in decision-making (Blunt & Pychyl, 2000 ). Distinct from academic procrastination, daily procrastination involves chronic delays in routine tasks such as paying bills, responding to emails, or completing household chores. This behavior arises from a misjudgment of time, lack of urgency, or avoidance of mundane tasks. It negatively impacts personal relationships and financial stability, with chronic procrastinators often perceived as unreliable and facing penalties such as late fees or fines (Sirois, 2023 ). Addressing daily procrastination involves shifting focus from avoiding negative consequences to valuing the satisfaction of task completion. While studies have demonstrated the detrimental impact of procrastination on productivity (Asio, 2021 ), its consequences likely extend beyond productivity, affecting health and well-being as well (Sirois et al., 2023 ). Chronic procrastination, in particular, has been linked to heightened stress (Sirois, 2003 ), increased levels of depression, unhealthy lifestyle behaviors (Sirois, 2003 ), and a greater incidence of physical illnesses and symptoms (Johansson & Kim 2023). 2.1. Situational Procrastination in Teaching Situational procrastination, initially studied in academic contexts, has expanded to include the domains of health and work (Hen et al., 2021 ). Despite the demanding nature of teaching—tight schedules, dense curricula, and challenging classroom environments—society often perceives the profession as relatively easy (Labaree, 2000 ). This misconception stems from factors such as long vacations and perceived "free afternoons." However, teachers generally work autonomously with little oversight and are often intrinsically motivated to pursue teaching (Richardson & Watt, 2014 ). This autonomy necessitates strong self-regulation skills; when these are insufficient, teachers may experience heightened stress levels (Nissim, 2019 ). Most research on procrastination focuses on students, but growing evidence highlights its prevalence among teachers, who face unique challenges such as balancing instructional responsibilities with administrative duties and navigating high-pressure environments that demand emotional resilience. These factors may exacerbate procrastination tendencies differently compared to students. Teacher procrastination is associated with increased stress and decreased job satisfaction (Mohsin & Ayub, 2014 ), both of which contribute to occupational burnout (Skaalvik & Skaalvik, 2009 ). Teacher burnout can negatively affect students and their academic performance (Roeser et al., 2013 ). 2.2. Medical Procrastination The effect of procrastination on health can be negative. Monaghan et al. ( 2025 ) have suggested that it can affect health through both direct and indirect pathways. The procrastination health model (Sirois, 2003 ) suggests that procrastination negatively impacts health by generating stress, which may activate the sympathetic nervous system (Sirois & Pychyl, 2013 ), ultimately leading to a decline in health (Sirois et al., 2023 ). Additionally, procrastination can adversely affect mental health by fostering feelings of self-blame, criticism, and depression (Monaghan et al., 2025 ). While the term "medical procrastination" is not widely established in academic literature, the concept aligns with behaviors observed in various studies examining its impact on health-related actions (Sirois, & Pychyl, 2013 ), and refers to delays in seeking medical care or treatment for symptoms, health concerns, or routine checkups. For instance, teachers may postpone annual physical exams or necessary medical treatments due to their demanding schedules and professional responsibilities. Such delays not only exacerbate health issues but also reflect broader challenges, such as limited access to healthcare or societal expectations. This behavior can lead to serious health consequences, as untreated conditions may worsen and reduce the effectiveness of belated interventions (Sirois et al., 2023 ). The procrastination–health model (ibid.) links procrastination to poor physical health, primarily through increased stress and unhealthy behaviors. However, the model's reliance on cross-sectional studies limits understanding of the long-term effects of procrastination and its interplay with broader personality traits. Delays in health-seeking behaviors often stem from procrastinators' preference for avoiding unpleasant tasks or ambiguous information (Sirois, 2014 ). Chronic procrastination has been extensively studied, with a primary focus on its cognitive and behavioral dimensions, particularly the tendency to delay starting or completing tasks despite negative consequences (Steel, 2007 ). However, recent research has highlighted the critical role of emotional factors, such as shame and guilt, in understanding the complexities of this phenomenon. Shame and guilt are two distinct affective experiences that have been explored in the context of procrastination. Shame, a self-conscious emotion linked to negative evaluations of the self, has been found to have a stronger connection to procrastination than guilt, which is more focused on negative evaluations of specific behaviors (Tangney & Dearing, 2002 ). Findings suggest that procrastinators may avoid tasks not only due to cognitive or time-management issues, but also to escape feelings of inadequacy or self-blame. Furthermore, shame appears to interact with other psychological constructs, such as perfectionism. Using hierarchical regression analysis, shame was identified as a moderator between chronic procrastination and socially prescribed perfectionism, a subtype of perfectionism driven by perceived external expectations (Hewitt & Flett, 1991 ). This relationship underscores the role of external pressures in exacerbating the procrastinator's emotional distress and avoidance behaviors. In addition to shame and perfectionism, other factors such as self-esteem, fear of negative evaluation, and conscientiousness have been examined in relation to procrastination (Rosenberg, 1965 ). Lower self-esteem and greater fear of negative evaluation are particularly prominent among chronic procrastinators, this reinforcing the avoidance of tasks due to a fear of failure or criticism (Pychyl & Sirois, 2016 ). Overall, the literature indicates that emotional dynamics, particularly shame, play a pivotal role in chronic procrastination. These insights suggest the need for integrative approaches in interventions, combining emotional regulation strategies with cognitive-behavioral techniques to address both the affective and behavioral dimensions of procrastination. Psychological factors, such as fear, serve as central drivers of medical procrastination. Individuals may postpone seeking care due to fears about receiving a serious diagnosis, or undergoing medical procedures. This avoidance often leads to a feedback loop, where untreated health issues exacerbate emotional distress and reinforce procrastination behaviors (Sirois et al., 2023 ). Additionally, denial plays a significant role, as individuals may minimize or dismiss symptoms to justify delays, thereby missing critical opportunities for early detection and intervention for conditions such as cancer or cardiovascular diseases. External barriers, such as geographic, financial, or systemic challenges, may also contribute to medical procrastination. Limited healthcare access and negative past experiences with providers can discourage individuals from seeking care. Cultural stigma and societal judgment surrounding certain conditions can compound delays, particularly among marginalized populations (Romash et al., 2022 ). 2.3. Consequences and the Procrastination Cycle among Teachers Stress significantly impacts teachers' health and well-being, with recent studies revealing that high stress levels correlate with maladaptive coping strategies, negatively affecting emotional health and overall well-being (Emeljanovas et al., 2023 ). The stress and anxiety associated with procrastination can contribute to depression, feelings of worthlessness, and diminished academic performance. Breaking this cycle requires strategies such as time management, setting realistic goals, and cultivating intrinsic motivation. Rewarding incremental progress can help counter entrenched avoidance patterns. Teachers are particularly vulnerable to medical procrastination due to their demanding profession, societal expectations, and personal responsibilities. Analyzing how this vulnerability varies across different education systems or cultural contexts could provide valuable insights into tailored intervention strategies. Figure 1 illustrates the conceptual framework for the study. Predictors of medical procrastination include age, healthy lifestyle behaviors, stress, BMI, and chronic disease. Stress is proposed as a potential mediator between chronic disease and medical procrastination, while age and healthy behaviors may moderate the effect of stress on procrastination. The teaching profession context, including occupational demands and gender-specific health behaviors, provides the backdrop for understanding these relationships Moreover, external pressures, such as standardized testing and accountability measures, leave educators with limited time for personal health management. Additionally, the expectation for teachers to model resilience can discourage them from seeking medical care, fearing it might signal weakness (Romash et al., 2022 ). 2.4. Contributing Factors Social expectations and systemic barriers play significant roles in medical procrastination among teachers. Limited health insurance and bureaucratic obstacles exacerbate the issue (Hen, 2018 ). During crises, such as pandemics or armed conflicts, teachers' heightened sense of responsibility this can ncreases delays in seeking care (Burgess et al.,2023). Privatized healthcare services in some countries have made timely access to care increasingly difficult (Williams & Miller, 2024 ). 2.5. Implications and Solutions Addressing medical procrastination among teachers requires improving access to healthcare, increasing awareness of preventive care, and fostering open communication between educators and providers. Effective workplace initiatives, such as offering flexible scheduling for medical appointments, providing comprehensive health benefits, and organizing health awareness workshops, have shown promise in mitigating these challenges in similar professional contexts. Supporting teachers through professional development and workplace policies can enhance their overall well-being and reduce procrastination-related consequences. There is a needed to explore the interplay of personal health behaviors and health literacy within this demographic, ultimately informing policy and improving teacher support programs (Burgess et al., 2023 ). 3. Method 3.1. Research Design This cross-sectional study was conducted at the end of 2024 (In the months of November and December in 2024) among elementary school teachers in northern Israel. The study focused exclusively on female teachers because they constitute the majority of elementary educators (87%) and some health behaviors examined, such as breast self-examination, are gender-specific. A total of 173 teachers participated, recruited using purposive sampling to capture a broad range of ages, teaching experience, seniority, educational backgrounds, and teaching roles. Inclusion criteria required participants to be active elementary school teachers with at least one year of teaching experience, residing in northern Israel, and willing to provide informed consent prior to completing the questionnaire. In the introduction to the questionnaire, which was conducted on Google Forms, the research topic was explained to the participants, and only if they agreed to continue answering the questionnaire did they do so of their own free will. The institutional review board of Tel Hai Academic College reviewed this process and approved it (approval number 14 − 9/2024) on 06.10.2024. The sample size was determined based on feasibility and guidelines for exploratory quantitative studies, providing adequate power for multivariable regression analyzes (Cohen, 1992). While the sample reflects diversity in demographic and professional characteristics, findings should be interpreted with caution, as they may not fully generalize to the entire population of Israeli elementary school teachers. 3.2. Participants The sample consisted of 173 female teachers with a mean age of 43 (SD = 10, range 24–65). 92 teachers (53.2%) hold a master's degree with a mean seniority of 15 years (SD = 10). Most participants are married or living with a partner (89.6%) and have an average of four children (SD = 2). Regarding religious observance, 95 (54.9%) of the teachers are Modern Orthodox or Ultra-Orthodox while the rest are traditional or secular. Additionally, 105 of the participants (60.7%) are class teachers, while the others have different roles in the school (Table 1 ). Regarding lifestyle characteristics, most of the teachers are non-smokers (91%) and they engage in less than two hours weekly physical activity (1.8 with SD = 2.0, range 0–10 hours per week). One-fifth of the teachers are identified with obesity (BMI ≥ 30 kg/h 2 ) (Table 1 ). Table 1 Participants' Demographic and Lifestyle Characteristics (n = 173). Variables Mean / n S.D. / % Demographic characteristics Age yr. (M ± SD) 43.0 9.6 Family status (n, %) Married/live with partner 155 89.6% Single 9 5.2% Other 9 5.2% Degree (n, %) B. Ed 81 46.8% M. Ed 92 53.% No. of children (M ± SD) 4 2 Level of religious observance (n, %) Traditional/secular 78 45.1% Orthodox/Ultra-orthodox 95 54.9% Role in school (n, %) Class teachers 105 60.7% Managerial positions 68 39.3% Seniority yrs. (M ± SD) 15.1 10.2 Lifestyle characteristics Smoking (n, %) 16 9.2% Physical activity h/week (M ± SD) 1.8 2.0 BMI kg/h 2 (M ± SD) 25.4 4.8 BMI ≥ 30 kg/h 2 (n, %) 35 20.2 M - mean, S.D. - standard deviation, BMI - body mass index. 3.3. Procedures Teachers were asked to sign an informed consent form to participate in the study to ensure that they understood the confidentiality of both the data and their identity. The questionnaire was answered online using Qualtrics software, which allowed an anonymous and convenient response. It took the teachers 10–15 minutes to answer the questionnaire. 3.4. Instruments For the current study, five instruments were employed: Demographic and lifestyle characteristics : age, educational background, marital status and the number of children, degree of religious observance, position at school, and seniority. In addition, we added lifestyle factors (e.g., smoking, weekly physical activity and BMI). Perceived Stress Scale (PSS; Cohen et al. 1983 ). A self-report questionnaire to assess the feelings and thoughts during the previous month with five items measured on a 5-point Likert scale (0 = never to 4 = very often). For example, “How often have you felt nervous and stressed?”. The PSS was calculated as the sum of the items with Cronbach's alpha = 0.80. High scores are related to high levels of stress. Chronic Disease Questionnaire (Israeli Society of Internal Medicine) measured the five most common chronic diseases: diabetes, hyperlipidemia, hypertension, cardiovascular and autoimmune diseases (CVD) using Yes/No answers. In addition, a question about the consumption of medications was asked to validate those answers. Self-Related Procrastination Questionnaire (SRPQ). The questions aimed to assess compliance with routine medical examinations according to the recommendations of the Israeli Ministry of Health using Yes/No answers (yes = 1 and no = 0). For example, "Have you been to a dentist in the last year?”; “For teachers over 50 years old: Have you had a mammogram in the last two years?”. The SRPQ was calculated as the sum of the items. Health Behavior Questionnaire (HBQ). The questions aimed to assess adherence to a healthy lifestyle according to indicators of the Israeli Ministry of Health by eight items measured on a 5-point Likert scale (1 = never to 5 = almost always). For example, “I follow a healthy diet”; “I usually receive vaccinations according to the instructions of the Ministry of Health”. The HBQ was calculated as the mean of the items with Cronbach's alpha = 0.64. 3.5. Data Analysis Descriptive statistics were used to summarize data on the demographic and clinical characteristics of teachers, giving arithmetic means (M) and standard deviations (SD) for continuous variables and frequencies (n) and percentages for categorical variables The test as applied to test the difference between the chronic and non-chronic groups in their use of chronic medications and whether they smoked. Internal consistency for each scale was assessed using Cronbach's alpha (α), which indicates the reliability of the items within a scale, with values above 0.70 generally considered acceptable. In this study, the HBQ scale showed a Cronbach's alpha of 0.68, which is slightly below the conventional threshold. While this suggests acceptable reliability, the scale has been widely used in prior research and provides useful information on health-related behaviors Coefficients were calculated to assess the internal consistency for the PSS and HBQ questionnaires. Independent-samples t-tests were used to compare teachers with and without chronic diseases on continuous variables such as age, BMI, PSS, HBQ, and SRPE. Chi-square tests were used for categorical variables, such as smoking and medication use. Multivariate linear regression was performed to predict self-reported procrastination examinations using significant factors with age adjustment. A p-value of 0.05 or less was considered statistically significant. Data were analyzed using the SPSS software version 29 (IBM). 4. Findings Table 2 presents the numbers and percentages of participants who responded positively to the questions in the SRPQ. Table 2 Self-Related Preventive Care Health Examinations Among Female Teachers. Examinations Number of Participants Percentage (%) Have you had general blood tests in the last year? 125 72.3 Have you visited your family doctor in the last year? 147 85.0 Have you visited the dentist in the last year? 94 54.3 Do you regularly perform a breast self-examination? 67 38.7 Have you been examined by a gynecologist in the last year? 108 62.4 Have you had a breast exam by a doctor in the last two years? 90 52.0 Less than 55% of the teachers go to the dental hygienist annually (54.3%) and have a breast exam by a doctor (52.0%), and less than 40% perform breast self-examination (38.7%). In contrast, about two-thirds of teachers have annual blood tests (72.3%) and teachers over the age of 50 years have mammograms (77.6%). Distribution of chronic diseases and SRPQ among female teachers is presented in Table 3 . Table 3 Distribution of chronic diseases and SRPQ among female teachers. Chronic Disease Number of Participants Percentage (%) Hyperlipidemia 30 17.3 Autoimmune disease 14 8.1 Hypertension 13 7.5 Diabetes 10 5.8 CVD 7 4.0 Use of chronic medications 49 28.3 The most common chronic disease was hyperlipidemia (17.3%). Fifty-six teachers (32.4%) have chronic diseases. Of them, 40 (71.4%) have one disease, 14 teachers (25.0%) have two, and two teachers (3.6%) have three chronic diseases. A significant correlation was found between the presence of chronic disease and consumption of medications (χ 2 = 19.16, p < 0.001). Regarding the first hypothesis that mean differences will be found in the various factors and indices between female teachers with chronic diseases vs. those without chronic diseases, an independent t-test and Chi-square tests were used (Table 4 ). Table 4 Means and standard deviation of the study variables according to the presence of chronic disease. Chronic Disease Variable No (n = 117) Yes (n = 56) p Mean S.D. Mean S.D. Age, yr. 41.5 9.6 46.0 9.1 0.002 BMI, kg/h 2 ↓ 24.3 4.5 27.8 4.6 < 0.001 Smoking n, % 7 6.0% 9 16.1% 0.032 Physical activity h/week ↑ 1.9 2.0 1.7 2.0 0.217 Use of chronic medications n, % 21 17.9% 28 50.0% < 0.001 PSS ↓ 18.7 5.3 20.3 5.4 0.033 HBQ ↑ 2.8 0.6 3.0 0.6 0.067 SRPE ↑ 3.8 1.6 4.3 1.8 0.050 ↑↓ - The arrows indicate the positive direction of the index. Female teachers with chronic diseases were older than those without chronic diseases (46.0 vs. 41.5 years, p < 0.01), had higher BMI (27.8 vs. 24.3, p < 0.001), and took more chronic medication (50.0% vs. 17.9%, p < 0.001). They also reported higher perceived stress (20.3 vs. 18.7, p < 0.05). On the other hand, their HBQ and SRPE scores were higher compared to the group without chronic disease (3.0 vs. 2.8, p < 0.1; 4.3 vs. 3.8, p ≤ 0.05, respectively). In addition, teachers with chronic diseases were more likely to smoke than their peers (16.1% vs. 6.0%, p < 0.05), yet they underwent more recommended medical examinations and reported healthier behaviors overall. No significant differences in PSS, HBQ, or SRPE were found between class teachers and teachers with managerial positions (p > 0.05). According to the second hypothesis, with age adjustment, a multivariate regression model was used to assess predictors of SRPE, including PSS, HBQ, presence of chronic disease, and BMI (Table 5 ). Table 5 Multivariate linear regression to predict self-reported procrastination examinations using significant factors, with age adjustment. Variable B S.E. β PSS 0.03 0.02 0.09 HBQ 1.12 0.18 0.43*** Age 0.04 0.01 0.20** Chronic disease 0.04 0.26 0.01 BMI 0.02 0.03 0.06 F (5,168) 11.77*** R 2 0.27 **p < 0.01, ***p < 0.001. The model explained 27% of the variance in medical procrastination. Healthy behaviors (β = 0.43, p < 0.001) and older age (β = 0.20, p < 0.01) were significant predictors of lower procrastination. In contrast, stress, BMI, and chronic disease status were not significant predictors, despite showing positive correlations with SRPE in the bivariate analysis. These findings indicate that older teachers and those who adopt healthier behaviors are less likely to procrastinate in seeking medical care. 5. Summary This study aimed to deepen understanding of medical procrastination among female elementary school teachers. The phenomena that is defined as the tendency to delay seeking medical care until health issues become more severe (Sirois et al., 2023 ). What can affect the educational profession in general and the teacher's health in particular. Despite its significance, research on this phenomenon among educator's remains limited (Moonaghi & Beydokhti, 2017 ). The intersection of occupational demands, personal health behaviors, and stress forms the backdrop of this exploratory study. The findings highlight key health-related behaviors and challenges among female teachers. Chronic diseases are prevalent, with hyperlipidemia being most common (17.3%), and 32.4% reporting at least one chronic condition. Among teachers with chronic diseases, there was a significant association between the presence of these conditions and use of chronic medications (χ²=19.16, p < 0.001). Engagement in preventive health behaviors varied: while annual blood tests (72.3%) and bi-annual mammograms for those over 50 (77.6%) were common, less than half performed critical preventive actions such as annual visits to the dental hygienist (54.3%), doctor-administered breast exams (52.0%), or breast self-examinations (38.7%). Teachers with chronic diseases exhibited higher BMI (27.8 vs. 24.3, p < 0.001), higher perceived stress (PSS 20.3 vs. 18.7, p = 0.033), were more likely to smoke (16.1% vs. 6.0%, p = 0.032), and reported higher self-related medical procrastination (SRPE 4.3 vs. 3.8, p = 0.050). The sample size (N = 173) was determined based on feasibility and exploratory study guidelines (Cohen, 1992). Purposive sampling ensured diversity in age, teaching experience, and roles, although findings may not generalize to the entire population of elementary teachers. 6. Discussion The study provides initial empirical evidence linking health behaviors and age to medical procrastination, offering directions for both theoretical development and practical interventions. Older teachers and those with healthier behaviors reported lower levels of medical procrastination, suggesting that lifestyle and life-stage factors play central roles in shaping health-related behaviors. These findings resonate with Procrastination Theory (Steel, 2007 ), which highlights the role of self-regulation in delaying or initiating health actions. Older teachers may possess stronger self-regulatory capacities and a greater sense of future orientation, while healthier lifestyle habits reinforce the intention-action link. At the same time, the results challenge purely trait-based conceptions of procrastination, underscoring that contextual health behaviors can serve as protective factors regardless of personality dispositions. The results also reveal a relationship between stress, chronic disease, and procrastination, as they explained 27% of the medical procrastination variance. Therefore, 73% of the variance in medical procrastination cannot be explained by the model, suggesting that additional unmeasured factors may also contribute to it, as well as possible overlapping influences among predictors. Although stress did not emerge as a direct predictor in the multivariable model, it may operate as a mediator between chronic disease and procrastination, while age and health behaviors could moderate its influence. This nuanced pattern extends the Health Belief Model (Rosenstock, 1974) and the Theory of Planned Behavior (Ajzen, 1991), both of which emphasize perceived control and health appraisal in shaping decisions. In this study, stress appears to interact with chronic illness and individual behaviors rather than act independently, pointing to the need for theoretical refinements that account for stress as a conditional, context-dependent factor. Teachers' mental and physical health were positively correlated, emphasizing the importance of integrated interventions targeting both domains. This reinforces prior evidence on the reciprocal links between physical and mental health (Kessler et al., 2003 ). Theoretically, this finding challenges narrow conceptualizations of procrastination as solely a cognitive delay and instead supports a biopsychosocial perspective, where psychological, behavioral, and health-related dimensions are interdependent. Medical procrastination, in this sense, cannot be disentangled from broader well-being trajectories. Finally, the implications extend beyond individual health. Medical procrastination among teachers not only affects personal outcomes but may also influence occupational functioning and professional sustainability (Romash et al., 2022 ). From a theoretical standpoint, this broadens the application of procrastination research into professional contexts, where organizational culture, occupational stress, and systemic barriers become integral to understanding health-related delay. Accordingly, interventions should address both individual self-regulation and institutional conditions, combining professional development in health management, stress reduction, and work–life balance strategies with systemic reforms to improve healthcare access and cultivate a culture that prioritizes self-care (Johnson & Patel, 2024 ). Israel has an advanced healthcare system available to every citizen and maintains a computerized medical record for all its citizens. Therefore, in theory, the problem of medical procrastination should not exist at all, but according to this study and despite an advanced healthcare system, there is a problem of medical procrastination, and it must be addressed. 7. Conclusions This study examined predictors of self-related medical procrastination among female elementary school teachers. Healthier behaviors and older age were significantly associated with lower medical procrastination, whereas stress, BMI, and chronic disease status were not significant predictors in the multivariable model. No differences were observed between class teachers and those in managerial positions, suggesting that health-related procrastination reflects general tendencies rather than occupational role. Findings underscore the potential for interventions promoting healthy behaviors, stress management, and preventive care among educators. Future research should explore additional variables, include longitudinal or experimental designs, and test the causal pathways between medical procrastination, health outcomes, and professional functioning. 8. Study Limitations This exploratory study is preliminary and pioneering, with a modest sample size and a focus on female teachers. While the results provide valuable insights, further research should expand to broader populations, incorporate more sophisticated modeling (e.g., mediation/moderation), and test interventions to advance theoretical understanding and practical applications. Declarations Author Contributions: Conceptualization, E.S. and Y.N.; methodology, A.S.N.; validation, A.S.N.; formal analysis, A.S.N.; data curation, A.S.N.; writing—original draft preparation, E.S.; writing—review and editing, Y.N.; supervision, Y.N. Funding: This research received no external funding. Institutional Review Board Statement: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Ethics Committee of the Tel Hai Academic College (14-9/2024, 6 October 2024). Informed Consent Statement: Informed consent was obtained from all subjects involved in the study. Data Availability Statement: The data supporting the conclusions of this article will be made available by the authors upon reasonable request. Conflicts of Interest: The authors declare no conflict of interest. References Asio, JMR (2021). Disaster Awareness and Level of Compliance to Disaster Programs in a Highly Urbanized City. Aquademia, 5(1).‏ Badri, R., Vahedi, S., Bairami, M., and Einipour, J. (2016). Prediction of procrastination behavior in high school male students based upon emotional styles. Educ. Psychol. 12, 81–95. Blunt, A., & Pychyl, T. A. (2000). Task aversiveness and procrastination: A multi-dimensional approach to task aversiveness across stages of personal projects. Personality and Individual Differences, 24 , 837-846. Burgess, S., Smith, G. D., Davies, N. M., Dudbridge, F., Gill, D., Glymour, M. M., ... & Theodoratou, E. (2023). Guidelines for performing Mendelian randomization investigations: update for summer 2023. Wellcome open research, 4, 186.‏ Cohen, S., Kamarck, T., and Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24 , 386-396. Emeljanovas, A., Sabaliauskas, S., Mežienė, B., & Istomina, N. (2023). The relationships between teachers’ emotional health and stress coping. Frontiers in Psychology, 14 , 1276431.‏ Gustavson, D. E., Miyake, A., Hewitt, J. K., & Friedman, N. P. (2014). Genetic relations among procrastination, impulsivity, and goal-management ability: Implications for the evolutionary origin of procrastination. Psychological Science, 6 , 1178-1188. Hen, M. (2018). Causes for procrastination in a unique educational workplace. Journal of Prevention & Intervention in the Community, 46 (3), 215-227. Hen, M., Goroshit, M., & Viengarten, S. (2021). How decisional and general procrastination relate to procrastination at work: An investigation of office and non-office workers. Personality and Individual Differences, 172 , 110581.‏ Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60 (3), 456–470. https://doi.org/10.1037/0022-3514.60.3.456 Israeli Ministry of Health https://www.gov.il/he/collectors/publications (accessed 2.2.2025) Israeli Society of Internal Medicine https://internal.doctorsonly.co.il/ (accessed 2.2.2025) Johnson, A., & Kim, H. (2023). Impact of occupational health interventions on teacher well-being. Journal of Health Education Research & Development, 41 (1), 105-120. Johnson, K., & Patel, M. (2024). Teachers as mental health role models: Implications for teacher health and well-being. Journal of Teacher Education and Wellness, 42 (1), 8-18. Kazemi, M., Fayyazi, M., and Manijeh, K. (2010). Investigation of procrastination prevalence and its causes among university managers and employees. Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., ... & Zaslavsky, A. M. (2003). Screening for serious mental illness in the general population. Archives of general psychiatry, 60(2), 184-189.‏ Koppenborg, M., & Klingsieck, K. B. (2022). Group work and student procrastination. Learning and Individual Differences, 94 , 102117. Labaree, D. F. (2000). On the nature of teaching and teacher education: Difficult practices that look easy. J. Teach. Educ. 51 , 228–233. doi: 10.1177/0022487100051003011 Mohsin, F. Z., & Ayub, N. (2014). The relationship between procrastination, delay of gratification, and job satisfaction among high school teachers. Japanese Psychological Research, 56(3), 224-234.‏ Moonaghi, H. K., & Beydokhti, T. B. (2017). Academic procrastination and its characteristics: a narrative review. Future of medical education journal, 7(2).‏ Monaghan, C., de Andrade Moral, R., & Power, J. M. (2025). Procrastination and preventive health-care in the older US population. Preventive Medicine, 190 , 108185.‏ Nissim, Y. 2019. Teacher smile your stress away! Emotional Labour, Stress, and Stress Management Techniques in the Eastern Galilee. Perspectives of Arts and Social Studies 1 , 1-16. Pychyl, T. A., & Sirois, F. M. (2016). Procrastination, health, and well-being . Academic Press. Richardson, P. W., & Watt, H. M. (2014). Why people choose teaching as a career: An expectancy-value approach to understanding teacher motivation. In Teacher motivation (pp. 3-19). Routledge.‏ Romash, I. R., Neyko, V. E., Romash, I. B., Vynnyk, M. I., Gerych, O. M., & Pustovoyt, M. M. (2022). The nature of the manifestation of procrastination among medical university teachers during the period of altered psycho-emotional state during forced social distancing due to the COVID-19 pandemic and its impact on the quality of life. Scientific Studies on Social and Political Psychology, 49 (52), 97-106. Rosenberg, M. (1965). Society and the adolescent self-image . Princeton University Press. Roeser, R. W., Schonert-Reichl, K. A., Jha, A., Cullen, M., Wallace, L., Wilensky, R., ... & Harrison, J. (2013). Mindfulness training and reductions in teacher stress and burnout: Results from two randomized, waitlist-control field trials. Journal of educational psychology, 105(3), 787.‏ Rozental, A., & Carlbring, P. (2014). Understanding and treating procrastination: A review of a common self-regulatory failure. Psychology, 5(13), 1488.‏ Sirois, F. M. (2003). Procrastination and intentions to perform health behaviors: The role of self-efficacy and the consideration of future consequences. Personality and Individual Differences, 43 (1), 15-26. Sirois, F. M. (2014). Out of sight, out of time? A meta-analytic investigation of procrastination and time perspective. European Journal of Personality, 28 , 511-520. Sirois, F. M. (2023). Procrastination and stress: A conceptual review of why context matters. International Journal of Environmental Research and Public Health, 20 (6), 5031. Sirois, F. M., & Pychyl, T. A. (2013). Procrastination and health: Exploring the link to physical health. Personality and Individual Differences, 55 (3), 204-208. Sirois, F. M., Stride, C. B., & Pychyl, T. A. (2023). Procrastination and health: A longitudinal test of the roles of stress and health behaviours. British Journal of Health Psychology, 28 (3), 860-875.‏ Skaalvik, E. M., & Skaalvik, S. (2009). Does school context matter? Relations with teacher burnout and job satisfaction. Teaching and teacher education, 25(3), 518-524.‏ Steel, P. (2007). The nature of procrastination: A meta-analytic and theoretical review of quintessential self-regulatory failure. Psychological Bulletin, 133 (1), 65–94. https://doi.org/10.1037/0033-2909.133.1.65 Steel, P. (2010). Arousal, avoidant and decisional procrastinators: do they exist? Personal. Individ. Differ. 48, 926–934. doi: 10.1016/j.paid.2010.02.025 Tangney, J. P., & Dearing, R. L. (2002). Shame and guilt . Guilford Press. Williams, E., & Miller, C. (2024). Privatization of healthcare and its impact on teachers' access to medical services. Journal of Public Health Policy, 50 (3), 273-289. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7610944","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":549381753,"identity":"987d5095-bd17-4ff5-b260-4ce64ad84a71","order_by":0,"name":"Eitan Simon","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA10lEQVRIie3PsQrCMBCA4ZODdknNmtLBV4gUiqDYVwkUnB0FQQtCXQRXfRvLDW46SxfBFxBcCnZQWnAQ8XBzyD9kCPm4C4DN9o9hfQ4AXAFg6htMGVKbkQJ8kRZDmjHUkCaGSFfmt3F1nEn08usZhh1wGeIvEINtVih/0U6UgaSbcotpQgi8tFCahH4SNOxfYkK8i+qgYhJhaWDOE43oBMLZKY0iek4hnijCqO9lib8hEfWM3nczjsh1filENZRyuQpP5WTakZJ2X8n7ngDOL+9tNpvN9rkHW500WEGkP5YAAAAASUVORK5CYII=","orcid":"","institution":"Tel Hai Academic College","correspondingAuthor":true,"prefix":"","firstName":"Eitan","middleName":"","lastName":"Simon","suffix":""},{"id":549381756,"identity":"8ac03f79-1226-40be-9619-673607b73600","order_by":1,"name":"Yonit Nissim","email":"","orcid":"","institution":"Tel Hai Academic College","correspondingAuthor":false,"prefix":"","firstName":"Yonit","middleName":"","lastName":"Nissim","suffix":""},{"id":549381757,"identity":"20a286e3-987d-42c8-a75d-687b38e27668","order_by":2,"name":"Adi 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13:39:02","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":109331,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7610944/v1/84e5b84a76398c3bd8f2f259.html"},{"id":96636829,"identity":"47da171f-d652-424b-91a7-eccbb86c20a4","added_by":"auto","created_at":"2025-11-24 13:39:05","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":220444,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ethe conceptual framework Predictors of medical procrastination: age, healthy lifestyle behaviors, stress, BMI, and chronic disease.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7610944/v1/84ca0e6719af81b906e5ec50.jpeg"},{"id":108226341,"identity":"a6bf066b-935c-48a9-aae7-6af5b5929f7a","added_by":"auto","created_at":"2026-04-30 16:25:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":605803,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7610944/v1/f9efa79d-abc8-4645-92e6-7ff7ca6513bc.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eTeacher, Heal Thyself! Exploring Medical Procrastination Among Female Educators – A preliminary pioneering study\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eProcrastination, defined as the unnecessary delay of tasks or decisions, is a common behavior with adverse effects on stress, productivity, and well-being (Sirois, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). It is associated with emotional regulation difficulties, diminished prefrontal activity, and social or cultural factors, and while avoidance may provide temporary relief, it typically increases stress and guilt (Sirois \u0026amp; Pychyl, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Chronic procrastination harms physical health by fostering unhealthy lifestyle habits and elevating stress, thereby reducing resilience (Kazemi et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Steel, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Rozental \u0026amp; Carlbring, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Badri et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Koppenborg \u0026amp; Klingsieck, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eA specific form, health-related procrastination, involves delaying medical or health-promoting activities despite awareness of risks and benefits (Kazemi et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Steel, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). This behavior obstructs the management of chronic conditions (Sirois, 2015) and preventive practices such as cancer screening (Azami-Aghdash et al., 2015). Within this domain, medical procrastination\u0026mdash;postponing professional healthcare\u0026mdash;has been identified as a substantial barrier to health maintenance (Ferrari \u0026amp; D\u0026iacute;az-Morales, 2014). Personality traits like perfectionism may intensify such tendencies, especially in complex decision-making (Rozental \u0026amp; Carlbring, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eFor teachers, the issue is particularly pressing. Their health affects not only personal well-being but also professional effectiveness and the learning environment of students (Day \u0026amp; Gu, 2010). Yet, research on medical procrastination among educators is scarce. Existing studies focus mainly on general populations and view procrastination as an individual psychological tendency, overlooking sociobehavioral, cultural, and systemic influences such as occupational stress, health literacy, financial constraints, and stigma. Addressing these broader factors is critical for understanding the phenomenon in educational contexts.\u003c/p\u003e\u003cp\u003eThis study applies procrastination theory, which conceptualizes procrastination as a self-regulatory failure involving intention-action gaps (Steel, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). In health contexts, this aligns with models of health behavior (Ajzen, 1991), emphasizing how stress, lifestyle, and personal characteristics shape decision-making. We propose that stress may mediate avoidance behaviors, while factors such as age and health practices may moderate them.\u003c/p\u003e\u003cp\u003eThe study focuses on female elementary school teachers, who constitute about 87% of the teaching workforce in Israel (Ministry of Education, 2023). Gender-specific health behaviors, such as breast self-examinations, this underscore the relevance of this population.\u003c/p\u003e\u003cp\u003eH1: Mean differences will be found in the various factors and indices between female teachers with chronic diseases vs. those without chronic diseases\u003c/p\u003e\u003cp\u003eH2: Stress, chronic diseases, health behaviors and demographic characteristics will predict Medical Procrastination.\u003c/p\u003e\u003cp\u003eBy integrating procrastination theory and health behavior perspectives, this pioneering study contributes to both theory and practice. Theoretically, it extends procrastination research into the domain of medical help-seeking. Practically, it highlights factors that may inform targeted interventions to support teachers' health and, by extension, their professional functioning.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"2. Literature Review","content":"\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eProcrastination often arises from the avoidance of discomfort or the lack of immediate rewards (Blunt \u0026amp; Pychyl, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2000\u003c/span\u003e). While commonly viewed as situational, procrastination is also considered a persistent trait influenced by emotional regulation difficulties, personality traits such as perfectionism, and cognitive overload. Studies indicate its stability over time, with genetic components linked to impulsivity and poor impulse control (Gustavson et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eProcrastination often stems from emotional avoidance, where individuals delay tasks to escape negative feelings such as fear of failure or anxiety. Although this behavior provides temporary relief, it often leads to long-term stress and guilt (Sirois \u0026amp; Pychyl, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Moreover, perfectionism exacerbates procrastination by fostering analysis paralysis, as the pursuit of ideal outcomes prevents progress (Sirois, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Cognitive overload and decision fatigue, intensified by today's information-rich environment, can overwhelm individuals, prompting delays in decision-making (Blunt \u0026amp; Pychyl, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2000\u003c/span\u003e). Distinct from academic procrastination, daily procrastination involves chronic delays in routine tasks such as paying bills, responding to emails, or completing household chores. This behavior arises from a misjudgment of time, lack of urgency, or avoidance of mundane tasks. It negatively impacts personal relationships and financial stability, with chronic procrastinators often perceived as unreliable and facing penalties such as late fees or fines (Sirois, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Addressing daily procrastination involves shifting focus from avoiding negative consequences to valuing the satisfaction of task completion. While studies have demonstrated the detrimental impact of procrastination on productivity (Asio, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), its consequences likely extend beyond productivity, affecting health and well-being as well (Sirois et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eChronic procrastination, in particular, has been linked to heightened stress (Sirois, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2003\u003c/span\u003e), increased levels of depression, unhealthy lifestyle behaviors (Sirois, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2003\u003c/span\u003e), and a greater incidence of physical illnesses and symptoms (Johansson \u0026amp; Kim 2023).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1. Situational Procrastination in Teaching\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eSituational procrastination, initially studied in academic contexts, has expanded to include the domains of health and work (Hen et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Despite the demanding nature of teaching\u0026mdash;tight schedules, dense curricula, and challenging classroom environments\u0026mdash;society often perceives the profession as relatively easy (Labaree, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2000\u003c/span\u003e). This misconception stems from factors such as long vacations and perceived \"free afternoons.\" However, teachers generally work autonomously with little oversight and are often intrinsically motivated to pursue teaching (Richardson \u0026amp; Watt, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). This autonomy necessitates strong self-regulation skills; when these are insufficient, teachers may experience heightened stress levels (Nissim, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMost research on procrastination focuses on students, but growing evidence highlights its prevalence among teachers, who face unique challenges such as balancing instructional responsibilities with administrative duties and navigating high-pressure environments that demand emotional resilience. These factors may exacerbate procrastination tendencies differently compared to students. Teacher procrastination is associated with increased stress and decreased job satisfaction (Mohsin \u0026amp; Ayub, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2014\u003c/span\u003e), both of which contribute to occupational burnout (Skaalvik \u0026amp; Skaalvik, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). Teacher burnout can negatively affect students and their academic performance (Roeser et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2. Medical Procrastination\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe effect of procrastination on health can be negative. Monaghan et al. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) have suggested that it can affect health through both direct and indirect pathways. The procrastination health model (Sirois, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2003\u003c/span\u003e) suggests that procrastination negatively impacts health by generating stress, which may activate the sympathetic nervous system (Sirois \u0026amp; Pychyl, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2013\u003c/span\u003e), ultimately leading to a decline in health (Sirois et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Additionally, procrastination can adversely affect mental health by fostering feelings of self-blame, criticism, and depression (Monaghan et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eWhile the term \"medical procrastination\" is not widely established in academic literature, the concept aligns with behaviors observed in various studies examining its impact on health-related actions (Sirois, \u0026amp; Pychyl, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2013\u003c/span\u003e), and refers to delays in seeking medical care or treatment for symptoms, health concerns, or routine checkups. For instance, teachers may postpone annual physical exams or necessary medical treatments due to their demanding schedules and professional responsibilities. Such delays not only exacerbate health issues but also reflect broader challenges, such as limited access to healthcare or societal expectations. This behavior can lead to serious health consequences, as untreated conditions may worsen and reduce the effectiveness of belated interventions (Sirois et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe procrastination\u0026ndash;health model (ibid.) links procrastination to poor physical health, primarily through increased stress and unhealthy behaviors. However, the model's reliance on cross-sectional studies limits understanding of the long-term effects of procrastination and its interplay with broader personality traits.\u003c/p\u003e\u003cp\u003eDelays in health-seeking behaviors often stem from procrastinators' preference for avoiding unpleasant tasks or ambiguous information (Sirois, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Chronic procrastination has been extensively studied, with a primary focus on its cognitive and behavioral dimensions, particularly the tendency to delay starting or completing tasks despite negative consequences (Steel, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). However, recent research has highlighted the critical role of emotional factors, such as shame and guilt, in understanding the complexities of this phenomenon.\u003c/p\u003e\u003cp\u003eShame and guilt are two distinct affective experiences that have been explored in the context of procrastination. Shame, a self-conscious emotion linked to negative evaluations of the self, has been found to have a stronger connection to procrastination than guilt, which is more focused on negative evaluations of specific behaviors (Tangney \u0026amp; Dearing, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2002\u003c/span\u003e). Findings suggest that procrastinators may avoid tasks not only due to cognitive or time-management issues, but also to escape feelings of inadequacy or self-blame.\u003c/p\u003e\u003cp\u003eFurthermore, shame appears to interact with other psychological constructs, such as perfectionism. Using hierarchical regression analysis, shame was identified as a moderator between chronic procrastination and socially prescribed perfectionism, a subtype of perfectionism driven by perceived external expectations (Hewitt \u0026amp; Flett, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e1991\u003c/span\u003e). This relationship underscores the role of external pressures in exacerbating the procrastinator's emotional distress and avoidance behaviors.\u003c/p\u003e\u003cp\u003eIn addition to shame and perfectionism, other factors such as self-esteem, fear of negative evaluation, and conscientiousness have been examined in relation to procrastination (Rosenberg, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e1965\u003c/span\u003e). Lower self-esteem and greater fear of negative evaluation are particularly prominent among chronic procrastinators, this reinforcing the avoidance of tasks due to a fear of failure or criticism (Pychyl \u0026amp; Sirois, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eOverall, the literature indicates that emotional dynamics, particularly shame, play a pivotal role in chronic procrastination. These insights suggest the need for integrative approaches in interventions, combining emotional regulation strategies with cognitive-behavioral techniques to address both the affective and behavioral dimensions of procrastination.\u003c/p\u003e\u003cp\u003ePsychological factors, such as fear, serve as central drivers of medical procrastination. Individuals may postpone seeking care due to fears about receiving a serious diagnosis, or undergoing medical procedures. This avoidance often leads to a feedback loop, where untreated health issues exacerbate emotional distress and reinforce procrastination behaviors (Sirois et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Additionally, denial plays a significant role, as individuals may minimize or dismiss symptoms to justify delays, thereby missing critical opportunities for early detection and intervention for conditions such as cancer or cardiovascular diseases.\u003c/p\u003e\u003cp\u003eExternal barriers, such as geographic, financial, or systemic challenges, may also contribute to medical procrastination. Limited healthcare access and negative past experiences with providers can discourage individuals from seeking care. Cultural stigma and societal judgment surrounding certain conditions can compound delays, particularly among marginalized populations (Romash et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3. Consequences and the Procrastination Cycle among Teachers\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eStress significantly impacts teachers' health and well-being, with recent studies revealing that high stress levels correlate with maladaptive coping strategies, negatively affecting emotional health and overall well-being (Emeljanovas et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The stress and anxiety associated with procrastination can contribute to depression, feelings of worthlessness, and diminished academic performance. Breaking this cycle requires strategies such as time management, setting realistic goals, and cultivating intrinsic motivation. Rewarding incremental progress can help counter entrenched avoidance patterns.\u003c/p\u003e\u003cp\u003eTeachers are particularly vulnerable to medical procrastination due to their demanding profession, societal expectations, and personal responsibilities. Analyzing how this vulnerability varies across different education systems or cultural contexts could provide valuable insights into tailored intervention strategies. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e illustrates the conceptual framework for the study. Predictors of medical procrastination include age, healthy lifestyle behaviors, stress, BMI, and chronic disease. Stress is proposed as a potential mediator between chronic disease and medical procrastination, while age and healthy behaviors may moderate the effect of stress on procrastination. The teaching profession context, including occupational demands and gender-specific health behaviors, provides the backdrop for understanding these relationships\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eMoreover, external pressures, such as standardized testing and accountability measures, leave educators with limited time for personal health management. Additionally, the expectation for teachers to model resilience can discourage them from seeking medical care, fearing it might signal weakness (Romash et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4. Contributing Factors\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eSocial expectations and systemic barriers play significant roles in medical procrastination among teachers. Limited health insurance and bureaucratic obstacles exacerbate the issue (Hen, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). During crises, such as pandemics or armed conflicts, teachers' heightened sense of responsibility this can ncreases delays in seeking care (Burgess et al.,2023). Privatized healthcare services in some countries have made timely access to care increasingly difficult (Williams \u0026amp; Miller, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.5. Implications and Solutions\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eAddressing medical procrastination among teachers requires improving access to healthcare, increasing awareness of preventive care, and fostering open communication between educators and providers. Effective workplace initiatives, such as offering flexible scheduling for medical appointments, providing comprehensive health benefits, and organizing health awareness workshops, have shown promise in mitigating these challenges in similar professional contexts. Supporting teachers through professional development and workplace policies can enhance their overall well-being and reduce procrastination-related consequences. There is a needed to explore the interplay of personal health behaviors and health literacy within this demographic, ultimately informing policy and improving teacher support programs (Burgess et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Method","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e3.1. Research Design\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThis cross-sectional study was conducted at the end of 2024 (In the months of November and December in 2024) among elementary school teachers in northern Israel. The study focused exclusively on female teachers because they constitute the majority of elementary educators (87%) and some health behaviors examined, such as breast self-examination, are gender-specific. A total of 173 teachers participated, recruited using purposive sampling to capture a broad range of ages, teaching experience, seniority, educational backgrounds, and teaching roles.\u003c/p\u003e\u003cp\u003eInclusion criteria required participants to be active elementary school teachers with at least one year of teaching experience, residing in northern Israel, and willing to provide informed consent prior to completing the questionnaire. In the introduction to the questionnaire, which was conducted on Google Forms, the research topic was explained to the participants, and only if they agreed to continue answering the questionnaire did they do so of their own free will. The institutional review board of Tel Hai Academic College reviewed this process and approved it (approval number 14\u0026thinsp;\u0026minus;\u0026thinsp;9/2024) on 06.10.2024. The sample size was determined based on feasibility and guidelines for exploratory quantitative studies, providing adequate power for multivariable regression analyzes (Cohen, 1992). While the sample reflects diversity in demographic and professional characteristics, findings should be interpreted with caution, as they may not fully generalize to the entire population of Israeli elementary school teachers.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e3.2. Participants\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe sample consisted of 173 female teachers with a mean age of 43 (SD\u0026thinsp;=\u0026thinsp;10, range 24\u0026ndash;65). 92 teachers (53.2%) hold a master's degree with a mean seniority of 15 years (SD\u0026thinsp;=\u0026thinsp;10). Most participants are married or living with a partner (89.6%) and have an average of four children (SD\u0026thinsp;=\u0026thinsp;2). Regarding religious observance, 95 (54.9%) of the teachers are Modern Orthodox or Ultra-Orthodox while the rest are traditional or secular. Additionally, 105 of the participants (60.7%) are class teachers, while the others have different roles in the school (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Regarding lifestyle characteristics, most of the teachers are non-smokers (91%) and they engage in less than two hours weekly physical activity (1.8 with SD\u0026thinsp;=\u0026thinsp;2.0, range 0\u0026ndash;10 hours per week). One-fifth of the teachers are identified with obesity (BMI\u0026thinsp;\u0026ge;\u0026thinsp;30 kg/h\u003csup\u003e2\u003c/sup\u003e) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eParticipants' Demographic and Lifestyle Characteristics (n\u0026thinsp;=\u0026thinsp;173).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean / n\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eS.D. / %\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemographic characteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge yr. (M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamily status (n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried/live with partner\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e155\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e89.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDegree (n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eB. Ed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eM. Ed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53.%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo. of children (M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLevel of religious observance (n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTraditional/secular\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOrthodox/Ultra-orthodox\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e54.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRole in school (n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eClass teachers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e60.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManagerial positions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e39.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSeniority yrs. (M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLifestyle characteristics\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking (n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePhysical activity h/week (M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI kg/h\u003csup\u003e2\u003c/sup\u003e (M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI\u0026thinsp;\u0026ge;\u0026thinsp;30 kg/h\u003csup\u003e2\u003c/sup\u003e (n, %)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eM - mean, S.D. - standard deviation, BMI - body mass index.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e3.3. Procedures\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eTeachers were asked to sign an informed consent form to participate in the study to ensure that they understood the confidentiality of both the data and their identity. The questionnaire was answered online using Qualtrics software, which allowed an anonymous and convenient response. It took the teachers 10\u0026ndash;15 minutes to answer the questionnaire.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.4. Instruments\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eFor the current study, five instruments were employed:\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eDemographic and lifestyle characteristics\u003c/b\u003e: age, educational background, marital status and the number of children, degree of religious observance, position at school, and seniority. In addition, we added lifestyle factors (e.g., smoking, weekly physical activity and BMI).\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003ePerceived Stress Scale\u003c/b\u003e (PSS; Cohen et al. \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e1983\u003c/span\u003e). A self-report questionnaire to assess the feelings and thoughts during the previous month with five items measured on a 5-point Likert scale (0\u0026thinsp;=\u0026thinsp;never to 4\u0026thinsp;=\u0026thinsp;very often). For example, \u0026ldquo;How often have you felt nervous and stressed?\u0026rdquo;. The PSS was calculated as the sum of the items with Cronbach's alpha\u0026thinsp;=\u0026thinsp;0.80. High scores are related to high levels of stress.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eChronic Disease Questionnaire\u003c/b\u003e (Israeli Society of Internal Medicine) measured the five most common chronic diseases: diabetes, hyperlipidemia, hypertension, cardiovascular and autoimmune diseases (CVD) using Yes/No answers. In addition, a question about the consumption of medications was asked to validate those answers.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eSelf-Related Procrastination Questionnaire\u003c/b\u003e (SRPQ). The questions aimed to assess compliance with routine medical examinations according to the recommendations of the Israeli Ministry of Health using Yes/No answers (yes\u0026thinsp;=\u0026thinsp;1 and no\u0026thinsp;=\u0026thinsp;0). For example, \"Have you been to a dentist in the last year?\u0026rdquo;; \u0026ldquo;For teachers over 50 years old: Have you had a mammogram in the last two years?\u0026rdquo;. The SRPQ was calculated as the sum of the items.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eHealth Behavior Questionnaire\u003c/b\u003e (HBQ). The questions aimed to assess adherence to a healthy lifestyle according to indicators of the Israeli Ministry of Health by eight items measured on a 5-point Likert scale (1\u0026thinsp;=\u0026thinsp;never to 5\u0026thinsp;=\u0026thinsp;almost always). For example, \u0026ldquo;I follow a healthy diet\u0026rdquo;; \u0026ldquo;I usually receive vaccinations according to the instructions of the Ministry of Health\u0026rdquo;. The HBQ was calculated as the mean of the items with Cronbach's alpha\u0026thinsp;=\u0026thinsp;0.64.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e3.5. Data Analysis\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eDescriptive statistics were used to summarize data on the demographic and clinical characteristics of teachers, giving arithmetic means (M) and standard deviations (SD) for continuous variables and frequencies (n) and percentages for categorical variables The test as applied to test the difference between the chronic and non-chronic groups in their use of chronic medications and whether they smoked. Internal consistency for each scale was assessed using Cronbach's alpha (α), which indicates the reliability of the items within a scale, with values above 0.70 generally considered acceptable.\u003c/p\u003e\u003cp\u003eIn this study, the HBQ scale showed a Cronbach's alpha of 0.68, which is slightly below the conventional threshold. While this suggests acceptable reliability, the scale has been widely used in prior research and provides useful information on health-related behaviors\u003c/p\u003e\u003cp\u003eCoefficients were calculated to assess the internal consistency for the PSS and HBQ questionnaires. Independent-samples t-tests were used to compare teachers with and without chronic diseases on continuous variables such as age, BMI, PSS, HBQ, and SRPE. Chi-square tests were used for categorical variables, such as smoking and medication use. Multivariate linear regression was performed to predict self-reported procrastination examinations using significant factors with age adjustment.\u003c/p\u003e\u003cp\u003eA p-value of 0.05 or less was considered statistically significant. Data were analyzed using the SPSS software version 29 (IBM).\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Findings","content":"\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents the numbers and percentages of participants who responded positively to the questions in the SRPQ.\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSelf-Related Preventive Care Health Examinations Among Female Teachers.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExaminations\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of\u003c/p\u003e\u003cp\u003eParticipants\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHave you had general blood tests in the last year?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e72.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHave you visited your family doctor in the last year?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e147\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e85.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHave you visited the dentist in the last year?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e54.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDo you regularly perform a breast self-examination?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHave you been examined by a gynecologist in the last year?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e108\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e62.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHave you had a breast exam by a doctor in the last two years?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e52.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eLess than 55% of the teachers go to the dental hygienist annually (54.3%) and have a breast exam by a doctor (52.0%), and less than 40% perform breast self-examination (38.7%). In contrast, about two-thirds of teachers have annual blood tests (72.3%) and teachers over the age of 50 years have mammograms (77.6%).\u003c/p\u003e\u003cp\u003eDistribution of chronic diseases and SRPQ among female teachers is presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of chronic diseases and SRPQ among female teachers.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic Disease\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of\u003c/p\u003e\u003cp\u003eParticipants\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperlipidemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAutoimmune disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiabetes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCVD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUse of chronic medications\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe most common chronic disease was hyperlipidemia (17.3%). Fifty-six teachers (32.4%) have chronic diseases. Of them, 40 (71.4%) have one disease, 14 teachers (25.0%) have two, and two teachers (3.6%) have three chronic diseases. A significant correlation was found between the presence of chronic disease and consumption of medications (χ\u003csup\u003e2\u003c/sup\u003e = 19.16, p \u0026lt; 0.001).\u003c/p\u003e\u003cp\u003eRegarding the first hypothesis that mean differences will be found in the various factors and indices between female teachers with chronic diseases vs. those without chronic diseases, an independent t-test and Chi-square tests were used (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMeans and standard deviation of the study variables according to the presence of chronic disease.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e\u003cp\u003eChronic Disease\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003e(n = 117)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003e(n = 56)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eS.D.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eS.D.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge, yr.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e46.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e9.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI, kg/h\u003csup\u003e2\u003c/sup\u003e \u003cb\u003e↓\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking n, %\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e16.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.032\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePhysical activity h/week \u003cb\u003e↑\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.217\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUse of chronic medications n, %\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e50.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePSS \u003cb\u003e↓\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.033\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHBQ \u003cb\u003e↑\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.067\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSRPE \u003cb\u003e↑\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.050\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cb\u003e↑↓ -\u003c/b\u003e The arrows indicate the positive direction of the index.\u003c/p\u003e\u003cp\u003eFemale teachers with chronic diseases were older than those without chronic diseases (46.0 vs. 41.5 years, p \u0026lt; 0.01), had higher BMI (27.8 vs. 24.3, p \u0026lt; 0.001), and took more chronic medication (50.0% vs. 17.9%, p \u0026lt; 0.001). They also reported higher perceived stress (20.3 vs. 18.7, p \u0026lt; 0.05). On the other hand, their HBQ and SRPE scores were higher compared to the group without chronic disease (3.0 vs. 2.8, p \u0026lt; 0.1; 4.3 vs. 3.8, p ≤ 0.05, respectively). In addition, teachers with chronic diseases were more likely to smoke than their peers (16.1% vs. 6.0%, p \u0026lt; 0.05), yet they underwent more recommended medical examinations and reported healthier behaviors overall. No significant differences in PSS, HBQ, or SRPE were found between class teachers and teachers with managerial positions (p \u0026gt; 0.05).\u003c/p\u003e\u003cp\u003eAccording to the second hypothesis, with age adjustment, a multivariate regression model was used to assess predictors of SRPE, including PSS, HBQ, presence of chronic disease, and BMI (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMultivariate linear regression to predict self-reported procrastination examinations using significant factors, with age adjustment.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eB\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eS.E.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eβ\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePSS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHBQ\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.43***\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.20**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eF\u003csub\u003e(5,168)\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.77***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e**p \u0026lt; 0.01, ***p \u0026lt; 0.001.\u003c/p\u003e\u003cp\u003eThe model explained 27% of the variance in medical procrastination. Healthy behaviors (β = 0.43, p \u0026lt; 0.001) and older age (β = 0.20, p \u0026lt; 0.01) were significant predictors of lower procrastination. In contrast, stress, BMI, and chronic disease status were not significant predictors, despite showing positive correlations with SRPE in the bivariate analysis. These findings indicate that older teachers and those who adopt healthier behaviors are less likely to procrastinate in seeking medical care.\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"5. Summary","content":"\u003cp\u003eThis study aimed to deepen understanding of medical procrastination among female elementary school teachers. The phenomena that is defined as the tendency to delay seeking medical care until health issues become more severe (Sirois et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). What can affect the educational profession in general and the teacher's health in particular. Despite its significance, research on this phenomenon among educator's remains limited (Moonaghi \u0026amp; Beydokhti, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The intersection of occupational demands, personal health behaviors, and stress forms the backdrop of this exploratory study.\u003c/p\u003e\u003cp\u003eThe findings highlight key health-related behaviors and challenges among female teachers. Chronic diseases are prevalent, with hyperlipidemia being most common (17.3%), and 32.4% reporting at least one chronic condition. Among teachers with chronic diseases, there was a significant association between the presence of these conditions and use of chronic medications (χ²=19.16, p \u0026lt; 0.001).\u003c/p\u003e\u003cp\u003eEngagement in preventive health behaviors varied: while annual blood tests (72.3%) and bi-annual mammograms for those over 50 (77.6%) were common, less than half performed critical preventive actions such as annual visits to the dental hygienist (54.3%), doctor-administered breast exams (52.0%), or breast self-examinations (38.7%). Teachers with chronic diseases exhibited higher BMI (27.8 vs. 24.3, p \u0026lt; 0.001), higher perceived stress (PSS 20.3 vs. 18.7, p = 0.033), were more likely to smoke (16.1% vs. 6.0%, p = 0.032), and reported higher self-related medical procrastination (SRPE 4.3 vs. 3.8, p = 0.050).\u003c/p\u003e\u003cp\u003eThe sample size (N = 173) was determined based on feasibility and exploratory study guidelines (Cohen, 1992). Purposive sampling ensured diversity in age, teaching experience, and roles, although findings may not generalize to the entire population of elementary teachers.\u003c/p\u003e"},{"header":"6. Discussion","content":"\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe study provides initial empirical evidence linking health behaviors and age to medical procrastination, offering directions for both theoretical development and practical interventions. Older teachers and those with healthier behaviors reported lower levels of medical procrastination, suggesting that lifestyle and life-stage factors play central roles in shaping health-related behaviors. These findings resonate with Procrastination Theory (Steel, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2007\u003c/span\u003e), which highlights the role of self-regulation in delaying or initiating health actions. Older teachers may possess stronger self-regulatory capacities and a greater sense of future orientation, while healthier lifestyle habits reinforce the intention-action link. At the same time, the results challenge purely trait-based conceptions of procrastination, underscoring that contextual health behaviors can serve as protective factors regardless of personality dispositions.\u003c/p\u003e\u003cp\u003eThe results also reveal a relationship between stress, chronic disease, and procrastination, as they explained 27% of the medical procrastination variance. Therefore, 73% of the variance in medical procrastination cannot be explained by the model, suggesting that additional unmeasured factors may also contribute to it, as well as possible overlapping influences among predictors.\u003c/p\u003e\u003cp\u003eAlthough stress did not emerge as a direct predictor in the multivariable model, it may operate as a mediator between chronic disease and procrastination, while age and health behaviors could moderate its influence. This nuanced pattern extends the Health Belief Model (Rosenstock, 1974) and the Theory of Planned Behavior (Ajzen, 1991), both of which emphasize perceived control and health appraisal in shaping decisions. In this study, stress appears to interact with chronic illness and individual behaviors rather than act independently, pointing to the need for theoretical refinements that account for stress as a conditional, context-dependent factor.\u003c/p\u003e\u003cp\u003eTeachers' mental and physical health were positively correlated, emphasizing the importance of integrated interventions targeting both domains. This reinforces prior evidence on the reciprocal links between physical and mental health (Kessler et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). Theoretically, this finding challenges narrow conceptualizations of procrastination as solely a cognitive delay and instead supports a biopsychosocial perspective, where psychological, behavioral, and health-related dimensions are interdependent. Medical procrastination, in this sense, cannot be disentangled from broader well-being trajectories.\u003c/p\u003e\u003cp\u003eFinally, the implications extend beyond individual health. Medical procrastination among teachers not only affects personal outcomes but may also influence occupational functioning and professional sustainability (Romash et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). From a theoretical standpoint, this broadens the application of procrastination research into professional contexts, where organizational culture, occupational stress, and systemic barriers become integral to understanding health-related delay. Accordingly, interventions should address both individual self-regulation and institutional conditions, combining professional development in health management, stress reduction, and work\u0026ndash;life balance strategies with systemic reforms to improve healthcare access and cultivate a culture that prioritizes self-care (Johnson \u0026amp; Patel, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIsrael has an advanced healthcare system available to every citizen and maintains a computerized medical record for all its citizens. Therefore, in theory, the problem of medical procrastination should not exist at all, but according to this study and despite an advanced healthcare system, there is a problem of medical procrastination, and it must be addressed.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"7. Conclusions","content":"\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThis study examined predictors of self-related medical procrastination among female elementary school teachers. Healthier behaviors and older age were significantly associated with lower medical procrastination, whereas stress, BMI, and chronic disease status were not significant predictors in the multivariable model. No differences were observed between class teachers and those in managerial positions, suggesting that health-related procrastination reflects general tendencies rather than occupational role.\u003c/p\u003e\u003cp\u003eFindings underscore the potential for interventions promoting healthy behaviors, stress management, and preventive care among educators. Future research should explore additional variables, include longitudinal or experimental designs, and test the causal pathways between medical procrastination, health outcomes, and professional functioning.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"8. Study Limitations","content":"\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThis exploratory study is preliminary and pioneering, with a modest sample size and a focus on female teachers. While the results provide valuable insights, further research should expand to broader populations, incorporate more sophisticated modeling (e.g., mediation/moderation), and test interventions to advance theoretical understanding and practical applications.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u003c/strong\u003e Conceptualization, E.S. and Y.N.; methodology, A.S.N.; validation, A.S.N.; formal analysis, A.S.N.; data curation, A.S.N.; writing\u0026mdash;original draft preparation, E.S.; writing\u0026mdash;review and editing, Y.N.; supervision, Y.N.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This research received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstitutional Review Board Statement:\u003c/strong\u003e The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Ethics Committee of the Tel Hai Academic College (14-9/2024, 6 October 2024).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement:\u003c/strong\u003e Informed consent was obtained from all subjects involved in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement:\u003c/strong\u003e The data supporting the conclusions of this article will be made\u003c/p\u003e\n\u003cp\u003eavailable by the authors upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u003c/strong\u003e The authors declare no conflict of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAsio, JMR (2021). 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Arousal, avoidant and decisional procrastinators: do they exist? Personal. Individ. Differ. 48, 926\u0026ndash;934. doi: 10.1016/j.paid.2010.02.025\u003c/li\u003e\n\u003cli\u003eTangney, J. P., \u0026amp; Dearing, R. L. (2002). \u003cem\u003eShame and guilt\u003c/em\u003e. Guilford Press.\u003c/li\u003e\n\u003cli\u003eWilliams, E., \u0026amp; Miller, C. (2024). Privatization of healthcare and its impact on teachers\u0026apos; access to medical services. \u003cem\u003eJournal of Public Health Policy, 50\u003c/em\u003e(3), 273-289. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Self-related procrastination, stress, health behaviors, elementary teachers","lastPublishedDoi":"10.21203/rs.3.rs-7610944/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7610944/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis exploratory pioneering study examined sociobehavioral and health-related predictors of medical procrastination among female elementary school teachers in Israel, a group that represents the overwhelming majority of the profession. Medical procrastination, defined as the delay or avoidance of seeking medical care despite recognizing its importance, has rarely been studied among teachers, a profession characterized by high stress and significant health demands. Grounded in procrastination theory and health behavior models, we hypothesized that higher stress levels and higher body mass index (BMI) would positively predict medical procrastination, while healthier lifestyle behaviors and the presence of chronic disease would negatively predict it. A cross-sectional survey was administered to 173 female teachers, including validated measures of stress, lifestyle behaviors, and medical procrastination, along with self-reported BMI and chronic illness status. Linear regression analyzes were conducted to test the hypotheses. Findings revealed that stress was a significant positive predictor, while lifestyle behaviors reduced the likelihood of procrastination. Although limited by its modest sample size, and focus on female teachers, this study provides a first empirical step toward extending procrastination theory into the domain of health-seeking behaviors. The findings suggest that medical procrastination is linked to teachers' health-related behaviors and may have implications for their professional performance or effectiveness. The results underscore the potential value of targeted interventions aimed at reducing stress and medical procrastination to support educators' overall well-being. Although associations between medical procrastination and health behaviors are observed, its direct impact on teachers' physical or mental health, or on professional performance, remains to be tested in future research.\u003c/p\u003e","manuscriptTitle":"Teacher, Heal Thyself! Exploring Medical Procrastination Among Female Educators – A preliminary pioneering study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-24 13:38:35","doi":"10.21203/rs.3.rs-7610944/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"34085ea8-e0d0-43cb-a142-ab733d657e3b","owner":[],"postedDate":"November 24th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":58512696,"name":"Health sciences/Health care"},{"id":58512697,"name":"Health sciences/Medical research"},{"id":58512698,"name":"Biological sciences/Psychology"},{"id":58512699,"name":"Social science/Psychology"},{"id":58512700,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2026-04-30T16:24:54+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-24 13:38:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7610944","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7610944","identity":"rs-7610944","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}