Understanding Cervical Cancer Screening Intentions among Latinas Using An Expanded Theory of Planned Behavior Model

We examined the utility of an expanded theory of planned behavior (TPB) model in predicting cervical cancer screening intentions among Latinas. The model included acculturation and past cervical cancer screening behavior along with attitude, subjective norms, and perceived behavioral control. This cross-sectional study included a sample of 206 Latinas who responded to a self-administered survey. Structural equation modeling was employed to test the expanded TPB model. Acculturation (p = .025) and past screening behavior (p = .001) along with attitude (p = .019), subjective norms (p = .028), and perceived behavioral control (p = .014) predicted the intention to be screened for cervical cancer. Our findings suggest that the TPB is a useful model for understanding cervical cancer screening intentions among Latinas when both past behavior and culture are included. This research highlights the importance of culture on behavior and indicates a need to develop culturally sensitive, theory-based interventions to encourage screening and reduce cervical cancer-related health disparities in Latinas.     

基于计划行为理论及学习倦怠感的考试作弊行为

目的探讨计划行为理论模型及学习倦怠感对作弊意向与行为的预测。方法采用基于计划行为理论的考试作弊意向量表和学习倦怠感量表对四川省6所高校的228名大二～大四学生做调查,并自我报告大学期间的考试作弊行为频数。结果①有60.1%的被试报告自己有过作弊行为;②学习倦怠感与计划行为理论模型呈显著的正相关;③作弊行为的意向及实际发生情况与计划理论模型(t=4.603,8.061;P<0.001)及学习倦怠感(t=4.142,4.753;P<0.001)的得分均存在显著差异。结论学习作弊是大学校园较为普遍的问题;计划行为理论模型及学习倦怠感能有效评估考试作弊意向及预测作弊行为。     

Contribution of Partner Support in Self-Management of Rheumatoid Arthritis Patients. An Application of the Theory of Planned Behavior

The aim of this exploratory study was to test the applicability of a model derived from the Theory of Planned Behavior on self-management. In this model social support from the partner, attitude and self-efficacy are determinants of intention, and intention and self-efficacy are determinants of self-management. We tested the model on rheumatoid arthritis patients who have a partner, using regression analyses and structural equation models. Partner support and attitude partly explained the variance in intention. Intention in turn partly explained the variance in self-management. Self-efficacy showed a tendency to positively affect intention and self-management. The present study provided moderate support for the use of the constructs and ideas derived from the Theory of Planned Behavior-attitude, social support, self-efficacy, and intention-in predicting and explaining self-management.     

Helping Middle-Aged Women Translate Physical Activity Intentions Into Action: Combining the Theory of Planned Behavior and Implementation Intentions

The current experiment examined whether women with implementation intentions show greater correspondence between their exercise intentions and behaviors, exercise more frequently, and show changes over time in measures of theory of planned behavior (TPB) constructs and scheduling self-efficacy relative to a control group. Participants were 47 women randomly allocated to an implementation intentions or control condition. Measures of TPB constructs and scheduling self-efficacy were assessed at baseline and 8 weeks later. Regression analyses showed that intentions were a significant predictor of behavior for women in the experimental condition (p .01). A significant Condition * Time interaction was found for scheduling efficacy (p .03) and a nonsignificant interaction was found for perceived behavioral control (p = .06), indicating that only the experimental group increased scheduling self-efficacy and perceived behavioral control. No significant group differences were found for the other TPB constructs or self-reported exercise.     

Hispanic Adults' Beliefs, Attitudes, and Intentions Regarding the Female Condom

The present study used the theory of planned behavior (TPB) (Ajzen, 1985) augmented by AIDS knowledge to investigate factors influencing intentions of Hispanic adults to use the female condom. A total of 146 persons (75 women and 71 men; mean age, 27 years) recruited from community-based organizations completed an anonymous survey regarding intentions to use the female condom with their main sex partner. The TPB model had greater predictive utility for women's, than for men's, female condom use intentions. For men, attitudes and norms did not predict female condom use intentions, but greater AIDS knowledge was related to lower intentions to use the female condom, above and beyond the TPB constructs. Perceived behavioral control, operationalized as self-efficacy, significantly increased the predictive utility of the TPB model for women's female condom use intentions but not for men's. Behavior change strategies to increase female condom use are discussed in light of these findings.     

The Effect of Accuracy of Perceptions of Dietary-Fat Intake on Perceived Risk and Intentions to Change

Consumption of excess fat increases risk for many health problems and diseases. In the present study, 188 undergraduate students were studied to understand self-perceptions of dietary-fat intake and the impact of those perceptions. Findings indicated that the majority of participants had inaccurate perceptions about the amount of fat in their diets. Further, compared to people who overestimated dietary-fat intake, people who underestimated fat intake had lower perceived risk of cancer, had lower intentions to change, and demonstrated less knowledge about the dietary-fat content of many foods. Findings suggest that this unrealistic underestimation of fat intake is a cognitive barrier to dietary change and people who underestimate dietary fat intake may require more intensive intervention to change their diets.     

Action Control of Exercise Behavior: Evaluation of Social Cognition,Cross-Behavioral Regulation,and Automaticity

Intention is considered the proximal determinant of behavior in many popular theories applied to understanding physical activity, yet intention–behavior discordance is high. Thus, an understanding of constructs that facilitate or inhibit the successful translation of intentions into behavior is both timely and important. The action control approach of dividing the intention–behavior relationship into quadrants of successful/unsuccessful intenders has shown utility in the past by demonstrating the magnitude of intention–behavior discordance and allowing for an outcome variable to test predictors. The purpose of this article was to evaluate automaticity and cross-behavioral regulation as predictors of exercise action control, in conjunction with other more standard social cognitive predictors of perceived behavioral control and affective and instrumental attitudes. Participants were a random sample of 263 college students who completed predictor measures at time one, followed by exercise behavior two weeks later. Participants were classified into three intention–behavior profiles: (1) nonintenders (14.1%; n = 31), (2) unsuccessful intenders (35.5%; n = 78), and (3) successful intenders (48.6%; n = 107). Affective attitude, perceived behavioral control, automaticity, and cross-behavioral regulation were predictors of action control. The results demonstrate that automaticity and cross-behavioral regulation, constructs not typically used in intention-based theories, predict intention–behavior discordance.     

Social Cognitive Predictors of Sun Protection Intention and Behavior

The authors investigated sunbathing behavior and intention prospectively using the Theory of Planned Behavior (TPB). Before summer, 85 young adults who intended to sunbathe completed a TPB questionnaire. After summer, 46 of them completed a second questionnaire about their summertime sunbathing behavior. The proposed model was successful in predicting both behavior and intention to use sun protection, with 45% of the variance of self-reported sunscreen use and 32% of the variance in intention explained by the TPB. Items designed to measure self-efficacy and perceived control loaded onto different factors and demonstrated discriminant validity. Self-efficacy predicted both intention and behavior (after controlling for all other TPB variables), but perceived behavioral control did not. The authors discuss the implications of the findings for potential interventions to improve sun protection behavior.     

HPV Vaccination and the Effect of Information Framing on Intentions and Behaviour: An Application of the Theory of Planned Behaviour and Moral Norm

Background

Human papillomavirus (HPV) is a common sexually transmitted infection (STI) known to cause cervical cancer and genital warts. However, making the genital warts aspect explicit may reduce HPV vaccination intention and behaviour due to perceived stigma associated with STIs.

Purpose

This study investigated the effect of differential information framing on intention to receive the HPV vaccine using the Theory of Planned Behaviour (TPB) and moral norm construct.

Method

Female university students were randomised to receive a fact sheet describing the HPV vaccine as: (1) preventing cervical cancer only (n?=?81); or (2) preventing both cervical cancer and genital warts (n?=?78). A 2-month follow-up investigated relationships between vaccination intention and actual behaviour.

Results

No effect of information framing was detected on intention to receive the HPV vaccine, or vaccine uptake behaviour at 2-month follow-up. The traditional TPB components predicted 54% of the variance in vaccination intention (F _3,155?=?61.580, p?<?0.001), and moral norm explained an additional 6.2%. Intention predicted a significant but relatively small proportion of variation (9.6%) in behaviour.

Conclusion

The HPV vaccine does not seem to be associated with perceptions of stigma related to genital warts, and has broad acceptance among a female university population. This study demonstrates that TPB is suited to investigate HPV vaccination, and has helped clarify the role of moral norm within the TPB.     

Functional Systems Theory and the Probabilistic Prediction of Behavior

This article addresses the role of probabilistic prediction in the systems organization of behavioral acts. The systems mechanisms predicting the required results of the behavioral acts of living beings in stable and changing conditions are discussed. It is suggested that in all these types of behavior, the parameters of results satisfying the leading needs, which constitute the aims of behavior, are strictly predicted. The author believes that probabilistic prediction is related only to the means, actions, and accompanying emotional states, as well as that possible ways of achieving results, i.e., not to the parameters but to the means of achieving the required results.     

Masculinity and Intentions to Perform Health Behaviors: The Effectiveness of Fear Control Arguments

This study examined the impact of fear control and danger control messages on intentions to perform health behaviors. It was hypothesized that persons high in masculinity would be more influenced by messages that address fear than messages that exclusively focus on the efficacy of the behavior (danger control). To test this proposition, 172 participants were classified into high and low masculinity groups according to their scores on the Bem Sex Role Inventory, and randomly assigned fear reducing or danger control messages either encouraging detection behavior (skin cancer self-examination) or promotion behavior (sunscreen usage). Highly masculine participants demonstrated greater behavioral intentions and more positive attitudes about the behavior when exposed to a fear-reducing message. The results suggest that it is possible to motivate adaptive health behavior even when a person is engaging in fear control.     

Quitting Smoking: Applying an Extended Version of the Theory of PlannedBehavior to Predict Intention and Behavior1

This study examined the ability of the theory of planned behavior (TPB)to predict students' intentions to quit smoking and the subsequent behavior6 months later. In addition, the impact of past behavior, moral norms, self‐identity, group identity, and positive/negative anticipated affect was examined. The intention‐behavior relationship was examined by dividing the sample in four subgroups: inclined actors/abstainers and disinclined actors/abstainers. Analyses were based on data from a prospective sample of 698 smokers. Attitude, subjective norms, and perceived behavioral control accounted for 36% (adjusted R²) of the variance in intentions. Moral norms, positive anticipated affect, group identity, and past behavior added 9% (adjusted R²) to the explained variance in intention, beyond the effect accounted for by the TPB components. Subsequent behavior was predicted by intentions (adjusted R²= .12). Past behavior, moral norms, self‐identity, and the Past Behavior x Intention and Moral Norm x Negative Affect interactions explained an additional 9% (adjusted R²) of the variance in behavior. Inclined abstainers constituted the main source of the discrepancy between intention and behavior.     

Using the Internet to Promote Health Behavior Change: A Systematic Review and Meta-analysis of the Impact of Theoretical Basis,Use of Behavior Change Techniques,and Mode of Delivery on Efficacy

Background

The Internet is increasingly used as a medium for the delivery of interventions designed to promote health behavior change. However, reviews of these interventions to date have not systematically identified intervention characteristics and linked these to effectiveness.

Objectives

The present review sought to capitalize on recently published coding frames for assessing use of theory and behavior change techniques to investigate which characteristics of Internet-based interventions best promote health behavior change. In addition, we wanted to develop a novel coding scheme for assessing mode of delivery in Internet-based interventions and also to link different modes to effect sizes.

Methods

We conducted a computerized search of the databases indexed by ISI Web of Knowledge (including BIOSIS Previews and Medline) between 2000 and 2008. Studies were included if (1) the primary components of the intervention were delivered via the Internet, (2) participants were randomly assigned to conditions, and (3) a measure of behavior related to health was taken after the intervention.

Results

We found 85 studies that satisfied the inclusion criteria, providing a total sample size of 43,236 participants. On average, interventions had a statistically small but significant effect on health-related behavior (d₊ = 0.16, 95% CI 0.09 to 0.23). More extensive use of theory was associated with increases in effect size (P = .049), and, in particular, interventions based on the theory of planned behavior tended to have substantial effects on behavior (d₊ = 0.36, 95% CI 0.15 to 0.56). Interventions that incorporated more behavior change techniques also tended to have larger effects compared to interventions that incorporated fewer techniques (P < .001). Finally, the effectiveness of Internet-based interventions was enhanced by the use of additional methods of communicating with participants, especially the use of short message service (SMS), or text, messages.

Conclusions

The review provides a framework for the development of a science of Internet-based interventions, and our findings provide a rationale for investing in more intensive theory-based interventions that incorporate multiple behavior change techniques and modes of delivery.     

A Longitudinal Test of the Theory of Planned Behavior Predicting Smoking Onset among Asthmatic and Non-asthmatic Adolescents

Despite the particularly detrimental health risks of smoking for adolescent with asthma, several studies demonstrated higher smoking rates among asthmatic adolescents than among healthy adolescents. To gain insight into underlying mechanisms, longitudinal studies on differences in smoking predictors between asthmatic and non-asthmatic adolescents are essential. This longitudinal study with two waves with an 18 months interval tests the Theory of Planned Behavior (TPB) among 346 asthmatic adolescents and 3,733 non-asthmatic adolescents aged 12-16 years. Structural equation models were used to test the predictive value of the TPB in these two groups. The results show, consistent with the TPB, that smoking-related cognitions (attitude, perceived behavioral control, and subjective norm) predict smoking onset via intention among both asthmatic and non-asthmatic adolescents. The TPB predicted smoking onset even stronger among adolescents with asthma. These findings may contribute to the development of tailored interventions for the prevention of smoking among asthmatic adolescents.     

行为抑制与父母教养方式对青少年焦虑的影响

目的:探讨行为抑制以及父母教养方式如何影响青少年的焦虑水平。方法:使用行为抑制量表、父母教养方式量表、Spence儿童焦虑量表,以班级为单位,集体测查了北京、新疆两地1533名初中学生。结果:①行为抑制预测青少年焦虑水平的回归系数显著。②母亲教养方式和父母教养方式的差异预测子女焦虑水平的回归系数分别显著。③行为抑制强、母亲教养方式倾向不良的青少年在焦虑量表上的得分显著高;同时,行为抑制强、父母双方教养方式差异大的青少年在焦虑量表上的得分显著高。结论:行为抑制预测青少年焦虑,良性父母教养方式是保护行为抑制青少年远离焦虑障碍的有力措施。     

Use of a Text Message Program to Raise Type 2 Diabetes Risk Awareness and Promote Health Behavior Change (Part I): Assessment of Participant Reach and Adoption

Background

There are an estimated 25.8 million American children and adults, equivalent to 8.3% of the US population, living with diabetes. Diabetes is particularly burdensome on minority populations. The use of mobile technologies for reaching broad populations is a promising approach, given its wide footprint and ability to deliver inexpensive personalized messages, to increase awareness of type 2 diabetes and promote behavior changes targeting risk factors associated with type 2 diabetes. As a part of the Beacon Community Cooperative Agreement Program, txt4health, a public-facing mobile health information service, was launched in 3 Beacon Communities: the Southeast Michigan Beacon Community in Detroit, MI, the Greater Cincinnati Beacon Community in Cincinnati, OH, and the Crescent City Beacon Community in New Orleans, LA. Txt4health is a mobile health information service designed to help people understand their risk for type 2 diabetes and become more informed about the steps they can take to lead healthy lives.

Objective

The purpose of this investigation was to use the RE-AIM framework to document txt4health reach and adoption by focusing on enrollment and participant engagement in program pilots in Southeast Michigan and Greater Cincinnati.

Methods

We conducted a retrospective records analysis of individual-level txt4health system data from participants in Southeast Michigan and Greater Cincinnati to determine participant usage of txt4health and engagement with the program.

Results

Results from the retrospective records analysis revealed that 5570 participants initiated the 2-step enrollment process via 1 of 3 enrollment strategies: text message, website, or directly with Beacon staff who signed participants up via the website. In total, 33.00% (1838/5570) of participants completed the 2-step enrollment process and were fully enrolled in the program. All participants (100.00%, 1620/1620) who enrolled via text message completed the entire 2-step enrollment process versus 5.52% (218/3950) of participants who enrolled via website or a Beacon staff member. Of those who fully enrolled, 71.00% (1305/1838) completed the diabetes risk assessment and 74.27% (1365/1838) set an initial weight loss goal. Overall, 39.06% (718/1838) of participants completed all 14 weeks of the program and 56.26% (1034/1838) dropped out before completing all 14 weeks, with the bulk of dropouts occurring in the first 4 weeks. Length of participation varied greatly, ranging from 0-48.7 weeks (median 8.6, mean 15.8, SD 15.8). Wide variability of participant engagement in regards to weekly weight and physical activity was documented.

Conclusions

Although broadly focused public health text message interventions may have the potential to reach large populations and show high levels of engagement among some users, the level of individual engagement among participants varies widely, suggesting that this type of approach may not be appropriate for all.     

Patterns of Sexual Risk Behaviors and Psychiatric Disorders in a Community Sample of Young Adults

This cross-sectional study documents significant associations between patterns of sexual risk behaviors and psychiatric diagnoses in a multiethnic community sample of young adults (N = 1803) in South Florida. Self-report data regarding sexual behavior and psychiatric symptoms were collected in structured interviews in a follow-up of an earlier school-based study. Cluster analysis was used to group participants with regard to levels of sexual risk behaviors during the past year. Chi-square analysis and ANOVA identified significant associations between cluster membership and (a) lifetime and (b) past year diagnoses for affective disorders, conduct disorder, antisocial personality disorder, alcohol abuse/dependence, marijuana abuse/dependence, and other drug abuse/dependence. In addition, higher levels of sexual risk behaviors were associated with higher levels of cumulative lifetime psychiatric disorders. Implications for selected prevention of sexually transmitted diseases (STDs) and the treatment of psychiatric disorders in young adulthood are discussed.     

Culture Change and Ethnic-Minority Health Behavior: An Operant Theory of Acculturation

Data on acculturation and ethnic-minority health indicate that acculturation has opposite effects on the same health behavior among different ethnic groups; opposite effects on different health behaviors within an ethnic group; opposite effects on the same health behavior for the women vs. the men of most ethnic groups; and no effect whatsoever on some health behaviors for some ethnic groups. This evidence is so incoherent that it is unintelligible, and hence it continues to be largely useless to health psychology and behavioral medicine. This paper presents a new theory of acculturation that renders these confusing data coherent by predicting such changes in minority health behavior a priori. By so doing, the operant model of acculturation has the potential to improve health promotion and disease prevention and thereby reduce ethnic health disparities.