Role of anticipated regret,intentions and intention stability in adolescent smoking initiation

Objectives To examine the impact of anticipated regret within the theory of planned behaviour (TPB) on intentions of adolescents to initiate smoking. To examine the moderating role of anticipated regret and intention stability on the relationship between intentions and smoking initiation in adolescents. Methods We conducted two studies measuring anticipated regret within the TPB applied to adolescent smoking initiation. In the first study, 347 non‐smoking adolescents (between 11 and 12 years of age) completed the TPB and anticipated regret measures about smoking initiation. In the second study, 675 non‐smoking adolescents (between 11 and 12 years of age) completed the TPB, anticipated regret, and intention stability measures in relation to smoking initiation. Smoking was assessed objectively by carbon monoxide breath monitor 9 months later. Results In Studies 1 and 2, regret significantly added to predictions of intentions over and above components of the TPB (p <.001). In Study 2, smoking behaviour was predicted by intentions and the relationship of intentions to behaviour was moderated by regret and intention stability. Conclusions Regret and intention stability were shown to be important variables within the TPB in understanding intentions and behaviour of smoking initiation in adolescents.     

Gender power imbalance and differential psychosocial correlates of intended condom use among male and female adolescents from Venda,South Africa

Objectives. In South Africa, a gender power imbalance exists which may prevent women from negotiating safe sexual encounters. In this study we tested which constructs from Protection Motivation Theory (PMT) and the Theory of Planned Behavior (TPB) under these circumstances were most related to condom use intention. We hypothesized that in a situation of gender power imbalance self‐efficacy would be a more salient correlate of intended condom use for females, while for males attitude to condoms and subjective norm would be more important. Design. This study employed a cross‐sectional questionnaire design. Method. Male participants (N = 94) and female participants (N = 101) from Venda, South Africa completed standard, multi‐item, reliable measures of TPB constructs (condom‐related attitude, subjective norm, perceived behavioural control, intention) and PMT constructs (vulnerability, severity, fear, response‐efficacy, self‐efficacy) and reported their past condom use behaviour. Results. Regression analysis indicated that among males attitude to condoms and subjective norm were significantly related to intended condom use. Among females attitude and self‐efficacy were significantly related to intended condom use. Conclusion. The findings indicate that in a situation of gender power imbalance psychosocial correlates of intended condom use differ for males and females. Gender‐specific analysis of determinants of condom use may be more appropriate in a situation of gender power imbalance.     

Help‐seeking intentions for breast‐cancer symptoms: A comparison of the self‐regulation model and the theory of planned behaviour

Purpose: Delays in seeking help for symptoms have been found to be associated with poorer outcome in breast‐cancer patients. This study explores symptom perceptions and health beliefs as predictors of intentions to seek medical help in a general female population. The utility of the self‐regulation model of illness cognition and the theory of planned behaviour were examined in predicting help‐seeking intentions for potential symptoms of breast cancer in a general population sample. Methods: A general population sample of 546 women completed a postal questionnaire comprising items examining components of the self‐regulation model and the theory of planned behaviour. Help‐seeking intention was determined by asking participants to rate the likelihood of visiting their GP for a range of breast symptoms. Results: Hierarchical multiple regression analysis revealed that the cognitive component of the self‐regulation model accounted for approximately 22% of the variance in help‐seeking intention. Identity (β = 0.45, p < .001) emerged as a significant predictor of intention to seek help. Inclusion of the components of the theory of planned behaviour accounted for an additional 7% of the variance; the significant predictors were attitude to help‐seeking (β = 0.19, p <.001) and perceived behavioural control (β = 0.12, p <.01). Conclusions: Intention to seek medical help for a potential breast‐cancer symptom may be mediated, partly, by cognitive representations of the identity and consequences of breast cancer and by attitudes towards help‐seeking and perceived behavioural control. Although less than one‐third of the variance was accounted for, these results have important implications for future research (in terms of identifying which variables should be examined) and for the development of a model of help‐seeking behaviour in women with breast‐cancer symptoms.     

Reasons for binge drinking among undergraduate students: An application of behavioural reasoning theory

Objectives. This study sought to apply behavioural reasoning theory (BRT) to the prediction of undergraduate students’ binge drinking intentions and behaviour. The reasons students use to justify and defend binge drinking may provide important information on motivations underlying such behaviour. Methods. Undergraduate students (N= 265) completed questionnaires assessing their reasons for and against binge drinking, attitude, subjective norm, perceived behavioural control, intention, and past behaviour. Frequency of binge drinking was assessed at 1‐week follow‐up (N= 172). Results. A series of path analyses were conducted to assess the direct and indirect effects of the BRT variables on binge drinking intentions and behaviour. The variables under consideration accounted for 80% of the variance in binge drinking intentions (with past behaviour, reasons for binge drinking, and attitude having significant direct effects on intention), and 34% of the variance in binge drinking at 1‐week follow‐up (with past behaviour, perceived behavioural control, and intention having significant direct effects on future behaviour). Additional regression analyses revealed that respondents who strongly endorsed being sociable and having fun as reasons for binge drinking were more likely to intend to engage in binge drinking over the subsequent week. Conclusions. The results provide support for BRT as a framework for understanding undergraduate students’ binge drinking intentions and behaviour, and suggest that interventions need to focus on the social reasons for engaging in binge drinking in undergraduate students.     

Does perceived behavioural control mediate the relationship between power beliefs and intention?

Objectives: In order to determine whether the relationship between power beliefs (Σp) and health‐related behavioural intentions is mediated by perceived behavioural control (PBC) we used structural equation modelling of eight cross‐sectional data sets. Method: Eight studies that examined health‐related behaviours and employed representative samples totallingN = 4663 participants were analysed. All studies involved power belief items derived from pilot testing and employed standard multiitem measures of power beliefs, PBC and intention that were highly reliable. Results: Confirmatory factor analysis confirmed the discriminant validity of power beliefs, PBC and intention. Structural equation modelling of relevant paths indicated that PBC only partially mediated the relationship between power beliefs and intention (Z_Sobel = 5.15,p < .001;Z_Baron&Kenny = 5.16,p < .001). Power beliefs had a significant direct relationship with intention even after PBC had been taken into account. Conclusion: The findings undermine Ajzen's contention that PBC mediates the power beliefs‐intention relationship and suggests that it is important to employ measures of power beliefsin addition to measures of PBC in order to enhance the prediction of intentions to perform health‐risking, or health‐promoting, behaviours.     

Predicting and explaining transtheoretical model stage transitions in relation to condom‐carrying behaviour

Objectives The stages of change component of the transtheoretical model have been applied to safe sex behaviours in cross‐sectional analyses, but have not yet been subject to prospective analysis. It was predicted that: (a) cross‐sectional analyses would demonstrate good discrimination between the stages of change; (b) prospective analyses would allow for the identification of predictors of stage transitions; and (c) implementation intentions would explain progression from the preparation stage. Design This study employed an experimental longitudinal design. Participants were randomly assigned to the experimental (implementation intention) or control conditions and completed questionnaires at baseline and at 2‐month follow‐up. Methods Five hundred and twenty‐five adolescents who were broadly representative of the UK population completed questionnaires at baseline and follow‐up (N=393) measuring: demographic variables; stage of change; theory of planned behaviour constructs; anticipated regret; and moral norm in relation to condom‐carrying behaviour. The experimental condition completed a self‐generated implementation intention to carry condoms at the end of the baseline questionnaire. Results Discriminant function analyses indicated that the stages of change could be accurately discriminated from one another cross‐sectionally and that, longitudinally, the measured variables were able to predict transitions between most stages. Implementation intentions caused people to progress from the preparation stage. Conclusions Transitions between most stages were reliably predicted, thereby providing potential targets for intervention. The brief implementation intention intervention was effective and could easily be utilized and expanded to encompass a broader range of sexual health behaviours.     

Theory of planned behaviour cognitions do not predict self‐reported or objective physical activity levels or change in the ProActive trial

Objective. The objective was to test, in a trial cohort of sedentary adults at risk of Type 2 diabetes, whether theory of planned behaviour (TPB) cognitions about becoming more physically active predicted objective and self‐reported activity levels and change. Design. Participants of a randomized controlled trial underwent measurement at baseline, 6 and 12 months. Methods. Participants (N= 365, 30–50 years) were recruited via their parent or family history registers at 20 general practices in the UK. Energy expenditure was measured objectively at baseline and 1 year. Participants completed questionnaires assessing physical activity and beliefs about becoming more physically active over the next year at baseline, 6 and 12 months. Results. Between baseline and 12 months, objective energy expenditure in the cohort increased by an average of 20 minutes of brisk walking per day. Based on the 252 participants who provided complete data, affective attitude and perceived behavioural control consistently predicted intention, but intention and perceived behavioural control failed to predict physical activity levels or change (p‐values > .05). Conclusions. Failure of the theory to predict behaviour and behaviour change may be due to inapplicability of the theory to this at‐risk population or to trial participation and intensive measurement facilitating behaviour change without affecting measured cognitions, or lack of correspondence between cognitive and behavioural measures. A wide range of potential personal and environmental mediators should be considered when designing physical activity interventions among at‐risk groups. High‐quality experimental tests of the theory are needed in clinical populations.     

Predicting alcohol consumption and binge drinking in company employees: an application of planned behaviour and self-determination theories

Objectives. This study tested an integrated model of the psychosocial determinants of alcohol‐related behaviour among company employees from four nations. A motivational sequence was proposed in which motivational orientations from self‐determination theory influenced intentions to consume alcohol within guideline limits and alcohol‐related behaviour via the mediation of the theory of planned behaviour variables of attitude, subjective norms, and perceived behavioural control (PBC). Design. A three‐wave prospective design using self‐reported psychological and behavioural measures. Methods. Company employees (N= 486, males = 225, females = 261; M age = 30.41, SD= 8.31) from four nations (Estonia, Finland, Sweden, and UK) completed measures of autonomous and controlled motivation from self‐determination theory, attitudes, subjective norms, PBC, intentions from the theory of planned behaviour, and self‐reported measures of past alcohol consumption and binge‐drinking occasions at the first time point (time 1). Follow‐up psychological and behavioural measures were taken one month later (time 2) and follow‐up behavioural measures taken a further 2 months later (time 3). Results. Path analyses supported the motivational sequence with identified regulation (time 1), predicting intentions (time 1), and alcohol units consumed (time 2). The effects were indirect via the mediation of attitudes and PBC (time 1). A similar pattern of effects was found for the effect of time 2 psychological variables on time 3 units of alcohol consumed. There was little support for the effects of the psychological variables on binge‐drinking behaviour. Conclusions. Findings provide new information on the psychosocial determinants of alcohol behaviour in company employees and the processes involved. Results may provide impetus for the development of interventions to reduce alcohol consumption.     

Why do heterosexual young adults who use reliable contraception also use condoms? Results from a diary‐based prospective longitudinal study

Objectives. To identify characteristics of individuals and characteristics of sexual encounters that predict whether people using contraception will also use condoms (dual use), and to determine whether dual use is prompted by concerns about unplanned pregnancy and/or sexually transmitted infections (STIs). Design. A longitudinal prospective design was used to identify characteristics of individuals and characteristics of specific sexual encounters that predict condom use. Methods. A sample of 349 sexually active heterosexual young adults was recruited at universities and trade colleges in Melbourne, Australia. Participants completed a self‐administered questionnaire, and a representative subsample (N = 103) completed a structured condom use diary in which they reported on up to 10 instances of vaginal intercourse. Respondents reported use of condoms and other forms of contraception during 919 instances of vaginal intercourse. Results. In multivariate analyses, dual use of condoms in addition to other contraception was predicted by attitudes toward condoms, intentions to use condoms, partner type and discussion of condom use with sexual partners. Dual use was not related to greater concern about HIV/STIs or unplanned pregnancy. Conclusion. Encouraging heterosexual young adults to discuss condom use, and developing their skills for negotiation of condom use will increase rates of condom use, thereby reducing current high rates of unplanned pregnancy and STIs.     

Using an extended theory of planned behaviour to inform interventions aimed at increasing breastfeeding uptake in primiparas experiencing material deprivation

Objectives The theory of planned behaviour (TPB) was employed to investigate infant feeding intentions and subsequent behaviour in women from selected areas of economic hardship in the UK. Underlying beliefs were examined in order to inform future interventions aimed at increasing breastfeeding uptake among women living in such areas, which is associated with low rates of breastfeeding. Design Midwives recruited women from areas meeting study criteria. TPB measures were obtained from 303 primiparas via postal questionnaires completed during pregnancy, and feeding method was subsequently obtained from 286 of these women. Results A model containing age, education, deprivation, attitude, subjective norm (SN), and perceived behavioural control (PBC) predicted intention to breastfeed (R²=.44) and intention to formula feed (R²=.45). A model controlling for age, education and deprivation predicted ever having breastfed (86.1% correctly classified) and ever having formula fed (77.1% correctly classified). MANCOVAs differentiated those who intended to breastfeed and subsequently did (inclined actors), those who intended to breastfeed but did not (inclined abstainers), and those who did not intend to breastfeed and did not (disinclined abstainers). Differentiating outcome beliefs, normative beliefs, and control beliefs are presented. Conclusions The TPB provided a useful framework with which to examine the factors underlying breastfeeding intentions and behaviour amongst primiparas. A grouping system based on the congruence between intentions and subsequent behaviour revealed important differences between beliefs of the three groups. Further research might usefully test the effectiveness of interventions targeting the beliefs identified here in increasing breastfeeding uptake and duration.     

Physically active patients with coronary artery disease: A longitudinal investigation of the processes of exercise behaviour change

Objectives. Although regular exercise is important for patients with coronary artery disease (CAD), most CAD patients are not sufficiently active. The transtheoretical model offers a framework for the process of exercise behaviour change. But until today, it is not clear which processes of exercise behaviour change (POC) support CAD patients in maintaining exercise after discharge. Design. A longitudinal study with baseline measure and 6‐month follow‐up has been conducted. German CAD patients were mailed at home after discharge. POC and exercise were self‐reported. Methods. A total of 204 CAD patients were selected from five rehabilitation centres. A total of 108 CAD patients, which were in the post‐action stages, provided data at baseline and follow‐up. Two different analyses were carried out. Firstly, structural equation modelling with baseline data (N =147) was used to test the hierarchical order of the POC in experiential and behavioural processes. Secondly, cross‐lagged panel analysis was used to investigate whether POC lead to exercise or vice versa and which POC support CAD patients in maintaining exercise. Results. Comparative analysis indicates that the two hierarchical‐factor model fits the data significantly better than the one hierarchical‐factor model (χ²diff ₍₁₎=19.04, p <.001), even though experiential and behavioural processes are highly correlated (r =.98, p <.001). Standardized effects of the antecedent cross‐lags are significant for consciousness raising (β=0.27), reinforcement management (β=0.28), self‐liberation (β=0.28), and stimulus control (β=0.33) indicating that these POC are predictive for CAD patients maintaining exercise. Conclusion. Although some POC support the exercise behaviour change process and the hierarchical structure is apparent, it may be beneficial to adapt the POC to give a more precise understanding of the change processes.     

Theory of planned behaviour and ecstasy use: An analysis of moderator‐interactions

Objective: This study tested potential moderator interactions between components of the Theory of Planned Behaviour (TPB) in relation to ecstasy use, extending previous research. It was expected that attitudes, subjective norms and perceived behavioural control (PBC) would moderate each other in predicting intended use of this drug. Method: A cross‐sectional survey was administered to 200 young adults. Results: In hierarchical multiple regression analysis, past behaviour and attitude independently predicted intention; previous use of ecstasy and more positive attitudes towards ecstasy use were associated with stronger intentions to use this drug in the future. Moreover, there was a significant interaction between attitude and PBC (R²_change = 0.05). Slope analysis revealed that PBC better predicted intention given more positive attitudes towards ecstasy use. Conclusions: This moderator function may help explain predictive inconsistencies reported in the literature. Implications for the TPB are considered.     

Psychosocial predictors of rule following in hostels for women experiencing homelessness

This study examined the psychosocial factors impacting upon the rule‐following behaviour of residents of a hostel providing crisis accommodation to women who are homeless. After their arrival, residents of a women's hostel (N=83) completed questionnaires assessing the theory of planned behaviour constructs of attitude, subjective norm, perceived behavioural control (PBC), and intentions related to rule following while residing at the hostel. Perceived resident group norms for rule following were assessed also. Follow‐up staff evaluations of the target behaviour were completed after participants ceased their hostel residence. As expected, attitude, subjective norm, PBC, and group norm significantly predicted intention to follow hostel rules, and intention and PBC predicted rule‐following behaviour. As rule following is a crucial requirement for continuation of their stay, these findings can inform strategies to improve the experiences and outcomes of women's short‐term hostel stays. © 2011 Wiley Periodicals, Inc.     

Protection motivation theory and the prediction of physical activity among adults with type 1 or type 2 diabetes in a large population sample

Objectives. To investigate the utility of the protection motivation theory (PMT) for explaining physical activity (PA) in an adult population with type 1 diabetes (T1D) and type 2 diabetes (T2D). Design. Cross‐sectional and 6‐month longitudinal analysis using PMT. Methods. Two thousand three hundred and eleven individuals with T1D (N =697) and T2D (N =1,614) completed self‐report PMT constructs of vulnerability, severity, response efficacy, self‐efficacy, and intention, and PA behaviour at baseline and 6‐month follow‐up. Multi‐group structural equation modelling was conducted to: (1) test the fit of the PMT structure; (2) determine the similarities and differences in the PMT structure between the two types of diabetes; and (3) examine the explained variance and compare the strength of association of the PMT constructs in predicting PA intention and behaviour. Results. The findings provide evidence for the utility of the PMT in both diabetes samples (χ²/df =1.27?4.08, RMSEA=.02–.05). Self‐efficacy was a stronger predictor of intention (β=0.64–0.68) than response efficacy (β=0.14–0.16) in individuals with T1D or T2D. Severity was significantly related to intention (β=0.06) in T2D individuals only, whereas vulnerability was not significantly related to intention or PA behaviour. Self‐efficacy (β's=0.20–0.28) and intention (β's=0.12–0.30) were significantly associated with PA behaviour. Conclusions. Promotion of PA behaviour should primarily target self‐efficacy to form intentions and to change behaviour. In addition, for individuals with T2D, severity information should be incorporated into PA intervention materials in this population.     

Perceived partner beliefs about condoms and self-efficacy communication within the context of the theory of gender and power

The theory of gender and power provides a unique framework for understanding condom use by accounting for distinct challenges faced by minority women in particular. This study examined whether self-efficacy about condom use communication (SECC) and perceived partner's beliefs about condom (PPBC) use had an influence on condom use frequency; and whether these associations varied by gender. A sample of 252 African–American college students (101 males and 151 females) completed a confidential online survey assessing SECC, PPBC, and condom use behavior. SECC and PPBC showed significant associations with condom use behavior. Furthermore, there was a gender interaction effect with PPBC on condom use behavior. As PPBC increases toward positive associations about condom use, condom use behavior increased significantly more for females (B = 0.42; p = .02) as compared to males (B = 0.26; p = .19). This study supports the need to teach young women effective communication skills in order for them to accurately assess what their partner thinks about condom-related behaviors; and ultimately not allow partner discouragement to influence their decisions to use condoms. Interventions aimed at reducing risky sexual behavior on predominantly Black college campuses, in particular, may benefit from directly addressing relationship power and focusing on building self-efficacy in communicating condom use.     

Testing an integrated model of the theory of planned behaviour and self‐determination theory for different energy balance‐related behaviours and intervention intensities

Objectives The aim of the study was to test the relations between constructs from the self‐determination theory (autonomous and controlled motivation), the theory of planned behaviour (attitudes, self‐efficacy, and intentions), and behaviour change within a theoretically integrated model. Additionally, the aim was to test if these relations vary by behaviour (physical activity or dietary behaviour) or intervention intensity (frequency). Design. It was a randomized controlled trial with a ‘usual care’ condition (medical screening only) and an intervention condition (medical screening+access to a website and coaching). Participants in the latter condition could freely determine their own intervention intensity. Methods. Participants (N= 287) completed measures of the theoretical constructs and behaviour at baseline and after the first intervention year (N= 236). Partial least squares path modelling was used. Results. Changes in autonomous motivation positively predicted changes in self‐efficacy and intentions towards a healthy diet. Changes in controlled motivation positively predicted changes in attitudes towards physical activity, changes in self‐efficacy, and changes in behavioural intentions. The intervention intensity moderated the effect of self‐efficacy on intentions towards physical activity and the relationship between attitude and physical activity. Changes in physical activity were positively predicted by changes in intentions whereas desired changes in fat intake were negatively predicted by the intervention intensity. Conclusions Important relations within the theoretically integrated model were confirmed but others were not. Moderation effects were found for behaviour and intervention intensity.     

Predicting Intended Condom Use among Tanzanian Students using the Theory of Planned Behaviour

This study examined whether perceived behavioural control predicted the intention to use condoms at next sexual intercourse above the components of the theory of reasoned action, as well as the sufficiency of the theory of planned behaviour (TPB) as a theory of intention among Tanzanian adolescents. Five hundred and twenty-eight students who were sexually active, from seven secondary schools in Arusha, Northern Tanzania, completed a questionnaire designed to measure the components of the TPB. Behavioural intentions were significantly predictable from attitudes (.11), subjective norms (.22) and perceived behavioural control (.48). The inclusion of past behaviour into the regression equation increased R(2) only marginally (2 percent) but significantly, suggesting that the TPB provides a fairly accurate explanation of intention to use condoms among Tanzanian adolescents. The implications of this finding in relation to theoretical and practical issues are discussed.