Consumer perceptions of dietary changes for reducing fat intake

Although consumers have been advised to reduce their dietary fat intake, there has been no change in average fat intake (as a percentage of energy) in the United Kingdom over the past decade. In the study reported in this paper, the theory of planned behavior (Ajzen, 1991) was used to investigate consumers' attitudes, subjective norm and perceived control as they relate to reducing fat in the diet. Information about current fat intake was also obtained using a Food Frequency Questionnaire, for all 390 respondents who were then classified into tertiles based on their actual and perceived current fat intakes. For the total sample, subjective norm was the most important predictor of intentions to reduce fat intake and to carry out specific dietary changes. This was also the case for people consuming a low fat diet and for those who perceived their fat intake as low, while attitude was the best predictor of intention for people consuming a high fat diet and for those who perceived their fat intake as high. Perceived control was found to be a poor predictor of intention in all cases.     

Spring Break Versus Spring Broken: Predictive Utility of Spring Break Alcohol Intentions and Willingness at Varying Levels of Extremity

Within the domain of risk-related behavior, many times the decision to engage is not a product of premeditation or intention. The prototype willingness model was created to capture and explain the unintended element of risk behavior. The present study aimed to evaluate the importance of willingness versus intention, two important constructs within the prototype willingness model, in relation to spring break drinking behavior when assessed at both high and low extremities. College undergraduates (N?=?275) completed questionnaires prior to spring break regarding their anticipated spring break activities. Willingness and intention were assessed for different levels of risk. Specifically, participants indicated the extent to which they intended to (a) get drunk and (b) drink enough to black out or pass out; and the extent to which they were willing to (a) get drunk and (b) drink enough to black out or pass out. When classes resumed following spring break, the students indicated the extent to which they actually (a) got drunk and (b) drank enough to black out or pass out. Results demonstrated that when the health-related risk was lower (i.e., getting drunk), intention was a stronger predictor of behavior than was willingness. However, as the level of risk increased (i.e., getting drunk enough to black out or pass out), willingness more strongly predicted behavior. The present study suggests that willingness and intentions differentially predict spring break alcohol-related behavior depending on the extremity of behavior in question. Implications regarding alcohol interventions are discussed.     

Adolescents' intentions to smoke as a predictor of smoking

BACKGROUND: Adolescents' intentions to smoke are generally regarded as a valid and reliable predictor of subsequent smoking. This association is largely based on research with adults and needs a more detailed analysis for adolescents. METHODS: Data on intentions and smoking status were collected as part of a longitudinal, birth-cohort study when the study members were 9, 11, 13, 15, 18, and 21 years of age. RESULTS: The results showed that intention to smoke only had an important predictive power in the subgroup of previous nonsmokers. Among those already smoking (on a monthly basis or greater), previous level of smoking was a more important predictor of future behavior than intention to smoke. In addition, the effect of positive intention to smoke was nonlinear over age and had the greatest effect at age 15. CONCLUSION: The results indicated that in adolescence, measurement of intentions to smoke or not smoke cannot be assumed to be a general predictor of behavior at a later age for all groups of adolescents.     

Understanding pedestrians' road crossing decisions: an application of the theory of planned behaviour.

This paper reports a study applying the Theory of Planned Behaviour (TPB) to the prediction of pedestrians' road crossing intentions. Respondents (N = 210) completed questionnaires which included scenarios of three potentially dangerous road crossing behaviours, followed by measures of attitude, subjective norm, perceived behavioural control, self-identity and intention. The results indicated that the social psychological variables under consideration were able to explain between 39 and 52% of the variance in intentions to cross the road in the manner depicted in the scenarios. The perceived behavioural control component of the TPB emerged as the strongest predictor of pedestrians' intentions, suggesting that perceptions of control have an important role to play in road safety behaviour. The results are discussed in relation to the predictive utility of the TPB in this area and possible interventions to encourage safe road crossing behaviour.     

Predicting the intention to eat healthier food among young adults

The purpose of this study was to investigate which factors predictedthe intention to eat healthier food. The empirical data stemfrom a questionnaire survey carried out among 527 young adultsaged 23–26 years living in Oslo, Norway. The study wascarried out in September 1991. The Theory of Planned Behavior(TPB) was used as a guiding theoretical framework. The componentsof the TPB accounted for 32% of the variance in behavioral intention.Attitude was the strongest predictor, followed by perceivedbehavioral control. Subjective norm received the lowest weightA detailed analysis of the underlying cognitive structures revealedthat the outcomes which discriminated most strongly betweenthose who intended to eat healthier food, those who were undecidedand those who had no intention, were that healthier food wouldimprove the shape of the body, increase enjoyment of food andreduce weight. In addition, the control beliefs ‘weight’,‘able to make healthier dishes’, ‘social eating’and ‘busy’ discriminated mostly between the threeintender groups. These outcomes might preferably be addressedin persuasive communications to change intentions to eat healthierfood.     

Theory-based identification of barriers to quality improvement: induced abortion care.

BACKGROUND: The UK Royal College of Obstetricians and Gynaecologists published the clinical guideline, The Care of Women Requesting Induced Abortion, to address recognized variations in care. There is little empirical evidence on factors that influence compliance with the guideline. A better understanding of such factors is needed for quality improvement initiatives. OBJECTIVE: To identify factors that influence compliance with two key guideline recommendations: offer of an assessment appointment within 5 days of referral, and supply of contraceptives at discharge. SETTING: Thirteen hospital gynaecology units in Scotland. METHODS: Guideline compliance was measured by a case note review. Barriers and facilitators were identified using a combination of approaches: semi-structured interviews with local gynaecologists and a survey of clinical staff. The questionnaire, based upon constructs from the Theory of Planned Behaviour, measured behavioural intention, attitude, subjective norm (perceived social pressure), and perceived behavioural control. RESULTS: Of 507 cases reviewed, median unit compliance was 46% for the assessment appointment and 59% for contraceptive supplies. Questionnaires were returned by 151 (74%) of 205 staff in 12 units. The interviews and open-ended questions highlighted organizational barriers to guideline implementation. Staff generally had strong intentions and positive attitudes to follow both recommendations. For the assessment appointment, perceived behavioural control was low. The Theory of Planned Behaviour accounted for 27% of the variation in intentions, with subjective norm being the strongest predictor. Intention and perceived behavioural control best explained unit compliance, together explaining 15% of the variation. For contraceptive supplies, the theory accounted for 34% of the variation in intentions, with perceived behavioural control being the strongest predictor. CONCLUSION: Clinical staff were highly motivated to implement the guideline but hindered by organizational constraints. Quality improvement initiatives need to target organizational barriers as well as individual professionals.     

An overlooked concept? Intention to return to work among individuals on sick leave due to common mental disorders: A scoping review

Intention to return to work (RTW) is an important predictor of actual RTW among individuals on sick leave in general. However, it is not known whether this is also the case for individuals with common mental disorders (CMDs). Because CMDs are a leading cause of disability worldwide, the RTW process is often more complex and sick leave periods are longer than for other diagnoses. Thus, it is important to focus solely on this group. The purpose of this scoping review was to summarise studies targeting individuals' RTW intention and its importance for actual RTW after sick leave due to CMDs. Studies relevant for the aim were identified by a structured searching in three electronic databases (PubMed, CINAHL and PsycINFO) from their inception until the end of June 2020, as well as grey literature and reference lists of included articles. To cover all aspects of “intention”, close concepts such as “expectation” and “willingness” were searched for as well. After the selection process, 10 original research papers were included in the review: eight quantitative and two qualitative. Nine of the studies used the concept “expectation” and one “intention”. There was also a lack of consistency in measurements across studies. However, they showed that intention (expectation) was a significant predictor of actual RTW. The conclusion is that RTW intention among individuals after sick leave due to CMDs has been narrowly investigated, with a lack of consistency in measurements. Future research should use behavioural–psychological theories to cover the concept “intention” in a more comprehensive and consistent manner.     

Do ethnicity and gender matter when using the theory of planned behavior to understand fruit and vegetable consumption?

A majority of Americans do not meet the recommendation to eat five servings of fruits and vegetables per day (5-A-Day). The purpose of the present study was to examine the utility of the theory of planned behavior (TPB) for understanding 5-A-Day intentions and behavior and to determine whether any of the TPB relationships were moderated by ethnicity or gender. A total of 413 participants completed a baseline TPB questionnaire and a fruit and vegetable consumption measure 2 weeks later. Path analyses showed that affective attitude and perceived behavioral control significantly predicted intention for blacks, whites, males and females (R(2) ranged from .32 to .40), whereas subjective norm was a significant predictor for blacks, males, and females only. Intention significantly predicted 5-A-Day (R(2) ranged from .17 to .22) for all groups. Follow-up invariance analyses showed that the subjective norm/intention relationship was significantly stronger for black compared to white students. Finally, several key beliefs were identified for all four demographic groups. Therefore, the current results suggest that the TPB may be a useful framework to utilize when developing 5-A-Day interventions.     

Identifying specific beliefs to target to improve restaurant employees' intentions for performing three important food safety behaviors

Current national food safety training programs appear ineffective at improving food safety practices in foodservice operations, given the substantial number of Americans affected by foodborne illnesses after eating in restaurants each year. The Theory of Planned Behavior (TpB) was used to identify important beliefs that may be targeted to improve foodservice employees' intentions for three food safety behaviors that have the most substantial affect on public health: hand washing, using thermometers, and proper handling of food contact surfaces. In a cross-sectional design, foodservice employees (n=190) across three midwestern states completed a survey assessing TpB components and knowledge for the three food safety behaviors. Multiple regression analyses were performed on the TpB components for each behavior. Independent-samples t tests identified TpB beliefs that discriminated between participants who absolutely intend to perform the behaviors and those with lower intention. Employees' attitudes were the one consistent predictor of intentions for performing all three behaviors. However, a unique combination of important predictors existed for each separate behavior. Interventions for improving employees' behavioral intentions for food safety should focus on TpB components that predict intentions for each behavior and should bring all employees' beliefs in line with those of the employees who already intend to perform the food safety behaviors. Registered dietitians; dietetic technicians, registered; and foodservice managers can use these results to enhance training sessions and motivational programs to improve employees' food safety behaviors. Results also assist these professionals in recognizing their responsibility for enforcing and providing adequate resources for proper food safety behaviors.     

Embedding health messages into entertainment television: effect on gay men's response to a syphilis outbreak

The entertainment education (EE) approach seeks to impact audiences' health behavior by embedding messages in mass media productions, storylines, and characters that appeal strongly to them. Effect on behavioral intentions was examined following a storyline about syphilis in men who have sex with men (MSM) presented in a popular dramatic series. Five hundred and one MSM drawn from gay Internet chat rooms completed the questionnaire. Differences in item responses between those who did and did not view the syphilis storyline were calculated, and linear regression was used to examine predictors of intentions to take action. Those who viewed the syphilis storyline were more likely to report intention to get screened and to tell others to get screened for syphilis. Seeing the episode was a predictor of these intentions. Education was also a predictor of intention to tell others to get screened. Results suggest that exposure to a storyline about syphilis in gay men had a positive public health outcome on users of Internet chat rooms for MSM. Further studies are warranted to examine the extent to which and how the EE approach can produce health-relevant outcomes for U.S. populations, just as the approach has done in the developing world.     

Psycho-social determinants for sexual partner referral in Uganda: quantitative results.

The purpose of this study was to investigate the factors influencing sexual partner referral using the Attitude-Social influence self-Efficacy model as a guiding theoretical framework. The data was collected in an interview survey with 236 women and 190 men attending a sexually transmitted disease clinic in Kampala, Uganda. Intention, attitude, subjective norm, self-efficacy, and past behaviour in relation to partner referral as well as partner type were collected at time 1. At time 2 (1 month later), sexual partner referral was assessed. Intention, self-efficacy, and previous behaviour predicted partner referral for women whereas intention, partner type and previous behaviour predicted partner referral for men. For the women the strongest predictors for intention were self-efficacy followed by attitude and partner type. For the men the strongest predictor was attitude followed by partner type and self-efficacy. Social influence was a better predictor of intention for women than for men. An analysis of underlying cognitive beliefs discriminating those who referred and those who did not refer the sexual partner showed that attitudinal beliefs were the most important for men whereas self-efficacy beliefs were the most important for women. The targeting of the gender-based discriminatory beliefs in intervention may improve compliance with sexual partner referral.     

Examining intentions to use CoQ10 amongst breast cancer patients

OBJECTIVE: To determine factors that influence breast cancer patients' intentions to supplement with CoQ10. METHODS: A survey based upon the expanded rational expectations intentions model was completed by breast cancer outpatients (N=160). RESULTS: A significantly positive relationship existed between referent other (the influence specific people have in terms of an individual's behavior) and subjective norm (subject's perception of how people view a behavior). Beliefs, referent other, attitude, and subjective norm did have a significant effect on intention to use CoQ10. CONCLUSIONS: Health practitioners may address supplementation with breast cancer patients with a better understanding of what factors impact supplement use.     

Hygienic food handling behaviours. An application of the Theory of Planned Behaviour

It is estimated that 5.4 million Australians get sick annually from eating contaminated food and that up to 20% of this illness results from food handling behaviour. A study was undertaken to investigate the efficacy of the Theory of Planned Behaviour (TPB) including past behaviour in predicting safe food handling intention and behaviour. One hundred and nine participants completed questionnaires regarding their attitudes, perceived behavioural control (PBC), subjective norm, intentions and past behaviour. Behaviour was measured 4 weeks later. The TPB predicted a high proportion of variance in both intentions and behaviour, and past behaviour/habit was found to be the strongest predictor of behaviour. The results of the present study suggest interventions aimed at increasing safe food handling intentions should focus on the impact of normative influences and perceptions of control over their food handling environment; whereas interventions to change actual behaviour should attempt to increase hygienic food handling as a habitual behaviour.     

Embedding Health Messages into Entertainment Television: Effect on Gay Men's Response to a Syphilis Outbreak

ABSTRACT

The entertainment education (EE) approach seeks to impact audiences' health behavior by embedding messages in mass media productions, storylines, and characters that appeal strongly to them. Effect on behavioral intentions was examined following a storyline about syphilis in men who have sex with men (MSM) presented in a popular dramatic series.

Five hundred and one MSM drawn from gay Internet chat rooms completed the questionnaire. Differences in item responses between those who did and did not view the syphilis storyline were calculated, and linear regression was used to examine predictors of intentions to take action.

Those who viewed the syphilis storyline were more likely to report intention to get screened and to tell others to get screened for syphilis. Seeing the episode was a predictor of these intentions. Education was also a predictor of intention to tell others to get screened.

Results suggest that exposure to a storyline about syphilis in gay men had a positive public health outcome on users of Internet chat rooms for MSM. Further studies are warranted to examine the extent to which and how the EE approach can produce health-relevant outcomes for U.S. populations, just as the approach has done in the developing world.     

An application of the integrative model to women's intention to be vaccinated against HPV: implications for message design

Human papillomavirus (HPV) is the only definitively identified causal agent of cervical cancer. Given the availability of a vaccine that is effective against the two strains of HPV most commonly associated with cervical cancer, understanding the factors that influence women's decision to be vaccinated is crucial to uptake. Fishbein's (2000 ) integrative model of behavior provided theoretical guidance for a Web-based survey of college women (n=174). Taken together, attitude, subjective norm, and perceived control predicted intention to vaccinate at R=.83, with attitude being the strongest single predictor by a factor of 2. However, attitude and subjective norm interacted with perceived control such that both were more potent predictors of intention at higher levels of control. These results suggest modification of the integrative model. Attention to the beliefs that underlie attitude revealed that the best candidates for change were feelings of security regarding future health and certainty that the vaccine will provide protection. The findings are discussed in terms of their implications for health education.     

Entertainment-education and recruitment of cornea donors: the role of emotion and issue involvement

This study examined the role of emotional responses and viewer's level of issue involvement to an entertainment-education show about cornea donation in order to predict intention to register as cornea donors. Results confirmed that sympathy and empathy responses operated as a catalyst for issue involvement, which emerged as an important intermediary in the persuasion process. Issue involvement also was found to be a common causal antecedent of attitude, subjective norm, and perceived behavioral control, the last two of which predict intentions unlike attitude, which does not. The revised path model confirmed that involvement directly influences intention. The findings of this study suggest that adding emotion and involvement in the Theory of Planned Behavior (TPB) enhances the explanatory power of the theory in predicting intentions, which indicates the possibility of combining the Elaboration Likelihood Model (ELM) and the TPB in the prediction of human behaviors.     

Influences on intention to reduce dietary intake of fat and sugar

A theoretical understanding of factors influencing nutrition behavior can potentially enhance the effectiveness of educational strategy design. This cross-sectional study used the Ajzen and Fishbein theory of reasoned action to examine specific factors influencing intentions to reduce dietary intake of fat and sugar (“dieting”). A questionnaire was developed to measure belief, value and social influences on intention to reduce fat and sugar intake; the behavioral intention (BI) to reduce fat and sugar intake; and current self-reported fat and sugar restriction. The subjects were university health and non-health majors. Regression analysis revealed that both subjective norms and attitudes toward the behavior predicted the subject's intention to reduce fat and sugar intake. For health majors, the attitude toward the behavior was more influential in predicting BI; for the non-health majors, the subjective norm was more important. Those reporting current restriction of fat and sugar intake also had significantly more positive behavioral beliefs about health benefits than those not reporting restriction. Implications for the development of educational programs include the importance of identifying primary motivational factors (attitudes or social influences), and specific belief and value perceptions for intervention in targeted populations.     

Psychosocial Predictors of Human Papillomavirus Vaccination Intentions for Young Women 18 to 26: Religiosity,Morality, Promiscuity,and Cancer Worry

ObjectivesTo determine whether five psychosocial variables, namely, religiosity, morality, perceived promiscuity, cancer worry frequency, and cancer worry severity, predict young women's intentions to receive the human papillomavirus (HPV) vaccination.MethodsFemale undergraduate students (n = 408) completed an online survey. Questions pertaining to hypothesized predictors were analyzed through bivariate correlations and hierarchical regression equations. Regressions examined whether the five psychosocial variables of interest predicted intentions to vaccinate above and beyond controls. Proposed interactions among predictor variables were also tested.ResultsStudy findings supported cancer worry as a direct predictor of HPV vaccination intention, and religiosity and sexual experience as moderators of the relationship between concerns of promiscuity reputation and intentions to vaccinate. One dimension of cancer worry (severity) emerged as a particularly robust predictor for this population.ConclusionsThis study provides support for several important, yet understudied, factors contributing to HPV vaccination intentions among college-aged women: cancer worry severity and religiosity. Future research should continue to assess the predictive contributions of these variables and evaluate how messages and campaigns to increase HPV vaccination uptake can utilize religious involvement and worry about cancer to promote more effectively HPV vaccination as a cancer prevention strategy.