The theory of planned behaviour and binge drinking: Assessing the moderating role of past behaviour within the theory of planned behaviour

A sample of 398 undergraduate students completed questionnaires assessing the main constructs of the theory of planned behaviour (TPB) in relation to binge drinking, as well as past binge drinking behaviour. Of these, 273 were followed up at 1 week. Regression analyses revealed attitude, self‐efficacy, and perceived control (negative relationship) to be predictive of binge drinking intentions. Intention and self‐efficacy were, in turn, predictive of binge drinking at 1‐week follow‐up. Past behaviour was found to explain additional variance in intention and behaviour. In addition, past behaviour was found to moderate the attitude–intention and intention–behaviour relationships, such that weaker relationships were observed with increasing frequency of past behaviour. The results are discussed in relation to the need to develop and test alternative measures of habit. The implications of the findings for interventions to encourage more appropriate drinking behaviour are outlined.     

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.     

Determinants of condom use among a random sample of single heterosexual adults

Objectives. The aim of this study was to identify the determinants of single heterosexuals' use of condoms during each sexual intercourse. Design. Cohort of individuals followed over a period of 2 years. Methods. Respondents were 574 single heterosexual individuals who answered questions during a telephone interview. Results. Attitude, perceived behavioural control, self‐efficacy and moral norm explained 65% of the variance in intentions to use condoms (p <.0001). The determinants of condom use at 1 year follow‐up (27% explained variance) were perceived behavioural control, past behaviour, and the interaction between intention and intention stability. At 2 years follow‐up, the significant determinants were past behaviour and intention by intention stability. In the present study, intentions to use condoms which remained stable across time were strong predictors of condom use (at 1 year: β=.42, p <.0001; at 2 years: β=.39, p <.003), while unstable intentions were not (at 1 year: β=.02, ns; at 2 years: β=.19, ns). Conclusion. Intention stability is a major determinant of the accuracy of intention for the prediction of subsequent behaviour.     

Deciding to exercise: The role of anticipated regret

Objectives: Two studies tested (a) whether anticipated regret (AR) qualifies as an additional predictor of intentions to engage in a health‐enhancing behaviour (exercise) after variables from the Theory of Planned Behaviour (TPB) and past behaviour have been controlled, and (b) whether a manipulation that induces participants to focus on AR causes stronger intentions to exercise. Design: Study 1 employed a cross‐sectional questionnaire design; Study 2 employed a between‐participants experimental design (AR focus vs. no AR focus). Method: Participants (N = 385) completed standard, multi‐item, reliable measures of TPB constructs and AR and also reported their past behaviour (Study 1). Participants in Study 2 (N = 70) completed measures of AR and intention; salience of AR was manipulated by means of item order. Results: Study 1 showed that even though TPB variables and past behaviour were reliable predictors of intention, and explained 51% of the variance, AR contributed a substantial increment in the variance (5%) even after these predictors had been taken into account. Study 2 showed that participants who were induced to focus on AR prior to intention formation had significantly stronger intentions to exercise compared to controls. Conclusion: The findings indicate that AR predicts a health‐enhancing behaviour (as well as the health‐risk behaviours examined in previous research) and that effects of AR are independent of TPB variables and past behaviour. The findings also indicate that a simple and inexpensive manipulation of the salience of AR can be used to promote exercise intentions.     

The impact of social influence on adolescent intention to smoke: Combining types and referents of influence

Objectives Theory and research suggest that the intention to smoke is the main determinant of smoking initiation and emphasizes the role of cognitive and social factors on the prediction of the intention to smoke. However, extended models such as the I‐Change and results from published studies reveal inconsistencies regarding the impact of social influence on the intention to smoke. Possible explanations for this may be the definition and measurement of the constructs that have been used. Design and methods The current study was designed with two main goals: (i) to test a measurement model for social influence, combining different types of social influence (subjective norms, perceived behaviour, and direct pressure) with various referents of influence (parents, siblings, peers, and teachers); (ii) to investigate the impact of social influence on adolescent intention to smoke, controlling for smoking behaviour. LISREL was used to test these models. The sample includes 3,064 Portuguese adolescents, with a mean age of 13.5 years, at the beginning of the seventh school grade. Results The hypothesized measurement model of social influence was supported by results and explained 29% of the variance of the intention to smoke. A more extended model, including attitude and self‐efficacy, explained 55% of the variance of the intention to smoke. Perceived behaviour of peers, parental norms, and perceived behaviour of parents were the social influence factors with impact on adolescent intention to smoke. Conclusions Results suggest that different referents exert their influence through distinct types of social influence and recommend further work on the definition and measurement of social influence.     

Predicting breakfast consumption: An application of the theory of planned behaviour and the investigation of past behaviour and executive function

Objectives . The objective of the current study is to examine the determinants of breakfast consumption with the application of the Theory of Planned Behaviour (TPB; 1991) and investigate the additional variables of past behaviour and executive function. Design . A prospective 1‐week study investigating the predictive ability of TPB variables, past behaviour and executive function was utilized. Methods . Ninety‐six participants were administered two measures of executive function (response inhibition and planning) and completed self‐report questionnaires regarding their attitudes, subjective norms, perceived control, intentions and past behaviour of breakfast consumption. One week later, participants returned a follow‐up questionnaire on their behaviour. Results . The result of the study showed that the TPB significantly predicted intentions and prospective behaviour of breakfast consumption, however, past behaviour was found to be the strongest predictor of future behaviour. Considering executive function, response inhibition was not found to predict behaviour, however, planning ability explained unique variance in behaviour and moderated the association between intention and behaviour. Conclusions . The findings support the use of the TPB in explaining breakfast eating habits, and suggest that executive function of planning may be somewhat useful to predict this behaviour. The significance of past behaviour also suggests that breakfast consumption may commonly be a stable, habitual behaviour that may undermine the need for self‐regulation. Implications for creating behavioural‐change interventions are discussed.     

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.     

Self-regulation following prostatectomy: phase-specific self-efficacy beliefs for pelvic-floor exercise

Objective. Beliefs in one's ability to perform a task or behaviour successfully are described as self‐efficacy beliefs ( Bandura, 1977 ). Since individuals have to deal with differing demands during a behaviour‐change process, they form phase‐specific self‐efficacy beliefs directed at these respective challenges. The present study, based on the Health Action Process Approach ( Schwarzer, 2001 ), examines the theoretical differentiation, relative importance, and differential effects of four phase‐specific self‐efficacy beliefs, including task self‐efficacy, preactional self‐efficacy, maintenance self‐efficacy, and recovery self‐efficacy. Design. In a prospective longitudinal study, 112 prostatectomy‐patients received questionnaires at 2 days, 2 weeks, 1 month, and 6 months post‐surgery. Methods. Participants provided data on phase‐specific self‐efficacies as well as phase indicators of health‐behaviour change, that is, intentions, planning, and pelvic‐floor exercise. Hierarchical regression analyses were conducted to test the study hypotheses. Results. Task self‐efficacy was not uniquely associated with intentions. Preactional self‐efficacy was related to action planning. Maintenance self‐efficacy did not predict behaviour. Recovery self‐efficacy was associated with re‐uptake of pelvic‐floor exercise after relapses only. Conclusion. Findings underline the importance of differentiating between task self‐efficacy and preactional self‐efficacy during early phases of behaviour change as well as of considering the occurrence of relapses as a moderator of potential effects of recovery self‐efficacy on the maintenance of behaviour change. Advanced knowledge on distinct, phase‐specific self‐efficacy beliefs may facilitate the design of effective tailored interventions for behaviour change.     

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.     

Stages of motivational readiness for physical activity: A comparison of different algorithms of classification

Objective: The aim of this study was to compare two approaches to classify individuals into stages of motivational readiness for physical activity and test which one was better explained by attitude and perceived behavioural control, as defined by Ajzen (1991). Design: A survey of 20430 respondents from a population‐based sample. Methods: The relevant variables were assessed in a self‐administered questionnaire. The cluster approach consisted of combining both intention and behaviour in order to determine clusters of individuals; such clusters correspond to different stages of motivational readiness. The stage of change (SC) approach consisted of grouping the same individuals by using the SC variable of the Transtheoretical Model (TTM). Results: The SC and cluster‐solution approaches were replicated across four subsamples of the total number of respondents. Attitude and perceived behavioural control were more strongly associated with stage membership derived from four‐cluster solution than with stage membership in the five categories assessed by the SC method. Conclusion: Stage of motivational readiness for physical activity, and possibly for other health‐related behaviours, may usefully be characterized when both recent past behaviour and intention in the near future are simultaneously and explicitly taken into consideration.     

Decision‐making about the use of hormone therapy among perimenopausal women

Objectives. Women reaching menopause must make a controversial decision about whether to use hormone therapy (HT). The theory of planned behaviour (TPB) was the organizing framework. The objectives were to determine if (1) influence of different TPB constructs varied with stage of menopause and HT use, (2) women with diabetes were influenced in significantly different ways from women without, (3) the overall perceived behavioural control (PBC) and self‐efficacy (SE) have independent effects on intention, and (4) physician influence was mediated by subjective norm (SN). Design. Cross‐sectional survey of women from a managed care organization. Methods. Multiple regression analysis was used to analyse 765 responses (230 from women with diabetes) and separately four main subgroups: (1) early menopause stage and never used HT, (2) late menopause stage and never used HT, (3) late menopause stage and previously used HT, and (4) late menopause stage currently using HT. Results. For the entire sample, the model explains 68% of variance in intention, where SE, physicians' influence, self‐identification with menopause as a natural part of ageing, self‐identification as someone who wants to delay menopause, HT status, menopause status, and diabetes were added to the TPB. For the entire sample, SE added 2% to the explained variance and the physician determinant added 7%. Conclusions. An augmented TPB is useful for understanding women's HT use decisions. The theory explains more variance in intention before a behaviour is enacted than after, and decision structure changes over time. PBC and SE have independent effects on intention.     

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.     

Understanding young and older male drivers' willingness to drive while intoxicated: The predictive utility of constructs specified by the theory of planned behaviour and the prototype willingness model

Objective. The present study examined the predictive utility of constructs specified by the theory of planned behaviour (TPB) and prototype willingness model (PWM) for young and older male drivers' willingness to drive while intoxicated. Design and methods. A cross‐sectional questionnaire was employed. Two hundred male drivers, recruited via a street survey, voluntarily completed measures of attitude, subjective norm, perceived behavioural control, prototype perceptions, and willingness. Results. Findings showed that the TPB and PWM variables explained 65% of the variance in young male drivers' willingness and 47% of the variance in older male drivers' willingness, with the interaction between prototype favourability and similarity contributing 7% to the variance explained in older males' willingness to drive while intoxicated. Conclusions. The findings possess implications for theory, research, and anti‐drink driving campaigns.     

Using past behaviour and spontaneous implementation intentions to enhance the utility of the theory of planned behaviour in predicting exercise

Objectives. This study examined the utility of the theory of planned behaviour (TPB), past behaviour, and spontaneous implementation intentions in predicting exercise behaviour. The psychological correlates of spontaneous implementation intentions and the moderating effects of intention, perceived behavioural control, past behaviour, and implementation intentions at various time points were also examined. Design. Data collection occurred over three phases with a 2‐ and 3‐week interval. The attrition rate was 35.97% leaving a total of 162 participants (63 males, 99 females). In the first wave, participants completed measures of TPB, spontaneous implementation intentions, and past behaviour. Behaviour was assessed in the second and third waves, and a follow‐up measure of spontaneous implementation intentions was completed in Phase 3. Results. Several regression analyses were conducted. Attitude towards exercise and perceived behavioural control made a significant contribution to the prediction of intention. Intention made a significant contribution to the prediction of implementation intentions. Spontaneous implementation intentions reduced the effect of intention and past behaviour for behaviour at 2 weeks and when indexed over a 5‐week period. When behaviour was measured for a 3‐week period (following an initial 2‐week period), the variance that intention and past behaviour accounted for in exercise behaviour decreased, and spontaneous implementation intentions were no longer a significant predictor of behaviour. Spontaneous implementation intentions were found to interact with past behaviour, such that implementation intentions predicted exercise behaviour only among participants who did not exercise frequently in the past. Conclusions. Implications and future research directions are discussed.     

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.     

With a little help from my goals: Integrating intergoal facilitation with the theory of planned behaviour to predict physical activity

Objective . Integration of a multiple goal theory approach into the theory of planned behaviour (TPB) to investigate how the perceived facilitating and conflicting relationships in multiple goal pursuit predict performance of a health‐related behaviour. Design . Prospective design with 8‐week follow‐up. Methods . At baseline, perceived intergoal facilitation and intergoal conflict were measured using personal projects analysis supplemented with standard TPB measures for physical activity (PA). Self‐reported PA was measured at follow‐up 8 weeks later. N=137 participants completed measures at both time points (55.4% response rate at follow‐up). Results . Hierarchical regression showed that perceived intergoal facilitation, but not intergoal conflict, directly predicted PA beyond intention and perceived behavioural control (PBC), accounting for more than 4% of additional variance in PA. Intergoal facilitation had an indirect effect on intention through attitude and PBC, and intention partially mediated the effect of intergoal facilitation on behaviour. Conclusion . The perceived facilitating effect of pursuing other personal goals predicts the performance of a health‐related behaviour over and above single behaviour‐focused social cognitions.     

The theory of planned behaviour predicts self‐reports of walking,but does not predict step count

Objectives. This paper compares multiple measures of walking in two studies, and the second study compares how well Theory of Planned Behaviour (TPB) constructs perform in predicting these different measures. Methods. In Study 1, 41 participants wore a New Lifestyles NL‐2000 pedometer for 1 week. Subsequently, participants completed a questionnaire containing measures of the TPB constructs and two self‐report measures of walking, followed by two interview measures of walking. For Study 2, 200 RAF trainee aircraftsmen wore pedometers for 2 weeks. At the end of each week, participants completed the questionnaire and interview measures of walking. Results. Both studies found no significant association between questionnaire measures of walking and pedometer measures. In Study 1, the interview measures produced significant, large correlations with the pedometer measure, but these relationships were markedly weaker in the second study. TPB variables were found to explain 22% of variance in intention to walk in Study 1 and 45% of the variance in Study 2. In Study 2, prediction of subsequent measures of behaviour was found to be weak, except when using a single‐item measure of walking. Conclusions. Recall of walking is poor, and accurate measurement by self‐report is problematic. Although the TPB predicts intentions to walk well, it does not predict actual amount of walking, as assessed by pedometer. Possible reasons for these findings include the unique nature of walking as an activity primarily used to facilitate higher order goals. The use of single‐item measures may exaggerate the effectiveness of the TPB model for walking, and possibly other forms of physical activity.     

Habit, identity, and repetitive action: a prospective study of binge-drinking in UK students

Objectives. Repeated action can lead to the formation of habits and identification as ‘the kind of person’ that performs the behaviour. This has led to the suggestion that identity‐relevance is a facet of habit. This study explores conceptual overlap between habit and identity, and examines where the two constructs fit into an extended Theory of Planned Behaviour (TPB) model of binge‐drinking among university students. Design. Prospective, questionnaire‐based correlational design. Methods. A total of 167 UK university students completed baseline measures of past behaviour, self‐identity, the Self‐Report Habit Index (SRHI), and TPB constructs. One week later, 128 participants completed a follow‐up behaviour measure. Results. Factor analyses of the SRHI and four identity items revealed two correlated but distinct factors, relating to habit and identity, respectively. Hierarchical regression analyses of intention and behaviour showed that identity contributed over and above TPB constructs to the prediction of intention, whereas habit predicted behaviour directly, and interacted with intentions in predicting behaviour. Habits unexpectedly strengthened the intention–behaviour relation, such that strong intenders were more likely to binge‐drink where they also had strong habits. Conclusions. Identity and habit are conceptually discrete and impact differently on binge‐drinking. Findings have implications for habit theory and measurement. Recommendations for student alcohol consumption reduction initiatives are offered.