Self-conscious emotions and self-regulation in the promotion of condom use

Two prospective studies examined the self-regulatory role of anticipated negative self-conscious emotions (ANSCE) in the theory of planned behavior. In Study 1, 147 undergraduates reported condom attitudes, perceived norms, self-efficacy, ANSCE (shame and guilt) should they not use condoms, and intentions to use condoms during the coming 6 weeks. At a 6-week follow-up, ANSCE predicted condom use intentions and behavior and partially mediated the effect of attitudes and norms on both. Study 2 experimentally tested the social nature of self-consciousness in ANSCE; 61 female undergraduates read a scenario priming the private-self or social-self or were assigned to a no-scenario control. They reported condom attitudes, perceived control, ANSCE, condom use intentions, and a 6-week follow-up. ANSCE again predicted condom use intentions. A test of moderated mediation indicated that ANSCE influenced condom intentions more in the social-self condition than in the control condition. Implications of these findings are discussed.     

Today I'll use a condom, but who knows about tomorrow: a daily process study of variability in predictors of condom use

OBJECTIVE: Most models of health behavior change applied to condom use behavior have focused on individual differences in theoretical constructs to explain condom use or nonuse, while ignoring the possibility that day-to-day within-person changes in these constructs may contribute to understanding behavior. The goal of the present study was to investigate day-to-day variability in condom use attitudes, self-efficacy, and behavioral intentions and assess the utility of this variability in predicting the likelihood of condom use each day. DESIGN: A 30-day Web-based structured daily diary was used to collect daily reports of sexual behaviors and data on theoretical predictors of condom use behavior from sexually active college students (N = 116). MAIN OUTCOME MEASURES: The authors investigated whether condom use attitudes, self-efficacy, and behavioral intentions vary day to day; whether this within-person variability predicts condom use behavior; and whether negative affective states explain this variability. RESULTS AND CONCLUSIONS: Within-person variability was found for each of the constructs. Within-person day-to-day changes in behavioral intentions and attitudes predicted the instances in which an individual used a condom and daily negative affect partially explained within-person day-to-day changes in behavioral intentions and self-efficacy. Implications for models of health behavior change and for behavior change interventions are discussed.     

Predicting changes in teenage drug use: the role of intention-behavior discrepancy

This research investigated the role of intention-behavior discrepancy in predicting changes in drug use by American teenagers. The tested behavior included drinking alcohol, smoking cannabis, and taking hard drugs. Data were collected from 1,177 young adolescents at two time points separated by one year. Two sets of analysis were performed--a multitrait-multimethod latent variable model and longitudinal analyses. The results of longitudinal analyses indicated that, although young adolescents were legally and socially prohibited from engaging in drug-taking activities, some of them intended to use drugs. This discrepancy between behaviors and intentions decreased neither drug-taking behaviors nor intentions to use drugs over time; on the contrary, it increased adolescents' illegal drug use and intention to engage in such behaviors as predicted by Brehm's reactance theory. This discrepancy factor was a better predictor of later drug-taking behavior and positive intentions to use drugs than early intentions alone. The best predictor of later behavior and intentions was prior drug use.     

Incorporating adolescent females' perceptions of their partners' attitudes toward condoms into a model of female adolescent condom use

The highest rates of sexually transmitted infections in the U.S. occur among adolescent females. One prevention strategy promoted for sexually active adolescents is condom use: therefore, influences on correct and consistent condom use are worth examining. Because interventions and observational research into predicting and increasing condom use have yielded mixed results, we hypothesized that a theoretically driven model incorporating female adolescents' perceptions about partner sentiments along with their own perceptions, intentions, and behaviours would improve condom use predictions. We also measured condom use errors and consistency for a more precise estimate of effective use than is common in the literature. In three structural equation models tested on a sample of 519 female adolescents, we found that intentions were associated with both correct and consistent condom use; that females' expectancy beliefs about condom use were associated with intentions; and that females' expectancy beliefs about partners' sentiments reduced the impact of their expectancy beliefs about condom use. The implications of these relations upon condom use correctness and consistency are discussed with respect to informing interventions, among other future research.     

Application of the Theory of Planned Behavior to Adolescents’ Condom Use: A Panel Study1

The authors report a longitudinal study of factors determining use of condoms with new sexual partners in a representative sample of 650 German youth. Measures derived from the theory of planned behavior (Ajzen, 1985) were obtained in 2 waves separated by 1 year. Consistent with the theory, intentions to use condoms could be predicted from attitudes, subjective norms, and perceived behavioral control with respect to this behavior; and actual condom use was strongly related to intentions and perceptions of control assessed in Wave 2. Due to changes in beliefs and attitudes over time, only about 10% of the variance in reported condom use was accounted for by intentions and perceived control assessed 1 year earlier. Reported condom use was found to exert a direct effect on later intentions, unmediated by their hypothesized antecedents. Theoretical and practical implications of these findings are discussed.     

Having Casual Sex: Additive and Interactive Effects of Alcohol and Condom Availability on the Determinants of Intentions

The impact of alcohol, condom availability, and gender on intentions to engage in casual sex and its antecedents was investigated. Students ( N = 384) who were or were not intoxicated with alcohol completed measures based on the theory of planned behavior (TPB) in relation to having casual sex in a scenario. The scenario described sex between 2 individuals not in a relationship and manipulated the consumption of alcohol of the sexual partners and availability of condoms. The data were supportive of the TPB: Intentions were predictable from attitudes, subjective norms, and perceived behavioral control (PBC). Results also support the inclusion of measures of past behavior and anticipated affective reactions, but not self-identity or moral norms as predictors of intentions. Alcohol in the scenario and condom availability increased intentions to have sex. There were also several interaction effects. Implications for using the TPB to understand sexual behaviors under the influence of alcohol are discussed.     

The influence of significant others on attitudes, subjective norms and intentions regarding dietary supplement use among adolescent athletes

Dietary supplement use has increased significantly over the past decade. The use of supplements among adolescents seems to be influenced by their beliefs and attitudes. The influence of coaches, parents, and athletic trainers also may be important. The purpose of this study was (1) to determine whether attitudes are a better predictor of adolescents' intentions to use dietary supplements than are subjective norms, and (2) to assess the influence of significant others (coaches, parents, and trainers) on attitudes, subjective norms, and intentions among adolescent athletes. Adolescents (N = 1,626) who were enrolled in grades six through twelve in nine public schools completed a self-report questionnaire that measured attitudes, subjective norms, and intentions regarding dietary supplement use. Results indicated that attitudes were a better predictor of intentions to use dietary supplements than were subjective norms. It was also found that trainers had more influence on the attitudes, subjective norms, and intentions of adolescents regarding supplement use than did parents and coaches. Implications for prevention are addressed.     

Theories of reasoned action and planned behavior as models of condom use: a meta-analysis

To examine how well the theories of reasoned action and planned behavior predict condom use, the authors synthesized 96 data sets (N = 22,594) containing associations between the models' key variables. Consistent with the theory of reasoned action's predictions, (a) condom use was related to intentions (weighted mean r. = .45), (b) intentions were based on attitudes (r. = .58) and subjective norms (r. = .39), and (c) attitudes were associated with behavioral beliefs (r. = .56) and norms were associated with normative beliefs (r. = .46). Consistent with the theory of planned behavior's predictions, perceived behavioral control was related to condom use intentions (r. = .45) and condom use (r. = .25), but in contrast to the theory, it did not contribute significantly to condom use. The strength of these associations, however, was influenced by the consideration of past behavior. Implications of these results for HIV prevention efforts are discussed.     

Health beliefs and teenage condom use: a prospective study

The authors investigated the extent to which Health Belief Model (HBM) measures can be used to predict subsequent sexual activity and consistency of condom use among teenagers, especially those who report having new sex partners. Results from a longitudinal survey of sex behavior and HIV-relevant cognitions among 258 sexually active 16 and 18 year olds in Dundee, Scotland, are reported. Participants responded to a confidential postal questionnaire on their demographic characteristics, previous sexual experience, prior condom use, beliefs specified by the HBM, peer norms regarding condom use, and condom use intentions. Measures of sexual behavior and condom use consistency were then included in a follow-up questionnaire 1 year later. Demographic and HBM measures, as determined through discriminant analysis, did not account for significant proportions of variance in the consistency of condom use or mediate the effects of prior sexual experience or demographic measures. The respondents who reported more frequent sexual intercourse were less likely to use condoms consistently while those who had used condoms previously reported more consistent use. Female respondents were less likely than the young men to follow through upon their intentions to consistently use condoms.     

Adolescents' self-efficacy to communicate about sex: its role in condom attitudes, commitment, and use

This study examined whether and how self-efficacy to communicate with parents and peers about sex relate to sexually experienced adolescent males' and females' (N= 144, 112) condom attitudes, intentions, and use. Results showed that males who reported greater self-efficacy to communicate with parents used condoms more frequently; and both males and females who can communicate with peers used condoms more frequently. Self-efficacy to communicate with peers was related to more positive condom attitudes, which in turn were associated with greater condom commitment and use. Greater ability to communicate with parents was also related to greater condom commitment and use among males. These results suggest the importance of designing interventions that give adolescents the skills they need to feel efficacious in their ability to communicate about sex and contraception.     

Sexual Self‐Control and Male Condom‐Use Outcome Beliefs: Predicting Heterosexual Men's Condom‐Use Intentions and Behavior1

A model of condom‐use intentions and behavior that we previously developed for women was replicated and extended with heterosexual men (n= 203; M age = 20.1 years). The general determinants of intentions to use condoms were consistent for men and women. The predictors of general condom attitudes and condom‐use self‐efficacy differed across gender. Male condom‐use outcome beliefs and sexual self‐control emerged as predictors of sexually experienced men's condom attitudes and self‐efficacy, respectively. In a 3‐month follow‐up, intentions and sexual self‐control predicted condom‐use behavior. These findings have implications for specificity vs. generality in the correlates of common behaviors across groups, the study of gender differences in condom use, and the development of intervention content targeted to specific populations.     

Improving condom use intentions and behavior by changing perceived partner norms: an evaluation of condom promotion videos for college students.

OBJECTIVE: To examine the effectiveness of 2 condom promotion videotapes on self-efficacy, intentions, and behavior. DESIGN: Two hundred twenty college students completed social-cognitive and behavioral measures and were then randomly assigned to receive one of two 30-min condom promotion videotapes (male or female student presenters) or to a wait-list control condition. Participants who watched 1 of the videotapes completed immediate posttest measures, and 85% of participants completed a 4-month follow-up. MAIN OUTCOME MEASURES: Self-efficacy for condom use, intentions to use condoms, use of condom during last sex, and consistent condom use over the last month. RESULTS: Participants who received either video reported greater self-efficacy to refuse to have unprotected sex and intentions than controls at follow-up. Individuals who received either video were more likely than controls to report using a condom during last sex with a regular partner, and those who watched the female presenter were more likely to report consistent condom use. CONCLUSION: Participants benefited in terms of self-efficacy and intentions from receiving either video, but both men and women benefited more in terms of condom use behavior from receiving the female video. Future research is needed to determine whether opposite-sex speaker videos could be beneficial with a larger (and more sexually active) sample and whether these effects are maintained over time.     

Determinants of Condom Use Among High-Risk Heterosexual Adults: A Test of the Theory of Reasoned Action1

The research presents tests of traditional and augmented versions of Fishbein and Ajzen's Theory of Reasoned Action (TRA), applied to condom use among adult clients of a sexually transmitted disease clinic. In a longitudinal survey, predictor variables suggested by Ajzen and Fishbein (1980), plus gender and condom use self-efficacy, were measured at Time 1. Condom use at Time 2, 3 months later, was regressed onto these variables. The traditional TRA worked well to predict condom use intentions and behavior. Support was also found for inclusion of gender and self-efficacy in the prediction of intention to use condoms, but not behavior. Implications for interventions to increase condom use among those at high risk for AIDS and other STDs are discussed.     

Justify your love: testing an online STI-risk communication intervention designed to promote condom use and STI-testing

The efficacy of a tailored, web-based intervention communicating the risks of sexually transmitted infections (STI) for heterosexual young adults was examined in a randomised, controlled trial. The main aims of the relationship-oriented intervention were to influence risk perceptions and to promote (maintenance of) condom use and STI-testing among young adults who reported being recently engaged in a heterosexual relationship. The intervention addressed risk perceptions, attitudes, normative beliefs, self-efficacy and skills related to condom use and STI-testing. Outcomes were compared immediately after the intervention (N = 171) and 3 months later (N = 115) to a non-tailored intervention group and to a control group. Cognitive and behavioural outcomes showed that the tailored intervention was efficacious in influencing perceived susceptibility to STI and STI-testing intentions immediately after the intervention, and in reducing rates of unprotected sex at 3 months.     

Predicting intention to use condoms in homosexual men: an application and extension of the theory of reasoned action

A questionnaire based upon the Theory of Reasoned Action was developed and tested to identify predictors of intention to use condoms. Behavioral intentions, attitudes and subjective normative beliefs, behavioral norms, and age of HIV-positive status were included on the questionnaire. Internal consistency of the four components was high, with Cronbach's alpha coefficients of 0.76-0.87. Qualitative data were collected over 2 months from 194 homosexual men who participated in Sydney's homosexual community. Participants aged 17-64 years of mean age 29.5 attended individual interviews or small focus groups to discuss their views concerning condom use. 15% reported having tested HIV-positive, 59% tested negative, and 26% reported not knowing their HIV serostatus. According to logistic modeling, the significant predictors of intentions to use a condom were attitudes and behavioral norms, while HIV antibody positive status and age directly influence behavioral intentions to use a condom. About 50% of men over age 25 years intended to use a condom, irrespective of HIV status. Overall, 59% of men aged 25 years and younger intended to use a condom; 22% of HIV-positive men and 63% of HIV-negative men.     

Condom use among US students: the importance of confidence in normative and attitudinal perceptions

The author performed a study among U.S. undergraduates to test an earlier conclusion (D. Trafimow, 1994) that confidence in the correctness of one's perceptions of normative pressure to use a condom influences the correspondence between those perceptions and the intentions actually to perform the behavior. Consistent with previous findings (Trafimow), the participants' perceptions of normative pressure strongly predicted their intentions to use condoms only under conditions of extreme normative confidence. Otherwise, their attitudes were better predictors of their intentions to use condoms. In addition, 2 other variables (attitudinal confidence and perceived behavioral control) were found to be unimportant predictors of intentions. Results of a 2nd study suggest that behaviors performed by sexual partners and knowing the sexual partners affected the participants' normative confidence.     

The theory of planned behavior and healthy eating.

Application of the theory of planned behavior (TPB) to healthy eating in 144 health promotion clinic attendees is reported. Respondents completed self-report TPB measures after the clinic (Time 1) and 6 months later (Time 2) with a measure of perceived past behavior. Intention stability was assessed on Time 1-2 differences. Six years later (Time 3), respondents completed measures of healthy eating intentions and behavior. Intentions were predicted by attitudes, perceived behavioral control, and perceived past behavior (cross-sectionally). Healthy eating behavior (Time 3) was predicted from intentions (Time 2). As intention stability increased, intentions and perceived past behavior became stronger and weaker predictors of behavior, respectively. Implications for understanding health cognitions in long-term performance of health behavior are discussed.     

Structure of outcome beliefs in condom use. The Project RESPECT Study Group.

To study the structure of beliefs about condom use outcomes, the authors derived and tested 4 psychosocial hypothetical models: (a) a 2-factor model of the personal and social outcomes of condom use; (b) a 2-factor model of the pros and cons of the behavior; (c) a 3-factor model (i.e., physical, self-evaluative, and social) of outcome expectancies; and (d) a thematic 4-factor model of the protection, self-concept, pleasure, and interaction implications of the behavior. All 4 models were studied with a confirmatory factor analysis approach in a multisite study of 4,638 participants, and the thematic solution was consistently the most plausible. Self-concept and pleasure were most strongly associated with attitudes toward using condoms, intentions to use condoms, and actual condom use, whereas protection and interaction generally had little influence.     

The relationship between attitude,assertiveness and condom use

The Australian study investigated condom-specific assertiveness and condom use as a means of prevention infection from sexually transmitted diseases. 211 men participated including 83 homosexual men (aged 19-62 years) and 128 heterosexual men (aged 17-49) who completed a questionnaire that comprised demographic details such as age, monogamy, and sexual activity as well as attitudinal and assertiveness measures. General assertiveness was measured by the Rathus Assertiveness Schedule (RAS) which had been widely used across a wide range of social situations. Assertiveness relating specifically to situations involving condoms was measured by the Condom Assertiveness Scale (CAS). Intention to use condoms was positively related to favorable attitudes, which were related to condom-specific assertiveness for both groups. For the heterosexual men only, general social assertiveness was negatively related to attitudes toward condoms. For both groups, the condom-specific measure of assertiveness was positively correlated with attitudes toward condoms. Condom-specific assertiveness was positively related to general social assertiveness as measured by the Rathus Assertiveness Schedule for the homosexual, but not for the heterosexual men. The negative relationship between general assertiveness and attitude to condoms among the heterosexual men implies that the risk reducing behavior of condom use did not seem to accord with the perceptions of masculinity and social assertiveness among heterosexual men. Thus, female partners of such heterosexual men exhibiting negative attitudes toward condom use combined with assertiveness would have to overcome resistance to insist on the use of condoms. Recently some advertising campaigns have been directed at women. The promotion of condom use among heterosexual men has to deal with the perceptions of condom use as unmasculine behavior.