The prediction of condom use intention among South African university students

A questionnaire was administered to 294 sexually active, unmarried undergraduate students to investigate the role of social norms in the prediction of the intention to use condoms. Components of social cognitive theory and the theory of reasoned action and planned behaviour were integrated with those of the Health Belief Model to predict future intention to use condoms with a new partner. Logistic regression analyses of selected risky sexual behaviours on the intention to use condoms showed that, among males, attitudes towards using condoms and the Health Belief Model component of perceived barriers predicted the intention to use condoms. The Health Belief Model component of perceived benefits could not be interpreted. Attitudes, subjective norms and perceived self-efficacy were associated with female students' intention to use condoms. Implications for strategies of HIV/AIDS prevention are discussed.     

Psychological Predictors of Condom Use to Prevent HIV Transmission Among Zimbabwean Students

Psychologists have much to contribute to HIV prevention. It is important to identify predictors of HIV preventive behaviour and to incorporate this information in AIDS education. The Health Belief Model is an established model of health behaviour that has recently been applied to AIDS prevention. It originally posited that perceptions of susceptibility to, severity of, and solutions to, illness predicted health behaviour. It thus emphasized “disease” dimensions of illness. It was expanded to include barriers to, cues to, and social support for, health behaviour. The enlarged model thus incorporated “social” dimensions of health behaviour. Because preventing AIDS involves a partner and considerable social risks and skills, inclusion of social components may improve the capacity of the Health Belief Model to predict HIV preventive behaviour. An inventory measuring condom use and the enlarged Health Belief Model was completed by 181 male and 171 female teacher-trainees. Data were analysed using multiple regression with hierarchical entry, first of disease dimensions (susceptibility, severity, solution), then social dimensions (barriers, cues, social support). Addition of social dimensions to the disease dimension equation yielded a significant F-change among both sexes and increased the variance explained from 16% to 30% among males, and from 4% to 14% among females. The full regression was significant only among males. The implications of these results for intervention goals, messages and strategies among both sexes are elucidated.     

Scaling satan

The influence on social behavior of beliefs in Satan and the nature of evil has received little empirical study. Elaine Pagels (1995) in her book, The Origin of Satan, argued that Christians' intolerance toward others is due to their belief in an active Satan. In this study, more than 200 college undergraduates completed the Manitoba Prejudice Scale and the Attitudes Toward Homosexuals Scale (B. Altemeyer, 1988), as well as the Belief in an Active Satan Scale, developed by the authors. The Belief in an Active Satan Scale demonstrated good internal consistency and temporal stability. Correlational analyses revealed that for the female participants, belief in an active Satan was directly related to intolerance toward lesbians and gay men and intolerance toward ethnic minorities. For the male participants, belief in an active Satan was directly related to intolerance toward lesbians and gay men but was not significantly related to intolerance toward ethnic minorities. Results of this research showed that it is possible to meaningfully measure belief in an active Satan and that such beliefs may encourage intolerance toward others.     

Psychosocial predictors of gay men's AIDS risk-reduction behavior.

Used psychosocial variables derived from the health belief model (Rosenstock, 1974), Bandura's (1986) self-efficacy framework, and protection motivation theory (Rogers, 1984) to predict self-reported AIDS risk-reduction behaviors in a sample of 389 homosexual men who participated in the Multicenter AIDS Cohort Study in Los Angeles and who knew their HIV antibody status. Hierarchical multiple regression analyses showed that self-efficacy, perceived risk, response efficacy, and prior sexual behavior accounted for approximately 70% of the variance in the total number of sexual partners and the number of anonymous partners over a 6-month interval, controlling for demographic variables, HIV antibody status, and presence of a primary partner. A logistic regression analysis showed that barriers to change predicted increased unprotected anal receptive intercourse over a 6-month interval, controlling for prior behavior. The relation of health beliefs to risk-reduction behavior was substantially different for HIV-seropositive men without primary partners than for other groups of gay men. Implications for interventions are discussed.     

Preventing childhood accidents in the home: Parental behavior to reduce household hazards

The parents of all children between 6 and 18 months in four Norwegian municipalities participated in an investigation to assess to what extent parents take actions to reduce household hazards their children are exposed to, and to identify factors associated with such behaviors. The Health Belief Model was used as a theoretical framework guiding the selection of variables. The results indicate that most parents take considerable action to reduce household hazards. The constructs derived from the Health Belief Model accounted for only a small part of the variance in parental behavior to reduce hazards in the home.     

Behavioral determinants of mothers' safety measures to prevent injuries of pre-school children

Home-related injuries are a major threat to pre-school children in the western world. In this study the behavioral determinants of 18 parental safety measures were assessed. To select behavioral determinants, the Attitude-Social influence-Self-efficacy/barriers model was used with the inclusion of variables from the Health Belief Model and the Protection Motivation Theory. A written questionnaire was completed by 1129 Dutch mothers of pre-school children. Most safety measures were explained (rather) well by the same set of determinants. Main determinants for adopting or not adopting a safety measure were the mother's belief in the necessity of the safety measure according to the child's age, her belief about her partner's opinion on the necessity and her belief about the success of taking the measure. Subsequent important determinants were the mother's belief about the inconvenience and instrumentality of the safety measure; the perceived susceptibility had a minor or moderate influence on most measures. This study did not indicate that more highly educated mothers were more knowledgeable about safety-related subjects. The theoretical implications of this study are discussed.     

Scaling Satan

The influence on social behavior of beliefs in Satan and the nature of evil has received little empirical study. Elaine Pagels (1995) in her book, The Origin of Satan, argued that Christians' intolerance toward others is due to their belief in an active Satan. In this study, more than 200 college undergraduates completed the Manitoba Prejudice Scale and the Attitudes Toward Homosexuals Scale (B. Altemeyer, 1988), as well as the Belief in an Active Satan Scale, developed by the authors. The Belief in an Active Satan Scale demonstrated good internal consistency and temporal stability. Correlational analyses revealed that for the female participants, belief in an active Satan was directly related to intolerance toward lesbians and gay men and intolerance toward ethnic minorities. For the male participants, belief in an active Satan was directly related to intolerance toward lesbians and gay men but was not significantly related to intolerance toward ethnic minorities. Results of this research showed that it is possible to meaningfully measure belief in an active Satan and that such beliefs may encourage intolerance toward others.     

Application of a modified health belief model to hiv preventive behavioral intentions among gay and bisexual men

Abstract

The utility of a modified health belief model (Janz and Becker, 1984) for predicting the intention to use condoms was tested in a study among gay and bisexual men. The model explained a reasonable amount of variance. It was found that younger men's decision to have safe sex was guided by factors other than those that influenced older men. Among younger men, the intention to use a condom was positively related to the relative number of persons with AIDS in their social environment (cues to action) and to the perceived benefits of HIV preventive behavior. Among older men, this behavioral intention was much more determined by their perception of the prevalence of HIV and by their perception of their vulnerability to HIV infection. These findings are important because they may partly explain the recent increase in AIDS-risk behavior among young gay and bisexual men. The discussion focuses on these findings and on the implications for interventions aimed at promoting safe sex.     

Health Behavior Theories and Research: Implications for Suicidal Individuals’ Treatment Linkage and Adherence

Treatment linkage and adherence to psychotherapeutic interventions can be challenging with suicidal individuals. Health behavior theories, specifically the Health Belief Model, Stages of Change, and Theory of Planned Behavior, focus on individuals' beliefs, their readiness to change, their perceptions of illness severity and "threat," their perceptions of significant others' attitudes toward illness and treatment, and their behavioral intentions to change. These constructs have relevance both for understanding suicidal individuals' behaviors related to treatment utilization and for understanding cultural variations in these behaviors. Furthermore, these theories have implications for clinical practices aimed at facilitating improved treatment follow-through and adherence. After describing the theories and their constructs, clinical examples are provided to illustrate applications to practice with suicidal individuals.     

Young adults' contraceptive practices: an investigation of influences

This study investigated young adults' contraceptive behaviors and attitudes through application of a comprehensive, theoretical framework. Specifically, a social-psychological approach to understanding preventive behaviors (e.g., contraceptive practices), was developed, incorporating the Health Belief Model and other factors, which offered a means for evaluating the extent to which contraceptive behaviors were influenced by individual and group characteristics. The study group consisted of 283 unmarried students at several schools who were, on average, 19 years of age. Results suggested that effective contraceptive behavior associated most strongly with respondents' perceiving relatively few barriers to their use of contraception, their maintenance of extensive interpersonal skills, and their regarding peer norms as consistent with effective contraceptive behavior. Findings also underlined a need for continuing education about sexuality and contraception. Dangerous misinformation prevailed regarding respondents' knowledge of areas that include anatomy, physiology, and appropriate use of effective contraceptive methods. Finally, results implied a need to consider broad behavioral, social, and interpersonal issues as they relate to young adults' effective contraceptive behavior. Future studies of contraceptive risk taking are encouraged to examine both individual and social factors affecting sexual and contraceptive practices if unplanned pregnancy is to be minimized, if not eliminated.     

Health beliefs,optimism, and health‐related decisions: A study with Hong Kong Chinese

T he Health Belief Model (HBM; Rosenstock, 1966) is the most widely used psychological theory of health‐related behaviours but its applicability to non‐Western, especially Asian, populations has not been systematically studied. The main objective of the current study was to examine the effects of components of the HBM and dispositional optimism on preventive intention in two separate samples of 220 Hong Kong Chinese adults and 340 Hong Kong Chinese adolescents. Two HBM variables, benefits and barriers, were experimentally manipulated for an imaginary flu outbreak and a hypothetical vaccine. Optimism in the two samples was assessed using the Chinese revised Life Orientation Test (Lai et al., 1998). Participants indicated their intention to take the hypothetical vaccine after reading information for each of the treatment combinations defined by the two HBM variables. The order of the presentation of each of the six treatment conditions was counterbalanced. Results of ANOVA showed that the effects of the two HBM variables were similar in the two groups. Higher benefits and lower barriers were associated with stronger behavioural intention to take the vaccine. The two HBM variables interacted significantly in the adolescent but not the adult sample. Among the adolescents, the difference in intention scores between low and high barriers became larger when the benefits of taking the vaccine increased. In addition, optimism had significant effect on preventive intention only among the adolescents. These findings suggest that age may be an important factor moderating the effects of HBM components as well as optimism on preventive intention in Hong Kong Chinese. Implications of these findings to future research among Chinese were discussed.     

Efficacy of the Health Belief Model for Predicting Intention to Pursue Genetic Testing for Colorectal Cancer

This study examined the Health Belief Model’s efficacy to predict intention to undergo genetic testing for the Colorectal Carcinoma (CRC) gene within a rural/frontier setting. Survey data were collected on 558 Southwest Montanan residents. Regression analysis revealed that perceived benefits, including affordability and satisfying curiosity, were the strongest indicators of intention to undergo genetic testing for CRC. Select consumer barriers and cues to action variables were also found to be significant predictors. Collectively the model explained approximately 36% of the variance. These preliminary findings have implications for genetic counselors, health practitioners and health care providers concerned with genetic counseling and addressing the public health issue of CRC.     

Understanding AIDS preventive behavior with casual and primary partners in homosexual men: The theory of planned behavior and the information-motivation-behavioral-skills model

Abstract

This study examined whether components from the Information-Motivation-Behavioral-Skills Model, in particular information, added explanatory power to factors derived from the Theory of Planned Behavior with respect to predicting AIDS-preventive behaviors among gay men. Participants were recruited from a longstanding cohort study in Amsterdam. Multivariate regression analyses showed that concepts from the Theory of Planned Behavior could account adequately for intentions to use condoms with casual as well as with steady partners. Actual behavior was best predicted by past behavior. In addition, structural equation modeling demonstrated that the causal paths as posited by Theory of Planned Behavior had a good fit to the data. From the presented findings implications for preventive interventions can be drawn. Specifically, interventions to increase condom use with casual partners need to focus at improving perceived behavioral control regarding this behavior, for instance through skills training. Interventions aimed at safer sex within steady relationships should take into account that the HIV-status of the individual and his partner plays an important role in the occurrence of unprotected anal sex in a romantic dyad.     

Predictors of proficient technique and successful lesion detection in breast self-examination

Seventy-three women attending a health fair completed a questionnaire that measured demographic and health history variables, knowledge, and current practice of breast self-examination (BSE), Multidimensional Health Locus of Control (MHLC; Wallston, Wallston, & DeVellis, 1978), and components of the Health Belief Model (HBM; Rosenstock, 1974) in relation to breast cancer and BSE. These variables formed the basis of a conceptual model of BSE behavior that was examined by having each woman participate in a behavioral trial with a breast model in which her BSE technique and ability to detect simulated tumors was assessed. Regression analyses revealed that self-confidence in the efficacy of BSE was the best single predictor of proficient BSE. Powerful others HLC, knowledge of correct BSE behaviors, and chance HLC, respectively, also contributed significantly to the variance in performance. As anticipated, successful lesion detection was most strongly associated with more proficient BSE technique and higher frequency of BSE practice in the past six months. Internal HLC scores were not predictive of either behavioral measure. Similarly, except for perceived efficacy of BSE, HBM variables showed no strong relationships to observed behavior.     

The Common Belief Inventory for Students: a measure of rationality in children

The Common Belief Inventory for Students (CBIS) was developed to create a measure of rationality in children. The CBIS was formulated within Ellis's conceptual framework of Rational Behavior Training. It was constructed to yield a total score as well as a score for each of Ellis's 11 irrational ideas. A pretest/post-test design was employed over experimental and control groups (n = 1,226), Subjects in the experimental group were exposed to one hour of Rational Behavior Training each week for six weeks. Results indicated that the items were reliable indicators of the total test score and the belief scores. Belief components were reliable indicators of the total test score. Total test reliability estimates were adequate. The CBIS also appeared sensitive to the use of RBT methods to enhance rational thinking.     

Religion and Health: Holistic Wellness From the Perspective of Two African American Church Denominations

This study examined differences in beliefs, concerns, practices, and perceptions of susceptibility to illness by gender and religion in 2 Baptist and 3 Seventh Day Adventist (SDA) African American churches. A modified Health Belief Model Questionnaire was completed by 363 African Americans. Health beliefs were more related to gender than to religion. Results revealed that women were concerned about being ill, being susceptible to illness, and expressed confidence in doctors. Men exercised more frequently, were sick less, and felt less susceptible to illness. SDAs believed in following a certain diet and avoiding alcohol and cigarettes. SDA women and Baptist men thought more about health than did SDA men or Baptist women.     

Predicting Zimbabwean women's ability to tell their partners to use condoms.

The effectiveness of AIDS education may depend on the development of models that predict and explain HIV prevention behavior. In this study, the aim was to test Fishbein and Ajzen's theory of reasoned action model in predicting women's capacity to tell their partner to use condoms. The basic theory pertains to the relationship of 1) attitude toward behavior and 2) the subjective norms to behavior; further refinements reflect factors such as 3) perceived behavioral control or self-efficacy, 4) and perceived barriers. A sample was drawn of 123 female first-year teacher trainees in Harare, Zimbabwe, in late 1990; a self-administered questionnaire was distributed and returned. 72% of the respondents were sexually experienced. The mean age of the entire sample was 24 years. The results of the multiple linear regression indicated that the model was able to predict were F(2,74)=32.81, p.0001. 47% of the variance was explained by this Fishbein model. Attitude toward behavior was significantly associated with the intention to tell one's partner to use condoms (beta = .60, p .05). Subjective norms were not significant (beta = .15, p .05). Perceived behavioral control and perceived barriers were also not significantly associated with the intention to tell one's partner to use condoms. A caveat was that the subjective norm was measured by only one item, and an improved conceptualization and measurement of this construct might have changed the relationship. The suggestion is that health educators should address women's underlying beliefs and attitudes about the benefits of telling their partners to use condoms. Future prospective studies will better delineate the relationship between attitude and behavior.     

Information and attitudes about HIV/AIDS in Portuguese adolescents: state of art and changes in a four year period

The incidence of infection with HIV/AIDS among the heterosexual population has been increasing in young adults. The goal of this research was to deepen knowledge of preventive sexual behavior in Portuguese adolescents, including knowledge and attitudes about HIV/AIDS, and assessing whether they changed from 2002 to 2006. Data were collected through a self-administered questionnaire from the Portuguese sample of the Health Behavior in School-aged Children (HBSC), a collaborative WHO study. The study provides national representative data of 7093 Portuguese adolescents, randomly chosen from those attending 8th and 10th grade of high school. Results showed there was an increase in the age of first sexual intercourse and a decrease in the number of teenagers who reported having had sexual intercourse, also in the level of information regarding HIV/AIDS transmission/prevention and in positive attitudes towards people with HIV/AIDS. In general, adolescents have good knowledge about how to protect themselves from becoming infected. However, comparing to 2002, there was a reduction of knowledge and consequent increase in the doubts regarding HIV/AIDS. Given the incipient state of sex education in 2006, the results cannot be attributed to sex education, but they will be relevant for comparison with the 2010 HBSC results.     

The role of risk perception and efficacy cognitions in the prediction of HIV-related preventive behavior and condom use

The salience of the Protection Motivation Theory to HIV preventive behavior was investigated in a sample of 468 heterosexual men 20-45 years of age recruited in Germany and at vacation spots in Spain. This theory conceptualizes self-protective behaviors as a function of the severity of the threat, perceived personal vulnerability to this threat, the availability of coping responses, and the effectiveness of these responses. Cognitive variables measured included perceived severity of the threat of AIDS, sexual self-efficacy expectancy, self-efficacy expectations in terms of sexual communication skills, response efficacy, and attitude toward condom use. On a scale of 1 (low) to 6 (high), perceived severity of the AIDS threat averaged 5.3, individual susceptibility ratings averaged 3.5, and susceptibility of peers had a mean of 4.9. Although 33% of respondents had made behavioral changes in response to the AIDS epidemic, only 15% always used condoms while 12% used them occasionally. Self-efficacy expectancy with regard to assertiveness and use of preventive measures emerged as the most significant predictor of HIV-related behaviors. The causal analyses indicated that high communicative self-efficacy expectancy is associated with high-risk sexual behaviors, while self-efficacy expectancy regarding assertiveness and the use of preventive measures promotes risk reduction. These associations were strongest in men over 26 years of age, singles, and tourists. These findings suggest a need for interventions for couples such as assertiveness training and guidance on communicating about sex and AIDS. Also demonstrated was the need for AIDS education programs to identify where participants are in terms of perceiving the threat of and coping with the AIDS epidemic and promote conditions that will help people advance to the next stage.     

Factors Predisposing Women to Take Precautions Against Breast and Cervix Cancer

The utility of the Theory of Reasoned Action (TRA), the Health Belief Model (HBM), and the Subjective Probability Model (SPM) in a health education diagnosis to discover predisposing factors for performing breast self-examination (BSE) and having a Pap test was explored in a survey of 123 women. Each model was a significant predictor of BSE and Pap test intentions. However, a composite model comprising the TRA's attitudinal and normative components supplemented by the barriers component of the HBM was the most useful in performing a health education diagnosis in relation to breast self-examination and the Pap test. "Psychological relevance" scores of particular beliefs obtained by SPM procedures tended to confirm the TRA's correlational method of identifying primary beliefs that would be the targets of persuasion to change BSE and Pap test intentions.