Adherence to Hormone Replacement Therapy: A Longitudinal Study Using the Theory of Planned Behaviour

The aim of this longitudinal study was to assess the stability and determinants of the intention to adopt HRT over a one-year period using the Theory of Planned Behaviour. At baseline, a total of 644 middle-aged premenopausal women who had never used HRT, were recruited. At follow-up, 417 women completed an interview to assess any change in their reproductive status and in their behavioural intention. Among women who stayed premenopausal (n = 172) and among those who became perimenopausal (n = 209), the intention to adopt HRT was quite stable over the one-year period. However, being perimenopausal had a significant effect on the intention to adopt HRT at follow-up, as did subjective norm, perceived behavioural control and moral norm measured at baseline. Attitude towards HRT did not have a significant effect on the intention to adopt HRT one year later. Therefore, interventions to support women's decision-making about HRT should be tailored to their menopausal status and take into account their perception of social pressure to perform, control over this behaviour and moral obligation.     

Prospective Study on the Determinants of Repeat Attendance and Attendance Patterns in Breast Cancer Screening Using the Theory of Planned Behaviour

This prospective study, using the Theory of Planned Behaviour (TPB) as a theoretical framework, was carried out to identify the determinants of repeat attendance and attendance patterns in organised breast screening. A group of 2657 women filled out a baseline questionnaire, approximately 8 weeks after having been invited for an initial screening in the Dutch Breast Cancer Screening Programme. Data on actual attendance in second and third screening round were subsequently collected. Personal variables such as family history of breast cancer, breast cancer in someone close and fear of breast cancer were not related to repeat attendance. The TPB variables could explain approximately 17% of the variance in attendance in the second and third round. Maintenance behaviour (consistent attendance vs. dropout) was related to the TPB variables, but the amount of variance explained was only 6%. Initiation of behaviour (consistent refusal vs. delayed attendance) also was related to TPB variables, with a substantially higher amount of explained variance than with maintenance behaviour. Results indicate that the TPB variables are more related to the initiation of screening behaviour than to the maintenance of screening behaviour. Implications of these findings for breast cancer screening are discussed.     

Application of the Theory of Planned Behaviour in Behaviour Change Interventions: A Systematic Review

This paper reviews studies explicitly applying the Theory of Planned Behaviour (TPB) to behaviour change interventions. A systematic and multiple search strategy identified 30 papers, describing 24 distinct interventions. Studies were rarely explicit about use of the TPB. The TPB was mainly used to measure process and outcome variables and to predict intention and behaviour, and less commonly to develop the intervention. Behaviour change methods were mostly persuasion and information, with increasing skills, goal setting, and rehearsal of skills used less often. When reported, half of the interventions were effective in changing intention, and two-thirds in changing behaviour, with generally small effect sizes, where calculable. Effectiveness was unrelated to use of the theory to develop interventions. Evidence about mediation of effects by TPB components was sparse. The TPB may have potential for developing behaviour change interventions, but more comprehensive studies are needed that compare the utility of the TPB with other social cognition models and behavioural techniques.     

Accounting for the Theory of Planned Behaviour in departure time choice

Motivating people to change their departure time could play a key role in reducing peak-hour congestion, which remains one of the most prevalent transport problems in large urban areas. To achieve this behavioural change, it is necessary to better understand the factors that influence departure time choice. So far departure time choice modelling focussed mainly on objective factors, such as time and costs as main behavioural determinants. In this study, we derived psychological factors based on the Theory of Planned Behaviour, estimated them based on structural equation modelling, and included them into a discrete choice model. The psychological factors were measured based on an online questionnaire addressed to car commuters to the city centre of Copenhagen (N = 286). The questionnaire additionally included a travel diary and a stated preference experiment with nine departure time choice scenarios. All psychological factors had a significant effect on departure time choice and could improve the model as compared to a basic discrete choice model without latent constructs. As expected, the effects of the psychological factors were different depending on framework conditions: for people with fixed starting times at work, the intention to arrive at work on time (as estimated by subjective norm, attitude, perceived behavioural control) had the strongest effect; for people with flexible working hours, the attitude towards short travel time was most relevant. Limitations, the inclusion of additional psychological factors and their possible interactions are discussed.     

Evidence for Discontinuity Patterns Across the Stages of Change: A Role for Attitudinal Ambivalence

Cross-sectional analyses of the transtheoretical ("stages of change") model (TTM) can provide valuable information concerning the variables that are likely to shift individuals from one stage to the next. The present study was designed to investigate the roles of theory of planned behaviour (TPB) variables and attitudinal ambivalence across the stages of change. Two samples derived from the general population completed measures of stage, TPB and attitudinal ambivalence with respect to consuming a low-fat diet (n = 148) and eating five portions of fruit and vegetables per day (n = 151). Consistent with previous research, the present study found linear increases in TPB variables across the stages of change. However, as predicted, attitudinal ambivalence showed discontinuity patterns, displaying a quadratic relationship with the stages of change, such that least ambivalence was experienced in the precontemplation and maintenance stages. Discussion of the findings focuses on implications for the development of theory-driven interventions.     

Affective and cognitive attitudes,uncertainty avoidance and intention to obtain genetic testing: An extension of the Theory of Planned Behaviour

To ensure successful implementation of genetic screening and counselling according to patients best interests, the attitudes and motives of the public are important to consider. The aim of this study was to apply a theoretical framework in order to investigate which individual and disease characteristics might facilitate the uptake of genetic testing. A questionnaire using an extended version of the Theory of Planned Behaviour was developed to assess the predictive value of affective and cognitive expected outcomes, subjective norms, perceived control and uncertainty avoidance on the intention to undergo genetic testing. In addition to these individual characteristics, the predictive power of two disease characteristics was investigated by systematically varying the diseases fatality and penetrance (i.e. the probability of getting ill in case one is a mutation carrier). This resulted in four versions of the questionnaire which was mailed to a random sample of 2400 Norwegians. Results showed genetic test interest to be quite high, and to vary depending on the characteristics of the disease, with participants preferring tests for highly penetrant diseases. The most important individual predictor was uncertainty avoidance.     

Untangling the Theory of Planned Behavior's auxiliary assumptions and theoretical assumptions: Implications for predictive and intervention studies

It has been asserted that the Theory of Planned Behavior (TPB) is better at behavioral prediction than it is behavioral change. However, the performance of a theory depends not only on the theoretical propositions, but the auxiliary assumptions attached to the theory. It is because of such auxiliary assumptions, which are required to bridge the gap between nonobservational terms at the level of theory and the observational terms at the level of the empirical hypothesis, that we believe critiques of the TPB's utility are misguided. We argue that a failure to separate theoretical assumptions from auxiliary assumptions leads to this false assumption. We suggest the importance of distinguishing between the auxiliary assumptions required for prediction studies and the auxiliary assumptions required for intervention studies. We believe that in attaching sound auxiliary assumptions to intervention studies, the TPB is equally effective at facilitating behavior change as it is behavior prediction.     

品牌社区的形成与发展:社会认同和计划行为理论的视角

品牌社区是指一种特定的,不受地域限制的,基于某一品牌崇拜者之间结构化的社会关系而建立的社区。大量研究围绕社会认同理论、计划行为理论等相关理论,试图揭示品牌社区的形成、发展及作用机制。现有研究发现消费者对品牌的态度及其所感受到的主观行为规范等因素会影响个体的社区参与水平,而参与品牌社区有助于社区成员产生品牌认同,进而有效地维持并提高其品牌忠诚度。未来研究应该更多地关注自尊、自我意识以及社会认同威胁等变量。此外,国内研究者还应当考虑到东西方文化差异,促进相关理论及概念的本土化。     

Intention to Participate in Predictive Genetic Testing for Hereditary Cancer: The Role of Attitude toward Uncertainty

This study aimed to identify factors predictive of intentions to participate in genetic testing for hereditary cancer. Measures of the psychosocial influences on intention were based on the theories of reasoned action (TRA) and planned behaviour (TPB) and a new measure of Attitude toward Uncertainty. The participants (the breast cancer sample, n = 124; the colon cancer sample, n = 168) were recruited via a general practitioner's patient database and asked to complete postal questionnaires. The overall response rate was 57.4% (54.7% in the colon cancer sample, 61.4% in the breast cancer sample). In the colon cancer sample, 72% of respondents stated that they would choose to participate in genetic testing for colon cancer susceptibility. In the breast cancer sample, 77% of respondents stated that they would choose to participate in genetic testing for breast cancer susceptibility. The TRA components (attitudes and subjective norms) and Attitude toward Uncertainty emerged as the strongest predictors of intention. The Attitude toward Uncertainty appears to moderate intention in that participants with more negative attitudes toward uncertainty are more likely to undergo the test than those seeking more certainty.     

Distracted pedestrians in crosswalks: An application of the Theory of Planned Behavior

Thousands of adult pedestrians are killed or injured each year. In spite of ever growing knowledge of correlates of risk pedestrian behavior, much remains to be learned. A small body of research has applied the Theory of Planned Behavior (TPB) to the problem of risky crossing decisions. We employed TPB to examination of intentions to cross under varying types of distraction. Eighty adults completed measures of injury exposure, followed by a questionnaire structured around TPB assessing intentions to cross streets under common conditions of self-imposed distraction. Results were similar to other research, suggesting attitude and perceived behavioral control predicted intentions to cross streets while distracted. Results are discussed in the context of similar studies, and with regard to future directions and injury prevention efforts.     

COVID-19 Help-Seeking Behaviors: Application of the Theory of Planned Behavior

The novel coronavirus disease (COVID-19) is highly contagious. More than 247 million cases have been confirmed by the end of October 2021. Seeking help earlier may slow the spread of COVID-19 because it may help in early detection of infected cases, and it facilitate tracing those who were with close contact with infected cases. The purpose of this study is to identify participants’ intentions toward COVID-19 seeking help and the factors affecting their decision. This is a cross-sectional study. An online survey using Google Forms was used for data collection. Hierarchical multiple regression analysis was used to explain intentions to seek help for COVID-19. The concepts included in the Theory of Planned Behavior and COVID-19 knowledge were used as predictors. The sample included 780 participants, with an average age of 28.60±9.86 years old. Most of the sample were female (67.4%) and having a bachelor’s degree (72.7%). Participants showed high level of knowledge regarding COVID-19, 73% of the sample had a total knowledge score equal to or higher than 85%. Also, participants had high positive attitudes and high intentions to seek help for COVID-19. The four predictors: Attitudes towards COVID-19, subjective norm, perceived behavioral control, and COVID-19 knowledge significantly explained intentions to seek help. Participants had high intentions to seek help for COVID-19, which was related to having positive attitudes toward seeking help, high social approval, high perceived controllability, and high COVID-19 knowledge levels. Regular awareness campaigns during early stages of pandemics should be performed to improve attitudes and knowledge level, which may improve prevention measures, and promote help seeking behaviors. Consequently, this may facilitate early detection of cases, and slow the spread of pandemics.     

The Effects of Social Identity and Perceived Autonomy Support on Health Behaviour Within the Theory of Planned Behaviour

The present study employed constructs from self-determination theory, social-identity theory, and the theory of planned behaviour to examine the combined effects that social identity and perceived autonomy support exerted on attitudes, intentions and health behaviour. A prospective design was employed measuring constructs from the theory of planned behaviour, group norms, group identification, and perceived autonomy support at baseline and physical activity behaviour 5 weeks later. Self-report questionnaires were administered to 231 pupils (male = 113, female = 118, M = 14.21 years, SD = .90). Hierarchical regression analysis demonstrated that group norms predicted participation in physical activities and attitudes, but only for participants who identified strongly with their group. Perceived autonomy support predicted attitudes, intentions and behaviour. The effects of perceived autonomy support and social-identity constructs were independent. It was concluded that both social identity and perceived autonomy support should be included in the theory of planned behaviour.     

Even with the Best of Intentions: Paternal Involvement and the Theory of Planned Behavior

Implicit in much of the fatherhood discourse is the assumption that if fathers want to take an active role in their children's lives, they could and would do so. While research has highlighted the factors associated with fathers' involvement, very few, if any, of these studies have been guided by a theory that accounts for both fathers' involvement intentions and their ability to follow through on those intentions. The theory of planned behavior and its emphasis on attitudes, the beliefs of significant others, and whether one has control over engaging in behavior is a conceptual fit to respond to questions related to the complex nature of paternal involvement. Using data from the Fragile Families and Child Well‐being Study, the purpose of this study was to test the utility of the theory of planned behavior in predicting fathers' involvement intentions and reports of involvement. The results revealed that the theory of planned behavior can be useful in examining paternal involvement and should be used in future research to enhance the fatherhood literature.     

The Theory of Planned Behavior as a model for understanding sedentary behavior

ObjectivesSedentary time has emerged as an independent risk factor for numerous adverse health outcomes. However, little is known about the social-cognitive correlates of sedentary behavior. The purpose of this study was to provide preliminary evidence for the factor structure and composition of sedentary derived Theory of Planned Behavior (TPB) constructs and to determine the utility of these constructs in predicting sedentary intention and sedentary time.MethodTwenty-three items were created to assess attitudes, subjective norms (SN), perceived behavioral control (PBC), and intention with respect to time spent being sedentary. Using a web-based survey, 372 adults completed a modified Sedentary Behavior Questionnaire and were then randomised to one of three TPB questionnaire packages: general, weekday, and weekend. Weekday and weekend participants completed items for work/school (less-volitional) and leisure/recreation (volitional) activities separately, resulting in five TPB models being analyzed: general, weekday work/school, weekday leisure/recreation, weekend work/school, and weekend leisure/recreation.ResultsIrrespective of model, items grouped into coherent factors consistent with TPB and explained 9–58% and 8–43% of the variance in intention and behavior, respectively. The strongest and most consistent predictor of intention and behavior were SN and intentions, respectively. Mediation analyses indicated that attitudes consistently affected sedentary time through intention.ConclusionsThere is growing evidence that the TPB is a useful framework for understanding sedentarism.     

Binge-Drinking: A Test of the Role of Group Norms in the Theory of Planned Behaviour

A study was undertaken to assess the utility of the theory of planned behaviour in the prediction of students' binge-drinking. Additionally, a perspective was utilised to address the usually weak contribution of subjective norms in predicting behavioural intentions. Respondents were 289 undergraduate students. The study employed a longitudinal design, with the predictors of performing the behaviour under consideration assessed prior to the measure of reported behaviour. Support was found for the application of the theory of planned behaviour to binge-drinking. A reconceptualisation of norms in the theory of planned behaviour, from a social identity theory/self-categorization theory perspective, was also supported; consistent with expectations, the norms of a behaviourally relevant reference group predicted intentions to binge-drink, especially for participants who identified strongly with the reference group. The results are discussed in relation to measures which may help to reduce the incidence of binge-drinking by university students.     

Socioeconomic status as a moderator between social cognitions and physical activity: Systematic review and meta-analysis based on the Theory of Planned Behavior

BackgroundHealth inequalities are to a substantial degree due to socioeconomic status (SES) related differences in health behaviors such as physical activity. However, little is known about the role SES plays in the self-regulation of physical activity.PurposeThis systematic review with meta-analysis examines whether a comprehensive set of indicators of SES (income, education, occupational status) impacts on the behavioral self-regulation by moderating the relationships between social cognitions in the Theory of Planned Behavior (TPB) and physical activity.MethodsA systematic literature search identified 99 studies from 88 articles that provided information on sample SES and correlations between TPB variables and physical activity. Random-effects meta-analyses were used to pool correlations corrected for sampling and measurement error. Random-effects meta-regression was used to examine moderating effects of study-level SES on these correlations.ResultsEducation moderated the relationship between intentions and physical activity, such that studies with better educated samples reported stronger intention-physical activity relationships.ConclusionsThese results suggest that education might play a major role in the self-regulation of physical activity, with better educated samples more likely to translate intentions into behavior. This can both help to explain heterogeneity in the relation between intentions and physical activity as well as support the development of more effective interventions targeting intentions and physical activity.     

An online study combining the constructs from the theory of planned behaviour and protection motivation theory in predicting intention to test for chlamydia in two testing contexts

Chlamydia is a common sexually transmitted infection that has potentially serious consequences unless detected and treated early. The health service in the UK offers clinic-based testing for chlamydia but uptake is low. Identifying the predictors of testing behaviours may inform interventions to increase uptake. Self-tests for chlamydia may facilitate testing and treatment in people who avoid clinic-based testing. Self-testing and being tested by a health care professional (HCP) involve two contrasting contexts that may influence testing behaviour. However, little is known about how predictors of behaviour differ as a function of context. In this study, theoretical models of behaviour were used to assess factors that may predict intention to test in two different contexts: self-testing and being tested by a HCP. Individuals searching for or reading about chlamydia testing online were recruited using Google Adwords. Participants completed an online questionnaire that addressed previous testing behaviour and measured constructs of the Theory of Planned Behaviour and Protection Motivation Theory, which propose a total of eight possible predictors of intention. The questionnaire was completed by 310 participants. Sufficient data for multiple regression were provided by 102 and 118 respondents for self-testing and testing by a HCP respectively. Intention to self-test was predicted by vulnerability and self-efficacy, with a trend-level effect for response efficacy. Intention to be tested by a HCP was predicted by vulnerability, attitude and subjective norm. Thus, intentions to carry out two testing behaviours with very similar goals can have different predictors depending on test context. We conclude that interventions to increase self-testing should be based on evidence specifically related to test context.     

The adoption of physical activity and eating behaviors among persons with obesity and in the general population: the role of implicit attitudes within the Theory of Planned Behavior

Obesity can be prevented by the combined adoption of a regular physical activity (PA) and healthy eating behaviors (EB). Researchers mainly focused on socio-cognitive models, such as the Theory of Planned Behavior (TPB), to identify the psychological antecedents of these behaviors. However, few studies were interested in testing the potential contribution of automatic processes in the prediction of PA and EB. Thus, the main objective of this study was to explore the specific role of implicit attitudes in the pattern of prediction of self-reported PA and EB in the TPB framework, among persons with obesity and in adults from the general population. One hundred and fifty-three adults participated to this cross-sectional study among which 59 obese persons (74% women, age: 50.6 ± 12.3 years, BMI: 36.8 ± 4.03 kg m^–²) and 94 people from the general population (51% women; age: 34.7 ± 8.9 years). Implicit attitudes toward PA and EB were estimated through two Implicit Association Tests. TPB variables, PA and EB were assessed by questionnaire. Regarding to the prediction of PA, a significant contribution of implicit attitudes emerged in obese people, β = .25; 95%[CI: .01, .50]; P = .044, beyond the TPB variables, contrary to participants from the general population. The present study suggests that implicit attitudes play a specific role among persons with obesity regarding PA. Other studies are needed to examine which kind of psychological processes are specifically associated with PA and EB among obese people.