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.     

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.     

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.     

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.     

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.     

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.     

Smoking-specific communication and children's smoking onset: An extension of the theory of planned behaviour

The aim of this study was to test whether maternal smoking-specific communication and parental smoking related to smoking cognitions (i.e. attitude, self-efficacy and social norm) derived from the Theory of Planned Behaviour in association with smoking onset during preadolescence. A total of 1478 pairs of mothers and children participated (mean age: 10.11; standard deviation?=?0.78). Structural equation models in Mplus were used to examine whether smoking-specific communication influences children's smoking cognitions, which in turn, affect smoking onset. A positive association was found between pro-smoking attitudes and smoking onset. Smoking-specific communication and parental smoking were related to smoking cognitions. Specifically, frequency of communication was negatively associated with pro-smoking attitudes, social norms of mother and best friend. Quality of communication related negatively to pro-smoking attitudes and positively to self-efficacy and norms of friends. Parental smoking was positively associated with pro-smoking attitudes and norms of mother and (best) friends. Additionally, more frequent communication and higher levels of parental smoking were associated with higher smoking onset. In conclusion, smoking-specific communication and parental smoking were associated with smoking cognitions and smoking onset. Already during preadolescence, parents contribute to shaping the smoking cognitions of their children, which may be predictive of smoking later in life.     

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。     

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.     

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.     

Distress intolerance and worry: the mediating role of cognitive variables

Background and Objectives: Distress intolerance (DI) has been identified as a potential risk factor for a variety of maladaptive avoidance behaviors, including worry. However, mechanisms linking DI to specific behaviors remain poorly understood. One hypothesis is that DI is a general vulnerability that confers risk of particular avoidance behaviors via more specific, lower-order vulnerabilities. The current study examined associations between DI and worry-related cognitions. Design: A multiple mediator model tested the hypothesis that worry-related variables (intolerance of uncertainty [IU], cognitive avoidance, beliefs about worry, and negative problem orientation) mediated the association between DI and worry. Methods: An undergraduate student (n = 281) and a clinical (n = 123) sample completed self-report measures. Results: Across samples, worry was associated with higher levels of DI, IU, cognitive avoidance, beliefs about worry, and negative problem orientation. Mediation results differed somewhat between the two samples. In the undergraduate sample, IU, negative beliefs about worry, and positive beliefs about worry mediated the association between DI and worry. In the clinical sample, negative problem orientation and negative beliefs about worry mediated the association between DI and worry. Conclusions: Results provide initial evidence that DI may be associated with worry via unique risk factors.     

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.     

Interpersonal effects of parents and adolescents on each other’s health behaviours: a dyadic extension of the theory of planned behaviour

Objective: Interpersonal relationships are important predictors of health outcomes and interpersonal influences on behaviours may be key mechanisms underlying such effects. Most health behaviour theories focus on intrapersonal factors and may not adequately account for interpersonal influences. We evaluate a dyadic extension of the Theory of Planned Behaviour by examining whether parent and adolescent characteristics (attitudes, subjective norms, perceived behavioural control and intentions) are associated with not only their own but also each other’s intentions/behaviours.

Design: Using the Actor-Partner Interdependence Model, we analyse responses from 1717 parent-adolescent dyads from the Family Life, Activity, Sun, Health, and Eating study.

Main Outcome Measures: Adolescents/parents completed self-reports of their fruit and vegetable consumption, junk food and sugary drinks consumption, engagement in physical activity, and engagement in screen time sedentary behaviours.

Results: Parent/adolescent characteristics are associated with each other’s health-relevant intentions/behaviours above the effects of individuals’ own characteristics on their own behaviours. Parent/adolescent characteristics covary with each other’s outcomes with similar strength, but parent characteristics more strongly relate to adolescent intentions, whereas adolescent characteristics more strongly relate to parent behaviours.

Conclusions: Parents and adolescents may bidirectionally influence each other’s health intentions/behaviours. This highlights the importance of dyadic models of health behaviour and suggests intervention targets.     

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.     

Supportive Social Contexts and Intentions for Civic and Political Participation: An Application of the Theory of Planned Behaviour

We investigated how general social support from family, friends and acquaintances, and community predicted intentions for civic (e.g. volunteering) and political (e.g. petitioning) participation via the constructs specified in the theory of planned behaviour. Participants were young adults living in the former East Germany, a post‐communist region, who were surveyed by telephone in 2010 (N_civic = 695, N_political = 694). Civic participation was perceived more favourably than political participation. Supportive family predicted intentions for civic participation; supportive community services predicted both types of intentions; and supportive friends and acquaintances had no significant effects. The mediating variables were subjective norms and perceived behavioural control, but not attitudes. All effects were controlled for sociodemographic variables, richness of the social network, and past experience of civic and political participation. Findings underscore the role of supportive community in fostering both civic and political participation. Copyright © 2014 John Wiley & Sons, Ltd.     

Future-oriented emotions in the prediction of binge-drinking intention and expectation: the role of anticipated and anticipatory emotions

The Theory of Planned Behavior (TPB) offers a parsimonious explanation of purposive behavior, but in the study of healthy and risk behaviors its sufficiency may be questioned. Working with binge-drinking, a very common risk behavior in Spanish undergraduate students, we used two strategies for improving predictions from TPB: using behavioral intention (BI) and behavioral expectation (BE) as proximal antecedents of behaviors and adding as new predictors two future-oriented emotions (anticipated and anticipatory). Hierarchical regression analyses show that while anticipated emotions improved TPB explanations of BI, anticipatory emotions improved the explanations of BE. The present results show the influence of future emotions in the prediction of behavioral intention and behavioral expectation.     

Modelling decisions to undergo genetic testing for susceptibility to common health conditions: An ancillary study of the Multiplex Initiative

New genetic tests reveal risks for multiple conditions simultaneously, although little is understood about the psychological factors that affect testing uptake. We assessed a conceptual model called the multiplex genetic testing model (MGTM) using structural equation modelling. The MGTM delineates worry, perceived severity, perceived risk, response efficacy and attitudes towards testing as predictors of intentions and behaviour. Participants were 270 healthy insured adults aged 25–40 from the Multiplex Initiative conducted within a health care system in Detroit, MI, USA. Participants were offered a genetic test that assessed risk for eight common health conditions. Confirmatory factor analysis revealed that worry, perceived risk and severity clustered into two disease domains: cancer or metabolic conditions. Only perceived severity of metabolic conditions was correlated with general response efficacy (β?=?0.13, p<0.05), which predicted general attitudes towards testing (β?=?0.24, p<0.01). Consistent with our hypothesised model, attitudes towards testing were the strongest predictors of intentions to undergo testing (β?=?0.49, p<0.01), which in turn predicted testing uptake (OR 17.7, β?=?0.97, p<0.01). The MGTM explained a striking 48% of the variance in intentions and 94% of the variation in uptake. These findings support use of the MGTM to explain psychological predictors of testing for multiple health conditions.     

Functional significance of psychological variables that are included in the Theory of Planned Behaviour: a Self-Determination Theory approach to the study of attitudes,subjective norms,perceptions of control and intentions

The Theory of Planned Behaviour was proposed by Ajzen (1985) in an attempt to expand the applicability of the Theory of Reasoned Action (TRA) to situations where behaviour is not under complete volitional control. However, recent research does not address the issue of the stability of intentions, yet this is considered a boundary condition of the TRA on theoretical grounds. Therefore, the purposes of the present article were, first, to make a theoretical approach to the study of the stability of behavioural intentions by discussing assumptions underlying self-determination theory. Second, because, according to self-determination theory (Deci & Ryan, 1985), stability of intentions is related to the functional significance of psychological events, investigation of the functional significance of attitudes, subjective norms and perceived behavioural control was attempted through a study dealing with leisure-time physical activity. Because investigation of functional significance requires instruments assessing behavioural regulations, instrument development took place. Results partially supported the validity of behavioural regulations with respect to leisure-time physical activity. Furthermore, subjective norms were found to represent only the controlling dimension of functional significance. Attitudes and perceived behavioural control were found to represent both the controlling and informational dimensions of functional significance. Results are discussed in relation to assumptions underlying the Theories of Reasoned Action and Planned Behaviour and the Theory of Trying. Implications for theory development are made. © 1998 John Wiley & Sons, Ltd.