Using the theory of planned behaviour to predict screening uptake in two contexts

Given current policy that decisions about screening should be based on informed choice, such decisions should reflect people's values and attitudes. This prospective study compares the attitudes and other cognitive predictors of screening uptake in two contexts: when conducted as part of a routine visit and when it is conducted at a separate, test-specific visit. It was conducted in two hospitals in England, differing in method of screening organisation. 1499 pregnant women offered serum screening for Down Syndrome completed a questionnaire assessing theory of planned behaviour constructs: attitude towards undergoing the test, subjective norms of others, perceived behavioural control and intention to undergo the test.

Intention predicted screening uptake in both screening settings, but more strongly when screening was part of a routine visit. Perceived behavioural control was not predictive of uptake, and only weakly predictive of intention in both settings. Subjective norm predicted intention more strongly when it referred to partner and friends than when it referred to health professionals, in both settings.

Attitude was more strongly predictive of intention to attend screening when screening was organised as a part of routine screening, rather than requiring a separate visit. These results suggest that offering a screening test at a routine visit compared with a separate visit is more likely to facilitated uninformed choices, given the stronger association between attitudes and intention and the absence of an association with the perceived influence of health professionals.     

Health enhancing physical activity as perceived in interviews based on the theory of planned behaviour

Abstract

The perception of behaviours from two categories of health enhancing physical activity (HEPA): outdoor aerobic exercise (OAE) and everyday commuting activity (ECA) was examined in a sample of middle-aged persons (N= 50). A focused semi-standardised interview was constructed on the bases of the components of the Theory of Planned Behaviour (TPB). The participants perceived OAE behaviours predominantly from the viewpoint of exercise and those of the ECA from that of the fluency of daily routines. They considered the OAE as sensible and associated it with positive health or fitness outcomes, but only those practising it also attributed positive psychological effects to OAE behaviours. A slightly better congruence with the TPB was found for the OAE behaviours than for those of the ECA. The difference is discussed in the light of the higher degree of decisional control with the OAE behaviours and the greater psychological heterogeneity of the ECA.     

Development and test of an integrative model of job search behaviour

Research on job search and the theory of planned behaviour (TPB) has identified job search attitude, subjective norm, and job search self-efficacy as the most proximal determinants of job seekers’ search intentions and subsequently job search behaviours. However, we do not yet know how more distal individual differences (e.g., personality) and situational factors (e.g., social context) might help to predict these key TPB determinants of job search behaviour. In an integrative model of job search behaviour, we propose specific relationships between these distal variables and the TPB determinants, which in turn are expected to mediate the effects of individual differences and situational factors on job search behaviour. The hypothesized model is tested in a large representative sample of 1,177 unemployed Flemish job seekers using a two-wave design and provides a satisfactory fit to the data. Extraversion, conscientiousness, core self-evaluations, employment commitment, financial need, and social support are found to differentially relate to instrumental job search attitude, affective job search attitude, subjective norm, and job search self-efficacy. In addition, all distal variables are indirectly related to job search behaviour through their effects on the TPB variables. These results support our expanded and integrative model of job search behaviour.     

Judgments of mean speed and predictions of route choice

How are driving speeds integrated when speeds vary along a route? In a first study, we examined heuristic processes used in judgments of mean speed when the mean speeds on parts of the trip varied. The judgments deviated systematically from objective mean speeds because the distances driven at different speeds were given more weight than travel time spent on the different distances. The second study showed that when there was a 10–15 min pause during a travel the effect on the mean speed decrease was underestimated for driving speeds of 90 km/h and higher. In the third study, the objective mean speeds and the subjective biased mean speed judgments were used to predict choices between routes with different speed limits. The results showed that subjective judgments predicted decisions to maximize mean speed significantly better than objective mean speeds. Finally, some applied and basic research implications of the results were discussed.     

Exploring the beliefs underpinning drivers’ intentions to comply with speed limits

Using the theory of planned behaviour (TPB; [Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhl, J. Beckmann (Eds.), Action control: From cognition to behavior (pp. 11–39). Berlin: Springer-Verlag.]) as a theoretical framework, the present study was designed to: (a) identify the beliefs underpinning drivers’ intentions to comply with speed limits, and (b) test the expectancy-value theory held to underpin those beliefs. A sample of drivers (N = 598) completed questionnaires designed to measure TPB variables with respect to compliance with speed limits. The results of hierarchical multiple regression analyses provided support for the expectancy-value theory held to underpin each behavioural beliefs (outcome beliefs X outcome evaluations), normative beliefs (referent beliefs X motivation to comply), and control beliefs (control frequency beliefs X control power beliefs). Belief targets for road safety countermeasures that aim persuade drivers to comply with speed limits were also identified by selecting those beliefs that were the statistically significant predictors of direct TPB measures (attitudes, subjective norm, perceived control) and intention. Theoretical and practical implications of the results are discussed.     

The theory of planned behaviour and breast self-examination: Assessing the impact of past behaviour,context stability and habit strength

This study applied the theory of planned behaviour (TPB) to the prediction of breast self-examination (BSE) intentions and behaviour, and tested whether the frequency of past behaviour and context stability moderates intention–behaviour and habit–behaviour relations. Seventy-seven females completed measures of the TPB, frequency of past behaviour, context stability and habit strength (Self-Report Habit Index). BSE behaviour was assessed at 1-month follow-up (n?=?66). The TPB explained 33% of the variance in BSE intentions and 11% of the variance in time 2 BSE. The frequency of past behaviour moderated the intention–behaviour relationship such that the intention was only positively related to time 2 BSE behaviour when the frequency of past behaviour was low. Context stability and the combination of the frequency of past behaviour?×?context stability moderated the habit–behaviour relationship such that habit strength was only positively related to time 2 BSE behaviour when context stability and the combination of frequency of past behaviour?×?context stability were high. The results are consistent with the proposal that behaviours that are performed frequently in stable contexts are predominantly under the control of habitual processes, whereas behaviours that are performed infrequently in unstable contexts are predominantly under the control of intentional processes.     

Predictive validity of the theory of planned behaviour: the role of questionnaire format and social desirability

The present study was designed to assess the predictive validity of a theory of planned behaviour extended to include self‐identity, in the context of health‐related food choice. Following criticism of the use of questionnaires in social cognitive research, the impact of questionnaire format (random vs structured) and social desirability on questionnaire responses was assessed. Findings indicated that intention was the principal determinant of food choice; attitude, subjective norm and self‐identity were independently predictive of intention. There was only weak evidence to suggest effects of social desirability or questionnaire format on component relationships. The present study indicates that the impact of questionnaire format and social desirability on models such as the theory of planned behaviour is minimal, and that such models are robust predictors of food choice. Copyright © 1999 John Wiley & Sons, Ltd.     

Effects of action planning and coping planning within the theory of planned behaviour: A physical activity study of patients undergoing haemodialysis

Objective

Patients on dialysis have low physical activity levels. The aim of the study was to examine the validity of action planning and coping planning within the theory of planned behaviour framework, for predicting physical activity behaviour of patients on haemodialysis.

Design

This is a prospective study design.

Methods

One hundred and forty-four patients who were undergoing haemodialysis were selected from dialysis centres. The mean age of the patients was 56.61 (SD = 11.38) years. The patients completed a questionnaire including variables from the theory of planned behaviour, action planning and coping planning. Physical activity was prospectively assessed at 4-weeks with the validated International Physical Activity Questionnaire self-report measure. A hierarchical regression analysis was performed to examine the effects of action planning and coping planning on physical activity behaviour.

Results

There was a main effect for coping planning but not for action planning. Moreover, the analyses resulted in a significant amount of incremental variance accounted for by the interaction of coping planning and intention.

Conclusion

Results suggest the combination of high levels of coping planning and intention is associated with increases in physical activity.     

Predicting intentions to text and call while driving using the theory of planned behaviour

There is extensive evidence that using a mobile phone while driving causes degradation in driving performance, and thereby results in reduced safety on the road. The present study examined intentions to use mobile phones while driving using the Theory of Planned Behaviour (TPB). A total of 212 Ukrainian drivers (mean age = 35 years SD = 10 years; males = 82%) completed a survey that included measures of the TPB components related to intentions to send or read text messages or to make or receive handheld phone calls across two different scenarios; one where they were running late, and the other when they were not in a hurry. Measures of the frequency of mobile phone use were also collected. The results showed that 63% of the sample reported using a mobile phone while driving at least daily, with the most frequent types of usage being making and answering a phone call with a handheld device. The most consistent predictor of intentions to interact with a mobile phone while driving was having a positive attitude towards doing so. Perceived behavioural control was also significantly and positively associated with mobile phone use while driving, but only a small number of associations were found with subjective norms. Our results suggest that intentions to interact with mobile phones while driving may be context specific.     

Testing the relationship between personality characteristics,contextual factors and entrepreneurial intentions in a developing country

Drawing upon the theory of planned behaviour (TPB ), we developed and tested a conceptual model which integrates both internal personality factors and external contextual factors to determine their associations with motivational factors and entrepreneurial intentions (EIs ). We then investigated if the model of EI applies in a developing country, namely Iran. We also set out to identify the most relevant factors for EI within this developing country context. Do distal predictors of EI including personality factors (i.e. need for achievement, risk taking and locus of control) and contextual factors (i.e. perceived barriers and support) significantly relate to EI via proximal predictors including motivational factors (i.e. attitudes towards entrepreneurship and perceived behavioural control [PBC])? Data were collected on 331 students from 7 public universities. The findings support the TPB for EI in Iran. All three motivational factors related to EI , but PBC showed the strongest association, which is different than in developed country contexts. Possible explanations for these differences are discussed. All three personality characteristics indirectly related to EI via the proximal attitudes towards entrepreneurship and PBC . Perceived contextual support and barriers indirectly related to EI via proximal PBC while perceived barriers also directly related to EI .     

Young adults' intention to eat healthy food: Extending the theory of planned behaviour

Abstract

The present study predicts adults' intention to eat healthily, using the theory of planned behaviour (TPB) and additive and moderating effects of role identity, group norms and group identification, derived from identity theory and self categorisation theory. A total of 735, 25 years old adults participated in a mailed questionnaire survey in 1997. The TPB explained 52% of the variance in young adults' decision to eat healthily, with perceived behavioural control and subjective norms being the strongest (β= .56, p < .001) and weakest (β = .05, p < .005) determinants, respectively. Although, role identity accounted for an additional amount of 4% of the variance in behavioral intention, past behaviour did not moderate the impact of role identity on intention, as hypothesised. Neither perceived group norm nor group identification added to the prediction of intention over and above the TPB. However, group identification was found to act as a moderator on the relation between group norm and behavioural intention in the predicted direction. The wider social context seems to play a stronger role for the formation of adults' healthy eating decisions than indicated by the TPB.     

The theory of planned behaviour: Reactions and reflections

The seven articles in this issue, and the accompanying meta-analysis in Health Psychology Review [McEachan, R.R.C., Conner, M., Taylor, N., & Lawton, R.J. (2011). Prospective prediction of health-related behaviors with the theory of planned behavior: A meta-analysis. Health Psychology Review, 5, 97–144], illustrate the wide application of the theory of planned behaviour [Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211] in the health domain. In this editorial, Ajzen reflects on some of the issues raised by the different authors. Among the topics addressed are the nature of intentions and the limits of predictive validity; rationality, affect and emotions; past behaviour and habit; the prototype/willingness model; and the role of such background factors as the big five personality traits and social comparison tendency.     

Predicting uptake of a routine cervical smear test: A comparison of the health belief model and the theory of planned behaviour

Abstract

This paper reports on a study carried out to identify predictors of uptake of cervical screening among 142 women (59% response rate) in inner London. Two social cognition models were used: The Health Belief Model (HBM; Becker, 1974) and the Theory of Planned Behaviour (TPB; Ajzen, 1991) and in addition anticipated affect following non-attendance for screening was assessed. The TPB emerged as by far the superior model for predicting screening intentions, explaining 51% of the variance in comparison with only 4% explained by the HBM variables. However, neither model was able to predict a significant amount of variance in uptake of screening three months later. Possible reasons for the poor prediction of this type of behaviour are discussed.     

Sleep hygiene behaviours: An application of the theory of planned behaviour and the investigation of perceived autonomy support,past behaviour and response inhibition

This study investigated the sleep hygiene behaviour of university students within the framework of the Theory of Planned Behaviour (TPB [Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.]), and examined the predictive validity of additional variables including perceived autonomy support, past behaviour and response inhibition. A total of 257 undergraduate students from an Australian university were administered two online questionnaires at two time points. At time 1, participants completed the TPB questionnaire and the Go/NoGo task as a measure of response inhibition. A week later at time 2, participants completed a questionnaire measuring the performance of sleep hygiene behaviours. Multiple and hierarchical regression analyses showed that the TPB model significantly predicted intention and behaviour. Although intention and perceived behavioural control were statistically significant in predicting behaviour, past behaviour and response inhibition accounted for more variance when added to the TPB model. Subjective norm was found to be the strongest predictor of intention implying the importance of normative influences in sleep hygiene behaviours. Response inhibition was the strongest predictor of behaviour, reinforcing the argument that the performance of health protective behaviours requires self-regulatory ability. Therefore, interventions should be targeted at enhancing self-regulatory capacity.     

Conceptual overlap between moral norms and anticipated regret in the prediction of intention: Implications for theory of planned behaviour research

Moral norms and anticipated regret are widely used extensions to the theory of planned behaviour, yet there is some evidence to suggest that these constructs may conceptually overlap as predictors of intention. Two health-related behaviours with distinct moral implications (Study 1: organ donation registration, N?=?352 and Study 2: condom usage, N?=?1815) were therefore examined to ascertain whether moral norms and anticipated regret are indeed conceptually distinct. While evidence consistent with conceptual overlap was identified in Study 1, the evidence for such overlap in Study 2 was more ambiguous. In Study 3, a meta-analysis of existing literature revealed that the relationship between moral norms and anticipated regret was moderated by the extent of the moral implications arising from the behaviour under examination. Taken together, these findings suggest that conceptual overlap between moral norms and anticipated regret is more likely to occur among behaviours with obvious moral implications. Researchers wishing to examine the predictive utility of moral norms and anticipated regret among such behaviours would therefore be advised to aggregate these measures to form a composite variable (personal norms).     

Identity and travel behaviour: A cross-sectional study on commute mode choice and intention to change

IntroductionSocial and self-identities have been conceptualised to prevent travel behaviour change, as threats to one’s identity may cause resistance to change. This study focuses on the role of social, transport, place, and self-identities on commute mode choice and intention to change mode choice.MethodData were collected in June 2015 in Utrecht, the Netherlands. Invitations to participate were distributed by mail using data from the municipality, resulting in 1062 adult participants.The outcome measures were the transport mode shares based on a 14-day travel-to-and-from-work record of trips (i) involving any car use, (ii) involving any bicycling, (iii) involving any walking, and (iv) involving any public transport use. The second series of outcome measures concerned the willingness to change the amount of car use, bicycle use and walking, determined by the question ‘to what extent do you intend to change the use of …?’. Identity was measured on a seven-point disagree/agree scale for 17 items by asking to what extent the respondent ‘sees him/herself as …’. Separate multinomial regression models were estimated stepwise adjusting for socioeconomic and transport characteristics.ResultsMultiple identity items were associated with the use of all commute modes. In the maximally adjusted models, identities associated with the respective modes remained significant. For example, whether someone identified themselves with being a cyclist corresponded with higher likelihood of cycling occasionally (relative risk ratio (RRR): 1.84; 95% confidence interval (CI):1.47–2.30), or always to work (RRR: 2.86; 95% CI: 2.16–3.79). In addition, we found that a family-oriented identity was negatively associated with occasional commuting by car, and a ‘sporty’ identity was negatively associated with always cycling to work.Transport identities were also associated with stated intentions to change as were several social, place, and self-identities. Identifying with being a car driver decreased the likelihood of intending to reduce car use, but it increased the likelihood of intending to increase car use, as did identifying with being career-oriented. Individuals that identified with being a cyclist were less likely to have an intention to reduce bicycle use, whereas countryside-lovers had greater intentions of increasing cycling. Individuals that identified themselves as pedestrians had a lower intention of decreasing their walking levels, and a higher intention of increasing them, as did those who identified themselves as being family-oriented.DiscussionThe results confirm limited previous findings that identifying with users of a transport mode correspond with its use. Nevertheless, questions around causality remain. The intention to change mode choice was associated with several identities, including transport-related identities, place-related identities, social/family-related identities, and self-identities. Future research should focus on the associations between identity and actual behaviour change to further our understanding of the effect of identity on travel behaviour.     

Driving speed choice: The role of conscious monitoring and control (reinvestment) when driving

This study aimed to examine the role of reinvestment - the propensity to consciously monitor and control actions (movement specific reinvestment) and to consciously monitor and evaluate decision making processes (Decision specific reinvestment) while driving in everyday risky scenarios. The study also aimed to evaluate the association between reinvestment and previously validated driver attitude measures. Fifty one participants completed a series of questionnaires (Driving Self-Efficacy Scale, Driver Attitude Questionnaire, Movement Specific Reinvestment Scale, Decision Specific Reinvestment Scale) after which they completed a test phase in a driving simulator. In the test phase, driving scenarios included roads with different markings (i.e., double yellow, wide centrelines, wire rope barriers, Audio Tactile Profiled markings) and alerting scenarios (i.e., police car present, high crash risk area sign, reduced speed zone). Results revealed that on risky roads (wide centrelines), participants with a high propensity for decision specific reinvestment drove slower than those with a low propensity. Driver experience, attitudes towards speeding and scores on the Decision Reinvestment subscale of the Decision Specific Reinvestment Scale significantly predicted speed choice. More experienced participants with higher scores on the Decision Reinvestment subscale were more likely to drive slower and participants with worse attitudes towards speeding were likely to drive faster. Participants with a low propensity for movement specific reinvestment (specifically, Movement Self-Consciousness) reduced their speed to a greater extent than those with a high propensity when driving in the police car scenario. There was some evidence to suggest that high decision specific and movement specific reinvesters were more likely to be involved in crashes and receive driving infringements. The current study is the first to demonstrate a significant relationship between reinvestment and driving. The implications of these findings for road safety are discussed.