Understanding pregnant women's decision making concerning prenatal screening

OBJECTIVE: This study is aimed at enhancing understanding prenatal screening decision making through testing a hypothesized decision model based on decision theory and health behavior theory. DESIGN: We obtained questionnaires from 1,666 pregnant women who were offered prenatal screening for Down's syndrome. Path analysis (using LISREL) resulted in a final model with reasonable model fit, which was verified by split-sample cross-validation. MAIN OUTCOME MEASURES: These included perceived probability, perceived severity, attitude toward termination, response efficacy, attitude toward prenatal screening, subjective norm, child-related anxiety, and intention to undergo prenatal screening. RESULTS: Attitude toward termination of pregnancy, perceived test efficacy, and subjective norm regarding the desirability of having prenatal screening determined a woman's attitude toward having a prenatal test. Anxiety was influenced by perceived risk and perceived severity of having a child with Down's syndrome, and by subjective norm, but this appeared to be a weak predictor of intention to test. Pregnant women with a positive attitude toward prenatal screening, and who perceived a subjective norm in favor of undergoing prenatal screening, showed a greater intention to have prenatal screening done. CONCLUSION: These findings suggest that more attention should be paid toward the values and social context of pregnant women during the counseling process.     

Does Mother Know Best? An Actor–Partner Model of College‐Age Women's Human Papillomavirus Vaccination Behavior

This study examined the associations of perceived threat, perceived efficacy, and parent–child communication with the extent to which college‐age women received the human papillomavirus (HPV) vaccine. Daughters and their mothers completed a survey about the HPV vaccine (N = 182 dyads). The results showed that mothers' perceived self‐efficacy to talk to their daughters and mothers' response efficacy of the vaccine were indirectly related to mother–daughter communication about HPV. Further, mother–daughter communication mediated the relation between mothers' intention to talk to their daughters and daughters' HPV vaccination behavior. This study demonstrates the importance of the social context of health behavior and the role of communication in understanding maternal influence on the HPV vaccination behavior of young adult women.     

Predictors of smoking cessation in Taiwan: using the theory of planned behavior

This study aimed to explore the factors predicting the intention to quit smoking and the subsequent behavior 6 months later using the theory of planned behavior (TPB). Data were obtained from 145 smokers who attended a smoking cessation clinic in a community hospital. All participants completed a questionnaire which included demographic information, TPB-based items, perceived susceptibility and previous attempts to quit. The actual quitting behavior was obtained by follow-up phone calls 6 months later. The TPB constructs explained 34% of the variance in intention to quit smoking. By adding perceived susceptibility, the explained variance was significantly improved to 40%. The most important predictors were perceived behavior control and perceived susceptibility, followed by attitude. Subjective norm did not contribute to the prediction of intention. Attitude and perceived behavior control contributed to the prediction of actual quitting behavior, but intention, subjective norm and perceived susceptibility did not. Our findings support that the TPB is generally a useful framework to predict the intention to quit smoking in Taiwan. The inclusion of perceived susceptibility improved the prediction of intention. With regards to successfully quitting, attitude and perceived behavior control played more crucial roles than other TPB constructs. Smoking cessation promotion initiatives focusing on reinforcing cessation belief, enhancing a smoker’s perception of their capability to quit smoking, and persuading smokers that they can overcome cessation barriers to cessation could make subsequent interventions more effective.     

Psychological predictors of eco-driving: A longitudinal study

Eco-driving has well-known positive effects on fuel economy and greenhouse-gas emissions. Moreover, eco-driving reduces road-traffic noise, which is a serious threat to the health and well-being of many people. We investigated the psychological predictors of the adoption of eco-driving from the perspective of road-traffic noise abatement. The data came from 890 car drivers who participated in a longitudinal survey over four months. Specifically, we tested the effects of the intention to prevent road-traffic noise, variables derived from the theory of planned behavior (social norm, perceived behavioral control, and attitude), and variables derived from the health action process approach (implementation intention, maintenance self-efficacy, and action control) on the intention to practice eco-driving and on eco-driving behavior. The intention to prevent road-traffic noise was not linked to the intention to practice eco-driving. The strongest predictors of the intention to practice eco-driving were attitude and perceived behavioral control. The strongest predictor of eco-driving behavior was action control. The link between behavioral intention and behavior was weak, indicating that drivers have difficulties putting their intention to practice eco-driving into action. Therefore, intervention efforts should directly address and support the transition from intention to behavior. This could be accomplished by providing reminders, which help to maintain behavioral intention, and by providing behavior feedback, which helps car drivers to monitor their behavior.     

Differences in smoking attitudes of adolescents and young adults

This study employed the Theory of Planned Behavior to examine the differences between adolescent (n = 182) and young adults (n = 209) in their intention to smoke and examined possible differences. Analysis showed that young adults had more positive self-reported attitudes toward smoking than adolescents, had higher intentions to smoke, lower perceived behavioral control over smoking and perceived they were more informed about smoking. The Theory of Planned Behavior provided good prediction of intention for both young adults (R2 = .70, attitudes, information, and past behavior significant) and adolescents (R2 = .68, attitudes, past behavior significant). For both samples attitudes were the strongest predictor of intentions to smoke. Implications for understanding intention toward smoking between adolescents and young adults are discussed.     

Self-affirmation increases acceptance of health-risk information among UK adult smokers with low socioeconomic status.

This study reports an experiment designed to test whether self-affirmation can overcome defensive processing of risk information in a sample of UK adult smokers with low socioeconomic status. Participants (N = 57) were randomized to either a self-affirmation or control condition before reading a government-sponsored antismoking leaflet and completing measures of message acceptance, intention, and self-efficacy. Participants' subsequent behavior (taking leaflets) was recorded surreptitiously. Results showed that the manipulation significantly increased message acceptance, intention and behavior, and that the effects of the manipulation on behavior were mediated through message acceptance and intention. The practical and theoretical implications of the findings are discussed in relation to the possible use of self-affirmation manipulations to enhance the effectiveness of smoking cessation interventions.     

The Impact of Social Influences in the Context of Attitude,Self-Efficacy,Intention, and Previous Behavior as Predictors of Smoking Onset1

Three different constructs for measuring social influence were utilized in the present study to explain adolescents' present and future smoking behavior at 6 (T2), 12 (T3), and 18 months (T4) after the first test. Social influence was assessed by measuring the social norms, perceived smoking behavior, and direct pressure. The impact of the social influence constructs was also assessed in the context of broader models, including attitudes and self-efficacy expectations, intention, and previous behavior. The three social influence measures correlated significantly with intention and behavior. Stepwise regression analyses showed that perceived behavior and pressure made significant contributions, after entering social norms, in explaining actual and future adolescent smoking behavior. Adding attitudes and self-efficacy increased the predictive power of the model significantly. In agreement with the theory of Fishbein & Ajzen (1975), intention was the most powerful predictor in explaining present and future smoking behavior. Attitudes, self-efficacy, and the social influences also made small unique contributions improving the explanatory power by approximately 5%. Previous behavior, however, had a substantial unique contribution in predicting future behavior after attitudes, social influences, self-efficacy, and intention were entered in the equations. Since social influences may exert their impact via different routes, it is recommended that smoking prevention programs discuss not only overt pressures such as direct pressure from peers, parents, and media, but also address the more covert social pressures such as modeling and the adolescents' ability to cope with these covert influences. Furthermore, norms on nonsmoking should be made explicit.     

Breast cancer: The intention to have a mammography and a clinical breast examination - application of the theory of planned behavior

Abstract

The purpose of these cross sectional studies was to identify the psychosocial factors explaining women's intention to have a mammography within the next two years and their intention to have a clinical breast examination (CBE) by a professional within the next year. Two random samples of women aged 40–69 years (n_a = 354, n_b = 344) completed a self-administered questionnaire that investigated theoretical constructs of the theory of planned behavior. The results of structural equation modeling showed that subjective norms and perceived behavioral control explained 81 % of the variance in intention of having a mammography. Sixty-five percent (65%) of the variance in intention of having a CBE was explained by attitude and perceived behavioral control. In conclusion, women need to be better informed, have better skills to overcome psychological and physical barriers in performing preventive breast behaviors, and promotion of preventive breast cancer methods should consider people significant for women.     

Predicting Participation in Cancer Screening: The Role of Perceived Behavioral Control1

We examined the role played by perceived behavioral control in predicting participation in colorectal cancer screening among individuals recently informed that they were at high risk for this type of cancer. A telephone interview based primarily on the theory of reasoned action was administered to 96 high-risk individuals and 144 average-risk individuals. All participants then were sent materials needed to complete the screening test. In both groups, perceived behavioral control enhanced prediction of intention to complete the test over and above the contributions of attitude and subjective norm. In addition, perceived behavioral control had a direct effect on behavior but only in the high-risk group. Further, for high-risk subjects, knowledge about test procedures moderated the relationship of perceived behavioral control and intention to behavior, but in ways only partially consistent with theory. Finally, the model was better at predicting behavior in the average than in the high-risk group. We conclude that perceived behavioral control plays an important role in the prediction of screening behavior. Perceived behavioral control's motivational role manifests itself unambiguously through its influence on intention. The role of perceived behavioral control above and beyond its influence on intention, however, needs further study and clarification.     

To Brexit or not to Brexit: The roles of Islamophobia,conspiracist beliefs,and integrated threat in voting intentions for the United Kingdom European Union membership referendum

We used an identities approach to examine voting intentions in the June 2016 UK referendum on membership of the European Union (EU). In April 2016, 303 British adults (58.7% women, age M = 34.73) indicated their voting intentions for the referendum and completed measures of identification with the national in-group, perceived threat from Muslim immigrants, belief in Islamophobic conspiracy narratives, Islamophobia, general conspiracist beliefs, ambiguity tolerance, and belief in a clash of civilizations. Path and mediation analyses indicated that greater belief in Islamophobic conspiracy theories mediated the link between Islamophobia and intention to vote to leave. Islamophobia and Islamophobic conspiracist beliefs also mediated the effects of perceived threat from Muslims on voting intentions. Other variables acted as antecedents of perceived threat or Islamophobic conspiracy narratives. These findings highlight the role that identity-based cognitions may have played in shaping voting intentions for the UK EU referendum.     

Beyond a Paycheck: The Influence of Workforce Participation on Women’s Cancer Screening in Turkey

The present study investigates the influence of workforce participation on women’s cancer screening behaviors in Turkey. In cultures with predominantly Muslim populations like Turkey, emphasis is typically placed on a woman’s traditional role as a child bearer. Although the impact of workforce participation on women’s welfare has been studied in various contexts, the relationship between workforce participation and health protective behavior has received scant attention. Using quantitative data from a survey of women aged 40 and above from 33 urban cities in Turkey (N?=?483), we examine the influence of workforce participation on breast and cervical cancer screening behaviors. Homemakers were less likely than working/retired women to be up-to-date on screenings. Women with lower income and education screened less; however, workforce participation seemed to have a positive effect on screening among these women. Additionally, working/retired women and homemakers differed from each other in terms of their perceptions regarding their risk of developing cancer (perceived susceptibility). In addition, both perceived susceptibility and women's perceptions regarding their ability to get cancer screening (self-efficacy) were significant predictors of intention to engage in screening in future. In Turkey, homemakers are in a vulnerable position due to lower rates of cancer screening. Furthermore, targeting homemakers for interventions may be easier than trying to identify other low screening groups of women such as those with lower education or income. Interventions raising perceptions of susceptibility to cancer, possibly by targeting neighborhoods during working hours, could be useful in increasing screening rates at risk women.     

Perceived threat and depression among patients with cancer: the moderating role of health locus of control

Illness perception was found to be a better predictor of psychological outcome among cancer patients than the objective characteristics of illness. The current study explored the association between the perceived threat of illness (a major aspect of illness perception) and depression among cancer patients. We examined the hypothesis that this association will be higher for persons with low External (others) or internal (self) Health Locus of Control (HLC) than for those with high HLC. The study took an exploratory approach regarding the role that different sources of control (external and internal) may assume. Fifty-seven cancer patients completed self-report measures of Perceived Life Threat (PLT), HLC and Depression. The possible moderating role of HLC on the relationship between PLT and Depression was examined. A significant relationship between perceived threat and depression was found only among participants reporting low levels of internal locus of control. The results support the hypothesis that perception of cancer as life threatening is important factor in determining the level of depression among cancer patients. The results also support the differentiation between internal and external HLC and suggest that internal HLC may be more relevant than external HLC in managing perceived threat. Internal locus of control can be interpreted as having a sense of agency and mastery which is important in managing the cognitive perception of the threat of illness. Further research is needed in order to determine the role of external HLC in managing perceived or actual threats.     

Predictors of Intention to Take Precautions Against AIDS Among Black College Students1

This research explored the relationship between behavioral intentions to engage in AIDS-risky sexual practices and a variety of variables that are theoretically and/or popularly assumed to be important factors in AIDS prevention. These variables included beliefs and knowledge about AIDS, fear of AIDS, perceived vulnerability of self and others, as well as probability that self and others on one's campus would contract AIDS, perceived efficacy to control exposure to AIDS, self-esteem, general locus of control, and past behavioral reaction to the threat of AIDS. General intention to “do something to protect oneself against AIDS,” and specific behavioral intention to use condoms in vaginal sex were measured and considered as possible proxies for future behavior. Data were collected from 124 black respondents in a southeastern university. In a series of multiple regression analyses, each of these measures of behavioral intentions was “predicted” from the other variables. Results showed that situational efficacy (to protect oneself from AIDS) was the best predictor of general intention, followed by reports of past behavioral changes as a result of the AIDS epidemic, and by knowledge. Proximal fear of AIDS was a negative predictor. For specific intentions, a specific belief about inconvenience in condom use was the best predictor, followed by past behavioral change, followed by knowledge. Normative beliefs, a belief that condoms would prevent disease, and distant threat of AIDS were also significant predictors. Theoretical and policy implications of the findings are discussed.     

Effects of intergroup exclusion on individual needs threat and behavior tendencies

This study explores the effects of intergroup exclusion on need‐threat and the behavioral tendencies of excluded individuals. Results show that those excluded by in‐group members perceived more threat to relational needs, while participants excluded by out‐group members perceived more threat to efficacy needs. In addition, participants excluded by out‐group members displayed significantly more aggression intention and less helping intention than those who were excluded by in‐group members. This study indicates that the group relationship between excluders and the excluded will directly affect threat perception and behavioral responses.     

Predicting Screening Uptake by First‐Degree Relatives of Patients Diagnosed with Colorectal Cancer1

Colorectal cancer represents a significant health threat worldwide. First‐degree relatives (FDRs) of colorectal cancer patients are at increased risk of developing the disease. There is a need to understand the psychosocial predictors of screening uptake in this group. An extended theory of planned behavior (TPB) that included perceived risk was employed to do this. Telephone interviews were conducted with 110 FDRs. The TPB accounted for up to 51% and between 16% and 25% of the variance in intention and behavior, respectively. Injunctive norm emerged as the strongest predictor of screening intention. Therefore, it is recommended that interventions to maximize screening uptake target this variable in particular.     

Effects of Message Framing on Breast-Cancer-Related Beliefs and Behaviors: The Role of Mediating Factors

The effects of gain-loss message framing on breast-cancer-related cognitions and behaviors were assessed among 539 women aged 30 to 70 years. The design involved a prebrochure telephone interview, followed by a brochure mailout, and a postbrochure telephone interview. The brochures contained information about breast cancer and the risk of family history. Recommended behaviors were framed to emphasize gains, losses, or were neutral; and statistical risk information was presented either positively or negatively. Measures included demographics, family history, breast self-examination (BSE) performance, BSE intention, self-efficacy in performing BSE, perceived early detection risk of breast cancer, perceived susceptibility to breast cancer, and anxiety about breast cancer. A loss-framed message led to greater positive change in BSE behavior. Interactions between framing effects and variables of issue involvement, perceived early detection risk, and self-efficacy indicated effects on behavior, but not beliefs.     

Impact of an interactive anti-speeding threat appeal: how much threat is too much?

This study investigates the impact of an interactive television public-service announcement (PSA) containing an anti-speeding threat appeal on feelings of telepresence and behavioral intention. In a 2?×?2?×?2 between-subjects factorial design with 213 participants, the level of threat evoked by a traditional PSA, by the interactive part of the PSA (dedicated advertising location or DAL) and by the preceding program context are manipulated to be either low or high. The results support the assumptions of the Extended Parallel Processing Model with regard to the effect of the level of perceived threat and perceived efficacy in an interactive media environment, and the important role of telepresence as a processing variable. The results of the three-way interaction effect of threat evoked by the program, the PSA and the DAL on telepresence show that when the threat levels of the program and the PSA are both either low or high, exposure to the threatening information in the DAL does not generate a significantly higher feeling of telepresence. However, when a low-threat program is followed by a high-threat PSA, the threat level of the DAL has a positive effect on telepresence. The same trend is found with a high-threat program and a low-threat PSA, although the effect of the threat evoked by the DAL on telepresence is not significant at conventional levels. Finally, there is a positive effect of telepresence on the behavioral intention to reduce speeding, which is partly mediated by the viewer's perceived efficacy to follow the recommended behavior.     

The Theory of Planned Behavior and Breast Self-Examination: Distinguishing Between Perceived Control and Self-Efficacy

This paper reports an application of the theory of planned behavior (TPB) to the prediction of breast self-examination (BSE) intentions and behavior. The study also considered the distinction between perceived control and self-efficacy within the TPB and the additional predictive utility of past behavior. A sample of 95 women completed questionnaires based on the TPB and were followed up at 1 month. Support for the distinction between perceived control and self-efficacy was provided by principal components analysis. The TPB was found to be highly predictive of intention to perform BSE and subsequent BSE behavior. Regression analyses revealed self-efficacy and attitude to be predictive of intention to perform BSE. Intention, in turn, was the sole predictor of BSE at 1-month follow-up. Past behavior was found to explain additional variance in intention, but not BSE behavior at 1-month follow-up. The results are discussed in relation to the conceptual status of the perceived behavioral control construct, and the practical implications of the results are highlighted.     

戒烟社会支持与吸烟者戒烟意向的关系：亲友认同的调节作用和吸烟危害认识的中介作用

研究旨在考察吸烟者的亲友认同和吸烟危害认识在亲友戒烟社会支持与戒烟意向关系中的作用。对340名吸烟者被试进行问卷调查,结果表明：（1）戒烟社会支持显著正向预测戒烟意向;（2）吸烟危害认识对社会支持和戒烟意向的关系起完全中介作用;（3）亲友认同对戒烟社会支持和戒烟意向的关系起显著调节作用。研究拓展了压力缓冲模型,说明了戒烟社会支持的认知功能,且支持了社会认同在社会支持发挥作用过程中的重要性。