Risk perceptions,worry, and attitudes about genetic testing for breast cancer susceptibility

This study assessed the unique associations of risk perceptions and worry with attitudes about genetic testing for breast cancer susceptibility. Women (general practitioner clinic attenders, university students, and first-degree relatives of breast cancer survivors; N?=?303) read information about genetic testing and completed measures assessing perceived cancer risk, cancer worry, and genetic testing attitudes and beliefs. Worry was associated with greater interest in genetic testing, stronger beliefs that testing has detrimental emotional consequences, and positive beliefs about benefits of testing and risk-reducing surgeries. Perceived risk was unrelated to interest and associated with more skeptical beliefs about emotional consequences and benefits of testing and risk-reducing surgeries. At low worry levels, testing interest increased with more positive beliefs about testing benefits; at high worry levels, interest was high regardless of benefits beliefs. The findings support Leventhal's Common-Sense Model of self-regulation delineating interactive influences of risk-related cognitions and emotions on information processing and behavior.     

Self-determination and functional persuasion to encourage physical activity

This research advances a novel approach to promoting physical activity, based on the principle of functional matching in persuasion, and the self-concordance (SC) of people's motivations for physical activity. We propose that SC establishes a positive or negative orientation toward the challenge inherent in physical activity, and that the maximum yield of participation will be achieved by communications that appeal to each orientation. In two studies, we compared how messages emphasizing challenge versus available social support would influence recipients’ self-reported practices of physical activity and attitudes toward a physical activity setting. As hypothesized, these messages had differential effects for recipients whose pursuit of physical activity varied in SC, such that favorable outcomes were more reliably associated with challenge-oriented messages among respondents higher in SC versus support-oriented messages among respondents lower in SC. The findings suggest the merits of using self-regulatory, compared with object- or personality-based, constructs and measures to indicate psychological functions of ongoing health-related behaviors.     

Perceived behavioural control,subjective norms,attitudes and intention to use condom: A longitudinal cross-lagged design

Based on the Theory of Planned Behaviour (TPB), the purpose of this investigation was to examine the directionality of the association among condom use, intention, attitudes, subjective norms and perceived behavioural control. The present study investigated the nature of these relationships using a longitudinal cross-lagged design applied to data from a cohort of 958 randomly selected Italian adults. Using structural equation modelling, two cross-lagged panel analyses revealed reciprocal relationships between intention and attitudes and between intention and condom use. Contrary to expectations, baseline subjective norms and perceived behavioural control did not predict subsequent intention to use condom when controlled for the autoregressive effect of intention at T1 on the same variable at T2. Also, perceived behavioural control at T1 did not influence condom use at T2 after controlling for the effect of baseline intention. The possibility of reciprocity was also tested for all relations and significant results were found. The moderation effect of perceived behavioural control on the relationship between intention and condom use was not significant. The differences in age, gender and partnership status were taken into account in the analyses.     

Physical activity and diabetes: An application of the theory of planned behaviour to explain physical activity for Type 1 and Type 2 diabetes in an adult population sample

Physical activity (PA) plays a key role in the management of Type 1 (T1D) and Type 2 diabetes (T2D) but there are few theory-based, effective programs to promote PA for individuals with diabetes. The purpose of this study was to investigate the utility of the Theory of Planned Behaviour (TPB) in understanding PA in an adult population with T1D or T2D. A total of 2311 individuals (691 T1D; 1614 T2D) completed self-report TPB constructs of attitude, subjective norms, perceived behavioural control (PBC), intention and PA at baseline and 1717 (524 T1D; 1123 T2D) completed the PA measure again at 6-month follow-up. Multi-group Structural Equation Modelling was conducted to: (1) test the fit of the TPB structure (2) determine the TPB structural invariance between the two types of diabetes and (3) to examine the explained variances in PA and compare the strength of associations of the TPB constructs in the two types of diabetes. The TPB constructs explained ≥40% of the variance in intentions for both diabetes groups. In cross-sectional models, the TPB accounted for 23 and 19% of the variance in PA for T1D and T2D, respectively. In prospective models, the TPB explained 13 and 8% of the variance in PA for T1D and T2D, respectively. When adjusting for past PA behaviour, the impact of PBC and intention on behaviour was reduced in both groups. The findings provide evidence for the utility of the TPB for the design of PA promotion interventions for adults with either T1D or T2D.     

Understanding adolescent type 1 diabetes self-management as an adaptive process: A grounded theory approach

Objective: To develop a conceptual understanding of the process of adapting to the self-management of type 1 diabetes during adolescence.

Design: Participants were recruited from a National Health Service paediatric diabetes service within the south-west of England which runs six countywide diabetes clinics. Thirteen interviews were conducted using a social constructivist grounded theory approach.

Results: The findings illustrate how self-management can be understood in terms of a continuum-based framework, ranging from difficulties with, to successful self-management. Adaptation within the continuum can further be understood by specific transitional phases and process mechanisms, providing further depth to individuals’ experiences of adaptation.

Conclusion: This investigation provides a conceptual understanding of the complex issues adolescents encounter while adapting to and integrating a diabetes self-management regime into their lives. It provides an invaluable framework for exploring psychological mechanisms and contextualising them within a self-management continuum. Implications for healthcare professionals are discussed and further research proposes whether the model could be applicable to other chronic illnesses.     

The prediction of safe sex behaviour: The role of intentions,attitudes, norms and control beliefs

Abstract

The present study was designed to examine the utility of the theory of reasoned action (Fishbein and Azjen, 1975) in relation to people's propensity to engage in a range of different safe sex strategies, including engaging in an exclusive sexual relationship, avoiding casual sex, and asking sexual partners about their previous sexual and IV drug use history. It was proposed that the intention to engage in a particular safe sex practice would be influenced by the person's attitude towards engaging in the practice, as well as his or her perception of the extent to which others thought they should do so (subjective norm), while behavioural intentions were proposed to predict actual behaviour. The study was also designed to examine whether, after control of the effects of the components of the theory of reasoned action, the person's generalised control beliefs would explain any additional variance in either behavioural intentions or actual behaviour. One hundred and two sexually active heterosexual students participated in the study. At the first wave of data collection, subjects completed measures of intentions, attitudes, and norms appropriate to each of the different behaviours. Measures of actual behaviour were obtained at follow-tip (three months after first period of data collection). The results of the study indicated that attitudes and norms predicted intentions for avoiding casual sex and asking sexual partners about their previous sexual and IV drug use history, while intentions predicted actual behaviour for all three safe sex strategies. Although there were no significant main effects of control beliefs on intentions or behaviour, subjects with internal control beliefs were more likely than their counterparts with external control beliefs to behave in accordance with their intentions to engage in an exclusive sexual relationship and ask sexual partners about their previous sexual and IV drug use history. Additional analyses revealed that the levels and determinants of intentions and actual behaviour were, in general, similar for males and females.     

Dispositional and comparative optimism interact to predict avoidance of a looming health threat

Research indicates that when confronted with a health threat, individuals high in both dispositional and comparative optimism employ a more avoidant style of coping than individuals high in dispositional but low in comparative optimism. We examined the hypothesis that threat distance moderates this interactive optimism association. In two studies, participants were randomly assigned to a looming or distant threat condition. Study 1 revealed that in the looming threat condition, participants high in both forms of optimism were more likely to minimise the threat and less inclined to seek additional health information relative to participants high in dispositional but low in comparative optimism. In Study 2, the same interaction pattern emerged on a measure of psychological abstraction suggesting these variables combine to alter broad information processing strategies. Implications for considering multiple forms of optimism when delivering health status information are discussed.     

Do sedentary motives adversely affect physical activity? Adding cross-behavioural cognitions to the theory of planned behaviour

The purpose of this study was to explore whether sedentary behavior cognitions explain physical activity (PA) intention and behavior when integrated within the theory of planned behavior framework (TPB). A random community sample of 206 adults and a sample of 174 undergraduate students completed measures of the TPB pertaining to PA and four popular leisure-time behaviors (TV viewing, computer use, sedentary hobbies, and sedentary socializing) and an adapted Godin Leisure-Time Exercize Questionnaire (community sample = cross-sectional, undergraduate sample = 2-week prospective). Results using ordinary least squares regression provided evidence that TV viewing intention explains additional variance in PA behavior, and affective attitude (community sample) and perceived behavioral control (undergraduate sample) towards TV viewing explains additional variance in PA intention even after controlling for PA-related TPB constructs. These results underscore the potential value of adding sedentary control interventions in concert with PA promotion.     

Resolving the theory of planned behaviour's ‘expectancy-value muddle’ using dimensional salience

The theory of planned behaviour is one of the most widely used models of decision-making in the health literature. Unfortunately, the primary method for assessing the theory's belief-based expectancy-value models results in statistically uninterpretable findings, giving rise to what has become known as the ‘expectancy-value muddle’. Moreover, existing methods for resolving this muddle are associated with various conceptual or practical limitations. This study addresses these issues by identifying and evaluating a parsimonious method for resolving the expectancy-value muddle. Three hundred and nine Australian residents aged 18–24 years rated the expectancy and value of 18 beliefs about posthumous organ donation. Participants also nominated their five most salient beliefs using a dimensional salience approach. Salient beliefs were perceived as being more likely to eventuate than non-salient beliefs, indicating that salient beliefs could be used to signify the expectancy component. The expectancy-value term was therefore represented by summing the value ratings of salient beliefs, an approach that predicted attitude (adjusted R ²?=?0.21) and intention (adjusted R ²?=?0.21). These findings suggest that the dimensional salience approach is a useful method for overcoming the expectancy-value muddle in applied research settings.