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.     

Socio-economic health inequalities: Their origins and implications

Abstract

Evidence attests to substantial variations in health contingent on socioeconomic position. It is argued that these effects cannot be dismissed as artefact nor can they be explained, in the main, by either social selection or an unequal distribution of accepted behavioural risk factors among different social groups. The most likely explanation would seem to be social causation. However, it is continuing social and material inequality that appears most implicated; accounts which locate the effects in childhood social and material causes are far less compelling. The persistence of socioeconomic health differentials into the materially better-off social strata and the possible determining role of relative as well as absolute living standards suggest that psychological, in addition to material, variables are likely to be involved. Isolating the key psychological variables and identifying the nature of their influences will not be easy tasks, although social relations, psychological stress, uplifts, and control have emerged as possible candidates. However, psychological mediators of this sort most probably constitute surface rather than basic causes. Socio-economic inequality, it is contended, remains the basic cause, and, as such, the proper target for intervention. Psychological interventions are unlikely to yield much in the way of dividends in this context and indeed could inadvertently contribute to victim blaming.     

Identity,coping style,and health behaviour among first generation Irish immigrants in England

Abstract

Berry's (1997) framework for acculturation research was used to explore the relationship between identity and health among Irish immigrants in England. One hundred and twelve first generation Irish immigrants completed questionnaire measures of ethnic identity, opportunities for identity expression, generalised coping style, and health behaviour. Significant, though small, positive correlations were observed between identity and health behaviour as predicted. Regression analyses and path analysis were used to present a model of the link between variables. Of particular note were the contrasting ways in which the two dimensions of identity were associated with health behaviour. Participants who positively evaluated their ethnic origins reported engaging in healthier behaviour and adopting more beneficial coping strategies when faced with day-to-day stresses and problems. Participants who reported their ethnic origin as more central to their overall identity were also more likely to adopt beneficial coping strategies. Concomitantly, however, they had fewer than desired opportunities for expressing their ethnic identity which was, in turn, associated with less beneficial coping and health behaviour. In looking for ways to tackle the well-documented health problems of both first and second generation Irish in England, the results suggest that encouragement to feel more positive about their ethnic identity might result in greater usage of behavioural approach coping and, relatedly, to improved health behaviour.     

How highlighted utensils influence consumption in a dark setting

Abstract

Objective: Previous research has shown that people consume less food in the dark compared to normal vision conditions. While this effect is commonly attributed to increased attention to internal cues, it could also be caused by increased difficulty to maneuver in a dark setting. This study investigated this potential alternative explanation.

Design: A 2 (dark versus normal vision setting)?×?2 (highlighted versus non-highlighted utensils) between-subjects design was employed.

Main outcome measures: Perceived difficulty of maneuvering and consumption of yoghurt were assessed as main outcome measures.

Results: Participants consumed marginally less in dark compared to normal vision conditions, and experienced higher difficulty of maneuvering. Importantly, both effects were qualified by a significant interaction with highlighting, which increased consumption and reduced perceived difficulty compared to no highlights. Difficulty of maneuvering did not mediate the interactive effect of vision and highlighting on consumption.

Conclusion: Difficulty to maneuver should be considered when investigating eating behaviour under dark conditions. In line with an embodied cognition account, results also reveal the necessity of visual information for interaction with objects in the environment and imply that detail-deprived object information may be sufficient for activation of the motor system.     

Predictors of willingness to register as an organ donor among dutch adolescents

Abstract

In order to identify relevant determinants of organ donor registration among Dutch adolescents, a school-based cross-sectional survey was conducted among 145 high school students. Fifty-one percent of respondents indicated they were willing to register as organ donors and 80% reported a positive general attitude towards registration. Various misconceptions about the registration and donation procedure were identified. On average only moderate knowledge levels related to organ donation were found. In order of strongest association, negative outcome expectancies, past behaviour and experience, positive outcome expectancies, and social outcome expectancies proved to be significant predictors of willingness to register as organ donors. Self-efficacy was indirectly associated with willingness via outcome expectancies. Knowledge about organ donation was not significantly associated with willingness. The results suggest that in order to persuade adolescents to register as organ donors, refutational messages will have to be developed to counterargue the prevailing negative outcome expectancies related to organ donation and registration as an organ donor.     

Reducing demand for ineffective health remedies: overcoming the illusion of causality

Abstract

Objective: We tested a novel intervention for reducing demand for ineffective health remedies. The intervention aimed to empower participants to overcome the illusion of causality, which otherwise drives erroneous perceptions regarding remedy efficacy.

Design: A laboratory experiment adopted a between-participants design with six conditions that varied the amount of information available to participants (N?=?245). The control condition received a basic refutation of multivitamin efficacy, whereas the principal intervention condition received a full contingency table specifying the number of people reporting a benefit vs. no benefit from both the product and placebo, plus an alternate causal explanation for inefficacy over placebo.

Main outcome measures: We measured participants’ willingness to pay (WTP) for multivitamin products using two incentivized experimental auctions. General attitudes towards health supplements were assessed as a moderator of WTP. We tested generalisation using ratings of the importance of clinical-trial results for making future health purchases.

Results: Our principal intervention significantly reduced participants’ WTP for multivitamins (by 23%) and increased their recognition of the importance of clinical-trial results.

Conclusion: We found evidence that communicating a simplified full-contingency table and an alternate causal explanation may help reduce demand for ineffective health remedies by countering the illusion of causality.     

Response of the pituitary-adrenal axis in terms of type a behaviour,hostility and vital exhaustion in healthy middle-aged men

Abstract

Pituitary-adrenal axis was studied in terms of Type A behaviour, hostility and vital exhaustion among 69 healthy middle-aged men. The results showed that psychological factors could explain a significant proportion of the biologically manipulated responses of HPA axis, but they worked in different ways. Type A behaviour was related to a high level of mean basal ACTH and a low level of cortisol response to ACTH stimulation after dexamethasone suppression; hostility was related to a high level of mean basal cortisol and a high cortisol in cortisol/ACTH ratio, while vital exhaustion was characterized by a low level of mean basal ACTH and a decreased ACTH in relation to cortisol. The adrenocortical patterns, i.e. a high ACTH-low cortisol; a high cortisol; and a low ACTH-low mean basal cortisol, as related to Type A behaviour, hostility and exhaustion, respectively, are in line with the traditional physiological stress model and suggest that different adrenocortical responses might be able to identify different mental stress processes. Sense of control has been suggested to be a key concept for psychological understanding of this finding.     

Bringing up condom use and using condoms with new sexual partners: Intentional or habitual?

Abstract

A prospective study of 94 Dutch adults who have casual sexual partners examined whether two important aspects of safe sex, namely bringing up condom use (BCU) and actual condom use (ACU) are intentional or habitual. For each of these aspects, a model based on the Theory of Planned Behaviour (TPB: Ajzen, 1991) was pitted against a similar model that was extended with a path from past to later BCU and ACU, respectively. The results suggest that bringing up the issue of condom use was equally predicted by intentions and past BCU. However, among people with casual partners, using condoms - and more importantly not using condoms - was especially predicted by past ACU, suggesting a strong habitual component. These results are discussed in terms of their implications for safe sex education and the use of theories in safe sex promotion campaigns.     

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.