PU505: Health Behavior Unit 4 Theory of Reasoned Action and Theory of Planned Behavior Flashcards
What is the essence sentence?
Health behavior is influenced by intention.
What are the constructs of TRA and TPB?
Attitudes: A series of beliefs about something that affect behavior
Subjective norms: Behaviors perceived as expected by important people in one’s life and desire to comply with them
Volitional control: The ability to decide at will to engage or not engage in a behavior
Behavioral control: The perceived ease or difficulty of performing a behavior
When was the prevailing assumption that attitude determined behavior even though there was no evidence to support this? (Fishbein & Ajzen, 1975)
1960s 1970s
In 1975, Fishbein and Ajzen conducted a review of studies done on attitude and behavior and, once again, found little evidence supporting a relationship between the two, further confirming that the assumption was false. They argued that although attitude should be related to behavior, it is not necessarily so. Instead, they proposed it was the intention to perform rather than the attitude toward a behavior that determined behavior and with this came the conceptual basis for the theory of reason action.
Hayden, Joanna. Introduction to Health Behavior Theory (p. 109). Jones & Bartlett Learning. Kindle Edition.
As it turned out, the theory of reason action (TRA) was useful in explaining behaviors under a person’s willful (volitional) control, but not so useful in explaining behaviors not under willful control. To address this situation, in 1991 the theory of reason action was revised. The revision is the theory of planned behavior (TPB) (Ajzen, 1991, 2002).
Hayden, Joanna. Introduction to Health Behavior Theory (p. 109). Jones & Bartlett Learning. Kindle Edition.
Why is TRA and TPB not presented as behavior change theories?
Their utility lie in the ability to predict and explain people’s intentions and, subsequently, their behavior.
What does TRA and TBP propose that behavior is based on the concept of what?
Intention
Why isn’t intention the same as actually engaging in the behavior?
Intention is the EXTENT to which a person is ready to engage in a particular behavior
OR
The likelihood that a person will engage in a particular behavior
It is just the prediction of actual behavior, not the behavior itself.
For example, intending to walk three time a week is not the same as putting on sneakers and walking three times a week, but someone who intends to walk is more likely to actually do it.
Which theory predicts behavior that is under willful control and which theory predicts behavior that is not under willful control?
TRA is for willful control (volitional control) and TPB is for unwilful control (behavioral control)
How is an attitude towards a behavior formed?
By a series of personal beliefs.
Each belief links the behavior to an expected outcome of engaging in the behavior. The expected outcome reflects a person’s judgment of its desirability.
Consequently, people form favorable attitudes toward and tend to engage in behaviors that they judge to have desirable or positive outcomes (Ajzen, 1991).
Examples of attitudes influencing behavior
An example of this is high school students’ intention to meditate. Students with favorable attitudes toward meditation have greater intentions to meditate (Erbe et al., 2019). The beliefs of students with favorable attitudes toward meditating twice a week are that it will reduce stress, improve their focus, and be calming. Among the negative or unfavorable beliefs linked to the behavior that might lessen the intention to meditate are that it’s time consuming and sleep inducing (Erbe et al., 2020).
In a study of 300 college students in Columbia, their attitudes toward cigarette smoking had the strongest influences over their smoking behavior. Attitude was determined by the extent to which the students agreed with the following statements: cigarette use may help me forget my problems, avoid feeling sad, avoid feeling lonely, and avoid feeling worried (Valencia-Arias et al., 2021).
In another example, a nationally representative sample of more than two thousand people in Spain revealed that those with pro-environmental attitudes—that is, they believed it was necessary to protect and conserve the environment even if the cost of doing so was high—was linked to engagement in pro-environmental behaviors, such as usually buying products with minimal or reusable packaging and separating and recycling paper, plastic, and glass (Escario et al., 2020).
Farmers’ attitudes toward pesticide use literally kill thousands of them every year. Pesticide use is ubiquitous in farming. Although pesticides protect crops, they are a threat to human health, poisoning almost 400 million farmers every year and killing 11,000 (Boedeker et al., 2020).
Hayden, Joanna. Introduction to Health Behavior Theory (p. 113). Jones & Bartlett Learning. Kindle Edition.
In 2020, a national sample of more than 1,000 adults in the United States were surveyed to determine their attitudes toward COVID-19 vaccination among those who did not intend to be vaccinated. Of the 11% of adults who fell into this group, the reasons they provided reflected negative attitudes toward vaccination. For example, they did not believe in, want, or feel comfortable with vaccines, didn’t believe vaccines worked, or that it’s possible to vaccinate against a virus (Fisher et al., 2020).
Intention to vaccinate children against COVID-19 depends on parental attitudes. A survey of more than 1,000 parents in China who had at least one child under the age of 18 found that the majority of them (72.6%) were likely or very likely to have their children vaccinated. These parents had positive attitudes toward vaccinating their children, which was reflected in their agreement with the following statements: COVID-19 vaccination is highly effective in protecting children from the disease; COVID-19 vaccination can contribute to the control of COVID-19; there will be an adequate supply of vaccine (Zhang, et al., 2020).
Unfortunately, positive parental attitudes don’t always result in health enhancing behaviors. As an example, even when some parents have a positive attitude toward their children’s oral health—that is, they generally agree it’s important for them to practice recommended oral health behaviors, that oral hygiene recommendations can prevent cavities, and that poor oral health can be a severe problem—they still don’t enforce adherence to the behaviors known to protect their children’s teeth (Brega et al., 2019).
Cyberbullying is an example of a positive attitude leading to an undesirable behavior. Elementary and high school students with positive or favorable attitudes toward cyberbullying—that is, they agree that teasing people online is fun and that making fun of people in text messages feels good—are more likely to engage in cyberbullying behavior than those who do not have positive attitudes (Barlett et al., 2019). Similarly, favorable attitudes toward cyberbullying in college students is associated with greater intention to cyberbully, which is predictive of more frequent cyberbullying behaviors (Doane et al., 2014).
Sexting is an example of a situation when a negative attitude toward a behavior is desirable. Adolescents with negative attitudes toward sexting believe sending sexually suggestive texts is risky, leaves them vulnerable, or may cause them problems in the future are less likely to send sexually explicit texts or images on social media (Confalonieri et al., 2020; Weisskirch & Delevi, 2011). In contrast, those with positive attitudes toward sexting believe it’s fun, exciting, and just part of flirting and being in a relationship (Weisskirch & Delevi, 2011).
What are subjective norms aka perceived norms?
They are perceived social pressures a person feels to engage or not to engage in a certain behavior because of what they believe important others expect of them.
These important others are often family members, friends, or peers but can be religious figures, healthcare providers, or any others we hold in high esteem. They are people we want to please.
An example of how subjective norms influence behavior is the hand hygiene practices of critical care nurses. In two medical centers in the southeastern United States, subjective norms were the strongest predictor of nurses washing their hands with soap and water or using hand sanitizer before and after caring for a patient. Hand hygiene behavior resulted from their motivation to comply with the perceived social pressures (injunctive beliefs) of their colleagues, the medical staff, and most importantly their nursing managers. Interestingly, although the nurses’ attitudes toward hand hygiene was positive and associated with intention to practice hand hygiene, it was subjective norms rather than attitude that was associated with them actually washing their hands or using sanitizer (Pira et al., 2018).
During the COVID-19 pandemic, practicing personal protective measures was essential to reduce viral transmission. This was especially important for older adults and those with chronic diseases. The intention to engage in preventative behaviors, for example wearing a mask, social distancing, and washing hands with soap and water or using hand sanitizer, was strongly influenced by subjective norms. People who perceived a social pressure to practice the preventative recommendations had a greater intention to do so (Andarge et al., 2020).
Subjective norms also played a role in the behavior of older adults during the COVID-19 pandemic when stay-at-home orders were replaced with safer-at-home advisories. The intention of older adults to continue social distancing as they had during the strict stay-at-home period or to ease up on it were influenced by what they perceived their friends and families expected them to do. Their subjective norms reflected their injunctive beliefs that most people who were important to them thought they should stay home and that these important people expected them to do so (Callow et al., 2020).
What are subjective norms formed by? (2)
Injunctive normative beliefs
Descriptive normative beliefs
What are injunctive normative beliefs?
It is the expectation that important people in our lives approve or disapprove of a particular behavior.
What are descriptive normative beliefs?
It is our beliefs as to whether these important people perform the behavior themselves.
Even though behavior then results from our motivation to comply with what we PERCEIVE important people in our lives want and expect us to do, however, they expectations are based on what?
This should be remembered.
The expectations are based on PERCEPTIONS rather than fact, so they may or may not be based in reality.
More information on subjective norms
Not surprising, subjective norms play a significant role in the behavior of adolescents. This is especially true in relation to addictive behaviors such as smoking (Tapera et al., 2020), drug use (Hohman et al., 2014), and gambling (Leon-Jariego et al., 2020).
While the negative health effects of smoking and drug use during adolescence are significant, gambling behavior during adolescence is also a worrisome behavior because it’s a precursor of pathological gambling later in life. The best predictors of adolescent intention to start gambling are subjective norms. For example, adolescents’ injunctive beliefs of what they think (perceive) parents and peers want them to do about gambling (Leon-Jariego et al., 2020), what they perceive the opinions of parents and peers are about gambling, how important these opinions are to them (Botella-Guijarro et al., 2020), and if their parents and peers gamble (descriptive beliefs) influence their motivation to comply with these perceptions (Leon-Jariego et al., 2020). Therefore, if adolescents think their parents and peers are okay with them gambling, if they think their parents’ and peers’ opinions are that gambling is an acceptable behavior, and if their parents’ and peers’ gamble, there is greater motivation for them to comply with these perceptions and gamble.
Another behavior significantly affected by subjective norms is speeding. Speeding directly influences the risk of an accident, the severity of injuries, and the likelihood of death. For passengers in a car, an impact speed of 50 mph (80 km/h) raises the likelihood of death 20 times over what it is at 20 mph (30 km/h) (World Health Organization, 2004). It’s the perceived subjective norms (injective norms) of passengers in the car, family members, or friends toward speeding that encourages speeding (Liang & Xiao, 2020) and motivates the driver to comply. Subjective norms could just as easily discourage speeding.
The unsafe driving practices of online car hailing drivers, such as illegal parking and lane changing, speeding, and running yellow lights, have caused traffic accident rates to surge. When the unsafe behaviors of these drivers were studied, it turned out they were strongly related to driver subjective norms. Specifically, they reflected the drivers’ perceptions of their families’, friends’, and employers’ approval or disapproval of unsafe driving and the extent to which they cared about their views (Xiao, 2020).
Hayden, Joanna. Introduction to Health Behavior Theory (pp. 117-118). Jones & Bartlett Learning. Kindle Edition.
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