University Students’ Attitudes and Behaviours Towards Smoking and Exercise

BackgroundDespite evidence-based efficacy, mental health services are underutilized due to low rates of help-seeking, leaving unmet mental health needs a global concern. The Theory of Planned Behavior (TPB) has been applied to understand the help-seeking process and in the development of behavior change interventions. The aim of this scoping review was to map the literature on the TPB as applied to mental health help-seeking in adults aged >18 years.MethodsThis scoping review was conducted based on the methodology presented by Arksey and O’Malley (2005). Six databases (CINAHL, PsycINFO, MEDLINE, ProQuest Health and Medicine, ProQuest Dissertations and Theses, Web of Science) and two grey literature sources (OpenGrey, Google Scholar) were systematically searched in February 2018 and updated in March 2020. Studies that explicitly discussed the TPB in the context of mental health help-seeking were initially selected; only studies that explored formal help-seeking for mental health problems and were published in English were retained. Data were extracted using Microsoft Excel.ResultsInitially, 8898 records were identified. Of these, 49 met the selection criteria and were included: 32 were journal articles and 17 were theses. Forty-three papers reported on non-intervention studies and seven articles reported on TPB-based interventions. Most studies (n = 39) identified predictors of help-seeking intentions. Attitudes and perceived behavioral control were significant predictors of intentions in 35 and 34 studies, respectively. Subjective norms were a significant predictor of intentions in 23 studies. Few studies aimed to predict help-seeking behavior (n = 8). Intentions and perceived behavioral control were significant predictors of behavior in seven and six studies, respectively. Only six TPB-based interventions were identified, all used digital technology to influence help-seeking, with mixed results.ConclusionsThe present scoping review identified a considerable evidence base on the TPB for predicting mental health help-seeking intentions. Attitudes and perceived behavioral control were frequently found to be significant predictors of help-seeking intentions. Knowledge on the TPB for predicting mental health help-seeking behavior, and on TPB-based interventions, is limited. Thus, the role of the TPB in developing help-seeking interventions remains unclear. Recommendations are presented to address such research gaps and inform policy and practice.

Using the theory of planned behavior to explore attitudes and beliefs about dietary supplements among HIV-positive Black women

The purpose of this study was to check the moderating role of individualism/collectivism in predicting male Chinese university students’ exercise behavior using the theory of planned behavior (TPB) model. The TPB model was validated through SEM (structure equation model), and the moderating effect of individualism and collectivism was validated through a hierarchical regression and simple slopes analysis using a sample collected from 115 male Chinese university students. The results showed that the product terms of individualism and TPB factors were not able to significantly predict exercise intention after inclusion in the regression equation, nor were the product terms of collectivism and PBC (perceived behavior control) able to do so. However, the product terms of collectivism and attitude, as well as collectivism and SN (subjective norm) were able to significantly predict exercise intention when included in the regression equation. That is, horizontal and vertical collectivism can significantly moderate TPB constructs, primarily by moderating the relationship between attitude-exercise intention and SN-exercise intention. This study found that the predictive validity of exercise attitudes on exercise intentions in TPB constructs is greater only at low levels of horizontal and vertical collectivism and low at high levels. The predictive validity of SN is greater at high levels of horizontal and vertical collectivism and low in the inverse case. This research serves to enrich the theoretical framework for the theory of planned behavior and provides useful information for understanding university students’ exercise intentions and behaviors.

Prediction of pharmacist intention to provide Medicare medication therapy management services using the theory of planned behavior

Cesarean delivery on maternal request is one of the important public health issues in China. Our study aimed to apply the theory of planned behaviour to comprehensively determine the factors regarding pregnant women's preference for cesarean section and to provide references for establishing measures to reduce cesarean delivery on maternal request. This cross-sectional analysis was conducted in four women's and children's hospitals in China from May to June 2018. Eligible women arriving for routine antenatal visits at these hospitals were recruited to answer a structured questionnaire. A total of 1853 pregnant women consented to participate in the investigation, with a response rate of 88.75%. Finally, 1677 pregnant women (984 nulliparae and 693 multiparae) were involved in the analysis. Descriptive statistics and logistic regression analyses were used. Of the study participants, 20.39% preferred cesarean section. For both nulliparae and multiparae, those who had lower scores of attitudes towards vaginal delivery, lower scores of childbirth self-efficacy and higher scores of subjective norms were more likely to prefer cesarean section. Pregnant women's birth preferences were significantly associated with their attitudes towards the delivery mode, childbirth self-efficacy and subjective norms, which is consistent with the theory of planned behaviour. Interventions to reduce cesarean delivery on maternal request can be developed based on the theory of planned behaviour.

This study evaluated the effects of a continuing education class that applied the theory of planned behavior to the intentions and behavior of mental health practitioners. In 2006 a total of 94 mental health practitioners were randomly assigned to either a standard continuing education class or one that applied principles of the theory of planned behavior. The class topic was a brief, self-report tool that assesses felt need for employment among people with serious mental illnesses. Participants' intentions to apply the tool were evaluated before and after each class. Participants' implementation of the tool was measured three months after the class. The class guided by the theory of planned behavior significantly and substantially increased the participants' intentions to use the tool in comparison with the standard class. Significantly more participants in the theory-guided class than in the standard class (74% versus 42%) had applied the tool by the three-month follow-up. Among those who implemented the assessment tool, the participants in the theory of planned behavior class also assessed significantly more of their caseload. The theory of planned behavior can improve and may be well suited to continuing education in psychiatry.

Physical Education, Exercise, Fitness and Sports: Early PM&R Leaders Build a Strong Foundation

This study employed an extended theory of planned behaviour (TPB) to investigate the factors underlying smoking intentions and subsequent smoking behaviour three months later in a population of schoolchildren (N = 741). The TPB provided good predictions of both intentions (R2 = 0.518; attitude, subjective norm and perceived behavioural control significant) and smoking (R2 = 0.299; intentions and PBC significant). However, intention did not fully mediate the subjective norm–behaviour relationship. Moral norm explained additional variance in intentions but not smoking. Perceived family smoking and anticipated regret explained additional variance in both intentions and smoking. Perceived friends' smoking and past behaviour explained additional variance in smoking but not intentions. Findings are discussed in relation to how the TPB can further our understanding of adolescent smoking. Implications for additions to the theory and possible interventions are also considered.

Examination of psychosocial predictors of Virginia pharmacists' intention to utilize a prescription drug monitoring program using the theory of planned behavior

Predicting Exercise Intentions and Behaviors of Taiwanese Children in a Longitudinal Sample

The present study examined the relationships among the theory of planned behavior (TPB), stages of change, and exercise behavior in 131 older persons over a three year period. Participants completed a baseline questionnaire by mail that assessed attitude, perceived control, subjective norm, intention, and stage and then received a telephone call three years later in which current exercise stage and behavior were assessed. Path analyses showed that (a) TPB constructs were significant predictors of exercise stage, (b) intention mediated the effects of TPB constructs on exercise stage, and (c) exercise behavior was best predicted by intention rather than stage. Results were interpreted as providing evidence for the long term predictive validity of TPB in the exercise domain and as questioning the necessity of combining both intention and stage in a single predictive model.

The non-medical use of methylphenidate for cognitive enhancement becomes a more and more common practice among college and university students. Although physicians are a source of access, little is known about the underlying mechanisms that might lead to physicians’ intention and behaviour of prescribing methylphenidate to improve students’ academic performance. Applying Ajzen’s theory of planned behaviour (TPB), we tested whether attitudes, subjective norms (controllability and self-efficacy) and perceived behavioural control predicted the intention and the prescribing behaviour of physicians. Participants were 130 physicians (62.3% males). Structural equation modelling was used to test the ability of TPB to predict physicians’ behaviour. Overall, the present study provides support for the TPB in predicting physicians’ prescribing behaviour of methylphenidate for cognitive enhancement. Subjective norms, followed by attitudes, are the strongest predictors of physicians’ intention to prescribe methylphenidate. To a lesser extent, controllability predicts the intention of physicians, and self-efficacy predicts the self-reported behaviour. Compared to their male colleagues, female physicians seem to have more negative attitudes towards prescribing methylphenidate for cognitive enhancement, feel less social pressure and perceive more control over their behaviour. Intervention programmes that want to decrease physicians’ intention to prescribe methylphenidate for improving academic performance should primarily focus on alleviating the perceived social pressure to prescribe methylphenidate and on converting physician neutral or positive attitudes towards prescribing methylphenidate into negative attitudes.

The purpose of this qualitative study rooted in the theory of planned behaviour (TpB) was to investigate South Korean physical education (PE) teachers’ and female secondary school students’ beliefs about girls’ physical activity (PA) participation. Particular focus was given to the curricular and pedagogical factors influencing their engagement. Participants of this study were six PE teachers and 12 female students (two from each teacher’s PE programme, one identified as having low PA and the other high PA) in two public middle schools and four public high schools in South Korea. Data were collected through demographic questionnaires, a series of semi-structured interviews with each PE teacher and one with each female secondary school student, and non-participant observations (e.g. fieldnotes) of three lessons of each PE teacher. The data were analyzed through thematic analysis using TpB to guide the coding (e.g. attitude toward the behaviour, subjective norms, and perceived behavioural control). Findings indicated that the teachers assumed mixed-gender and traditional curriculum were core barriers, whereas the female students had more diverse and conflicting perspectives, but overall, expressed desire for more choice within the curriculum. Teacher and student beliefs are compared, and pertinent pedagogical implications are provided in light of their differences.

The aim of this study was to examine the attitude–exercise behavior relationship according to the theory of planned behavior. Two additional variables, multicomponent attitude strength and role identity, were constructed to expand the initial model. The participation of 395 females in physical fitness programs over a 2-month period served as a behavioral criterion. Attitudes toward behavior, perceived behavioral control, role identity, and attitude strength predicted intention to exercise. Also, exercise behavior was predicted from intention, perceived behavioral control, role identity, and attitude strength. Perceived behavioral control was a more accurate predictor of behavior than of intention. Results also showed that the planned behavior model was slightly more successful in predicting exercise behavior when attitude strength and role identity were added to the analysis. Findings are discussed in terms of theoretical and practical implications and in terms of the role of intention, perceived behavioral control, role identity, and attitude strength variables for understanding attitude–behavior relationships.

Abstract: Background: The ownership types of pharmacies are important because it plays a significant role at the services provided by pharmacists. The competitive structure of community pharmacy sector might prompt pharmacists to pay attention for business issues more than health issues. Similar to all businesses, community pharmacists must protect their profitability to continue their profession functions. In this context, partnerships are thought as a solution for taking market advantage in community pharmacy sector. Aims: The aim of this study is modeling the community pharmacists’ intention towards pharmacist partnership by the Theory of Planned Behavior (TPB). Attitudes, subjective norms and perceived behavioral control are used as estimators of the partnership intention. Methods and Material: The measurement tool was applied face to face to a random sample of 392 community pharmacists within Ankara, Turkey. Two-sample independent t-test and ANOVA are used to determine significant differences between groups. The structural equation model (SEM) is used for modeling the pharmacists’ partnership intention. Results: A response rate of 77% was achieved. Developed “Partnership Intention of Community Pharmacists (PICP)” model provided a good fit to the data and explain 66% of the variation in the community pharmacists’ partnership intention. One unit increase in the “positive attitudes towards behavior” factor leads 0.22 units increase, one unit increase in the “negative attitudes towards behavior” factor leads 0.15 units decrease, one unit increase in the “subjective norms” factor leads 0.37 increase, and one unit increase in the “perceived behavioral control” factor leads 0.21 units in the “partnership intention”. Conclusions: The present work contributes to the literature by developing a structural model for partnership intention that contains attitudes, subjective norms, and perceived behavioral control. The extension of the PICP model can be used in modeling the pharmacists’ behaviors toward pharmacist partnership. Key words: Community Pharmacist, Pharmacist Partnership, Theory of Planned Behavior, Structural Equation Model.