Attitudinal Beliefs Research Articles

Comparison of four methods for assessing the importance of attitudinal beliefs: An international Delphi study in intensive care settings

Behaviour change interventions often target 'important' beliefs. The literature proposes four methods for assessing importance of attitudinal beliefs: elicitation frequency, importance ratings, and strength of prediction (bivariate and multivariate). We tested congruence between these methods in a Delphi study about selective decontamination of the digestive tract (SDD). SDD improves infection rates among critically ill patients, yet uptake in intensive care units is low internationally. A Delphi study involved three iterations ('rounds'). Participants were 105 intensive care clinicians in the United Kingdom, Canada, and Australia/New Zealand. In Round 1, semi-structured interviews were conducted to elicit beliefs about delivering SDD. In Rounds 2 and 3, participants completed questionnaires, rating agreement and importance for each belief-statement (9-point Likert scales). Belief importance was assessed using elicitation frequency, mean importance ratings, and prediction of global attitude (Pearson's correlations; beta-weights). Correlations between indices were computed. Participants generated 14 attitudinal beliefs. Indices had adequate variation (frequencies: 4-94, mean importance ratings: 4.93-8.00, Pearson's correlations: ± 0.09 to ± 0.54, beta-weights: ± 0.01 to ± 0.30). SDD increases antibiotic resistance was the most important belief according to three methods and was ranked second by beta-weights (behind Overall, SDD benefits patients to whom it is delivered). Spearman's correlations were significant for importance ratings with frequencies and correlations. However, other indices were unrelated. The top four beliefs differed according to the measure used. Results provided evidence of congruence across three methods for assessing belief importance. Beta-weights were unrelated to other indices, suggesting that they may not be appropriate as the sole method. What is already known on this subject? Attitudinal beliefs (specific beliefs about the consequences of performing an action) are key to designing interventions to change intentions and behaviour. The literature reports four methods for assessing the importance of attitudinal beliefs: frequency of elicitation in interviews, importance ratings in questionnaires, and strength of prediction (bivariate and multivariate) of global attitude scores. The congruence between these measures of importance is not known. What does this study add? Four indices of importance were examined in a multi-professional, international study about the use of selective digestive decontamination to prevent infection in intensive care settings. Three indices were correlated with one another. Each method used to assess importance produced a different subset of the most important beliefs. Selection of the most important beliefs should use multiple assessment methods. This evidence suggests that multiple regression approaches may not be appropriate as the sole method for assessing belief importance.

Barriers and facilitators to CPR training and performing CPR in an older population most likely to witness cardiac arrest: A national survey

BackgroundBystander CPR rates are lowest at home, where 85% of out-of-hospital cardiac arrests occur. We sought to identify barriers and facilitators to CPR training and performing CPR among older individuals most likely to witness cardiac arrest. MethodsWe selected independent-living Canadians aged ≥55 using random-digit-dial telephone calls. Respondents were randomly assigned to answer 1 of 2 surveys eliciting barriers and facilitators potentially influencing either CPR training or performance. We developed survey instruments using the Theory of Planned Behavior, measuring salient attitudes, social influences, and control beliefs. ResultsDemographics for the 412 respondents (76.4% national response rate): Mean age 66, 58.7% female, 54.9% married, 58.0% CPR trained (half >10 years ago). Mean intentions to take CPR training in the next 6 months or to perform CPR on a victim were relatively high (3.6 and 4.1 out of 5). Attitudinal beliefs were most predictive of respondents’ intentions to receive training or perform CPR (Adjusted OR; 95%CI were 1.81; 1.41–2.32 and 1.63; 1.26–2.04 respectively). Respondents who believed CPR could save a life, were employed, and had seen CPR advertised had the highest intention to receive CPR training. Those who believed CPR should be initiated before EMS arrival, were proactive in a group, and felt confident in their CPR skills had the highest intention to perform CPR. InterpretationAttitudinal beliefs were most predictive of respondents’ intention to complete CPR training or perform CPR on a real victim. Behavioral change techniques targeting these specific beliefs are most likely to make an impact.

Attitudinal, normative, and control beliefs underlying people’s curbside household waste recycling decisions

This study examined the beliefs underlying people’s decision-making, from a theory of planned behaviour (TPB) framework, in the prediction of curbside household waste recycling. Community members in Brisbane, Australia (N = 148) completed a questionnaire assessing the belief based TPB measures of attitudinal beliefs (costs and benefits), normative beliefs (important referents), and control beliefs (barriers) in relation to engaging in curbside household waste recycling for a 2-week period. Two weeks later, participants completed self report measures of recycling behaviour for the previous fortnight. The results revealed that the attitudinal, normative, and control beliefs for people who performed higher and lower levels of recycling differed significantly. A regression analysis identified both normative and control beliefs as the main determinants of recycling behaviour. For normative beliefs, high level recyclers perceived more approval from referents such as partners, friends, and neighbours to recycle all eligible materials. In addition, the strong results for control beliefs indicated that barriers such as forgetfulness, lack of time, and laziness were rated as more likely to hamper optimal recycling performance for low level recyclers. These findings provide important applied information about beliefs to target in the development of future community recycling campaigns.

Attitudes towards family–staff relationships in Australian residential aged care settings: Development and psychometric evaluation of the ‘Family and Staff Relationship Attitude Tool’ (FASRAT)

To develop and psychometrically evaluate the Family and Staff Relationship Attitude Tool (FASRAT) for use in Australian residential aged care facilities to assess the attitudinal beliefs of residential aged care staff towards staff-family relationships. Development and testing of the psychometric properties of the 26-item FASRAT occurred in three phases which included item development based on a systematic review of the research literature, interviews with aged care staff and families, expert panel review and testing with aged care staff. Content validity and internal consistency of the FASRAT support its use as an instrument to measure staff attitudinal beliefs about staff-family relationships in the residential aged care setting. The FASRAT will enable residential aged care facilities to measure the attitudinal beliefs of its staff about staff-family relationships and provide a basis for the development and implementation of interventions to address identified gaps which impact on relationship quality.

Social Cognitive Changes Resulting from an Effective Breastfeeding Education Program

Infants of parents with a history of asthma could benefit from exclusive breastfeeding during the first 6 months of life to reduce the chance of developing childhood asthma. Continuing to breastfeed for 6 months seemed difficult to perform for many Dutch women. Therefore, an educational breastfeeding program was developed and implemented. The program (a theory-based booklet and pre- and postnatal home visits by trained assistants) significantly improved exclusive breastfeeding rates at 6 months postpartum (48% for intervention vs. 27% for control). Repeated-measurements analyses showed significant increases in knowledge and more positive attitudinal beliefs regarding breastfeeding for 6 months, in particular immediately after exposure to the program, compared with the controls. As expected, over time perceived self-efficacy and women's positive emotions toward breastfeeding increased, and support for breastfeeding diminished in both groups. The intervention group was reported to perceive more pressure to bottle feed and to know more breastfeeding models than the control group. Implications for practice are discussed.

Workplace Hand Hygiene and Wellness

Community hand hygiene interventions have reduced the spread of infectious disease in elementary schools, daycare centers, and private homes. Despite this success, and the potential for reducing workplace absenteeism and presenteeism, few peer-reviewed hand hygiene intervention studies among workers have been published. This research used the Theory of Planned Behavior (TPB) to guide the development of a model to understand and predict motivations for performing hand hygiene, and to examine related illness, absenteeism, and presenteeism among employees from 39 bank branches in Ohio. Although the TPB has been used extensively to elucidate hand hygiene practices among employees in the health care and food industries, little is known about the ability of the TPB to predict hand hygiene practices among workers in public settings. These survey findings indicate a need for hand hygiene improvement, and support the use of attitudinal beliefs and social norms to guide multimodal approaches for workplace hand hygiene interventions.

An Examination of Behavioral Antecedents to Individuals' Participation in a Social Mentoring Network from a Protégé's Perspective

The present study seeks to identify the behavioral antecedents to individuals' participation as protégé in a social mentoring network (SMN). It draws on social psychology and vocational literature and applies the Theory of Planned Behavior (TPB) to understand and predict the specific behavioral context. A SMN was operationally defined as a special case of informal mentoring coupled with a social networking platform. Two additional variables--similarity and self-disclosure--were incorporated into the standard TPB model to improve its predictive power. A total of 376 respondents completed their first- and second wave questionnaires in a 2-week-longitudinal survey design. Two hierarchical multiple regressions were performed to determine the unique contributions made by the extended TPB model to the variance in behavioral intention and behavior. The results indicate that intention was demonstrated as a single significant variable in determining the behavior. Furthermore, intention was significantly influenced by respondents' attitudinal and normative beliefs toward the behavior, weighted by their internal mechanism that establishes the importance of necessary preconditions for the development of successful mentoring relationship. These preconditions include protégés' need for similarity with their mentor as well as willingness to self-disclose themselves to the SMN.

Challenges to prepare pre-service teachers for inclusive education in Bangladesh: beliefs of higher educational institutional heads

This paper reveals the beliefs of higher education institutional heads about the challenges they face in preparing pre-service teachers for inclusive education in Bangladesh. Semi-structured interviews were conducted with 22 institutional heads. Data were analysed by applying thematic analysis procedure. Challenges were found in four theme areas: attitudinal beliefs, academic challenges, challenges in practicum and challenges for beginning teachers. Lack of appropriate information in the teacher preparation curriculum, untrained teacher educators, limited resources, inappropriate teaching-learning approaches, insufficient practicum experiences, and large class sizes were some of the major challenges identified. Participants also identified some useful strategies to address the challenges which ranged from curriculum reform, emphasizing practicum more than theories, human resource development empowering institutional heads to implement inclusion and resource support. Implications of the findings for university educators are discussed.

What a Difference a Case Makes Or: What Goes into a Strong Supreme Court Majority

We undertake an analysis of majority size by issue area, Court composition, party of appointing President, and Martin-Quinn scores to gain leverage on what global factors, besides attitudinal belief, could be at play in a given case, and more specifically, what the trend of certain issues or Court compositions are in making larger majorities.

The Poverty in Psychoanalysis: ‘Poverty’ of Psychoanalysis?

The article reviews psychoanalytic scholarship on the themes of poverty and deprivation available on the Psychoanalytic Electronic Publications (PEP-web). The article evaluates select definitions and explanations of poverty as illustrated in the scientific papers published in the PEP-web from 1933 to 2003 (covering 70 years) and finds that psychoanalytic scholarship has very little to say about poverty or the poor. In spite of references to the poverty of dreams, poverty of affect, poverty of intellect, there is in reality little engagement with ‘real’ poverty. The reasons and effects of this neglect are firstly traced to the attitudinal biases and beliefs held by the psychoanalytic authors which prevents them from acknowledging poor and deprived as worthy of their attention. The review also points out to great confusions, oversimplifications and neglect shown in the use of poverty and related terminologies. Absence of fuller appreciation of poverty is then traced to some philosophical quandaries in psychoanalytic epistemology such as the place of real versus psychic, culture versus individual and need versus value to cite a few. A third reason for this neglect may be attributed to the uneven spread, reception and development of psychoanalysis in different geopolit-zical locations, and the neglect in addressing these cultural differences could be behind these social inequalities remaining unaddressed in the literature.

Colorectal Cancer Survivors' Interest in Genetic Testing for Hereditary Cancer: Implications for Universal Tumor Screening

Benefits of universal tumor screening for Lynch syndrome (LS), the most common form of hereditary colorectal cancer (CRC), will be realized only if patients are interested in genetic counseling and testing. This study explores interest in genetic testing for hereditary CRC among CRC patients who have never received genetic counseling or testing. Using results from a cross-sectional survey of CRC patients (n=91) at varying categories of risk for hereditary CRC, bivariate and multivariable analyses were conducted to compare positive and negative attitudinal beliefs regarding genetic testing, risk perceptions, demographics, and tumor stage of those who were interested in genetic testing (n=61) and those who were not interested or were not sure (n=30). Although significant at the bivariate level, gender, perceived relative risk of hereditary cancer, employment status, and belief that genetic testing would help in preparing for the future were not significantly related to interest in genetic testing when controlling for all other variables in a logistic regression model. The two factors that remained significant include a single-item question measuring the belief that genetic testing is warranted based on personal/family history and a positive attitudinal scale regarding the utility of genetic testing in medical decision making and cancer prevention. Results have potential implications for policies regarding universal tumor screening for LS.

Social Cognitive Predictors of Exercise Intentions Among Substance Users in Recovery

The present study examined the social-cognitive predictors of exercise intention among substance abusers in recovery. An extended version of the theory of planned behavior was used, accounting for past exercise behavior and self-esteem. Members of self-help groups in Melbourne, Australia (N = 201) completed an anonymous questionnaire. Hierarchical regression, multiple mediation, and moderation analysis were used. The findings showed that attitudes and perceived behavioral control were the strongest predictors of exercise intentions, and mediated the effects of past behavior and self-esteem. Psychological interventions to promote exercise among substance abusers should target attitudinal beliefs and build self-control skills.

Psychological Insulin Resistance (PIR) Among Type 2 Diabetes Patients at Public Health Clinics in Federal Territory of Malaysia

Introduction: Insulin has been viewed as a treatment option of last resort in type 2 diabetes management. The decision to start insulin therapy is often diffi cult. Patients are usually reluctant to begin insulin and many cases delay the initiation of insulin therapy. The aim of this study is to determine the magnitude of insulin refusal or recognize as psychological insulin resistance (PIR) and to identify its predictors. Materials and Methods: This is a cross-sectional study and data was collected from two primary public health clinics in Kuala Lumpur and Putrajaya. The study sample consisted of 404 insulin naive patients with type 2 diabetes. A self-administered questionnaire was used to obtain demographic and clinical information. Results: Fifty-one percent of patients with type 2 diabetes were found to be unwilling to take insulin. Regression analysis revealed that females were 2.7 times more likely to resist insulin treatment compared to males and those with uncontrolled diabetes were 1.8 times more likely to resist insulin treatment compared to controlled diabetics. Patients will refuse insulin if they perceived their diabetes worsen with insulin use. After controlling for other attitudinal belief factors in the model, an increase in one unit of perceived disease severity will increase the likelihood of PIR around 2 times. Conclusion: Several misconceptions regarding insulin therapy were identifi ed and specifi c education intervention is recommended for successful transition to insulin therapy.

Determinants of exclusive consumption of fluoride-free water: a cross-sectional household study in rural Ethiopia

The occurrence of high fluoride concentrations in the ground- and surface water all over the world leads to the risk of developing dental and skeletal fluorosis. In Ethiopia, 8 million people depend on water sources with excessive fluoride. In four project areas in the Ethiopian Rift Valley, fluoride removal household filters based on bone char media have been implemented. This study examines possible predictors of consuming filtered water derived from various behavior change theories. In a complete cross-sectional survey, 160 filter users were interviewed through structured face-to-face interviews. A logistic regression was carried out to reveal factors predicting consumption of filtered water. The results show that the consumption of fluoride-free water is mainly related to people’s pride in offering filtered water to guests (status norm) and the feeling of being able to produce enough water with the filter (perceived behavioral control). Moreover, the study showed that the more filter users like the taste of filtered water and the more expensive they perceive the filter media, the more likely users will exclusively consume filtered water (attitudinal beliefs). Furthermore, perceiving the act of filling as a matter of habit (perceived habit) enhances filtered water consumption. Based on the results, possible intervention strategies to change the influential psychological factors and, hence, increase the consumption of treated water can be designed.

Which psychological factors change when habitual water treatment practices alter?

AimHousehold water treatment systems (HWTS) and safe storage systems are an effective measure to ensure safe water supply. The adoption of HWTS requires long-term changes in behavior. During campaigns for health related behavior change, many people appear to have fixed behavioral patterns that are difficult to change. Since behavior change originates in the altering of inner psychological factors, it is necessary to investigate the transformation of these factors. Five categories of psychological factors are identified as responsible for the formation of habitual behavior: risk beliefs, attitudinal beliefs, normative beliefs, ability beliefs, and maintenance beliefs. This study analyzes which factors change when long-term users of HWTS, non-users, or ‘tryers’ (using HWTS occasionally), transform their behavior type or remain in their current behavior type.Subjects and methodsData were obtained by conducting six panel interviews about the use of solar water disinfection (SODIS) over a period of 14 months, with 694 households, in the slum areas of Harare, Zimbabwe.ResultsThe results reveal that progressing to a higher level of user type (one who increases their use of SODIS), or staying at a high level of use (maintaining their level of use) is associated with the user’s ability to avoid being hindered by other habits, to remember the behavior in respective situations, and to notice that other people are also using SODIS.ConclusionSuggested strategies which may foster these factors include the control of distracting stimuli, forming implementation intentions, daily routine planning, applying reminders, and using public commitments.

Determinants of HIV Risk and Protective Needle-Sharing Behaviors Among Drug Injectors

Few studies have tested a broad range of theory-based determinants of injection-related risk and protective behaviors. The current study hypothesize relationships among attitudinal beliefs, normative influences, perceived self-efficacy, intentions, and performing these behaviors consistent with the theory of planned behavior and related models. The conceptual model was tested in a cross-sectional sample of 895 drug injectors recruited from street settings in the southwestern United States and who completed a face-to-face interview. Structural equation modeling results showed intention and self-efficacy most consistently predicted needle sharing and bleaching considering all other model variables. Discussion focuses on the value of using these theoretical concepts to examine needle sharing and other behaviors among injection drug users and their relevance for developing HIV-reduction interventions.

Construal Level Theory and Theory of Planned Behavior: Time Frame Effects on Salient Belief Generation

This study tests implications of different time specifications in behavioral definitions as used in belief-elicitation research. Using construal level theory and the theory of planned behavior as complementary frameworks, the authors examined temporal frame effects on beliefs about eating fruits and vegetables and beliefs about condom use generated in a belief-elicitation study. Consistent with propositions from construal level theory, the authors found that temporal perspective (performing the behavior tomorrow, in 3 months, in 6 months, or in 5 years) affects the type of salient behavioral beliefs, such that individuals generate more feasibility (efficacy) beliefs when thinking about proximal behaviors, but more desirability (attitudinal and normative) beliefs when the behavior in question is distal. The authors' results indicate the importance of time frame in behavioral definitions in belief-elicitation research.

Evaluating impaired drivers confidence and intention to “(Please) drink responsibly”

Introduction Currently, alcohol industry-sponsored advertisements subsume traditional designated driver and don't drink and drive messages within responsible drinking campaigns. Yet, to date, there remains a dearth of literature specifically examining the attitudinal beliefs impaired drivers attach to the responsible drinking message. Objective This investigation sought to examine the responsible drinking attitudes and beliefs of impaired drivers, specifically examining their confidence and intention to drink responsibly the next time they consumed alcohol. Methods A random sample of 729 students attending a large, public Texas university completed a web-based administration of the Characteristic of Responsible Drinking Survey (CHORDS). Results Participants in this sample who had driven while impaired by alcohol exhibited significantly less confidence in refraining from drinking and driving and reported significantly lower intentions to designate a driver, take a taxi, or use a safe-ride program the next time they consumed alcohol. Additionally, they also reported less confidence, and lower intentions, to ensure their blood alcohol concentrations remained below the legal limit (0.08%) the next time they consumed alcohol. Conclusions Drivers who had driven while impaired significantly differed in their confidence and intention to drink responsibly the next time they consumed alcohol. Logistic regression results indicate that by increasing one's confidence in responsible drinking, and increasing their intention to drink responsibly, the likelihood of impaired driving can be decreased. Impact on industry Results from this investigation demonstrate one’s responsible drinking attitudinal beliefs accounts for a significant amount of the variance associated with one’s alcohol-related behaviors. Thus, further research should examine and establish how individuals conceptualize and practice responsible drinking.

What Determines Interest in an IS Career? An Application of the Theory of Reasoned Action

This study posits an IS specific career choice model that provides good predictive power and elucidates the nuances of factors underlying attraction to an IS career. IS is a relatively new career option, which many students may be unaware of or may misconstrue; this suggests the need for discipline-specific understanding. In this study, we used the Theory of Reasoned Action, which is a well-developed and widely applied theoretical model, but it has only recently begun to be applied to understanding occupational intentions. We argue that the TRA is an especially useful model for developing an IS-specific model of career attraction because, unlike other theories of career choice, it specifies the effect of social environment and allows for a more nuanced understanding of the factors underlying attraction to IS. Undergraduate students in an introductory IS course at a large public university were surveyed to test the study’s model, providing empirical validation of a career choice model comprising IS-career relevant beliefs and values. Overall, findings reveal that intentions significantly influence actual behavior—completion of an IS degree. IS career attitudes and social beliefs, in turn, collectively form intentions about pursuing IS careers. More specifically, attitudinal beliefs such as software/programming skill self-efficacy and technical, income, leadership, and job-variety-related work values have significant influence on favorable attitudes. The normative beliefs derived from one’s referent others, i.e., family members, friends, teachers, and significant others, significantly impact IS attitudes and intentions. The research contribution and practical implications of this work are discussed.

Work in Progress: The role of brand trust in the individual decision process towards the use of new technologies: An empirical investigation

The aim of this paper is to present the current work in progress of the author’s research on the role of brands in the individual decision process towards the use of new technologies. Most contemporary research published in the field of innovation acceptance is based on a model originally developed in the field of psychology during the 1960s, the Theory of Planned Behaviour (TPB). In the TPB model behaviour is determined by intention which in turn is determined by three fundamental factors, the Attitude toward the Behaviour, the Subjective Norms and the Perceived Behavioural Control. These fundamental factors, in turn, are moderated by a set of background factors, which depending on the context of the study range from demographic or socio-economic variables to more abstract constructs as brand ownership. In the curse of this empirical research it will be tested whether brands have an influence on belief formation towards new technologies by moderating the attitudinal beliefs in the TPB model. Literature review suggests that greater brand trust reduces the perceived risks associated with an innovation and thus strengthens the intention to use a new technology. This relationship, however, currently lacks a convincing empirical verification.