Changes In Behavioral Intentions Research Articles

"Practice What You Preach": Induced Hypocrisy as an Intervention Strategy to Reduce Children's Intentions to Risk Take on Playgrounds

An intervention based on induced hypocrisy was conducted to reduce children's intentions to show fall-risk behaviors on playground equipment. To induce hypocrisy participants (7-12 years) advocated for safe-play behaviors while being made mindful about past failures to play safely on playgrounds. To measure the impact of the intervention, children created posters indicating which playground behaviors they Would Do and Would Not Do; children believed they would have to demonstrate the behaviors endorsed on their posters. The intervention resulted in significant reductions in the risk behaviors children endorsed both for risk behaviors targeted (specific effects) and nontargeted risk behaviors (generalized effects). Assessing the mechanism by which the intervention produced changes in behavioral intentions revealed it yielded changes in cognitions that predicted subsequent reductions in risk-taking intentions. The present intervention was successful in reducing children's intentions to engage in risky playground behaviors and it did so by changing cognitions.

Today I'll use a condom, but who knows about tomorrow: A daily process study of variability in predictors of condom use.

Most models of health behavior change applied to condom use behavior have focused on individual differences in theoretical constructs to explain condom use or nonuse, while ignoring the possibility that day-to-day within-person changes in these constructs may contribute to understanding behavior. The goal of the present study was to investigate day-to-day variability in condom use attitudes, self-efficacy, and behavioral intentions and assess the utility of this variability in predicting the likelihood of condom use each day. A 30-day Web-based structured daily diary was used to collect daily reports of sexual behaviors and data on theoretical predictors of condom use behavior from sexually active college students (N = 116). The authors investigated whether condom use attitudes, self-efficacy, and behavioral intentions vary day to day; whether this within-person variability predicts condom use behavior; and whether negative affective states explain this variability. Within-person variability was found for each of the constructs. Within-person day-to-day changes in behavioral intentions and attitudes predicted the instances in which an individual used a condom and daily negative affect partially explained within-person day-to-day changes in behavioral intentions and self-efficacy. Implications for models of health behavior change and for behavior change interventions are discussed.

Short-term effects of a peer group intervention for HIV prevention among trainee teachers in Malawi

This report describes the implementation and short-term results of a peer group intervention for HIV prevention on the HIV-related attitudes, knowledge and behaviours of primary school teachers in Malawi. The intervention, based on the social-cognitive learning model, took place in 2000 at two teacher training colleges with a distance-learning programme. Primary school teachers attending a final six-week training session before certification volunteered to participate. Group leaders were teachers selected by each group, and after training they facilitated the peer group intervention. The teachers completed a pre-test and post-test questionnaire. The 286 trainee teachers whose pre- and post-test samples could be matched, largely reported positive changes in their HIV-prevention-related knowledge, attitudes, self-efficacy, behaviour change and condom-use intentions. However, at post-test immediately after the intervention they did not show a higher level of perceived-risk, a greater hope that people could change their high-risk sexual behaviour, or greater agreement that persons infected with HIV should be allowed in public places. This research demonstrates the feasibility of an HIV-prevention intervention for primary school teachers during their training. The Malawi Ministry of Education has since made the programme available to over 90 per cent of all trainee teachers through an NGO.

Getting Through to Them: Reaching Students Who Need Career Counseling

The purpose of this study was to examine the effects of a persuasive message, designed using the theory of planned behavior (TOPB; I. Ajzen, 1985) and written in the form of a student newspaper column, on undecided students' intent to seek career counseling from an informed source, such as a career counseling workshop. An experiment was conducted to test TOPB's applicability, and it was found that a message using positive reinforcement of salient beliefs and creating positive links between outcomes and workshop attendance caused a change in behavioral intention toward a greater reported likelihood of workshop attendance.

Process Model of Voluntary Travel Behavior Modification and Effects of Travel Feedback Programs

This study tested an integrated process model of travel behavior modification. The model combined a theory of planned behavior, a theory of norm activation, a theory of implementation intention, and theories of habit. To test the integrated model, panel data (n = 208) obtained before and after travel feedback programs (TFPs) were used (the TFP is a communication program aimed at voluntary modification of travel behavior, from automobile use to nonautomobile means of travel such as public transit and bicycle). A structural equations model using the collected data tested the integrated model. The results indicated that habit prevented people from forming behavioral intentions for behavior change; behavior change was induced by implementation intentions, which were influenced by behavior intentions; behavioral intentions were influenced by altruistic determinants.

Temporal stability of the theory of planned behavior: a prospective analysis of sugar consumption among Ugandan adolescents

This study addressed three questions: What is the power of the Theory of Planned Behavior (TPB) in predicting adolescents' intended and self-perceived consumption of non-milk extrinsic sugars using a non-intervention prospective approach? To what extent do the TPB constructs change across time following adolescents' mere exposure to an oral health survey? Do changes in self-perceived sugar consumption at follow-up associate with changes in behavioral intention as predicted by the TPB? A survey was conducted in Kampala (urban) and Lira (rural) and 1146 secondary school students completed questionnaires assessing the TPB at school (Time 1). A random sub-sample of 415 students was selected from the original survey of which 372 students were examined clinically. After 3 months (Time 2), the questionnaire was administered a second time in the sub-sample. All analyses are based on the number of students who participated on both survey occasions, n = 372. Attitudes and perceived behavioral control predicted intended sugar consumption at Time 1 and Time 2, accounting for 58% (DeltaR(2) = 0.58) and 19% (DeltaR(2) = 0.19) of the variance, respectively. Time 1 intention provided significant prediction of Time 2 self-perceived sugar consumption with DeltaR(2) = 0.5. Adolescents with high-caries experience more than their counterparts with low, changed towards weaker intentions and less frequent sugar consumption across the survey period. Mean sugar consumption scores changed from 2.6 to 2.7 (ns), 3.1 to 2.6 (P < 0.001) and 2.3 to 3.2 (P < 0.001) among adolescents who, respectively, remained stable, increased and decreased their intentions across time. This study supports the validity of the TPB in predicting intended and self-perceived sugar consumption prospectively.

Financial incentives for behavioral change in the ecological city

The author is a Professor of Geography at the University of Toronto and former Director of the Institute for Environmental Studies. His research interests are in urban environmental management/urban infrastructure; adaptation to climate change; catastrophes, environmental liability and the insurance industry; and risk analysis and environmental finance. He has extensive overseas experience, especially in Africa and China. He was the Principal Investigator for the GIS-based Soil Erosion Management Project in North China and for the Toronto component of the Sustainable Water Management Project in the Beijing-Tianjin Region, both funded by CIDA. He has held teaching appointments at North-western University, McMaster University and Ibadan University, and has also taught short courses in Senegal, Malawi and Vietnam. He holds degrees in geography from Oxford (B.A., 1965), Pennsylvania State University (M.Sc., 1967) and Bristol University (Ph.D, 1971). His most recent books are Building the Ecological City, published by Woodhead Publishing in 2002 and Environmental Finance: A Guide to Environmental Risk Assessment and Financial Products (with Sonia Labatt) published by Wiley in 2002. The text that follows is an edited version of a paper presented at the international symposion on "The Natural City," Toronto, 23-25 June, 2004, sponsored by the University of Toronto's Division of the Environment, Institute for Environmental Studies, and the World Society for Ekistics.

THE EFFECT OF ATTITUDES ON THE OCCUPATIONAL SAFETY ACTIONS OF AUSTRALIAN CONSTRUCTION WORKERS: THE RESULTS OF A FIELD STUDY

The recognition that unsafe behavior is a factor in the majority of workplace accidents has led to considerable research effort in the behavioral aspects of occupational health and safety (OHS). Much of this research has focused on the effect of external stimuli, such as feedback and rewards, on workers' actions. The role of internal cues, such as workers' beliefs and attitudes towards OHS, on their actual behavior has been less thoroughly investigated. This paper presents the findings of a study in which a sample of Australian construction workers' attitudes towards OHS were explored in indepth interviews and their OHS behavior was directly observed. Measurements were taken before and after the workers attended a first aid training course. The results of the study suggest that the first aid training changed the workers' attitudes towards OHS. In particular, the first aid training appeared to make participants more aware that their own behavior is an important factor in the avoidance of occupational injury and increase participants' perceived probability that they would suffer an accident at work. The training also appeared to reduce participants' willingness to accept prevailing levels of OHS risk and participants' expressed a greater concern about taking risks and a stronger intention to avoid occupational injuries after undergoing first aid training. This change in behavioral intention was reflected in improvements in safety behavior observed in the categories of housekeeping, use of tools, personal protective equipment and access to heights. However, no improvements in manual handling were observed. The results of the study are presented and discussed in terms of Ajzen's theory of planned behavior.

CAUSAL ANALYSIS OF EXERCISE AND CALCIUM INTAKE BEHAVIORS FOR OSTEOPOROSIS PREVENTION AMONG YOUNG WOMEN IN THAILAND

The goal of health education is to provide information to affect attitudes, beliefs, and intentions for behavior change. However, little is known about the effects of changes in knowledge on behaviors for osteoporosis prevention. Our objective is to develop and test theoretical models of the effects of knowledge, attitude, and self-efficacy on exercise and calcium intake among young women before and after an intervention program. First, we hypothesized that knowledge would positively predict attitude, self-efficacy, calcium intake, and exercise. Second, attitude would positively predict self-efficacy, calcium intake, and exercise. Third, self-efficacy would positively predict calcium intake and exercise. Fourth, attitude and self-efficacy would mediate the effect of knowledge on calcium intake and exercise. At the beginning and end of the study, participants in the control group and intervention group completed the osteoporosis knowledge test, the osteoporosis health belief scale, the osteoporosis self-efficacy scale, a self-report for food records, and exercise. The causal model was examined as a result of our study. After the intervention program, calcium intake and exercise were predicted by knowledge when mediated by attitudes and self-efficacy. The final model accounted for 30% and 45% of the variance in calcium intake and exercise, respectively. We conclude that interventions to enhance young women's knowledge and self-efficacy may result in increased calcium intake and exercise.

An assessment of the effectiveness of the Mottep model for increasing donation rates and preventing the need for transplantation--adult findings: program years 1998 and 1999.

The National Minority Organ Tissue Transplant Education Program (MOTTEP) evaluated the effects of a community-implemented health education program for adult members of minority population groups to affect attitude, knowledge, and intent to change behavior. In addition, this study represents 1 of the first major initiatives to formally address prevention as a strategy to contribute to reducing the need for organ/tissue transplantation among minorities in the United States. The study targeted students (youth) and adults representing different ethnic groups (African-Americans, Alaskan Natives, Filipinos, Latinos, and Native Americans) who attended health education presentations addressing organ tissue donation, transplantation, and illness prevention in 15 different cities in churches, schools, and other sites. A cross-sectional study that used questionnaires was designed for collecting data from all participants. This article presents data on the adult sample only. Preintervention and postintervention data were collected from 914 adult participants to determine any immediate effects of the intervention. By using data from matched sets of the preintervention and postintervention questionnaires for all adult participants, there were significant increases in (P < or =.000) trust in doctors, future plans to become organ donors, and in participants' spiritual/religious beliefs about organ/tissue donation. There was also a significant increase (P <.05) in participants' awareness of the perceived need for organ/tissue donation. African-American participants were significantly more likely (P < or =.000) to report trust in doctors, future plans to donate organs/tissue, and perceive the need for donation as a result of MOTTEP presentation. Caucasian participants showed a significant increase (P < or =.007) in trust in doctors, perceived need for organ donation (P < or =.05), and in shifting spiritual/religious beliefs about organ/tissue donation (P < or =.02). Attitudes, knowledge, beliefs, and behavioral intentions about organ/tissue donation and illness prevention can be affected by culturally appropriate health education programs designed for targeted population groups. Sustained changes in behavioral intentions toward organ donation and illness prevention may require multiple educational interventions in different community settings to increase donation rates and improve behavioral health practices to prevent illness.

Predictors of HIV risk behavior among Russian men who have sex with men: an emerging epidemic.

Russia is experiencing one of the sharpest increases in HIV incidence in the world. Almost no research has examined patterns of risk behavior among Russian men who have sex with men (MSM). A total of 434 MSM were surveyed in all of St. Petersburg's gay-identified clubs during June 2000. Men completed questionnaires about their sexual practices, AIDS risk knowledge, safer sex attitudes, behavior change intentions, perceived safer sex norms, and fatalism. Most MSM were bisexual; 79% had female partners in their lives and 37% had female partners in the previous 3 months. Sexually transmitted disease treatment was reported by 32% of the men, 23% had sold sex to gain money, and knowledge about critical HIV risk-reduction steps was low. Of all men surveyed, 38% had unprotected anal sex in the previous 3 months, consistent condom use was reported by only 30% of men, and most recent anal intercourse occasions 37% of particpants'. Regression analyses showed that high-risk behavior was predicted by poor safer sex attitudes, weak behavior change intentions, low knowledge about AIDS risk, perceived peer norms that did not support safer sex, and having a boyfriend. To avert a widespread epidemic, HIV prevention interventions for Russian MSM are critically needed. Factors predicting risk were consistent with those found among MSM in other countries early in the HIV epidemic. However, unique cultural factors, including frequent bisexual behavior, the 'newness' of openly gay communities in Russia and lack of community experience in dealing with AIDS, require HIV prevention program tailoring.

Life optimism, substance use, and AIDS-specific attitudes associated with HIV risk behavior among disadvantaged innercity women.

The development of more effective human immunodeficiency virus (HIV) prevention programs for disadvantaged women requires identification of factors associated with risk. In the present study, 158 women - all of whom met criteria indicative of HIV risk - were recruited in innercity primary healthcare clinics and administered measurements that assessed variables in three domains believed pertinent to HIV sexual risk behavior: (1) substance use in the past 3 months, (2) acquired immunodeficiency syndrome (AIDS)-specific cognitive and attitudinal factors, including AIDS risk knowledge, condom attitudes, perceived risk for AIDS, behavior change intentions, and perceived self-efficacy, and (3) life context variables, including self-esteem, fatalism, personal optimism toward the future, and current life satisfaction. When women were categorized into highest and lower groups based on their recent risk behavior, AIDS-specific cognitive and attitudinal factors, as expected, differentiated the groups. However, women at highest risk for HIV also most often used a variety of substances and scored lower in self-esteem, held views more characterized by personal fatalism and low optimism concerning the future, and had greater life dissatisfaction than women at lower risk. HIV prevention programs for disadvantaged women require attention not only to AIDS-specific knowledge, attitudes, and skills development but also to broader issues of life context that, if unaddressed, may limit women's ability and motivation to reduce risk for HIV/AIDS.

Predictors of long-term maintenance of safer sex and lapse/relapse: A nine-year follow-up of the chicago CCS/MACS cohort

Understanding the antecedents of long-term patterns of sexual risk behavior is important for HIV/AIDS prevention research. This study assessed various psychosocial and demographic predictors of safer anal intercourse maintenance and of lapses to unsafe sex between 1984 and 1993 among 906 homosexually active men from the Chicago Coping & Change Study/MACS cohort. Semiannual self-reports of sexual activities were used to classify anal intercourse behavior patterns over a series of 2-year intervals. Two sorts of safer sex were evaluated: (1) definite safety, consistent condom use with all partners or abstinence and (2) modified safety, a broader standard that also included unprotected anal intercourse limited to a monogamous relationship. Results showed that the percentage of men who maintained definitely safe behavior increased from 16% of participants after the first 2 years of study to almost 63% during the 8th and 9th years (38% to 82% rates for modified safety). Lapses from definite safety peaked at 22% during the 3rd and 4th years, and 41% of the men lapsed from unfailing condom use at least once during the study (29% lapsed or relapsed by modified-safety criteria). Key predictors of long-term propensities (9-year rates)—both maintaining safer sex and lapse/relapse—included consistency of participation (a possible marker for behavior change intentions), predisposition toward risk taking, and age. Thus, personality traits that determine a person's level of commitment to behavior change, tendencies for risk taking, and age need to be considered when designing effective long-term HIV prevention interventions.

Reinforcement value of unsafe sex as a predictor of condom use and continued HIV/AIDS risk behavior among gay and bisexual men.

The pleasure or reinforcement value of high-risk sex may be an important influence on success in risk reduction efforts. Seronegative gay and bisexual men (N = 297) completed measures assessing their unprotected and safer sex practices, as well as measures of cognitive and skill factors and a measure assessing the subjective reinforcement value of unprotected anal intercourse. Regression analyses showed that the reinforcement value of unprotected anal intercourse accounted for variance in predicting levels of condom use above that that could be accounted for by factors such as knowledge, behavior change intentions, perceived vulnerability, condom attitudes, and sexual communication skills. Only reinforcement value of unprotected sex and substance use significantly predicted how frequently participants engaged in high-risk sex. Increased attention to the valence of sexual reinforcers will improve HIV risk reduction models and enhance AIDS prevention efforts.

Continued high-risk sex among HIV seropositive gay and bisexual men seeking HIV prevention services.

The authors examined HIV risk-related sexual behaviors in an ethnically diverse sample of HIV seropositive gay and bisexual men (N = 86). Measures of sexual behavior, substance use, condom attitudes, behavior change intentions, and engagement in risk-reducing practices were completed. Thirty-nine percent of the men reported engaging in unprotected anal intercourse in the past 3 months. Unprotected anal intercourse was associated with using nitrite inhalants, sex partners who used substances before sex, and low intentions to change risk behavior. These results highlight the difficulties that people living with HIV infection face in maintaining a lifetime of safer sex and the necessity of integrating clinical and prevention interventions for these persons.

The Smoking Cessation Process: Longitudinal Observations in a Working Population

Background. Few prospective studies have investigated variables related to the smoking cessation process in nonvolunteer samples. Methods. Smoking history, behavioral intentions, degree of addiction, and demographic characteristics were examined over a 2-year period as predictors of four behavioral outcomes related to smoking cessation-participation in a smoking cessation program, attempting to quit, relapse, and success in quitting-in 802 working adults who were daily smokers at baseline. Change in behavioral intentions over the 2-year period was also examined. Results. Sixty-four percent of smokers made a serious quit attempt in the 2-year study period, 16% succeeded in quitting, and an additional 9% shifted from daily to occasional smoking. Stated intention to quit at baseline was a powerful and consistent predictor of three of the behavioral outcomes, but several demographic and smoking-related variables were differentially associated with these three outcomes. Conclusions. Study findings indicate that smoking cessation is a dynamic process in which a majority of smokers are actively engaged. Smoking pattern and sociodemographic characteristics are predictors of whether smokers will participate in programs, make quit attempts, and succeed in quitting. Intention to quit is related to smoking outcomes in a manner that would be predicted by the Transtheoretical Model of Behavior Change.

Adolescent risk-taking: Effects of perceived benefits on behavioral change and behavioral intentions

Adolescent risk-taking: Effects of perceived benefits on behavioral change and behavioral intentions

Prenatal alcohol education for low-income women with interactive multimedia

Prenatal alcohol use is a major cause of birth defects and other adverse outcomes of pregnancy. Educating expectant mothers concerning the need to limit alcohol consumption has been advocated as a method to decrease alcohol-related birth problems, however providing this service for lowincome women is increasingly difficult due to ongoing changes in obstetrical practice patterns. The purpose of this work was to develop and test a computer-based multimedia prenatal alcohol education program which would be appropriate for use in a poor rural patient population. We first review the effect of alcohol consumption during pregnancy and previously employed intervention strategies. Then the design, development, and evaluation of the program is described. The content of the program reflects user beliefs and attitudes and takes advantage of a computer-based multimedia approach. This format provides numerous opportunities for user interaction, requires little reading ability and offers the potential to increase levels of health education efforts with no increase in staff. The program was found to be well accepted, to provide new information and to demonstrate potential for effecting change in behavioral intention. Possible uses of this technology for educating similar populations and the use of computers for health screening are discussed.

Predicting Mothers' Intentions to Limit Frequency of Infants' Sugar Intake: Testing the Theory of Planned Behavior1

This study examines the ability of the Theory of Planned Behavior to account for mothers' intentions to limit the frequency of their infants' sugar consumption. One group of mothers (experimental) was exposed to a dental health education program designed to promote this behavior, the other (control) group was not. Each group of mothers was interviewed twice; the intervention was delivered to mothers in the experimental group immediately after their first interview. The interviews incorporated measures of the key constructs in the Theory of Planned Behavior (attitudes to behavior, subjective norms, perceived behavioral control, and behavioral intentions). Results indicated that the addition of perceived behavioral control resulted in small but significant increments in the amount of explained variance in intentions, thereby supporting the theory. Although the change in intentions to perform the advocated behavior was not significantly greater in the experimental group than in the control group, there was a significant change in attitudes to the behavior in the experimental group but no such change in the control group. Moreover, amount of change in behavioral intentions was significantly correlated with amount of change in attitudes, but not with amount of change in subjective norms or perceived behavioral control. Analysis of behavioral beliefs indicated that the attitude change reflected a change in a specific behavioral belief that was targeted in the intervention. Further analyses focused on the role played by direct experience of the behavior and show that such experience tended to enhance the role of perceived behavioral control in intention formation, apparently because mothers who have older children have discovered that they have relatively little control over frequency of child's sugar consumption. The implication of these results for the Theory of Planned Behavior are discussed.

Effects of a Persuasive Communication on Beliefs, Attitudes, and Career Choice

Fishbein's Theory of Reasoned Action was used to formulate a persuasive communication in an attempt to influence unclassified American college students' beliefs, attitudes, intentions, and behaviors regarding signing up for a career as a registered nurse. A two-stage cluster sample was used to assign 90 male and female students to either an experimental or control group. After persuasive communication exposure, the experimental group showed a significantly more positive change in beliefs, attitudes, and intentions than did the control group exposed to a neutral message. Sign-up rate was also statistically significant for the experimental group. With the Fishbein model to predict sign-up behavior, no other scores were found to add to the prediction once behavioral intention was entered into the model. Change in behavioral intention explained 49% of the variation in behavior. Normative belief scores did not approach statistical significance.