Theory Of Planned Behavior Questionnaire Research Articles

Measuring beliefs about gluten free diet adherence in adult coeliac disease using the theory of planned behaviour

The theory of planned behaviour (TPB) was used to elicit the salient beliefs about gluten free diet (GFD) adherence in adults with coeliac disease (CD) and to design a TPB questionnaire to predict adherence levels. This questionnaire was administered to 265 CD participants with adherence and quality of life (QOL) measures, a GFD knowledge test, and self-reported psychiatric history. Regression analyses were used to test the fit of the TPB in predicting adherence, and to determine the nature of the relationships between adherence, QOL, knowledge, and psychiatric history. The TPB combined with self-reported depression and anxiety, and QOL explained significant variance in intention (41.0%) and adherence (33.7%). Poorer dietary adherence and psychiatric history were also associated with lower QOL. Findings suggest that the TPB provides an adequate model for predicting GFD adherence in CD, and the presence of psychiatric conditions represents a potential intervention target to improve adherence and QOL.

The effect of mere-measurement of cognitions on physical activity behavior: a randomized controlled trial among overweight and obese individuals

BackgroundThe promotion of physical activity among an overweight/obese population is an important challenge for clinical practitioners and researchers. In this regard, completing a questionnaire on cognitions could be a simple and easy strategy to increase levels of physical activity. Thus, the aim of the present study was to test the effect of completing a questionnaire based on the Theory of Planned Behavior (TPB) on the level of physical activity.MethodsOverall, 452 overweight/obese adults were recruited and randomized to the experimental or control group. At baseline, participants completed a questionnaire on cognitions regarding their participation in leisure-time physical activity (experimental condition) versus a questionnaire on fruit and vegetable consumption (control condition). The questionnaires assessed the TPB variables that are beliefs, attitude, norm, perception of control, intention and a few additional variables from other theories. At three-month follow-up, leisure-time physical activity was self-reported by means of a short questionnaire. An analysis of covariance with baseline physical activity level as covariate was used to verify the effect of the intervention.ResultsAt follow-up, 373 participants completed the leisure-time physical activity questionnaire. The statistical analysis showed that physical activity participation was greater among participants in the experimental condition than those in the control condition (F(1,370) = 6.85, p = .009, d = 0.20).ConclusionsFindings indicate that completing a TPB questionnaire has a significant positive impact on subsequent participation in physical activity. Consequently, asking individuals to complete such a questionnaire is a simple, inexpensive and easy strategy to increase the level of physical activity among overweight/obese adults.

Predictors of physical activity, healthy eating and being smoke-free in teens: A theory of planned behaviour approach

This paper elicited context specific underlying beliefs for physical activity, fruit and vegetable consumption and smoke-free behaviour from the Theory of Planned Behaviour (TPB), and then determined whether the TPB explained significant variation in intentions and behaviour over a 1 month period in a sample of grade 7–9 (age 12–16 years) adolescents. Eighteen individual interviews and one focus group were used to elicit student beliefs. Analyses of this data produced behavioural, normative and control beliefs which were put into a TPB questionnaire completed by 183 students at time 1 and time 2. The Path analyses from the main study showed that the attitude/intention relationship was moderately large for fruit and vegetable consumption and small to moderate for being smoke free. Perceived behavioural control had a large effect on being smoke free and a moderately large effect for fruit and vegetable consumption and physical activity. Intention had a large direct effect on all three behaviours. Common (e.g. feel better, more energy) and behaviour-specific (e.g., prevent yellow fingers, control my weight) beliefs emerged across the three health behaviours. These novel findings, to the adolescent population, support the importance of specific attention being given to each of the behaviours in future multi-behavioural interventions.

Using the Theory of Planned Behaviour to design a food hygiene intervention

Twenty percent of food poisoning annually in Australia is believed to result from consumer food handling behaviour. Research advocates the use of social cognition theories in designing food hygiene interventions, however very few studies have actually done so. Thus, this study investigated the efficacy of a food hygiene intervention based on the Theory of Planned Behaviour (TPB). One hundred and eighty-four participants completed a TPB questionnaire, including questions regarding past behaviour and food hygiene knowledge, and then were randomly allocated to a knowledge and implementation intention group, a combined knowledge/implementation intention/PBC group, or a control group. Behaviour was measured 4 weeks later. The TPB predicted a high proportion of variance in both intentions and behaviour, but neither intervention improved participants’ food hygiene behaviours. However, knowledge and PBC were significantly increased in the PBC group. The implications of this for future research are explored.

Predicting intention to treat HIV-infected patients among Tanzanian and Sudanese medical and dental students using the theory of planned behaviour - a cross sectional study

BackgroundThe HIV epidemic poses significant challenges to the low income countries in sub Saharan Africa (SSA), affecting the attrition rate among health care workers, their level of motivation, and absenteeism from work. Little is known about how to deal with deterioration of human resources in the health care systems. This study aimed to predict the intention to provide surgical treatment to HIV infected patients among medical- and dental students in Tanzania and Sudan using an extended version of the Theory of Planned Behaviour (TPB).MethodsFour hundred and seventy five medical- and dental students at the University of Dar es Salaam (mean age, 25 yr) and 642 dental students attending 6 public and private dental faculties in Khartoum (mean age 21.7 yr) completed self-administered TPB questionnaires in 2005 and 2007, respectively.ResultsBoth Tanzanian and Sudanese students demonstrated strong intentions to provide care for people with HIV and AIDS. Stepwise linear regression revealed that the TPB accounted for 51% (43% in Tanzania and Sudan) of the variance in intention across study sites. After having controlled for country and past behaviour, the TPB in terms of attitudes, subjective norms and perceived behavioural control accounted for 34% and moral norms for an additional 2,3% of the explainable variance in intention. Across both study sites, attitudes were the strongest predictor of intention followed in descending order by subjective norms, moral norms and perceived behavioural control.ConclusionThe TPB is applicable to students' care delivery intentions in the context of HIV and AIDS across the two SSA countries investigated. It is suggested that attitudes, subjective norms, moral norms and perceived behavioural control are key factors in students' willingness to treat AIDS and HIV infected patients and should be targets of interventions aimed at improving the quality of health care delivery in this context.

What sense do people make of a theory of planned behaviour questionnaire?

This study aimed to understand the processes of interpretation of, and responses to, the task of completing a theory of planned behaviour (TPB) questionnaire. Forty-five adults verbalized their thoughts while completing a full TPB questionnaire on walking behaviour. On average, participants' verbalizations indicated around 16 problems with the 52 questions. Further, problems as identified from verbalizations were associated with increased endorsement of the middle option on the questionnaire. Normative and intention questions were found to be particularly problematic. The current standardized method to develop TPB measures systematically yields problematic questions, as indicated by both talk and questionnaire responses.

Attitudes that determine willingness to seek psychiatric help for depression: a representative population survey applying the Theory of Planned Behaviour

Many people suffering from mental disorders do not seek appropriate help. We have examined attitudes that further or hinder help-seeking for depression with an established socio-psychological model, the Theory of Planned Behaviour (TPB), comparing models for respondents with and without depressive symptoms. A qualitative preparatory study (n=29) elicited salient behavioural (BB), normative (NB) and control beliefs (CB) that were later included in the TPB questionnaire. Telephone interviews with a representative population sample in Germany (n=2303) started with a labelled vignette describing symptoms of a major depression, followed by items covering the components of the TPB. Intention to see a psychiatrist for the problem described was elicited at the beginning and at the end of the interview. We screened participants for current depressive symptoms using the mood subscale of the Patient Health Questionnaire (PHQ-9). In non-depressed respondents (n=2167), a TPB path model predicted 42% of the variance for the first and 51% for the second question on intention. In an analogous model for depressed respondents (n=136), these values increased to 50% and 61% respectively. Path coefficients in both models were similar. In both depressed and non-depressed persons, attitude towards the behaviour was more important than the subjective norm, whereas perceived behavioural control was of minor influence. Willingness to seek psychiatric help for depression can largely be explained by a set of attitudes and beliefs as conceptualized by the TPB. Our findings suggest that changing attitudes in the general population are likely to effect help-seeking when people experience depressive symptoms.

Changes in BMI and blood pressure after a school based intervention: The CHILDREN study

Identification of the behavioural, normative and control beliefs influencing children's behaviour is an important prerequisite in designing effective interventions. The current study aims to evaluate the effectiveness of an intervention program, based on the Theory of Planned Behaviour (TPB), on obesity indices and blood pressure (BP) in Ioannina, Greece. Participants were 646 fifth grade pupils (360 girls and 286 boys). The intervention group (IG) consisted of 321 children in 13 randomly selected schools while the rest (n = 325 children) served as the control group (CG). Based on the outcome of the TPB questionnaire, the intervention focused on overcoming the barriers in accessing physical activity areas, increasing the availability of fruits and vegetables and increasing parental support. General linear mixed model and mediating variable analysis were used to evaluate the differences between the two groups and to test whether changes in certain dietary, physical activity and anthropometrical indices mediated the effect of the intervention on BP. IG had higher consumption of fruits and lower consumption of fats/oils and sweets/beverages compared with the CG. Intervention's effect on BMI could be explained by the changes in fruit and fats/oils intake whereas the reduction of systolic and diastolic BP could be explained by the reduction of BMI. The findings indicate favourable changes in BP and obesity indices after the implementation of a 1-year school-based intervention program based on the TPB. These results highlight the importance of developing a social and physical environment that promotes balanced eating behaviours and extra-curricular access to physical activity venues.

Do ethnicity and gender matter when using the theory of planned behavior to understand fruit and vegetable consumption?

A majority of Americans do not meet the recommendation to eat five servings of fruits and vegetables per day (5-A-Day). The purpose of the present study was to examine the utility of the theory of planned behavior (TPB) for understanding 5-A-Day intentions and behavior and to determine whether any of the TPB relationships were moderated by ethnicity or gender. A total of 413 participants completed a baseline TPB questionnaire and a fruit and vegetable consumption measure 2 weeks later. Path analyses showed that affective attitude and perceived behavioral control significantly predicted intention for blacks, whites, males and females ( R 2 ranged from .32 to .40), whereas subjective norm was a significant predictor for blacks, males, and females only. Intention significantly predicted 5-A-Day ( R 2 ranged from .17 to .22) for all groups. Follow-up invariance analyses showed that the subjective norm/intention relationship was significantly stronger for black compared to white students. Finally, several key beliefs were identified for all four demographic groups. Therefore, the current results suggest that the TPB may be a useful framework to utilize when developing 5-A-Day interventions.

Effects of Email-Based Positive Exercise Images on Attitude, Intention, and Exercise Behavior in Sedentary Young Adults

PURPOSE: To determine the effect of positive exercise images sent via email on psychological constructs associated with theory of planned behavior (TPB) and exercise behavior (EB) in sedentary young adults. METHODS: 220 sedentary adults (19.9±0.9 years, 59.4% Caucasian, 37.3% African American, 52% male) completed the Godin Leisure Time Exercise Questionnaire (GLTEQ) and self-report measures examining components of the TPB. Participants were sent persuasive electronic mail messages every other day for 2 weeks. One randomly assigned group received positively framed messages (PM; n=73); the other received positively framed messages with positive exercise images (PMI, n=73); and the control group (CG; n=74) received none. Participants completed the GLTEQ and TPB questionnaires following the 2-wk treatment phase (follow-up) and again one month later (retention). ANCOVAS with repeated measures were used in all analyses with baseline test results serving as the covariate. RESULTS: ANCOVA results revealed that PM and PMI reported significantly higher levels of affective attitude (AA) than CG at follow-up (F (2, 217) = 6.65, p < .008, η2 = .53). Further, PMI reported higher AA than PM and CG at retention (F (2,217) = 19.07, p < .008, η2 = .55). For EB, PMI reported higher levels than both PM and CG at follow-up (F (2,217) = 7.22, p < .008, η2 = .57) and retention (F (2,217) = 9.30, p < .008, η2 = .60). At follow-up, pairwise comparisons revealed than PM also reported higher levels of EB compared to CG. Examination of exercise intention showed that PMI reported higher levels than both PM and CG at follow-up (F (2,217) = 6.47, p < .008, η2 = .59) and retention (F (2,217) = 10.01, p < .008, η2 = .62). Also, pairwise comparisons revealed that PM reported higher levels of intention compared to CG at follow-up and retention (F (2,217) = 5.58, p < .008, η2 = .55). CONCLUSION: Positively framed messages and positively framed messages with positive exercise images sent via email improved levels of AA, EB, and intention in sedentary young adults. Also, positively framed messages with images were more effective than positively framed messages alone for improving AA, EB, and intention. Email-based persuasive messaging combined with positive exercise imagery can be used to improve attitude, intention, and exercise behavior in sedentary young adults.

Understanding exercise behaviour during home-based cardiac rehabilitation: a theory of planned behaviour perspectiveThis article is an invited paper from 2007 ICRH Leadership in Science: a Forum for Trainees and New Investigators.

Although home-based cardiac rehabilitation (CR) programs have been shown to produce significant increases in exercise capacity, obtaining patient adherence to these programs has been challenging. It is therefore critical to identify key theoretical determinants of exercise during home-based CR in order to inform the development of behavioural interventions that improve adherence. The present study examined the utility of the theory of planned behaviour (TPB) in explaining exercise behaviour during home-based CR. Seventy-six patients who were receiving 6 months of home-based CR completed a TPB questionnaire at the beginning and mid-point of the program and a physical activity scale at the mid-point and end of the program. Path analyses showed that attitude and perceived behavioural control significantly predicted intention for both time intervals (baseline to 3 months, and 3 months to 6 months), whereas subjective norm only predicted intention within the 1st 3 months. Intention significantly predicted implementation intention, which, in turn, significantly predicted exercise for both time intervals. Finally, several underlying accessible beliefs were significantly related to exercise for both time intervals. Therefore, results suggest that the TPB is a potentially useful framework for understanding exercise behaviour during home-based CR.

Ethnicity as a Moderator of the Theory of Planned Behavior and Physical Activity in College Students

Most college students do not meet physical activity (PA) guidelines, and ethnic disparities exist. The present study examined the utility of the theory of planned behavior (TPB) in explaining PA intentions and behavior in black and white college students and whether any TPB relationships were moderated by ethnicity. Black (n = 170) and white (n = 180) students completed a baseline TPB questionnaire and PA assessment 2 weeks later. Hierarchical latent variable regression analyses showed that affective attitude, subjective norm, and perceived behavioral control (PBC) were significant predictors of intention for both ethnic groups, whereas the PBC-intention relationship was significantly stronger for white students. Intention significantly predicted PA for both ethnic groups. Furthermore, common and ethnic-specific beliefs were identified.

Ethnicity as a Moderator of the Theory of Planned Behavior and Physical Activity in College Students

Most college students do not meet physical activity (PA) guidelines, and ethnic disparities exist. The present study examined the utility of the theory of planned behavior (TPB) in explaining PA intentions and behavior in black and white college students and whether any TPB relationships were moderated by ethnicity. Black (n = 170) and white (n = 180) students completed a baseline TPB questionnaire and PA assessment 2 weeks later. Hierarchical latent variable regression analyses showed that affective attitude, subjective norm, and perceived behavioral control (PBC) were significant predictors of intention for both ethnic groups, whereas the PBC-intention relationship was significantly stronger for white students. Intention significantly predicted PA for both ethnic groups. Furthermore, common and ethnic-specific beliefs were identified.

Theory of Planned Behavior: Implications for an email-based physical activity intervention

Objectives A 3-week study was conducted to determine the effect of persuasive messages sent via email on psychological constructs associated with Theory of Planned Behavior (TPB) and exercise behavior in sedentary college students ( N=170). Methods Participants (105 M; 65 F; 94% Caucasian; 20.2±.9 years) completed the Godin Leisure Time Exercise Questionnaire (GLTEQ) and self-report measures of the TPB. Participants received persuasive messages every other day for 2 weeks. One randomly assigned group received positively framed messages (PFM; n=57); the other received negatively framed messages (NFM, n=57); and the control group (CG; n=56) received none. Participants completed the GLTEQ and TPB questionnaires following the 2-week treatment phase and again 1 week later. Results ANCOVA results revealed that PFM reported higher exercise behavior levels than both NFM and CG at follow-up ( p<.05) and retention ( p<.05). For exercise intention, PFM and NFM reported significantly higher levels than CG at follow-up ( p<.05), while PFM reported higher levels than NFM and CG at retention ( p<.05). Also, pairwise comparisons revealed higher intention levels for NFM compared to CG at retention ( p<.05). PFM reported higher levels of affective attitude compared to CG at follow-up ( p<.05) and retention ( p<.05), while NFM reported higher levels than CG at follow-up ( p<.05). For instrumental attitude, all three groups were statistically different ( p<.05) at retention (PFM>NFM, NFM>CG, PFM>CG). Conclusions Only positively framed persuasive messages sent via email improved exercise behavior. Both types of messages affected attitude, and intention in sedentary young adults. This research provides useful information for creating interventions to enhance exercise adherence.

Ethnicity and the theory of planned behavior in an exercise context: A mediation and moderation perspective

Objectives Most college students fail to meet recommended exercise levels and ethnic disparities in participation are apparent. The present study examined the moderating and mediating relationships among ethnicity, the theory of planned behavior (TPB), and exercise, and identified common and ethnic-specific beliefs related to exercise. Method College students completed a baseline TPB questionnaire and an exercise assessment at either two-week ( n=237 blacks; n=176 whites) or two-month ( n=280 blacks; n=273 whites) follow-ups. Design One week and two month longitudinal designs. Results Structural equation modeling showed that the TPB was invariant by ethnicity in both samples with affective attitudes and perceived behavioral control being significant predictors of intention, which in turn, significantly predicted exercise. Furthermore, analyses showed that the TPB had a small mediating effect on the ethnicity/exercise relationship in both samples. Finally, common and ethnic-specific beliefs were identified that varied by sample. Conclusion The TPB is a useful framework to explain exercise behavior in black and white students; however, its ability to explain the ethnic disparity in exercise may be limited.

What Do People Think about When They Answer Theory of Planned Behaviour Questionnaires?

Two studies aiming to identify the nature and extent of problems that people have when completing theory of planned behaviour (TPB) questionnaires, using a cognitive interviewing approach are reported. Both studies required participants to 'think aloud' as they completed TPB questionnaires about: (a) increasing physical activity (six general public participants); and (b) binge drinking (13 students). Most people had no identifiable problems with the majority of questions. However, there were problems common to both studies, relating to information retrieval and to participants answering different questions from those intended by researchers. Questions about normative influence were particularly problematic. The standard procedure for developing TPB questionnaires may systematically produce problematic questions. Suggestions are made for improving this procedure.

Measuring young people’s attitudes to breastfeeding using the Theory of Planned Behaviour

The focus of this study was to design and pilot a questionnaire to measure young people's attitudes to breastfeeding using the Theory of Planned Behaviour (TPB). This is intended for subsequent use in a large-scale attitude survey, which in turn will inform the design of a breastfeeding intervention programme with adolescents. The first three phases of a research programme employing the theory are described: belief elicitation, questionnaire development and a pilot study. Firstly, an elicitation study to identify the modal salient beliefs underlying young peoples' motivations to breastfeed, using six semi-structured focus groups with 48 young people, was performed. Secondly, the measurement instrument was constructed, incorporating all the key theoretical constructs and both direct and belief-based measures. The questionnaire was then piloted on a sample of 121 female and male schoolchildren to identify and assess the relative importance of the determinants of breastfeeding intention. The questionnaire proved to be reliable, and preliminary analysis provided strong support for the predictive power of the TPB. Some key issues involved in the operationalization of the theory are highlighted, which may be of interest to researchers involved in the design of TPB questionnaires for use in other intervention programmes.

Testing the Efficacy of the Theory of Planned Behavior to Explain Strength Training in Older Adults

The purpose of this study was to use the constructs of the theory of planned behavior (TPB) to gain a better understanding of the factors influencing older adults' participation in strength training. Two hundred men and women age 55 years and older were purposely sampled from seniors' centers in Ontario Canada. Participants completed a TPB questionnaire and reported their current physical activity participation. It was hypothesized that perceived behavioral control followed by attitude would be the strongest determinants of strength-training intentions and that intention would be the strongest determinant of strength-training behavior. Regression analyses revealed that subjective norm and perceived behavioral control explained 42% of the variance in intention and intention explained 40% of the variance in behavior. Gender and current strength-training participation did not significantly moderate the relationship between the TPB variables. The results suggest that interventions targeting subjective norm and perceived control might be helpful in promoting strength-training behavior among older adults.

REDUCING FRIDAY ALCOHOL CONSUMPTION AMONG MODERATE, WOMEN DRINKERS: EVALUATION OF A BRIEF EVIDENCE-BASED INTERVENTION

A randomized controlled trial was used to evaluate a brief research-based intervention designed to promote drinking within recommended limits on Fridays and Saturdays among moderate drinkers. The two-page, leaflet-like intervention included persuasive communication targeting motivational and volitional antecedents of behaviour as specified by an extended theory of planned behaviour (TPB) and implementation intention theory. Participants were randomly allocated to a control group (TPB questionnaire only) or to a group receiving the TPB questionnaire plus leaflet-like intervention. Cognitions and drinking behaviour were measured immediately before the intervention and at 8-weeks follow-up. The pre-intervention questionnaire was distributed to 573 participants of whom 347 (61%) responded at follow-up. Significantly greater reduction in risky drinking on Fridays was observed among women (but not men) in the intervention group at 8-weeks follow-up. No other post-intervention differences were found. A low-cost, readily-produced, written intervention focusing on recommended daily limits reduced risky drinking amongst women on Fridays. Further work on similar interventions is warranted.

ABS67: Developing and validating a questionnaire to evaluate the impact of patient-centred asthma training on GPs and practice nurses

UK evidence-based guidelines recommend helping those with asthma to control their symptoms through education and individualised, written action plans. Training professionals to help a range of patients with individual disease characteristics, personal attributes and lifestyles may be an important factor in asthma management. Training in patient-centred, communication has proven benefits at the level of randomised controlled trials [1,2]. However, we do not know in what way these interventions are effective. Psychological theories of behaviour change such as the theory of planned behaviour (TPB) [3] can be helpful in determining exactly why an intervention was effective, or not. This can provide information on training variants and their possible effects on outcome. To develop and validate a questionnaire using the TPB to explore GP and practice nurses’ beliefs and attitudes towards training in patient-centred asthma management. This training is modified from a programme successfully implemented with American office based paediatricians [5]. We constructed a TPB questionnaire using published guidelines [4] and with reference to the goals of the training programme [5]. The resultant questionnaire was validated through a web-based survey of GPs and practice nurses. Data was analysed using multiple regression. Results and The process of constructing and validating the TPB questionnaire will be described, and its use discussed in relation to primary care respiratory research and training. Conflict of interest and funding None.