This article describes the integrative model of behavioral prediction (IM), the latest formulation of a reasoned action approach. The IM attempts to identify a limited set of variables that can ...account for a considerable proportion of the variance in any given behavior. More specifically, consistent with the original theory of reasoned action, the IM assumes that intentions are the immediate antecedents of behavior, but in addition, the IM recognizes that environmental factors and skills and abilities can moderate the intention-behavior relationship. Similar to the theory of planned behavior, the IM also assumes that intentions are a function of attitudes, perceived normative pressure and self-efficacy, but it views perceived normative pressure as a function of descriptive as well as of injunctive (i.e., subjective) norms. After describing the theory and addressing some of the criticisms directed at a reasoned action approach, the paper illustrates how the theory can be applied to understanding and changing health related behaviors.
This book describes the reasoned action approach, an integrative framework for the prediction and change of human social behavior. It provides an up-to-date review of relevant research, discusses ...critical issues related to the reasoned action framework, and provides methodological and conceptual tools for the prediction and explanation of social behavior and for designing behavior change interventions.
This study attempts to show the relevance of behavioral theory for developing communications designed to promote healthy and/or to prevent or alter unhealthy behaviors. After describing an ...integrative model of behavioral prediction, the model’s implications for designing persuasive communications are considered. Using data from a study on smoker’s intentions to continue smoking and to quit, it is shown how the theory helps identify the critical beliefs underlying these or other intentions. Finally, it is argued that although behavioral theory can help identify the beliefs that should be targeted in a persuasive communication, our ability to change these beliefs will ultimately rest on communication theory.
This article demonstrates the usefulness of two theories for the development of effective health communication campaigns. The integrative model of behavioral prediction focuses on changing beliefs ...about consequences, normative issues, and efficacy with respect to a particular behavior. Media priming theory focuses on strengthening the association between a belief and its outcomes, such as attitude and intention toward performing the behavior. Both the integrative model of behavioral prediction and media priming theory provide guidance with respect to the selection of beliefs to target in an intervention. The article describes the theories, shows how they can be applied to the selection of target beliefs, and, for each theory, defines the criteria for belief selection. The two theories as well as their appropriate analytic strategies are complementary rather than conflicting.
To examine how well the theories of reasoned action and planned
behavior predict condom use, the authors synthesized 96 data sets
(
N
= 22,594) containing associations
between the models' key ...variables. Consistent with the theory of
reasoned action's predictions, (a) condom use was related
to intentions (weighted mean
r
. =
.45), (b) intentions were based on attitudes
(
r
. = .58) and subjective norms
(
r
. = .39), and
(c) attitudes were associated with behavioral beliefs
(
r
. = .56) and norms were
associated with normative beliefs (
r
. =
.46). Consistent with the theory of planned behavior's
predictions, perceived behavioral control was related to condom use
intentions (
r
. = .45) and
condom use (
r
. = .25),
but in contrast to the theory, it did not contribute significantly to
condom use. The strength of these associations, however, was
influenced by the consideration of past behavior. Implications of these
results for HIV prevention efforts are discussed.
Studies of the content of persuasive messages in which the central arguments of the message are scrutinized have traditionally relied on the technique of thought-listing to assess argument strength. ...Although the validity of the thought-listing procedure is well documented, its utility can be limited in situations involving nonadult populations and sensitive topics. In this paper, we present a self-reported scale that can be used to assess perceived argument strength in contexts where thought-listing may be less appropriate. This scale taps into perceived argument strength from multiple points of view, including but also extending beyond the potential of the argument to elicit positive and negative thoughts. Reliability and validity of this scale were assessed in health communication contexts involving anti-drug public service announcements (PSAs) directed at adolescents and anti-smoking PSAs targeting adults. Evidence of convergence between this scale and the thought-listing technique was also obtained using the classical comprehensive exam arguments.
The amount of cancer-related information available in the media and other sources continues to increase each year. We wondered how people make use of such content in making specific health decisions. ...We studied both the information they actively seek ("seeking") and that which they encounter in a less purposive way ("scanning") through a nationally representative survey of adults aged 40-70 years (n = 2,489) focused on information use around three prevention behaviors (dieting, fruit and vegetable consumption, and exercising) and three screening test behaviors (prostate-specific antigen, colonoscopy, mammogram). Overall, respondents reported a great deal of scanning and somewhat less seeking (on average 62% versus 28% for each behavior), and they used a range of sources including mass media, interpersonal conversations, and the Internet, alongside physicians. Seeking was predicted by female gender, age of 55-64 vs. 40-44, higher education, Black race and Hispanic ethnicity, and being married. Scanning was predicted by older age, female gender, and education. Respondents were fairly consistent in their place on a typology of scanning and seeking across behaviors. Seeking was associated with all six behaviors, and scanning was associated with three of six behaviors.
This article examines the multiplicative combination of belief strength by outcome evaluation in the expectancy–value model of attitudes. Because linear transformation of a belief strength measure ...results in a nonlinear transformation of its product with outcome evaluation, use of unipolar or bipolar scoring must be empirically justified. Also, the claim that the Belief × Evaluation product fails to explain significant variance in attitudes is found to be baseless. In regression analyses, the main effect of belief strength takes account of the outcome's valence, and the main effect of outcome evaluation incorporates the outcome's perceived likelihood. Simulated data showed that multiplication adds substantially to the prediction of attitudes only when belief and evaluation measures cover the full range of potential scores.
A growing body of literature documents the efficacy of decision support interventions (DESI) in helping patients make informed clinical decisions. DESIs are frequently described as an adjunct to ...shared decision-making between a patient and healthcare provider, however little is known about the effects of DESIs on patients' interactional behaviors-whether or not they promote the involvement of patients in decisions.
Shared decision-making requires not only a cognitive understanding of the medical problem and deliberation about the potential options to address it, but also a number of communicative behaviors that the patient and physician need to engage in to reach the goal of making a shared decision. Theoretical models of behavior can guide both the identification of constructs that will predict the performance or non-performance of specific behaviors relevant to shared decision-making, as well as inform the development of interventions to promote these specific behaviors. We describe how Fishbein's Integrative Model (IM) of behavior can be applied to the development and evaluation of DESIs. There are several ways in which the IM could be used in research on the behavioral effects of DESIs. An investigator could measure the effects of an intervention on the central constructs of the IM - attitudes, normative pressure, self-efficacy, and intentions related to communication behaviors relevant to shared decision-making. However, if one were interested in the determinants of these domains, formative qualitative research would be necessary to elicit the salient beliefs underlying each of the central constructs. Formative research can help identify potential targets for a theory-based intervention to maximize the likelihood that it will influence the behavior of interest or to develop a more fine-grained understanding of intervention effects.
Behavioral theory can guide the development and evaluation of DESIs to increase the likelihood that these will prepare patients to play a more active role in the decision-making process. Self-reported behavioral measures can reduce the measurement burden for investigators and create a standardized method for examining and reporting the determinants of communication behaviors necessary for shared decision-making.
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