Predicting intended contraception in a sample of ethiopian female adolescents: The validity of the theory of planned behavior

Sexual behaviors, contraception use and barriers among adolescents and young adults in rural Haiti

BACKGROUND

Adolescents and young adults (AYAs) in Haiti experience a high unintended pregnancy rate, in part due to unmet contraception needs. Little is known about AYA opinions of and experiences with contraception that may explain remaining gaps in coverage. We aimed to describe barriers and facilitators to contraception use among AYAs in Haiti.

METHODS

We conducted a cross-sectional survey and semi-structured qualitative interviews with a convenience sample of AYA females aged 14-24 in two rural communities in Haiti. The survey and semi-structured interviews assessed demographics, sexual health and pregnancy prevention behaviors and explored contraception opinions and experiences according to Theory of Planned Behavior constructs: attitudes, subjective norms, and perceived behavioral control. We used descriptive statistics to report means and responses to Likert scale and multiple-choice questions. Guided by content analysis, we analyzed interview transcripts through inductive coding and team debriefing.

RESULTS

Among 200 survey respondents, 94% reported any past vaginal sexual activity, and 43% reported ever being pregnant. A large majority were trying to avoid pregnancy (75%). At last sexual activity, 127 (64%) reported use of any contraceptive method; Among them, condoms were the most common method (80%). Among those with previous condom use, most reported use less than half the time (55%). AYAs were concerned about parental approval of birth control use (42%) and that their friends might think they are looking for sex (29%). About one-third felt uncomfortable going to a clinic to ask for birth control. In interviews, AYAs desired pregnancy prevention but frequently noted concerns about privacy and parental, community and healthcare provider judgement for seeking care for reproductive health needs. AYAs also noted a lack of contraception knowledge, evident by frequent misconceptions and associated fears.

CONCLUSION

Among AYAs in rural Haiti, a large majority were sexually active and desire pregnancy avoidance, but few were using effective contraception due to numerous concerns, including privacy and fear of judgement. Future efforts should address these identified concerns to prevent unintended pregnancy and improve maternal and reproductive health outcomes in this population.

Use of modern contraceptives in Lagos Nigeria during the COVID-19 pandemic

We estimated modern contraceptive prevalence rate (mCPR) and examined predictors of modern contraceptives utilization amongst 1,445 sampled reproductive age women in Lagos (Nigeria's epicenter) during the devastating COVID-19 pandemic. Estimated mCPR was 30.8%. Women aged 20-29 years were 50% (95%CI:0.37-0.71) less likely to use modern contraceptives during the pandemic than those 30-39 years. Married and divorced women were about three (95%CI:1.37-5.25) and over three (95%CI:1.32-7.79) times more likely to use modern contraceptives compared to single women. Though mCPR has not reduced, sustained contraceptive needs assessment of sometimes obscure sub-populations is required, especially if outbreaks like COVID-19 become our 'new normal'.

You Have Options: Implementing and evaluating a contraceptive choice social marketing campaign

Background:

Up to two-thirds of pregnancies among young, unmarried women in the United States are unintended, despite increased access to highly effective contraceptive options.

Aim:

This study implemented and evaluated a social marketing campaign designed to increase access to a full range of contraceptive methods among women aged 18–24 years on a southeastern university campus.

Methods:

Researchers partnered with Choose Well and Student Health Services to design, implement, and evaluate You Have Options, a 10-week multi-media social marketing campaign. The campaign aimed to raise awareness, increase knowledge, and improve access to contraceptive options, including long-acting reversible contraception (LARC) methods among college women. A pretest-posttest web-based survey design measured campaign awareness and recognition, as well as attitudes, subjective norms, and behavior.

Results:

Participants demonstrated a significant increase in knowledge about intrauterine devices (IUDs) between pretest ( M = 2.66, SD = 1.30) and posttest ( M = 3.06; SD = 1.96); t(671) = −2.60, p < .01). Analysis revealed that frequent exposure to the campaign prompted participants to engage in discussions about LARC with friends ( p < .05). In addition, 20- to 24-year-olds who reported seeing the campaign messages were more likely to seek out information ( p < .01) and adopt a LARC method ( p = .001) than 18- or 19-year-olds who saw the campaign messages.

Conclusion:

Findings from the study offer practical recommendations for implementing social marketing campaigns aimed at increasing access to LARC and reducing unintended pregnancy.

Developing the evidence base for gender- and age-relevant school sex education: questionnaire findings from an adolescent sample using an augmented theory of planned behaviour

BACKGROUND

Positive adolescent sexual health is supported by effective school-based sex education. Methods to promote positive sexual health need to reflect determinants of contraception intention, which must include understanding gender and age (year group) differences. To date, there has been limited theory-based exploration of these determinants in school age participants, placing limitations on sexual health educators to tailor learning most effectively.

METHODS

Cross-sectional survey data were collected from UK school pupils (n=1378) aged 12-16 years. Measures included theory of planned behaviour, prototype willingness, anticipated regret and knowledge items. Linear regression determined significant predictors of intention to use condoms, the oral contraceptive pill and emergency contraception (EC). The significance of differences by gender and school year was evaluated using t-tests and analysis of variance (ANOVA).

RESULTS

Three distinct predictive models emerged for condom, pill and EC use, predicting 36%, 18% and 23% of variance respectively. Attitude, gender and anticipated regret for unprotected sex significantly predicted intention for all types of contraception (P<0.001). The effects of other explanatory variables differed by contraceptive. Girls scored higher on all variables except condom intention, and intention scores peaked in Year 10.

CONCLUSION

Intention to use condoms, the pill and EC have different predictive profiles, with girls more strongly motivated and Year 10 a crucial stage for intention. Social comparisons and control beliefs exert different effects across contraceptive types, whereas attitudes and anticipated regret are consistently strong influences. The findings suggest clear scope for supporting sexual health and well being through modified school sex education.

Structural Equation Modeling Test of an Integrated Model of Spanish Youth's Condom Use

Heterosexual transmission represents 26 % of newly diagnosed infection in Spanish youth. Behavioral change models have emphasized the influence of multiple variables to predict condom use behavior. The aim of this study is to examine how those variables are organized and which theory explains the condom use behavior better. A sample of 424 young heterosexuals (M _age  = 20.62; SD = 2.16) filled out a battery of self-report questionnaires for assessing AIDS-related variables, personality traits and clinical variables (general, sexuality-related and health-related). A structural model was specified that included perceived pleasure and condom use self-efficacy as predictive variables. Depression and sexual compulsivity indirectly influence behavior. The final model accounted for 65.9 % of the variance in behavior. These results highlight the importance of cognitive and emotional variables as predictors of behavior (ex. expectations of pleasure and self-efficacy beliefs). This is important information for designing effective psychological interventions.

"It Makes You Rethink Your Choice of the Pill": Theory-Based Formative Research to Design a Contraceptive Choice Campaign

Half of all pregnancies in the United States remain unplanned despite improved access to highly effective long-acting reversible contraception, including the intrauterine device and the implant. This study conducted theory-based formative research to develop a contraceptive choice campaign aimed at increasing long-acting reversible contraception uptake by women ages 18-44 years in Charleston, South Carolina, an urban area in the southeastern United States. Researchers developed and tested message concepts and designs. Six focus groups and 18 interviews were conducted among reproductive-age women (n = 79). Qualitative data analysis revealed messages and designs that resonated with these women. Emphasizing long-acting reversible contraception as the healthy option, highlighting long-acting reversible contraception effectiveness, including relatable and trustworthy characters, and using language of control emerged as themes. Women reported a preference for statistics illustrating effectiveness combined with empowering messages of control over contraceptive decision making. Findings from this study offer practical recommendations for developing contraceptive choice campaigns targeting long-acting reversible contraception use and further the goal of reducing unintended pregnancy among women.

Predictors of non-condom use intentions by university students in Britain and Greece: The impact of attitudes, time perspective, relationship status, and habit

OBJECTIVE

This study investigated the impact of socio-cognitive factors (attitudes and norms), time perspective (TP), relationship status (RS), and past sexual behaviour on intended non-condom use in 104 Greek and 93 British university undergraduates.

METHOD

Data were obtained by a self-report questionnaire. Data analysis included correlation, regression and ANOVA procedures.

RESULTS

Attitudes were the strongest predictors of non-condom use intentions for participants who had casual relationships or were single (i.e. unstable relationship context), and past behaviour was the strongest predictor of non-condom use intentions for those who perceived themselves to be in an exclusive relationship (i.e. stable relationship context). Past behaviour was the strongest predictorof intended non-condom use in relation to all the variables of this study. TP managed to predict non-condom use intentions and moderate the attitudes-intentions relationship. In terms of temporal influences, participants high in fatalistic TP were strongly inclined not to use condoms, irrespective of their attitudes, but TP did not differ as a function of culture.

CONCLUSIONS

Our data revealed the value of considering the combined effects of relationship status, habit and attitudes, when investigating undergraduate non-condom use intentions and designing interventions. The construct of TP was introduced as a meaningful addition to sexual risk research.

The theory of planned behaviour as a framework for predicting sexual risk behaviour in sub-Saharan African youth: A critical review

Amongst the psychological theories that have been used to help understand why people have unprotected sex, the Theory of Planned Behaviour (TPB: Ajzen 1991) has earned a prominent position. This article is a critical review of 11 peer-reviewed studies conducted in sub-Saharan Africa during 2001 to 2009, which used the TPB as a model of predicting sexual risk behaviour in young people. All the studies revealed the predictive ability of the TPB in urban, rural, and traditional African settings, with R (2) coefficients ranging between 0.14 and 0.67. With data comparing favourably to those obtained in the international literature, these studies indicate that the TPB can be used to study sexual risk intentions and behaviour in sub-Saharan African youth, and question arguments against the theory's use in non-Western settings.

An empirical test of the Theory of Planned Behaviour applied to contraceptive use in rural Uganda

There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health-behaviour-change theories to contraceptive use among this population. This study tested the Theory of Planned Behaviour's ability to predict contraceptive-use-related behaviours among post-partum women in rural Uganda. Results gave modest support to the theory's application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries.

Intention to voluntary HIV counseling and testing (VCT) among health professionals in Jimma zone, Ethiopia: the theory of planned behavior (TPB) perspective

Background

Voluntary HIV Counseling and Testing (VCT) forms one of the cornerstones of HIV prevention strategies. It is imperative to understand HIV testing correlates and their theoretical underpinnings in order to promote VCT uptake. The aim of this study was to predict the intention to VCT and associated factors among health professionals in Jimma zone, Ethiopia using the theory of planned behavior.

Methods

An institution based cross-sectional quantitative study among a sample of 336 health professionals in 12 selected districts of Jimma, Ethiopia was conducted in 2012. The constructs and principles of the theory of planned behavior (TPB) were measured. Data were collected using structured questionnaire on self administered basis. A multivariable linear regression model was used to predict the role of independent variables/TPB constructs on the intention to use VCT using SPSS version 16.0.

Results

The components of TPB independently explained the variance in intention to VCT by 30.3%. Both components of TPB and socio-demographic characteristic in the final model explained 32.7% of variance in the intention to use VCT services. Significant proportions (33.0%) of the respondents have never been tested for HIV. The respective indirect components of the TPB predicted the direct components. The strongest predictors of intention to VCT were subjective norm (β=0.39, p<0.001) and attitude (β= 0.19, p<0.001) whereas, none of the socio-demographic variables were significantly predicted the intention to use VCT. Past VCT experience did not have significant statistical association with VCT use intention.

Conclusions

Behavioral intention to use VCT was a function of attitude and perceived social pressure. Demographic related social determinants were not barriers for VCT use intention. Most health workers test their blood by themselves. Strategies to empower health professionals on social pressure resistance and programs targeted at changing negative attitude on VCT use can enhance intention of health professionals to use VCT.

Expanding the theory of planned behaviour: the role of social norms and group identification

The purposes of the study were twofold. First, to explore the predictive power of the descriptive and group norms, when the effect of subjective norm had already been accounted for. Second, to investigate to what extent perceived group norm of a behaviourally relevant reference group would predict the intention to use contraception among those who identified strongly with the relevant reference group. The empirical data were generated from a sample of 354 sexually active female adolescents living in Addis Ababa, Ethiopia. The results revealed that subjective (injunctive) norm was the most important predictor of contraceptive intentions (β = .33, p<.001). In addition, descriptive norms (β = .20, p <.001) and (unexpectedly) group norm (β = .11, p <.035) exerted significant main effects upon intention. The study indicated that contraceptive intentions in Ethiopian adolescent girls were influenced more by 'social' (injunctive, descriptive) than 'personal' considerations (attitudes: β = .20, p <.001, and; PBC: β = .17, p<.001). However, none of the interaction terms between group identification and social influence variables were significant. Furthermore, collective-self did not emerge to have either a direct effect upon intention, or a moderation effect upon the social norms-intention relationships (as expected).

Constructing multiplicative measures of beliefs in the theory of planned behaviour

OBJECTIVE

Commonly used theories in health psychology involve multiplicative composites of measures, which have been used as predictors, mediators, and outcomes. The chosen scaling system can affect correlations with other variables. This study evaluated how best to construct composites in the context of the theory of planned behaviour (TPB), using hierarchical linear regression, a priori defined scaling systems, and optimal scaling.

DESIGN

Longitudinal.

METHODS

At baseline, 6 and 12 months, 365 trial participants (ProActive) completed questionnaires assessing salient beliefs, which were used to construct composites (indirect measures), and direct measures of instrumental and affective attitude, subjective norm, and perceived behavioural control towards becoming more physically active over the next 12 months.

RESULTS

Linear regression supported a multiplicative model for indirect instrumental attitude and perceived control. Except for perceived control, associations between composites and direct measures were unaffected by different a priori scaling systems. Optimal scaling produced widely differing composites over time for subjective norm and affective attitude and a negative association between composite and direct measure for subjective norm.

CONCLUSIONS

We recommend that researchers who use multiplicative composites first establish clear support for a multiplicative model, before they examine a range of meaningful scaling systems on theoretical and empirical grounds. Caution is needed when using optimal scaling without checking that a multiplicative model is supported and the resulting scaling system meaningful.

STATEMENT OF CONTRIBUTION

What is already known on this subject? Multiplicative composites are included in commonly used theories in health psychology (e.g., theory of planned behaviour). Valid measures are needed as the choice of scaling system (e.g., unipolar or bipolar) can affect estimates of associations between composites and other variables. Ajzen has advocated the use of optimal scaling. What does this study add? The study shows that optimal scaling can result in meaningless measures. We recommend that health psychologists use optimal scaling with great caution and we provide alternative recommendations for constructing composites.

The role of tobacco promoting and restraining factors in smoking intentions among Ghanaian youth

BACKGROUND

In Western countries, the relationship between smoking intentions and smoking behaviour is well established. However, youth smoking intentions and associated factors in developing countries are largely unexplored and the former may occur for a variety of reasons. We investigated youth smoking intentions in Ghana with regard to several tobacco promoting and restraining factors, including environmental, familial, attitudinal and knowledge measures.

METHODS

A school-based survey of a representative sample of 12-20-year-olds was conducted in 2008 in Ghana (N = 1338, response rate 89.7%).

RESULTS

In a bivariate model, both among ever and never smokers, allowing smoking on school compound, exposure to tobacco advertisement and parental smoking were associated with future intention to smoke. Compared to those who agreed that smoking is harmful to health, smoking is difficult to quit and that tobacco should not be sold to minors, those who disagreed or were not sure were more likely to have an intention to smoke. In the multivariate analyses, these associations persisted, except that the attitude measures concerning the difficulty of quitting smoking once started and tobacco sales ban were no longer significantly associated with smoking intentions.

CONCLUSIONS

These findings underscore the importance of school smoking policy, parental smoking behaviour and knowledge of the harmful effects of tobacco use in determining Ghanaian youths' future smoking intentions. Because current high percentages of smoking intentions may turn into high smoking rates in the future, the introduction of effective tobacco control measures at all levels of society to prevent youth smoking in Ghana may be essential.

Sexual health professionals' evaluations of a prototype computer-based contraceptive planning intervention for adolescents: implications for practice

BACKGROUND

This paper aims to demonstrate how an online planning intervention to enhance contraceptive and condom use among adolescents was viewed by sexual health professionals. It identifies feedback that has facilitated improvement of the intervention both in terms of potential effectiveness and sustainability in practice. The data illustrate how professionals' feedback can enhance intervention development.

METHOD

Ten practitioners (two male; eight female) representing a range of roles in sexual health education and healthcare were given electronic copies of the prototype intervention. Interviews were conducted to elicit feedback. Transcripts of the interviews were subjected to thematic analysis.

RESULTS

Practitioners provided positive feedback about the intervention content, use of on-line media, the validity of planning techniques and the inclusion of males in contraceptive planning. Issues with rapport building, trust, privacy, motivation, and time and resources were raised, however, and the promotion of condom carrying was contentious.

CONCLUSIONS

Professionals' feedback provided scope for developing the intervention to meet practitioners' concerns, thus enhancing likely feasibility and acceptability in practice. Ways in which particular feedback was generalisable to wider theory-based and online intervention development are explored. Some responses indicated that health practitioners would benefit from training to embed theory-based interventions into sexual health education and healthcare.

The effects of smoking norms and attitudes on quitting intentions in Malaysia, Thailand and four Western nations: a cross-cultural comparison

This research investigated the influence of smoking attitudes and norms on quitting intentions in two predominantly collectivistic countries (Malaysia and Thailand) and four predominantly individualistic Western countries (Canada, USA, UK and Australia). Data from the International Tobacco Control Project (N = 13,062) revealed that higher odds of intending to quit were associated with negative personal attitudes in Thailand and the Western countries, but not in Malaysia; with norms against smoking from significant others in Malaysia and the Western countries, but not in Thailand; and with societal norms against smoking in all countries. Our findings indicate that normative factors are important determinants of intentions, but they play a different role in different cultural and/or tobacco control contexts. Interventions may be more effective if they are designed with these different patterns of social influence in mind.

Correlates of intention to use condoms among Sub-Saharan African youth: the applicability of the theory of planned behaviour

AIMS

To test the applicability of an extended version of the theory of planned behaviour for the study of condom use intentions among large samples of young people in South Africa and Tanzania.

METHODS

Baseline data of a randomized controlled trial of school-based HIV/AIDS prevention programmes were used. The setting comprised secondary schools in the regions of Cape Town, Polokwane and Dar es Salaam. Participants were 15,782 secondary school students. The main measures were scales for intentions, knowledge, risk perceptions, attitudes, perceived social norms and perceived self-efficacy regarding condom use.

RESULTS

Seven variables accounted for 77% of the variance in intentions to use condoms: attitudes (beta = 0.17), injunctive norms (beta = 0.27), self-efficacy (beta = 0.41), gender (lower condom use intentions among females), being a student at the Dar es Salaam site (lower scores than students in Cape Town and Polokwane), socioeconomic status (higher intentions with higher status), and access to condoms (higher intentions with higher access).

CONCLUSIONS

Our results are comparable to those of studies conducted in Europe and the USA. Social cognition models such as the theory of planned behaviour are applicable in understanding the correlates of condom use intentions in African contexts.

Applicability of the theory of planned behavior to intended and self-reported condom use in a rural Ethiopian population

This study aimed to assess the applicability of the Theory of Planned Behavior (TPB) in predicting intended and self-reported condom use and to examine the effect of previous condom use (PCE) among young adults in rural Ethiopia. A TPB interview was completed by 802 adults (mean age 20.7 years, 74.7% women) and 743 adults (mean age 20.7 years, 76.4% women) reported use of condom at three-months follow-up. The TPB and PCE explained 36% and 2.2% of the variance in intended condom use. Subjective norms discriminated strongly between individuals with and without PCE. The TPB and PCE accounted for 5.3% and 8.5% of the variance in reported condom use. This study concludes that the TPB provided a fairly accurate description of the process underlying intention but was less sufficient to account for self-reported condom use. Ethiopian youth decided on condom use if they anticipated predominantly positive consequences associated with performance and social support, whereas perceived barriers seemed to have less impact. Once they had started to use condoms, they were more likely to continue to do so in the future.

Gender power imbalance and differential psychosocial correlates of intended condom use among male and female adolescents from Venda, South Africa

OBJECTIVES

In South Africa, a gender power imbalance exists which may prevent women from negotiating safe sexual encounters. In this study we tested which constructs from Protection Motivation Theory (PMT) and the Theory of Planned Behavior (TPB) under these circumstances were most related to condom use intention. We hypothesized that in a situation of gender power imbalance self-efficacy would be a more salient correlate of intended condom use for females, while for males attitude to condoms and subjective norm would be more important.

DESIGN

This study employed a cross-sectional questionnaire design.

METHOD

Male participants (N=94) and female participants (N=101) from Venda, South Africa completed standard, multi-item, reliable measures of TPB constructs (condom-related attitude, subjective norm, perceived behavioural control, intention) and PMT constructs (vulnerability, severity, fear, response-efficacy, self-efficacy) and reported their past condom use behaviour.

RESULTS

Regression analysis indicated that among males attitude to condoms and subjective norm were significantly related to intended condom use. Among females attitude and self-efficacy were significantly related to intended condom use.

CONCLUSION

The findings indicate that in a situation of gender power imbalance psychosocial correlates of intended condom use differ for males and females. Gender-specific analysis of determinants of condom use may be more appropriate in a situation of gender power imbalance.

Condom use in African adolescents: The role of individual and group factors

This study set out to assess the ability of the Theory of Planned Behaviour (TPB) to predict and explain condom use in a traditional African context and in particular to assess the relative contributions of individual and normative constructs. A questionnaire survey was administered to 152 young adults (48% male, 52% female) at two points in time. Key constructs contained within the TPB were measured at Time 1. A short follow-up set of items was administered one week later at Time 2, thereby allowing for the measurement of actual behaviour. The results not only provide strong support for the predictive power of the TPB, since 67% of the variance in intention was explained, but also highlight the extent to which sexual behaviour in a rural location is governed by family/social influences. Subjective norm not only proved to be one of the most significant elements of the TPB model, together with self-efficacy (neither attitude nor perceived control were significantly involved), but 'my family' emerged as the most significant other. As such, the findings offer empirical evidence to support interventions that penetrate community networks.

Predicting intended use of voluntary HIV counselling and testing services among Tanzanian teachers using the theory of planned behaviour

The theory of planned behaviour (TPB) provides a conceptual model for understanding individual cognitions that influence behavioural intentions and enactment of the actual behaviours. This study examined the applicability of the TPB and the additional predictive role of perceived risk in predicting intended use of voluntary HIV counselling and testing (VCT) services. We conducted a cross-sectional questionnaire survey among 918 primary school teachers in the Mwanza region, Tanzania between September 2003 and November 2003. Analysis was based on 737 teachers (mean age 38.9) who had never tested for HIV. Results of the hierarchical regression analysis indicate that perceived behavioural control and attitude toward using VCT services were significant predictors of intention to use VCT services in the TPB model. Perceived behavioural control added 12% of variance to intention over and above attitudes and subjective norms, while perceived risk added 3% of variance. Socio-economic status did not moderate the predictive value of the TPB components. The present study demonstrates that the TPB is a useful conceptual framework for predicting intended use of HIV counselling and testing services among Tanzanian teachers. A theory-based VCT intervention programme among Tanzanian teachers should mainly focus on reducing social and psychological barriers related to the use of VCT services.

Normative processes and adolescents’ smoking behaviour in Norway: A multilevel analysis

Currently, smoking prevalence is still high among adolescents. This is of major concern for public health organizations. Factors that influence adolescent smoking behaviour need to be identified and addressed. Research in this area has identified attitudes, subjective norms and perceived behavioural control as some of the contributing factors, but subjective norms have often been the weakest predictor of smoking behaviour. This could be due to inadequate measurement. The current paper suggests that examining different types of norms and their relationship with smoking behaviour could help increase the contribution of norms. The paper set out to identify other normative concepts, such as the subjective estimate of smoking prevalence, and descriptive and desired societal norms that are not captured by subjective norms but that could be related to adolescents' smoking behaviour. Data were collected from 15-year-old students from Norway (n = 1670 in 89 grade 10 school classes). Multilevel logistic regression analysis was used to determine how the various concepts of norms relate to each other and their relationship with adolescent smoking behaviour. The findings of the study showed that an individual's opinion of societal norms, and the expectations of significant others as well as their behaviour all seem significantly related to adolescent smoking behaviour, either as an individual or as a school class predictor. Hence, rather than playing down the role of norms, the addition of a subjective estimate of smoking prevalence, and descriptive and desired societal norms could extend the normative concept as well as increase its predictive power. Future intervention could address different types of norms as well as the effect of shared context to help prevent adolescents from smoking.

Examining intention to control preschool children's sugar snacking: a study of carers in Uganda

AIM

The aims of this study were to investigate parents' intention to control their children's sugar consumption and whether that behaviour is reported to occur in 3-5-year-old preschool children according to sociodemographics and attitudinal factors derived from the Theory of Planned Behaviour (TPB).

DESIGN

Some 589 children aged 3-5 years (51% boys, response rate = 85%) attending nursery schools in Kampala Central (urban) and Nakawa (suburban), Uganda, were examined clinically for dental caries. A questionnaire to assess sociodemographic factors, sugar intake and the constructs of the TPB was completed by their parents'/caregivers in face-to-face interviews.

RESULTS

Analyses of variance revealed more positive attitudes and stronger intention to control children's intake of sugared snacks in highly as compared to less highly educated parents. Independent of educational level, parents having children with caries perceived themselves to have less control over their child's intake of sugared snacks and perceived them to be more susceptible to tooth decay compared to parents of children without caries. In multiple linear regression, the TPB provided a significant prediction of intention with attitude (b = 0.16, P < 0.001), subjective norms (b = 0.18, P < 0.001) and perceived barriers (b = 0.11, P = 0.01), significant and reported sugar intake with attitudes (b = -0.10, P = 0.02), and perceived susceptibility (b = 16, P < 0.001) all significant.

CONCLUSION

The TPB components predict parental intention to control sugar snacking and whether that behaviour occurs in preschool children. The strengths of parents' attitudes and reported level of child sugar snacking varied between diverse socioeconomic family groups. Implications for oral health education are discussed.

Psychosocial correlates of HIV protection motivation among black adolescents in Venda, South Africa

We assessed the usefulness of the theory of planned behavior (TPB) and protection motivation theory (PMT) to predict intended condom use among 201 adolescents from Venda, South Africa. Results indicated that both the TPB and the PMT could significantly predict intended condom use, although the level of explained variance was limited. Hierarchical regression analysis indicated that there was considerable overlap between the TPB and the PMT in predicting condom use intention. In the regression analysis that used both the TPB and the PMT variables subjective norms and response efficacy were positively related to intended condom use. The results indicated that both the TPB and the PMT were valuable in explaining intended condom use among African adolescents. The TPB made clear that the social environment is an important contextual factor, whereas the PMT made clear that response efficacy is positively related to condom use intention. The results of this study indicated that social cognition models have some value in the analysis of condom use intention of African adolescents, but the role of other factors like myths about condoms should be further examined.

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

PURPOSE

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?

METHOD

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.

RESULTS

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.

CONCLUSION

This study supports the validity of the TPB in predicting intended and self-perceived sugar consumption prospectively.

SELF-IDENTITY IN PLANNED BEHAVIOR PERSPECTIVE: PAST BEHAVIOR AND ITS MODERATING EFFECTS ON SELF-IDENTITY-INTENTION RELATIONS

The self-identity and past behavior measures were included in a structured TPB (Theory of Planned Behavior) questionnaire, with the major aim of providing support for the hypothesized main and interaction effects. Results supported the validity of the TPB model, with subjective norm as the strongest predictor of intention. In addition, self-identity (β=.10,p<.049), and past behavior (β=.25,p<.001) emerged as significant predictors of intention in the augmented model. Moreover, a moderation effect was observed for past behavior on self-identity- intention relations (β=-.15,p<.001), the significance of which was confirmed by simple slope analysis. Based on the findings, the possibility of integrating the self-identity perspective within the TPB is suggested. Further theoretical and practical implications are discussed.