Predicting adherence to ankle-foot orthoses in people with stroke: An application of the Theory of Planned Behavior

BACKGROUND

Ankle-foot orthoses (AFOs) are often prescribed for people with stroke to address motor impairment. However, not all patients adhere to using their AFOs as prescribed. Predictors of AFO adherence are likely to constitute useful targets for interventions that aim to promote this behavior.

OBJECTIVE

To identify the predictors of AFO adherence in people with stroke using an established theoretical framework, namely the Theory of Planned Behavior (TPB; Ajzen, 1991).

STUDY DESIGN

Prospective survey design.

METHOD

N = 49 people who had been prescribed an AFO after a stroke completed a TPB questionnaire. One month later, they completed another questionnaire that measured adherence to AFOs as prescribed by an orthotic practitioner. Predictors of intention and AFO-adherence behavior were identified using regression analyses.

RESULTS

Adherence to AFOs was 63%. The TPB accounted for 61% of the variance in intentions and 43% of the variance in AFO-adherence behavior. Attitude and perceived behavioral control were predictors of intention, and intention was the sole predictor of behavior.

CONCLUSION

The TPB is a useful model for explaining adherence to AFOs in people with stroke. Interventions could be designed to increase intentions to use an AFO as prescribed by promoting positive attitudes towards, and perceived behavioral control of AFO adherence.

Understanding aberrant driving intentions based on the Theory of Planned Behavior: Literature review and Meta-Analysis

INTRODUCTION

Despite deployed efforts to establish strict road safety standards, human factors is still the leading cause of road crashes. To identify determinants of driver's behavior, TPB (Theory of Planned Behavior) is widely used as a prominent theory of behavior change. However, the existence of different aberrant driving behaviors (decision errors, recognition errors, violations, and physical condition related errors) and several studies using TPB to understand driving behavior, makes it important to conduct a literature review and a meta-analysis of existing studies to use their results in effective driving behavior change interventions.

METHOD

The selection process provided 125 relevant studies that were published between 1991 and 2022, and that used TPB for the understanding of aberrant driving behavior. Five fundamental research questions were defined to identify information to be discovered from the literature review and from the meta-analysis.

RESULTS

In addition to the standard TPB constructs (attitudes, subjective norms, and perceived behavioral control), past behavior, moral norms, and descriptive norms were used in studies for a more comprehensive understanding of aberrant driving intention. This analysis demonstrated a significant correlation between aberrant driving intentions and past behavior. Also, moral norms construct was correlated with violations and recognition errors, whereas descriptive norms construct was correlated just with recognition errors.

CONCLUSIONS

The results of this study highlight the strength of TPB in the prediction of aberrant driving intention and its potential effectiveness to guide interventions aimed at changing aberrant driving behaviors. The study contributes to the comprehension of the relevant psychological factors influencing the engagement of drivers in each category of aberrant driving behaviors.

PRACTICAL APPLICATIONS

Researchers can use the results of this study to select the relevant psychological factors adapted to their interventions of driving behavior change. The results of the meta-analysis can also be used in the prediction of driver's intentions.

Assessing the effectiveness of psychoeducational interventions on driving behavior: A systematic review and meta-analysis

This review aimed to quantitatively summarize the evidence concerning the effectiveness of psychoeducational interventions on driving behavior. A final pool of 138 studies, totaling approximately 97,000 participants, was included in the analyses and covered all types of driving behavior targeted by the interventions. Using a random effects model, significant results were found for almost all driving outcomes, both post-intervention and long-term. The strongest effect was for reducing distracted driving at post-intervention (d = 1.87 [1.12, 2.60], Z = 4.94, p < 0.001). The only non-significant effects were for reducing errors in the long term (d = 0.50 [-0.87, 1.86], Z = 0.71, p = 0.48) and driving under the influence at post-intervention (d = 0.35 [0.00, 0.71], Z = 1.96, p = 0.05). Concerning which type of intervention was more effective, feedback, training and motivational ones appear to work best. Educational interventions show only weak effects, while awareness interventions seem mostly ineffective. Overall, our results show that most interventions can reduce different types of driving behaviors, but there are specific aspects to be considered based on the targeted behavior.

An Expectancy-Value approach to investigate socio-cognitive determinants of speeding among adolescent powered two-wheeled riders in Vietnam

Speeding increases the likelihood and severity of road traffic crashes, but many riders do not consider speeding as a serious safety issue. By using belief-based variables derived from the Theory of Planned Behaviour (i.e. behavioural beliefs, normative beliefs, and control beliefs), this study investigated the socio-cognitive determinants of speeding intentions among Vietnamese adolescents operating motorized/electrified two-wheelers. 189 adolescent powered two-wheeled riders in Ho Chi Minh City participated in a cross-sectional survey. The results lend clear support to the Expectancy-Value approach since belief-based product factors (e.g. outcome beliefs x outcome evaluations) significantly and independently contributed to the prediction of speeding intentions. Speeding intentions were mostly influenced by behavioural beliefs, followed by normative beliefs and control beliefs, respectively. This study not only proves the Expectancy-Value approach as an appropriate framework for the investigation of speeding intentions but also supports authorities in the formulation and execution of more effective interventions for reducing speeding among adolescent powered two-wheeled riders in Vietnam. Instead of motivation-oriented methods, there is a need for strategies that stimulate the translation of good intentions into the desirable behaviour, and encourage adolescents not to relapse in case they are exposed to risk facilitating circumstances. Yet, besides focussing on person-specific dispositions towards speeding, policy makers are advised to adopt a more broadly encompassing systemic approach with inclusion of safe roads, safe vehicles, improved post-crash care, and shared stakeholder responsibilities.

Identification of beliefs determining wrong lane riding intentions among Vietnamese adolescent two-wheeled riders: An Expectancy-Value approach

INTRODUCTION

In Vietnam, road traffic crashes are one of the leading causes of death and serious injury in adolescents, especially in the 15-19-year age group. Wrong lane riding (WLR) is seen as the most common risky behavior of adolescent two-wheeled riders. This study (a) tested the expectancy-value model held to underpin the key determinants of behavioral intention (i.e., attitude, subjective norm, perceived behavioral control) as proposed by the Theory of Planned Behavior, and (b) identified appropriate targets for road safety interventions.

METHOD

A cluster random sample of 200 adolescent two-wheeled riders in Ho Chi Minh City participated in a cross-sectional study designed to measure the variables of interest (i.e., behavioral beliefs, normative beliefs, control beliefs, and intention towards wrong lane riding).

RESULTS

The results of hierarchical multiple regression lend clear support for the expectancy-value theory as an approach to model the different belief components behind the key determinants of behavioral intention.

CONCLUSION

Road safety interventions aimed at reducing WLR among Vietnamese adolescent two-wheeled riders would best target both the cognitive and the affective components of attitude, subjective norm, and perceived behavioral control. Interestingly, the sample investigated in this study is rather negatively predisposed toward WLR.

PRACTICAL APPLICATIONS

It is recommended to further strengthen and stabilize these safety-oriented beliefs, and to develop the required implementation intentions to guarantee that the appropriate goal intentions in terms of WLR are translated into action. More research is needed to see whether the commission of WLR can also be explained in function of a reactive pathway, or is exclusively under volitional control.

Are Anti-Prostitution Advertising Campaigns Effective? An Experimental Study

Many governments invest public funds in communication interventions and campaigns against prostitution and sexual exploitation in an attempt to change attitudes toward prostitution and eventually decrease its consumption. Despite the considerable investment that public institutions have made in campaigns against prostitution and sexual slavery, no known empirical studies have evaluated the effectiveness of such campaigns on attitudes and behavioral change. The messages of these campaigns usually center on one of two thematic focuses: Prostituted women who suffer exploitation and male consumers of prostitution. The present study examines the impact of different anti-prostitution advertisements on attitudes among male participants (N = 155 male participants). Specifically, the experiment aims to test the differential effect of these two focuses, compared to a no-advertisement control condition, on social support for prostitution, negative and incorrect beliefs about prostitutes, and family values related to prostitution. The results show that compared with the no-advertisement control condition, advertisements focused on men who use prostitutes have a significant effect on social support toward prostitution and incorrect beliefs about prostitutes, whereas advertisements focused on female prostitutes have no effect. The results have practical implications for governments and councils regarding the efficacy of this kind of public communication campaign against prostitution consumption.

Commercial motorcyclists and road safety measures compliance. A case study of Dodoma city, central Tanzania

Objective

Road traffic accidents have been reported to contribute a greater proportion of deaths. Motorcyclists are among the high-risk group within road users to succumb to road traffic accidents. Road traffic accidents reflect the co-occurrence of multiple causes that involve road infrastructure, vehicle, and people. Understanding the level of compliance with road safety measures and their associated factors among commercial motorcyclists is important approach in the steps towards road traffic accident prevention.

Study design

A cross-sectional study of commercial motorcyclists from two districts in Dodoma region was conducted in 2020.

Methods

Multistage sampling method was used to recruit motorcyclists from registered parking stations. At first stage, purposive sampling was used to select the two districts, while in the second stage simple random sampling by lottery method was employed in the selection of wards and parking stations. Descriptive and Chi-square test analyses determined the compliance level. Bivariate and multivariate logistic regression analyses were performed to determine the associated factors.

Results

A total of 378 male commercial motorcyclists participated in the study. Majority (87.8%) were within the age range of 18-29 years. A significant proportion of participants (61.9%) had adequate knowledge and 59.5% showed positive attitude towards road safety measures. Only 39.7% reported to have good level of compliance with road safety measures. Married motorcyclists and those with good road safety practice regarding road safety measures were more likely to comply with road safety measures than their counterpart.

Conclusion

Good road safety practices and marital status were predictors of good compliance with road safety measures. Coordinated approaches, including continuing provision of road safety education and enforcement of road safety measures are needed to control the way motorcyclist behave on the road.

The Validity of the Theory of Planned Behaviour for Understanding People's Beliefs and Intentions toward Reusing Medicines

Background: many factors can impact a person’s behaviour. When the behaviour is subject to prediction, these factors can include, for example, the perceived advantages and disadvantages of performing the behaviour, normative beliefs, and whether the behaviour is thought to be achievable. This paper examines intentions to engage in medicines reuse, i.e., to accept medicines that are returned unused to a pharmacy to be reused. The paper aims to outline the validity of the Theory of Planned Behaviour (TPB) for understanding people’s intentions to engage in medicines reuse by examining this against other long-standing health-related psychological theories of behavioural change. Thus, the Health Belief Model (HBM), Protection Motivation Theory (PMT), Trans-Theoretical Model of Health Behaviour Change (TTM/SoC), Theory of Reasoned Action (TRA), and TPB are examined for their application in the study of medicines reuse. Discussion: the HBM, PMT, TTM/SoC, TRA, and TPB were assessed for their relevance to examining medicines reuse as a behaviour. The validity of the TPB was justified for the development of a Medication Reuse Questionnaire (MRQ) to explore people’s beliefs and intention toward reusing medicines. Conclusion: TPB has been widely used inside and outside of health-related research and it was found to have more accurately defined constructs, making it helpful in studying medicines reuse behaviour.

Understanding intentions to override intelligent speed assistance prior to widespread availability: An application of the theory of planned behaviour

Intelligent Speed Assistance (ISA) offers a technological solution to reduce speeding that will become more common in vehicles in the short to medium term. Many implementations allow drivers to override the system's speed control and minimising such interventions can optimise safety benefits. This paper aims to inform behaviour change interventions to reduce ISA overriding targeted to drivers as they obtain vehicles fitted with ISA. We explore the beliefs underlying intentions to override ISA to exceed the speed limit in drivers with limited ISA experience using the Theory of Planned Behaviour. In a sample of 121 drivers (mean age 36 years), regression modelling showed that attitudes strongly predicted intentions with an additional contribution from subjective norms but not perceived behavioural control. Behavioural beliefs underlying attitudes addressed overriding ISA for (1) responsibly controlling the car to minimise crash risk and (2) reducing journey times and enjoying fast driving. Salient normative beliefs focussed on groups that would disapprove of overriding ISA including emergency services and parents. We discuss how these beliefs might be addressed in interventions to maximise the safe adoption of ISA.

Greater fruit selection following an appearance-based compared with a health-based health promotion poster

Background

This study investigated the impact of an appearance-based compared with a traditional health-based public health message for healthy eating.

Methods

A total of 166 British University students (41 males; aged 20.6 ± 1.9 years) were randomized to view either an appearance-based (n = 82) or a health-based (n = 84) fruit promotion poster. Intentions to consume fruit and immediate fruit selection (laboratory observation) were assessed immediately after poster viewing, and subsequent self-report fruit consumption was assessed 3 days later.

Results

Intentions to consume fruit were not predicted by poster type (largest β = 0.03, P = 0.68) but were associated with fruit-based liking, past consumption, attitudes and social norms (smallest β = 0.16, P = 0.04). Immediate fruit selection was greater following the appearance-based compared with the health-based poster (β = −0.24, P < 0.01), and this effect remained when controlling for participant characteristics (β = −0.21, P < 0.01). Subsequent fruit consumption was greater following the appearance-based compared with the health-based poster (β = −0.22, P = 0.03), but this effect became non-significant on consideration of participant characteristics (β = −0.15, P = 0.13), and was instead associated with fruit-based liking and past consumption (smallest β = 0.24, P = 0.03).

Conclusions

These findings demonstrate the clear value of an appearance-based compared with a health-based health promotion poster for increasing fruit selection. A distinction between outcome measures and the value of a behavioural measure is also demonstrated.

Preventing tobacco in vocational high schools: study protocol for a randomized controlled trial of P2P, a peer to peer and theory planned behavior-based program

BACKGROUND

In France, the issue of youth smoking remains a major challenge for public health. School failure, socio-economic and socio-cultural backgrounds influence the initiation and maintenance of smoking behavior in adolescents. Vocational students are at particularly high risk of using psychoactive substances, including tobacco. One of the most important factors is the environment, whether family, friends or peers. Therefore, peer education has a positive potential to change smoking behavior of adolescents. It has also been demonstrated that the Theory of Planned Behavior (TPB) has yielded the best prediction of intentions and behavior, in several health domains, including on tobacco. However, it is usually confined to the measurement of processes by which interventions change behavior, rather than to the development of these interventions. The objective of this paper is to describe the protocol for a randomized controlled trial of a peer intervention based on the TPB on a highly exposed young population.

METHODS/DESIGNS

This is a cluster randomized controlled trial comparing an intervention group to a control group, randomized into clusters (professional schools and classes) and stratified in three departments (Hérault, Aude and Gard) in the Languedoc-Roussillon region. The primary issue is the prevalence of daily smoking at 24 months, defined by a daily tobacco use of at least 1 cigarette, validated by CO levels in exhaled air. The primary hypothesis is that intervention will lead to decrease the daily smoking prevalence of 10% between the intervention group and the control group during a 2-year follow-up.

DISCUSSION

The results from this trial will provide evidence on the effectiveness of an innovative peer-to-peer intervention based on the TPB.

TRIAL REGISTRATION

ISRCTN: 37336035 , Retrospectively registered 11/12/2015.

Evaluation of an Intimate Partner Violence Training for Home Visitors Using the Theory of Planned Behavior

INTRODUCTION

Intimate partner violence (IPV) is a public health issue with recent intervention focus by home visiting programs with at-risk families in the United States. Home visitors are typically required to assess IPV but feel unprepared to do so and desire training. Our aim was to evaluate the impact of a daylong IPV training on the intention to enact three key IPV behaviors (screening, making referrals, and safety planning) using the theory of planned behavior.

METHOD

Survey of 125 home visitors in West Virginia was conducted before and after a daylong IPV training.

RESULTS

The IPV training had a positive impact on intention to perform the three behaviors of interest, with the greatest impact on the intention to conduct IPV screenings.

DISCUSSION

Results provide important preliminary evidence supporting the effectiveness of professional development as a means of increasing intentions to conduct activities related to IPV. The impact on IPV screening intention is promising because screening is the first step in addressing IPV.

CONCLUSION

The IPV training proved beneficial in increasing intentions and such trainings should be expanded, but further study is needed to link intentions to subsequent behaviors to address IPV with at-risk families.

Intentions and willingness to drive while drowsy among university students: An application of an extended theory of planned behavior model

A web-based questionnaire was used to assess the utility of constructs from the Theory of Planned Behavior (TPB) and the Prototype Willingness Model (PWM) to predict intentions and willingness to engage in drowsy driving in a sample of 450 university students. Those students who reported more favorable attitudes and subjective norm and greater perceived control and willingness in relation to drowsy driving behavior were more likely to report stronger intentions to engage in drowsy driving behavior. Augmenting the TPB constructs with the PWM construct of willingness significantly explained up to an additional 8 percent of the variance in drowsy driving intention. Perceived behavioral control and willingness were consistently the strongest predictors of drowsy driving intention in the augmented model, which together with the control (personal) variables explained up to 70 percent of the variance in intention. Thus, the Theory of Planned Behavior and the Prototype Willingness Model may be useful for understanding motivational influences on drowsy driving behavior in young people and present promising theoretical frameworks for designing more effective interventions against drowsy driving in this population.

How Effective are Behavior Change Interventions Based on the Theory of Planned Behavior?

Abstract. The theory of planned behavior (TPB) is a prominent framework for predicting and explaining behavior in a variety of domains. The theory is also increasingly being used as a framework for conducting behavior change interventions. In this meta-analysis, we identified 82 papers reporting results of 123 interventions in a variety of disciplines. Our analysis confirmed the effectiveness of TPB-based interventions, with a mean effect size of .50 for changes in behavior and effect sizes ranging from .14 to .68 for changes in antecedent variables (behavioral, normative, and control beliefs, attitude, subjective norm, perceived behavioral control, and intention). Further analyses revealed that the interventions’ effectiveness varied for the diverse behavior change methods. In addition, interventions conducted in public and with groups were more successful than interventions in private locations or focusing on individuals. Finally, we identified gender and education as well as behavioral domain as moderators of the interventions’ effectiveness.

Identifying beliefs underlying pre-drivers' intentions to take risks: An application of the Theory of Planned Behaviour

Novice motorists are at high crash risk during the first few months of driving. Risky behaviours such as speeding and driving while distracted are well-documented contributors to crash risk during this period. To reduce this public health burden, effective road safety interventions need to target the pre-driving period. We use the Theory of Planned Behaviour (TPB) to identify the pre-driver beliefs underlying intentions to drive over the speed limit (N=77), and while over the legal alcohol limit (N=72), talking on a hand-held mobile phone (N=77) and feeling very tired (N=68). The TPB explained between 41% and 69% of the variance in intentions to perform these behaviours. Attitudes were strong predictors of intentions for all behaviours. Subjective norms and perceived behavioural control were significant, though weaker, independent predictors of speeding and mobile phone use. Behavioural beliefs underlying these attitudes could be separated into those reflecting perceived disadvantages (e.g., speeding increases my risk of crash) and advantages (e.g., speeding gives me a thrill). Interventions that can make these beliefs safer in pre-drivers may reduce crash risk once independent driving has begun.

Evidence that attitude accessibility augments the relationship between speeding attitudes and speeding behavior: a test of the MODE model in the context of driving

According to the MODE model of attitude-to-behavior processes, attitude accessibility augments attitude-behavior correspondence, reflecting an automatic influence of attitudes on behavior. We therefore tested whether attitude accessibility moderates the attitude-behavior relationship in a context that is governed by characteristically automatic behavior, namely driving. In study 1 (correlational design), participants (N=130) completed online questionnaire measures of the valences and accessibilities of their attitudes towards speeding. Two weeks later, online questionnaire measures of subsequent speeding behavior were obtained. Attitude valence was a significantly better predictor of behavior at high (mean+1SD) versus low (mean-1SD) levels of attitude accessibility. In study 2 (experimental design), attitude accessibility was manipulated with a repeated attitude expression task. Immediately after the manipulation, participants (N=122) completed online questionnaire measures of attitude valence and accessibility, and two weeks later, subsequent speeding behavior. Increased attitude accessibility in the experimental (versus control) condition generated an increase in attitude-behavior correspondence. The findings are consistent with the MODE model's proposition that attitudes can exert an automatic influence on behavior. Interventions to reduce speeding could usefully increase the accessibility of anti-speeding attitudes and reduce the accessibility of pro-speeding attitudes.

Potential determinants of drink driving in young adults

OBJECTIVE

The main purposes of this study were to examine the usefulness of the variables of the theory of planned behavior (viz. attitudes, social norms, and self-efficacy) and to explore the relationship between optimism bias and drink driving in young adults. In addition, we explored gender differences in drink driving with provision for the effect of variables such as driving frequency and alcohol consumption.

METHODS

Data were collected via a questionnaire administered to 274 drivers (59.9% females) aged 18-30 years (24.36 ± 2.96).

RESULTS

The results obtained with provision for driving frequency revealed substantial differences in driving behaviors between genders. Thus, males were more prone to drink driving, perceived less disapproval by their significant others (parents and peers), and felt less able to avoid drinking-and-driving situations. In addition, they self-reported more frequent alcohol consumption and driving under the influence. The results also confirm the significance of peers' subjective norms and attitudes to drink driving in males. Overconfidence in their own driving skills for driving drunk and perceived behavioral control were found to be significant predictors for drink driving in females. Optimism bias also played a slightly significant role in predicting drink driving but only in females.

CONCLUSIONS

The important practical implications of these results with a view to designing effective interventions to prevent the risks associated with drink driving in the young population are discussed. Interventions should focus on young people's perceptions of group norms and promoting cautionary driving choices and alternatives to drink driving.

Sensation seeking and drunk driving: the mediational role of social norms and self-efficacy

The aim of this work was to examine the role of sensation seeking in drunk driving by youths, and the potential mediational effect of social, cognitive and emotional variables on their relationship. To this end, a survey was conducted on 274 drivers (164 females and 110 males) aged 24.36±2.96 years (range 18-30 years). The results obtained confirm the significance of sensation seeking to drunk driving by youths and the mediating role of biased self-efficacy perceptions in their relationship. The important practical implications of this finding on the development of effective interventions to prevent the risks of drunk driving in youths are discussed.

A randomised controlled trial of a theory of planned behaviour to increase fruit and vegetable consumption. Fresh Facts

Young adults are less likely than other adults to consume fruit and vegetables. Fresh Facts is a theory of planned behaviour based intervention designed to promote fruit and vegetable consumption. The present study sought to evaluate Fresh Facts using a randomised controlled trial. Australian young adults (n = 162) were allocated to the Fresh Facts intervention or to the control group in 2011. Intervention participants received automated email messages promoting fruit and vegetable consumption every 3 days over the course of the 1 month intervention. Messages targeted attitude, subjective norm, and perceived behavioural control. Theory of planned behaviour variables and fruit and vegetable intake were measured at baseline and post-intervention (Day 30). Significant increases in attitude and subjective norm relative to control were found among Fresh Facts participants. However, intention, perceived behavioural control and fruit and vegetable consumption did not change as a result of the intervention. Changes in intention reported by each participant between baseline and follow-up were not correlated with corresponding changes in fruit and vegetable consumption. Fresh Facts was not successful in increasing fruit and vegetable consumption. Current evidence does not support the use of the theory of planned behaviour in the design of interventions to increase fruit and vegetable intake in this population.

Development and preliminary evaluation of a decision aid for disclosure of mental illness to employers

OBJECTIVE

Many mental health service users delay disclosing to employers or never do so due to previous experience of, or anticipation of discrimination. However, non-disclosure precludes requesting 'reasonable workplace adjustments'. Service users may experience conflicting needs and values in deciding whether to disclose. No evidence-based interventions exist to support this decision.

METHODS

A decision aid (CORAL, or COnceal or ReveAL) to support mental health service users in reaching disclosure decisions was developed and subjected to preliminary evaluation (n=15).

RESULTS

The majority found the decision aid quick (60%) and relevant (60%) and would recommend it (80%). Eighty percent reported that they would definitely or probably use it in making disclosure decisions. Forty percent each were positive or neutral on its ease of use. Semi-structured interviews revealed a demand for more information on the legal implications of disclosure. The mean level of 'decisional conflict' regarding disclosure reduced from 52.0 to 35.5 and mean Stage of Decision-making Scale score from 4.6 to 4.3.

CONCLUSION

The results suggest that the CORAL decision aid is feasible, relevant and valuable in supporting decisions about disclosing a mental illness to an employer.

PRACTICE IMPLICATIONS

The decision aid could be deployed in routine care without significant resource implications.

Determinants of personal protective equipment (PPE) use in UK motorcyclists: exploratory research applying an extended theory of planned behaviour

Despite evident protective value of motorcycle personal protective equipment (PPE), no research has assessed considerations behind its uptake in UK riders. A cross-sectional online questionnaire design was employed, with riders (n=268) recruited from online motorcycle forums. Principal component analysis found four PPE behavioural outcomes. Theoretical factors of intentions, attitudes, injunctive and descriptive subjective norms, risk perceptions, anticipated regret, benefits and habit were also identified for further analysis. High motorcycle jacket, trousers and boots wear, middling high-visibility wear and low non-Personal Protective Equipment wear were found. Greater intentions, anticipated regret and perceived benefits were significantly associated with increased motorcycle jacket, trousers and boots wear, with habit presence and scooter use significantly associated with increased high-visibility wear. Lower intentions, anticipated regret and risk perceptions, being female, not holding a car licence and urban riding were significantly associated with increased non-PPE wear. A need for freedom of choice and mixed attitudes towards PPE use were evident in additional comments. PPE determinants in this sample provide a preliminary basis for future uptake interventions. Larger scale and qualitative research is needed to further investigate relevant constructs.

Preventing risky driving: A novel and efficient brief intervention focusing on acknowledgement of personal risk factors

Impulsive personality is an important predictor of risky driving. Acknowledging their impulsive tendencies may help novice drivers to drive more safely. The aim of this study was to evaluate the efficacy of a novel brief intervention targeting novice drivers' risky behavior in traffic, taking into account potential moderator effects. Driving school students (n=1866) were divided into an intervention group and a control group. The intervention consisted of a lecture and group work (1.5h). Subjects' traffic offenses and crashes were monitored during the following year using police and traffic insurance fund databases. The groups were similar in their baseline characteristics. The intervention group had half as many speeding violations in the year following the intervention compared with the controls. The proportion of speeders was significantly lower in the intervention group compared with the control group in subgroups of subjects with medium cognitive abilities and low or medium BIS-11 impulsiveness levels. In alpha(2A)-adrenoceptor gene (ADRA2A) G allele carriers, general traffic risk and speeding decreased in response to the intervention, unlike in subjects with the CC genotype. It is concluded that brief interventions that are integrated into the driving education program and focus on personal psychological risk factors may be effective for improving traffic safety.

Evidence that changes in social cognitions predict changes in self-reported driver behavior: Causal analyses of two-wave panel data

Previous research on the theory of planned behavior (TPB) is characterized by cross-sectional tests of the model's proposed causal relationships. In the absence of effective experimental techniques for changing the TPB's cognitive antecedents, the present research aimed to provide a stronger non-experimental test of the model, using causal analyses of two-wave panel data. Two studies of driver behavior were conducted in which naturally occurring within-participant changes in TPB constructs were measured over time, and used to predict corresponding within-participant changes in both intentions and behavior. A two-wave panel design was used in both studies. Study 1 had a one-month gap between baseline and follow-up. At both waves, a convenience sample comprising predominantly university students (N=135) completed questionnaire measures of all TPB cognitions and behavior (compliance with speed limits in urban areas). Cross-lagged multiple regressions and bootstrapping procedures for testing multiple mediators supported all of the relationships proposed by the TPB. These findings were extended in study 2 using a large, non-student sample of speed limit offenders (N=1149), a six-month gap between baseline and follow-up, and a larger number of cognitive antecedents. Participants completed postal questionnaires at both waves to measure all cognitions proposed by the two-component TPB, along with moral norm, anticipated regret, self-identity and speeding on urban roads, country roads, and fast dual carriageways or motorways. Changes in instrumental and affective attitude, descriptive norm, self-efficacy, moral norm, anticipated regret and self-identity predicted changes in intention to speed. Changes in intention and self-efficacy predicted behavior-change. Injunctive norm and perceived controllability did not predict intention or behavior-change. Additionally, direct (unhypothesized) relationships with behavior were found for affective attitude, descriptive norm and anticipated regret. The implications of the findings for theory and the development of effective behavior-change interventions are discussed.

Predicting university undergraduates' binge-drinking behavior: a comparative test of the one- and two-component theories of planned behavior

This study provides a comparative test of the one- and two-component theories of planned behavior (TPB) in the context of university undergraduates' binge-drinking. Participants (N=120) self-completed questionnaire measures of all TPB constructs at time 1 and subsequent binge-drinking at time 2 (two-weeks later). The data were analyzed using a combination of path analyses and bootstrapping procedures. Both models accounted for a substantial proportion of the variation in behavior. However, the two-component TPB provided a significantly better fit to the data, with the total direct and indirect effects accounting for 90% of the variance. Intention was the only direct predictor of behavior. Instrumental attitude, affective attitude and self-efficacy had indirect effects. Although health interventions could usefully target these cognitive antecedents, simulation analyses, modeling the effects of cognition change on behavior, showed that only large-sized (0.8 SD) changes to affective attitude, or moderate-sized changes to all of these cognitions in combination were sufficient to reduce binge-drinking.

The social cognitive determinants of offending drivers' speeding behaviour

The efficacy of an extended theory of planned behaviour (TPB) was tested in relation to offending drivers' (N=1403) speeding behaviour. Postal questionnaires were issued at Time 1 to measure intention, instrumental and affective attitude, subjective and descriptive norm, self-efficacy, perceived controllability, moral norm, anticipated regret, self-identity, and past speeding behaviour. At Time 2 (6 months later), subsequent speeding behaviour was measured, again using self-completion postal questionnaires. The extended TPB accounted for 68% of the variation in intention and 51% of the variation in subsequent behaviour. The independent predictors of intention were instrumental attitude, affective attitude, self-efficacy, moral norm, anticipated regret and past behaviour. The independent predictors of behaviour were intention, self-efficacy, anticipated regret and past behaviour. Theoretical and practical implications of the findings are discussed in relation to targeting road safety interventions.

Predicting motorcyclists' intentions to speed: effects of selected cognitions from the theory of planned behaviour, self-identity and social identity

This study sought to identify cognitive predictors of motorcyclists' intentions to speed using a model that comprised selected constructs from the theory of planned behaviour (TPB), supplemented with constructs from identity theory and social identity theory. Participants (N=110) were sampled from motorcycle clubs in Scotland and they completed web-based questionnaire measures of all cognitive variables, operationalized with respect to speeding on both 30 mph urban roads and 70 mph dual carriageways and motorways. In support of the TPB element of the model, affective attitude and perceived controllability accounted for significant variance in intention to speed on each road type. The identity constructs accounted for additional variance in intentions to speed on 70 mph roads. The significant independent predictors of speeding intentions on 30 mph roads were affective attitude and perceived controllability. For 70 mph roads, the independent predictors of intention were affective attitude, self-identity, perceived group norm, group identification, and an interaction between perceived group norm and group identification. Consistent with predictions derived from social identity theory, decomposition of the interaction showed that perceived group norm had an increasing effect on intention with increases in group identification. Implications for theory development and safety interventions are discussed.

Test of a brief theory of planned behaviour-based intervention to promote adolescent safe sex intentions

The present study tested a brief (303 word) intervention designed to change attitude, subjective norm, and perceived behavioural control regarding a safe sex behaviour in a sample of 16- to 18-year-olds. Participants (N=288) were randomized to receive either an experimental intervention or a control (knowledge only) intervention and completed measures of their reactions to the stimuli as well as pre- and post-test measures of theory of planned behaviour variables. The experimental intervention significantly increased message processing (mean between-group difference=0.73, 95% CI=0.40, 1.06; Cohen's d=.52), message acceptance (mean between-group difference=0.82, 95% CI=0.57, 1.07; Cohen's d=.77), subjective norm (adjusted Mean between-group difference=0.54, 95% CI = 0.26, 0.81; Cohen's d=.37; mean within-group difference for intervention condition=0.59, 95% CI = 0.36, 0.81; Cohen's d=.38) and intention (adjusted Mean between-group difference=0.27, 95% CI = 0.02, 0.53; Cohen's d=.20; mean within-group difference for intervention condition=0.54, 95% CI = 0.33, 0.75; Cohen's d=.31), but not attitude or perceived behavioural control. The effects of the experimental intervention on intention were mediated solely through subjective norm. The present findings: (a) compare favourably in terms of the effect sizes reported in previous research in this area (mean Cohen's d for within-group difference for intervention conditions=.009 and .09, for norms and intention, respectively, see Albarracín et al. (2003)), (b) imply that subjective norms are causally related to intentions, and (c) suggest that interventions designed to change subjective norms (as opposed to communication of risks and fear appeals) might ultimately be effective in changing behaviour.