Augmenting the theory of planned behaviour with the prototype/willingness model: Predictive validity of actor versus abstainer prototypes for adolescents' health-protective and health-risk intentions

Cell phone distraction behavior of young pedestrians: evidence from China

Cell phone use while walking escalates pedestrian safety risks, particularly among students, given their heavy reliance on these devices. Psychological factors wield significant influence on individual behavior, particularly among adolescents who navigate a blend of rational and social-reactive pathways in decision-making. Therefore, this paper employs the Prototype Willingness Model (PWM) to scrutinize psychological determinants of students' cell phone use while walking, drawing on data from 368 valid samples. Structural equation modeling (SEM) dissects the impact of psychological constructs on this behavior, highlighting the significance of both the social response and reasoning pathways within PWM. The study comprehensively analyzes direct, indirect, and overall effects of exogenous variables on behavioral intention and behavior.

Who follows through? Different factors predict initial commitment vs. Following through in a national survey of organ donor registration

OBJECTIVE

Little research has investigated factors that determine whether people falter in the face of an obstacle or successfully follow through on an initial commitment to act. We integrated multiple theories (the Reasoned Action Approach [RAA], Prototype Willingness Model, and anticipated regret theory) to test which factors predict initial commitment to register as an organ donor and to discover whether different factors predict initial commitment vs. following through with registration.

METHODS

Participants from a nationally representative UK sample (N = 1,008) reported their beliefs about organ donation and indicated their decision to register. An obstacle that participants could not foresee was that they had to complete registration in a second survey 3 days after making their initial commitment.

RESULTS

Findings showed that 14.8% of participants followed through, 19.7% demonstrated initial commitment, and 65.5% declined to register. Linear discriminant function analysis derived two functions that distinguished these registration patterns. The first function discriminated participants who declined to register from the other groups. The declined group had lower scores on RAA variables compared to their counterparts. The second function distinguished participants who made an initial commitment to register from those who followed through. Follow-through was associated with less anticipated negative affect, more favorable descriptive norms, and stronger identification with organ donors.

CONCLUSIONS

The present findings indicate that even modest friction leads to a large reduction in follow-through. Moreover, different factors influence initial commitment vs. following through. Whereas RAA variables predicted initial commitment, following through was a function of anticipated negative affect and social processes.

Users' unverified information-sharing behavior on social media: The role of reasoned and social reactive pathways

Unverified or false information spread by irresponsible users can amplify the dissemination of fake news or misinformation. This phenomenon may not only undermine the credibility of social media platforms but also pose severe consequences for individuals and society. This study applies and extends the prototypical willingness model with the aim of comprehending the reasons, and decision-making process driving users' unverified information-sharing behavior a reasoned and intended pathway or an impulsive and unconscious one. Data from a sample of 646 users were analyzed using Structural Equation Modeling to assess the determinative effect of both the reasoned pathway (attitude toward unverified information-sharing, subjective norm, and perceived behavioral control) and the social-reaction pathway (prototype favorability and similarity). Findings highlight the substantial role of the social-reaction pathway in forecasting users' unverified information-sharing behavior, with prototype similarity and attitude being the dominant predictors. Meanwhile, components of the reasoned pathway, specifically perceived behavior control, and attitude, also exhibited significant contributions toward predicting the behavior. In summary, while a deliberate, reasoned process has some influence, the sharing of unverified information on social media by users is primarily an intuitive, spontaneous response to specific online circumstances. This study therefore offers valuable insights that could aid relevant stakeholders in effectively regulating the spread of misinformation. Against this backdrop, highlighting potential risks associated with sharing unverified information and the negative portrayal of users propagating misinformation may contribute to the development of a more critical perspective toward online information sharing by users themselves.

Ethnic and Gender Differences in Sun-Related Cognitions Among College Students: Implications for Intervention

BACKGROUND

Skin cancer incidence and prognosis vary by ethnicity and gender, and previous studies demonstrate ethnic and gender differences in sun-related cognitions and behaviors that contribute to this disease. The current study sought to inform skin cancer interventions tailored to specific demographic groups of college students. The study applied the prototype willingness model (PWM) to examine how unique combinations of ethnic and gender identities influence sun-related cognitions.

METHOD

Using data from a survey of 262 college students, the study tested whether self-reported sun-related cognitions were different for White women, Hispanic women, White men, and Hispanic men. Path modeling was also used to identify which PWM cognitions (e.g., prototypes, norms) were the strongest predictors of risk and protection intentions and willingness in each demographic group.

RESULTS

Several differences in sun-related cognitions and PWM pathways emerged across groups, emphasizing the need for tailored skin cancer education and interventions. Results suggest that, for White women, interventions should primarily focus on creating less favorable attitudes toward being tan.

CONCLUSION

Interventions for Hispanic women may instead benefit from manipulating perceived similarity to sun-related prototypes, encouraging closer personal identification with images of women who protect their skin and encouraging less identification with images of women who tan. For White men, skin cancer interventions may focus on creating more favorable images of men who protect their skin from the sun. Lastly, interventions for Hispanic men should increase perceived vulnerability for skin cancer.

Development and Validation of the Cheers Attitudes towards Non-drinkers Scale (CANS)

Non-drinkers report experiencing stigma, which can act as a barrier to non-drinking. Two studies were undertaken to develop and test a new scale to measure attitudes towards non-drinkers. In Study 1, 29 items were presented to 426 Australian drinkers. In Study 2, the refined 12-item Cheers Attitudes to Non-drinkers Scale (CANS) was presented to 389 drinkers. Alcohol consumption, Harm and the Regan Attitudes towards Non-drinkers Scale (RANDS) were presented for scale validation. Exploratory factor analysis revealed three factors representing the Threats to Fun, Connection and Self that drinkers perceive non-drinkers to pose. Confirmatory factor analysis showed that the scale meets the required fit indices and had good reliability (α = 0.842). Evidence of validity was shown through significant correlations with Alcohol Consumption, Harm and the RANDS. These studies show the CANS to be a reliable and valid measure that could be utilised to understand and modify the stigma experienced by non-drinkers.

Mobile phone use while cycling among e-bikers in China: Reasoned or social reactive?

INTRODUCTION

China has the largest number of e-bikers in the world, and e-bike crashes cause thousands of fatalities and tens of thousands of serious injuries annually. Mobile phone use while e-biking is a violation of Chinese law and associated with increased crash risk. The current study investigated mobile phone use behavior while cycling among Chinese e-bikers and the psychological factors surrounding why individuals might choose to engage in this risk-taking behavior.

METHOD

In particular, this study investigates whether the decision to use a mobile phone while cycling is explained through reasoned decision making or is a social reactive decision, or both, as defined by the prototype willingness model (PWM). Questionnaire data were collected from 784 Chinese adults with e-bike experience.

RESULTS

Results showed that 40.2 % of the participants reported mobile phone use while cycling e-bikes in the past month. Both behavioral intention and behavioral willingness were predictors of mobile phone while using e-bikes, and they were approximately equal in their magnitude of predictive power (β_BI = 0.25; β_BW = 0.26). E-bikers' attitudes, perceived behavioral control, and perception of prototype similarity and favorability were strong predictors of intention, willingness, and self-reported behavior to use mobile phones while e-biking.

CONCLUSIONS

Both social reactive decision-making and reasoned decision-making contribute to decisions to use a mobile phone while riding an e-bike.

PRACTICAL APPLICATIONS

Results have implications for guiding development of interventions to prevent and reduce mobile phone use when e-bike cycling.

Intention to Engage in Alcohol Use during Pregnancy: The Role of Attitudes and Prototypes

Background: There is no known risk-free level of alcohol use in pregnancy. Despite this, many still believe that occasional drinking is safe. To-date, there is limited evidence of the influences on women's decisions about low to moderate alcohol use in pregnancy. The aim of this study was to explore alcohol use intentions during pregnancy, using variables from the theory of planned behavior, the prototype/willingness model and personality variables. The study also investigated whether priming participants with exposure to prototypes describing different alcohol use behaviors had an impact on intentions.Methods: Participants, 746 women aged 20 to 45 years, were randomized to be prompted to think of one of two different "types" of behaviors, i.e., small level of alcohol use in pregnancy and ambiguous level of alcohol use in pregnancy. They then completed measures of theoretical variables, impulsivity, venturesomeness, and self-efficacy. Participants then answered whether they intended to use alcohol during a future pregnancy.Results: Over half of the variance in intentions to consume alcohol while pregnant were predicted by the final model (R2= .527, F (1, 438) = 13.201, p < .001). Positive attitudes toward alcohol use in pregnancy, from the theory of planned behavior, were the most significant predictor of intentions and intentions did not differ between groups according to prototype exposure.Conclusions: Future research should aim to explore the efficacy of interventions to reduce low to moderate alcohol use in pregnancy that utilize both the theory of planned behavior and prototype/willingness model to target determinants of intentions.

A survey with interventional components delivered on tablet devices versus usual care to increase pre-exposure prophylaxis uptake among cisgender Black women: a pilot randomized controlled trial

BACKGROUND

Cisgender (cis) Black women in the USA are more likely to become HIV positive during their lifetime than other women. We developed and implemented a behavioral intervention, Increasing PrEP (iPrEP), the first pilot randomized controlled trial (RCT) aimed at motivating cis Black women to be willing to use PrEP for HIV prevention and attend an initial PrEP clinic visit following an emergency department visit.

METHODS

Eligible participants were Black cisgender women ages 18-55 years who acknowledged recent condomless sex and substance use. Participants were randomized to iPrEP or usual care (UC). iPrEP is a survey-based intervention designed to raise awareness and knowledge about PrEP. Participants completed an assessment of knowledge of and willingness to use PrEP before and after the intervention, then received a warm-hand off with referral to a local PrEP clinic. Enrolled participants were followed for 6 months.

RESULTS

Forty enrolled participants were ages 18-54 years. Education levels varied evenly between some high school education and graduate education. Most participants were single (n = 25) or married (n = 7). Twenty-two participants were employed full-time. Pre-test results indicated that 21 of 40 participants had heard of PrEP. All participants identified PrEP as a daily HIV prevention medication. For those randomized to iPrEP, the odds of knowing about PrEP at post-test, when controlling for baseline, were higher relative to UC (OR = 5.22, 95%CrI = 0.50, 94.1]. iPrEP did not have any effect on willingness relative to UC. The estimate for iPrEP on willingness is marginally higher (4.16 vs. 4.04; i.e., 0.12 points higher); however, the posterior probability of 67.9% does not suggest a strong degree of evidence in favor of an effect. During the post-test, those receiving iPrEP were less ready to take PrEP than those receiving UC.

CONCLUSIONS

Findings suggest that iPrEP increased knowledge about the PrEP medication but had a negative impact on readiness to take PrEP relative to UC. It is imperative that future research among cisgender Black women carefully considers the content provided in interventions designed to increase PrEP use, balancing the benefits of PrEP with the side effects and daily pill burden.

TRIAL REGISTRATION

clinicaltrial.gov Identifier: NCT03930654, 29/04/2019.

Perceptions of two different alcohol use behaviours in pregnancy: an application of the prototype/willingness model

Objective:

This study explored whether exposure to either an ‘ambiguous consumption’ prototype (no amount of alcohol specified) or a ‘small consumption’ prototype (‘small’ amount of alcohol specified) had an impact on prototype perceptions of, and willingness to use, small amounts of alcohol during pregnancy.

Method:

Participants were 140 women living in the UK, aged 20–45 years old, of whom 92% had previously been, or intended to become, pregnant. Participants completed measures to assess how favourably they viewed alcohol use in pregnancy, how similar they felt to those who would use alcohol in pregnancy and how responsible they perceived those who would use alcohol in pregnancy to be. Participant’s own willingness to use small amounts of alcohol during pregnancy was also assessed.

Results:

Having at least one child was positively correlated with being willing to accept an alcoholic drink while pregnant for those exposed to the ‘ambiguous consumption’ prototype only. Although perceptions of favourability, similarity and responsibility were consistently higher for those exposed to a ‘small consumption’ condition, there were no differences in willingness to drink according to exposure.

Conclusion:

This research suggests that women’s perceptions of those who drink alcohol while pregnant differ according to the amount of alcohol that they perceive as typical. This may have implications for how alcohol use in pregnancy is portrayed in public health messaging, particularly regarding the level of acceptance that may be associated with low to moderate alcohol use.

Bystander intervention among secondary school pupils: Testing an augmented Prototype Willingness Model

This study augmented the Prototype Willingness Model (PWM) to assess reactive and deliberative decision-making underpinning bystander intervention in gender-based violence contexts. There were 2079 participants (50% male, 49% female, and 1% unreported), aged 11-15 years old (M = 12.32, SD = 0.91), attending 19 secondary schools across Scotland. Participants self-reported the augmented PWM variables, then their intervention behaviour approximately 1 month later. Path analyses mostly supported the predicted relationships between positive and negative bidimensional attitudes, subjective norms, prototype perceptions, perceived behavioural control, and self-efficacy on intentions and willingness. Willingness predicted positive (speaking with a teacher) and negative (doing nothing) intervention in less serious violence. Self-efficacy predicted negative intervention in more serious violence. Subjective norms positively moderated the attitudes-intentions relationship. Overall, the results suggested that reactive (willingness) more so than deliberative (intention) decision-making account for intervention when young people witness gender-based violence. Additionally, the findings highlight the complexity of bystander intervention decision-making, where adding control perceptions, bidimensional attitudes, and moderators have independent contributions. Furthermore, self-comparison to the typical bystander who positively intervenes (prototype perceptions) was the strongest predictor of intentions and willingness, highlighting in a novel way the importance of image and group membership on decision-making.

“Intervention Program Based on Self”: A Proposal for Improving the Addiction Prevention Program “Unplugged” through Self-Concept

The “Intervention Program based on Self” (IPSELF) project was created to address the gap between the acquisition of life skills during prevention programs and their application with a session for developing one’s self-concept included in the European program “Unplugged”. The present study evaluated its effectiveness. A total of 157 middle school students (94 girls, 63 boys, M_AGE= 12.89, SD = 0.45) from three schools in France participated in this study. The participants attended one of two programs (Unplugged/IPSELF). The effectiveness of the IPSELF add-on session was measured with the Self-Concept Clarity Scale, and the differences between the two programs was measured with the prototype willingness model. Adolescents in IPSELF rated the typical nonsmoker and cannabis nonsmoker more favorably, and the typical drinker less favorably. They felt more different from the typical smoker and drinker after participation in IPSELF. More alcohol experimenters were observed in Unplugged. The knowledge gained in IPSELF appeared to help adolescents more than that gained in Unplugged to change their smoking behavior. Furthermore, IPSELF had a more beneficial effect for girls, who felt that they had gained more control over their alcohol and cannabis use than boys, whereas Unplugged had a more positive effect on boys, who gained better control over their consumption. Moreover, the girls felt that they had gained more knowledge about the substances discussed in IPSELF than in Unplugged. We therefore recommend the use of IPSELF especially with female audiences.

Adolescents' Algorithmic Resistance to Short Video APP's Recommendation: The Dual Mediating Role of Resistance Willingness and Resistance Intention

Adolescents have gradually become a vital group of interacting with social media recommendation algorithms. Although numerous studies have been conducted to investigate negative reactions (both psychological and behavioral reactance) that the dark side of recommendation algorithms brings to social media users, little is known about the resistance intention and behavior based on their agency in the daily process of encountering algorithms. Focusing on the concept of algorithm resistance, this study used a two-path model (distinguishing resistance willingness and resistance intention) to investigate the algorithmic resistance of rural Chinese adolescents (N = 905) in their daily use of short video apps. The findings revealed that the perceived threat to freedom, algorithmic literacy, and peer influence were positively associated with the resistance willingness and intention; while the independent psychology on algorithmic recommendations significantly weakened resistance willingness and intention. Furthermore, this study verified the mediating role of resistance willingness and intention between the above independent variables and resistance behavior. Additionally, the positive impact of resistance willingness on resistance intention was confirmed. In conclusion, this study offers a comprehensive approach to further understanding adolescents’ algorithmic resistance awareness and behavior by combining psychological factors, personal competency, and interpersonal influences, as well as two types of resistance reactions (rational and irrational).

The importance of prototype similarity for physical activity: Cross-sectional and longitudinal associations in a large sample of young adolescents

Objectives

Physical activity declines during adolescence. The Theory of Planned Behaviour (TPB) is a useful framework for investigating activity but leaves variance unexplained. We explored the utility of a dual‐process approach using the TPB and the Prototype Willingness Model (PWM) to investigate correlates of physical activity, and 1‐year change in physical activity, among a large sample of adolescents.

Design

A cross‐sectional and longitudinal analysis of baseline and follow‐up data from the Fit to Study cluster‐randomized trial.

Methods

A total of 9,699 secondary school pupils at baseline and 4,632 at follow‐up (mean age = 12.5 years) completed measures of past week physical activity and constructs from both behaviour‐change models, at time‐points 1 year apart. Cross‐sectional analyses used multilevel, stepwise regression models to measure the strength of associations between model constructs and physical activity, and variance in behaviour explained by PWM over and above TPB. In longitudinal analyses, change scores were calculated by subtracting follow‐up from baseline scores. Models controlling for trial treatment status measured the strength of associations between change scores, and variance explained.

Results

At baseline, after controlling for past behaviour, physically active prototype similarity had the strongest relationship with activity after the intention to be active. Change in prototype similarity had the strongest relationship with change in activity after the change in intention and attitudes. Prototype perceptions and willingness explained additional variance in behaviour.

Conclusion

A dual‐process model incorporating prototype perceptions could more usefully predict physical activity than models based on rational expectations alone. Behaviour‐change interventions promoting an active self‐image could be tested for effects on physical activity.

Testing daily-level drinking and negative consequences as predictors of next-day drinking cognitions

OBJECTIVE

Limited research has examined how alcohol use and related consequences affect drinking-related cognitions, which is important as these cognitions may contribute to future drinking. The current study examines daily associations between alcohol use and alcohol-related negative consequences with next-day Prototype Willingness Model (PWM) social reaction pathway cognitions.

METHOD

Participants ages 15-25 years (N = 124, Mean age 18.7, SD = 2.87) completed daily surveys for up to three weeks (i.e., up to 11 surveys/week) using an ecological momentary assessment design. Linear mixed models and Poisson generalized mixed models were conducted to examine whether number of alcoholic drinks or number of negative alcohol-related consequences were associated with next-day PWM social reaction cognitions, including perceived vulnerability, descriptive normative perceptions of number of drinks consumed and the percentage of friends who drink, prototype favorability, prototype similarity, and willingness (i.e., openness) to drink.

RESULTS

Within-person results indicated more alcohol use on a given day was associated with lower next-day normative perceptions of the percentage of friends who drink on that day of the week and higher prototype similarity. Furthermore, within-person results indicated that experiencing more negative alcohol-related consequences on a given day was associated with higher perceived vulnerability and lower willingness to drink the next day.

CONCLUSIONS

Findings showed that next-day social reaction PWM cognitions were associated with prior day alcohol use and negative alcohol-related consequences, suggesting that an intervention might be timed to target drinking cognitions the morning following a drinking event, particularly after experiencing negative alcohol-related consequences.

Adolescents at a Distance

Abstract. Background: In many countries, physical distancing is seen as one of the crucial preventive measures for limiting the COVID-19 pandemic. However, it is likely to be very difficult to ensure that adolescents keep apart from one another since peer interactions are extremely significant for them. Aims: We examined the utility of the Theory of Planned Behavior enhanced with a construct of the Protection Motivation Theory for predicting physical distancing behavior among adolescents during the period following the national lockdown imposed in Italy to tackle the pandemic. Method: Measures of attitude, subjective norm, perceptions of behavioral control, perceptions of threat regarding personal health and the health of loved ones, and intention were administered to the participants ( N = 363) at baseline. Measures of physical distancing behavior were then administered 3 weeks later ( N = 350). Results: The tested structural equation model accounted for 77% of variance in intention and 25% of variance in behavior. Perceived behavioral control and attitude were important predictors of intention and behavior, while the data did not support the hypothesized impact of perceptions of threat. Limitation: Due to the observational nature of the data caution should be taken in drawing causal inferences. Conclusion: The results suggest that programs for increasing physical distancing behavior in adolescents by concentrating exclusively on risks to their health or that of their loved ones might prove to be ineffective. Instead, it seems likely that prevention campaigns targeting adolescents will be more successful if they focus on perceived behavioral control and attitude.

Alcohol-related cognitions: Implications for concurrent alcohol and marijuana use and concurrent alcohol and prescription stimulant misuse among young adults

INTRODUCTION

This study examined the associations between alcohol-related cognitions within the social reaction pathway of the Prototype Willingness Model and concurrent (use of two or more substances within a specified time period) use of 1) alcohol and marijuana and 2) alcohol and prescription stimulant misuse.

METHODS

A convenience sample of 1,062 emerging adults in the U.S. (18-20 years old; 54.5% female) who reported past 3-month alcohol use completed a baseline survey as part of a larger randomized controlled trial.

RESULTS

Results indicate that controlling for age, biological sex, race, ethnicity, and college enrollment, perceived descriptive norms and willingness to drink were associated with past 3-month concurrent alcohol and marijuana use and concurrent alcohol and prescription stimulant misuse. However, alcohol prototype similarity and alcohol-related perceived vulnerability were not associated with either concurrent use outcome examined.

DISCUSSION

These findings suggest that alcohol-related perceived descriptive norms and willingness to drink are associated with concurrent substance use among young adults. Thus, it is possible that existing efficacious alcohol interventions that target descriptive norms and willingness to drink may have the added benefit of also reducing concurrent substance cognitions and ultimately use.

Whistleblowing Against Doping Misconduct in Sport: A Reasoned Action Perspective With a Focus on Affective and Normative Processes

Whistleblowing against doping misconduct represents an effective deterrent of doping use in elite competitive sport. The present study assessed the effects of social cognitive variables on competitive athletes' intentions to report doping misconduct. A second objective was to assess whether the effects of social norms on whistleblowing intentions were mediated by actor prototype evaluations and group identification and orientation. In total, 1,163 competitive athletes from Greece, Russia, and the United Kingdom completed a questionnaire on demographics, past behavior, social cognitive variables, and intentions toward whistleblowing. Regression analyses showed that whistleblowing intentions were associated with different social cognitive variables in each country. Multiple mediation modeling showed that attitudes and subjective norms were associated with whistleblowing intentions indirectly, via the effects of anticipated negative affect and group identification and orientation, respectively. The findings of this study are novel and have important implications about the social, cognitive, and normative processes underlying decision making toward reporting doping misconduct.

Comparing Theoretical Models for the Understanding of Health-Risk Behaviour: Towards an Integrative Model of Adolescent Alcohol Consumption

The aim of the present manuscript is to test and compare the theory of reasoned action (TRA), theory of planned behaviour (TPB) and prototype-willingness model (PWM) in predicting risky alcohol consumption among adolescents and to build an integrative model to get a more comprehensive understanding of such risky behaviour. A total sample of 518 adolescents (55% females; 13-19 aged) recruited from Italian schools (7th to 12th grade) participated in a cross-sectional research study and completed an online questionnaire. Risky alcohol use assessed through the AUDIT-C was the dependent variable; whereas, variables from the TRA, TPB, and PWM (i.e. attitude, subjective norms, perceived behavioural control, intention, prototype favourability and similarity, and willingness to alcohol use) were used as predictors. Data were analysed using structural equation modelling (SEM). The findings show that the integrative model had greater explanatory power and provided a better fit to the data, compared to the TRA, TPB, and PWM, indicating attitudes and subjective norms as the best predictors. In conclusion, perceived social approval from significant others and the volitional component have a central role in understanding adolescents’ alcohol consumption.

The influence of WeChat use on driving behavior in China: A study based on the theory of planned behavior

Driving has become common, and distracted driving, especially that caused by WeChat use, is a significant cause of traffic crashes. Based on the theory of planned behavior, this study analyzes self-reports from a sample of 286 drivers from China to explore the influence of different WeChat functions on driving behavior. The analyses reveal that the intention to use WeChat while driving can substantially predict the use of WeChat while driving. Moreover, drivers' attitudes can effectively predict whether they will send texts, listen to voice messages, and send and browse pictures on WeChat while driving. However, drivers' attitudes cannot effectively predict whether they will read texts or send voice messages on WeChat while driving. In recent years, WeChat has become a popular messaging software, and many drivers use it. Therefore, it is important and necessary to raise awareness among drivers about the dangers of using WeChat while driving.

The 'sober eye': examining attitudes towards non-drinkers in Australia

BACKGROUND

The proportion of Australians who choose not to drink alcohol has increased in recent years; yet, non-drinkers report experiences of stigma and judgement from peers for this choice. This study aimed to explore the attitudes that exist towards non-drinkers and examine what drives this stigma.

METHOD

Thematic analysis of four focus groups was undertaken, comprising 37 drinking and non-drinking Australian adults.

RESULTS

Three themes were identified that elucidate the stigma, with non-drinkers being perceived as a: (1) threat to fun, a judgemental 'sober eye' disrupting the desired hedonistic environment created by alcohol, (2) threat to connection, described as difficult to initiate and maintain a social connection with and (3) threat to self, with the presence of a non-drinker described by drinkers as encouraging an unwanted reflection on the problematic aspects of their own drinking. Participant responses also suggested that the gender of the non-drinker influenced these perceptions.

CONCLUSION

Through the lens of Integrated Threat Theory, this study proposes that the stigma experienced by non-drinkers may be understood as a response to threats non-drinkers are perceived to pose to drinkers' group values (e.g. hedonism) and self-esteem. This study offers new direction for health promotion efforts to challenge negative perceptions of non-drinkers.

Patient Prototypes

Abstract. Despite large bodies of research examining perceptions of illnesses and perceptions of people who engage in various health behaviors, very little research has examined perceptions of people who have a specific illness. The aims of this research were to create a measure of “patient prototypes,” mental representations of the type of person who has a specific illness, and to examine their associations with other health cognitions and behaviors. Two survey studies (Study 1: N = 208 and Study 2: N = 246) assessed patient prototype favorability for three illnesses (skin cancer, Human papillomavirus (HPV), and type 2 diabetes) as well as constructs from the common-sense model and prototype willingness model. Patient prototypes for the three illnesses were distinct in terms of specific traits and overall favorability. Generally, patient prototype favorability was unrelated to illness representation dimensions in the common-sense model but was positively associated with some constructs in the prototype/willingness model. All three prototypes were positively correlated with perceived vulnerability. The skin cancer prototype was positively correlated with measures of behavioral willingness, behavioral intention, and actual health behavior (UV exposure). Limitations include the use of young adult participants who have relatively little experience with the illnesses examined. Measures of patient prototype favorability and health behaviors need to be further examined and refined. The novel construct of patient prototype favorability provides a foundation for future inquiry into the role that patient perceptions play in health behavior and the implications for the prototype/willingness model and the common-sense model.

Moral Disengagement and Risk Prototypes in the Context of Adolescent Cyberbullying: Findings From Two Countries

Cyberbullying is associated with a wide range of mental health difficulties and behavioral problems in adolescents and research is needed to better understand psychological correlates of this behavior. The present study used a novel model that incorporated Social Cognitive Theory and the prototype/willingness model to identify the correlates of behavioral willingness to engage in cyberbullying in two countries. Adolescent students were randomly selected from secondary schools in Italy (n = 1710) and Greece (n = 355), and completed anonymous measures of moral disengagement, descriptive norms, risk prototype evaluations and behavioral willingness to engage in cyberbullying. Hierarchical linear regression analyses showed that willingness to engage in cyberbullying was associated with moral disengagement, prototype evaluations and descriptive social norms in Italy, and with gender, moral disengagement and descriptive social norms in Greece. Regression-based multiple mediation modeling further showed that the association between moral disengagement and cyberbullying willingness was mediated by prototype evaluations in Italy and by descriptive norms in Greece. The implications of our findings are discussed in the context of self-regulating cyberbullying perpetration in adolescents and informing school-based policies and interventions to prevent cyberbullying behavior.

Predicting Future Academic Willingness, Intentions, and Nonmedical Prescription Stimulant (NPS) Use with the Theory of Reasoned Action and Prototype/Willingness Model

Background: Nonmedical prescription stimulant (NPS) use for academic reasons (e.g., to improve concentration) is a growing problem among college students. However, there is limited theory-driven research that attempts to identify risk cognitions underpinning decisions to use and NPS use for academic purposes. Furthermore, it is unclear if academic NPS use is characterized by deliberative and/or socially reactive processing and what health decision-making model or combination of models best predicts NPS use decisions and use. Identifying cognitions associated with NPS use decisions is essential to develop interventions aimed at preventing and reducing NPS use. Objective: The present study tested the Theory of Reasoned Action (TRA), Prototype/Willingness Model (PWM), and a combined TRA/PWM model to identify which model best predicts academic NPS use decisions (willingness and intentions) and past 2-month use among college students. Method: Undergraduates (N = 344) participated in a two-wave study assessing T1 constructs from the TRA and PWM as predictors of T2 (2 months later) academic NPS use decisions and use. Results: In the combined TRA/PWM, all T1 constructs were associated with T2 NPS willingness, intentions, and use except for injunctive norms. The integrated model also explained greater variance in T2 use, willingness, and intentions than each model alone. Conclusions/Importance: The combination of cognitions from the TRA/PWM was superior to each individual model and improved the prediction of future NPS use willingness, intentions, and use. The overall results derived from all three models suggest that both deliberative and socially reactive processing influence and characterize academic NPS use decisions and use.

Women's Self-Perceived Similarity to Their Mother and Associations with Patterns of Alcohol Misuse over 20 Years

AIMS

This study examined transgenerational transmission of risk for female alcohol misuse. Women's perceived similarity to their mother/father in adulthood was examined in terms of its influence on the expected association between perceived maternal alcohol use and female offsprings' trajectories of alcohol misuse. We hypothesized that a daughter's self-perceived similarity to her mother, in instances where her mother was perceived to be a frequent- or problem-drinker, would be associated with an increase in the daughter's count of negative consequences from alcohol use and potential symptoms of alcohol dependence across adulthood.

SHORT SUMMARY

Women's perceived similarity to their mother/father was examined as a factor influencing associations between perceived parental alcohol use during childhood and patterns of alcohol misuse in adulthood. Women's self-perceived similarity to their frequent- or problem-drinking mothers increased the risk of negative consequences from drinking over time as well as potential symptoms of alcohol dependence over time.

METHODS

Analyses utilized data from a survey of women (N = 911) who were followed over a 20-year period, beginning in 1981. Women, ages 21 or older and living in households in the contiguous USA, were eligible, and women who consumed four or more alcoholic drinks per week were oversampled. Model estimates were weighted to adjust for the oversampling of heavier drinking women and to reflect national demographics. Latent growth mixture models estimated regression parameters that captured variation in participants' alcohol misuse over time.

RESULTS

Women who reported that their mother was a frequent- or problem-drinker and who perceived themselves to be similar to their mother, in general, showed increases in alcohol misuse. The same pattern of results was not shown for fathers.

CONCLUSIONS

Results support that interventions seeking to reduce female alcohol misuse should address the role of perceived similarity to heavy-drinking female role models or 'female-drinker' prototypes to reduce problem-drinking behavior among female drinkers.

Positive excessive drinker prototypes predict greater drinking and alcohol problems

OBJECTIVES

According to the prototype willingness model, risky behaviours such as heavy drinking may be influenced by images of others who engage in this behaviour. In this study, we examined whether college students' prototypes of an individual who frequently drinks "over the limit" were associated with their own alcohol consumption and experience of alcohol-related problems during their first 2 years in college.

METHODS

We assessed students' (N = 340) prototypes of excessive drinkers and their own alcohol consumption and problems at four time points, across their first 2 years in college. Along with examining the trajectory of prototypes, consumption, and problems, we tested whether prototypes significantly predicted consumption and problems across the 2 years. Additional analyses examined whether the predictive value of prototypes was unique from related variables including perceived descriptive norms, perceived injunctive norms, and peer pressure to drink alcohol.

RESULTS

Primary analyses indicated that more positive prototypes of an excessive drinker were significantly associated with greater alcohol consumption in both year 1 and year 2. More positive prototypes were also significantly associated with experiencing more alcohol-related problems in year 2. These findings held when controlling for perceived descriptive and injunctive norms, and peer pressure.

CONCLUSIONS

Findings further support the importance of drinker prototypes to one's own drinking behaviour. By examining prototypes over time and their relationship to alcohol-related problems, this study makes a novel contribution to the existing research. Statement of contribution What is already known on this subject? Perceived norms (beliefs about how much others drink and what they approve of) are associated with own drinking. Individuals construct "risk prototypes," or images of people who engage in risky behaviours like drinking alcohol. Positive risk prototypes of drinkers have been associated with own willingness to drink and subsequent drinking. What does this study add? This study shows the trajectory of drinker prototypes across the first 2 years of college. Findings highlight consistent patterns of positive associations between drinker prototypes and own drinking. More positive drinker prototypes are associated with a greater number of problems with alcohol.

Understanding the psychological precursors of young drivers' willingness to speed and text while driving

This study applied the Prototype Willingness Model (PWM) to investigate the factors that may predict young drivers' (non-intentional) willingness to text while driving, text while stopped, and engage in high and low levels of speeding. In addition, the study sought to assess whether general optimism bias would predict young drivers' willingness to text and speed over and above the PWM. Licenced drivers (N = 183) aged 17-25 years (M = 19.84, SD = 2.30) in Queensland, Australia completed an online survey. Hierarchical multiple regressions revealed that the PWM was effective in explaining the variance in willingness to perform all four illegal driving behaviours. Particularly, young drivers who possessed favourable attitudes and a positive prototype perception towards these behaviours were more willing to engage in texting and speeding. In contrast to the study's predictions, optimistically biased beliefs decreased young drivers' willingness to text while stopped and engage in high and low levels of speeding. The findings of the study may help inform policy and educational campaigns to better target risky driving behaviours by considering the influence of attitudes, prototypes and the non-intentional pathway that may lead to engagement in texting while driving and stopped and engagement in high and low levels of speeding.

Racial (vs. self) affirmation as a protective mechanism against the effects of racial exclusion on negative affect and substance use vulnerability among black young adults

Affirming one's racial identity may help protect against the harmful effects of racial exclusion on substance use cognitions. This study examined whether racial versus self-affirmation (vs. no affirmation) buffers against the effects of racial exclusion on substance use willingness and substance use word associations in Black young adults. It also examined anger as a potential mediator of these effects. After being included, or racially excluded by White peers, participants were assigned to a writing task: self-affirmation, racial-affirmation, or describing their sleep routine (neutral). Racial exclusion predicted greater perceived discrimination and anger. Excluded participants who engaged in racial-affirmation reported reduced perceived discrimination, anger, and fewer substance use cognitions compared to the neutral writing group. This relation between racial-affirmation and lower substance use willingness was mediated by reduced perceived discrimination and anger. Findings suggest racial-affirmation is protective against racial exclusion and, more generally, that ethnic based approaches to minority substance use prevention may have particular potential.

Prototype Willingness Model Drinking Cognitions Mediate Personalized Normative Feedback Efficacy

Personalized normative feedback (PNF) interventions have been shown to be efficacious at reducing college student drinking. Because descriptive norms have been shown to mediate PNF efficacy, the current study focused on examining additional prototype willingness model social reaction cognitions, namely, prototypes and willingness, as mediators of intervention efficacy. We expected the PNF interventions to be associated with increased prototype favorability of students who do not drink, which would in turn be associated with decreased willingness to drink and subsequently, less drinking. The current study included 622 college students (53.2% women; 62% Caucasian) who reported one or more heavy drinking episodes in the past month and completed baseline and three-month follow-up assessments. As posited by the framework of the prototype willingness model, sequential mediation analyses were conducted to evaluate increases in abstainer prototype favorability on willingness on drinking, and subsequently willingness to drink on drinking behavior. Mediation results revealed significant indirect effects of PNF on three-month drinking through three-month prototypes and willingness, indicating that the social reaction pathway of the prototype willingness model was supported. Findings have important implications for PNF interventions aiming to reduce high-risk drinking among college students. Study findings suggest that we should consider looking at additional socially-based mediators of PNF efficacy in addition to perceived descriptive norms.

Who is watching user-generated alcohol posts on social media?

AIM

To examine students' exposure to user-generated alcohol content on social media, and identify characteristics (i.e. demographics, personality traits, alcohol use, alcohol-related cognitions, and social media factors) associated with monthly or more frequent exposure.

METHOD

College/university students (N=11,236) in Bergen, Norway, completed a web-survey measuring exposure to alcohol on social media - both frequency and interpretations of alcohol content. The survey included questions regarding demographics, personality, alcohol-related cognitions, and general use of social media and alcohol. Binary logistic regressions were run to identify characteristics associated with monthly or more frequent exposure to alcohol-related posts on social media.

RESULTS

A total of 96.7% had been exposed to alcohol-related posts, exposure to posts with a positive valence of alcohol were more frequently reported than exposure to content with a negative valence of alcohol. Reports of monthly or more frequent exposure to alcohol on social media were associated with a range of characteristics, among these younger age, being native Norwegian, lower extroversion and higher agreeableness and self-monitoring scores, higher alcohol use, stronger descriptive norms for alcohol use among online-friends, and more frequent logins to social media.

CONCLUSIONS

Students' potential inflated alcohol norms (originating from social media) should be addressed. The results suggest that exposure may be determined by high alcohol use and membership in demographical groups associated with high alcohol use, an increased attentiveness towards others' behavior, and excessive social media use. Future studies investigating the relationship between alcohol exposure on social media and later alcohol use should control for such factors.

What do help-seeking measures assess? Building a conceptualization framework for help-seeking intentions through a systematic review of measure content

Mental health services are underutilised by people who could benefit from treatment. Research into help-seeking intentions (HSI) is required to support interventions to increase service use. Existing HSI measures are not psychometrically robust and problems with content validity undermine research in this field. Our purpose was to create a clear conceptualization of HSI and systematically review the content of existing measures. Previous researchers had defined help-seeking and intentions separately, so the first step was to create a more comprehensive definition. Seven theoretical perspectives identified in the HSI literature were mapped onto the new definition and aggregated to form a conceptual framework that reflects expert opinion. This framework guided an analysis of item relevance and a comparison of completeness across measures. Most individual items (99.1%) were relevant, lending credibility to the proposed framework. However, no measure provided a complete assessment of the HSI construct. This study used a novel methodology to develop a definition and conceptual framework, both of which reflect sound theoretical perspectives and represent the consensus-view of experts. The current results will guide the development of stronger measures with improved construct validity and will support interventions aimed at improving help-seeking.

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.

Prototypes reflect normative perceptions: implications for the development of reasoned action theory

The reasoned action approach is one of the most successful behavioral theories in the history of social psychology. This study outlines the theoretical principles of reasoned action and considers when it is appropriate to augment it with a new variable. To demonstrate, we use survey data collected from a 4 to 17 year old U.S. adolescents to test how the 'prototype' variables fit into reasoned action approach. Through confirmatory factor analysis, we find that the prototype measures are normative pressure measures and when treated as a separate theoretical construct, prototype identity is not completely mediated by the proximal predictors of behavioral intention. We discuss the assumptions of the two theories and finally consider the distinction between augmenting a specific theory versus combining measures derived from different theoretical perspectives.

Cool or Fool? The Association Between Drinker Prototypes and Alcohol Consumption Using Multiple Time-Point Diary Assessments in Adolescent Males

OBJECTIVES

There is still limited understanding of how different kinds of drinker prototypes are associated with adolescent drinking. This study uses the strengths of multiple time-point diary measures (enhanced validity of alcohol use measurement) to test the predictive value of abstainer, moderate and heavy drinker prototypes in social situations. We examined whether the favorability of these prototypes (i.e., "prototype evaluation"), the perceived similarity of these prototypes to one's self-image (i.e., "prototype similarity") assessed at baseline, and their interaction predict alcohol use assessed in social situations.

METHODS

Drinker prototypes were assessed in a baseline sample of 599 adolescents. Subsequently, a sample of 77 alcohol-using 16 to 18-year-old males reported their Friday and Saturday evening drinking behavior the next day during eight weeks (resulting in 495 daily measures). Alcohol use was assessed in the company of peers.

RESULTS

The more adolescents perceived themselves as similar to heavy drinker prototypes the higher their alcohol consumption in social situations. The more adolescents held favorable abstainer prototypes, the lower their alcohol consumption. The interaction between prototype evaluation and similarity was not significant.

CONCLUSIONS

By using a more reliable and valid method to assess adolescents' alcohol use, the present study showed that more "extreme" drinker prototypes (i.e., heavy drinker and abstainer prototypes) are most predictive of adolescent alcohol use in social situations. Increasing the perceived dissimilarity to heavy drinker prototypes and the favorability of abstainer prototypes may therefore be important targets in interventions aimed at reducing adolescents' alcohol consumption.

Investigating the role of implicit prototypes in the prototype willingness model

One useful theory to predict health behavior is the prototype-willingness model (PWM), which posits that people are more willing to engage in behavior to the extent that they have a positive view of the prototypical person who performs that behavior. The goal of the present research is to test whether adding an implicit measure of prototype favorability might improve explanatory power in the PWM. Two studies examined whether implicit prototype favorability uniquely predicted White women's intentions to engage in healthy sun behavior over the next 3-6 months, and their willingness to engage in risky sun behavior, should the opportunity arise. The results suggested that implicit prototype favorability, particularly implicit prototypes of those who engage in risky UV-related behaviors, uniquely predicted intentions to engage in healthy sun behavior and willingness to engage in risky sun behavior in the PWM.

The social image of drinking - mass media campaigns may inadvertently increase binge drinking

Mass media campaigns that promote responsible drinking are rarely tested for their usefulness in reducing heavy alcohol consumption. Existing campaigns that appeal to responsible drinking while simultaneously displaying young people in social drinking situations may even have paradoxical effects. To examine such possible effects, we drew on a real-world media campaign, which we systematically modified on the basis of recent prototype research. We pilot tested questionnaires (using n = 41 participants), developed two different sets of posters in the style of an existing campaign (n = 39) and investigated their effectiveness (n = 102). In the main study, young men were randomly assigned to one of three conditions: sociable or unsociable binge drinker prototype condition or a control group. Outcome variables were intention, behavioural willingness, attitude, subjective norm, self-efficacy, prototype evaluation and prototype similarity with respect to binge drinking. Binge drinking as a habit was included to control for the fact that habitual drinking in social situations is hard to overcome and poses a particular challenge to interventions. The manipulation check showed that the experimental variation (sociable vs. unsociable drinker prototype condition) was successful. Results of the main study showed that the sociable drinker prototype condition resulted in a higher willingness and - for those with less of a habit - a higher intention to binge drink the next weekend. The unsociable drinker prototype condition had no effects. The results imply that the social components of mass media campaigns might inadvertently exacerbate binge drinking in young men. We therefore advocate against campaigns including aspects of alcohol consumption that might be positively associated with drinker prototype perception. Finally, we provide suggestions for future research.

Applying an extended theory of planned behaviour to predict breakfast consumption in adolescents

BACKGROUND/OBJECTIVES

Breakfast skipping increases during adolescence and is associated with lower levels of physical activity and weight gain. Theory-based interventions promoting breakfast consumption in adolescents report mixed findings, potentially because of limited research identifying which determinants to target. This study aimed to: (i) utilise the Theory of Planned Behaviour (TPB) to identify the relative contribution of attitudes (affective, cognitive and behavioural) to predict intention to eat breakfast and breakfast consumption in adolescents and (ii) determine whether demographic factors moderate the relationship between TPB variables, intention and behaviour.

SUBJECTS/METHODS

Questionnaires were completed by 434 students (mean 14±0.9 years) measuring breakfast consumption (0-2, 3-6 or 7 days), physical activity levels and TPB measures. Data were analysed by breakfast frequency and demographics using hierarchical and multinomial regression analyses.

RESULTS

Breakfast was consumed everyday by 57% of students, with boys more likely to eat a regular breakfast, report higher activity levels and report more positive attitudes towards breakfast than girls (P<0.001). The TPB predicted 58% of the variation in intentions. Overall, the model was predictive of breakfast behaviours (P<0.001), but the relative contribution of TPB constructs varied depending on breakfast frequency. Interactions between gender and intentions were significant when comparing 0-2- and 3-6-day breakfast eaters only highlighting a stronger intention-behaviour relationship for girls.

CONCLUSIONS

Findings confirm that the TPB is a successful model for predicting breakfast intentions and behaviours in adolescents. The potential for a direct effect of attitudes on behaviours should be considered in the implementation and design of breakfast interventions.

Examining daily variability in willingness to drink in relation to underage young adult alcohol use

A key component of the Prototype Willingness Model is willingness, which reflects an openness to opportunity to perform a behavior in situations that are conducive to that behavior. Willingness has traditionally been tested using global, hypothetical assessments, and has not been examined at the daily level. We expected to find within-person variability in willingness to drink, such that on days with greater willingness, individuals would report greater drinking. A national sample (N=288) of young adults aged 18 to 20 (31.60% female) completed a Web-based survey that was comprised of measures of drinking and sexual behavior, including the Timeline Follow-Back (Sobell & Sobell, 1992). Findings show daily variability in willingness to drink (ICC=0.54), which suggests that there are substantial differences from day-to-day in this drinking-related cognition. Participants drank more on days when individuals also reported feeling more willing to drink than their own average level across the two weeks. Daily process level mechanisms allow greater insight into factors contributing to increased risk in-the-moment, which may point to targets for interventions aimed at improving adolescents' and young adults' abilities to make healthier choices in moments when they may be at greater risk for engaging in risky behaviors.

Past racial discrimination exacerbates the effects of racial exclusion on negative affect, perceived control, and alcohol-risk cognitions among Black young adults

Racial discrimination is associated with alcohol use and risky sex cognitions and behaviors, which are risk factors for negative health outcomes, including human immunodeficiency virus infection. The current study investigated the causal impact of racial discrimination on alcohol and sexual-risk cognitions while exploring potential mediators that might help explain this relation: negative affect, perceived control, and meaningful existence. We also examined if past discrimination impacts the strength of (moderates) these effects. Participants were 287 Black/African American young adults aged 18-25. They were randomly assigned to be excluded or included by White peers via the game Cyberball. Racial exclusion (vs. inclusion) predicted greater: perceived racial discrimination, negative affect, alcohol use willingness, and reduced perceived control and meaningful existence. Furthermore, excluded participants who experienced more past racial discrimination reported the lowest perceived control, and greatest negative affect and alcohol-risk cognitions. The findings suggest that past racial discrimination exacerbates the harmful health effects of immediate experiences of discrimination.

Examining a social reaction model in the prediction of adolescent alcohol use

The prototype willingness model (PWM; Gerrard et al., 2008) is a modified dual-processing model designed to improve the predictive value of existing health risk behavior by suggesting that there are two pathways to health risk behaviors: a reasoned path that is mediated by behavioral intention and a social reaction path that is mediated by behavioral willingness. Although there is evidence supporting the social reaction path to risk behavior among adolescents, most of this work has focused on specific components of the pathway such as prototypes or willingness rather than looking at the entire social reaction pathway as a whole. As such, the primary goal of the present study was to determine whether the social reaction pathway has acceptable fit for a sample of adolescents using a longitudinal design. Results from 835 adolescents support the social reaction pathway of the PWM model when applied to adolescent alcohol use. Specifically, prototypes, perceived vulnerability, and norms predicted willingness to drink, which in turn predicted drinking behavior (drinks per week and peak number of drinks) over a period of 12months. As such, these findings suggest that the social reaction pathway of the PWM is applicable to adolescent drinkers, meaning that adolescent drinking behavior is based on a less planned and socially based decision process.

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.

Lost in translation: a focus group study of parents' and adolescents' interpretations of underage drinking and parental supply

Background

Reductions in underage drinking will only come about from changes in the social and cultural environment. Despite decades of messages discouraging parental supply, parents perceive social norms supportive of allowing children to consume alcohol in ‘safe’ environments.

Methods

Twelve focus groups conducted in a regional community in NSW, Australia; four with parents of teenagers (n = 27; 70 % female) and eight with adolescents (n = 47; 55 % female). Participants were recruited using local media. Groups explored knowledge and attitudes and around alcohol consumption by, and parental supply of alcohol to, underage teenagers; and discussed materials from previous campaigns targeting adolescents and parents.

Results

Parents and adolescents perceived teen drinking to be a common behaviour within the community, but applied moral judgements to these behaviours. Younger adolescents expressed more negative views of teen drinkers and parents who supply alcohol than older adolescents. Adolescents and parents perceived those who ‘provide alcohol’ (other families) as bad parents, and those who ‘teach responsible drinking’ (themselves) as good people. Both groups expressed a preference for high-fear, victim-blaming messages that targeted ‘those people’ whose behaviours are problematic.

Conclusions

In developing and testing interventions to address underage drinking, it is essential to ensure the target audience perceive themselves to be the target audience. If we do not have a shared understanding of underage ‘drinking’ and parental ‘provision’, such messages will continue to be perceived by parents who are trying to do the ‘right’ thing as targeting a different behaviour and tacitly supporting their decision to provide their children with alcohol.