H571 Week 2 - HB_TRA_Miller

Theory of Reasoned Action (TRA) Lindsay Miller Oregon State University

Outline • Brief discussion of Value-expectancy theory • Overview of the Theory of Reasoned Action • George’s example from book • Personal example that YOU will help me walk through • Short quiz of TRA • Relationship between TRA and TTI

Value-expectancy • TRA has value-expectancy •

Explains, “how individuals make health-behavior decisions in terms of their expectations or beliefs regarding the health behavior and the value attached to the behavioral health outcome”

• Theory of Planned Behavior • The Information-Motivation-Behavioral Skills Model

Theory of Reasoned Action (TRA) Overview • TRA was developed by Ajzen and Fishbein 1980 • 2 focuses (constructs) o Beliefs about HBs will shape behavioral intent  Attitude o Social influences will shape behavioral intent  Subjective Norm

TRA Overview • Construct 1: o Attitude: A person’s evaluation of the anticipated positive or negative outcomes associated with engaging in a given behavior. o Consider belief about behavior and evaluate that behavior as good or bad. o 7 point scale: -3 to +3 o Create attitude about behavior

TRA Overview • Construct 2: o Subjective Norm: The idea that people are motivated by their perceptions of what is considered normative and acceptable by others o Normative belief: The perceptions that an individual has about what others think they should do in regards to the said behavior. o Weigh each normative belief by a person’s motivation to comply with the referent (source of the normative belief) o 7 point scale: 1-7 o Create Subjective Norm

TRA Overview • Behavioral Intent: o Key construct in TRA and the last step before the actual behavior o Defined very specifically as, 1. Time frame for performance of the behavior 2. And exact description of the action composing the behavior 3. The desired outcome (target) of the behavior, 4. The context of the behavior o Example: “intent to use condoms for STD prevention (target) in the next 6 months (time) for every act of penile-vaginal sex (action) with people other than your primary sex partner (context).

TRA Diagram

George Example from Text • George wants to lower cholesterol levels • Considers few options o Diet change o Exercise o Take cholesterol-lowering drugs

• Doc suggests changing diet

George Example – Construct 1 • Belief about becoming a vegetarian o May have difficult time finding enough food

• Evaluate his belief o Good versus bad o 7 point scale: -3 to +3 o Not finding enough food (-3)

• Create attitude about behavior

George Example Construct 2 • People are motivated by their perceptions of what is considered normative and acceptable to others. • Each normative belief is “weighted” by a persons motivation to comply with referent source o 7 point scale (1-7)

• Georges doctor believes he should take cholesterol-lowering drugs

Behavioral Intent • Last step in the theory before the actual behavior • Intent includes o o o o

Time frame for performance The action composing the behavior Desired outcome (target) The context of behavior

Behavioral Intent Specifics of Health Behavior for George Action

Target

Context

Time

Get

Prescription for Lipitor

Internist Office

Next 2 months

Use

Fresh Vegetables

In meals cooked at home

Always

Take

Lipitor

Unspecified

Daily

Order

A salad

Eating out

Always

Example: George intends to always (time) order (action) a salad (target) when eating out at a restaurant (context).

Example – Prehypertension • I go to the doctor, and I am diagnosed with prehypertension (Systolic of 120-139mmHg) • Doc suggests I reduce my alcohol consumption. • What is the first construct in TRA? • Create a belief about reducing alcohol o Difficult to not be in a situation with alcohol o Rate low, -2

• I have a negative attitude about reducing my alcohol consumption

Example - Prehypertension • Construct 2? • Create normative believes and “weigh” them by my motivation to comply with the referent source. o My sorority sisters would NOT want me to reduce my alcohol consumption (+5) o My doctor would want me to reduce my ETOH (+3)

• Arrive at Subjective Norm • Next Step?

Example - Prehypertension • Behavioral Intention o o o o

Time frame Action Target Context

Action

Target

Context

Time

Drink

Alcohol

At School

Graduate

Use

Low sodium foods

In meals cooked Always at home

Smoking – TRA Quiz 1. 2.

Your cousin Norm does not think you should quit (+3).

1.

Subjective Norm

Quitting smoking will save you money. You are a college student with loans.

1.

1.

Beliefs about the behavior and evaluations of that behavior

Your cousin Norm has smoked his entire life and has no health problems. Norm is your best friend, and you trust him.

1.

2.

Normative belief and motivation to comply

Quitting smoking will help you save money to pay your college loans (+3)

1. I

Attitude about belief

2

4

3

1

TRA and TTI

Summary

References • DiClimente, R., & Salazar, L. (2013). Health Behavior Theory for Public Health: Principles, foundations, and applications. Burlington, MA: Jones and Barlett Learning. • Preventing High Blood Pressure: Healthy Living Habits. (2014, July 7). Retrieved October 8, 2014.