The Theory of Reasoned Action, curtailed as TRA, is a theoretical model originally developed by Martin Fishbein (1975) and Icek Ajzen of 1980. These are the two theorists identified as the original founders of the theory of reason action. Like many social and cognitive theories, TPB is also the one with derivative and with original research of similar case that started out as the theory of attitude, which came about the associative study of attitude and behavior.
The more newly incarnated classical theory used to advance on the predicative influence of the theory of reasoned action is the theory of planned behavior, curtailed as TPB—the linkage between beliefs and behavior. The theory of Planned behavior was also planned by Icek Ajzen (1985) to help explain linkage between principles and comportment.
A classical work in the theory of planned behavior was presented in the article of Acarli & Kasap (2014) which was aimed at finding high school students’ smoking behavior and the influences affecting it. . In the gathering of data, an interview form was used which was developed by the researchers in accordance with the directives of Planned Behavior Theory. Interviews were conducted according to problem-based interview method. Data were analyzed by using the qualitative data analysis program MAXqda, and was evaluated by using qualitative content analysis method. Findings of the research show that antismoking campaigns have been reflected in students’ beliefs towards smoking behavior. Differences between female and male students in terms of the beliefs affecting their smoking behavior were detected. It was seen that having no economic difficulty in accessing cigarettes and the fact that cigarettes are being sold disregarding the age-limit are facilitating factors for students to try smoking. The theory of reasoned action is very fascinating in its tenets for so many reasons and so many beneficial factors. Its inception was very familiar from the beginning since the model was initially aimed to associate beliefs, behavior, actions and psychological reactions.
The basic concept that differentiates the theory of reasoned action from health belief model has to do with the way in which its model was set up. The model behind this theory was the one in which it envisages behavioral intention with real interaction of human attitude and behavior pattern. The key words used by the theorists are the idea of behavioral intention as one of the main comportment indicators of gameness in performing a said behavior. Ajzen (2002) displayed the understanding that humans predict with their cerebral mind to want to perform and deal with performance was the subject of behavioral intention; as it is based on the approach toward the comportment, professed interactive control, and idiosyncratic norm and with each analyst subjected for its significance in relative to the behavior and populace of concern.
The theory of reasoned action is extended into many classics of theories of attitude to help explain attitude in behaviors. Some of those established theories include expectancy-value theories, consistency theories, attribution theory, learning theories, Osgood and Tannenbaum’s Congruity Theory and the rest. The behavioral conversion of individuals and animals has been the central objective of many theorists like the founder(s) of Health Belief Model and the originator(s) of the theory of planned behavior. I used the “s” later to display a sense of multiplicity of the theorists with varying ideas and limitations in explanation of such theories. This is an important theoretical relationship between the two. And attitude and behavior change of individuals in this regard was very fascinated to my point of selecting the two.
In today’s society and when eyeing at the community health intervention, I seemed to realize the focus of behavior change and attitude as a snowballing focus on anticipation in health services at different echelons (US Center for Disease Control and Prevention, n.d.). For such reason, I have decided to focus on the community changes in human behaviors in relation to how community perceives health services as either a tool or a need. The earlier we understand the important of such a need the faster and better we can tackle mental behaviors of human attitude in healthcare. This is my synopsis; several health circumstances are begun by behavior threat such as the real problem of drug abuse, drinking abuse, smoking, irresponsible driving, reckless eating disorder, unprotected sexual attitude and so many hasty behaviors that negatively lead to health consequences. Because of such reasons, I believed these theories are important and co-related to my potential research of interest.
Health community relies on community health intervention but most importantly deals with the general concept of public health as more than just a system of theories and risk-interventional approaches. As Bellah et al. (1991) suggested that we simply cannot separate how and why we approach public health concerns. This is because whether we speak about changing behavioral designs, community structures and capacity building on communities, these changes cannot be detached neither can they set aside the healthy philosophy of what establishes a healthy community. Health psychologies have done great tasks in the psychological study of behavioral processes in health, illness and the care of the community. Cherry (n.d.) described the field of health psychology as the focus on promoting health as well as the prevention and treatment of disease and illness. He focus on understanding the mental meaning of what it is to be sick and/or to remain healthy living.
Rosenstock (1974) suggested the inception of health belief model as was originated in the 1950s era by social and health psychologists Hochbaum, Rosenstock and Kegels working in the U.S. Public Health Sectors. The model is a psychological and behavioral in nature that tries to explicate and foresee health behaviors of population. The model was developed in response to the failure of free TB health screening program established at United States Public Health Services. There was a study by Adams, Hall & Fulghum (2014) that aimed at utilizing the perceptions and cues for action constructs of the Health Belief Model (HBM) to assess the attitudes of patients receiving outpatient hemodialysis regarding acceptance of the seasonal influenza, pneumococcal, and hepatitis B virus vaccines. Vaccine acceptance is defined as receiving the vaccine. Study findings suggest age, perceived susceptibility, and perceived severity increase the odds of getting some vaccines.
The University of Twente in their description of Health Belief Theory aimed at understanding that individual will take health-related measures like stop smoking or wear seatbelt while driving if that personal feels the following:
| 1. Feels that a negative health condition (i.e., HIV) can be avoided, |
| 2. | Has a positive expectation that by taking a recommended action, he/she will avoid a negative health condition (i.e., using condoms will be effective at preventing HIV), and |
| 3. | Believes that he/she can successfully take a recommended health action (i.e., he/she can use condoms comfortably and with confidence). |
| Concept | Definition | Application |
| Perceived Susceptibility | One’s opinion of chances of getting a condition | Define population(s) at risk, risk levels; personalize risk based on a person’s features or behavior; heighten perceived susceptibility if too low. |
| Perceived Severity | One’s opinion of how serious a condition and its consequences are | Specify consequences of the risk and the condition |
| Perceived Benefits | One’s belief in the efficacy of the advised action to reduce risk or seriousness of impact | Define action to take; how, where, when; clarify the positive effects to be expected. |
| Perceived Barriers | One’s opinion of the tangible and psychological costs of the advised action | Identify and reduce barriers through reassurance, incentives, assistance. |
| Cues to Action | Strategies to activate “readiness” | Provide how-to information, promote awareness, reminders. |
| Self-Efficacy | Confidence in one’s ability to take action | Provide training, guidance in performing action. |
By Theory at a Glance by Glanz, Marcus Lewis & Rimer (1997).
One of the influential but classical works I found in the use of health belief model was the training of community health workers in the informed decision-making process for prostate screening among African American males. The study intended to a designed curriculum to train CHWs to use and HBM theory-driven approach to facilitate IDMs promotion of prostate screening among African American men. ACS (2009) suggested that African Americans experience a 60% higher incidence of prostate cancer and are twice as likely to die when diagnosed in comparison to whites. CHWs that are versed in the HBM will be aware of how these variables can influence prostate screening decisions in addition to their uniquely natural role as culturally competent educators. Based on the results of this study, focus group responses were consistent with the HBM model of decision-making regarding prostate screening that was constructed from the existing literature and CHWs showed an improvement in necessary knowledge about prostate cancer necessary to promote and aid screening IDMs.
The most important classical work that also connected the relationship between the two theories is the one presented by Gerend & Shepherd (2002) which aimed at comparing two classic theories of health behavior-the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB)-in their prediction of human papillomavirus (HPV) vaccination. This study sets a peak point for the importance of this article. The study method was done by watching a gain-framed, loss-framed, or control video, women ( N = 739) ages 18-26 completed a survey assessing HBM and TPB constructs. HPV vaccine uptake was assessed 10 months later. In terms of the results, although the message framing intervention had no effect on vaccine uptake, support was observed for both the TPB and HBM. Nevertheless, the TPB consistently outperformed the HBM. Key predictors of uptake included subjective norms, self-efficacy, and vaccine cost. At the end of the day, despite the observed advantage of the TPB, findings revealed considerable overlap between the two theories and highlighted the importance of proximal versus distal predictors of health behavior.
Another classical research study of TPB was the evaluation of constructs from the theory—i.e. attitudes, sense of control, subjective norms and intentions – as predictors of accuracy in blood pressure monitoring. Despite numerous initiatives aimed at teaching blood pressure measurement techniques, many healthcare providers measure blood pressures incorrectly. In terms of using the methods of study, medical assistants and licensed practical nurses were asked to complete a questionnaire on TPB variables. These nursing staff’s patients had their blood pressures measured and completed a survey about techniques used to measure their blood pressure. We correlated nursing staff’s responses on the TBP questionnaire with their intention to measure an accurate blood pressure and with the difference between their actual blood pressure measurement and a second measurement taken by a researcher immediately after the clinic visit. Theory of planned behavior constructs predicted the healthcare providers’ intention to measure blood pressure accurately and intention predicted the actual accuracy of systolic blood pressure measurement. However, participants’ knowledge about blood pressure measurement had an unexpected negative relationship with their intentions
Another reference list is the works of Enaker (2014) which deals with the use of theory of planned behavior to predict nonmedical anabolic steroid use in young adults. The use of nonmedical anabolic steroid is great but has negative side effects to so many young adults. The Theory of Planned Behavior is of en applied to predict behavior, and the use of the elements of the Theory of Planned Behavior may help develop a real-world construct to prevent steroid use. The purpose of this article is to explore the application of the Theory of Planned Behavior to improve understanding of the influences of nonmedical anabolic steroid use.
Work Cited:
- Enaker, V. “. (2014). USING THEORY OF PLANNED BEHAVIOR TO PREDICT NONMEDICAL ANABOLIC STEROID USE IN YOUNG ADULTS. American Journal Of Health Studies, 29(2), 178-181.
- Gerend, M., & Shepherd, J. (2012). Predicting Human Papillomavirus Vaccine Uptake in Young Adult Women: Comparing the Health Belief Model and Theory of Planned Behavior. Annals Of Behavioral Medicine, 44(2)
- Center For Equal Health. (n.d.). Using the health belief model to train community health workers in the informed decision-making process for prostate screening among African American males. University of South Florida College of Public Health. Retrieved March 29, 2015 from http://www.centerforequalhealth.org/downloads/publications/CERED/Posters/apos%20poster.pdf
- ACS, Cancer Facts & Figures for African Americans 2009-2010, in Cancer Facts & Figures, A.C. Society, Editor. 2009: Atlanta.
- Adams, A., Hall, M., & Fulghum, J. (2014). Utilizing the Health Belief Model To Assess Vaccine Acceptance Of Patients on Hemodialysis. Nephrology Nursing Journal, 41(4), 393-407
- University of Twente. (n.d.). Health Belief Model. Retrieved March 29, 2015 from http://www.utwente.nl/cw/theorieenoverzicht/Theory%20Clusters/Health%20Communication/Health_Belief_Model/
- Rosenstock, I. (1974). “Historical Origins of the Health Belief Model”. Health Education Behavior 2 (4): 328–335
- Cherry, K. (n.d.) What is Health Psychology? Psychology Education. Retrieved March 29, 2015 from http://psychology.about.com/od/branchesofpsycholog1/p/health-psychology.htm
- Bellah, R.N., Madsen, R., Sullivan, W.M., Swidler, A., Tipton, S.M., (1991). The Good Society. Vintage Books; New York.
- US Center for Disease Control and Prevention (n.d.). National Prevention Strategy. Retrieved March 29, 2015 from http://www.cdc.gov/features/preventionstrategy/
- Ajzen, I. (2002). Perceived Behavioral Control, Self-Efficacy, Locus of Control, and the Theory of Planned Behavior. Journal of Applied Social Psychology, 32, 665-683.
- Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhl & J. Beckmann (Eds.), Action control: From cognition to behavior. Berlin, Heidelber, New York: Springer-Verlag. (pp. 11-39).
- Nelson, J. M., Cook, P. F., & Ingram, J. C. (2014). Utility of the theory of planned behavior to predict nursing staff blood pressure monitoring behaviours. Journal Of Clinical Nursing, 23(3/4), 461-470
- Glanz, K., Marcus Lewis, F. & Rimer, B.K. (1997). Theory at a Glance: A Guide for Health Promotion Practice. National Institute of Health.
- Acarli, D. S., & Kasap, M. Y. (2014). AN EXAMINATION OF HIGH SCHOOL STUDENTS’ SMOKING BEHAVIOR BY USING THE THEORY OF PLANNED BEHAVIOR. Journal Of Baltic Science Education, 13(4), 497-507
