Theory of Planned Behavior

1. Theory of Planned Behavior Presented on: October 14, 2010 Meagan Beasley Allison Fels Kindra Lansburg Casey Mulligan Hailey Tipton

2. Conceptual Model of Theory of Planned Behavior Behavioral beliefs X Outcome evaluations Attitude towards behavior AB Normative beliefs X Motivation to comply Subjective Norms SN Behavioral intentions BI Behavior B Control beliefs X Control frequency Perceived control PBC Stead, M., Tagg, S., MacKintosh, A. M., & Eadie, D. (2005). Development and evaluation of a mass media Theory of Planned Behaviour intervention to reduce speeding. Health Education Research, 20, 36-50.

3. Texting While Driving: Psychosocial Influences on Young People’s Texting Intentions and Behaviour Heidi E. Nemme, Katherine M. White Using the TPB for Assessment

4. Assessment Background • Driver distraction has been identified as one of the main causes of road traffic accidents • Cell phone use while driving can be a major distraction because it requires the driver to divert attention from the road • Young adults (18-24) are more likely to use cell phones while driving • The risk of an accident is confounded by the lack of driving experience for this age group Nemme, H. E., & White, K. M. (2010). Texting while driving: Psychosocial influences on young people’s texting intentions and behavior. Accident Analysis and Prevention, 42, 1257-1265.

5. Assessment Study Design • Purpose: To examine the utility of the TPB in predicting intentions to engage in, and subsequent behavior of, sending and reading texts while driving in young adults between 17 and 24 years. • Variables: • Independent (predictor): intention to send and read texts while driving • Dependent (outcome): behavior of sending and reading texts while driving Nemme, H. E., & White, K. M. (2010). Texting while driving: Psychosocial influences on young people’s texting intentions and behavior. Accident Analysis and Prevention, 42, 1257-1265.

6. Assessment Study Design (Cont.) • Method: Prospective cohort study of 169 university students aged 17-24. Data was collected twice over a 1 week period for a duration of 3 weeks. • First questionnaire asked background questions related to TPB (intention, attitude, subjective norm, perceived behavioral control, past behavior, group norm, and moral norm). • Second questionnaire asked participants to report their behavior in the previous week. Nemme, H. E., & White, K. M. (2010). Texting while driving: Psychosocial influences on young people’s texting intentions and behavior. Accident Analysis and Prevention, 42, 1257-1265.

7. Assessment Results - Intention • Sending texts while driving: Significant predictors were attitude, subjective norm, perceived behavioral control, group norm, and moral norm • 50.5% (48.3% adjusted) of variance accounted for • Reading texts while driving: Significant predictors were attitude, group norm, and moral norm • 49.8% (47.5% adjusted) of variance accounted for Nemme, H. E., & White, K. M. (2010). Texting while driving: Psychosocial influences on young people’s texting intentions and behavior. Accident Analysis and Prevention, 42, 1257-1265.

8. Assessment Results - Behavior • Significant predictors of actual behavior were past behavior, moral norm, and intention for both sending and reading texts. • 38.8% (34.8% adjusted) of variance accounted for sending texts • 49.1% (45.8% adjusted) of variance accounted for reading texts Nemme, H. E., & White, K. M. (2010). Texting while driving: Psychosocial influences on young people’s texting intentions and behavior. Accident Analysis and Prevention, 42, 1257-1265.

9. Inputs Activities Outputs Outcomes/Impact Previous Studies Sample Population Intention Questionnaire Staff/ Researchers Use of TPB construct variance to form interventions Assessment Data Behavior Questionnaire Theory of Planned Behavior Constructs Participants Situation: Using the Theory of Planned Behavior to predict cell phone behavior while driving.

10. Overall, results support efficacy of the TPB model in understanding and predicting texts while driving among university students. Study shows intentions for sending and reading texts are influenced differently Attitudes, group norms, moral norms, and past behaviors (i.e. habits) were the strongest predictors of both behaviors Application to Assessment Nemme, H. E., & White, K. M. (2010). Texting while driving: Psychosocial influences on young people’s texting intentions and behavior. Accident Analysis and Prevention, 42, 1257-1265.

11. Implications for Intervention • Interventions should treat sending and reading texts as separate behaviors. • Interventions should address attitudes, group norms, moral norms, and past behaviors (habits) because these were the strongest predictors of both behaviors. Nemme, H. E., & White, K. M. (2010). Texting while driving: Psychosocial influences on young people’s texting intentions and behavior. Accident Analysis and Prevention, 42, 1257-1265.

12. Implications for Evaluation • Self-reporting isn’t the most reliable, so future studies could examine phone logs or have participants keep diaries • Measure how much illegality of action affects responses • Expand the sample group Nemme, H. E., & White, K. M. (2010). Texting while driving: Psychosocial influences on young people’s texting intentions and behavior. Accident Analysis and Prevention, 42, 1257-1265.

13. “Development and Evaluation of a Mass Theory of Planned Behaviour Intervention to Reduce Speeding” Stead et a. (2004) Using The Theory of Planned Behavior in Intervention

14. Intervention Background • Foolsspeed Campaign: use TPB to design a large-scale intervention and to use TPB to assess its impact • Three Components: • Perceived Behavioral Control (“PBC”) – speeders tend to feel more in control than they actually are and exaggerate own driving ability • Attitude – speeders perceived more benefits and less adverse consequences compared to nonspeeders • Subjective Norms – little stigma to speeding in comparison to more serious offenses such as DUI (a normative majority behavior) Speeding Behavior is dependent upon the three components of TBP Stead, M., Tagg, S., MacKintosh, A. M., & Eadie, D. (2005). Development and evaluation of a mass media Theory of Planned Behaviour intervention to reduce speeding. Health Education Research, 20, 36-50.

15. Foolsspeed: Scottish Road Safety Campaign Outcome Logic Model Inputs Activities Short-term Outcomes Long-termOutcomes Situation: There is a need to educate and therefore reduce speeding among Scottish men 25-44 years old in the ABC1 social group. Media Family First TV ad Change in attitudes and beliefs about speeding behaviors PR firms Mirror TV ad Reduction in speeding violations among target population drivers Corporate sponsors Simon Says TV ad Program staff Surveys Analysis and understanding of current beliefs and behaviors Program Materials Background Knowledge Questionnaire

16. Intervention Study Design • Purpose: to reduce speeding on Scotland’s roads • Variables: • Independent Variables – Mirror, Friends and Family and Simon Says ads • Dependent Variables – Attitude, Subjective Norms and PBC • Methods • Target pop.: 25-44 year old males in social class ABC1 • Mass media advertising is complimented by public relations and corporate sponsorship Stead, M., Tagg, S., MacKintosh, A. M., & Eadie, D. (2005). Development and evaluation of a mass media Theory of Planned Behaviour intervention to reduce speeding. Health Education Research, 20, 36-50.

17. Foolsspeed TBD Ads • Mirror (Attitude) • Friends and Family (Subjective Norms) • Simon Says (PBC) • Sought to challenge the beliefs that speeding in town saves time, that a speeding driver is fully in control of the car, that he or she is able to stop quickly in an emergency if necessary and that speeding can cause accidents – beliefs which research suggests are key in the formation of attitudes towards speeding [e.g. (Parker and Stradling 2001)] • Sought to highlight the mismatch between a driver’s own favourable view of his driving and the irritation and anxiety it may arouse in his passengers, and to increase the driver’s motivation to drive more safely to please others around him • Sought to increase drivers’ control over speeding. The creative brief for the advertising postulated that the advertisement should seek to challenge drivers with the sentiment ‘you’re responsible for the way you drive’, by depicting typical internal and external pressures which encourage drivers to speed and demonstrating that it is possible and desirable to withstand such pressures Stead, M., Tagg, S., MacKintosh, A. M., & Eadie, D. (2005). Development and evaluation of a mass media Theory of Planned Behaviour intervention to reduce speeding. Health Education Research, 20, 36-50.

18. Intervention Procedure and Results • Procedure: 4 year longitudinal cohort to examine a 3-year mass media campaign • Result: TPB inventions have more success in changing attitudes than other determinants of intentions and behavior • Subjective Norms and PBC were not significantly changed Stead, M., Tagg, S., MacKintosh, A. M., & Eadie, D. (2005). Development and evaluation of a mass media Theory of Planned Behaviour intervention to reduce speeding. Health Education Research, 20, 36-50.

19. Application for Intervention • Attitude is an important modifiable factor that can be targeted by advertising campaigns • PBC may be a key factor in determining driving behavior • Interventions could aim to decrease speeding behaviors by using TPB constructs to improve attitudes and beliefs associated with driving • Stages of Intervention: • Mirror Ad addresses attitude (1999) • Friends and Family addresses subjective norms (2000) • Simon Says addresses PBC (2001) Stead, M., Tagg, S., MacKintosh, A. M., & Eadie, D. (2005). Development and evaluation of a mass media Theory of Planned Behaviour intervention to reduce speeding. Health Education Research, 20, 36-50.

20. Implications for Assessment What did we learn about the driving education needs of this population in regards to TPB? • Efforts in changing attitude are more successful than efforts to alter subjective norms and PCB, and TPB approaches would be more effective than using hard hitting imagery • But: PBC was the most powerful independent variable associated with intentions to speed at the survey stage • Therefore: Those with undesirable attitudes and beliefs regarding driving behavior are more likely to speed Stead, M., Tagg, S., MacKintosh, A. M., & Eadie, D. (2005). Development and evaluation of a mass media Theory of Planned Behaviour intervention to reduce speeding. Health Education Research, 20, 36-50.

21. Implications for Impact Evaluation • Evaluations of program to reduce speeding on Scotland roads should focus on the following: • Associations between TPB components and behavioral/attitude changes • Reduction in speeding violations An effective intervention will demonstrate a significant reduction in speeding and a corresponding change in attitude regarding driving behavior Stead, M., Tagg, S., MacKintosh, A. M., & Eadie, D. (2005). Development and evaluation of a mass media Theory of Planned Behaviour intervention to reduce speeding. Health Education Research, 20, 36-50.

22. Using the Theory of Planned Behavior to Examine Effectiveness of an Educational Intervention on Infant Feeding in China Zhang et al., 2009 TPB Application to Evaluation

23. Evaluation Background • Complementary feeding has been identified as a critical factor in child malnutrition prevention • Previous educational and informational interventions intending to increase knowledge have not ended in behavioral changes • Various psychosocial factors may influence a mothers’ adherence towards recommended infant feeding • TPB may provide valuable insight to understanding these psychosocial factors and their predictive value on behavior Zhang, J., Shi, L., Chen, D., Wang, J., & Wang, Y. (2009). Using the Theory of Planned Behavior to examine effectiveness of an educational intervention on infant feeding in China. Preventive Medicine, 49, 529-534.

24. Inputs Activities Outputs Outcomes Impact Increased attention to practice optimal feeding Provision of infant feeding handbook Increased knowledge of appropriate infant feeding Received info about appropriate feeding Program Funds Provision of mandated info Greater adherence to recommended feeding Observational Learning Increased Self-Efficacy Program Staff Group Training Sessions Program Materials Guidance Problem-Solving Improved attitudes toward feeding Background Knowledge Home Visits Improved Child Nutrition University/ Hospital Affiliates Change in Constructs Pre- and post- questionnaire Target Group: 2-4 month old infants and their mothers in rural China townships.

25. Evaluation Study Design • Purpose: • Use a randomized controlled trial design to examine the effectiveness of an infant feeding intervention delivered through health services in rural China • Determine whether the psychosocial mediating variables had predictive effects on feeding behaviors Zhang, J., Shi, L., Chen, D., Wang, J., & Wang, Y. (2009). Using the Theory of Planned Behavior to examine effectiveness of an educational intervention on infant feeding in China. Preventive Medicine, 49, 529-534.

26. Variable Relationships

27. Variable Relationships

28. Methods • 599 infants (aged 2-4 months) enrolled from 8 rural townships in Laishui County, China • Townships were paired and randomly assigned to intervention or control group • Pre- and post-test questionnaires designed to measure key constructs on five messages of feeding behavior • 485 families were evaluated at the end of the 10-11 month intervention Zhang, J., Shi, L., Chen, D., Wang, J., & Wang, Y. (2009). Using the Theory of Planned Behavior to examine effectiveness of an educational intervention on infant feeding in China. Preventive Medicine, 49, 529-534.

29. Procedures • Intervention Group: • Township hospital doctors trained on child nutrition, breastfeeding, complementary feeding, and counseling skills • Infant feeding handbook distributed • Group training sessions • Home visits • Control Group: • Township hospital doctors provided routine counseling on infant feeding • Distribution of information and educational materials on breastfeeding Zhang, J., Shi, L., Chen, D., Wang, J., & Wang, Y. (2009). Using the Theory of Planned Behavior to examine effectiveness of an educational intervention on infant feeding in China. Preventive Medicine, 49, 529-534.

30. Results • Mothers in the intervention group had significant improvement on knowledge, attitudes, self-efficacy, intention, subjective norms, and feeding behaviors after the intervention • These were unchanged in the control group Zhang, J., Shi, L., Chen, D., Wang, J., & Wang, Y. (2009). Using the Theory of Planned Behavior to examine effectiveness of an educational intervention on infant feeding in China. Preventive Medicine, 49, 529-534.

31. Results continued… • Post-test: Intention (+) intervention, attitudes, self-efficacy, knowledge, number of siblings, and fathers’ education • Infant feeding behaviors (+) intervention, knowledge, intention, subjective norm of villagers, and infant age • The linear regression model explains only 20% of the variability in feeding behavior Zhang, J., Shi, L., Chen, D., Wang, J., & Wang, Y. (2009). Using the Theory of Planned Behavior to examine effectiveness of an educational intervention on infant feeding in China. Preventive Medicine, 49, 529-534.

32. Implication to Assessment • TPB helps determine where participants are mentally while identifying specific measurement variables • Baseline: no significant differences in knowledge, attitudes, subjective norms, self-efficacy, and infant feeding practices between groups • However, more fathers in the intervention group than control were immigrant laborers who worked temporarily in cities Zhang, J., Shi, L., Chen, D., Wang, J., & Wang, Y. (2009). Using the Theory of Planned Behavior to examine effectiveness of an educational intervention on infant feeding in China. Preventive Medicine, 49, 529-534.

33. Implications to Assessment continued… • Baseline intention: • (+) attitudes, subjective norm of family & self-efficacy • (-) household size and number helping with infant care • Cost of food and convenience of food preparation also played important roles in mothers’ decision on adopting recommended feeding practices Zhang, J., Shi, L., Chen, D., Wang, J., & Wang, Y. (2009). Using the Theory of Planned Behavior to examine effectiveness of an educational intervention on infant feeding in China. Preventive Medicine, 49, 529-534.

34. Implications to Intervention • TPB helps tailor interventions to the most important psychosocial issues relating to a desired behavior • In order to motivate caretakers to adopt optimal feeding behaviors, it is critical to provide them with necessary knowledge, information, skills and a supportive environment • Cooking demonstrations • Family training sessions • Providing families with a cookbook of age-appropriate, affordable, easy-to-prepare recipes • Establishment of a social support network Zhang, J., Shi, L., Chen, D., Wang, J., & Wang, Y. (2009). Using the Theory of Planned Behavior to examine effectiveness of an educational intervention on infant feeding in China. Preventive Medicine, 49, 529-534.

35. Applications to Evaluation • TPB allows for the evaluation of psychosocial components at baseline and after the intervention to understand longitudinal change • Helped explain why the educational program improved infant feeding behaviors • Also explained how a program could improve to be more effective • Generalizability is evaluated • ST and LT effects may be assessed Zhang, J., Shi, L., Chen, D., Wang, J., & Wang, Y. (2009). Using the Theory of Planned Behavior to examine effectiveness of an educational intervention on infant feeding in China. Preventive Medicine, 49, 529-534.

36. References • AAMI. (2007). AAMI Young Driver’s Annual Road Safety Index. AAMI, Melbourne, Retrieved March 21, 2009, from http://www.aami.com.au/Resources/File.aspx?id=99 • Nemme, H. E., & White, K. M. (2010). Texting while driving: Psychosocial influences on young people’s texting intentions and behavior. Accident Analysis and Prevention, 42, 1257-1265. • Fatos, G. (2002). Normative vs. attitudinal considerations in breastfeeding behavior: Multifaceted social influences in a developing country context. Soc. Sci. Med., 54, 1743-1753. • Parker, D. and Stradling, S. (2001) Influencing Driver Attitudes and Behaviour. Road Safety Research Report 17. Department of the Environment, Transport and the Regions, London. • Penny, M. E., Creed-Kanashiro, H. M., Robert, R. C., Narro, M. R., Caulfield, L., & Black, R. E. (2005). Effectiveness of an educational intervention delivered through the health services to improve nutrition in young children: A cluster-randomized controlled trial. Lancet 28, 365, 1863-1872. • Redelmeier, D.A., Tibshirani, R.J., 1997. Association between cellular-telephone calls and motor vehicle collisions. New England Journal of Medicine, 336 (7), 453-458. • Stead, M., Tagg, S., MacKintosh, A. M., & Eadie, D. (2005). Development and evaluation of a mass media Theory of Planned Behaviour intervention to reduce speeding. Health Education Research, 20, 36-50. • Stradling, S. G. (1999) Changing driver attitude and behavior. Presented at DETR Speed Review Seminar, London. • Zhang, J., Shi, L., Chen, D., Wang, J., & Wang, Y. (2009). Using the Theory of Planned Behavior to examine effectiveness of an educational intervention on infant feeding in China. Preventive Medicine, 49, 529-534.