Health Behaviour To think it is a good idea:
What are Attitudes?
Lecture 2: We here indicate that attitudes are predispositions to
respond to some class of stimuli with certain classes
Social cognition models: of responses and designate the three major types of
The Theory of Planned response as cognitive, affective, & behavioural.
(Rosenberg & Hovland, 1960, p. 3 )
... attitudes [are] enduring systems of positive or
negative evaluations, emotional feelings, and
Falko Sniehotta, T 8 William Guild Building pro or con action tendencies with respect to
firstname.lastname@example.org social objects.
(Krech, Crutchfield, & Ballachey, 1962, p.139)
Three Component Model of Why do people behave unhealthily?
• Behaviour is acquired through an lifelong ongoing
interaction with the environment.
cognitive reactions • Causal explanation for acts of behaviour are
difficult to find and they would not necessarily tell
us how to change behaviour.
Object Attitudes affective reactions
• Social cognitive models specify modifiable
immediate (proximal) determinants of behaviour.
behavioural reactions • They assume that other causes and determinants
are mediated by these proximal determinants of
A classic study: Richard LaPiere, 1934
• LaPiere travelled with a young Chinese couple through
the USA in 1930.
For a long time, attitudes were seen • They made 251 visits to the hotels and restaurants, and
in only one case were they refused service.
as key predictor of behaviour
• Six months later, he sent a letter to each establishment
enquiring whether they would accept members of the
Chinese race as guests in your establishment.
• 92 percent of the restaurants and hotels replied no.
Only one person gave a definite yes.
• Conclusion: people's verbal report of their attitudes might
not be very good predictors of their actual behaviour
Expectancy-Value Model of Attitudes
Expectancy-Value Model of Attitudes
(Fishbein & Ajzen, 1976)
A person holds many beliefs about an attitude • An attitude can be conceptualized by the following
object; an object is seen as having many attributes equation:
Associated with each attribute is an evaluative Ao= Σ(bi x ei)
response (i.e., an attitude) Ao = The attitude toward an object (o)
bi = A belief about the object's attributes
Through a learning process evaluative responses are
ei = The evaluation of an attribute
associated with the attitude object
• A belief is the subjective probability that an object
Learned evaluative responses summate
has a given attribute. A value could be assigned to
On future occasions, an attitude object will elicit this designate the degree to which the attitude object
summated evaluative response has a given attribute
An attitude is a function of a person's beliefs about • The evaluation is a rating of the attribute along
an object and the evaluative responses some evaluative dimension (e.g., good-bad).
Expectancy-Value Model of Attitudes Theory of Reasoned Action
Ajzen & Fishbein, 1980
One's attitude is a sum of the product of each belief Outcome
times its evaluation Evaluation
Beliefs are held in a hierarchy External Attitude
An attitude is determined at any given time by the 5 strength
to 9 most salient beliefs in one's belief hierarchy
Types of beliefs Demographic Importance Intention Behaviour
Descriptive belief: Based on direct experience with the variables
attitude object. Held with maximum confidence
Inferential belief: Belief based on an inference
process. Infer a belief from other beliefs Subjective
Informational belief: Belief based on information from Motivation to
an outside source Comply
Theory of Reasoned Action Theory of Planned Behavior
Ajzen & Fishbein, 1980 Ajzen, 1985
Demographic Importance Intention Behaviour
Control Beliefs Operationalization of the Model
What are the things that might make it easier for you Belief-based (indirect) measures
to engage in regular exercise over the next six months?
Pilot studies - semi-structured interviews or Qs
What are the things that might facilitate you
engaging in regular exercise over the next six months? Select the “modal salient beliefs”
What are the things that might make it more difficult
for you to engage in regular exercise over the next Ajzen & Fishbein (1980) suggest that “those beliefs
six months? that exceed a certain frequency” should be chosen
What are the things that might hinder or prevent you
from engaging in regular exercise over the next six
Behavioural Beliefs and Outcome Evaluations
1. Engaging in regular exercise over the next six
months would improve my fitness
Measurement of TPB cognitions Unlikely 1 2 3 4 5 6 7 Likely
2. Improving my fitness would be…
Bad 1 2 3 4 5 6 7 Good
Bad -3 -2 -1 0 1 2 3 Good
Normative Beliefs and Motivation to Comply Control Beliefs and Power
1. My friends think that I should/should not engage in 1. The availability of cheap sports facilities would make
regular exercise over the six months engaging in regular exercise over the next six
Think 1 2 3 4 5 6 7 Think I
I should should not More 1 2 3 4 5 6 7 More
2. With regard to exercising, how much do you want
2. Cheap sports facilities are available…
to do what your friends think you should?
Never 1 2 3 4 5 6 7 Frequently
Not 1 2 3 4 5 6 7 Very much
Operationalization of the Model Attitude
Direct measures 1. My engaging in regular exercise over the
next six months would be…
Bad 1 2 3 4 5 6 7 Good
Icek Ajzen (2006) Pleasant 1 2 3 4 5 6 7 Unpleasant
http://www.people.umass.edu/aizen/pdf/tpb.measurement.pdf Enjoyable 1 2 3 4 5 6 7 Unenjoyable
Wise 1 2 3 4 5 6 7 Foolish
Jill Francis et al (2004)
http://www.rebeqi.org/ViewFile.aspx?itemID=212 Harmful 1 2 3 4 5 6 7 Beneficial
Subjective Norm Perceived Behavioural Control
1. People who are important to me would approve/ 1. How much control do you feel you have over engaging
disapprove of me engaging in regular exercise in regular exercise over the next six months?
over the next six months
No 1 2 3 4 5 6 7 Complete
Would 1 2 3 4 5 6 7 Would control control
2. My engaging in regular exercise over the next six
2. People who are important to me think I should/
should not engage in regular exercise over the months would be…
next six months Easy 1 2 3 4 5 6 7 Difficult
Think 1 2 3 4 5 6 7 Think I
I should should not
Intention Theory of Planned Behavior
1. I intend to engage in regular exercise over the
next six months
Definitely 1 2 3 4 5 6 7 Definitely
do not do
2. How likely is it that you will engage in regular
exercise over the next six months?
Likely 1 2 3 4 5 6 7 Unlikely
110 patients attending a health promotion clinic at
Norman, P., Conner, M., & Bell, R. (2000) their general practice
87 followed-up by postal questionnaire at six months
The theory of planned behaviour and exercise.
British Journal of Health Psychology, 5, 249-261. Time 1 - TPB Questionnaire
Time 2 - Exercise Behaviour
Table 1 Descriptive Statistics
Taking regular physical activity over the next six months _____________________________________________
would be… bad-good, unpleasant-pleasant, etc
Items Alpha Mean SD
Subjective Norm _____________________________________________
People who are important to me think that I should/should
not take regular physical activity over the next six months Intention 3 0.95 2.01 1.52
Attitude 5 0.85 2.21 0.97
Perceived Behavioural Control Subjective Norm 1 - 1.40 1.77
How much control do you feel you have over taking Per Behav Control 4 0.87 1.71 1.33
regular physical activity over the next six months? ______________________________________________
I intend to take regular physical activity over the next six
Table 2 Correlations Table 3 Regression Analysis Predicting Intention
Intention Behaviour Intention
Intention - .32** Attitude .04
Attitude .33** .23* Subjective Norm .14
Subjective Norm .16 -.22 Per Behav Control .71***
Per Behav Control .74*** .37** ____________________________________
_____________________________________________ R2 = .53***, *** p < .001
* p < .05, ** p < .01, *** p < .001
Table 4 Regression Analysis Predicting Behaviour TPB meta-analysis (Conner & Armitage, 2001)
_________________________________ BBs ATT
Per Behav Control .39*
_________________________________ r=.50 r=.34 r=.47
R2 = .15**, * p < .05, ** p < .01 NBs SN INT BEH
APPLICATION OF THE THEORY OF
• More than 1000 studies have tested the PLANNED BEHAVIOUR IN
TPB in various behaviour domains. BEHAVIOUR
• There is compelling evidence that the CHANGE INTERVENTIONS:
TPB accounts for about 50% of the A SYSTEMATIC REVIEW
variance in intentions and about 28% of
the variance in behaviour.
• But do interventions based on the TPB Hardeman et al., 2002 Psych & Health
actually change behaviour?
Hardeman review of TPB interventions Hardeman review: Results
• 24 studies were found • half of the interventions were effective
in changing intention,
• TPB was mainly used to measure process
• two-thirds in changing behaviour, with
and outcome variables and small effect sizes.
• less frequently to develop the • Effectiveness was unrelated to use of
interventions the theory to develop interventions
• Sparse evidence about mediation of
effects by TPB
Does Changing Behavioral Intentions
Does Changing Behavioral Engender Behavior Change?
Intentions Engender • Method: Review of studies that assigned
Behavior Change? participants randomly to a treatment that
significantly increases the strength of
A Meta-analysis of the respective intentions relative to a control
condition, and comparing differences in
Experimental Evidence subsequent behavior
• Results: 47 experimental tests of intention-
behavior relations that satisfied these criteria.
Thomas L. Webb & Paschal Sheeran • “medium-to-large” change in intention (d =
In press, Psychological Bulletin .66) leads to a “small-to-medium” change in
behavior (d = .36).
Imagine this as a result of a regression. On
the y axis you see the predicted values
from the regression (a linear combination of
predictors), on the x axis the observed
values. The slope of the regression line
indicates a relationship. If we know the
values of predictors and the regression
equation we can make decent estimations
of participants observed values.
Without knowing the observed values, we can make predictions with
some accuracy based on a simple model. This model captures SOME of
the original variance but the deviances of the observed values to the
regression line indicates that there is variance in the measures that we
do not account for. If we rely on the regression model, this variance is
lost, i.e. it is unaccounted for.