Health Promotion in the Workplace

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HIV/AIDS RESEARCH BASED ON THE THEORY OF REASONED ACTION AND THE THEORY OF PLANNED BEHAVIOUR

The theory-based research on HIV/AIDS to be reviewed here will focus on the three HIV/AIDS health behaviours that form the focus of the study: condom use, voluntary counselling and testing, and monogamy. Most of the theory-based research is on condom use behaviour. Only three theory-based studies on monogamy and voluntary counselling and testing were found. Almost all the studies employed Ajzen and Fishbein’s (1980) recommended research methodology and tested hypotheses on relationships between intentions, theoretical constructs and specific AIDS preventive behaviour.

Theories of Reasoned Action and Planned Behaviour and Condom Use

Regular condom use has been identified as the most effective method of preventing the spread of HIV and AIDS (Department of Health, 2000; Rehle et al., 2007). Condom use – and attitudes towards it – has been the focus of HIV/AIDS behavioural research since the 1980s, with the advent of AIDS research in behavioural science (Ross & McClaws, 1993). The 1980s also heralded an era of behavioural science research in which social psychological models of behaviour change were applied to condom use behaviour (Abraham et al., 1999; Fisher & Fisher, 1992; Sheeran & Orbell, 1998; Sheeran & Taylor, 1999). In line with Ajzen and Fishbein’s (1980) proposition of a direct relationship between behaviour and intentions, most of the condom use research that applied the theories of reasoned action and planned behaviour reported a direct relationship between condom use intention and behaviour.

Studies Applying Modified or Extended Forms of the Theory of Reasoned Action to Condom Use Behaviour

As seen in Chapter 2, the adequacy of the theory of reasoned action has been questioned after Ajzen (1991) conceded that a significant proportion of the variance in behaviour is not predicted by the theory of reasoned action, and the theory is therefore open to the inclusion of other variables. In line with Ajzen’s thinking, Morrison et al. (1995) examined the utility of the original theory of reasoned action and its augmented version for understanding condom use decisions among heterosexual adults who were at high risk for sexually transmitted diseases and HIV infection. The finding of this longitudinal study was that attitudes and norms about condom use were significantly and strongly related to condom use intentions for both steady and casual partners. Women were under more normative influence than men, a possible indicator of their weaker role in relationships. Self-efficacy was more strongly related to condom use behaviour with steady than casual partners.

Theories of Reasoned Action and Planned Behaviour and

Monogamy Only two studies were found on monogamous behaviour and condom use. In an American study motivated by the preponderance of HIV/AIDS research focusing on women, Beadnell et al. (2008) were interested in heterosexual men’s sexual decision-making in relation to monogamy and condom use. They applied the theory of reasoned action by examining three safe sex strategies, namely monogamy, steady-partner condom use and intention to use a condom with casual partners. In addition, they examined intrapersonal, interpersonal and cultural variables not specified 78 by the theory of reasoned action, but that are known to be predictive of safe sex, especially understanding the ways in which they affect behaviour.

Sample Bias

The majority of the studies reviewed (79%) were conducted in North America, Europe and Australia, and used, as research participants, sections of their populations considered to be “high-risk”. It appears that these high-risk groups in those populations tend to be predominantly adolescents who also happen to be undergraduate university students (for example, Abraham et al., 1999; Boldero et al., 1992; Boyd & Wandersman, 1991), homosexual men (Fisher et al., 1995; Kasprzyk et al., 1998), heterosexual minorities (Bogart et al., 2000; Morrison et al., 1995) and injecting substance users (Bryan et al., 2003; Kasprzyk et al., 1998). It is apparent from the examples provided that most of the research conducted uses easily accessible convenience samples in the researchers’ work environments.

CONTENTS :

• CHAPTER 1: INTRODUCTION: OVERVIEW OF THE RELEVANCE OF THEORY-BASED RESEARCH ON HIV/AIDS HEALTH PROMOTION
  • 1.1 Background to the Study
  • 1.2 The Concepts of Health Behaviour and Health Promotion
  • 1.2.1 Health Behaviour
  • 1.2.2 Health Promotion
  • 1.3 Health Promotion in the Workplace
  • 1.4 Behavioural Theory in HIV/AIDS Health Promotion
  • 1.4.1 Health Belief Model
  • 1.4.2 Transtheoretical Model or Stages of Change Model
  • 1.4.3 Precaution Adoption Process Model
  • 1.4.4 Theory of Reasoned Action and Theory of Planned Behaviour
  • 1.5 Motivation for the Study
  • 1.6 Operational Definitions
  • 1.6.1 Health Behaviour
  • 1.6.2 Health Promotion
  • 1.7 Research Objectives
  • 1.8 Summary
  • 1.9 Outline of the thesis
• CHAPTER 2: THEORETICAL BACKGROUND: THE THEORY OF REASONED ACTION AND THE THEORY OF PLANNED BEHAVIOUR
  • 2.1 Theory of Reasoned Action
  • 2.1.1 Determinants of Behavioural Intentions
  • 2.1.2 Predicting Behaviour from Intentions
  • 2.1.3 Determinants of Attitudinal and Normative Components
  • 2.2 Theory of Planned Behaviour
  • 2.2.1 Behavioural Beliefs and Attitudes towards Behaviour
  • 2.2.2 Normative Beliefs and Subjective Norms
  • 2.2.3 Control Beliefs and Perceived Behavioural Control
  • 2.3 Critique of the Theory of Reasoned Action and the Theory of Planned Behaviour
  • 2.4 Proposed extension of the Theories of Reasoned Action and Planned Behaviour
  • 2.5 Summary
• CHAPTER 3: LITERATURE REVIEW: HIV/AIDS RESEARCH BASED ON THE THEORY OF REASONED ACTION AND THE THEORY OF PLANNED BEHAVIOUR
  • 3.1 Research Approaches to HIV/AIDS Prevention
  • 3.1.1 Intervention Studies
  • 3.1.2 Descriptive Surveys
  • 3.1.3 Theory-based Research on HIV/AIDS-preventive Behaviour
  • 3.2 HIV/AIDS Research Based on the Theory of Reasoned Action and the Theory of Planned Behaviour
  • 3.2.1 Theories of Reasoned Action and Planned Behaviour and Condom Use
  • 3.2.2 Theories of Reasoned Action and Planned Behaviour and Voluntary Counselling and Testing
  • 3.2.3 Theories of Reasoned Action and Planned Behaviour and Monogamy
• CHAPTER 4: ELICITATION STUDY
  • 4.1 Sample and Sampling Procedure
  • 4.2 Elicitation Questionnaire Design
  • 4.2.1 Aim
  • 4.2.2 Description and Measurement
  • 4.2.3 Administration
  • 4.2.4 Scoring
  • 4.3 Elicitation Study Findings
  • 4.3.1 Condom Use Behaviour
  • 4.3.2 HIV Testing Behaviour
  • 4.3.3 Monogamous Behaviour
  • 4.4 Intervention Implications of the Elicitation Study Findings
  • 4.4.1 Condom Use Intervention Implications
  • 4.4.2 HIV Testing Intervention Implications
  • 4.4.3 Monogamy Intervention Implications
  • 4.5. Summary
• CHAPTER 5: RESEARCH METHODOLOGY
• CHAPTER 6: RESULTS
• CHAPTER 7: DISCUSSION
• CHAPTER 8: CONCLUSION: REFLECTION ON LESSONS LEARNED
  

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THE APPLICATION OF THE THEORIES OF REASONED ACTION AND PLANNED BEHAVIOUR TO A WORKPLACE HIV/AIDS HEALTH PROMOTION PROGRAMME