Preventing HIV Infection

Background on the Model and Theorists

In the Theory of Reasoned Action (TRA), Fishbein and Ajzen (1975, p. 17) propose that attitudes and subjective norms combine to determine behavioral intentions, which in turn cause volitional behaviors. This theory remains the dominant theoretical framework in the attitude-behavior literature (Olson & Zanna, 1993, p. 131). The TRA is used to predict behavior in many contexts, and the model frequently serves as the standard to which new ideas and theories involving attitude and subjective norms are compared.

Recent applications of the TRA have been diverse (Olson & Zanna, 1993, p. 131). The TRA has been used successfully to predict intentions or behaviors associated with smoking (Norman & Tedeschi, 1989, pp. 543-558), seat belt use (Stasson & Fishbein, 1990, pp. 1541-1557), applying for a nursing program (Strader & Katz, 1990, pp. 141-150), and performing testicular self-examinations (Steffen, 1990, pp. 681-702).

The TRA can be considered an expansion of the Health Belief Model (Campbell, et al., 1995, pp. 457-464). In addition to describing an individual's beliefs about health threats and behaviors, the TRA includes the components of subjective social norms about those health behaviors, thus describing a more complete sociocultural context for the behaviors.

Relation of the Model to the Metaparadigm Nursing

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s that the behavior will produce a specific, desirable outcome, and has appropriate resources as well as the opportunity to perform the behavior. Although the sample consisted of undergraduate students, Madden, et al., 1992, p. 9) concluded that "in addition to changing behavior indirectly through behavioral intentions, behavior may be changed by providing a mechanism for enacting plans to change actual control over the behavior." The "mechanism" was perceived behavioral control. There is research support for this desired-outcome hypothesis among older people. Hooker and Kaus (1992, p. 404) using the concept of "possible selves" and found future-self perceptions of "hoped for" and "feared" conditions were more influential upon health behavior than agreement with general health values. Health behaviors of women, more than men, were influenced by outcome expectancies of "feared" conditions (Hooker & Kaus, 1992, p. 403). The TPB adds perceived behavioral control (a concept similar to self-efficacy) as a third predictor of intentions, independent from attitudes and subjective norms, the predictors in the TRA (Ajzen, 1985, pp. 11-39). The addition of perceived control was designed to expand the model to incorporate behaviors not
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Approximate Pages = 14 (250 words per page)

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