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PubMed1984

Intent to participate in worksite health promotion activities: a model of risk factors and psychosocial variables.

A model of risk factors and psychosocial variables that should enhance the prediction of participation in worksite health promotion programs was evaluated by a sample survey (10% random sample) of approximately 13,000 State employees in South Carolina. The response rate for the survey was 66.3%, n = 854. A split sample strategy was employed to develop and then validate the psychosocial model. Degree of satisfaction with one's current status and intent to change it were assessed in six health areas: weight, nutrition, exercise, cigarette smoking, alcohol consumption, and the handling of stress and tension. In each area, a known risk factor was used to predict degree of satisfaction and intent to change. Variables from the psychosocial model were added in a step-wise regression procedure. The key variables in the psychosocial model were Personal Efficacy (specific to each of five areas), Job Stress, Trait Anxiety, and Health Knowledge. Risk factors contribute significantly to the prediction of dissatisfaction and intent to change in all areas except cigarette smoking and nutrition. The model of psychosocial factors contributed significantly to the prediction of dissatisfaction and intent to change in all areas. Personal Efficacy was significantly related both to dissatisfaction and intent to change, whereas the Job Stress and Anxiety variables were more effective in predicting dissatisfaction than intent to change. Health Knowledge had little direct or interactive effects on dissatisfaction or intent to participate. The implications of these findings for health promotion programs were examined.

Adolescent↗

PubMed2006

From recommendation to action: psychosocial factors influencing physician intention to use Health Technology Assessment (HTA) recommendations.

BACKGROUND: Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy-makers. Using a psychosocial theoretical framework, this study aimed at exploring the factors affecting physician intention to adopt HTA recommendations. The selected recommendations were prioritisation systems for patients on waiting lists for two surgical procedures: hip and knee replacement and cataract surgery. METHODS: Determinants of physician intention to use HTA recommendations for patient prioritisation were assessed by a questionnaire based upon the Theory of Interpersonal Behaviour. A total of 96 physicians from two medical specialties (ophthalmology and orthopaedic surgery) responded to the questionnaire (response rate 44.2%). A multiple analysis of variance (MANOVA) was performed to assess differences between medical specialties on the set of theoretical variables. Given the main effect difference between specialties, two regression models were tested separately to assess the psychosocial determinants of physician intention to use HTA recommendations for the prioritisation of patients on waiting lists for surgical procedures. RESULTS: Factors influencing physician intention to use HTA recommendations differ between groups of specialists. Intention to use the prioritisation system for patients on waiting lists for cataract surgery among ophthalmologists was related to attitude towards the behaviour, social norms, as well as personal normative beliefs. Intention to use HTA recommendations for patient prioritisation for hip and knee replacement among orthopaedic surgeons was explained by: perception of conditions that facilitated the realisation of the behaviour, personal normative beliefs, and habit of using HTA recommendations in clinical work. CONCLUSION: This study offers a model to assess factors influencing the intention to adopt recommendations from health technology assessment into professional practice. Results identify determinant factors that should be considered in the elaboration of strategies to support the implementation of evidence-based practice, with respect to emerging health technologies and modalities of practice. However, it is important to emphasise that behavioural determinants of evidence-based practice vary according to the specific technology considered. Evidence-based implementation of HTA recommendations, as well as other evidence-based practices, should build on a theoretical understanding of the complex forces that shape the practice of healthcare professionals.

Journal Article↗

PubMed1998

Metacognition in action: the importance of implementation intentions.

When people furnish their goal intentions ("I intend to attain the goal x!") with implementation intentions ("I will initiate the goal-directed response y when situation z arises!"), the initiation of goal-directed responses becomes automatized. As this type of automaticity stems from a single act of will, it is referred to as strategic automaticity. We report various studies demonstrating that strategic automaticity leads to immediate and efficient responding, which does not need a conscious intent. In addition, the situational cues specified in implementation intentions seem to be easily detected and readily attended to. Further research indicates that the strategic automaticity induced by implementation intentions also helps resist temptations and fight bad habits. Following Nelson's (1996; Nelson & Narens, 1994) model of metacognition, we suggest that goal intentions and, in particular, implementation intentions are important components of the metacognitive control of action geared toward its initiation, continuation, and termination.

Journal Article↗

PubMed1975

Therapy of intention myoclonus with L-5-hydroxytryptophan and a peripheral decarboxylase inhibitor, MK 486.

Three patients with postanoxic intention myoclonus, two patients with intention tremor, and one patient with cerebral palsy were administered L-5-hydroxytryptophan (L-5HTP), the precursor of serotonin, in combination with MK 486, a peripheral amino acid decarboxylase inhibitor. L-5HTP combined with MK 486 were potent long-term therapeutic agents for postanoxic intention myoclonus, but had no effect on intention tremor or cerebral palsy. These drugs were well-tolerated by the patients, and more effective than any other known therapy for intention myoclonus. Cerebrospinal fluid concentration of 5-hydroxyindoleacetic acid, the main catabolite of serotonin, appeared low in two patients with intention myoclonus and increased markedly during drug therapy. Postanoxic intention myoclonus may be causally related to a deficiency of brain serotonin.

5-Hydroxytryptophan↗

PubMed1984

Predicting undergraduates' intentions to drink.

Sex-linked differences in motivation to drink were studied with Fishbein's model of the relationship between attitudes and behavior. Fishbein's model was revised so that personal normative beliefs were seen as measuring ideal behavioral intentions (what the person intended given real-world constraints) rather than personal norms. A total of 101 college students (53 women) completed a questionnaire. Also, 10 additional students (five women) were interviewed to determine referents whose expectations were salient for the present sample. Both attitudes and social normative beliefs (SNB) correlated significantly with ideal behavioral intentions (IBI); IBI was able to be predicted from the weighted sum of attitudes and SNB. IBI correlated significantly with actual behavioral intentions and accounted for the majority of the variance in actual intentions to drink. Support for the revision of Fishbein's model was shown by the direct effect of attitude on women's intentions to drink. The lack of mediation of attitudes by IBI showed that IBI function differently from actual intentions. The revised model was shown to be very successful in predicting intentions to drink, and in exploring gender and cultural differences therein.

Adult↗

PubMed2003

Are "accidental" gun deaths as rare as they seem? A comparison of medical examiner manner of death coding with an intent-based classification approach.

OBJECTIVES: Unintentional firearm death is often considered a nearly negligible proportion of overall gun death. These rates are based on medical examiner (ME) and coroner death classifications, which affect derived epidemiologic data and subsequent prevention measures. The aim of this study was to compare the proportion of pediatric unintentional gun deaths in Miami-Dade County based on manner of death coding by the ME with an intent-based classification of child gun deaths. METHODS: ME and police records for all pediatric firearm fatalities in Miami-Dade County from 1994 to 1998 were reviewed. The ME's assignment of manner of death as homicide, suicide, or accident was compared with an intent-based classification of intentional homicide, intentional suicide, and unintentional firearm death based on expressed or implied evidence of intent to harm. RESULTS: There were 123 pediatric firearm deaths in Miami-Dade County from 1994 to 1998. A significant difference between ME coding and the intent-based classification was found for homicide (94 vs 78) but not for suicide. A significant difference was also found between the ME's coding for "accident" and the investigator's classification of "unintentional" firearm death (4 vs 26). CONCLUSIONS: The incidence of unintentional pediatric firearm deaths is significantly underreported by the Miami-Dade County ME when the classification of "accidental" firearm death is used. Reviewing the manner of death classification criteria or establishing an intent code on official death documentation is recommended. Furthermore, clinicians should be aware that the true incidence of unintentional gun death may be higher than that reported as accidental.

Accidents↗

PubMed2001

The theory of planned behavior as related to intention to exercise and exercise behavior.

In a previously reported study we sought to assess the usefulness of the theory of planned behavior in explaining the exercise behavior of 73 adults enrolled in an exercise program over a 5-mo. period. The correlation between scores on Intention to Exercise and Exercise Behavior was moderate and inverse, conflicting with a primary tenet of the Theory of Planned Behavior. In this analysis of the data we sought to explain that finding by partitioning participants into groups based on a median split of their scores on Intention to Exercise and Exercise Behavior. Using the four Intention by Behavior groups as independent variables and scale scores as dependent variables, post hoc tests for Fitness Attitude showed significant differences only when High Intention conflicted with Low Intention, irrespective of Exercise Behavior. Perceived Behavioral Control showed opposite tendencies, i.e., differences were significant when High Behavior conflicted with Low Behavior, irrespective of Intention to Exercise. We conclude that Perceived Behavioral Control defines one's ultimate Exercise Behavior over a 5-mo. period while scores on Fitness Attitude define Intentions to Exercise.

Adult↗

PubMed1999

The activation of unrelated and canceled intentions.

The intention superiority effect is the finding that intentions to perform an activity are stored in a heightened state of activation. The effect has also been generalized to the finding that once an intention is fulfilled, it is inhibited relative to more neutral material about which no intentionality has been formed. In two experiments, we tested some ecological and naturally occurring situations taken from the literature on prospective memory and demonstrated that they have consistent consequences for the activation level of an intention. In Experiment 1, a constellation of unrelated activities displayed heightened activation prior to completion and displayed inhibition after completion. In Experiment 2, canceling the intention resulted in inhibition just as completing the intention does in this paradigm. The results are discussed in terms of their practical and theoretical importance to theories of prospective memory.

Humans↗

PubMed1999

Intention to learn results of genetic testing for hereditary colon cancer.

INTRODUCTION: This report investigates the correlates of intention to find out genetic test results in colorectal cancer patients undergoing genetic counseling and testing for hereditary nonpolyposis colon cancer. Specifically, we investigated whether intention to learn genetic test results was associated with sociodemographic factors, medical history, psychosocial factors, attitudes, beliefs, and decisional considerations related to genetic testing. MATERIALS AND METHODS: Among 342 colorectal cancer patients who went through an informed consent process and gave blood for genetic testing and who were eligible for a psychosocial questionnaire study, 269 cases completed a baseline interview. Patients were contacted in person during a routine clinic visit or by letter and follow-up telephone call and were interviewed either in person or by telephone. RESULTS: In univariate analysis, intention to learn test results was positively associated with income, quality of life, a belief that being tested will help family members prevent cancer, being worried about carrying an altered gene, and a belief that one has the ability to cope with test results. It was negatively associated with a belief that genetic counseling is too much trouble relative to the benefits. Intention also was positively associated with scales measuring the pros of learning test results and the pros of informing relatives about test results; it was negatively associated with the cons of learning test results. In multivariable analysis, the belief that testing would help family members prevent cancer, being worried about carrying an altered gene, and the pros of learning test results remained statistically associated with intention when other variables were included in the model. CONCLUSIONS: Our findings showed that the positive aspects of genetic testing were more strongly associated with intention than were the negative aspects. They also showed that persons who stated an intention to learn their genetic test results were more likely than persons who did not to affirm both the benefits and the importance of such testing. These results are consistent with the literature on psychosocial aspects of genetic testing for breast cancer.

Adaptation, Psychological↗

PubMed1999

Managers' leadership and critical care nurses' intent to stay.

BACKGROUND: Cyclical fluctuations in turnover of critical care nurses are a large and complex problem. Managers' leadership characteristics may be a determinant of critical care nurses' intent to stay in the job. OBJECTIVE: To examine the direct and indirect effects of nurse-managers' characteristics of power, influence, and leadership style on critical care nurses' intent to stay in the nurses' employment positions. METHODS: The sample was 255 staff nurses in intensive care units at 4 urban hospitals. Established instruments with sound reliability and validity were used to assess the predictor, intervening, and outcome variables. Path analysis was used to examine the relationships in a conceptual model of intent to stay. RESULTS: The model explained 52% of the variance in intent to stay, and managers' characteristics were significant at each stage. Managers' position power and influence over work coordination had a direct link to intent to stay; structuring expectations and consideration contributed indirectly through the variables of instrumental communication, autonomy, and group cohesion. Instrumental communication, autonomy, and group cohesion decreased job stress and thus increased job satisfaction. Job satisfaction was directly linked with intent to stay. CONCLUSIONS: Inclusion of nurse-managers' characteristics explained more variance in intent to stay than did previous models. Managers with leadership styles that seek and value contributions from staff, promote a climate in which information is shared effectively, promote decision making at the staff nurse level, exert position power, and influence coordination of work to provide a milieu that maintains a stable cadre of nurses.

Adult↗

PubMed1990

The relationship of attitude, subjective norm, and behavioral intent to the documentation behavior of nurses.

Ajzen and Fishbein's theory of reasoned action was used to assess the relationship of nurses' attitude, subjective norm, and behavioral intention to their documentation behavior. Attitudes, subjective norms, and behavioral intentions toward documentation were elicited from 108 staff nurses. Documentation behavior was based on what should be documented in any hospitalized patient's chart during a shift. This exploratory model was analyzed with LISREL VI. The overall fit of the final model to the data was good, as judged by a chi-square (df = 7, p = .845). The total coefficient of determination for the structural equation was .461. Attitude toward documentation did not relate significantly to intention to document optimally. Subjective norm did have a significant effect on behavioral intent. Attitude and subjective norm accounted for 46.1% of the variance in behavioral intent. Behavioral intent had a significant effect on documentation behavior, accounting for 15.2% of the variance. It appears that subjective norm, which is the influence of others, is what directs the intention to document and thus relates to subsequent documentation. Recommendations for practice include the communication of high ideals and expectations of important others to the staff nurse in order to improve the quality of documentation.

Attitude of Health Personnel↗

PubMed1989

Predicting changes in teenage drug use: the role of intention-behavior discrepancy.

This research investigated the role of intention-behavior discrepancy in predicting changes in drug use by American teenagers. The tested behavior included drinking alcohol, smoking cannabis, and taking hard drugs. Data were collected from 1,177 young adolescents at two time points separated by one year. Two sets of analysis were performed--a multitrait-multimethod latent variable model and longitudinal analyses. The results of longitudinal analyses indicated that, although young adolescents were legally and socially prohibited from engaging in drug-taking activities, some of them intended to use drugs. This discrepancy between behaviors and intentions decreased neither drug-taking behaviors nor intentions to use drugs over time; on the contrary, it increased adolescents' illegal drug use and intention to engage in such behaviors as predicted by Brehm's reactance theory. This discrepancy factor was a better predictor of later drug-taking behavior and positive intentions to use drugs than early intentions alone. The best predictor of later behavior and intentions was prior drug use.

Adolescent↗

PubMed2006

Condom use among South African adolescents: developing and testing theoretical models of intentions and behavior.

We developed and tested models of intentions and behavior among adolescents from Cape Town, South Africa. Data from 261 participants who completed an initial measure of attitudes, beliefs, and prior behavior were used to develop a model of intentions to use condoms based on the Theory of Planned Behavior (TPB) and additional constructs found to be important in previous research with adolescents. Of the initial sample, 227 (87%) completed a behavioral follow-up 4 months later, and approximately one-third of those (n=72; 44 boys and 30 girls) reported having had sex in the prior 4 months. Data from this smaller sample were used to develop a model of condom use behavior based on intentions (as per the TPB) and the additional sub-population relevant constructs. Analyses generally supported the validity of the TPB in this context for predicting intentions and behavior. HIV knowledge and positive outlook (self-esteem and future optimism) were significantly related to TPB predictors of intentions. Intentions, acceptance of sexuality, and gender were significant predictors of behavior. Implications for the status of the TPB and the design of interventions for South African adolescents are discussed.

Adolescent↗

PubMed2006

Imitation of intentional and accidental actions by children with autism.

To determine whether children with autism (CWA) would selectively imitate intentional, as opposed to accidental actions, an experimenter demonstrated either an "intentional" and an "accidental" action or two "intentional" actions on the same toy [Carpenter, Akhtar, & Tomasello (1998a) Infant Behavior and Development, 21, 315-330]. CWA tended to imitate the experimenter exactly. Children with developmental delay and older typically developing children (TD) reproduced only the intentional action as often as they imitated the experimenter exactly. Younger TD mostly produced only the intentional action. It is concluded that, contrary to comparison groups, the CWA did not show an appreciation of the model's intentions. Results are discussed in terms of theories of social cognition.

Accidents↗

PubMed2006

Informed decision making and prostate specific antigen (PSA) testing for prostate cancer: a randomised controlled trial exploring the impact of a brief patient decision aid on men's knowledge, attitudes and intention to be tested.

OBJECTIVE: To examine the impact of a brief patient decision aid (pDA) on men's knowledge, attitudes and intention to have a prostate specific antigen (PSA) test. To explore the important predictors of intention to be tested in men who received the brief pDA. METHODS: A brief pDA designed to facilitate informed decision-making for men considering PSA testing was developed for the NHS Prostate Cancer Risk Management Programme. Men aged 40-75 years selected from 11 General Practices in England and Wales were randomised to receive either a mailed copy of the brief pDA and a questionnaire (intervention group), or a questionnaire alone (control group). The questionnaire assessed knowledge, attitudes, perceived risk and intention to have a PSA test and, for the intervention group, their perceptions of the brief pDA. RESULTS: Nine hundred and ninety of the men who were eligible for the study returned completed questionnaires (response rate=54%). Men who received the brief pDA had significantly higher knowledge scores (p<0.0001) and less positive attitudes (p<0.0001) regarding PSA testing than men in the control group. There was no significant difference between the two groups in intention to be tested within the next 12 months. 87% of men found the brief pDA was easy to read, 94% considered it contained about the right amount of detail and 94% felt the information was presented in a balanced way. Multivariate analysis identified perceived risk (p<0.0001), perceived benefits of PSA testing (p<0.0001), knowledge (p=0.004), attitude (p=0.007) and age (p=0.01) as the most important independent predictors of intention to be tested amongst men in the intervention group. CONCLUSION: The brief pDA was shown to dramatically increase men's knowledge of the benefits and risks of the PSA test. Men who received the brief pDA were significantly less positive about the PSA test, although there was no difference between the two groups regarding their intention to be tested within the next year. PRACTICE IMPLICATIONS: This brief pDA could serve as an acceptable and low cost adjunct to counselling by the General Practitioner (GP), and should promote informed decision making regarding the PSA test. Further research is required to ascertain the utility of the decision aid during the consultation.

Adult↗

PubMed2003

Obstetricians' attitudes, subjective norms, perceived controls, and intentions on antibiotic prophylaxis in caesarean section.

Over 10% of current births in all countries of the world are delivered by caesarean section. Single-dose ampicillin or cefazolin administered after cord clamping has been proven to be effective for the prevention of post-caesarean infections as indicated in many randomised trials and reviews in the Cochrane Library. This study aimed to determine three determinants of behavioural intention using the theory of planned behaviour: attitudes, subjective norms, and perceived controls. Intentions were examined for five aspects of the use of antibiotic prophylaxis, namely whether or not antibiotics were used, used in all caesarean sections, after rather than before cord clamping, whether ampicillin/cefazolin or broader-spectrum antibiotics were used, and whether single or multiple doses were given. Fifty obstetricians selected from university, regional, and general hospitals in southern Thailand, were surveyed using a questionnaire and in-depth interview. Their intentions to use a single dose and to use in all cases were low, and this was related to negative attitudes and reference groups who did not approve of the single dose. The negative attitude was based on scepticism concerning the applicability of well-equipped trials from the developed world and fear of consequences of post-caesarean infections. Norms carried over from residency training had more long-term influence in their practice than newer information from books or journals. Perceived external controls on their practice were less predictive of intentions. Intentions were only partly predictive of behaviour. Changing attitudes, introducing evidence-based information into residency training and strengthening control systems in the hospital are essential to improve intentions.

Adult↗

PubMed2003

Effects of pro- and anti-tobacco advertising on nonsmoking adolescents' intentions to smoke.

PURPOSE: To determine the effects of pro- and anti-tobacco advertising on nonsmoking adolescents' intention to smoke in a single cohort. METHODS: All ninth graders at seven public high schools were invited to participate in a study on adolescent tobacco use; 59.0% participated (n = 1229; active positive parental consent required). Adolescents who self-identified as never having smoked even a puff of a cigarette (n = 512) completed a self-administered questionnaire that included questions on intention to smoke in the near future and tobacco advertising. Independent variables used to predict intention included exposure to, recognition of, and receptivity and attitudes toward pro-tobacco and anti-tobacco advertising. Potential confounding variables included gender, race/ethnicity, smoking influences (adult household members, siblings, and friends), socioeconomic status, stress, and depression. Data analysis used logistic regression. RESULTS DEMOGRAPHICS: 50.5% female, average age 14.9 +/- 0.4 years old at baseline, and varied race. Those variables found to be significant predictors of intention to smoke included: (positive, or increased intention) recognition of brand of favorite advertisement, willingness to use or wear tobacco-branded products, stress, and having friends who smoke and (negative, or decreased intention) agreement with anti-tobacco advertising and having a live-in father who smokes. CONCLUSIONS: Although anti-tobacco advertising has a protective effect, it was unable to counteract the effects of pro-tobacco advertising in the same cohort.

Adolescent↗

PubMed2006

Linking hearts and minds in couple interactions: intentions, attributions, and overriding sentiments.

This study examined the role of emotion and relationship satisfaction in shaping attributions about a partner's intentions in couple interactions. Using video recall, participants (N = 156 couples) reported on their own and their partner's intentions and emotions during affective moments of a discussion about an upsetting event. Links were found between relationship satisfaction and factor-analytically derived intention and attribution scales. Attributions about a partner's intentions were weakly to moderately correlated with the partner's self-reported intentions. Relationship satisfaction accounted for part of the discrepancy between self-reported intentions and partner attributions. Emotions mediated the links between relationship satisfaction and attributions, suggesting that clinicians working with distressed couples should pay more attention to the emotional climate in which attributions are made.

Adult↗