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Theories & Approaches

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How Can I Use the TRA in my Setting?

If you have identified a behavior — such as condom use, in the examples above — that you would like to understand and influence in a more effective way in a particular population, the TRA is likely to offer some useful insights.

However, applying the TRA is a relatively intense exercise, requiring an investment of time and other resources to explore and identify the many possible attitudes and norms and to develop and analyze scales and measures. (In other words, it may well be worth the effort but do not rely on the TRA for a quick study or instant set of revelations!) Depending on the staffing configuration of your setting, developing and analyzing measures may require some specific skills that may not be readily available (e.g., statistical analyses).

The first step is to conduct some in-depth, open-ended interviews with representatives of the population of interest. Aim for at least 15-20 people from the population you're interested in, half of whom have performed the behavior (or intend to), and half of whom have not.

Ask the group to describe any positive or negative reasons for performing the behavior. This will yield insights about their attitudes towards the behavior (e.g., "If my partner uses a condom, I won't get pregnant").

Next, ask about the individuals or groups they would listen to regarding the behavior — either pro or con (e.g., "My boyfriend told me that he does not like to use condoms. . . " or "If you ask someone to use a condom they will think you do not trust them").

Using the results of this initial interview, identify the attributes or outcomes of the behavior (positive or negative) according to the participants, and which people or groups influence them (again, pro or con). Work with this list to develop a questionnaire that attaches scales to each factor you have identified. These might include multiple factors in each of the following categories, depending on the behavior, its complexity, and the range of attributes and opinions: positive or negative attributes of the outcome or behavior, whether different individuals or groups might approve or disapprove of the behavior in question, and whether the person whose behavior should change is influenced by those opinions).

Beliefs about the likelihood that a behavior will lead to particular outcomes would be measured from "unlikely" to "likely" or "agree" to "disagree." (Using a scale that starts on either side of 0 — from -3 to +3, for example — is a way around the problem of double negatives: a belief that a behavior won't result in a negative outcome is the same as a positive contribution to the person's attitude about that behavior.)

As in the examples of research studies above, some of these scales (such as "Peer Deviance") may already exist. Once the scores are obtained, the belief score about each outcome is multiplied by the evaluation rating and these totals are added for all the outcomes for a given behavior. (Example: Quitting smoking is unlikely to make me gain weight: outcome score of -3. Gaining weight would be very bad: evaluation score of -3. The two multiplied together are +9: a positive effect, because although I am worried about gaining weight and evaluate that as a strong negative consequence, I also don't think quitting smoking is going to cause this negative consequence.)

To measure subjective norms, each influential person (e.g., my physician) or group (e.g., my friends) must be rated in two ways: how much the influential person approves or disapproves of the behavior and whether or not the respondent wants to behave in a way that is consistent with the influential person's approval (i.e., motivation to comply).

For example, if you were trying to quit smoking, an influential person might be your physician. On a scale (e.g., from -3 to +3), you could say that you believe it is very likely that your physician would approve of your attempt to quit smoking: a +3. You could go on to say that, in general, you try to follow your physician's advice and do what she thinks is best for you — on a scale of 1 to 7. Let's say that in this case, it would be 7. The "subjective norms" score is a combination of the two measures, multiplied together (3 x 7 = 21). These scores are created for each influential person/group for each respondent.

Next comes more math and statistics: to test whether the attitude, subjective norms, and intention are indeed related, you will have to run a multiple regression. This will reveal the effect of attitude and subjective norms in terms of intentions, predicting later behavior. Some behaviors may be completely affected by attitude, others by subjective norms, and some by one or both depending on the population.

Correlation and analysis of variance — two other statistical analysis techniques — can also help determine which specific beliefs are most strongly associated with the intentions and behaviors, guiding intervention efforts to change them. For example, a study of Planned Behavior Theory (an expanded version of TRA) found that among Spanish-dominant youth (as opposed to those who use English or a combination of English and Spanish), attitudes, perceived partner approval, self-pride, and parental pride significantly affected intentions to engage in sex in the next three months. Attitudes, subjective norms, self-efficacy, partner and parental approval, and impulse control beliefs were predictors of intentions to use condoms.

The researchers suggested that identifying the specific beliefs that predict sexual risk and protective behaviors could lead to the design of culturally and linguistically specific interventions that address these beliefs for Latino youth who communicate predominantly in Spanish.6

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6 Villarruel, AM, Jemmott, JB, Jemmott, LS, and Ronis, DL. 2004. Predictors of sexual intercourse and condom use intentions among Spanish-dominant Latino youth. Nursing Research 53(3); 172181.