How much behaviour change should we expect from health promotion campaigns targeting cognitions? An approach to pre-intervention assessment

Abstract

For those planning interventions based on social cognition models, it is usually not clear what impact on behaviour will follow from attempts to change the cognitions specified in these models. We describe a statistical simulation technique to assess the likely impact of health promotion targeting Theory of Reasoned Action (TRA)-based predictors of condom use. We apply regression-based simulation techniques to data from the SHARE project (n = 756 Scottish adolescents) to assess the potential impact of changes in cognitions on condom use. Results support the predictive utility of TRA-based models of psychological antecedents of condom use but also provide a cautionary warning about the magnitude of behaviour change likely to be achieved by interventions based on such models.

Keywords:

• Theory of Reasoned Action
• intervention simulation
• sexual behaviour
• young people
• HIV/AIDS

Acknowledgements

The SHARE programme was funded by the Medical Research Council. The authors wish to think Daniel Wight, Marion Henderson and colleagues at the Medical Research Council Social & Public Health Sciences Unit, Glasgow, UK for access to the SHARE dataset and their helpful comments. We also thank Patrick Sturgis, University of Surrey, for introducing the first author to the political science literature on modelling information effects and two anonymous reviewers for helpful comments on an earlier draft of this manuscript.