The role of theory in developing effective interventions: Implications from Project SAFER

This paper summarizes the results of project SAFER, in which a revised integrated theoretical model was used to predict and understand condom use intentions in seven non-overlapping groups at high risk for acquiring or transmitting HIV and other STDs. Despite highly significant demographic, behavioural and psychosocial differences among the seven groups, the model successfully predicted intentions in all seven groups (R ranged from 0.70 to 0.81). Consistent with expectations, the relative importance of the five immediate psychosocial determinants of intention (i.e. attitude, subjective norms, partner norm, perceived behavioural control and the mean of weighted control beliefs) varied across both populations and behaviours. Although the critical target beliefs for a behaviour change intervention also varied across populations and behaviours, two beliefs emerged as potential targets for a national campaign. A distinction is made between identifying critical target beliefs and developing interventions to change those beliefs. Strategies for changing beliefs are discussed.