The Moderated Influence of Perceived Behavioral Control on Intentions Among the General U.S. Population: Implications for Public Communication Campaigns

Abstract

This study reports results from a large population-based survey of U.S. adults showing perceived behavioral control (PBC) moderations of associations between (a) attitude and intention and (b) perceived norms and intention to engage in 6 health behaviors. Results are based on data collected from a nationally representative sample of U.S. adults ages 40–70 (N = 2,489) and extend understanding of how behavioral theory can be used to guide the design and evaluation of health communication campaigns. Ordinary least squares regression analyses show evidence of a significant positive PBC moderation of (a) attitude and intention and (b) perceived norms and intention such that attitude or perceived norms toward the behavior is more strongly associated with behavioral intention among participants reporting higher levels of PBC. Implications for message design and the evaluation of communication campaigns are discussed.

Acknowledgments

We are grateful to Dr. Robert C. Hornik and the reviewers for their insightful comments on earlier drafts of the article.

Funding

We acknowledge the funding support of the National Cancer Institute’s Center of Excellence in Cancer Communication located at the Annenberg School for Communication, University of Pennsylvania (P50-CA095856-05).

Notes

¹ Previous studies have used limited samples (between 139 and 461 participants in six studies reviewed by Yzer (2007), and an average sample size of 268 in a meta-analysis by Boudewyns, 2013), a factor that may “have hurt robustness of the demonstrated effects” (Yzer, 2007, p. 115).

² Models testing screening behaviors also excluded respondents who reported never having heard of colonoscopy screening and prostate-specific antigen (PSA) testing. Samples were further restricted for analyses of behaviors that were only recommended for certain subgroups. For example, the analysis for mammography included only women, for PSA only men, and for colonoscopy only participants older than the age of 50. In addition, for the dieting analysis we only included the 67% of our sample who reported an unhealthy body mass index (body mass index >25) indicating overweight or obesity.

³ More specifically, these behaviors were defined using 2005 guidelines from the American Cancer Society: (a) getting a colonoscopy in the next year (or when recommended), (b) getting a mammogram in the next year (or when recommended; women only), (c) getting a PSA in the next year (or when recommended; men only), (d) eating five or more servings of fruits and vegetables most days in the next year, (e) exercising at least three times in most weeks over the next year, and (f) dieting to control weight.

⁴ It should be noted that descriptive norms measures were slightly varied for gender-specific screening behaviors (e.g., getting a mammogram, PSA) because of the potential for important others to be members of the opposite sex. For example, it would not make sense to ask women if their husbands (who might represent important others) adhere to recommendations for getting mammograms.

⁵ For example, respondents who reported previously having a colonoscopy were asked, “How likely is it that you will have a colonoscopy when it is next recommended?” Respondents who reported never having had a colonoscopy or noted not having had one within the past 10 years were asked, “How likely is it that you will have a colonoscopy in the next year?”

Additional information

Funding

We acknowledge the funding support of the National Cancer Institute’s Center of Excellence in Cancer Communication located at the Annenberg School for Communication, University of Pennsylvania (P50-CA095856-05).