Marseille 2007
| Abstract #65 - Step on a Crack, Break your Momma's Back: Rational Thought and Reasoned Action | ||||
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Session: 41.2: Drugs Alcohol and Potions (Parallel) on Tuesday @ 16.30-18.30 in 3 Chaired by Jeffrey Weiss, Biljana Ristic Authors: Presenting Author: Dr Michael Blank - University of Pennsylvania, United States |
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| Additional Authors: Dr Thomas Ten Have, Dr Susan Eachus, Dr Martin Fishbein, | ||||
| Aim: There has been considerable confusion regarding the applicability of the Theory of Reasoned Action/Theory of Planned Behavior (Fishbein, 1967; Ajzen & Fishbein, 1980)to persons whose thought processes may not be rational, such as those with major mental illnesses. This study is intended to examine the utility of the TRA/TPB in predicting behavioral intentions and self-reported risk behaviors for HIV in persons in treatment for Serious Mental Illness (SMI)in community mental health centers (CMHCs) in Philadelphia. | ||||
| Method / Issue: Participants included 138 persons who were enrolled in an experiment designed to intergrate HIV prevention into ongoing, one-on-one case management. All had DSM-IV Axis I diagnoses of a serious mental illness such as schizophrenia or major depression and were either currently sexually active or interested in being sexually active, as well as current or past sustance abuse. Focus groups of these mental health consumers were conducted in an eliciation phase to develop meaures of attitudes, social norms, and self-efficacy for condom use. Cross-sectional data for the current analysis was collected at baseline. The data were fit to the domains inculded in the Theory of Reasoned Action/Theory of Planned Behavior using path analytic techniques. | ||||
| Results / Comments: Results of the path analysis indicated very good fit of the model to the data. R-squared was .67, indicating that much of the variance was accounted for by applying the TRA/TPB. The coefficient between attitudes toward condom use and intentions to use condoms in future sexual encounters was .44 (p > .001), and the coefficient between subjective norms regarding condom use and intentions to use them was .318 (p > .001), while self-efficiacy regarding condom use was unrelated to intentions to use them (r = .092, p > .293). | ||||
| Discussion: These data suggest that the TRA/TPB works well in predicting cross-sectional behavioral intentions in a sample of persons with serious mental illnesses. There has been confusion regarding whether reasoned action required rational thought since these value-expectancy theories were first introduced. To the extent that these participants' rational cognitive processes were disrupted, these data suggest that reasoning need not necessarily be based on rational belief systems,in order to predict behavioral intentions. The implications for HIV prevention among persons with mental illnesses will be discussed. | ||||
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