Integration of five health behaviour models: common strengths and unique contributions to understanding condom use

Abstract

The purpose of this research was to select from the health belief model (HBM), theories of reasoned action (TRA) and planned behaviour (TPB), information-motivation-behavioural skills model (IMB) and social cognitive theory (SCT) the strongest longitudinal predictors of women's condom use and to combine these constructs into a single integrated model of condom use. The integrated model was evaluated for prediction of condom use among young women who had steady versus casual partners. At Time 1, all constructs of the five models and condom use were assessed in an initial and a replication sample (n = 193, n = 161). Condom use reassessed 8 weeks later (Time 2) served as the main outcome. Information from IMB, perceived susceptibility, benefits, and barriers from HBM, self-efficacy and self-evaluative expectancies from SCT, and partner norm and attitudes from TPB served as indirect or direct predictors of condom use. All paths replicated across samples. Direct predictors of behaviour varied with relationship status: self-efficacy significantly predicted condom use for women with casual partners, while attitude and partner norm predicted for those with steady partners. Integrated psychosocial models, rich in constructs and relationships drawn from multiple theories of behaviour, may provide a more complete characterisation of health protective behaviour.

Figures

Figure 1

Hypothesized integrated model. Solid lines represent those included in the pure precursor model. The dashed line represents the residual relationship of Time 1 to Time 2 behaviour.

Figure 2

Estimation of the integrated model for samples 1 and 2. Unstandardized path coefficients, required for cross-group comparisons, are reported. Two coefficients are reported where group differences exist– the first referring to sample 1 and the second to sample2. χ2 (145) = 286.82, p ≤ .001; CFI=.91; SRMR= .08. *p ≤ .05. **p ≤ .01.

Figure 3

Estimation of the integrated model for women with casual and steady sexual partners. Unstandardized path coefficients, required for cross-group comparisons, are reported. Two coefficients are reported where group differences exist– the first referring to women with casual partners and the second to women with steady partners. χ2 (135) = 247.94, p ≤ .001; CFI=.93; SRMR= .08. *p ≤ .05. **p ≤ .01.