1. Applying the Theory of Planned Behavior to Predict Intention to
Consume Alcohol Among Female Adolescents
with Type 1 Diabetes Mellitus
Lauren Borchardt,1 Claire Guidinger, 1 Ashley Moss, M.S., 1 Astrida S. Kaugars, Ph.D., 1 Rachel N. Greenley, Ph.D.2
1 Marquette University, 2Rosalind Franklin University of Medicine and Science
Research suggests that adolescents with chronic illness, such as Type 1 Diabetes Mellitus (T1DM), engage in health risk behaviors at equal or greater frequency than their healthy peers (Kunz et al., 2013).
Alcohol is by far the most commonly used intoxicating substance consumed by adolescents in the United States (Barnard et al., 2012).
Studies show that approximately 26% of adolescents with T1DM report alcohol use; however, the potential health risks associated with alcohol use are higher for individuals with diabetes than the general population (Barnard et al., 2012).
The Theory of Planned Behavior (TOPB) states that one’s attitude toward a behavior, perceived subjective norm, and perceived behavioral control influence intention toward an action, which predicts future behavior engagement (Ajzen & Fishbein, 1980).
This study hypothesized that personal attitudes, perceived subjective norms, and perceived behavioral control regarding alcohol use are interrelated and can be used to predict future intention to engage in alcohol use among female adolescents with T1DM.
Participants: 51 female adolescents (Mage = years, age range: years) diagnosed with T1DM for at least one year prior to participation
Adolescents reported on:
Personal beliefs regarding children their age drinking alcohol (modified from Nash et al., 2005)
Perceived parental beliefs regarding children their age drinking alcohol (modified from Nash et al., 2005)
Perceived peer beliefs regarding children their age drinking alcohol (modified from Nash et al., 2005)
Perceived self-control to resist use of alcohol across various situations (modified from Nash et al., 2005)
Future intention to consume alcohol or become intoxicated (modified from Cromer et al., 1990)
*p < .05, **p < .01
As predicted, personal beliefs were positively correlated with perceived parental and peer regarding alcohol use.
Greater personal, parental, and approval of alcohol use were associated with lower perceived behavioral control to resist alcohol consumption in the future.
Greater personal and peer approval of alcohol use was associated with greater intention to use alcohol in the future.
A linear regression was used to predict future intention to consume alcohol from personal beliefs, perceived subjective norms (parental and peers) and perceived behavioral control.
The overall model was significant (F(4, 46)= 14.96, p < .01) and accounted for nearly 57% for variance of future intention to use alcohol. Perceived peer beliefs and perceived behavioral control to abstain from alcohol use significantly predicted future alcohol use intention.
The results of this study are consistent with the associations proposed by the Theory of Planned Behavior model and highlight the importance of considering perceived self-control and peer influence with regards to alcohol use among adolescents with T1DM.
Clinical Implications:
Results of the current study indicate that numerous factors variably predict intention to use alcohol.
Thus, when attempting to decrease the likelihood of adolescents with T1DM engaging in alcohol use in the future, it may be critica lto emphasize the importance of considering the impact peers and perceived self-control may have in adolescent decision making and behavior.
Future Research:
Future research should examine how actual alcohol use is predicted by TOPB constructs, rather than only considering current intention to engage in alcohol use in the future.
Future research should also consider whether other risk behaviors, such as illicit drug use and sexual activity, among adolescents with T1DM are influenced by the same constructs represented in the Theory of Planned Behavior.
Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.
Barnard, K., Sinclair, J.M.A, Lawtom, J., Young, A.J., & Holt, R.I.G. (2012). Alcohol-associated risks for young adults with Type 1 diabetes mellitus. Diabetic Medicine, 29(4),
Cromer, B. A., Enrile, B., McCoy, K., Gerhardstein, M. H., Fitzpatrick, M., Judis, J. (1990). Knowledge, attitudes and behavior related to sexuality in adolescents with chronic disability. Developmental Medicine and Child Neurology, 32,
Kunz, J.H., Greenley, R.N., Mussatto, K.A., Roth-Wojcicki, B., Miller, T., Freeman, M.R., & Lerand, B.R. (2013). Personal attitudes, perceived social norms, and health risk behavior among female adolescents with chronic medical conditions. Journal of Health Psychology, 19(7), 1-10.
Nash, S.G., McQueen, A., & Bray, J.H. (2005). Pathway to adolescent alcohol use: family environment, peer influence, and parental expectations. Journal of Adolescent Health, 37,
Introduction
Results
Discussion
Table 1. Pearson Product Moment Correlations Among TOPB Constructs
Parental Beliefs
Peer Beliefs
Behavioral Control
Intention to Engage
Personal Beliefs
.39**
.73**
-.70**
.55**
.43**
-.29*
.26
-.45**
.52**
-.71**
Future Behavior
Intention to Engage
Personal Attitudes
Subjective Norms
Behavioral Control
Figure 1. Theory of Planned Behavior
Table 2. Linear Regression Predicting TOPB Constructs
Hypothesis
Variable B
SE B β
Personal Beliefs
-.22
.24
-.17
Parental Beliefs
-.04
.23
-.02
Peer Beliefs
.37
.16
.35*
Perceived Behavior Control
-1.51
.31
-.68** R2
.57 F
14.96**
References
Method
Acknowledgements
Marquette University
Children’s Hospital of Wisconsin/Medical College of Wisconsin
Office of Research and Sponsored Programs
Graduate and Undergraduate Research Assistants
Participating Families
Department of Pediatric Endocrinology
Diabetes Clinic Staff