1. Theory of Reasoned Action (TRA)
My name is Lindsay Miller and I am going to cover the Theory of Reasoned Action, or TRA, which you read about in the first part of Chapter 4 in the text.
Lindsay Miller
Oregon State University

2. Outline Brief discussion of Value-expectancy theory
Overview of the Theory of Reasoned Action
George’s example from book
Personal example that YOU will help me walk through
Short quiz of TRA
Relationship between TRA and TTI
Before we dive in, I thought I’d let you know what we will be discussing. First there will be a short overview of the value-expectancy theory followed by a brief overview of the theory of reasoned action. Next I will discuss the example from the book, which you may remember focused on the fictional character George. Then I will discuss how TRA or theory of reasoned action is related to TTI, and finally, I will provide you with a personal example that YOU as a class will help me walk through.

3. Value-expectancy TRA has value-expectancy Theory of Planned Behavior
Explains, “how individuals make health-behavior decisions in terms of their expectations or beliefs regarding the health behavior and the value attached to the behavioral health outcome”
Theory of Planned Behavior
The Information-Motivation-Behavioral Skills Model
To begin, I wanted to first discuss the value-expectancy theory which is the theory that TRA is considered to be a part of. Value expectancy theories help explain how individuals make health behavior decisions in terms of their expectations or beilefs regarding the health behavior and the value attached to the behavioral health outcome. The theory of Planned Behavior and the information-motivation-behavioral skills model are also apart of the value expentancy theory, but Stephen will discuss will be presenting on those.

4. Theory of Reasoned Action (TRA) Overview
TRA was developed by Ajzen and Fishbein 1980
2 focuses (constructs)
Beliefs about HBs will shape behavioral intent  Attitude
Social influences will shape behavioral intent  Subjective Norm
The theory of reasoned action or TRA was developed in 1980 by Ajzen and Fishbein and began as a theory of attitude but led to both attitude and behavior. It consists of two focuses. The first is that beliefs about health behaviors will shape behavioral intent, and the second is that social influences will shape behavioral intent. I will cover the premise of behavioral intent a little later.

5. TRA Overview Construct 1:
Attitude: A person’s evaluation of the anticipated positive or negative outcomes associated with engaging in a given behavior.
Consider belief about behavior and evaluate that behavior as good or bad.
7 point scale: -3 to +3
Create attitude about behavior
The first construct, which I mentioned focuses on the fact that ones belief about a behavior will influence intent, begins by considering one belief about the behavior and evaluating that belief as good or bad. This is done on a 7 point scale between -3 and +3. Once the belief is evaluated, an attitude is created. Attitude is defined a a person’s evaluation of the anticipated positive or negative outcomes associated with engaging in a given behavior.
The second construct has to do with normative beliefs, which are the perceptions that an individual has about what others think they should do in regards to said behavior. This is taken from the idea that social costs are likely to be a determanent of behavior, since going against social norms can sometimes be highly detrimental. An example from the book talks about the social cost of being a vegetarian in a farming community. Once The individual creates a normative belief, they would then weigh each normative belief by there motivation to comply with the referent source, or the source of the normative belief. It is also weighted on a normative scale, but this time, between 1-7. Once this is weighted, a subjective norm is created, which is defined as the idea that people are motivated by their perceptions of what is considered normative and acceptable by others. In this sense, it is the equivalent to the attitude about the behavior.

6. TRA Overview Construct 2:
Subjective Norm: The idea that people are motivated by their perceptions of what is considered normative and acceptable by others
Normative belief: The perceptions that an individual has about what others think they should do in regards to the said behavior.
Weigh each normative belief by a person’s motivation to comply with the referent (source of the normative belief)
7 point scale: 1-7
Create Subjective Norm

7. TRA Overview Behavioral Intent:
Key construct in TRA and the last step before the actual behavior
Defined very specifically as,
Time frame for performance of the behavior
And exact description of the action composing the behavior
The desired outcome (target) of the behavior,
The context of the behavior
Example: “intent to use condoms for STD prevention (target) in the next 6 months (time) for every act of penile-vaginal sex (action) with people other than your primary sex partner (context).
The last step and key construct before the actual behavior, is the intent. It is very specifically defined as 1) the time frame for performance of the behavior, 2) the exct description of the action composing the behavior 3)the desired outcome or target of the behavior, and 4 the context of the behavior. For example: intent to use condoms for prevention (the target) in the next 6 months (time) for every act of penil-vaginal sex (action) with people other than your primary sex partner (context). This last step, behavioral intent, is sometimes where the theory breaks, but is probably due to external factors.

8. TRA Diagram

9. George Example from Text
George wants to lower cholesterol levels
Considers few options
Diet change
Exercise
Take cholesterol-lowering drugs
Doc suggests changing diet
TO further explain theory of reasoned action, I will first use the George example from the text, and then as I mentioned earlier, provide you with my own. To review, George, which is a fictional character, has high cholesterol and wants to lower his cholesterol levels. Upon going to the doctor, he is provided with a few options, change his diet, exercise, or take cholesterol- lowering drugs. The doctor suggests that changing his diet will be most effective.

10. George Example – Construct 1
Belief about becoming a vegetarian
May have difficult time finding enough food
Evaluate his belief
Good versus bad
7 point scale: -3 to +3
Not finding enough food (-3)
Create attitude about behavior
In relation to the first construct, or that the belief about the behavior will influence behavioral intent, George considers what he believes in regards to eliminating foods high in cholesterol, or becoming a vegetarian. One consideration is that George may have a difficult time finding enough food, which is then evaluates by weighing the good versus bad. Because George is a thin man, not finding enough food would be considered “bad” to George and thus he weighs it on a 7 point scale (-3 to 3) and determines it to be a -3. He may also consider that eliminating meat will in fact lower his cholesterol, which he considers to be a +3. At this point, he has created several attitudes toward the behavior.
Other examples of the attitudes george has toward becoming a vegetarian are that vegetables are expensive (-3), or may be socially awkward with colleagues (-1), and that a vegetarian diet will reduce the risk of colorectal cancer (+2)

11. George Example Construct 2
People are motivated by their perceptions of what is considered normative and acceptable to others.
Each normative belief is “weighted” by a persons motivation to comply with referent source
7 point scale (1-7)
Georges doctor believes he should take cholesterol-lowering drugs
As I mentioned earlier, The second construct suggests that people are motivated by their perceptions of what is considered normative and acceptable to others. Again, each normative belief is then “weighted” by a person’s motivation to comply with a referent source. Also weighted on a 7 point scale, but instead it is between 1-7.
An example of this is that George considers what his doctor may think about him taking cholesterol lowering drugs. Georges doctor is the referent source, and he believes that his doctor would want him to take the drugs. The weighting is in regards to Georges desire to please his doctor which he considers to be a (+2).

12. Behavioral Intent Last step in the theory before the actual behavior
Intent includes
Time frame for performance
The action composing the behavior
Desired outcome (target)
The context of behavior
Now we have reached the last step before the actual behavior – behavioral intent. Intent is defined by measures that include 1) the time frame for performance, 2) the action composing the behavior, 3) the desired outcome or target, and 4) the context of behavior.

13. Behavioral Intent
Specifics of Health Behavior for George
Action
Target
Context
Time
Get
Prescription for Lipitor
Internist Office
Next 2 months
Use
Fresh Vegetables
In meals cooked at home
Always
Take
Lipitor
Unspecified
Daily
Order
A salad
Eating out
Here is an example, taken from the text, of behavioral intent according to the example of George and adopting his vegetarian diet. For example: George intends to always order a salad when eating out at a restaurant.
Example: George intends to always (time) order (action) a salad (target) when eating out at a restaurant (context).

14. Example – Prehypertension
I go to the doctor, and I am diagnosed with prehypertension (Systolic of mmHg)
Doc suggests I reduce my alcohol consumption.
What is the first construct in TRA?
Create a belief about reducing alcohol
Difficult to not be in a situation with alcohol
Rate low, -2
I have a negative attitude about reducing my alcohol consumption
Lets say that I go to the doctor and am diagnosed with prehypertension. To be diagnosed, I would have to have a systolic blood pressure reading of anywhere between 120 and 139 mmHg. Being prehypertensive puts me at risk for hypertension which can lead to stroke, chronic heart disease and other health conditions. Therefore, the doctor informs me of several methods to controlling my BP and reducing the likelihood of developing hypertension.
Lets also say that I drink, a lot. Although exercising and changing my diet will help lower my BP, which he suggests that I consider, the doctor think that’s reducing my alcohol intake is a method I need to take seriously.
Can anyone tell me what the next step in the theory of reasoned action? I would create a belief about reducing alcohol consumption.
Let’s also say that I am in an active member in a sorority. How would that affect my belief about reducing alcohol?
I would think that it would be pretty difficult to not be in a situation with alcohol, and thus I’m going to rate it pretty low. Therefore, I have created a negative attitude toward reducing my alcohol consumption.
Of course there are other beliefs and attitudes that I can have about reducing my alcohol consumption. I could have a belief that reducing my alcohol consumption will in fact lower my blood pressure which will help me prevent other diseases and I would rate that pretty high, probably a +3.

15. Example - Prehypertension
Construct 2?
Create normative believes and “weigh” them by my motivation to comply with the referent source.
My sorority sisters would NOT want me to reduce my alcohol consumption (+5)
My doctor would want me to reduce my ETOH (+3)
Arrive at Subjective Norm
Next Step?
Do you remember what the second construct is?
People are motivated by what they believe is normal and acceptable by others. What is an example of a referent source in this situation?
Similar to the example about George, my doctor would be my referent. I believe that he would want me to reduce my alcohol and thus I am interested in complying with my doctor, who I have been going to for quite some time, and so I would rate it a +2

16. Example - Prehypertension
Behavioral Intention
Time frame
Action
Target
Context
Action
Target
Context
Time
Drink
Alcohol
At School
Graduate
Use
Low sodium foods
In meals cooked at home
Always
Now that we’ve gone through both of the constructs that lead to behavioral intent, we can discuss intent in regards to my decision to lower my blood pressure. Remember that intent includes the time frame, the action, target and context. An example here is that I plan to always use low sodium foods or food products when cooking meals at home.

17. Smoking – TRA Quiz
Your cousin Norm does not think you should quit (+3).
Subjective Norm
Quitting smoking will save you money. You are a college student with loans.
Beliefs about the behavior and evaluations of that behavior
Your cousin Norm has smoked his entire life and has no health problems. Norm is your best friend, and you trust him.
Normative belief and motivation to comply
Quitting smoking will help you save money to pay your college loans (+3)
Attitude about belief I 2 4 3 1

18. TRA and TTI
Now that we’ve gone through several examples, I can discuss the relationship between TRA and TTI. As we know, the TTI has 3
Here I have the TRA, which are the two constructs, social normative beliefs and attitude toward the behavior in the black box
, It is contained in the proximal levels of causation, meaning that they are under the control of the individual and are considered strong predictors of behavior.
, highlighted in the green box are the streams of influence asocciated with the TRA, Social Influences and cultural environmental influences and those evaluations and expectations influence

19. Summary
As a summary, The theory of reasoned action is an incredibly useful theory for predicting behavior for my interests of physical fitness and nutrition. As the examples illustrated, both topics of interest and the behaviors associated with those topics are highly influenced by both what you believe about it (whether physical fitness and nutrition or diet are good or bad) as well as what others perceive of those behaviors. For instance, diet may be influenced by culture or religion and therefore, the normative beliefs surround those ideas will be based upon what I believe other members of the church or society feel.

20. References
DiClimente, R., & Salazar, L. (2013). Health Behavior Theory for Public Health: Principles, foundations, and applications. Burlington, MA: Jones and Barlett Learning.
Preventing High Blood Pressure: Healthy Living Habits. (2014, July 7). Retrieved October 8, 2014.