Health behaviour advice : cognitive and educational influences
A systematic review showed that the four most common health behaviours studied are smoking, drinking alcohol, diet and exercise. The Theory of Planned Behaviour (TPB) was adopted as a framework for investigating the use of HBA, and use of a methodology called Discriminant Content Validity enabled the validation of a direct estimation method of assessing TPB cognitions, which was then used in each of the following studies. A cross-sectional study with students at two British medical schools, of their intention to give HBA, demonstrated that TPB cognitions successfully predicted intention, as well as allowing comparison between the constructs. Medical students in the early stages of their training had lower perceived behavioural control. An experimental study of the effect of manipulating two types of control on intention to give HBA found that higher actual control over a consultation situation increased intention and that higher personal control was also associated with higher intention. A longitudinal study of medical students during the first phase of their training showed that students displayed a pattern of polarisation, those who had initially negative beliefs became more negative over time, whilst those initially positive became more so. An observational study in a primary care setting (community pharmacy) provided more evidence for the success of the TPB in predicting HBA. Both self-report and actual advice giving behaviour were predicted by TPB constructs. A range of different methodologies and settings have been utilised to demonstrate that the TPB has an important role in predicting whether HBA is given or not, and further studies might utilise these findings to increase rates of HBA both directly and through medical education.