The Theory of Reasoned Action (TRA) is a measurement tool used by researchers, clinicians, and health coaches to assist in determining the likelihood that a patient or intervention group will engage in a particular health associated behavior based on their perceived will-power, and it assesses their attitude toward a behavior, perceived social norm of the behavior, and their perception of their ability to perform the behavior.
The Theory of Planned Behavior (TPB) is based on TRA and it hypothesizes that when someone feels that a behavior is enjoyable and has positive benefits, feels supported by their social network and have others that participate in and model the same behavior, feel like they are in control of and have the ability to meet the demands of the task and are not afraid to partake in the behavior, a person will have strong intentions and be more likely to engage in the behavior.
An example of how this might work or not work is a person finds a certain exercise not enjoyable despite knowing it is good for them, while having encouragement from a doctor to exercise but no friends that engage in the exercise, yet feel exhausted and find the exercise daunting, would lead to having low intentions and not likely to engage in that exercise.
On the opposite spectrum, if one find an exercise like aerobic classes enjoyable, has encouragement and social support from others, and doesn’t mind going to the work-out center, this would likely lead to having strong intentions and exercising with aerobic classes more often.
The primary feature of reasoned action and planned behavior theories is that behavioral intention is the most important determinant of behavior action in that people weigh the pros and cons coupled with personal factors, social influence, and control over the behavior before deciding to partake in or refrain from the behavior.
[Image Source: Theoretical Foundation of Health Education and Health Promotion 2nd Edition]
Once a particular behavior is determined, an evaluation process occurs that measures a person’s or group’s behavioral intention, attitude toward the behavior, behavioral beliefs, outcome evaluation (the value placed on the outcome of the behavior), subjective norms, normative beliefs, perceived behavioral control, control beliefs (internal or external factors that may facilitate or encumber a behavior), perceived power over the behavior, and motivation to comply. The evaluation of each category is usually measured on a seven-point scale and then calculated to access the likelihood of the behavior.
The TRA methodology has been used in health education and health promotion to predict behaviors for everything from exercise programs, to cancer screening, to breastfeeding, to eating healthier, to smoking among adolescents, and in condom usage.
Though we may be able to utilize TRA and TPB to predict behavioral intention, the theories do not explain behavior change or provide specific detail for behavior modification, nor do they consider cultural factors, personality related factors, demographic factors, or the built environment which all play a role in health behavior and the ability to change those behaviors.
Explaining behavior change is difficult as there is not a one-size-fits-all methodology, but we do have several models that help us understand behavior change from a health beliefs perspective, understand the general stages of behavior change and some factors that may influence behavior, predict the likelihood of behavior change, and know how to motivate healthy behavior change.
Knowing that there is not a one-size-fits-all methodology to behavior change, it is important to note that nagging never works to change behavior and that a person has a need need for self-mastery, social connectedness, and internal/intrinsic motivation to change their own behaviors.
It is indeed their life, and not ours to change.
The TRA and TRB methods indicate that brainstorming with an individual or group can help facilitate an understanding of their behavioral beliefs, and possibly spark the fire for health behavior change.
