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Assessing Condom Use Intentions through the Theory of Planned Behavior

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Assessing Condom Use Intentions through the Theory of Planned Behavior
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Zissimopulos, Leah
Lutz, Richard
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Assessing Condom Use Intentions through the Theory of Planned Behavior

Leah Zissimopulos


ABSTRACT


This study used the theory of planned behavior to try to understand condom use intentions for college

students. Students reported their attitudes, norms, perceived control, and intentions in the domain of condom

use. Control perceptions, subjective norms, and two indirect attitudes were the main predictors for condom

use intentions with occasional partners. STD prevention programs aimed at college students should focus

on changing attitudes, norms, and perceived levels of control with regard to condom use.



INTRODUCTION


Sexually transmitted diseases are a concern for sexually active youth. In 2000, 31,293 people aged 13-24

were reported to be HIV positive (STD Surveillance, 2003). Youth have greater chances of contracting

STDs compared with other age groups due to "multiple barriers to quality of STD prevention services, inducing lack

of insurance or other ability to pay, lack of transportation, discomfort with facilities and services designed for

adults, and concerns about confidentiality" (STD Surveillance, 2003). Women aged 15-19 have the highest rates

of gonorrhea compared to other groups of women and all "sexually active adolescents have high rates of

chlamydia infection." Since "there has not been a ... decline in the newly diagnosed HIV cases among the

youth" (STD Surveillance, 2003) and with the increased risks youths encounter in contracting STDs, it is beneficial

for sexually active youth and for society that new ways to promote safe sex through condom use are found.



Research has shown that merely telling people to use condoms to prevent themselves from getting AIDS and

other STDs is not enough to change people's behaviors (Albarracin, et al., 2001). In a study conducted by

the Centers for Disease Control, simple didactic messages that focused on the health risks associated

with unprotected sex were less likely to promote condom use than interactive sessions based on theoretical

models. Counseling sessions that employed theories from the behavioral sciences had the greatest impact

on promoting condom use (Albarracin, et al., 2000). Since it appears that merely informing youth of the

health dangers of unprotected sex is not enough to change behavior, it is imperative to use theoretical models

that are successful in predicting and changing behavior.


LITERATURE REVIEW





Research regarding condom use and AIDS prevention has generally centered on the theory of reasoned action

(TRA) and the theory of planned behavior (Glasman & Albarracin, 2003).



The theory of reasoned action was developed by Fishbein and Ajzen in order to understand the variables

that influence behavior. In the model, behavior is influenced by intentions, and intentions are influenced by

attitudes and subjective norms, as shown in Figure 1.





rb b, Attitude

Intention Future Behavior
'Enb ]- Norm



Figure 1. A visual representation of the Theory of Reasoned Action showing that Future Behavior

is affected by Intentions, Attitude, and Norms.



Future behavior, B, is therefore a function of a person's intention, I, to engage in a behavior. According to the TRA,

a person will typically use a condom with an occasional partner if their intentions to do so are high. Intentions

are determined by a person's attitude and the subjective norm of important referents:



IAAB + SNB



Attitude is the extent a person feels either positively or negatively toward the behavior. Attitude can be

measured either directly or indirectly. It is usually assessed directly with a set of bipolar semantic differential

scales like "condom use is unpleasant/pleasant, bad/good, unimportant/important, etc." When measured

indirectly, attitude can be determined by the beliefs (bi) a person has regarding the behavior times the

evaluative factors (ei) relating to the beliefs. For instance, a person's belief about whether or not using condoms

with their occasional partner would be responsible can be measured with a statement like strongly disagree/

strongly agree. The evaluative factor relating to the belief is measured with bipolar statements such as

"being responsible when having sex is bad/good". The evaluative factor is then multiplied by the belief and

summed across all salient beliefs, to construct the overall indirect attitude toward condom use:



AB; e bi ei



The other factor influencing Intentions is Subjective Norm. Subjective Norm is determined by the beliefs of

important referents multiplied by the participant's motivation to comply with each referent. Normative beliefs

of referents are assessed with statements such as "How important is it to your occasional partner that you use

a condom during vaginal intercourse." Motivation to comply is generally measured with statements like "I do what

my occasional partner wants not very often/very often." Multiplying the referent's beliefs by the motivation to





comply and summing across all salient referents is referred to as indirect subjective norm and is denoted as



SNB; e nbjmj



where nbj is the normative belief of referent j and mj is the participant's motivation to comply with referent j. Thus,

a person's intentions to use condoms will be greater if they perceive that their occasional partner believes

they should use condoms and the respondent wants to comply.



The theory of reasoned action has been extensively studied to determine its predictive power (Albarracin, et

al., 2001) and is usually an adequate means of assessing intentions for volitional behaviors. However, to

predict intentions for behaviors that are not completely under volitional control, Ajzen developed the theory

of planned behavior (TPB). This theory, as depicted in Figure 2, differs from the TRA with the addition of a

third variable--perceived behavioral control.


Figure 2. A visual representation of the Theory of Planned Behavior showing that Future Behavior

is affected by Intentions, Norms, Attitude, and Perceived Behavioral Control and that

Perceived Behavioral Control also affects Intentions.



Perceived Behavioral Control refers to the degree of control a person believes they have in performing a behavior

and influences both Intentions and Behavior directly.



B= I + PBC







I AB + SNB + PBC



Therefore, a person who believes they have control over the decision to use a condom will develop greater

intentions to perform this behavior than someone who does not believe they have control. Perceived

behavioral control is measured with questions that determine the participant's perceptions of control such as





"How much of the decision to use a condom is up to you" and "Do you see yourself as the kind of person who

could get your partner to use a condom."



The theory of planned behavior is especially useful in examining condom use because it accounts for the

perceived control a person might or might not believe they have in convincing their partner to use a condom.

Thus, to examine intentions to use condoms, a study was designed and administered to college students using

the theory of planned behavior.



METHODS



Procedure and Participants


In exchange for extra credit points a 36-question survey was administered to 128 college students taking

either Introduction to Marketing or Introduction to Statistics. Students signed up to participate by accessing

the College Experiments Website, which is linked to both participating courses. The description of the study on

the website emphasized the sensitive nature of the topic being researched and specified that the participants had

to be at least 18 years old. The sessions were held in the College of Business Experimental Laboratory in Bryan Hall.



To ensure the privacy of each participant, the questionnaire was completed in private cubicles. Participants

were asked a number of questions to determine their attitudes, norms, perceived behavioral control and

intentions related to condom use and were not required to answer any questions that they found offensive

or disturbing. The experimenter first distributed the Informed Consent forms, collected the signed forms, and

then issued a paper receipt to each participant. Then, the participants were seated in one of the lab's 24

individual cubicles, where an unmarked questionnaire and an unmarked envelope had been placed. The

participants completed the questionnaire at their own pace, and placed it in the envelope and sealed it.

The experimenter remained in the room to maintain experimental control, but was off to the side where she could

not observe any individual's responses. After completing the questionnaire, participants were asked to place

their envelopes in one of two identical boxes that were placed out of the line of sight of the experimenter. In

that way, the anonymity of the participants was guaranteed.



Measures


The questionnaire was designed to assess condom use intentions when having vaginal intercourse with

occasional partners participants had in the past or may have in the future. An occasional partner was defined as

a person with whom the participant was not in a monogamous relationship and as someone with whom

they infrequently had sexual intercourse. Due to past research that showed that different factors influence

condom use intentions for main and occasional partners, the survey only examined condom use with

occasional partners (Glasman & Albarracin, 2003).


Attitudes







Direct attitudes were measured with three semantic differential scales of the form, "using condoms when you

have sexual intercourse with your occasional partner is: bad/good, unpleasant/pleasant, unimportant/

important." Indirect attitudes were assessed by first asking participants to use a 7-point semantic differential scale

to express their beliefs about condom use. The belief statements, shown in Table 1, were drawn from earlier

related research (Albarracin et al., 2000).



Table 1
Belief Statements about Condom Use with Occasional Partners

Using Condoms would decrease sexual pleasure

Using condoms would protect you from getting AIDS and other STDs

Using condoms would protect your occasional partners) from getting AIDS and other STDs

Using condoms would make you feel safer

Using condoms would be the responsible thing to do

Using condoms would make your worry less

Using condoms would make you feel good about yourself

Using condoms would show your occasional partner that you care

Using condoms would make your occasional partner think you have an STD



Then participants were asked to give an evaluative rating to each of the nine beliefs relating to condom use such

as "a decrease in sexual pleasure is bad/good" and "feeling safe when you have sex is bad/good" consistent with

the standard procedure used by researchers on the TPB (Glasman & Albarracin, 2003). The answers to the

beliefs and evaluative term questions were then converted from a 7-point scale to a -3/3 bipolar scale where

positive answers received 1, 2, or 3 (depending on how strongly they agreed with the statement) and

negative answers received a -1, -2, or -3 (depending on how strongly they disagreed with the statement). A

neutral answer received a 0 rating. To find the overall indirect attitude toward condom use, the beliefs

were multiplied by their corresponding evaluative term and summed.



Norms


Common normative referents were gleaned from prior research (Glasman & Albarracin, 2003) and included

people that the participants considered important like the participant's occasional partner, family, friends, and

their doctor. The participants were asked how important it was to these people that they used a condom when

they had vaginal intercourse with their occasional partner. The participants responded to the question with a 7-

point scale raging from very unimportant to very important. These responses were then converted to a -3/3

bipolar scale in the same fashion that the beliefs and evaluative terms for attitudes were converted. Then

participants were asked how willing they were to comply with each referent. These questions were rated on

a unipolar 1 to 7 scale. To assess the overall measure of subjective norms, the perceived referent belief

about condom use was multiplied by the participant's motivation to comply with each referent and summed.







Control Perceptions


Participants were asked seven questions to assess how much perceived control they had in the domain of

condom use. They were asked how much of the decision to use/not use a condom was up to them and if they

saw themselves as the kind of person who could get their occasional partners) to use a condom every time.

They were also asked questions to see how likely they would be to use condoms under extenuating

circumstances, illustrated in Table 2.




Table 2
Control Perception Questions

How likely would you be to use condoms when your occasional partners) refuses to use condoms?

How likely would you be to use condoms when you are very excited?

How likely would you be to use condoms when your occasional partners) is very excited?

How likely would be to delay having sex when condoms are not readily available?

How likely would you be to use condoms with your occasional partners) when you have to delay/postpone sex
to purchase condoms?


Each question was answered using a 7-point scale and then converted to a bipolar -3/3 rating.



Intentions


Intentions to use condoms in the future were measured with the following two questions: "how likely is it that

you will use a condom with your occasional partners) in the future?" and "how motivated are you to use a

condom with your occasional partnerss)" and were measured on a 1-7 point scale.




RESULTS



A regression illustrates how well attitudes, norms, and perceived behavioral control affected intentions to use

condom use. See Table 3.




Table 3
Effect of Attitudes, Norms, and Perceived Control on Intentions to Use Condoms

Independent Variable Beta T Significance

Attitude -.003 -.049 .961

Norms .361 5.317 .001

Perceived Control .518 7.567 .001

R^2=.595


Norms and perceived control were both significant in explaining intentions to use condoms with p-values






of .001. However, attitude was not statistically significant. Thus, norms and perceived control are better predictors

of condom use than are attitudes.



To asses which subjective norm predicted condom use intentions best, a regression was run to determine

whether the norms of each referent had a large impact on intentions to use condoms. The results of the

subjective norm regression are presented in Table 4.




Table 4
Effect that Norms have on Intentions to Use Condoms

Independent Variable Beta T Significance

Norm of Occassional Partner .646 9.522 .001

Norm of Family .119 1.766 .080

Norm of Friends -.015 -.213 .832

Norm of Doctor .151 2.348 0.21

R^2=.497


The results showed that the norms of the occasional partner and doctor were highly significant and the norms

of family and friends did not show a statistical significance in predicting condom use intentions. Thus, the more

a person perceives that their partner expects them to use a condom, the greater the person's intentions to use

a condom will be.

The relationship between individual beliefs and intentions to use condoms is depicted in Table 5.




Table 5
Effect of Beliefs on Intentions to Use Condoms

Independent Variable Beta T Significance

Belief about sexual pleasure -.358 -4.239 .001

Belief about protecting yourself from contracting STDs .001 .013 .989

Belief about protecting your partner from contracting STDs -.127 -1.230 .221

Belief about safety .038 .384 .701

Belief about responsibility .215 2.379 0.19

Belief about worrying less .039 .380 .704

Belief about feeling good about yourself .107 .916 .362

Belief about showing partner that you care .144 1.103 .272

Belief about making partner think you have an STD -.042 -.529 .598

R^2=.319


Two of the beliefs did predict condom use intentions: the beliefs that using condoms would reduce one's

sexual pleasure and would be the responsible thing to do correlate with condom use intentions. Therefore, the more

a person believes that using condoms would be the responsible thing to do, the greater their intentions to






use condoms. Also, the more a person believes that using condoms would reduce sexual pleasure, the lower

their intentions to use condoms are.



The relationship between perceived control perceptions and intentions to use condoms is depicted in Table 6.




Table 6
Effect of Control Perceptions on Intentions to Use Condoms

Independent Variable Beta T Significance

Decision to use condom .201 3.083 .003

When partner refuses .178 2.086 .039

When you are very excited -.282 -2.306 .023

When partner is very excited .362/div> 2.725 .007

When condoms are not readily available .356 2.626 .010

When have to purchase condoms .094 .747 .456

Kind of person to convince partner to use a condom .024 .334 .739

R^2=.566


This regression showed that all but two control perceptions have a significant relationship to condom use

intentions. Delaying sex to purchase condoms and whether or not the participants viewed themselves as the type

of people to convince their occasional partners to use condoms were the only control perceptions that did not

show statistical significance in predicting condom use. However, if a person perceived the decision to use condoms

to be up to them, then they had a greater intention to use condoms.



DISCUSSION



Consistent with past research, the theory of planned behavior served as an excellent predictor of condom

use intentions (Albarracin et. al., 2001). Previous studies showed that attitudes significantly influenced intentions

to use condoms. The current study, however, only showed that attitudes about sexual pleasure and

responsibility during sex significantly affected intentions. Possible reasons for the difference could be a result of

the group sampled. Perhaps college-aged students have differing beliefs from those seeking STD counseling at

clinics (Glasman & Albarracin, 2003). Also, the beliefs of the students selected could differ from other college

student population's beliefs because of different social stigmas surrounding condoms and STDs. However, this

study did find two significant correlations regarding attitude: the more a person believes that condoms will

reduce sexual pleasure, the less likely that person is to use condoms; and believing that using condoms is

responsible increases the likelihood that a person will intend to use condoms.




Perceived behavioral control and subjective norms significantly correlated with intentions to use condoms.

More specifically, the subjective norms relating to a participant's occasional partner and doctor influenced





intentions. The more a participant believed that it is important to their occasional partner or doctor to use

condoms, the more likely the person is to engage in this behavior. The following control perceptions also

significantly influenced intentions:




Table 7
Control Perception Questions That Significantly Influenced Intentions

How likely would you be to use condoms when your occasional partners) refuses to use condoms?

How likely would you be to use condoms when your occasional partners) is very excited?

How likely would you be to use condoms when you are very excited?

How likely would be to delay having sex when condoms are not readily available?



Therefore, the more likely a person is to delay having sex when condoms are not readily available, the stronger

that person's intentions to use condoms will be.




It is important to understand how exactly each of these measures influences intentions in order to

determine effective ways to change condom use behavior. Past research has shown that intentions to use

condoms have increased when individuals develop favorable attitudes toward condoms or develop stronger

beliefs that those around them think condom use is important. These studies have shown that merely expounding

on the dangers associated with HIV and other STDs is not enough to change behavior (Albarracin et al.,

2000; Albarracin et al., 2003).



One possible limitation of this study is that the data is self-reported. It is difficult to assess the degree to which

the participants' reported answers might actually differ. In addition, this study did not measure the affect that

alcohol or drugs might have on condom use intentions, factors that could lead to behaviors different

from participants' self-reported intentions. Finally, participants were asked at the beginning of the study if they

had an occasional partner. Participants were not required to have an occasional partner to complete

the questionnaire. However, participants were asked to complete the survey with reference to occasional partner

(s) they had in the past or may have in the future. It is possible that some of the respondents who marked that

they did not have an occasional partner may never have engaged in sexual intercourse or never had an

occasional partner. Therefore, their frame of reference for answering questions regarding occasional partners

may not have been quite adequate.



Because merely informing people of the health related risks associated with unprotected sex is not enough to

change condom use intentions, people's beliefs about condom use must be changed. The theory of planned

behavior is an excellent predictor of condom use intentions (Albarracin, et al., 2001). The results of this study

and others employing the theory of planned behavior should be used to promote messages via advertising

campaigns and counseling sessions that are able to change people's beliefs about condom use. If people are able

to view condom use positively and believe that others around them want them to use condoms, then it is more




likely that these people will develop favorable intentions to use condoms. Also, it is important to develop

messages that help people feel that they have more control in the domain of condom use. With the

increasing number of youth contracting STDs, there has never been a more important time to find effective,

theory-based means of positively changing people's condom use intentions.


ACKNOWLEDGMENTS


This study was supported by the University Scholars Program and theWarrington College of Business. Thanks to

Dr. Albarracin for her help and expertise with the TPB and condom use. A special thanks to Dr. Lutz for his

unending support and patience as my USP Mentor.


REFERENCES


1. Albarracin, D., McNatt, P.S., Klein, C.T.F., Ho, R.M., Mitchell, A.L., and Kumkale, G.T. (2003).

Persuasive Communications to Change Actions: An Analysis of Behavioral and Cognitive Impact in HIV

Prevention. Health Psychology, 22, 166-177.

2. Albarracin, D., Johonson, B.T., Fishbein, M., and Muellerleile, P.A. (2001). Theories of Reasoned Action and

Planned Behavior as Models of Condom Use: A Meta-Analysis. Psychology Bulletin, 127, 142-161.

3. Albarracin, D., Ho, R.M., McNatt, P.S., Williams, W.R., Rhodes, F., Malotte, C.K., Hoxworth, T., Bolan, G.A.,

Zenilman, J., and latest, M. (2000). Structure of Outcome Beliefs in Condom Use. Health Psychology, 19, 458-468.

4. Glasman, L.R., and Albarracin, D. (2003). Models of Health-Related Behavior: A Study Of Condom Use in Two

Cities of Argentina. AIDS and Behavior, 7, 183-193.

5. STD Surveillance, Special Focus Profiles (2003). STDs in Adolescents and Young Adults, 53-61.


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PAGE 1

Journal of Undergraduate Research Volume 6, Issue 7 May/June 2005 Assessing Condom Use Intentions through the Theory of Planned BehaviorLeah Zissimopulos ABSTRACTThis study used the theory of planned behavior to try to understand condom use intentions for college students. Students reported their attitudes, norms, perceived control, and intentions in the domain of condom use. Control perceptions, subjective norms, and two indirect attitudes were the main predictors for condom use intentions with occasional partners. STD prevention programs aimed at college students should focus on changing attitudes, norms, and perceived levels of control with regard to condom use. INTRODUCTIONSexually transmitted diseases are a concern for sexually active youth. In 2000, 31,293 people aged 13-24 were reported to be HIV positive (STD Surveillance, 2003). Youth have greater chances of contracting STDs compared with other age groups due to multiple barriers to quality of STD prevention services, inducing lack of insurance or other ability to pay, lack of transportation, discomfort with facilities and services designed for adults, and concerns about confidentiality (STD Surveillance, 2003). Women aged 15-19 have the highest rates of gonorrhea compared to other groups of women and all sexually active adolescents have high rates of chlamydia infection. Since there has not been a decline in the newly diagnosed HIV cases among the youth (STD Surveillance, 2003) and with the increased risks youths encounter in contracting STDs, it is beneficial for sexually active youth and for society that new ways to promote safe sex through condom use are found. Research has shown that merely telling people to use condoms to prevent themselves from getting AIDS and other STDs is not enough to change peoples behaviors (Albarracin, et al., 2001). In a study conducted by the Centers for Disease Control, simple didactic messages that focused on the health risks associated with unprotected sex were less likely to promote condom use than interactive sessions based on theoretical models. Counseling sessions that employed theories from the behavioral sciences had the greatest impact on promoting condom use (Albarracin, et al., 2000). Since it appears that merely informing youth of the health dangers of unprotected sex is not enough to change behavior, it is imperative to use theoretical models that are successful in predicting and changing behavior. LITERATURE REVIEW

PAGE 2

Research regarding condom use and AIDS prevention has generally centered on the theory of reasoned action (TRA) and the theory of planned behavior (Glasman & Albarracin, 2003). The theory of reasoned action was developed by Fishbein and Ajzen in order to understand the variables that influence behavior. In the model, behavior is influenced by intentions, and intentions are influenced by attitudes and subjective norms, as shown in Figure 1. Figure 1. A visual representation of the Theory of Reasoned Action showing that Future Behavior is affected by Intentions, Attitude, and Norms. Future behavior, B, is therefore a function of a persons intention, I, to engage in a behavior. According to the TRA, a person will typically use a condom with an occasional partner if their intentions to do so are high. Intentions are determined by a persons attitude and the subjective norm of important referents: IAB + SNBAttitude is the extent a person feels either positively or negatively toward the behavior. Attitude can be measured either directly or indirectly. It is usually assessed directly with a set of bipolar semantic differential scales like condom use is unpleasant/pleasant, bad/good, unimportant/important, etc. When measured indirectly, attitude can be determined by the beliefs (bi) a person has regarding the behavior times the evaluative factors (ei) relating to the beliefs. For instance, a persons belief about whether or not using condoms with their occasional partner would be responsible can be measured with a statement like strongly disagree/ strongly agree. The evaluative factor relating to the belief is measured with bipolar statements such as being responsible when having sex is bad/good. The evaluative factor is then multiplied by the belief and summed across all salient beliefs, to construct the overall indirect attitude toward condom use: AB bi eiThe other factor influencing Intentions is Subjective Norm. Subjective Norm is determined by the beliefs of important referents multiplied by the participants motivation to comply with each referent. Normative beliefs of referents are assessed with statements such as How important is it to your occasional partner that you use a condom during vaginal intercourse. Motivation to comply is generally measured with statements like I do what my occasional partner wants not very often/very often. Multiplying the referents beliefs by the motivation to

PAGE 3

comply and summing across all salient referents is referred to as indirect subjective norm and is denoted as SNB nbjmjwhere nbj is the normative belief of referent j and mj is the participants motivation to comply with referent j. Thus, a persons intentions to use condoms will be greater if they perceive that their occasional partner believes they should use condoms and the respondent wants to comply. The theory of reasoned action has been extensively studied to determine its predictive power (Albarracin, et al., 2001) and is usually an adequate means of assessing intentions for volitional behaviors. However, to predict intentions for behaviors that are not completely under volitional control, Ajzen developed the theory of planned behavior (TPB). This theory, as depicted in Figure 2, differs from the TRA with the addition of a third variable--perceived behavioral control. Figure 2. A visual representation of the Theory of Planned Behavior showing that Future Behavior is affected by Intentions, Norms, Attitude, and Perceived Behavioral Control and that Perceived Behavioral Control also affects Intentions. Perceived Behavioral Control refers to the degree of control a person believes they have in performing a behavior and influences both Intentions and Behavior directly. B I + PBC I AB + SNB + PBC Therefore, a person who believes they have control over the decision to use a condom will develop greater intentions to perform this behavior than someone who does not believe they have control. Perceived behavioral control is measured with questions that determine the participants perceptions of control such as

PAGE 4

How much of the decision to use a condom is up to you and Do you see yourself as the kind of person who could get your partner to use a condom. The theory of planned behavior is especially useful in examining condom use because it accounts for the perceived control a person might or might not believe they have in convincing their partner to use a condom. Thus, to examine intentions to use condoms, a study was designed and administered to college students using the theory of planned behavior.METHODSProcedure and Participants In exchange for extra credit points a 36-question survey was administered to 128 college students taking either Introduction to Marketing or Introduction to Statistics. Students signed up to participate by accessing the College Experiments Website, which is linked to both participating courses. The description of the study on the website emphasized the sensitive nature of the topic being researched and specified that the participants had to be at least 18 years old. The sessions were held in the College of Business Experimental Laboratory in Bryan Hall. To ensure the privacy of each participant, the questionnaire was completed in private cubicles. Participants were asked a number of questions to determine their attitudes, norms, perceived behavioral control and intentions related to condom use and were not required to answer any questions that they found offensive or disturbing. The experimenter first distributed the Informed Consent forms, collected the signed forms, and then issued a paper receipt to each participant. Then, the participants were seated in one of the labs 24 individual cubicles, where an unmarked questionnaire and an unmarked envelope had been placed. The participants completed the questionnaire at their own pace, and placed it in the envelope and sealed it. The experimenter remained in the room to maintain experimental control, but was off to the side where she could not observe any individuals responses. After completing the questionnaire, participants were asked to place their envelopes in one of two identical boxes that were placed out of the line of sight of the experimenter. In that way, the anonymity of the participants was guaranteed. Measures The questionnaire was designed to assess condom use intentions when having vaginal intercourse with occasional partners participants had in the past or may have in the future. An occasional partner was defined as a person with whom the participant was not in a monogamous relationship and as someone with whom they infrequently had sexual intercourse. Due to past research that showed that different factors influence condom use intentions for main and occasional partners, the survey only examined condom use with occasional partners (Glasman & Albarracin, 2003). Attitudes

PAGE 5

Direct attitudes were measured with three semantic differential scales of the form, using condoms when you have sexual intercourse with your occasional partner is: bad/good, unpleasant/pleasant, unimportant/ important. Indirect attitudes were assessed by first asking participants to use a 7-point semantic differential scale to express their beliefs about condom use. The belief statements, shown in Table 1, were drawn from earlier related research (Albarracin et al., 2000). Table 1 Belief Statements about Condom Use with Occasional Partners Using Condoms would decrease sexual pleasure Using condoms would protect you from getting AIDS and other STDs Using condoms would protect your occasional partner(s) from getting AIDS and other STDs Using condoms would make you feel safer Using condoms would be the responsible thing to do Using condoms would make your worry less Using condoms would make you feel good about yourself Using condoms would show your occasional partner that you care Using condoms would make your occasional partner think you have an STD Then participants were asked to give an evaluative rating to each of the nine beliefs relating to condom use such as a decrease in sexual pleasure is bad/good and feeling safe when you have sex is bad/good consistent with the standard procedure used by researchers on the TPB (Glasman & Albarracin, 2003). The answers to the beliefs and evaluative term questions were then converted from a 7-point scale to a -3/3 bipolar scale where positive answers received 1, 2, or 3 (depending on how strongly they agreed with the statement) and negative answers received a -1, -2, or -3 (depending on how strongly they disagreed with the statement). A neutral answer received a 0 rating. To find the overall indirect attitude toward condom use, the beliefs were multiplied by their corresponding evaluative term and summed. Norms Common normative referents were gleaned from prior research (Glasman & Albarracin, 2003) and included people that the participants considered important like the participants occasional partner, family, friends, and their doctor. The participants were asked how important it was to these people that they used a condom when they had vaginal intercourse with their occasional partner. The participants responded to the question with a 7point scale raging from very unimportant to very important. These responses were then converted to a -3/3 bipolar scale in the same fashion that the beliefs and evaluative terms for attitudes were converted. Then participants were asked how willing they were to comply with each referent. These questions were rated on a unipolar 1 to 7 scale. To assess the overall measure of subjective norms, the perceived referent belief about condom use was multiplied by the participants motivation to comply with each referent and summed.

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Control Perceptions Participants were asked seven questions to assess how much perceived control they had in the domain of condom use. They were asked how much of the decision to use/not use a condom was up to them and if they saw themselves as the kind of person who could get their occasional partner(s) to use a condom every time. They were also asked questions to see how likely they would be to use condoms under extenuating circumstances, illustrated in Table 2. Table 2 Control Perception Questions How likely would you be to use condoms when your occasional partner(s) refuses to use condoms? How likely would you be to use condoms when you are very excited? How likely would you be to use condoms when your occasional partner(s) is very excited? How likely would be to delay having sex when condoms are not readily available? How likely would you be to use condoms with your occasional partner(s) when you have to delay/postpone sex to purchase condoms? Each question was answered using a 7-point scale and then converted to a bipolar -3/3 rating. Intentions Intentions to use condoms in the future were measured with the following two questions: how likely is it that you will use a condom with your occasional partner(s) in the future? and how motivated are you to use a condom with your occasional partner(s)? and were measured on a 1-7 point scale. RESULTSA regression illustrates how well attitudes, norms, and perceived behavioral control affected intentions to use condom use. See Table 3. Table 3 Effect of Attitudes, Norms, and Perceived Control on Intentions to Use Condoms Independent Variable Beta T Significance Attitude -.003 -.049 .961 Norms .361 5.317 .001 Perceived Control .518 7.567 .001 R^2=.595 Norms and perceived control were both significant in explaining intentions to use condoms with p-values

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of .001. However, attitude was not statistically significant. Thus, norms and perceived control are better predictors of condom use than are attitudes. To asses which subjective norm predicted condom use intentions best, a regression was run to determine whether the norms of each referent had a large impact on intentions to use condoms. The results of the subjective norm regression are presented in Table 4. Table 4 Effect that Norms have on Intentions to Use Condoms Independent Variable Beta T Significance Norm of Occassional Partner .646 9.522 .001 Norm of Family .119 1.766 .080 Norm of Friends -.015 -.213 .832 Norm of Doctor .151 2.348 0.21 R^2=.497 The results showed that the norms of the occasional partner and doctor were highly significant and the norms of family and friends did not show a statistical significance in predicting condom use intentions. Thus, the more a person perceives that their partner expects them to use a condom, the greater the persons intentions to use a condom will be. The relationship between individual beliefs and intentions to use condoms is depicted in Table 5. Table 5 Effect of Beliefs on Intentions to Use Condoms Independent Variable Beta T Significance Belief about sexual pleasure -.358 -4.239 .001 Belief about protecting yourself from contracting STDs .001 .013 .989 Belief about protecting your partner from contracting STDs -.127 -1.230 .221 Belief about safety .038 .384 .701 Belief about responsibility .215 2.379 0.19 Belief about worrying less .039 .380 .704 Belief about feeling good about yourself .107 .916 .362 Belief about showing partner that you care .144 1.103 .272 Belief about making partner think you have an STD -.042 -.529 .598 R^2=.319 Two of the beliefs did predict condom use intentions: the beliefs that using condoms would reduce ones sexual pleasure and would be the responsible thing to do correlate with condom use intentions. Therefore, the more a person believes that using condoms would be the responsible thing to do, the greater their intentions to

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use condoms. Also, the more a person believes that using condoms would reduce sexual pleasure, the lower their intentions to use condoms are. The relationship between perceived control perceptions and intentions to use condoms is depicted in Table 6. Table 6 Effect of Control Perceptions on Intentions to Use Condoms Independent Variable Beta T Significance Decision to use condom .201 3.083 .003 When partner refuses .178 2.086 .039 When you are very excited -.282 -2.306 .023 When partner is very excited .362/div> 2.725 .007 When condoms are not readily available .356 2.626 .010 When have to purchase condoms .094 .747 .456 Kind of person to convince partner to use a condom .024 .334 .739 R^2=.566 This regression showed that all but two control perceptions have a significant relationship to condom use intentions. Delaying sex to purchase condoms and whether or not the participants viewed themselves as the type of people to convince their occasional partners to use condoms were the only control perceptions that did not show statistical significance in predicting condom use. However, if a person perceived the decision to use condoms to be up to them, then they had a greater intention to use condoms.DISCUSSIONConsistent with past research, the theory of planned behavior served as an excellent predictor of condom use intentions (Albarracin et. al., 2001). Previous studies showed that attitudes significantly influenced intentions to use condoms. The current study, however, only showed that attitudes about sexual pleasure and responsibility during sex significantly affected intentions. Possible reasons for the difference could be a result of the group sampled. Perhaps college-aged students have differing beliefs from those seeking STD counseling at clinics (Glasman & Albarracin, 2003). Also, the beliefs of the students selected could differ from other college student populations beliefs because of different social stigmas surrounding condoms and STDs. However, this study did find two significant correlations regarding attitude: the more a person believes that condoms will reduce sexual pleasure, the less likely that person is to use condoms; and believing that using condoms is responsible increases the likelihood that a person will intend to use condoms. Perceived behavioral control and subjective norms significantly correlated with intentions to use condoms. More specifically, the subjective norms relating to a participants occasional partner and doctor influenced

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intentions. The more a participant believed that it is important to their occasional partner or doctor to use condoms, the more likely the person is to engage in this behavior. The following control perceptions also significantly influenced intentions: Table 7 Control Perception Questions That Significantly Influenced Intentions How likely would you be to use condoms when your occasional partner(s) refuses to use condoms? How likely would you be to use condoms when your occasional partner(s) is very excited? How likely would you be to use condoms when you are very excited? How likely would be to delay having sex when condoms are not readily available? Therefore, the more likely a person is to delay having sex when condoms are not readily available, the stronger that persons intentions to use condoms will be. It is important to understand how exactly each of these measures influences intentions in order to determine effective ways to change condom use behavior. Past research has shown that intentions to use condoms have increased when individuals develop favorable attitudes toward condoms or develop stronger beliefs that those around them think condom use is important. These studies have shown that merely expounding on the dangers associated with HIV and other STDs is not enough to change behavior (Albarracin et al., 2000; Albarracin et al., 2003). One possible limitation of this study is that the data is self-reported. It is difficult to assess the degree to which the participants reported answers might actually differ. In addition, this study did not measure the affect that alcohol or drugs might have on condom use intentions, factors that could lead to behaviors different from participants self-reported intentions. Finally, participants were asked at the beginning of the study if they had an occasional partner. Participants were not required to have an occasional partner to complete the questionnaire. However, participants were asked to complete the survey with reference to occasional partner (s) they had in the past or may have in the future. It is possible that some of the respondents who marked that they did not have an occasional partner may never have engaged in sexual intercourse or never had an occasional partner. Therefore, their frame of reference for answering questions regarding occasional partners may not have been quite adequate. Because merely informing people of the health related risks associated with unprotected sex is not enough to change condom use intentions, peoples beliefs about condom use must be changed. The theory of planned behavior is an excellent predictor of condom use intentions (Albarracin, et al., 2001). The results of this study and others employing the theory of planned behavior should be used to promote messages via advertising campaigns and counseling sessions that are able to change peoples beliefs about condom use. If people are able to view condom use positively and believe that others around them want them to use condoms, then it is more

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likely that these people will develop favorable intentions to use condoms. Also, it is important to develop messages that help people feel that they have more control in the domain of condom use. With the increasing number of youth contracting STDs, there has never been a more important time to find effective, theory-based means of positively changing peoples condom use intentions. ACKNOWLEDGMENTSThis study was supported by the University Scholars Program and theWarrington College of Business. Thanks to Dr. Albarracin for her help and expertise with the TPB and condom use. A special thanks to Dr. Lutz for his unending support and patience as my USP Mentor. REFERENCES1. Albarracin, D., McNatt, P.S., Klein, C.T.F., Ho, R.M., Mitchell, A.L., and Kumkale, G.T. (2003). Persuasive Communications to Change Actions: An Analysis of Behavioral and Cognitive Impact in HIV Prevention. Health Psychology, 22, 166-177. 2. Albarracin, D., Johonson, B.T., Fishbein, M., and Muellerleile, P.A. (2001). Theories of Reasoned Action and Planned Behavior as Models of Condom Use: A Meta-Analysis. Psychology Bulletin, 127, 142-161. 3. Albarracin, D., Ho, R.M., McNatt, P.S., Williams, W.R., Rhodes, F., Malotte, C.K., Hoxworth, T., Bolan, G.A., Zenilman, J., and Iatesta, M. (2000). Structure of Outcome Beliefs in Condom Use. Health Psychology, 19, 458-468. 4. Glasman, L.R., and Albarracin, D. (2003). Models of Health-Related Behavior: A Study Of Condom Use in Two Cities of Argentina. AIDS and Behavior, 7, 183-193. 5. STD Surveillance, Special Focus Profiles (2003). STDs in Adolescents and Young Adults, 53-61. --top-Back to the Journal of Undergraduate Research College of Liberal Arts and Sciences | University Scholars Program | University of Florida | University of Florida, Gainesville, FL 32611; (352) 846-2032.