Behavioral Research

Table of Contents
1 Description, Theoretical Background, and History
2 Components of Personal Control

The Role of Control in Health Behavior Theories


Measures and Measurements



6 Published Examples

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Other Constructs



Dispositional Optimism




Illness Representations

  Implementation Intentions
  Intention, Expectation, and Willingness
  Normative Beliefs
  Optimistic Bias
  Perceived Benefits
  Perceived Control
  Perceived Severity
  Perceived Vulnerability
  Self-Reported Behavior
  Social Influence
  Social Support

Perceived Control
Suzanne C. Thompson and Michèle M. Schlehofer

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The Role of Control in Health Behavior Theories

Several health behavior theories include a personal control component. The ways in which personal control is used to explain health behaviors differs slightly between the theories, but all have an underlying theme: personal control increases the chances a person will perform a health behavior. Below is a brief explanation of the role of control in the most common health behavior theories.

Two-Process Model of Perceived Control
The model, as presented by Rothbaum, Weisz, and Snyder (1982), makes a distinction between primary control, which involves taking action to get desired outcomes, and secondary control, which refers to changing one self to adjust to the environment. Secondary control also enhances an overall sense of personal control. The important contribution of this approach to control is that it proposes that both direct action on the environment and adjusting to the environment are sources of personal control. Although many parts of this theory are not directly relevant to health behavior change and the theory has not been widely applied in that area, this approach focuses attention on control strategies, which are the ways people use to get desired outcomes or handle stressful situations. Control strategies could have important implications for health protection. For example, those who use primary control strategies of changing the environment may be more likely to act to protect themselves. In addition, the theory identifies a source of personal control enhancement (i.e., secondary control acceptance of one's situation) that may bolster the personal control that is necessary for health behavior change.

Theory of Planned Behavior
In the theory of planned behavior (TPB), perceived behavioral control is assumed to be a proxy indicator of actual behavioral control. Research with the TPB has found that the theory is accurate at predicting intentions to perform health behaviors (Godin & Kok, 1996; Schifter & Ajzen, 1985), and research comparing the TPB with the theory of reasoned action has found that, generally, the inclusion of the perceived behavioral control construct in the TPB adds to predictive ability (Terry & O'Leary, 1995). However, researchers have generally operationalized perceived control as self-efficacy, and it is possible that if research used measures of perceived control the predictive power of the model would be further increased (Godin & Kok, 1996; Terry & O'Leary, 1995).

Social Cognitive Theory
Social cognitive theory (Bandura, 1986) is an extension of social learning theory, a behavioral theory that states individuals learn behaviors by observing similar others receive reinforcement or punishment for similar behaviors. In social cognitive theory, self-regulatory systems, or internal controls over one's behavior guide behavioral decisions. Bandura defines self-regulation as the "exercise of influence" over one's behavior. In the model, one's ability to self-regulate is dependent on the presence of two efficacy perceptions: self-efficacy and response efficacy. As mentioned earlier, these two efficacy perceptions comprise the construct of perceived control. The model places great emphasis on self-efficacy, which is defined as "the belief in one's capabilities to organize and execute the sources of action required to manage prospective situations." That is, self-efficacy is the belief that one can perform a behavior (e.g., use a condom correctly). The response efficacy component refers to beliefs that a certain behavior will reach a desired outcome (e.g., using condoms will prevent unplanned pregnancy). Response efficacy, therefore, is a belief in the efficaciousness of the health behavior. The greater self and response efficacy perceptions (and, hence, the greater perceived control one has), the greater likelihood that the behavior will be performed.

Protection Motivation Theory
Protection motivation theory (Maddux & Rogers, 1983; Rogers, 1975, 1983) proposes that motivations to protect oneself factor into decisions to engage in healthy behaviors. According to the model, individuals assess their self-efficacy (an individual's perceived ability to take action) and response efficacy (the perceived effectiveness of the action) in an effort to determine the extent to which they can cope with a health threat. Self- and response-efficacy are both components of perceived control, and as such, the model has a perceived control component. As perceptions of self- and response efficacy increase, the likelihood of engaging in healthy behaviors also increases (Rogers, 1983).

Self-Control Theory
In self-control theory (Rosenbaum, 1983), control refers to the ability to monitor and inhibit one's own emotions, thoughts, and behaviors. Examples of efforts to exert self-control include working to improve one's posture, maintaining a low-fat diet, and suppressing specific thoughts.

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DCCPSNational Cancer Institute Department of Health and Human Services National Institutes of Health

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