Purpose: The aim of this research is to investigate if positive attitudes influence the intentions to purchase groceries online. In order fulfil the purpose and test the relationship between attitudes and intentions, the Theory of Planned Behaviour is used as the underlying theoretical model. Background: The e-commerce market in Sweden is regarded as one of the most developed e-commerce markets in Europe, however the grocery market is still striving for an online breakthrough. One of the largest obstacles for the online grocery market is the lack of consumer adoption. Previous research has emphasized the importance of understanding consumer attitudes and its influence on the consumers’ intention to adopt an e-commerce behaviour. Existing theories recognize a gap within positive attitudes’ and their influence on the intentions to adopt e-commerce. Method: An explanatory strategy and a deductive approach were applied in order to test the Theory of Planned Behaviour. Three hypotheses were developed based on the model. The empirical study was based on a quantitative approach and the data collection was made possible through an online survey targeted towards adults in Sweden. Furthermore the analysis of the data was done in SPSS through factor analysis, correlation matrix, descriptive variables and multi linear regression analysis, this provided answers for the hypotheses with a 95% confidence interval. Findings and conclusion: The analysed empirical findings presented overall positive attitudes, as well as a strong correlation between positive attitudes and intentions within online grocery shopping. This answers the research question and fulfils the purpose of examining the influence that positive attitudes have on intentions within the field of online grocery shopping. This research successfully tests the Theory of Planned Behaviour and suggestions for further research is to examine the underlying factors in a qualitative study.

Purpose: To explore the relationship between social support and adherence to a peer-based program among adolescent girls using the Theory of Planned Behaviour (TPB), and to explore barriers and facilitators related to physical activity. Methods: Participants (N=13) completed self-reported measures of social support, TPB constructs, adherence to the program, and physical activity behaviour. A one-month follow-up was conducted on all baseline measures. Open-ended questions were used to determine facilitators and barriers to physical activity. Results: At baseline, social support was a significant correlate of subjective norm (r=0.58, p<.05). At post-program, frequency of attending the program with friends (r=0.97, p<.01) was a significant correlate of attendance in the program. Also, social support was a significant correlate of PBC at post-program (r=-0.82, p<.01). Conclusions: A physical activity program targeting peer social support may serve as a viable mechanism for increasing physical activity levels in adolescent girls.

Regular physical activity (PA) has shown to reduce the risk of several chronic diseases and improve physiological and psychological health, yet over half of the Canadian population remains inactive. Young adults, ages 25-44, show the sharpest declines in PA, but a paucity of research explaining the reasons for this deflection point exists. Recent research has indicated that life-transitions, such as marriage and parenthood, are probable reasons for the decline in PA, but little is known about how early career transitions impact PA status. Professional occupations have shown to be associated with the highest number of work hours per week and highest level of sedentary behaviour at work. The purposes of this study were to evaluate the changes in PA behaviour of new professionals across the early career transition using retrospective analysis and determine the critical correlates of changes in PA using the theory of planned behaviour. A Canada-wide sample of 267 new academic professors was examined. 30.7% of the sample reported meeting current PA guidelines. RM ANOVAs provided evidence that PA frequency (d = .36-.43) and total minutes (d = .39-.42) significantly declined across the transition to employment. PA levels across the transition were further attenuated after controlling for marital status, long work hours (>70 hrs/wk). The presence of young children in the home moderated the PA levels across the transition. The TPB explained 28-35% of PA behaviour (f2 = .39- .54), with intention and PBC emerging as independent predictors. Intention, in turn, was predicted by PBC, affective attitude, and instrumental attitude and explained 42% of the variance (f2 = .72). Perceptions of enjoyment and control based on limited time, inconsistent work schedule, heavy work demands, and pressure to reach tenure were critical correlates that distinguished between those who remained active across the transition from those who did not. The findings from this study highlight the importance for targeted PA interventions administered prior to the transition to professional employment to prevent habitual inactivity.

Despite a sound evidence base, the consideration of exercise as a therapeutic adjunct remains rare in mental health settings. This research project reports a series of studies examining the consideration of exercise as a strategy for promoting mental health in clinical settings. A broad, multi-level and multi-method analysis of exercise and mental health was adopted by focusing on trainers (key stakeholders responsible for treatment dissemination), providers (individuals at the forefront of treatment) and service users (individuals with clinical depression). First, the perceptions of exercise as an adjunctive therapy is qualitatively explored through interviews with Course Directors of UK training programmes in clinical psychology and mental health nurses working in acute, inpatient settings. A range of conceptual barriers are revealed such as the perceived `simplicity' of exercise interventions and the incompatibility of exercise with traditional models of understanding and treating clinical conditions. Second, the nature and extent of exercise promotion are identified within one NHS Mental Health Trust. A lack of training and protocols are the most significant barriers. The Theory of Planned Behaviour variables of attitude, subjective norms, perceived behavioral control, and intention predict stage of change of physical activity promotion in a health care setting. However, the past promotion of physical activity overrides much of these effects. Third, the role of exercise in the lives of individuals with depression is explored in a case study analysis of four participants of an exercise referral scheme. The context of each person's life is instrumental in understanding adherence and the experiences associated with participation in exercise and/or physical activity. These studies offer insight to some of the conceptual and structural barriers inhibiting the promotion of exercise as well as factors that may contribute to the success of such promotion within mental health settings. Recommendations are offered to enhance the development of comprehensive physical activity provision for people with mental health problems.

Sun protective attitudes and intentions were investigated in 2 experiments and 1 field study. Participants in the first experiment were female Caucasian university students between the ages of 17 and 35 years (N = 102). A 2 x 2 experimental design manipulated message frame and the normative context and measured the level of identification with the ingroup (university students) to examine intentions to engage in sun protective behaviour within the next fortnight and within the next month. To manipulate levels of ingroup normative support, participants studied bar graphs and testimonial statements showing ostensible information on the percentage of recreational sportswomen engaging in sun-protective behaviours in comparison to non-sporting women. To manipulate the message frame, messages were presented in either a gain or loss frame format. Regression analyses revealed significant effects for prior attitudes towards engaging in sun-protective behaviour in the next fortnight and also in the next month. Contrary to expectations, no interactive effects involving norms were found in the prediction of intentions. The lack of significant results were attributed to the unsuitability of the sample population (university students) in relation to sun-protective behaviours. To test third person perceptions, two measures of perceptions of influence were assessed. The first measure assessed perceptions of how much the target groups would be affected by the sun-protective advertisement and the second assessed perceptions of how much target groups would engage in regular sun-protective behaviour after reading the sun-protective advertisement. Results of the repeated measures mixed ANOVAS revealed reversed third person perceptions between self and other when participants were exposed to a supportive ingroup norms and a Sun-protective attitudes and behaviours vi classic third person effect when participants were exposed to a non-supportive ingroup norm. Similar patterns of results were found for perceptions between ingroup and outgroup members. It was concluded from study one that the manipulations due to ingroup norms may not have been effective for a sample of participants whose personal relevance for sun-protective behaviour was not strong. In study 2, sun protective attitudes, intentions and behaviour at a 2-week follow-up were investigated in an experimental study using a population more likely to engage in decision-making in relation to the target behaviour; Caucasian sportswomen between the ages of 17 and 35 years (N = 101). The 2 x 2 experimental design manipulated the normative context and image norms and measured the level of identification with ingroup (young recreational sportswomen). Ingroup norms were manipulated in a similar manner to study 1. Image norms were manipulated through the inclusion of a colour photograph featuring a sportswoman whose skin tone had been manipulated via a computer imaging program (Photoshop 6.0) to appear either pale or tanned. Regression analyses revealed a significant 2-way interaction for ingroup norm x identification on intentions. When decomposed, the interaction showed that participants who identified strongly with their ingroup had stronger intentions to engage in sun-protective behaviour in the next fortnight when exposed to a supportive ingroup norm. The findings lend support to the impact of social influence on intentions to engage in sun-protective behaviours. A trend was also revealed for the 2-way interaction for group norms x image norms on attitudes towards engaging in sun-protective behaviour in the next fortnight. The trend suggested that participants exposed to a pale image norm had more positive attitudes towards engaging in sun-protective behaviour when exposed to a supportive group norm in comparison to those exposed to a non-supportive group norm. Sun-protective attitudes and behaviours vii Thus, study 2 provided support for the interactive effects of ingroup norms and identification on intentions to engage in sun-protective behaviours suggesting that group norms, conceptualised from a SIT/SCT perspective, may be important in the sun-protective decision-making process. Study 2 also provided some support for the interactive effects of ingroup norm and image norms on attitudes towards engaging in sun-protective behaviours, highlighting the importance of investigating the effects of social influence factors in young sportswomen's sun-protective decision making processes. In study 3, participants were Caucasian women between the ages of 17 and 35 years (N = 123) who were visitors to beaches on the Sunshine Coast, Queensland, Australia. A model based on the theory of planned behaviour (Ajzen, 1991) was developed incorporating additional normative factors (i.e., image norms, group norms and personal norms). The revised TPB model was then compared to two models previously tested in the context of health behaviours. The first comparative model was based on Jackson and Aiken's (2000) psychosocial model of sunprotection and, the second model was based on Gibbons, Gerrard, Blanton and Russell's (1998) prototype/willingness model. The models were examined using the EQS structural equation modelling program which revealed that the TPB-based model provided the most parsimonious fit to the data. The results support the inclusion of different sources of social influence (i.e., group norms and personal norms) in a TPB-based predictive model for sun-protective intentions and behaviours. Results revealed it is important to consider the impact of group norms, from a SIT/SCT perspective, on young women's sun-protective decision-making processes. Results also showed that it is important to consider the impact of young women's personal norms (i.e., internal moral rules and expectations about their own Sun-protective attitudes and behaviours viii behaviour) in the sun-protective decision-making process. Overall, the findings of the program of research suggested that it was specific referent norms that were important in the sun-protective decision-making process rather than more broad and general societal norms. Overall, the program of studies established the important role of social influence factors in young women's sun-protective decision making processes. The program of studies highlighted important theoretical and practical contributions that can aid in the development and implementation of more effective sun-protection messages to motivate young women to engage in sun-protective behaviours. The current program of research adds to the field of research by providing a comparison of the impact of various sources of social influence on attitudes and intentions to engage in sun-protective behaviour. The current research also empirically elucidates the core dimensions, mechanisms and relationships underlying the formation of sunprotective attitudes, intentions and behaviours.

The worldwide organ shortage occurs despite people’s positive organ donation attitudes. The discrepancy between attitudes and behaviour is evident in Australia particularly, with widespread public support for organ donation but low donation and communication rates. This problem is compounded further by the paucity of theoretically based research to improve our understanding of people’s organ donation decisions. This program of research contributes to our knowledge of individual decision making processes for three aspects of organ donation: (1) posthumous (upon death) donation, (2) living donation (to a known and unknown recipient), and (3) providing consent for donation by communicating donation wishes on an organ donor consent register (registering) and discussing the donation decision with significant others (discussing). The research program used extended versions of the Theory of Planned Behaviour (TPB) and the Prototype/Willingness Model (PWM), incorporating additional influences (moral norm, self-identity, organ recipient prototypes), to explicate the relationship between people’s positive attitudes and low rates of organ donation behaviours. Adopting the TPB and PWM (and their extensions) as a theoretical basis overcomes several key limitations of the extant organ donation literature including the often atheoretical nature of organ donation research, thefocus on individual difference factors to construct organ donor profiles and the omission of important psychosocial influences (e.g., control perceptions, moral values) that may impact on people’s decision-making in this context. In addition, the use of the TPB and PWM adds further to our understanding of the decision making process for communicating organ donation wishes. Specifically, the extent to which people’s registering and discussing decisions may be explained by a reasoned and/or a reactive decision making pathway is examined (Stage 3) with the novel application of the TPB augmented with the social reaction pathway in the PWM. This program of research was conducted in three discrete stages: a qualitative stage (Stage 1), a quantitative stage with extended models (Stage 2), and a quantitative stage with augmented models (Stage 3). The findings of the research program are reported in nine papers which are presented according to the three aspects of organ donation examined (posthumous donation, living donation, and providing consent for donation by registering or discussing the donation preference). Stage One of the research program comprised qualitative focus groups/interviews with university students and community members (N = 54) (Papers 1 and 2). Drawing broadly on the TPB framework (Paper 1), content analysed responses revealed people’s commonly held beliefs about the advantages and disadvantages (e.g., prolonging/saving life), important people or groups (e.g., family), and barriers and motivators (e.g., a family’s objection to donation), related to living and posthumous organ donation. Guided by a PWM perspective, Paper Two identified people’s commonly held perceptions of organ donors (e.g., altruistic and giving), non-donors (e.g., self-absorbed and unaware), and transplant recipients (e.g., unfortunate, and in some cases responsible/blameworthy for their predicament). Stage Two encompassed quantitative examinations of people’s decision makingfor living (Papers 3 and 4) and posthumous (Paper 5) organ donation, and for registering and discussing donation wishes (Papers 6 to 8) to test extensions to both the TPB and PWM. Comparisons of health students’ (N = 487) motivations and willingness for living related and anonymous donation (Paper 3) revealed that a person’s donor identity, attitude, past blood donation, and knowing a posthumous donor were four common determinants of willingness, with the results highlighting students’ identification as a living donor as an important motive. An extended PWM is presented in Papers Four and Five. University students’ (N = 284) willingness for living related and anonymous donation was tested in Paper Four with attitude, subjective norm, donor prototype similarity, and moral norm (but not donor prototype favourability) predicting students’ willingness to donate organs in both living situations. Students’ and community members’ (N = 471) posthumous organ donation willingness was assessed in Paper Five with attitude, subjective norm, past behaviour, moral norm, self-identity, and prior blood donation all significantly directly predicting posthumous donation willingness, with only an indirect role for organ donor prototype evaluations. The results of two studies examining people’s decisions to register and/or discuss their organ donation wishes are reported in Paper Six. People’s (N = 24) commonly held beliefs about communicating their organ donation wishes were explored initially in a TPB based qualitative elicitation study. The TPB belief determinants of intentions to register and discuss the donation preference were then assessed for people who had not previously communicated their donation wishes (N = 123). Behavioural and normative beliefs were important determinants of registering and discussing intentions; however, control beliefs influenced people’s registering intentions only. Paper Seven represented the first empirical test of the role of organ transplant recipient prototypes (i.e., perceptions of organ transplant recipients) in people’s (N = 465) decisions to register consent for organ donation. Two factors, Substance Use and Responsibility, were identified and Responsibility predicted people’s organ donor registration status. Results demonstrated that unregistered respondents were the most likely to evaluate transplant recipients negatively. Paper Eight established the role of organ donor prototype evaluations, within an extended TPB model, in predicting students’ and community members’ registering (n = 359) and discussing (n = 282) decisions. Results supported the utility of an extended TPB and suggested a role for donor prototype evaluations in predicting people’s discussing intentions only. Strong intentions to discuss donation wishes increased the likelihood that respondents reported discussing their decision 1-month later. Stage Three of the research program comprised an examination of augmented models (Paper 9). A test of the TPB augmented with elements from the social reaction pathway in the PWM, and extensions to these models was conducted to explore whether people’s registering (N = 339) and discussing (N = 315) decisions are explained via a reasoned (intention) and/or social reaction (willingness) pathway. Results suggested that people’s decisions to communicate their organ donation wishes may be better explained via the reasoned pathway, particularly for registering consent; however, discussing also involves reactive elements. Overall, the current research program represents an important step toward clarifying the relationship between people’s positive organ donation attitudes but low rates of organ donation and communication behaviours. Support has been demonstrated for the use of extensions to two complementary theories, the TPB and PWM, which can inform future research aiming to explicate further the organ donation attitude-behaviour relationship. The focus on a range of organ donation behaviours enables the identification of key targets for future interventions encouraging people’s posthumous and living donation decisions, and communication of their organ donation preference.

This study investigates the factors that influence appropriate use of audit support systems. Appropriate use is use of an audit support system in a manner consistent with how the audit firm expects the system to be used. Investigating appropriate use of audit support systems is important because the extent to which these systems can assist auditors achieve efficient and high quality audits depends on how auditors use them. Adaptive Structuration Theory (AST) (DeSanctis and Poole, 1994) and the Theory of Planned Behaviour (TPB) (Ajzen, 1991) are combined to model the relationship between constructs hypothesised to increase the probability that audit support systems are used appropriately. The theoretical model decomposes two TPB antecedents, perceived normative pressure (or subjective norms) and perceived behavioural control, into the exogenous constructs hypothesised to influence whether audit support systems are used appropriately. Perceived normative pressure is decomposed into two socio-ideological control mechanisms, team and firm consensus on appropriation. Perceived behavioural control is decomposed into self-efficacy and two technocratic control mechanisms, perceived system restrictiveness and perceived audit review effectiveness. (For complete abstract open document)

ABSTRACT Objectives: To develop and validate in an Australian setting, an instrument to effectively measure patient safety culture; to survey health care workers (HCWs) in a large public healthcare system to establish baseline patient safety culture; and, using the Theory of Planned Behaviour (TPB), to use behavioural modelling to identify the factors that predict and influence Patient Safety Behavioural Intent (PSBI) Eg. Reporting clinical incidents and speaking up when a colleague makes an error. Design: Cross sectional survey analysed with multiple logistic regression (MLR). Setting: Metropolitan, regional and rural public hospitals in Queensland, Australia. Participants: 5294 clinical and managerial staff. Main outcome measures: 1) Behavioural models for high-level Patient Safety Behavioural Intent (PSBI) for senior and junior doctors, senior and junior nurses, and allied health professionals. 2) Odds ratios to compare levels of PSBI between professional groups. Results: 1) The factors that influence high-level PSBI for each professional group give rise to unique predictive models. Two factors stand out as influencing high-level PSBI for all HCWs (R2 0.21). These are: i) Preventive Action Beliefs (Adjusted Odds Ratio (AOR) 2.38) (HCWs??? belief that engaging in the target behaviour(s) will lead to improved patient safety) and ii) Professional Peer Behaviour (AOR 1.79) (HCWs??? perceptions of the safety behaviour(s) of one???s professional peers). 2) There was a six-fold difference in the level of target behaviour (PSBI) across the clinical groups with few (29.6%) junior doctors having a high-level of PSBI. When compared with the junior doctors, the senior doctors were nearly 1.5 times more likely (Odds Ratio (OR) 1.46, 95% Confidence Interval (CI) 1.01-2.13), allied health staff 2.7 times more likely (OR 2.71, 95%CI 1.91-3.73), junior nurses 3.9 times more likely (OR 3.86, 95%CI 2.83-5.26), and senior nurses 6.0 times more likely (OR 6.01, 95%CI 4.78-9.16) to have high-level PSBI. Conclusions: This is the first published study to develop behavioural models of factors that influence HCWs??? intention to engage in behaviours known to be associated with improved patient safety. The findings of this study will greatly assist in the future design and implementation of targeted and cost-effective patient safety improvement initiatives.

The project described in this thesis was designed to investigate HIV preventive behaviour in heterosexual adolescents from a social-cognitive perspective. The project consisted of three studies. The design of each study was guided by a theory of human decision making, the Theory of Reasoned Action (TRA), and its extension, the Theory of Planned Behaviour (TPB). In the first phase, an elicitation study was conducted in which characteristics of the population were identified. This study consisted of a series of semi-structured interviews in which participants' sexual behaviours, beliefs and normative influences were elicited. This information was required in order to enable studies two and three to target beliefs and behaviours relevant to the population being examined. In the second study, a large-scale survey of 417 university aged adolescents was conducted. This study was designed, primarily, to examine quantitatively the determinants of safe sex intentions and behaviours within the targeted population. Determinants of behaviour examined were those included in the TRA/TPB. Hierarchical multiple regression analyses were conducted to determine the amount of variance in safe sex intentions and behaviours accounted for by TRA/TPB variables. In addition, a number of methodological issues related to criticisms of the TRA/TPB in the context of prediction of sexual behaviours were investigated. These issues included the utility of examining preference for alternative safe sex strategies in accounting for non-use of condoms, the importance of considering behaviour change as a process rather than an outcome, the importance of heat of the moment decision-making in the prediction of condom use behaviour, and the importance of consistent specification of partner type in survey instruments examining condom use behaviour. The third phase of the project consisted of an intervention study designed to modify HIV-risk related beliefs and behaviours. Design and evaluation of the intervention were guided by the TRA/TPB. The intervention was conducted using 102 participants, randomly assigned to intervention or control conditions. Methodological issues examined in study 2 were further explored in this study. Overall, it was found that the Theories of Reasoned Action and Planned Behaviour provided a useful framework for understanding, predicting, and modifying HIV-related sexual behaviours. The theories were found to explain between 67 and 73% of variance in condom use intentions, and between 52 and 55% of variance in behaviour. The theories were also found to be applicable to other safe sex behaviours with 50% of variance accounted for in monogamy intentions, and 34% of variance explained in behaviour, and 40% of the variance in non-penetrative sexual intentions, but only 6% of variance in non-penetrative sexual behaviour explained. In addition, a behaviour modification intervention based on the theories was found to lead to change in both predictor variables and behaviours, relative to controls. These changes were maintained over a 6-month follow-up period. That is, a series of mixed factorial Analyses of Variance revealed that the percentage of encounters in which a condom was used was significantly greater for the four weeks prior to follow-up compared with the four weeks prior to the intervention. In addition, the number of 'slip-ups' into unsafe behaviours was found to be significantly less. Change in TRA/TPB predictor variables which accompanied these behavioural changes included increased perceptions of behavioural control, more positive attitudes towards sexuality and safe sex behaviours, and more positive normative perceptions. These results were seen to provide strong support for the theories of reasoned action and planned behaviour and for their relevance to the study of HIV-preventive behaviour. However, prediction of safe sex behaviours was found to be enhanced in most cases by consideration of the methodological issues explored in each study. Thus, it was found that consideration of safe sex strategies other than condom use and the type of partner with whom the behaviour was occurring were important in both the prediction and evaluation of efforts to modify condom use behaviour. In addition, prediction of condom use behaviour and evaluation of intervention effects were enhanced by the consideration of behaviour change as a stage-like process, rather than as an all or nothing outcome. Results relating to the importance of heat of the moment decision making were less clear, and further research is recommended to clarify the issue. Overall, these results have important implications for safe sex education, and should be considered in efforts to modify unsafe behaviour as well as efforts to evaluate the effects of this modification.

Background: Due to the fashion industry being one of the most polluting industries in the world with more clothing than ever being thrown away, attention has been brought to the need for more sustainable clothing behaviours. Therefore, the in-store recycling boxes have been introduced as an alternative for recycling. Previous literature has focused mainly on companies’ perspectives or consumers purchasing behaviours, hence there is a gap for literature on consumers’ disposal and recycling behaviours. Purpose: The purpose of this study is to examine what factors influence consumers’ intentions to use in-store recycling boxes. This will be done by applying the Theory of Planned Behaviour by Ajzen (1991). Method: A qualitative approach in terms of two focus groups and two individual interviews was applied. The study was made on the consumers’ perspectives, and therefore the participants were 11 Swedish female students. Conclusion: The empirical findings and analysis toward previous literature and theoretical framework revealed that the main factors influencing consumers’ intentions to use in-store recycling boxes are lack of information about the recycling process, the possibility to drop off damaged clothing, and the developing possibility to make new clothing out of recycled materials. The lack of information had the greatest impact, which was unfavourable toward the intention to perform the behaviour and hence obstructed the participants from using in-store recycling boxes.