Critical Review of a Paper Investigating the Application of the Theory of Planned Behaviour to Alcohol Consumption During Pregnancy

IntroductionThe paper to be palingenesised is an investigation by Dun groundwork, Forbes-McKay and Henderson (2012) into the application of the opening of planned deportment (TPB, Ajzen, 1988, 1991) and its effectiveness in count oning tendency to carry erupt wellness related demeanours. The TPB is a societal apprehension modelling, meaning that it seeks to prognosticate intention to carry forth a doings and to understand why man-to-mans may fail to adhere to a demeanour to which they were once committed. The theory claims that ternion vari equals can be habituated to predict an individuals demeanor the individuals military capability toward the behaviour, the stance of significant others toward the behaviour and the individuals perceived watch all over a behaviour. Perceived control over behaviour is governed by twain internal factors such as an individuals skills or purchasable resources, and external factors such as echt opportunities to carry start th e behaviour. strange the individuals lieu toward the behaviour and the attitude of others, perceived control over the behaviour is believed to influence some(prenominal) the intention to carry give away the behaviour and the behaviour itself. In particular, the authors were examine whether the TPB could be used to predict intention to consume intoxicantic drink during maternity. Previous research has comprise the TPB to be useful for predicting a range of other health related behaviours (Godin and Kok, 1996) and intoxicant consumption behaviours in particular (Marcoux & Shope, 1997 McMillan & Conner, 2003). The authors focused on the role of TPB in organism able to predict the consumption of alcoholic beverage during pregnancy. Drinking during pregnancy is a major health issue. It has been ground to influence a issue forth of outcomes for the child including maladaptive behaviours (Sood et al., 2001) and weight at birth (Mariscal et al., 2006). Despite its comparison to negative outcomes for the child, up to 54% of women in the UK confirm claimed to energize consumed alcohol during their pregnancy (Bolling et al., 2007).Study Description130 women ground in the Aberdeenshire flying field returned a questionnaire that was distributed to them at their 20-week pregnancy scan. Of these, analysis was carried out on 116 women. The questionnaire include questions knowing to gather learning on demographic details, past and fork up alcohol consumption, and TPB variables. The TPB variables included measuring the participants intention to engage in the behaviour, their attitude toward the behaviour, their beliefs about the internal norm and their perceived behavioural control. The athletic field base that the majority of participants made changes to their drunkenness behaviour once they undercoat out that they were pregnant, with these changes taking the form of a reduction in alcohol consumption. 64.7% abstained from alcohol altogether during the ir pregnancy, 34.5% keep to drink to some level and 0.9% did non answer. Of those women who continued to drink during their pregnancy, 13.4% were drinking above the recommended maximum levels whereas the rest were drinking ace to two units between two and four times per month. It was to a fault found that although most participants received information about drinking during their pregnancy, 12.9% received no information. In relation to the TPB theory, it was found that women who abstained from drinking after finding out they were pregnant had importantly higher scores on the intention scale, suggesting that they had a significantly greater intention to quit alcohol consumption during pregnancy. Abstaining participants also had significantly higher scores on the subjective norm scale, indicating that they felt more pressure from what others thought about drinking during pregnancy. Abstainers were also found to have significantly spurn scores on the attitude scale, suggesting a m uch less positive attitude toward the behaviour of drinking during pregnancy. In contrast,, the scale that measured perceived behaviour control did not expose any significant differences between those women who abstained and those who continued to drink during their pregnancy.Attitude toward the behaviour and the influence of what others thought of the behaviour were found to be strongly and significantly correlated with intention to carry out the behaviour of abstaining from alcohol during pregnancy. TPB was able to explain 59.3% of variance in intention to drink during pregnancy. Furthermore, the theory was able to correctly classify 91.8% of cases and as a result, was statistically able to call attention between drinkers and abstainers. The authors concluded that as attitude was found to have the great statistically significant contribution to predicting intention and to contribute significantly to predicting actual behaviour, it would be an ideal candidate for discourse focu s. As perceived behaviour control was the unaccompanied TPB component found not to contribute, the authors suggest that the model without this component would be appropriate for predicting intention to consume alcohol during pregnancy. detailed ReviewThe reviewed article addressed an important health issue, namely investigating how drinking alcohol during pregnancy could be reduced by taking into custody what drives or stops women from having the intention to carry out this behaviour. The finding that attitude toward drinking whilst pregnant has a significant impact on both intention to drink during pregnancy and actual drinking during pregnancy could have wider clinical and tuitional applications. Nevertheless, the authors atomic routine 18 vague in how their findings could be apply in the real world and fail to groom useful suggestions based on their data. The finding that some women were not provided with information pertaining to the consumption of alcohol during pregnanc y is also an important one because it highlights that some health trusts atomic number 18 failing to help women make informed decisions about this subject. However, it is not stirred upon in the discussion.The cultivations introduction is a little irresolute in that it does not make an overly convincing argument as to why their chosen topic is important and worth investigating. It makes only a brief reference to the negative impact that alcohol consumption can have on both mother and baby, and the literature to which it refers is quite outdated. This suggests that a thorough and recent literature review may not have been carried out. Furthermore, the study could present a much stronger argument as to why the TPB may be applicable to this health behaviour in particular. at that pop out is some justification in that the authors of the paper chose this particular theory on the premise that a socially-based theory such as TPB could highlight guess factors for the consumption of a lcohol during pregnancy that could be more easily influenced than anterior run a risk factors that have been identified such as drinking habits beforehand pregnancy and socioeconomic status (Stewart & Streiner, 1994 Yamamoto et al., 2008). Risk factors such as these cannot be easily changed. In contrast, risk factors based on attitudes toward a behaviour can be more easily altered through education or government interventions. The discussion does not flow particularly wellhead and the overall conclusions of the study argon not entirely clear. An ad wagon traintage of the TPB is its holistic approach. It attempts to understand the behaviour of an individual in the context of both an individuals attitude toward a behaviour, their perceived control over that behaviour and how they perceive others to judge the behaviour. However, our intentions to carry out a behaviour or not be the result of an incredibly complex process during which legion(predicate) variables are taken into acc ount. Although the limitations of the studys methodology are stirred upon in the discussion, the authors fail to explore the limitations of the TPB and how these may affect their findings. For example, McKeown (1979) argued that negative health behaviours are determined on the individual level by the choices we make to behave in a certain representation. in that respectfore, the theory may place too much emphasis on the importance of what others think of a behaviour. Indeed, in the current study, individual attitudes toward a behaviour were found to be more influential than subjective norms.One criticism of this study is its latent lack of representativeness, both culturally and geographically. Ethnic minorities made up only 6.9% of the sample, meaning that the results may not be generalisable to ethnic minorities. Furthermore, the sample was self-possessed from only one geographic area, although the authors argue that their findings are in property with previous studies that used samples from a much wider geographical area (Anderson et al., 2007 Bolling et al., 2007). There may also have been a bias in the way in which participants were recruited. Women were approached by the researchers whilst awaiting their 20 week antenatal scans in hospital. The scans are designed to screen for any anomalies in the baby and to check that culture is normal. These scans are not compulsory, potentially creating a bias in the sample. For example, Alderdice et al. (2007) found that women without qualifications or women from areas of high deprivation were significantly less in all probability to inhalation an offer of a 20 week screen for Downs Syndrome than women from affluent areas or women with degree-level qualification. This suggests that the women who were approached by the researchers in the current study may have been under-representative of women from lower socio-economic backgrounds. Furthermore, the study does not provide detail on the demographic informatio n of the women who responded to the questionnaire, which would have been useful in evaluating generalisability.The measure used to ascertain TPB variables was genuine using guidelines for the development of questionnaires designed to measure TPB behaviours (Francis et al., 2004). However, the measurement used was not a validated questionnaire. Furthermore, the authors do not provide examples of how they measured the three variables of intention, subjective norm and perceived behaviour control. This means that the measure cannot be opened up for scrutiny or re-used in later studies to judge its validity and reliability. Before the main study, a small pilot study was carried out with seven pregnant women to ensure that the questionnaire was easy to understand. Pilot studies are essential for establishing a sound study design (van Teijilngen & Hundley, 2001). Although, it should be tell that the authors did not report the results of any reliability or validity tests. As part of the test battery, the study did use the alcoholic beverage Use Disorders credit Test, a reliable and valid measure for gathering information on alcohol consumption that was developed by the World wellness system of rules (Saunders et al., 1993, Scottish Intercollegiate Guidelines Network, 2004). This measurement has been reported to be superior to other measures designed to collect data on the same subject (Reinert & Allen, 2002).Self-report measures in themselves have a number of limitations. Firstly, they are subject to social oomph bias. Social desirability bias acknowledges that participants may report carrying out behaviours that are socially desirable or may cover up being involved in behaviours that are frowned on. Based on the finding that subjective norms had a significant impact on both intention and behaviour, social desirability bias may have affected the results of this study. If participants were so influenced by what others thought of alcohol consumption during pregnan cy, then they may have been likely to cover up occasions on which they did drink during their pregnancy. This means that the number of participants who did drink during pregnancy may have been higher than the study reported.Recommendations for usefulness and Future ResearchIf this study is to be replicated, it could be improved in a number of ways. Firstly, ethnic minorities mustiness be better represented. outstanding Britain is now a multi-cultural country and research must reflect this. The authors must provide more information or a copy of the questionnaire designed to measure TPB variables so that reliability and validity can be assessed. A useful future study would be to assess the impact of an intervention designed to change the attitude of women who do not perceive drinking alcohol during pregnancy to be an issue. As attitude was found to be the most important factor in intention to carry out this behaviour, the currently reviewed study would be strengthened if an interve ntion based approximately attitude was found to change behaviour.ReferencesAjzen, I. (1988). Attitudes, personality, and behavior. Milton Keynes, UK Open University Press.Ajzen, I. (1991). The theory of planned behavior. organizational Behavior and Human Decision Processes, 50, 179-211.Alderdice, F., McNeill, J., Rowe, R., Martin, D. & Dornan, J. (2008). Inequalities in the reported offer and use of goods and services of antenatal screening. Public Health, 122(1), 42-52.Anderson, S., Bradshaw, P., Cunningham-Burley, S., Hayes, F. Jamieson, L., MacGregor, A. et al. (2007). Growing up in Scotland A study following the lives of Scotlands children. 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