To examine how well the theories of reasoned action and planned behavior predict condom use, the authors synthesized 96 data sets (N = 22,594) containing associations between the models' key variables. Consistent with the theory of reasoned action's predictions, (a) condom use was related to intentions (weighted mean r. = .45), (b) intentions were based on attitudes (r. = .58) and subjective norms (r. = .39), and (c) attitudes were associated with behavioral beliefs (r. = .56) and norms were associated with normative beliefs (r. = .46). Consistent with the theory of planned behavior's predictions, perceived behavioral control was related to condom use intentions (r. = . 45) and condom use (r. = .25), but in contrast to the theory, it did not contribute significantly to condom use. The strength of these associations, however, was influenced by the consideration of past behavior. Implications of these results for HIV prevention efforts are discussed.Because condom use can prevent infection with HIV and other STDs, health agencies have designed various interdisciplinary efforts, oriented by behavioral prediction models, to persuade people to use condoms consistently. For example, the health belief model (Becker, 1974;Rosenstock, 1974) posits in part that increasing perceptions of vulnerability to HIV infection should increase precautionary behavior. Yet a recent quantitative synthesis found that chronic perceived vulnerability to HIV infection in members of high-risk groups is insufficient to motivate protective actions (Gerrard, Gibbons, & Bushman, 1996; but see Bryan, Aiken, & West, 1996). The limited support for the perceived-risk hypothesis suggests a need for other behavioral models of HIV-risk-related behavior.In the present article, we modeled condom use behavior on the basis of two general theories of behavior: (a) the theory of reasoned action (Ajzen & Fishbein, 1977, 1980Fishbein, 1980; Fishbein & Ajzen, 1975) and (b) the theory of planned behavior (Ajzen, 1988(Ajzen, , 1991 Correspondence concerning this article should be addressed to: Dolores Albarracín, Department of Psychology, University of Florida, Gainesville, Florida 32611. albarrac@psych.ufl.edu. HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript Ajzen & Driver, 1991;Ajzen & Madden, 1986;Schifter & Ajzen, 1985). Given that these models have predicted a wide range of behaviors successfully (see reviews by Ajzen, 1991; Eagly & Chaiken, 1993;Sheppard, Hartwick, & Warshaw, 1988) and have served as a basis for several HIV prevention efforts (e.g., Kamb, Dillon, Fishbein, Willis, & Project RESPECT Study Group, 1996; Kamb et al., 1998), we expected that they would also be valuable to predict condom use (cf. Sheeran & Orbell, 1998). The large number of studies that have now examined these models in relation to condom use (see Albarracín & Fishbein, 1993) and the variability of the findings suggest that a quantitative synthesis of this literature would prove valuable. Therefore, the purpose of the pre...

A meta-analysis assessed whether exposure to information is guided by defense or accuracy motives. The studies examined information preferences in relation to attitudes, beliefs, and behaviors in situations that provided choices between congenial information, which supported participants' pre-existing attitudes, beliefs, or behaviors, and uncongenial information, which challenged these tendencies. Analyses indicated a moderate preference for congenial over uncongenial information (d. = 0.36). As predicted, this congeniality bias was moderated by variables that affect the strength of participants' defense motivation and accuracy motivation. In support of the importance of defense motivation, the congeniality bias was weaker when participants' attitudes, beliefs, or behaviors were supported prior to information selection, when participants' attitudes, beliefs, or behaviors were not relevant to their values or not held with conviction, when the available information was low in quality, when participants' closed-mindedness was low, and when their confidence in the attitude, belief, or behavior was high. In support of the importance of accuracy motivation, an uncongeniality bias emerged when uncongenial information was relevant to accomplishing a current goal.

A meta-analysis (k of conditions = 128; N = 4,598) examined the influence of factors present at the time an attitude is formed on the degree to which this attitude guides future behavior. The findings indicated that attitudes correlated with a future behavior more strongly when they were easy to recall (accessible) and stable over time. Because of increased accessibility, attitudes more strongly predicted future behavior when participants had direct experience with the attitude object and reported their attitudes frequently. Because of the resulting attitude stability, the attitude-behavior association was strongest when attitudes were confident, when participants formed their attitude on the basis of behavior-relevant information, and when they received or were induced to think about one- rather than two-sided information about the attitude object.

This meta-analysis tested the major theoretical assumptions about behavior change by examining the outcomes and mediating mechanisms of different preventive strategies in a sample of 354 HIVprevention interventions and 99 control groups, spanning the past 17 years. There were 2 main conclusions from this extensive review. First, the most effective interventions were those that contained attitudinal arguments, educational information, behavioral skills arguments, and behavioral skills training, whereas the least effective ones were those that attempted to induce fear of HIV. Second, the impact of the interventions and the different strategies behind them was contingent on the gender, age, ethnicity, risk group, and past condom use of the target audience in ways that illuminate the direction of future preventive efforts. Keywords behavior change; active intervention; HIV; health; communicationThe development of effective health behavior interventions and adequate understanding of the processes that underlie change to risky behavior continues to top the agenda for reducing disease and death among at-risk populations. For example, infection with HIV has been diagnosed in almost 1 million people in the United States (Centers for Disease Control [CDC], 2003) as well as an estimated 40 million worldwide (UNAIDS/ WHO Working Group, 2002). In some countries, the epidemic continues to escalate, and even in nations that have successfully Copyright 2005 by the American Psychological AssociationCorrespondence concerning this article should be addressed to Dolores Albarracín, Department of Psychology, University of Florida, Gainesville, FL 32611. E-mail: E-mail: dalbarra@ufl.edu. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript curbed the spread of the disease, certain groups still show increases in infection rates (see, e.g., CDC, 2003). Given these distressing figures, it is no surprise that research on HIV prevention has become increasingly important and progressively more sophisticated. Indeed, HIV prevention presently constitutes one of the most significant paradigms for the discovery of health behavior change techniques and for the understanding of the theoretical processes that underlie such change.In fact, the HIV epidemic of the 1980s stimulated the uniting of funds and expertise from various disciplines in the development of a shared behavior-change paradigm. As a key example, in 1992, a group of behavioral researchers joined forces-upon request from the National Institutes of Health-to develop a paradigm for behavior change that would guide research and practice in the prevention of HIV (see Fishbein et al., 1992). Various models were examined, and the key assumptions were condensed into a limited number of premises that illuminated preventive efforts.Although the various models had independently received broad support, this support was derived almost entirely from behavior prediction studies. However, the formulation of these general assumptions contributed to...

Fear appeals are a polarizing issue, with proponents confident in their efficacy and opponents confident that they backfire. We present the results of a comprehensive meta-analysis investigating fear appeals’ effectiveness for influencing attitudes, intentions, and behaviors. We tested predictions from a large number of theories, the majority of which have never been tested meta-analytically until now. Studies were included if they contained a treatment group exposed to a fear appeal, a valid comparison group, a manipulation of depicted fear, a measure of attitudes, intentions, or behaviors concerning the targeted risk or recommended solution, and adequate statistics to calculate effect sizes. The meta-analysis included 127 papers (9% unpublished) yielding 248 independent samples (NTotal = 27,372) collected from diverse populations. Results showed a positive effect of fear appeals on attitudes, intentions, and behaviors, with the average effect on a composite index being random-effects trued¯ = 0.29. Moderation analyses based on prominent fear appeal theories showed that the effectiveness of fear appeals increased when the message included efficacy statements, depicted high susceptibility and severity, recommended one-time only (vs. repeated) behaviors, and targeted audiences that included a larger percentage of female message recipients. Overall, we conclude that (a) fear appeals are effective at positively influencing attitude, intentions, and behaviors, (b) there are very few circumstances under which they are not effective, and (c) there are no identified circumstances under which they backfire and lead to undesirable outcomes.