Applying the theory of planned behavior to examine adjuvant endocrine therapy adherence intentions

Abstract

Objective Adherence to adjuvant endocrine therapy (AET) in breast cancer survivors is suboptimal. Using the theory of planned behavior (TPB), this study aimed to identify the strongest predictors from the TPB of AET intentions and past behavior and assessed whether ambivalence and anticipatory emotions increased the predictive capacity of TPB. Methods Two hundred eighty women diagnosed with hormone positive (HR+) breast cancer who filled at least one prescription of AET responded to a survey measuring TPB constructs, attitudinal ambivalence, and anticipatory emotions. The outcomes were intentions to adhere to AET and past medication adherence (previous 2 weeks). Results The TPB explained 66% of intentions to adhere to AET (P < 0.001). Ambivalence did not improve the TPB model's predictive value. When emotions were included with TPB, the model explained 70% of adherence intentions F11,226 = 52.84, P < 0.001 (R2c = .70). This increase of 4% in predictability was statistically significant (ΔR2 = 0.04), F6, 226 = 7.90, P < 0.001. Women who self‐reported nonadherence in the past 2 weeks differed significantly in the TPB variables, ambivalence, and anticipatory emotions from adherent women. Nonadherent participants reported lower‐future intentions to adhere F1, 236 = 5.63, P = 0.018. Conclusions Results suggest key concepts, such as anticipatory positive emotions that should be addressed in future interventions to enhance AET adherence and survivorship.

Application of the theory of planned behavior in the design and implementation of a behavior-based safety plan in the workplace

“…The findings of the present study showed that interventions based on the theory of planned behavior can be effective in creating safe behavior of supervisors. The findings of the present study are consistent with other studies that show the effectiveness of the theory of planned behavior in nutritional behavior,[ 18 ] energy savings in the workplace,[ 19 ] use of appropriate vehicles to reduce air pollution,[ 20 ] following the treatment,[ 21 ] infant nutrition,[ 22 ] and physical activity. [ 23 ]…”

Parent of Origin Effects on Family Communication of Risk in BRCA+ Women: A Qualitative Investigation of Human Factors in Cascade Screening

“…Thus, mapping our findings onto the Theory of Planned Behavior (TPB) contributes to advancing novel, tailored family interventions promoting cancer predisposition cascade genetic testing for BRCA . This theoretical contribution towards developing complex interventions promoting cascade screening is further supported by the demonstrated utility of the TPB in breast cancer and genetic counseling [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

“…Accordingly, the United Kingdom Medical Research Council recommends integrating relevant theories/frameworks when developing complex interventions [ 23 ]. One theory, the Theory of Planned Behavior (TPB) [ 24 ], has been effectively used in the context of breast cancer to describe a wide range of cancer-related behaviors including screening/mammography [ 25 ], risk-reducing surgeries [ 26 , 27 ], lymphedema risk reduction activities [ 28 ], adherence to adjuvant endocrine therapies [ 29 ], as well as contacting potentially at-risk relatives [ 30 ]. Similarly, the TPB has been employed in the field of genetic counseling [ 31 ] to better understand and predict behaviors around prenatal genetic testing [ 32 ] and expanded carrier screening [ 33 ].…”

Using abstractness to confront challenges: How the abstract construal level increases people’s willingness to perform desirable but demanding actions.

“…Following these previous applications, we recommend extending these applications to a broader variety of desirable but difficult behaviors. For instance, recent research investigating adherence to adjuvant endocrine therapy (AET) in breast cancer survivors has shown that women who associate positive emotions, such as calm and hopeful, with treatment (both positive emotions are associated with an abstract mindset) reported higher intentions of adherence (Hurtado-de-Mendoza et al, 2019). These results highlight the necessity of tailoring health promotion campaigns to focus on positive emotions and considering that women may have to endure the side effects of AET in the short term for greater chances of survival in the long term (a large personal challenge).…”