and AIDS and were available widely. They excluded those that were aimed at lesbians
due to their focus on protective measures other than condoms and those that targeted a
limited audience such as HIV positive men. The authors then identified the best cognitive
and behavioural correlates of condom use based upon a meta analysis by Sheeran
et al. (1999), defined 20 correlate representative categories to reflect these correlates
and then rated the leaflets according to the inclusion and frequency of these factors.
The results showed very little association between theory and this form of behavioural
intervention. Specifically, only 25 per cent of the leaflets referred to ten or more of the
correlates and two-thirds of the leaflets failed to frequently target more than two of
the correlates. Although, research is often aimed at informing practice, it would seem
that this is not often the case. How theory can be used to inform practice will now be
explored.Putting theory into practice
Given the call for more theory based interventions, some researchers have outlined how
this can be done. In particular, Sutton (2002b) draws upon the work of Fishbein and
Middlestadt (1989) and describes a series of steps which can be followed to develop an
intervention based upon the TRA although he argued that the steps could also be applied
to other models.Step 1: Identify target behaviour and target population.
Step 2: Identify the most salient beliefs about the target behaviour in the target popula-
tion using open ended questions.
Step 3: Conduct a study involving closed questions to determine which beliefs are
the best predictors of behavioural intention. Chose the best belief as the target
belief.
Step 4: Analyse the data to determine the beliefs which best discriminate between
intenders and non intenders. These are further target beliefs.
Step 5: Develop an intervention to change these target beliefs.However, as Sutton (2002b) points out this process provides clear details about the
preliminary work before the intervention. But the intervention itself remains unclear.
Hardeman et al. (2002) carried out a systematic review of 30 papers which used the TPB
as part of an intervention and described a range of frameworks which had been used.
These included persuasion, information, increasing skills, goal setting and rehearsal of
skills. Sutton (2002b) indicates that two additional frameworks could also be useful. These
are guided mastery experiences which involve getting people to focus on specific beliefs
(e.g. Bandura 1997) and the ‘Elaboration Likelihood’ model (Petty and Cacioppo 1986)
involving the presentation of ‘strong arguments’ and time for the recipient to think
about and elaborate upon these arguments. Studies have also used a range of methods
for their interventions including leaflets, videos, lectures and discussions. However,
to date although there has been a call for interventions based upon social cognition
models clear guidelines concerning how theory could translate into practice have yet to
be developed.42 HEALTH PSYCHOLOGY