behaviour and commitment. Reiss et al. tested the model and reported support for
the first three of the variables as predictive of contraception use. This model is still
predominantly concerned with individual cognitions.
The health belief model
This model was developed by Rosenstock and Becher (e.g. Rosenstock 1966; Becker and
Rosenstock 1987) and is described in detail in Chapter 2. The original HBM emphasized
individual cognitions and ignores the problem of interaction. Lowe and Radius (1982)
developed the HBM specifically to predict contraception and aimed to examine individual
cognitions within both the context of the relationship and broader social norms. They
added the following variables:
self-esteem;
interpersonal skills;
knowledge about sex and contraception;
attitudes to sex and contraception;
previous sexual, contraceptive and pregnancy experiences;
peer norms;
relationship status; and
substance use prior to sex.
Therefore, although this model still examines cognitions, it includes measures of the
individuals’ cognitions about their social world.
The theory of reasoned action
This theory was developed by Fishbein and Ajzen (1975) and is described in detail in
Chapter 2. The TRA was the first cognition model to include measures of individuals’
cognitions about their social world in the form of subjective norms. It therefore
represents an attempt to add the social context to individual cognitive variables and
consequently addresses the problem of interaction. The TRA has been used to predict
contraceptive use and research has indicated a correlation between the components of
the model and intentions to use the oral contraceptive (Cohen et al. 1978). In addition,
research by Werner and Middlestadt (1979) reported correlations between attitudes to
contraception and subjective norms and actual use of oral contraception.
Sexual behaviour sequence model
This model was developed by Byrne et al. (1977) and adds sexual arousal and emotional
responses to sex to the factors included in the TRA. Sexual arousal refers to how aroused
an individual is at the time of making a decision about contraception. Emotional
responses to sex describes a personality trait that Byrne et al. defined as either eroto-
philia (finding sexual cues pleasurable) or erotophobia (finding sexual cues aversive).
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