Reducing Adolescent Sexual Risk: A Theoretical - ETR Associates

4ImprovingPerceptions of Risks—Both Susceptibility and SeverityKeys to ImprovingPerceptions of RiskFocus on important risks (e.g., pregnancy andSTD/HIV) and situations that might lead torisk behavior. Help youth overcome a sense ofinvulnerability by visualizing and personalizingrisks, situations leading to risks and methodsof avoiding them.BackgroundAs we all observe daily, if people believe that somebehavior will greatly increase their likelihood of adeadly outcome, they are less likely to engage inthat behavior. For example, people do not intentionallydrive the wrong way down the freeway, because1) driving the wrong way increases the likelihood ofa head-on collision and 2) the severity of a head-oncollision is great.This basic principle of behavior is embedded in manysocio-psychological theories of human behavior,particularly those that assume that people generallyconsider alternative courses of action, identifythe possible consequences of each course of action,consider the probability of each consequence, assesseach consequence according to its desirability (orundesirability) and make a decision about whichcourse of action to follow.Many theories commonly used to design effectivehealth education programs incorporate thisprinciple. (See the “Health Education and HealthBehavior Theory” section in the resources at the endof this book.) According to the health belief model,individuals’ perceived susceptibility to a disease orhealth problem and their perceived severity of thatdisease or health problem affect their efforts to avoidit (Rosenstock 1974). For example, if people believethat 1) particular behaviors increase their likelihoodof contracting HIV and 2) HIV is a severe disease,then they are more likely to adopt behavior that willreduce their susceptibility to HIV.Similarly, in both the theory of planned behaviorand the theory of reasoned action, one of the threefactors most strongly affecting intentions to engagein any behavior is behavioral beliefs (Fishbein andAjzen 1975; Ajzen 1985; Ajzen and Madden 1986).These are beliefs about the likely outcomes of anybehavior (i.e., the probabilities of possible outcomes)and the evaluations of these outcomes (i.e., theextent to which they are positive or negative). Theseassessments of behavioral outcomes affect attitudestoward the behavior, which in turn affect intentionsand, ultimately, behavior.Finally, according to social cognitive theory, peopleevaluate alternative courses of action and develop“expectancies” (based on both expectations aboutthe consequences of courses of action and the valueattached to those consequences), which in turnaffect their decisions about behavior (Bandura 1986).Chapter 4 Improving Perceptions of Risks—Both Susceptibility and Severity 43