Reducing Adolescent Sexual Risk: A Theoretical - ETR Associates

Theories ofAttitude ChangeAttitudes sometimes change with new informationand experience. They can be influenced by parents,teachers, peers, religion, media, culture andother environmental influences, as well as personalexperience.Theories of attitude change can be used to intentionallychange attitudes about many things. However,in the field of public health, they are most commonlyused to change attitudes about one or morehealth behaviors. The examples used hereafter willinvolve attitudes about health behavior.Theories of attitude change expanded a few decadesago after health promotion interventions designedto increase knowledge and thereby change behaviorfailed to have an impact on behavior. Subsequently,researchers and practitioners became more interestedin how interventions designed to persuade people tochange their behavior actually affected their cognitiveprocesses. Early research studies found thatfactors thought to influence persuasion had differenteffects in different situations.The Elaboration Likelihood Model (ELM) (Petty,Barden et al. 2002) was one of the first modelsto fully recognize that there are many pathwaysthrough which interventions can change attitudesand that these pathways fall along an elaborationcontinuum. At one end of the continuum are processesthat require careful thinking about the argumentsin a communication message as a responseto that message (high elaboration). 7 This is calledthe central route. At the other end of the continuumare those processes that do not require much or anythinking (low elaboration). This is called the peripheralroute (see Figure 5-1).Central route. According to psychologists, thecentral route involves careful consideration of the7 “Messages” and “arguments” are used somewhat interchangeablyin this chapter. However, sometimes “messages” refers to admonitionsto engage in particular behavior conducive to public health and “arguments”refers to the reasons to engage in health-promoting behaviorand to avoid risk behaviors.information in a message about behavior, comparesthat information to knowledge already known aboutthat behavior and integrates it. This considerationprocess generates positive or negative thoughts thataffect attitudes and thereby change behavior. Forexample, new information about the likelihoodof unintended pregnancy, if sexually active, maygenerate positive or negative thoughts about havingunprotected sex. Whether the thoughts are positiveor negative determines whether the attitude changeis positive or negative. The extent to which thethoughts are either more positive or negative determinesthe amount of attitude change.According to Petty et al. (2002), two conditionsare necessary for any conscious cognitive processingrequiring some effort. First, an individual mustbe able to think about and process the information.This ability may be affected by a variety of factorsinvolving the cognitive development of the individual,the individual’s mental state (e.g., in a clearstate of mind or under the influence of drugs), thecharacteristics of the message (e.g., whether theindividual can understand the words being used),the control that the individual has over the process(e.g., whether the individual can review material athis/her discretion), the environment (e.g., the existenceand magnitude of distractions), the number oftimes the information is presented and other factors.For example, using understandable language,self-pacing, and removing distractions can increase aperson’s ability to thoughtfully consider messages.Figure5-1Peripheral RouteLow elaborationRequires little orno thinkingCentral RouteHigh elaborationRequires carefulconsiderationSecond, an individual must be motivated to thinkabout and process the information. This motivationmay be affected by characteristics of the individual(e.g., the general inclination of an individualto think about and process new information); theChapter 5 Addressing Attitudes, Values and Beliefs 57