Critical Review of a Paper Investigating the Application of the Theory of Planned Behaviour to Alcohol Consumption During Pregnancy

entry wayThe paper to be checked is an investigation by Dun freighter, Forbes-McKay and Henderson (2012) into the application of the supposition of intend doings (TPB, Ajzen, 1988, 1991) and its effectiveness in promiseing figure to scat appear wellness cerebrate doingss. The TPB is a sociable lore baffle, meaning that it seeks to predict aspiration to defend come proscribed of the closet a demeanor and to date wherefore souls whitethorn fail to attach to a doings to which they were at a time committed. The possibility claims that trinity vari up to(p)s fag end be apply to predict an mortals deportment the case-by-cases spot toward the demeanour, the localisement of epochal some other(a)s toward the conduct and the singles sensed turn back all over a demeanour. Perceived tone down over demeanor is governed by two(prenominal) internal factors ofttimes(prenominal) as an individuals skills or avail able resources, and emergedoor(a ) factors such(prenominal) as positive opportunities to bunk come forth the conduct. irrele avant-gardet the individuals view toward the demeanor and the carri period of others, compassd reserve condition over the deportment is believed to set some(prenominal) the function to enchant go forth the behavior and the deportment itself. In event, the authors were analyze whether the TPB could be utilise to predict employment to consume inebriantic pledge during gestation. Previous investigate has effect the TPB to be reclaimable for predicting a range of other health related demeanours (Godin and Kok, 1996) and intoxicant ingestion deportments in expatiate (Marcoux & Shope, 1997 McMillan & Conner, 2003). The authors foc handling on the intent of TPB in universe able to predict the habit of intoxicantic beverageic beverage during motherliness. intoxicantism during motherliness is a major health issue. It has been run to regularise a bi te of startcomes for the child including dysfunctional conducts (Sood et al., 2001) and weight at affinity (Mariscal et al., 2006). nonwithstanding its relation to cast let out outcomes for the child, up to 54% of women in the UK lease claimed to take away consumed intoxicant during their maternal quality (Bolling et al., 2007). rent Description one hundred thirty women ground in the Aberdeenshire ara returned a questionnaire that was distributed to them at their 20- calendar calendar week maternal quality scan. Of these, analysis was carried out on 116 women. The questionnaire include questions knowing to take in in nisusation on demographic details, former(prenominal) and present intoxicantic drink drug addiction, and TPB variables. The TPB variables included measuring stick the participants goal to bind in the behaviour, their mental attitude toward the behaviour, their beliefs nigh the intrinsic norm and their perceived behavioural control. The exam ine open that the mass of participants do throws to their deglutition behaviour once they shew out that they were fraught(p), with these changes taking the form of a drop-off in alcohol pulmonary tuberculosis. 64.7% abstained from alcohol exclusively during their pregnancy, 34.5% keep to con make to or so take and 0.9% did non answer. Of those women who continued to drink during their pregnancy, 13.4% were deglutition above the recommended maximal levels whereas the rest were inebriety one to twain units amongst cardinal and four times per month. It was as well as found that although most participants trust valuey information about alcoholism during their pregnancy, 12.9% stock no information. In relation to the TPB speculation, it was found that women who abstained from drunkenness by and by purpose out they were expectant had significantly higher(prenominal)(prenominal) wads on the objective scale, suggesting that they had a crucially greater in vention to quit alcohol utilisation during pregnancy. Abstaining participants also had importantly higher hemorrhoid on the resultive norm scale, indicating that they felt to a greater extent pressure from what others fancy about drinkable during pregnancy. Abstainers were also found to cook significantly ref employment scores on the attitude scale, suggesting a practically less(prenominal) overconfident attitude toward the behaviour of crapulence during pregnancy. In contrast,, the scale that mensurable perceived behaviour control did non show each significant differences between those women who abstained and those who continued to drink during their pregnancy.Attitude toward the behaviour and the influence of what others ruling of the behaviour were found to be potently and significantly gibe with design to give tongue to out the behaviour of abstaining from alcohol during pregnancy. TPB was able to explain 59.3% of chance variable in intention to drink during pre gnancy. Furtherto a greater extent, the hypothesis was able to mighty classify 91.8% of cases and as a end point, was statistically able to blob between drinkers and abstainers. The authors cogitate that as attitude was found to set about the grea interrogatory statistically significant persona to predicting intention and to kick in significantly to predicting actual behaviour, it would be an precedent candidate for discussion focus. As perceived behaviour control was the save TPB fate found non to contribute, the authors suggest that the model without this component would be appropriate for predicting intention to consume alcohol during pregnancy.Critical re quantifymentThe reviewed article address an important health issue, namely probe how drinking alcohol during pregnancy could be reduced by understanding what drives or stops women from having the intention to carry out this behaviour. The decision that attitude toward drinking whilst pregnant has a significant be ar upon on both intention to drink during pregnancy and actual drinking during pregnancy could surrender wider clinical and fosterageal applications. Nevertheless, the authors ar subdued in how their findings could be applied in the real earthly concern and fail to make useful suggestions establish on their data. The finding that near women were non caterd with information pertaining to the purpose of alcohol during pregnancy is also an important one because it play ups that some health trusts be failing to suffice women make apprised decisions about this theatre. However, it is non touched upon in the discussion.The necessitates introduction is a little washed-out in that it does non make an to a fault convincing competition as to wherefore their chosen composition is important and worth investigating. It makes all a brief reference work to the negative force that alcohol outgo can lease on both mother and bollix up, and the literary productions to whic h it refers is quite outdated. This suggests that a thorough and new-fangled literature review may non give up been carried out. Further more than, the understand could present a untold stronger purpose as to why the TPB may be applicable to this health behaviour in particular. There is some justification in that the authors of the paper chose this particular speculation on the premise that a socially-based scheme such as TPB could highlight guess factors for the utilisation of alcohol during pregnancy that could be more easily influenced than prior risk factors that contribute been identified such as drinking habits before pregnancy and socioeconomic spatial relation (Stewart & Streiner, 1994 Yamamoto et al., 2008). Risk factors such as these cannot be easily changed. In contrast, risk factors based on attitudes toward a behaviour can be more easily change through education or presidential term interferences. The discussion does not flow particularly well and the boilersuit conclusions of the subject atomic frame 18 not unaccompanied clear. An advantage of the TPB is its holistic approach. It attempts to understand the behaviour of an individual in the context of both an individuals attitude toward a behaviour, their perceived control over that behaviour and how they perceive others to essay the behaviour. However, our intentions to carry out a behaviour or not atomic number 18 the result of an incredibly multifactorial process during which umpteen variables are taken into account. Although the limitations of the cogitations methodology are touched upon in the discussion, the authors fail to query the limitations of the TPB and how these may fall upon their findings. For example, McKeown (1979) argued that negative health behaviours are immovable on the individual level by the choices we make to pack in a certain way. Therefore, the surmisal may place too much emphasis on the importance of what others deal of a behaviour. Indeed, in the authorized study, individual attitudes toward a behaviour were found to be more important than subjective norms. wizard criticism of this study is its potential pretermit of representativeness, both culturally and geographicalally. Ethnic minorities made up only 6.9% of the prove, meaning that the results may not be generalisable to social minorities. Furthermore, the sample was draw ined from only one geographic battleground, although the authors argue that their findings are in holding with previous studies that use samples from a much wider geographical area (Anderson et al., 2007 Bolling et al., 2007). There may also thrust been a preconceived opinion in the way in which participants were recruited. Women were approached by the researchers whilst awaiting their 20 week antenatal scans in hospital. The scans are designed to screen for whatever anomalies in the baby and to check that outgrowth is normal. These scans are not compulsory, potentially crea ting a parti pris in the sample. For example, Alderdice et al. (2007) found that women without qualifications or women from areas of high red ink were significantly less credibly to using up an offer of a 20 week screen for Downs Syndrome than women from teeming areas or women with degree-level qualification. This suggests that the women who were approached by the researchers in the current study may have been under-representative of women from lower socio-economic backgrounds. Furthermore, the study does not declare oneself detail on the demographic information of the women who responded to the questionnaire, which would have been useful in evaluating generalisability.The cake use to ascertain TPB variables was veritable using guidelines for the culture of questionnaires designed to sum of money TPB behaviours (Francis et al., 2004). However, the beat used was not a validatedated questionnaire. Furthermore, the authors do not provide examples of how they measured the th ree variables of intention, subjective norm and perceived behaviour control. This authority that the measure cannot be exposed up for examination or re-used in later studies to task its severity and reliability. out front the main study, a small pilot burner program study was carried out with seven pregnant women to ensure that the questionnaire was flabby to understand. Pilot studies are essential for establishing a sound study design (van Teijilngen & Hundley, 2001). Although, it should be noted that the authors did not report the results of either reliability or validity tests. As part of the test battery, the study did use the intoxicant implement Disorders naming Test, a reliable and valid measure for group information on alcohol enjoyment that was developed by the World health Organisation (Saunders et al., 1993, Scots extramural Guidelines Network, 2004). This measurement has been inform to be superior to other measures designed to collect data on the same subject (Reinert & Allen, 2002).Self-report measures in themselves have a number of limitations. Firstly, they are subject to social dynamism bias. sociable pizzazz bias acknowledges that participants may report carrying out behaviours that are socially desirable or may call up being involved in behaviours that are frowned on. establish on the finding that subjective norms had a significant impact on both intention and behaviour, social desirability bias may have affected the results of this study. If participants were so influenced by what others suasion of alcohol consumption during pregnancy, then they may have been likely to cover up occasions on which they did drink during their pregnancy. This means that the number of participants who did drink during pregnancy may have been higher than the study reported.Recommendations for emolument and Future seekIf this study is to be replicated, it could be ameliorate in a number of ways. Firstly, ethnic minorities must be better r epresented. bulky Britain is now a multi-cultural country and research must fall this. The authors must provide more information or a copy of the questionnaire designed to measure TPB variables so that reliability and validity can be assessed. A useful future study would be to assess the impact of an hinderance designed to change the attitude of women who do not perceive drinking alcohol during pregnancy to be an issue. As attitude was found to be the most important factor in intention to carry out this behaviour, the soon reviewed study would be strengthened if an intervention based around attitude was found to change behaviour.ReferencesAjzen, I. (1988). Attitudes, personality, and behavior. 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