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NATIONAL HIV/AIDS RESEARCH AND BEST PRACTICES CONFERENCE - page 23 / 103

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A.14.Extending the purview of the Risk Perception Attitude (RPA) framework: Findings from the baseline research from eight districts in Malawi

Rimal, R.N., Böse K., Brown J., Mkandawire, G., Joshi K., Folda L.

Objective and Scope The risk perception attitude (RPA) framework posits that efficacy beliefs moderate the relationship between risk perception and health outcomes.  Efficacy beliefs are individuals’ confidence in their ability to enact specific behaviors and their belief that enacting the behaviors will result in desired outcomes.  Risk perception is defined as the composite of perceived susceptibility (probability of harm) and perceived severity (noxiousness of harm).  Based on efficacy beliefs and risk perception, the RPA framework classifies people into four attitudinal groups: indifference (low risk perception, low efficacy beliefs), responsive (high risk perception, high efficacy beliefs), proactive (low risk perception, high efficacy beliefs), and avoidance (high risk perception, low efficacy beliefs).   The RPA framework hypothesizes that the four groups will differ in their self-protective motivations and behaviors, with the responsive group displaying the healthiest outcomes, the indifference group the least, and the other two displaying intermediate outcomes.  To extend the purview of the theory, this hypothesis was tested in the context of HIV/AIDS prevention behaviors.  

Methodology Data (N = 890) were collected from eight districts in Malawi as part of a baseline research undertaken by the BRIDGE Project in 2004. Results pertaining to two behaviors, use of condoms and remaining monogamous are reported in this study.  

Results  Relationships between risk perception and behavioral intentions were not significant, but those between efficacy beliefs and behavioral intentions were.  Efficacy beliefs moderated the relationship between risk perception and intentions to remain monogamous, but not between risk perceptions and intentions to use condoms.  The model was able to explain approximately 40 percent of the variance in intentions to use condoms, and 19 percent of the variance in intentions to remain monogamous.  

Recommendation  Implications for health campaigns included the need to strengthen efficacy beliefs and the need to be careful in enhancing risk perceptions without simultaneously strengthening efficacy beliefs.

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