Experiences of Latinos with Diabetes in the Central San Joaquin Valley Page: 11
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Importantly, these constructs are also affected by additional factors unique to each
individual such as education level, cultural background, skills, and others (Hayden 2014).
Described as modifying variables, the health belief model also considers what it terms 'cues to
action' and 'self-efficacy.' Cues to action are motivators for behavior change, and according to
Janz and Becker (1984), are either external (social) or internal (symptoms) motivations. Self-
efficacy is defined by Albert Bandura (1977) as, "the conviction that one can successfully
execute the behavior required to produce the outcomes" (1977, 193). Bandura also posits that
self-efficacy explains how people's behavior change moves beyond the mechanistic conditioning
process of behaviorism and gives individuals a role in their own process of change, or simply
rephrased, it gives an individual the perception of agency to enact change.
Theory of Reasoned Action
The theory of reasoned action (TRA) was developed as a model for explaining human
behavior change, in particular health behavior and an individual's attitude toward behavior
(McKenzie, Neiger, and Thackeray 2013). Citing work by Martin Fishbein and Icek Ajzen
(1975), McKenzie and colleagues (2013) review key features of this theory -the fundamental
framework posits that attitude, belief, intention, and behavior contribute to behavior change.
Ajzen (2012) wonderfully summarizes Fishbein's theory of reasoned action (Fishbein 1967). The
motivation for behavior change according to TRA is the individual's intention towards change
based on beliefs, particularly beliefs informed by subjective norms; much like the HBM which
posits behavior change is motivated by an individual's personal beliefs about their susceptibility
to a disease or other health risk.11
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Cortez, Jacqueline Nicole. Experiences of Latinos with Diabetes in the Central San Joaquin Valley, thesis, May 2018; Denton, Texas. (https://digital.library.unt.edu/ark:/67531/metadc1157605/m1/18/?q=green+energy: accessed July 17, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; .