Reasoned Action Theory

While researching for an article to use that correlated with the Theory of Reasoned Action and the Theory of Planned Behavior, I discovered an interesting article on substance abuse treatment and providers.

Roberto, A., Shafer, M., & Marmo, J. (2014). Predicting substance-abuse treatment providers' communication with clients about medication assisted treatment: A test of the theories of reasoned action and planned behavior. Journal Of Substance Abuse Treatment, 47(5), 307-313. Retrieved from https://www.clinicalkey.com/#!/content/journal/1-s2.0-S0740547214000956

This article discussed a combined focus of both the theory of reasoned action (TRA) and theory of planned behavior (TPB). The authors wanted to investigate how retrospectively one

could predict if a provider encouraged the medicated-assisted-treatment (MAT) for their treatment plan on the substance-abuse treatment patients. There were 210 substance-abuse treatment providers who were asked to answer a survey that measured: attitudes, subjective norms, perceived behavioral control, intentions, and behavior.
A link to the survey was sent via email to 510 substance-abuse treatment providers, the response rate was 210 research participants.

Characteristics of the sample used in the study: Age, Ethnicity, In recovery, Location of work, Core work functions, MAT offered, MAT organizational support level, Workshops/training about use of MAT to treat substance abuse, Self-rating knowledge level of MAT, Interest in participation in training using MAT. The questions were instrumented to assess behavior, behavioral intention, subjective norms, perceived behavioral control, and attitude. The design was qualitative and closely defined in the theory of planned

behavior.
The survey concluded that substance-abuse treatment providers had very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, and somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, but tended to engage in the actual behavior less than 20% of the time (Roberto, Shafer & Marmo, 2014).
The substance abuse treatment workforce has historically consisted of individuals in recovery. These individuals, many of whom were treated before the emergence of MAT as an evidence based practice, could be expected to have negatively biased perspectives regarding MAT. A series of independent-sample t tests revealed significant difference between these two groups on two of the TRA/TPB variables. Specifically, those who were in recovery perceived significantly lower norms to encourage clients to use MAT as part of their treatment plan than those who were not in. Further, those who were in recovery reported significantly lower intentions to encourage clients to use MAT as part of their treatment plan, than those who were not in recovery (Roberto, Shafer & Marmo, 2014).

The main conclusion from this study is that TPB aided in the improved encouragement of utilizing MAT in practice for substance-abuse treatment providers.

It also provided a list of factors that influence the recommendations of utilizing the MAT for a substance-abuse treatment provider. A few examples would be reinforcement of the positive attitudes toward MAT, or increase the neural subjective norms and perceived behavioral control to be more positive. Given the large population the substance-abuse treatment providers treat, interventions targeting providers could have a much greater impact on more individuals than those just targeting individual clients. This brings significance in this study because it was theory-based and extends the scope of the TRA and TPB to a topic and target audience, and also sheds light on the direction to where we focus the raising awareness and education to, which would be the providers. This will cause a considerably bigger trickle down affect by the ability to encourage their practice in utilizing MAT which will reach so many more patients this way. In addition, the results from this study also confirmed the applicability of TRA as a conceptual model for explaining counselor's attitudes and intentions, and linking the influence that social norms have upon both (Roberto, Shafer & Marmo,

2014).
However, with most studies, there is usually a non-significant finding. I discovered the TPB and TRA address various areas of the individual and interpersonal levels, but there is nothing to take into account the possibility of how a public policy level, organization, or community could affect ones behavior (Roberto, Shafer & Marmo, 2014).
Normally the TRA and TPB would be used to help predict the influence of an individual’s behavior choice, but it can also be used to better explain recommendations to the patient from the provider. This study supports those developing theory-based interventions using TRA or TPB should be successful in communicating to their clients about evidence-based treatment strategies, such as MAT.