The Integrative Behaviour Model (IBM), at times referred to as the Integrated Bevaviour Model (Fishbein, Kasprzyk & Montano, 1998), as already stated, emphasises three main constructs as determinants of behavioural intention, which were derived from the five theories. These are: (1) attitude toward performing the behaviour, (2) social norms associated with the behaviour and personal agency, including self-efficacy and (3) perceived control with regard to the behaviour (Ajzen & Fishbein, 2010). They proceed to refer to attitude as an individual’s overall
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perception of favourableness or unfavourableness towards a behavior (comprised of affective and cognitive dimensions). Perceived norm is referred to as the social pressure one feels to perform or not to perform a particular behaviour (comprised of the injunctive or subjective and descriptive norm) and personal agency is referred to as the individual’s capability to originate and direct actions for given purposes (comprised of self-efficacy and perceived control) (Ajzen, Albarracin, & Hornik, 2007). The theories overlap with the concept of perceptions about outcomes of performing the behavior as the main determinant of behaviour. They concur that behavioural performance is greater where expected positive outcomes outweigh expected negative outcomes (Fishbein, Kasprzyk & Montano, 1998). They go on to indicate that according to these theories, the second important concept is social support or social outcomes associated with behavioral performance. The third main concept included in these theories is concerned with the effect of environmental or situational conditions on behavioural performance. These are the control beliefs. Ajzen and Fishbein (1975) opined that “…a belief is a subjective probability that the object has a certain attribute” (cited in (Ajzen, Albarracin, & Hornik, 2007, p. 5). The IBM assumes that other factors affect behaviour through these constructs.
The present study objectives all fit in this framework, as explained below:
Source: Ajzen & Fishbein, 2000
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The present research is an application of the Integrated Behaviour Model (IBM) (Ajzen & Fishbein, 2000) in Figure 3.6. It is important to reemphasise that the framework attempts to capture both perceived environmental and individual factors that may shape the use of TAM by PLWHA in Zimbabwe. Thus, the model is concerned with understanding behavioural motivation towards TAM use. The model depicts that a person’s behavioural motivation or intention is shaped by individual- level (personal agency, social influence and attitude) factors, as well as by environmental–level (capacity, salience, system constrains and cultural) factors. Individual-level factors maybe direct determinants of behaviour, and may in turn be shaped by environmental factors. Additionally, environmental factors, particularly socio-cultural, may have direct effects or interact with individual factors to influence behavioural motivation. According to the model, individuals’ experiences with their environment affect their beliefs, attitudes and norms. Thus, a person’s perceptions about TAM may be determined by their experiences, including interaction with their socio-cultural environment. For example, the most important driver of a person’s use of TAM may be their own motivation to do so, which is determined by their attitude, social influence and personal agency. The beliefs underlying these model constructs are a reflection of the person’s experiences. Different individuals’ belief strengths and the relative importance of different beliefs in determining behavioural motivation may result from variations in those individuals’ socio-cultural experiences. Lavesque and Z.Li (2014) also report that culture, health conceptions and practices are interrelated.
The model stresses that each of these constructs has substantial internal complexity. For example, attitude toward the behaviour (the extent to which it is viewed as favourable or unfavourable) has both affective and cognitive dimensions. Perceived norms reflect the social pressure for and against the behaviour, as well as the perception of what peers or others are doing. The model goes on to indicate that personal agency consists of two constructs, self-efficacy (confidence in ability to perform the behaviour) and perceived control (barriers and facilitators) over behavioural performance. Each of these constructs can be examined by specific kinds of inquiry. For example, self-efficacy can be tested by asking respondents how they rate their behavioural confidence in carrying out specific behaviours. Each of
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the other constructs can be assessed by particular questions (See Interview Guide, Appendix 1) (Ajzen & Fishbeiben 2010).
This research was guided by this model in order to identify and understand the underlying beliefs that are perceived to be shaped by each person’s socio-cultural and other experiences, and that determine their model constructs and motivation to use TAM, as depicted in the IBM model. In addition, as noted earlier and as depicted in the IBM model (See Figure 3.6), perceived socio-cultural and other environmental factors may have a direct effect on TAM motivation since individual- level beliefs may not completely capture their effects. For example, individuals may hold cultural values regarding TAM, and these may affect individual-level constructs, as demonstrated in Figure 3.6. In addition, cultural practices may directly affect TAM motivation and behaviour. All these constructs were investigated in this study (see Interview Guide, Appendix 1).
The strength of the proposed framework is that while it defines high-level, theory based constructs known to be linked to behaviours (Ajzen & Fishbein, 2010; Ajzen & Fishbein, 2000; Ajzen & Fishbein, 1975;(Cappella & Fishbein, 2006), it does not define the specific content of variables included in these constructs that shape the motivation to use herbal and conventional therapies. Rather, this framework assumes the particular issues underlying each construct can be elicited from individuals using qualitative research, allowing the researcher to elicit the perceived drivers that may shape TAM motivations and behaviours. The framework also allows the researcher to assess perceived important socio-cultural environmental factors, and determine how they may shape individual factors (See more in the Empirical literature section). Thus, as mentioned earlier, the proposed research aims to provide an important scientific contribution to understand how perceived individual, socio-cultural and environmental factors may affect TAM use among PLWA.
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