Effect of substance use on condom use in the Theory of Planned Behavior: Analysis of differential item functioning

Ricardo Sánchez-Domínguez, Luis Villalobos-Gallegos, Violeta Felix-Romero, Silvia Morales-Chainé, Rodrigo Marín-Navarrete

DOI: https://doi.org/10.17711/SM.0185-3325.2017.002


Introduction. Substance use is one of the factors associated with lower condom use in young adults, which increases the likelihood of HIV infection. The Theory of Planned Behavior (TPB) is one of the most useful models for explaining this phenomenon since it considers the aim of engaging in a behavior based on attitudes, subjective norms and self-efficacy.

Objective. To develop a questionnaire and to evaluate the Differential Item Functioning (DIF) caused by substance use in TPB indicators, using the Multiple Indicators Multiple Causes Analysis (MIMIC).

Method. The study was conducted in two phases with Mexico City college students age 18 to 25.

Results. Adequate goodness of fit was obtained in all three models of the TPB: attitudes χ2S-B(2) = 3.902, p < .001; CFIs = .999; TLIs = .996; RMSEAs = .037, 90% CI ≤ .001-.095; subjective norms χ2S-B(7) = 9.103, p < 0.245; CFIs = .999; TLIs = .998; RMSEAs = .022, 90% CI ≤ .001-.056; and self-efficacy χ2S-B(25) = 65.115, p < .001; CFIs = .982; TLIs = .974; RMSEAs = .050, 90% CI = .036-.066; in one item in attitudes and two items in subjective norms a DIF effect was observed, while no item proved significant regarding self-efficacy.

Discussion and conclusion. There is little evidence in the detection of DIF due to substance use in TPB indicators in condom use, and this is the first study to conduct this type of analysis. Items presenting DIF open the door to future research due to the importance of assessing how the indicator behaves with a population displaying a particular trait.


Condom; substance use; attitudes; self-efficacy; subjective norms; young adults

Full Text:

HTML Pdf ePub Xml


Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179-211. https://doi.org/10.1016/0749-5978(91)90020-T

Ajzen, I., & Fishbein, M. (1980). Understanding Attitudes and Prediciting Social Behaviour. Englewood Cliffs: Prentice Hall.

Albarracín, D., Johnson, B. T., Fishbein, M., & Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. Psychological Bulletin, 127(1), 142-161. https://doi.org/10.1037/0033-2909.127.1.142

Alvarez, C., Villarruel, A. M., Zhou, Y., & Gallegos, E. (2010). Predictors of condom use among Mexican adolescents. Research and Theory for Nursing Practice, 24(3), 187-196. https://doi.org/10.1891/1541-6577.24.3.187

Andrew, B. J., Mullan, B. A., de Wit, J. B. F., Monds, L. A., Todd, J., & Kothe, E. J. (2016). Does the Theory of Planned Behaviour Explain Condom Use Behaviour Among Men Who have Sex with Men? A Meta-analytic Review of the Literature. AIDS and Behavior, 20(12), 2834-2844. https://doi.org/10.1007/s10461-016-1314-0

Armitage, C. J., & Conner, M. (2001). Efficacy of the Theory of Planned Behaviour: a meta-analytic review. The British Journal of Social Psychology / the British Psychological Society, 40(Pt 4), 471-499. https://doi.org/10.1348/014466601164939

Beauducel, A., & Herzberg, P. Y. (2006). On the Performance of Maximum Likelihood Versus Means and Variance Adjusted Weighted LEast Squares Estimation in CFA. Structural Equation Modeling, 13(2), 204-228. https://doi.org/10.1207/s15328007sem1302

Benjamini, Y., & Hochberg, Y. (1995). Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing. Journal of the Royal Statistical Society. Series B (Methodological), 57(1), 289-300. https://doi.org/10.2307/2346101

Bennett, P., & Bozionelos, G. (2000). The theory of planned behaviour as predictor of condom use: A narrative review. Psychology, Health & Medicine, 5(3), 307-326. https://doi.org/10.1080/713690195

Calsyn, D. A., Baldwin, H., Niu, X., Crits-Christoph, P., & Hatch-Maillette, M. A. (2011). Sexual risk behavior and sex under the influence: An event analysis of men in substance abuse treatment who have sex with women. American Journal on Addictions, 20(3), 250-256. https://doi.org/10.1111/j.1521-0391.2011.00123.x

Centers for Disease Control and Prevention [CDC]. (2014). Sexually Transmitted Disease Surveillance 2013.

Centro Nacional para la prevención y el control del VIH/SIDA [CENSIDA]. (2016). Vigilancia Epidemiológica de casos de VIH/SIDA en México, Registro Nacional de Casos de SIDA, actualización al 2do. trimestre de 2016. México, Secretaría de Salud. http://www.censida.salud.gob.mx/descargas/epidemiologia/RN_2do_trim_2016.pdf

Conner, M., Sutherland, E., Kennedy, F., Grearly, C., & Berry, C. (2008). Impact of alcohol on sexual decision making: Intentions to have unprotected sex. Psychology & Health, 23(8), 909-934. https://doi.org/10.1080/08870440701596551

Conrad, K. M., Conrad, K. J., Passetti, L. L., Funk, R. R., & Dennis, M. L. (2015). Validation of the Full and Short-Form Self-Help Involvement Scale Against the Rasch Measurement Model. Evaluation Review, 39(4), 395-427. https://doi.org/10.1177/0193841X15599645

Cribbie, R. a. (2007). Multiplicity Control in Structural Equation Modeling. Structural Equation Modeling: A Multidisciplinary Journal, 14(1), 98-112. https://doi.org/10.1207/s15328007sem1401_5

Crosby, R. A., Charnigo, R. A., Weathers, C., Caliendo, A. M., & Shrier, L. A. (2012). Condom effectiveness against non-viral sexually transmitted infections: a prospective study using electronic daily diaries. Sexually Transmitted Infections, 88(7), 484-489. https://doi.org/10.1136/sextrans-2012-050618

Davis, K. C., Jacques-Tiura, A. J., Stappenbeck, C. A., Danube, C. L., Morrison, D. M., et al. (2015). Men’s Condom Use Resistance: Alcohol Effects on Theory of Planned Behavior Constructs. Health Psychology, 35(2), 178-186. https://doi.org/10.1037/hea0000269

Donenber, G. R., Emerson, E., Bryant, F. B., Wilson, H., & Weber-Shifrin, E. (2001). Understanding AIDS-Risk Behavior Among Adolescents in Psychiatric Care: Links to Psychopathology and Peer Relationships. Journal of the American Academy of Child & Adolescent Psychiatry, 40(6), 642-653. https://doi.org/10.1097/00004583-200106000-00008

Donovan, D. M., Bigelow, G. E., Brigham, G. S., Carroll, K. M., Cohen, A. J., et al. (2012). Primary outcome indices in illicit drug dependence treatment research: systematic approach to selection and measurement of drug use end-points in clinical trials. Addiction, 107(4), 694-708. https://doi.org/10.1111/j.1360-0443.2011.03473.x

Ellickson, P. L., Collins, R. L., Hambarsoomians, K., & McCaffrey, D. F. (2005). Does alcohol advertising promote adolescent drinking? Results from a longitudinal assessment. Addiction, 100(2), 235-246. https://doi.org/10.1111/j.1360-0443.2005.00974.x

Encuesta Nacional de Salud y Nutrición 2012. Resultados Nacionales. Cuernavaca, México, Instituto Nacional de Salud Pública (MX), 2012. http://ensanut.insp.mx/informes/ENSANUT2012ResultadosNacionales.pdf

Enders, C. K., & Bandalos, D. L. (2001). The Relative Performance of Full Information Maximum Likelihood Estimation for Missing Data in Structural Equation Models. Structural Equation Modeling: A Multidisciplinary Journal, 8(3), 430-457. https://doi.org/10.1207/S15328007SEM0803_5

Fishbein, M. (1980). A theory of reasoned action: some applications and implications. In Nebraska Symposium on Motivation 27 ed. University of Nebraska Press, p. 65-116. http://www.ncbi.nlm.nih.gov/pubmed/7242751

Fishbein, M., & Ajzen, I. (2010). Predicting and changing behaviour: The reasoned action approach. New York: Psychology Press. https://doi.org/10.4324/9780203937082

Francis, A. J. J., Eccles, M. P. M., Johnston, M., Walker, A., Grimshaw, J., et al. (2004). Constructing questionnaires based on the theory of planned behaviour: A manual for health services researchers. Newcastle upon Tyne, UK, Centre for Health Services Research, University of Newcastle upon Tyne, UK. ISBN: 0-9540161-5-7. http://openaccess.city.ac.uk/1735

Francis, A. J. J., Eccles, M. P. M., Johnston, M., Walker, A., Grimshaw, J., Foy, R., … Francis, J. (2004). Constructing questionnaires based on the theory of planned behaviour: a manual for health services researchers. Direct. Newcastle, UK. http://openaccess.city.ac.uk/id/eprint/1735

Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. https://doi.org/10.1080/10705519909540118

Inmaculada, T., Bermudez, M. P., Ramiro, M. T., & Buela-Casal, G. (2014). Creencias religiosas y actitudes hacia el uso del preservativo en adolescentes peruanos. Revista Mexicana de Psicología, 31(1), 41-49.

Instituto Nacional de las Mujeres [INMUJERES]. (2012). Enfermedades de transmisión sexual y VIH-SIDA.

Krippendorff, K. (1990). Metodología del análisis de contenido. (Paidos, Ed.). Barcelona, España. 279 págs.

Lewis, T. T., Yang, F. M., Jacobs, E. A., & Fitchett, G. (2012). Racial/ethnic differences in responses to the everyday discrimination scale: a differential item functioning analysis. American Journal of Epidemiology, 175(5), 391-401. https://doi.org/10.1093/aje/kwr287

Maher, L., Phlong, P., Mooney-Somers, J., Keo, S., Stein, E., Couture, M. C., & Page, K. (2011). Amphetamine-type stimulant use and HIV/STI risk behaviour among young female sex workers in Phnom Penh, Cambodia. The International Journal on Drug Policy, 22(3), 203-209. https://doi.org/10.1016/j.drugpo.2011.01.003

Malcolm, S., Huang, S., Cordova, D., Freitas, D., Arzon, M., Jimenez, G. L., … Prado, G. (2013). Predicting condom use attitudes, norms, and control beliefs in Hispanic problem behavior youth: the effects of family functioning and parent-adolescent communication about sex on condom use. Health Education & Behavior, 40(4), 384-391. https://doi.org/10.1177/1090198112440010

Miles, J. N. V., Marshall, G. N., & Schell, T. L. (2008). Spanish and English versions of the PTSD Checklist-Civilian version (PCL-C): testing for differential item functioning. Journal of Traumatic Stress, 21(4), 369-376. https://doi.org/10.1002/jts.20349

Muthén, B., & Kaplan, D. (1985). A comparison of some methodologies for the factor analysis of non-normal Likert variables. British Journal of Mathematical and Statistical Psychology, 38(2), 171-189. https://doi.org/10.1111/j.2044-8317.1985.tb00832.x

Muthén, L. K., & Muthén, B. O. (2002). How to Use a Monte Carlo Study to Decide on Sample Size and Determine Power. Structural Equation Modeling: A Multidisciplinary Journal, 9(4), 599-620. https://doi.org/10.1207/S15328007SEM0904_8

Noar, S. M. (2006). A 10-Year Retrospective of Research in Health Mass Media Campaigns: Where Do We Go From Here? Journal of Health Communication, 11(1), 21-42. https://doi.org/10.1080/10810730500461059

Prati, G., Mazzoni, D., & Zani, B. (2014). Perceived behavioural control, subjective norms, attitudes and intention to use condom: A longitudinal cross-lagged design. Psychol Health, 29(10), 1119-1136. https://doi.org/10.1080/08870446.2014.913043

Rich, A., Mullan, B. A., Sainsbury, K., & Kuczmierczyk, A. R. (2014). The role of gender and sexual experience in predicting adolescent condom use intentions using the theory of planned behaviour. The European Journal of Contraception & Reproductive Health Care, 19(4), 295-306. https://doi.org/10.3109/13625187.2014.917624

Robles-Montijo, S., & Díaz-Loving, R. (2011). Validación de la Encuesta Estudiantil sobre salud sexual (EESS). Universidad Nacional Autónoma de México , Facultad de Estudios Superiores Iztacala, Ed.. México.

Rodríguez-Pérez, V., Valencia-Flores, M., Reyes-Lagunes, I., & Lara-Muñoz, M. del C. (2013). Adaptación y validación psicométrica del Cuestionario de Consecuencias Funcionales del Dormir (Functional Outcomes Sleep Questionnaire [FOSQ]) en habitantes de la Ciudad de México. Salud Mental, 36(4), 307-313.

Sacolo, H. N., Chung, M.-H., Chu, H., Liao, Y.-M., Chen, C.-H., et al. (2013). High risk sexual behaviors for HIV among the in-school youth in Swaziland: a structural equation modeling approach. PloS One, 8(7), e67289. https://doi.org/10.1371/journal.pone.0067289

Satorra, A., & Bentler, P. (2001). A scaled difference chi-square test statistic for moment structure analysis. Psychometrika, 66(4), 507-514. https://doi.org/10.1007/bf02296192

Selikow, T.-A., Ahmed, N., Flisher, A. J., Mathews, C., & Mukoma, W. (2009). I am not “umqwayito’’: a qualitative study of peer pressure and sexual risk behaviour among young adolescents in Cape Town, South Africa. Scandinavian Journal of Public Health, 37 Suppl 2, 107-112. https://doi.org/10.1177/1403494809103903

Starosta, A. J., Berghoff, C. R., & Earleywine, M. (2015). Factor structure and gender stability in the multidimensional condom attitudes scale. Assessment, 22(3), 374-384. https://doi.org/10.1177/1073191114547887

Tyson, M., Covey, J., & Rosenthal, H. E. S. (2014). Theory of planned behavior interventions for reducing heterosexual risk behaviors: A meta-analysis. Health Psychology, 33(12), 1454-1467. https://doi.org/10.1037/hea0000047

United Nations Programme on HIV and AIDS [UNAIDS]. (2014). Global statistics 2014. UNAIDS. http://files.unaids.org/en/media/unaids/contentassets/documents/factsheet/2014/20140716_FactSheet_en.pdf

United Nations Programme on HIV and AIDS [UNAIDS]. (2015). Position statement on condoms and the prevention of HIV, other sexually transmitted infections and unintended pregnancy. Retrieved from http://www.unaids.org/es/resources/presscentre/featurestories/2015/july/20150702_condoms_prevention

Valle, E. D. V., Canizales, G. M., & Potter, J. E. (2010). Religión e iniciación sexual premarital en México. Revista Latinoamericana de Población, 4(7), 7-30.

Vasilenko, S. A., & Lanza, S. T. (2014). Predictors of multiple sexual partners from adolescence through young adulthood. Journal of Adolescent Health, 55(4), 491-497. https://doi.org/10.1016/j.jadohealth.2013.12.025

Yzer, M. C. (2012). The Integrative Model of Behavior Prediction as a Tool for Designing Health Messages. In Cho, H. Designing Messages for Health Communication Campaigns: Theory and Practice. Sage Publishing. pp.21-40. https://pdfs.semanticscholar.org/7fe4/661aaa61090fa7ec59b38a382d13e5aad8b5.pdf