|
| Perceived consequences | An individual might hold any number of relevant and salient beliefs or perceptions about the consequences or outcomes of performing (or not performing) a given behaviour (e.g., “having my daughter cut will protect her virginity” or “not having my daughter cut will lead to her being ostracised by our community”). They will also hold evaluations about how desirable such an outcome is (e.g., “protecting my daughter's virginity is extremely important and desirable”). |
|
| Risk perception/perceived threat | This is often assessed as measures of perceived susceptibility/vulnerability and perceived severity of the threat. Some have argued that this element of BCTs could be subsumed by perceived consequences, in that one might perceive the susceptibility of a threat as an outcome belief (e.g., “going ahead with my daughter's circumcision may cause her to have pain and infections”), and an evaluation of that outcome is akin to perceived severity (e.g., “my daughter experiencing pain and infection is a very bad thing”). |
|
| Self-efficacy and perceived behavioural control (PBC) | Self-efficacy is often described as confidence in one's ability to perform a particular behaviour, and PBC as perceptions about how in control of performing a behaviour one is. This concept can be thought of as perceptions about barriers or facilitators to action, and these can be both perceived or real; for example, a person may perceive that there is a barrier preventing them from carrying out an action, but in some cases there might actually be real, tangible barriers, such as not having the power or resources to carry out a certain behaviour. Barriers and facilitators can also relate to an individuals’ internal (skill-based) and external factors. Believing that one is able to perform a behaviour is critical to the likelihood of performance (e.g., “I know the right people and have enough money to arrange for my daughter to be circumcised” or “I have the strength of character and the conviction to defend my decision not to circumcise my daughter”). |
|
| Link between self-efficacy/PBC and behaviour | Two theories, the theory of planed behaviour (TPB) and social cognitive theory (SCT), propose a direct relationship between self-efficacy or perceived control behaviour (PBC) and behaviour, as well as a relationship with intention or motivation to act. This is illustrated along with other concepts in Figure 1. Essentially, what this demonstrates is that where perceptions about ability to perform a behaviour reflect actual abilities, there will be a direct impact on behaviour regardless of how motivated an individual is. Ajzen, [48]; e.g., a mother may want to prevent her daughter from being cut but may lack control over this and fail to prevent the cutting. |
|
| Normative influences | These are included in various ways in BCTs, and discussion of their involvement in behavioural change has been prevalent. Normative influences refer to perceptions one has about what important individuals others think you should do with regards to a given behaviour (normative beliefs), perceptions about what other people do themselves (descriptive norm), and beliefs about what is right (moral norms). It seems likely that normative influences are very strongly related to decision-making related to FGM. |
|
| Intention | This is also known as motivation or desire to carry out a particular action. Intention mediates the relationship between social cognitive processes outlined thus far and behaviour. The only exception is self-efficacy/perceived behaviour control, which, as already outlined, can also have a direct impact on behaviour. The first three stages of change (from the TTM), outlined and adapted in Shell-Duncan and colleagues work on FGM [39], can be said to represent a measure, or continuum, of increasing intention or motivation. |
|
| Self-regulatory skills | Once a decision or intention to act has been made, there is consensus by theorists and researchers about the processes involved in translating intention into action. It is widely held that, in order to maintain and remember intentions and respond to opportunities when they arise, various self-regulatory skills are required. Intentions need to be strengthened and protected once formed, and careful plans about how, when, and where are required. |
|
| Behaviour or action | This might refer to any behaviour or action relevant to performing or not performing FGM and might include communication about FGM with other community members or any behaviour or activity suggested within Community Readiness Theory. |
|
