Liu Yifei, Farris Karen B, Nayakankuppam Dhananjay, Sorofman Bernard A, Urmie Julie M, Doucette William R
Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, United States.
Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, MI, United States.
Front Pharmacol. 2024 Sep 16;15:1375529. doi: 10.3389/fphar.2024.1375529. eCollection 2024.
Norm Balance is an approach under the Theory of Planned Behavior (TPB) where subjective norm is weighted by the relative importance of others and self-identity is weighted by the relative importance of self. The relative importance was measured previously by a trade-off measure. In this study, we developed separate measures for the relative importance. The study objectives were to: 1) assess the construct validity of the separate measures; 2) examine the approach of Norm Balance in predicting pharmacists' intention to collaborate with physicians to improve medication therapy; and 3) establish a modified TPB.
We selected a random sample of 750 Iowa pharmacists and conducted two surveys. The first survey was to examine intention prediction, and the second survey was to examine behavior prediction by measuring behavior among respondents to the first survey. The relative importance was measured by both the trade-off measure and the separate measures. Exploratory factor analyses were performed for the relative importance of others (separate measures) and subjective norm, and for the relative importance of self (separate measures) and self-identity. Regressions for intention prediction were conducted for TPB with self-identity and the approach of Norm Balance. The same regressions were also conducted for three subgroups according to the median of the relative importance of others (trade-off measure). Moreover, another regression was conducted for behavior prediction.
239 practicing pharmacists responded to the first survey, and 188 responded to the second survey. The separate measures had cross factor loadings, whereas the trade-off measure had low correlations with other constructs. Both regressions for intention prediction explained 75% of the variance, with self-efficacy and attitude being strong predictors. Self-identity was not a predictor in the TPB with self-identify, but self-identity weighted by the relative importance of self was a significant predictor in the approach of Norm Balance. Regression coefficients of subjective norm and self-identify varied across subgroups. The regression for behavior prediction explained 30% of the variance, with intention and self-efficacy being two predictors.
The trade-off measure was better than separate measures. The approach of Norm Balance appears to be a better model than the TPB with self-identity to examine pharmacist-physician collaboration.
规范平衡是计划行为理论（TPB）下的一种方法，其中主观规范由他人的相对重要性加权，自我认同由自我的相对重要性加权。相对重要性先前通过权衡测量来衡量。在本研究中，我们开发了相对重要性的单独测量方法。研究目的是：1）评估单独测量方法的结构效度；2）检验规范平衡方法在预测药剂师与医生合作以改善药物治疗意图方面的作用；3）建立修正的计划行为理论。
我们从爱荷华州的药剂师中随机抽取750名样本，并进行了两项调查。第一次调查是为了检验意图预测，第二次调查是通过测量第一次调查受访者的行为来检验行为预测。相对重要性通过权衡测量和单独测量方法来衡量。对他人的相对重要性（单独测量方法）和主观规范，以及自我的相对重要性（单独测量方法）和自我认同进行探索性因素分析。对包含自我认同和规范平衡方法的计划行为理论进行意图预测回归分析。根据他人相对重要性（权衡测量）的中位数，对三个亚组也进行了相同的回归分析。此外，还进行了行为预测的另一项回归分析。
239名执业药剂师回复了第一次调查，188名回复了第二次调查。单独测量方法存在交叉因子载荷，而权衡测量与其他结构的相关性较低。两项意图预测回归分析解释了75%的方差，自我效能感和态度是强有力的预测因素。在包含自我认同的计划行为理论中，自我认同不是预测因素，但在规范平衡方法中，由自我相对重要性加权的自我认同是一个显著的预测因素。主观规范和自我认同的回归系数在不同亚组中有所不同。行为预测回归分析解释了30%的方差，意图和自我效能感是两个预测因素。
权衡测量方法优于单独测量方法。规范平衡方法似乎是比包含自我认同的计划行为理论更好的模型，用于检验药剂师与医生的合作。
