What is the Theory of Planned Behaviour (TPB) in Health and Social Care?

The Theory of Planned Behaviour (TPB) is a psychological framework used to predict and understand human behaviour in a range of settings, including health and social care. It explains how an individual’s intentions, beliefs, and perceived control over their actions influence whether they carry out a particular behaviour. In health and social care, it is often applied to understand why people do or do not engage in healthy behaviours such as exercise, healthy eating, attending medical appointments, or adhering to treatment plans.

This theory was introduced by Icek Ajzen in the late 1980s and builds upon an earlier model called the Theory of Reasoned Action. The TPB adds the concept of “perceived behavioural control” to address situations where people may want to do something but feel unable to carry it out.

Components of the Theory of Planned Behaviour (TPB)

The TPB focuses on three key beliefs or influences on behaviour. These are:

Attitude towards the behaviour
This refers to how a person feels about carrying out a specific behaviour. It includes evaluating whether they see it as beneficial, harmful, enjoyable, unpleasant, or worthwhile.

Subjective norms
These are the social pressures a person perceives from others about whether they should or should not carry out the behaviour. Friends, family, colleagues, and community expectations can all influence subjective norms.

Perceived behavioural control
This describes how much control a person feels they have over performing a behaviour. It includes their confidence in being able to do it and whether they think there are barriers or opportunities that affect their ability.

The combination of these three elements influences a person’s behavioural intention, which is their willingness or plan to carry out the behaviour. The stronger the intention, the more likely they are to perform the action, provided they have the actual control to do so.

Attitude Towards Behaviour in Health and Social Care

In a health and social care context, attitude plays a major role. For example, a patient may have a positive attitude towards physiotherapy sessions if they believe the treatment will reduce pain and improve mobility. By contrast, if they think it will be too tiring or cause discomfort, they may have a negative attitude and be less likely to attend.

Attitude can be shaped by several factors such as:

• Past experiences with similar treatments
• Advice and explanations provided by health professionals
• Level of knowledge about the health benefits involved
• Emotional responses linked to the behaviour

Health and social care workers often try to strengthen positive attitudes by providing clear information, demonstrating benefits, and offering encouragement.

Subjective Norms in Health and Social Care

Subjective norms in this setting relate to how patients think others view the behaviour. For instance, a person may attend group therapy because they feel encouraged by peers who believe it helps recovery. Alternatively, they may avoid certain treatments if people they respect doubt its usefulness.

Social influences can come from:

• Family members
• Friends
• Community leaders
• Healthcare professionals

By involving supportive individuals in the care process, health practitioners can make positive subjective norms stronger and help motivate patients. Social approval often acts as a powerful force in behaviour change.

Perceived Behavioural Control in Health and Social Care

This part of the TPB is about how capable someone feels of performing the behaviour. For example, a patient who believes they can follow a home exercise programme and has the equipment to do it is more likely to succeed. On the other hand, someone who feels unable to manage the tasks, lacks transportation to appointments, or faces personal challenges may struggle to act, even if they have the intention.

Perceived behavioural control is influenced by:

• Availability of resources such as time, money, and equipment
• Physical ability and health status
• Skills learned through training or education
• Support from others

By offering practical help, teaching skills, and removing obstacles, health and social care staff can improve perceived control and increase the chance that people follow through with their intentions.

How Behavioural Intention Works

Behavioural intention acts as the link between thought and action in the TPB. Strong intentions often come from positive attitudes, supportive subjective norms, and high perceived control. If a patient intends to follow a diet plan, this is a sign they are likely to try. However, actual performance can still be influenced by unexpected events or new barriers.

For example:

• A patient may intend to attend counselling sessions but miss them because of transport issues
• Someone may plan to stop smoking but relapse after experiencing stress at work

Recognising the gap between intention and behaviour allows health professionals to put extra support in place.

Practical Applications in Health and Social Care

TPB can be applied in many areas to encourage healthy behaviours and treatment adherence. Examples include:

• Encouraging physical activity – Health workers can increase positive attitudes by explaining the physical and mental benefits of exercise, involve friends or family to strengthen norms, and provide resources to boost control such as guided sessions or equipment loans.
• Improving medication adherence – Patients’ attitudes can be improved by explaining how medication prevents worsening of conditions. Subjective norms can be influenced through peer support groups. Perceived control can be improved by offering pill organisers or reminders.
• Supporting dietary changes – Positive attitudes are encouraged by sharing healthy recipes and explaining nutritional benefits. Norms can be shaped by involving family meals or community cooking classes. Control can be improved by teaching shopping and cooking skills.
• Reducing substance misuse – Interventions may focus on creating negative attitudes towards misuse, supportive social norms that promote recovery, and a greater sense of control through coping strategies and practical resources.

Benefits of Using TPB in Health and Social Care

The TPB gives health and social care professionals a clear structure for understanding behaviour. This helps them design interventions that are more likely to work, because they address the underlying reasons that decide whether a person acts.

Benefits include:

• Pinpointing personal and social factors that influence behaviour
• Offering a practical framework to design personalised health plans
• Identifying and addressing barriers to change
• Strengthening the likelihood of lasting behaviour change

Limitations of the TPB

While the TPB is valuable, it is not perfect. People do not always behave in ways that match their intentions. Situations can change unexpectedly, emotions can be stronger than logical thought, and habits can override plans. The theory also relies heavily on self-reported beliefs, which may not always reflect true feelings or capabilities.

Barriers include:

• External factors beyond a person’s control
• Emotional states such as anxiety or depression
• Lack of accurate self-awareness
• Influence of habits and routines

Acknowledging these limits helps practitioners combine TPB with other approaches for more effective results.

Strategies to Strengthen Behaviour Change Using TPB

Approaches that can improve outcomes include:

• Building trust between patient and professional
• Using motivational interviewing to align care with patient goals
• Offering clear and realistic action plans
• Providing opportunities for skill development
• Creating community or peer support networks

By matching strategies with the three main components of the TPB, interventions become more focused and practical.

Final Thoughts

The Theory of Planned Behaviour offers a way to understand the link between what people think, what they intend to do, and what they actually do. In health and social care, this can guide professionals to create better plans for improving health and wellbeing.

By paying attention to attitudes, social pressures, and perceived control, it becomes easier to identify where support is needed. This approach does not guarantee action, but it increases the chances that individuals will follow through with positive behaviours that improve their quality of life.