Substance use avoidance among Iranian male adolescents: a comparison of three versions of the theory of reasoned action

The theory of reasoned action (TRA) is one of the most common models in predicting health-related behaviors and is used more often in health education studies. This study aimed to add two control constructs (perceived behavioral control – PBC and self-efficacy – SE) to the TRA and compare them using the structural equation modeling (SEM) for substance use avoidance among Iranian male adolescents in order to find out which model was a better fit in predicting the intention. This was a cross-sectional study carried out in Tehran, Iran. Data were collected from a random sample of high school male students (15–19 years of age) using a questionnaire containing items related to the TRA plus items reflecting two additional constructs (SE and PBC). In all, 433 students completed the questionnaires. The results obtained from SEM indicated a better fit to the data for the TRA with SE compared to the TPB (TRA with PBC) and TRA (χ2/df=2.55, RMSEA=0.072, CFI=0.96, NFI=0.94, NNFI=0.95, SRMR=0.058). Comparing SE and PBC, the results showed that self-efficacy was a better control construct in improving the TRA and predicting substance use avoidance intention (41%). The TRA with SE had a better model fit than TPB and the original version of the TRA.