Explaining the attitude-behaviour gap in adolescent sexual and reproductive health service utilization: A cognitive dissonance perspective from rural Uganda.

IF 1.9 Q3 PSYCHOLOGY, CLINICAL

Health Psychology Open Pub Date : 2026-07-31 eCollection Date: 2026-01-01 DOI:10.1177/20551029261476116

Noah Robert Nyende

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引用次数: 0

Abstract

Adolescents in low-resource settings hold positive attitudes toward sexual and reproductive health (SRH) services, yet fail to use them. This study presents a theoretical reinterpretation of mixed-methods data (N = 408 adolescents, aged 13-19) from Uganda's Busoga region, through Festinger's Cognitive Dissonance Theory. Quantitative findings showed health-seeking attitudes predicted SRH service utilization (β = 0.910, p < .001) and future intentions (β = 1.976, p < .001), but 52% of adolescents had no SRH service contact in past year, and mean uptake scores remained below 2.0 on a 5-point scale. Qualitative analysis of focus group discussions identified three dissonance-reduction strategies: avoidance of health facilities, rationalization through misinformation, and selective information-seeking from peers. The reinterpretation proposes four intervention strategies: barrier reduction, community norm campaigns, cues to action with immediate access, and targeted messaging for working and rural adolescents. Addressing psychological discomfort and structural barriers may help close the attitude-behaviour gap.

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解释青少年性健康和生殖健康服务利用中的态度-行为差距：来自乌干达农村的认知失调视角。

在资源匮乏的环境中，青少年对性健康和生殖健康服务持积极态度，但未能利用这些服务。本研究通过费斯廷格的认知失调理论，对来自乌干达布索加地区的混合方法数据（N = 408名13-19岁的青少年）进行了理论重新解释。定量结果显示，青少年求医态度能预测青少年性健康与健康服务的利用（β = 0.910, p < 0.001）和未来意向（β = 1.976, p < 0.001），但52%的青少年在过去一年中没有接触过性健康与健康服务，平均接受得分低于2.0分（5分制）。焦点小组讨论的定性分析确定了三种减少失调的策略：避开卫生设施，通过错误信息进行合理化，以及从同伴那里选择性地寻求信息。重新解释提出了四项干预策略：减少障碍、社区规范运动、立即获得的行动提示以及针对工作青少年和农村青少年的有针对性的信息传递。解决心理不适和结构性障碍可能有助于缩小态度-行为差距。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Psychology Open Psychology-Clinical Psychology

CiteScore

5.90

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： Health Psychology Open (HPO) is an international, peer-reviewed, open access, online-only journal providing rapid publication. HPO is dedicated to publishing cutting-edge research in health psychology from around the world. HPO seeks to provide a platform for both traditional empirical analyses and more qualitative and/or critically oriented approaches to health psychology. All areas of health psychology are covered, but these topics are of particular interest: Clinical health psychology Critical health psychology Community health psychology Health psychology practice Health psychology through a social, cultural or regional lens The journal particularly favours papers that focus on health psychology in practice, including submissions concerning community and/or clinical applications and interventions. Review articles are also welcomed. There is no fixed limit to the length of manuscripts, which is normally strictly limited in other journals, for example HPO’s sister journal, Journal of Health Psychology (JHP). Studies published in this journal are required to obtain ethical approval from an Institutional Review Board. Such approval must include informed, signed consent by all research participants. Any manuscript not containing an explicit statement concerning ethical approval and informed consent will not be considered.