Perceived Control
Suzanne C. Thompson and Michèle M. Schlehofer

Several health behavior theories include a personal control component. The ways in which personal control is used to explain health behaviors differs slightly between the theories, but all have an underlying theme: personal control increases the chances a person will perform a health behavior. Below is a brief explanation of the role of control in the most common health behavior theories.

Two-Process Model of Perceived Control
The model, as presented by Rothbaum, Weisz, and Snyder (1982) xClose
Rothbaum, F., Weisz, J. R., & Snyder, S. S. (1982). Changing the world and changing the self: A two process model of perceived control. Journal of Personality and Social Psychology Bulletin, 42, 5-37. , makes a distinction between primary control, which involves taking action to get desired outcomes, and secondary control, which refers to changing one self to adjust to the environment. Secondary control also enhances an overall sense of personal control. The important contribution of this approach to control is that it proposes that both direct action on the environment and adjusting to the environment are sources of personal control. Although many parts of this theory are not directly relevant to health behavior change and the theory has not been widely applied in that area, this approach focuses attention on control strategies, which are the ways people use to get desired outcomes or handle stressful situations. Control strategies could have important implications for health protection. For example, those who use primary control strategies of changing the environment may be more likely to act to protect themselves. In addition, the theory identifies a source of personal control enhancement (i.e., secondary control acceptance of one's situation) that may bolster the personal control that is necessary for health behavior change.

Theory of Planned Behavior
In the theory of planned behavior (TPB), perceived behavioral control is assumed to be a proxy indicator of actual behavioral control. Research with the TPB has found that the theory is accurate at predicting intentions to perform health behaviors (Godin & Kok, 1996 xClose
Godin, G., & Kok, G. (1996). The theory of planned behavior: A review of its applications to health-related behaviors. American Journal of Health Promotion, 11, 87-98. ; Schifter & Ajzen, 1985 xClose
Schifter, D. E., & Ajzen, I. (1985). Intention, perceived control, and weight loss: An application of the theory of planned behavior. Journal of Personality and Social Psychology, 49 (3), 843-851. ), and research comparing the TPB with the theory of reasoned action has found that, generally, the inclusion of the perceived behavioral control construct in the TPB adds to predictive ability (Terry & O'Leary, 1995 xClose
Terry, D. J., & O'Leary, J. E. (1995). The theory of planned behavior: The effects of perceived behavioral control and self-efficacy. British Journal of Social Psychology, 34, 199-220. ). However, researchers have generally operationalized perceived control as self-efficacy, and it is possible that if research used measures of perceived control the predictive power of the model would be further increased (Godin & Kok, 1996 xClose
Godin, G., & Kok, G. (1996). The theory of planned behavior: A review of its applications to health-related behaviors. American Journal of Health Promotion, 11, 87-98. ; Terry & O'Leary, 1995 xClose
Terry, D. J., & O'Leary, J. E. (1995). The theory of planned behavior: The effects of perceived behavioral control and self-efficacy. British Journal of Social Psychology, 34, 199-220. ).

Social Cognitive Theory
Social cognitive theory (Bandura, 1986 xClose
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall. ) is an extension of social learning theory, a behavioral theory that states individuals learn behaviors by observing similar others receive reinforcement or punishment for similar behaviors. In social cognitive theory, self-regulatory systems, or internal controls over one's behavior guide behavioral decisions. Bandura defines self-regulation as the "exercise of influence" over one's behavior. In the model, one's ability to self-regulate is dependent on the presence of two efficacy perceptions: self-efficacy and response efficacy. As mentioned earlier, these two efficacy perceptions comprise the construct of perceived control. The model places great emphasis on self-efficacy, which is defined as "the belief in one's capabilities to organize and execute the sources of action required to manage prospective situations." That is, self-efficacy is the belief that one can perform a behavior (e.g., use a condom correctly). The response efficacy component refers to beliefs that a certain behavior will reach a desired outcome (e.g., using condoms will prevent unplanned pregnancy). Response efficacy, therefore, is a belief in the efficaciousness of the health behavior. The greater self and response efficacy perceptions (and, hence, the greater perceived control one has), the greater likelihood that the behavior will be performed.

Protection Motivation Theory
Protection motivation theory (Maddux & Rogers, 1983 xClose
Maddux, J. E., & Rogers, R. W. (1983). Protection motivation and self-efficacy: A revised theory of fear appeals and attitude change. Journal of Experimental Social Psychology, 19, 469-479. ; Rogers, 1975 xClose
Rogers, R. W. (1975). A protection motivation theory of fear appeals and attitude change. Journal of Psychology, 91, 93-114. , 1983 xClose
Rogers, R. W. (1983). Cognitive and psychological processes in fear appeals and attitude change: A revised theory of protection motivation. In J. T. Caccioppo & R. E. Petty (Eds.), Social psychophysiology (pp. 153-176). New York, NY: Guilford. ) proposes that motivations to protect oneself factor into decisions to engage in healthy behaviors. According to the model, individuals assess their self-efficacy (an individual's perceived ability to take action) and response efficacy (the perceived effectiveness of the action) in an effort to determine the extent to which they can cope with a health threat. Self- and response-efficacy are both components of perceived control, and as such, the model has a perceived control component. As perceptions of self- and response efficacy increase, the likelihood of engaging in healthy behaviors also increases (Rogers, 1983 xClose
Rogers, R. W. (1983). Cognitive and psychological processes in fear appeals and attitude change: A revised theory of protection motivation. In J. T. Caccioppo & R. E. Petty (Eds.), Social psychophysiology (pp. 153-176). New York, NY: Guilford. ).

Self-Control Theory
In self-control theory (Rosenbaum, 1983 xClose
Rosenbaum, M. (1983). Learned resourcefulness as a behavioral repertoire for the self-regulation of internal events: Issues and speculations. In M. Rosenbaum, Franks, C. M., & Jaffe, Y. (Eds.). Perspectives on behavior therapy in the eighties (pp. 54-73). New York: Springer. ), control refers to the ability to monitor and inhibit one's own emotions, thoughts, and behaviors. Examples of efforts to exert self-control include working to improve one's posture, maintaining a low-fat diet, and suppressing specific thoughts.