Comparing Theoretical Models for the Understanding of Health-Risk Behaviour: Towards an Integrative Model of Adolescent Alcohol Consumption

The aim of the present manuscript is to test and compare the theory of reasoned action (TRA), theory of planned behaviour (TPB) and prototype-willingness model (PWM) in predicting risky alcohol consumption among adolescents and to build an integrative model to get a more comprehensive understanding of such risky behaviour. A total sample of 518 adolescents (55% females; 13-19 aged) recruited from Italian schools (7th to 12th grade) participated in a cross-sectional research study and completed an online questionnaire. Risky alcohol use assessed through the AUDIT-C was the dependent variable; whereas, variables from the TRA, TPB, and PWM (i.e. attitude, subjective norms, perceived behavioural control, intention, prototype favourability and similarity, and willingness to alcohol use) were used as predictors. Data were analysed using structural equation modelling (SEM). The findings show that the integrative model had greater explanatory power and provided a better fit to the data, compared to the TRA, TPB, and PWM, indicating attitudes and subjective norms as the best predictors. In conclusion, perceived social approval from significant others and the volitional component have a central role in understanding adolescents' alcohol consumption.