Using the risk behaviour diagnosis scale to understand Australian Aboriginal smoking — A cross-sectional validation survey in regional New South Wales

• First study on the Risk Behaviour Diagnosis (RBD) Scale in an Indigenous population
• Perceived efficacy and threat relate to intention to quit smoking in this sample.
• High-threat high-efficacy had the strongest evidence for danger control responses.
• The RBD Scale may help develop tailored anti-tobacco messages for Indigenous smokers.

ObjectiveTo validate, for the first time, the Risk Behaviour Diagnosis (RBD) Scale for Aboriginal Australian tobacco smokers, based on the Extended Parallel Process Model (EPPM). Despite high smoking prevalence, little is known about how Indigenous peoples assess their smoking risks.MethodsIn a cross-sectional study of 121 aboriginal smokers aged 18–45 in regional New South Wales, in 2014, RBD subscales were assessed for internal consistency. Scales included measures of perceived threat (susceptibility to and severity of smoking risks) and perceived efficacy (response efficacy and self-efficacy for quitting). An Aboriginal community panel appraised face and content validity. EPPM constructs of danger control (protective motivation) and fear control (defensive motivation) were assessed for cogency.ResultsScales had acceptable to good internal consistency (Cronbach's alpha = 0.65–1.0). Most participants demonstrated high-perceived threat (77%, n = 93); and half had high-perceived efficacy (52%, n = 63). High-perceived efficacy with high-threat appeared consistent with danger control dominance; low-perceived efficacy with high-threat was consistent with fear control dominance.ConclusionsIn these Aboriginal smokers of reproductive age, the RBD Scale appeared valid and reliable. Further research is required to assess whether the RBD Scale and EPPM can predict quit attempts and assist with tailored approaches to counselling and targeted health promotion campaigns.