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OBJECTIVE: In order to determine if easy-difficult item measures attitude or perceived behavioural control (PBC), we used structural equation modelling of 10 cross-sectional data sets. DESIGN: Cross-sectional design was used. METHOD: Ten studies that examined health-related behaviours and used the theory of planned behaviour as a theoretical framework were analysed. Samples totalling N=4,552 participants were employed. All studies involved multi-item measures of attitude (Aact) and PBC items derived from pilot testing. RESULTS: Confirmatory factor analysis confirmed the discriminant validity of Aact and PBC. Structural equation modelling of relevant path indicated that in three studies, easy-difficult item is an indicator of both Aact and PBC. In the other seven studies, easy-difficult item belongs to PBC. The indexes of meta-analysis suggest that overall, easy-difficult item is an indicator of PBC. CONCLUSION: Findings from 10 studies converged toward the conclusion that the easy-difficult item is an indicator of perceived PBC. However, since the easy-difficult item is sometimes classified as both Aact and PBC, and only the perceived difficulty dimension of PBC captures a significant increment in the variance of intention, it appears important to develop and validate a set of items devoted to measure the perceived difficulty dimension adequately.
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