Antecedents of self identity and consequences for action control: An application of the theory of planned behaviour in the exercise domain

ObjectivesTo study whether exercise action control profiles should be usefully extended to include exercise identity. Further, this study investigated theory of planned behaviour antecedents of exercise identity.DesignProspective data from 413 undergraduate students (M age = 21.4; 73.5% females).MethodValidated questionnaires were used at baseline and follow-up two weeks later to assess exercise behaviour, intention, self-identity, and theory of planned behaviour concepts. Research questions were analysed using chi-square analysis, discriminant function analysis and structural equation modelling. Results were interpreted using p-values and effect sizes.ResultsThere was a higher proportion of exercise intenders in the strong exercise identity group than in the weak exercise identity group (81.9% vs. 14.5%) and a higher proportion of successful intenders in the high exercise identity group than in the low exercise identity group (45.5% vs. 18.2%). Affective attitude and perceived behavioural control (PBC) were the most important predictors of exercise action control. Regarding the antecedents of identity, results showed significant and small-sized associations for baseline affective attitude and perceived behavioural control and large-sized association for baseline self-identity.ConclusionExercise identity should be usefully employed to understand exercise motivation and action control. Affective attitude and perceived behavioural control facilitate action control and exercise identity development and are suggested to be taken into account when developing exercise interventions.     

Self-efficacy for health-related behaviour change in patients with TIA or minor ischemic stroke

Abstract

Objective: To assess levels of self-efficacy for health-related behaviour change and its correlates in patients with TIA or ischemic stroke.

Methods: In this prospective cohort study, 92 patients with TIA or ischemic stroke completed questionnaires on self-efficacy for health-related behaviour change and fear, social support and depressive symptoms. Relations between fear, social support, depressive symptoms, cognitive impairment, vascular risk factors and history and demographic characteristics and low-self-efficacy were studied with univariable and multivariable logistic regression.

Results: Median total self-efficacy score at baseline was 4 (IQR 4–5). Older age (OR 1.05, 95% CI 1.01–1.09), depressive symptoms (OR 1.09, 95% CI 1.03–1.16), presence of vascular history (OR 2.42, 95% CI 0.97–6.03), higher BMI (OR 1.15, 95% CI 1.01–1.30), fear (OR 1.06, 95% CI 1.01–1.12) and low physical activity (OR 1.49, 95% CI 1.01–2.21) were significantly associated with low self-efficacy.

Conclusion: Patients with recent TIA or ischemic stroke report high self-efficacy scores for health-related behaviour change. Age, vascular history, more depressive symptoms, higher BMI, less physical activity and fear were correlates of low self-efficacy levels.

Practice implications: These correlates should be taken into account in the development of interventions to support patients in health behaviour change after TIA or ischemic stroke.     

Evaluation of a Behaviour Analysis and Treatment of Progressive Myoclonus Epilepsy,Type Unverricht-Lundborg: A Case Study

This case study evaluates the clinical effectiveness of a psychological treatment within a behaviour medicine approach to epilepsy of a subject with progressive myoclonic epilepsy. The pattern of seizure behaviour was identified in the behaviour analysis. Self-management skills were taught to the client and in vivo exposure was subsequently used in a desensitization process. The main findings in this study were that the debilitating effects of the myclonic jerks can be reduced and functioning level improved when fear of seizures is reduced. These results indicate that psychological treatment can increase the level of functioning in clients with progressive myoclonic epilepsy.     

Macronutrient intake as a prospective predictor of depressive symptom severity: An exploratory study with adolescent elite athletes

BackgroundAppropriate availability of macro- and micronutrients has an important impact on cognitive performance, mood and mental health. Although the critical role of nutrition for elite athletes’ performance was recognized early on, little is known about whether consumption of specific macronutrients (carbohydrates, proteins, fat) predict the development of future depressive symptoms in adolescent elite athletes.MethodsParticipants were recruited from three Swiss Olympic Partner Schools (SOPS) in the Northwestern German speaking part of Switzerland. A total of 97 adolescent elite athletes (38% girls, M_age = 16.35 ± 1.19) participated in the study. Depressive symptoms (PHQ9) were assessed at baseline and after 10 months follow-up. A 3-day food recall was completed three months after the baseline assessment. Linear regression analyses were used to examine whether macronutrients predict depression symptom severity after controlling for covariates and baseline depressive symptoms.ResultsHigher protein consumption in athletes was a prospective predictor of lower depressive symptom severity at follow-up (β = −35, p < .05). Several deviations from recommended nutritional standards were observed in elite athletes.ConclusionsThe findings of this exploratory study support the notion that dietary behaviour may be prospectively associated with athletes’ mental health. However, more research is required with larger samples and more in-depth assessment techniques. Future research should also examine whether nutrition education and dietary modification can be used to prevent depressive symptoms among adolescent elite athletes.     

Goal-setting in diabetes self-management: A systematic review and meta-analysis examining content and effectiveness of goal-setting interventions

Background: Goal-setting is recommended and widely used within diabetes self-management programmes. However, empirical evidence around its effectiveness lacks clarity. This review aims to evaluate the effectiveness of goal-setting interventions on diabetes outcomes and to determine which behaviour change techniques (BCTs) are frequently used within these interventions.

Methods: A systematic search identified 14 studies, describing 12 interventions targeting diabetic-control which incorporated goal-setting as the main intervention strategy. Study characteristics, outcome measures and effect sizes of the included studies were extracted and checked by two authors. The BCT taxonomy v1 was used to identify intervention content. Meta-analyses were conducted to assess intervention effects on the primary outcome of average blood glucose levels (HbA1c) and on body-weight. Psycho-social and behavioural outcomes were summarised in narrative syntheses.

Results: Significant post-intervention improvements in HbA1C were found (?.22, 95% CI, ?.40, ?.04) across studies. No other main effects were identified. The BCT ‘goal-setting (behaviour)’ was most frequently implemented and was identified in 84% of the interventions.

Conclusions: Goal-setting interventions appear to be associated with reduced HbA1C levels. However, the low numbers of studies identified and the risk biases across studies suggest more research is needed to further explore goal-setting BCTs in diabetes self-management.     

Macronutrient intake as a prospective predictor of depressive symptom severity: An exploratory study with adolescent elite athletes

BackgroundAppropriate availability of macro- and micronutrients has an important impact on cognitive performance, mood and mental health. Although the critical role of nutrition for elite athletes’ performance was recognized early on, little is known about whether consumption of specific macronutrients (carbohydrates, proteins, fat) predict the development of future depressive symptoms in adolescent elite athletes.MethodsParticipants were recruited from three Swiss Olympic Partner Schools (SOPS) in the Northwestern German speaking part of Switzerland. A total of 97 adolescent elite athletes (38% girls, M_age = 16.35 ± 1.19) participated in the study. Depressive symptoms (PHQ9) were assessed at baseline and after 10 months follow-up. A 3-day food recall was completed three months after the baseline assessment. Linear regression analyses were used to examine whether macronutrients predict depression symptom severity after controlling for covariates and baseline depressive symptoms.ResultsHigher protein consumption in athletes was a prospective predictor of lower depressive symptom severity at follow-up (β = −35, p < .05). Several deviations from recommended nutritional standards were observed in elite athletes.ConclusionsThe findings of this exploratory study support the notion that dietary behaviour may be prospectively associated with athletes’ mental health. However, more research is required with larger samples and more in-depth assessment techniques. Future research should also examine whether nutrition education and dietary modification can be used to prevent depressive symptoms among adolescent elite athletes.     

Using self-determination theory to examine the motivational correlates and predictive utility of spontaneous exercise implementation intentions

ObjectivesThis study adopted a self-determination theory approach to explore the correlates of a measure of spontaneous implementation intentions; designed to allow for volition in planning when, where, and how to exercise. The study further explored the relationship between spontaneous implementation intentions and measures of behavioural regulation, in explaining exercise behaviour.DesignThe initial sample of 253 (99 males, 153 females) Canadian University College students was reduced to 162 participants (63 males, 99 females) after three phases of data collection. Measures of spontaneous implementation intentions and the Behavioural Regulation in Exercise Questionnaire were completed during the first phase of data collection. Actual exercise behaviour was assessed two, then three weeks later.ResultsA standard regression analysis revealed that identified regulation significantly predicted spontaneous implementation intentions, accounting for 36% of the variance. A hierarchical regression analysis revealed that after the first step, identified regulation made a significant contribution accounting for 35% of the variance in exercise behaviour. The addition of spontaneous implementation intentions significantly increased the prediction of exercise by 8%. An investigation of the beta coefficients revealed that spontaneous implementation intentions reduced the effects of identification from .50 to .26 after taking into consideration the effects of spontaneous implementation intentions in the second step of the analysis. The indirect effect of identification on exercise via spontaneous implementation intentions was statistically significant (z=3.88, p<.05).ConclusionsPeople who exercise for more self-determined reasons are more likely to spontaneously form implementation intentions, and because implementation intentions have motivating effects, they might lead to more self-determined behaviour.     

Planning bridges the intention–behaviour gap: Age makes a difference and strategy use explains why

Objective: This study examines age-differential association patterns between intentions, planning and physical activity in young and middle-aged individuals. The effectiveness of planning to bridge the intention–behaviour gap is assumed to increase with advancing age. We explore the use of behaviour change strategies that include selection, optimisation and compensation (SOC) as underlying mechanisms for age differences. Methods: In N = 265 employees of a national railway company (aged 19–64 years), intentions, planning, SOC strategy use and physical activity were assessed at baseline (Time 1) and again 1 month later (Time 2). Hypotheses were tested in two different path models. Results: Age moderates the extent to which planning mediates the intention–behaviour relation due to an increasing strength of the planning–behaviour link. As a possible psychological mechanism for these age differences, we identified SOC strategy use as a mediator of the age by planning interaction effect on physical activity. Conclusion: These findings suggest differential mechanisms in behaviour regulation in young and middle-aged individuals.     

Behavioural Change Techniques used in road safety interventions for young people

IntroductionDeath and injury from road traffic is a public health problem worldwide and accordingly there is substantial interest and investment in developing interventions to change road user behaviour. Alongside this, there is growing awareness of the need to evaluate interventions and to identify the most effective mechanisms by which behaviour can be changed. Progress has been hindered due to lack of a common taxonomy with which to define specific techniques used in attempts to change behaviour.ObjectiveBehavioural Change Techniques (BCTs) have been successfully deployed to change a range of different health behaviours. This paper defines a series of BCTs that can be applied in the road safety setting and asks which ones are found in road safety interventions for young road users?MethodAbraham and Michie (2008) identified twenty-six techniques used in behavioural change interventions. These BCTs, plus one other adapted from forensic psychology, are classified into nine groupings. Six educational road safety interventions commonly used in the UK with pre-drivers and young, novice drivers are characterised in terms of the BCTs they employ.ResultsOnly a small subset of BCTs are employed in most of the interventions. They concentrate primarily on increasing awareness of the risks associated with a particular behaviour, and the severity of the potential adverse consequences.ConclusionRecommendations are given for improving the effectiveness of road safety interventions for young people including young, novice drivers by increasing the range of BCTs deployed.     

Self-regulatory efficacy's role in the relationship between exercise identity and perceptions of and actual exercise behaviour

Identity theory posits that when people endorse an identity they maintain or alter their behaviour in order to behave consistently with that identity. This assertion is supported in the exercise context where strength of exercise identity relates to exercise behaviour. Less is known about self-regulatory constructs that may aid individuals in behaving consistently with their exercise identity. Self-regulatory efficacy may mediate the relationship between exercise identity and exercise given the influence of this variable on exercise self-regulation; this relationship has not been examined. Exercise identity research has focused on the relationship between identity and behaviour; yet, identity theory recognizes perceptions of identity-behaviour consistency as theoretically important. Through influencing how identity-relevant information is processed, self-regulatory efficacy may also mediate the relationship between exercise identity and perceptions of identity-behaviour consistency.ObjectiveIdentity and social cognitive theories were used to examine self-regulatory efficacy as a mediator between exercise identity and i) exercise behaviour and ii) perceptions of identity-behaviour consistency.Method/designUndergraduate students (n = 311) were followed for 8 weeks. At baseline, participants completed demographic, exercise identity and exercise measures. After 4 weeks they reported their self-regulatory efficacy and after 8 weeks they reported their perceptions of identity-behaviour consistency and their exercise behaviour.ResultsConsistent with theory, self-efficacy mediated the relationship between exercise identity and both outcomes.ConclusionsFindings extend the exercise identity literature by providing empirical support for self-regulatory efficacy as a mechanism through which exercise identity strength leads to exercise behaviour and the perception of behavioural consistency with exercise identity meanings.     

‘It’s not a diet,it’s a lifestyle’: a longitudinal,data-prompted interview study of weight loss maintenance

Objective: To advance understanding of the individual and environmental factors underpinning weight loss maintenance. Design: Semi-structured, data-prompted interviews were conducted with twelve overweight adult participants (three men, nine women) who had lost over 5% of their body weight in the year before baseline. Participants gathered daily data through wireless scales, activity monitors (Fitbit?), ecological momentary assessment and experience sampling (taking photographs, writing notes). They were interviewed at 3- and 6-months post baseline. Interview stimuli included personal data of weight and activity graphs, correlations of psychological factors, and self-generated notes and photographs. Interview data were analysed using the Framework Method, applying pre-specified maintenance-relevant theoretical themes. Results: The theoretical Framework provided a good fit for the narratives, with five main themes underpinning successful weight loss maintenance: sustained motivation, effective self-regulation, plentiful resources, habit formation and a supportive environment. Additionally, participants reported an identity shift from being a dieter to accepting a new healthy lifestyle. Goal prioritising and allowing for occasional controlled lapses enhanced weight loss maintenance. Conclusions: This study successfully used the novel method of data-prompted interviews to explore weight loss maintenance experiences with new explanations emerging from the data. Future research should further develop behaviour change maintenance theory and data-prompted interview method.     

Physical activity participation and physical aggression in children and adolescents: A systematic review and meta-analysis

BackgroundAggressive behaviour is a substantial behavioural problem in children and adolescents. This review systematically summarises the current evidence on the relationship between physical activity participation and aggressive behaviour and quantifies the effects of physical activity interventions on aggression in children and adolescents.MethodsStudies were identified through a search of five electronic databases (PsycINFO, SPORTDiscus, MEDLINE, CINAHL and Web of Science) with combinations of three groups of keywords. Two independent reviewers screened and extracted data from the individual studies. The reporting quality and publication bias were assessed. The relationship between physical activity participation and aggressive behaviour was systematically summarized. Data (effect sizes) were pooled to investigate the effects of physical activity interventions on aggressive behaviour. A moderator meta-analysis was performed to identify potential moderators of the effects of physical activity interventions on aggressive behaviour.ResultsNineteen studies met the inclusion criteria. The relationship between physical activity participation and aggressive behaviour was mixed. A significant reduction in aggressive behaviour was observed after physical activity interventions (k = 8, SMD = −0.53, 95% CI [−0.27, −0.79], p < 0.001). The moderator meta-analysis showed that physical activity interventions involving team-based physical activity had greater effects than those involving individual-based physical activity (β = 0.42, SE = 0.18, p = 0.02). In addition, interventions involving physical activity alone were more effective in reducing aggressive behaviour than those that combined physical activity with other activities such as a philosophy course (β = −0.63, SE = 0.11, p < 0.001).ConclusionThe current meta-analysis presents evidence for the effect of physical activity interventions on aggressive behaviour in children and adolescents. Physical activity–only interventions involving team-based physical activity might be used for preventing or reducing aggressive behaviour in children and adolescents. Possible mechanisms, methodological strengths and weaknesses, implications, and suggestions for future studies were discussed.     

A 15-year longitudinal test of the theory of planned behaviour to predict physical activity in a randomized national sample of Canadian adults

BackgroundThere have been very limited long-term prospective studies examining social-cognitive models in the PA domain with large, representative population samples.ObjectiveThe primary objective was to examine the Theory of Planned Behaviour's (TPB) ability to explain PA behaviour in a randomly selected national sample of Canadian adults over a 15-year period. A secondary objective was to test the moderating effects of gender on TPB.DesignThe study employed a longitudinal design.MethodsA cohort of 1427 randomly-selected adults reported TPB constructs and PA behaviour in 1988, and again in 2003. Structural equation modelling techniques were employed to test TPB.ResultsThe full model including both 1988 and 2003 TPB measures accounted for 29% and 21% of the variance in intention, and 9% and 22% of the variance in PA in 1988 and 2003, respectively. Gender moderated aspects of the TPB in the full model. The core predictive model (1988 TPB constructs predicting 2003 PA behaviour) explained 13% of the variance in 2003 PA behaviour.ConclusionsThe TPB's long-term ability to predict PA behaviour is modest.     

Examination stress and changes in mood and health related behaviours

Abstract

The present exploratory study evaluated the effect of stress (an examination period) on changes in mood and health related behaviours. 83 medical students completed measures of mood and health related bchaviours at baseline and four weeks later either during their examinations period (the stress condition) or after a comparative control period (the control condition). All subjects also completed ratings of stress mediating variables: social support, perceived control and coping style at baseline. The results showed deterioration in mood in terms of increases in depression and anxiety and changes in health related behaviours in terms of increased numbers of subjects who identified thcmsehes as smokers, and dcmascs in alcohol consumption, exercise and food intake in subjects in the stress condition. The results also suggest that social support moderated the effects of the examination stress and was related to greater decreases in smoking, decrcases in alcohol craving and increases in eating behaviour. In addition, an avoidance coping style (problem avoidance, wishful thinking) was related to greater decreases in eating behaviour. 'Ihe nsults an discussed in the context of the stress/illness link and the role of behavioural change.     

Generalized Schedule Following in a Youth with Autism

Abstract

Photographic activity schedules were used to increase on-task behaviour in a youth with autism. The multiple probe design included baseline, training, tests for training effects, resequencing of photographs, generalization to new photographs, and maintenance. The results showed that the participant was able to carry out four different chains (photographic activity schedules) without any prompts from the staff, even when the photographs were resequenced, and new photographs were included. On the other hand, there was no reduction of training trials to reach criterion from the first to the fourth chain. The results are discussed with reference to different aspects of generalization.     

Differential Reinforcement of Other Behavior in the Treatment of Inappropriate Behavior and Aggression in an Adult with Mental Retardation at a Vocational Center

Differential reinforcement of other behavior (DRO) was used to reduce aggression and other inappropriate actions in a 26-year-old man with moderate mental retardation employed at a vocational center. Initially high baseline levels of inappropriate behavior were reduced by implementing contingent praise and a sticker system used to earn points needed to gain access to social activities. The procedure was low cost, required minimal time and effort on the part of center staff, and made it possible for the client to remain employed at the vocational center.     

The role of action and coping planning in the relationship between intention and physical activity: A moderated mediation analysis

Objective: Using a moderated mediation model, the present study investigated whether the mediation of intention into physical activity (PA) behaviour via action planning depends on the level of coping planning.

Method: A four-month prospective study was conducted among 157 French adults, who were recruited through a web-based survey. They were administrated measures of behavioural intention and sociodemographic variables at baseline and action and coping planning and PA four months later.

Results: Action planning partially mediated the contribution of intention on PA level. However, this indirect effect was conditional on the level of coping planning, insofar as action planning acted as a mediator of the intention–PA relationship only for individuals with high level of coping planning.

Conclusion: The results highlight the complexity of the relationship between intention and behaviour and provide evidence for the distinct role of both forms of planning.     

Cognitive mediation of intervention effects on physical exercise: Causal models for the adoption and maintenance stage

Objective: To investigate how the effects of a group-based intervention program (MoVo-LISA) on exercise behaviour were mediated by cognitive variables. Different causal models mapping the short-term (adoption) and long-term (maintenance) intervention effects were tested using path analyses.

Design: N?=?220 in-patients of a rehabilitation clinic were assigned to an usual care or intervention group (quasi-experimental design). Questionnaire-based assessment was conducted at baseline; discharge; and at six weeks, six months and 12 months post discharge.

Measures: The potential mediator variables were outcome expectations, self-efficacy, strength of goal intention (intention strength), self-concordance, action planning and barrier management.

Results: Observed intervention effects on exercise behaviour (p?<?0.05) were mediated by intention strength at the adoption and maintenance stages, by action planning only at the adoption, and by barrier management only at the maintenance stage. Self-efficacy and outcome expectations were only indirectly involved in these mediations by affecting intention strength and self-concordance.

Conclusion: This is the first study to track the cognitive mediation processes of intervention effects on exercise behaviour over a long time-period by differentiating the adoption and maintenance stages of behaviour change. The findings emphasise the importance of deconstructing intervention effects (modifiability vs. predictive power of a mediator) to develop more effective interventions.