Conditional health threats: health beliefs, decisions, and behaviors among adults.

We combined the health belief model with the theory of subjective expected utility to derive hypotheses about the relations among health beliefs and preventive decisions. The central implication of this combination of theories is the importance of conceptualizing, measuring, and communicating about health threats in ways that are clearly conditional on action. It is important to distinguish, for example, between how susceptible to a disease a person thinks he or she would be if that person were and were not to take a preventive action. An experimental study of judgments about a hypothetical preventive action was conducted to test many of the theoretically derived hypotheses. A correlation study of dental flossing behavior was conducted to test the hypotheses as they apply to overt behavior rather than to judgment. Results of both studies supported most of the tested hypotheses, especially those related to the conditional conceptualization of health threats. Implications for theory, research methods, and practical applications are discussed.     

A dual-process model of affective and instrumental attitudes in predicting physical activity

IntroductionA novel dual-process model based upon the affective-reflective theory which distinguishes between affective attitude and instrumental attitude at an explicit and implicit level was used to predict physical activity.MethodUndergraduate students (N = 114) completed a lab-based study at two time-points, spaced two weeks apart. Participants completed self-report measures of the theory of planned behavior constructs, including explicit affective attitude and explicit instrumental attitude. Implicit affective attitude and implicit instrumental attitude were measured using single category implicit association tests.ResultsExplicit affective attitude and perceived behavioral control indirectly predicted physical activity through intention, and explicit affective attitude, implicit affective attitude, and intention predicted physical activity directly with a modest effect size (R² = 0.24).DiscussionFindings suggest explicitly and implicitly held evaluative information are conceptually distinct, and affective evaluations are key in guiding physical activity behavior regardless of whether such evaluations are implicit or consciously accessible.     

Physical activity: the relative associations with cognitive and affective risk beliefs

Abstract

Objective: The role of affectively oriented risk beliefs in explaining health behaviors has not been examined in the context of physical activity or in diverse study populations. We evaluated whether affective risk beliefs account for unique variance in physical activity intentions and behavior above and beyond that accounted for by cognitive risk beliefs.

Design: A cross-sectional survey of socio-demographically diverse US residents (N?=?835; 46.4% no college training; 46.7% minority racial/ethnic ancestry; 42.6% men).

Main outcome measures: Physical activity intentions and behavior.

Results: Hierarchical linear regressions showed that affective risk beliefs accounted for variance in physical activity intentions beyond that predicted by socio-demographics and cognitive risk beliefs (F-change ps<.001). Specifically, intentions were higher among people with higher anticipated regret (ps<.001) and with higher absolute feelings of risk (ps<.05) or worry (ps<.05). There was an indirect relationship between perceived absolute likelihood and intentions through anticipated regret and feelings of risk. Neither cognitive nor affective risk beliefs accounted for variance in physical activity behavior (F-change ps>.05), but unsurprisingly, behavior was positively associated with physical activity intentions (p<.001).

Conclusion: Future interventions could target affective risk beliefs—particularly anticipated regret—to increase intentions, and then add other intervention components to bridge the intention–behavior gap.     

Fatalistic beliefs,risk perception and traffic safe behaviors

IntroductionRoad safety is a major worldwide concern especially for developing countries where a certain feeling of helplessness predominate. Local authorities are seeking ways to change people's behaviors considered as the first causal factor of traffic accidents. Risk perception and fatalistic beliefs have been identified as important socio-cognitive functioning patterns, which can shed light on people's behaviors towards risks, for prevention purpose. But the way fatalistic beliefs are associated with risk perception and safety behaviors remains blurred in literature.ObjectiveThis article examined the relationship between fatalistic beliefs, risk perception and traffic safety-related behaviors.MethodThe study was carried out in Cameroon on a sample of 525 road users with a questionnaire made up of scales measuring fatalistic beliefs, perceived risk for dangerous traffic events and reported safe behaviors.ResultsAs expected, participants with higher levels of fatalistic beliefs perceived dangerous traffic situations as less risky and reported less safe behaviors. Perceived risk partially mediated the association between fatalistic beliefs and reported safe behaviors.ConclusionPerceiving dangerous traffic situations as risky can mitigate the magnitude of one's fatalistic beliefs on the engagement in protective behaviors. The implications for more effective prevention including both beliefs and perceptions are suggested. One can explain to people how to avoid accidents, emphasizing on their capacity to change their behavior and the gains they retrieved from that behavioral change.     

The relationship between instrumental and expressive traits,health behaviors,and perceived physical health

Relations between instrumental and expressive traits, health behaviors, and self-reported physical health were examined among young adults. Individuals (169 men, 167 women) completed two measures of instrumental and expressive traits, the Bem Sex Role Inventory (BSRI) and the Personal Attributes Questionnaire (PAQ). Ethnic background of the sample included 72% European Americans, 13% Latin Americans, 6% Asian Americans, 5% African Americans, less than 1% Native American, and 4% did not specify a particular category. Expressive traits from the BSRI, and expressive and instrumental traits from the PAQ were associated with health behaviors, after controlling for neuroticism. Neuroticism explained 43% of the variance in perceived physical health. Separation of individuals into four groups on the basis of instrumental and expressive traits showed that androgynous individuals reported significantly better health practices than other individuals providing support for the androgyny model.     

Examining direct and indirect pathways to health behaviour: The influence of cognitive and affective probability beliefs

This study aimed to extricate the influence of rational (e.g. ‘I think …’) and intuitive (e.g. ‘I feel …’) probability beliefs in the behavioural decision-making process regarding skin cancer prevention practices. Structural equation modelling was used in two longitudinal surveys (sun protection during winter sports [N?=?491]; sun protection during summer [N?=?277]) to examine direct and indirect behavioural effects of affective and cognitive likelihood (i.e. unmediated or mediated by intention), controlled for attitude, social influence and self-efficacy. Affective likelihood was directly related to sun protection in both studies, whereas no direct effects were found for cognitive likelihood. After accounting for past sun protective behaviour, affective likelihood was only directly related to sun protection in Study 1. No support was found for the indirect effects of affective and cognitive likelihood through intention. The findings underscore the importance of feelings of (cancer) risk in the decision-making process and should be acknowledged by health behaviour theories and risk communication practices. Suggestions for future research are discussed.     

Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review.

This meta-analytic review examined whether negative affective states (depressive symptomatology, anxiety, anger) are associated with sexual behaviors that place people at risk for contracting or transmitting HIV. The results from 34 study samples were included in the analysis. Contrary to popular belief, the findings as a whole provide little evidence that negative affect is associated with increased sexual risk behavior. The average weighted correlation for the overall association was .05. The effect size was nonsignificantly higher for anger (r = .10) than for depressive symptoms (r = .04) or anxiety (r = .03). The variability of effect sizes was not accounted for by type of sexual risk measure, subject population, or methodological aspects of the studies. Conceptual and methodological limitations of the literature are identified and directions for future research are discussed.     

Success strivings and their relationship to affective work behaviors: gender differences.

Gender differences in the importance of six life success dimensions and their relationships to job satisfaction, job involvement, and propensity to stay on the job were examined among 756 working women and men in southeast Florida. Results showed that the female participants rated family relationships, personal fulfillment, and security as more important success measures than their male counterparts did, and they rated status/wealth as less important. Professional fulfillment and security were not significantly different. The relationships between measures of success and work behaviors also varied significantly by gender, even after controlling for demographic and job position variables.     

The impact of rape on women's sexual health risk behaviors.

This study used cluster analysis to identify three patterns of sexual health risk behaviors in a sample of adult rape survivors (N=102). Women in the 1st cluster (high risk) reported substantial increases from pre- to postrape in their frequency of sexual activity, number of sexual partners, infrequency of condom use, and frequency of using alcohol and/or drugs during sex. The 2nd cluster (moderate risk) reported increases in frequency of sexual activity and number of partners but mitigated that risk with increased condom use. Survivors in the 3rd cluster (low risk) indicated that their sexual health behaviors had become much less risky postrape. An ecological model predicting cluster membership revealed that individual-level and contextual factors predict patterns of risk behaviors.     

The role of social cognition models in predicting attendance at health checks

Abstract

The present study sought to apply the Health Belief Model and the Theory of Planned Behaviour to the prediction of attendance at health checks. In addition, the way in which patients were invited to the health checks and the effect this had on both the uptake of the service and the role of cognitive factors in predicting attendance was analysed. Based in a single general practice, 818 patients were either sent an invitation letter which included an appointment time or they were sent an open invitation to contact the practice to make their own appointment time. Prior to the commencement of the programme health belief questionnaires were sent to patients. The results of the study firstly showed that letters offering patients an appointment produced a much higher attendance rate (70%) than letters containing an open invitation (37%). Secondly, through stepwise discriminant function analyses, the predictors of attendance behaviour were found to vary according to how patients were invited. For patients sent an appointment, attenders were found to be more likely than non-attenders to place a high value on their health, to believe that their health is influenced by powerful others, that certain referent groups would advise them to attend, that attending would lead to positive outcomes and that motivational barriers would not prevent them from attending. For patients sent an open invitation, intention to attend and perceived control were found to be independent predictors of attendance behaviour. These results suggest that attendance at health checks may not be a homogeneous behaviour such that the beliefs which distinguish attenders and non-attenders may be seen to vary according to the way in which the service is offered.     

Dimensions of acculturation: associations with health risk behaviors among college students from immigrant families

In the present study, we examined a bidimensional model of acculturation (which includes both heritage and U.S. practices, values, and identifications) in relation to hazardous alcohol use, illicit drug use, unsafe sexual behavior, and impaired driving. A sample of 3,251 first- and second-generation immigrant students from 30 U.S. colleges and universities completed measures of behavioral acculturation; cultural values (individualism, collectivism, and self-construal); ethnic and U.S. identity; and patterns of alcohol and drug use, engagement in potentially unsafe sexual activities, and driving while (or riding with a driver who was) intoxicated. Results indicate that heritage practices and collectivist values were generally protective against health risk behaviors, with collectivist values most strongly and consistently protective. Nonetheless, heritage identifications were positively associated with sexual risk taking for Hispanics. U.S. practices, values, and identifications were not consistently related to risk behavior participation. Results are discussed in terms of bidimensional approaches to acculturation, the immigrant paradox, and implications for counseling practice.     

Changes in HIV treatment beliefs and sexual risk behaviors among gay and bisexual men, 1997-2005.

OBJECTIVE: Beliefs about HIV treatment effectiveness and the impact of HIV treatments on HIV transmission risks were initially related to sexual risk-taking in the late 1990s when multidrug HIV treatments first became available. This study examined changes in beliefs about the effects of HIV treatment for preventing HIV transmission and their association to sexual risk behaviors between the years 1997 and 2005. DESIGN: Anonymous surveys were administered to a convenience sample of gay and bisexual men attending a large community event in Atlanta, Georgia in 1997 (N = 498) and again at the same community event in 2005 (N = 448). Analyses were performed for men living with HIV/AIDS and for men who have not been diagnosed with HIV/AIDS. MAIN OUTCOME MEASURES: Rates of unprotected anal intercourse in the previous 3 months. RESULTS: There were significant increases in high-risk sexual practices that coincided with increased beliefs that HIV treatments can reduce the chance of transmitting HIV. However, optimistic beliefs about the health benefits of HIV treatments decreased over the 8 years and were not related to risk behaviors. CONCLUSIONS: Beliefs about how HIV treatments impact HIV infectiousness remain associated with HIV transmission risk behavior and interventions targeting at-risk as well as HIV-positive men who have sex with men must directly address these beliefs and perceptions.     

Beyond smile dynamics: mimicry and beliefs in judgments of smiles

The judgment that a smile is based on "true," usually positive, feelings affects social interaction. However, the processes underlying the interpretation of a smile as being more or less genuine are not well understood. The aim of the present research was to test predictions of the Simulation of Smiles Model (SIMS) proposed by Niedenthal, Mermillod, Maringer, and Hess (2010). In addition to the perceptual features that can guide the judgment of a smile as genuine, the model identifies the conditions that the judgments rely on: (a) the embodiment of the facial expression and its corresponding state, and (b) beliefs about the situations in which genuine smiles are most often expressed. Results of two studies are consistent with the model in that they confirm the hypotheses that facial mimicry provides feedback that is used to judge the meaning of a smile, and that beliefs about the situations in which a smile occurs guides such judgments when mimicry is inhibited.     

Associations between multiple health risk behaviors and mental health among Chinese college students

Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95%CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.     

Assessment of irrational health beliefs: relation to health practices and medical regimen adherence.

The purpose of the present research was to provide initial validation of the 20-item Irrational Health Belief Scale (IHBS). Study 1 included 392 undergraduate psychology students. Results from Study 1 suggested that the IHBS total score is internally consistent and stable over an 18-month time period. Greater health-related cognitive distortion (higher IHBS scores) was associated with weaker internal health locus of control beliefs, lower positive affectivity, stronger chance health locus of control beliefs, and greater negative affectivity. Most important, greater cognitive distortion was uniquely and significantly associated with a less positive pattern of health practices. Study 2 involved 107 individuals with Type I diabetes mellitus. Results indicated that higher IHBS scores were significantly associated with both objective (hemoglobin HbA1) and self-reported diabetic regimen adherence independent of trait neuroticism and conscientiousness.     

How do I feel about the behavior? The interplay of affective associations with behaviors and cognitive beliefs as influences on physical activity behavior.

Individuals have affective associations with health behaviors. In other domains such associations have been shown to influence behavior, but affective associations with health behaviors are not included in current health decision-making models. The authors examined whether affective associations with exercise predicted individuals' activity behavior and, if so, how they interfaced with other decision-making constructs to influence behavior. Adult participants (N = 433) reported their current physical activity behavior and affective associations with physical activity. Health belief model and theory of planned behavior constructs were also assessed. More positive affective associations with activity significantly predicted greater activity behavior. Moreover, the influence of the health belief model and theory of planned behavior constructs on activity behavior was mediated through affective associations. Affective associations were shown to play a central role in individuals' activity behavior, both as a mediator of the effects of cognitively based decision-making factors and as an independent predictor of activity behavior. The results suggest the need to include affective influences on behavior in formal models of health decision making and, potentially, to explore affectively based intervention routes to change behaviors.     

Beyond cognitive deficits: how social class shapes social cognition

Lower social class is thought to contribute to poorer executive functioning and working memory. Nevertheless, lower social class individuals consistently outperform their higher-class counterparts on social cognitive tasks that rely on similar underlying cognitive processes (e.g., working memory and executive functioning). Why would lower social class inhibit such processes in one domain, but promote them in another? We argue that features of lower-class communities (e.g., resource scarcity) promote social cognition via cultural processes. We then argue that social cognition involves partially unique task and neural demands that are separate from nonsocial cognition. We conclude that unique task and neural demands, together with the distinctive cognitive proclivities of lower- and higher-class cultures, can explain variable associations between social class and cognitive functioning.     

Thirdhand smoke beliefs and behaviors among healthcare professionals

Thirdhand smoke (THS) refers to tobacco smoke contaminants and by-products that remain in the environment after a cigarette is extinguished. The purpose of this study was to assess beliefs and behaviors regarding THS among healthcare professionals, and to examine associations among smoking attitudes/beliefs, provider demographics, and THS beliefs and behaviors. Healthcare professionals (N = 204) at a comprehensive cancer center and affiliated general hospital in a northeastern urban area completed online questionnaires. About one third of the respondents had heard of THS before completing the survey, and more than two thirds of the sample believed that THS issues do not receive enough attention. Being female, likelihood of discussing THS with others, endorsing the belief that smoking affects the quality of parenting, and support for government action towards smoking bans were significantly associated with providers’ belief that THS is harmful. Endorsing the belief that smoking affects the quality of parenting and belief that THS is harmful were significantly associated with the likelihood of discussing THS with others. Findings shed light on THS beliefs and behaviors of healthcare providers (a group of individuals that could be trained to educate and advise patients about THS) and inform recommendations for new tobacco policies and clinical guidelines for best practices in tobacco control and prevention.