Integration of five health behaviour models: Common strengths and unique contributions to understanding condom use

The purpose of this research was to select from the health belief model (HBM), theories of reasoned action (TRA) and planned behaviour (TPB), information–motivation–behavioural skills model (IMB) and social cognitive theory (SCT) the strongest longitudinal predictors of women's condom use and to combine these constructs into a single integrated model of condom use. The integrated model was evaluated for prediction of condom use among young women who had steady versus casual partners. At Time 1, all constructs of the five models and condom use were assessed in an initial and a replication sample (n?=?193, n?=?161). Condom use reassessed 8 weeks later (Time 2) served as the main outcome. Information from IMB, perceived susceptibility, benefits, and barriers from HBM, self-efficacy and self-evaluative expectancies from SCT, and partner norm and attitudes from TPB served as indirect or direct predictors of condom use. All paths replicated across samples. Direct predictors of behaviour varied with relationship status: self-efficacy significantly predicted condom use for women with casual partners, while attitude and partner norm predicted for those with steady partners. Integrated psychosocial models, rich in constructs and relationships drawn from multiple theories of behaviour, may provide a more complete characterisation of health protective behaviour.     

Differential Determinants of Young Adult Substance Use and High‐Risk Sexual Behavior1

This investigation evaluated how personality traits, self‐efficacy, and outcome expectancies differentially relate to young adult substance use and high‐risk sex. Experiments I (N= 481) and 2 (N= 73) report the development of a new questionnaire to assess self‐efficacy for substance use and sexual behavior. Experiment 3 (N= 375) tested self‐efficacy, outcome expectancies, and trait measures of social conformity and sensation seeking as correlates of substance use and high‐risk sex. Using structural equation modeling, cross‐sectional analyses revealed that positive outcome expectancies had the largest association with substance use, whereas self‐efficacy had the largest association with sexual behavior. Further, personality traits were related to substance use and sexual behavior indirectly through outcome expectancies, with social conformity also having a direct effect on behavior. When examined longitudinally, past alcohol and drug use served as the final pathway by which expectancies and personality impacted substance use, whereas past behavior, self‐efficacy, and social conformity all contributed to high‐risk sex. Results support the utility of different models for explaining, and possibly preventing, young adult substance use and high‐risk sex.     

Beliefs about age-related changes in physical functioning across the adult life span and their relationship with physical activity levels of older adults

Physical activity declines across the adult life span despite the well-established links between physical activity and health-related, psychological, cognitive, and social benefits. We contrasted the beliefs young and older adults hold about how aging affects both physical abilities and physical activity and determined whether older adults’ beliefs about physical aging relate to their engagement in physical activity. Using visual rating scales, 56 young and 49 community-dwelling older adults indicated the extent to which a typical woman or typical man aged 20–90 possesses six different physical abilities and engages in three different types of physical activity. Stereotypes of physical aging were ability- and activity-specific, and older adults endorsed more positive views than their younger peers. Stereotypical beliefs predicted older adults’ engagement in moderate-intensity activity. This study offers intriguing avenues for future research and suggests that better understanding physical aging stereotypes may contribute toward designing interventions that promote lifelong physical activity.     

Les effets de variables psychosociales sur l'intention d'adolescents obèses de changer leurs comportements

We investigate whether psychosocial factors affect intentions from French obese adolescents to change their habits related to nutrition and physical activities. 32 overweight adolescents (age: 10-14y, BMI: M = 27 kg/m²) participating to a program prevention of obesity, answered to pre-test and post-test measures of psychosocial factors (outcome expectancies for self and for other, perceived control, self-efficacy, intention behavior) and of factors related to obesity (BMI, nutrition knowledge, nibbling and television activities). Outcome expectancies and perceived control are positively predictive of intention to change behavior. Conversely, BMI and self-efficacy are negatively predictive of intention to change habits related to nutrition and physical activities. These results are related to difficulties from the subjects to implement their intention with concrete goals.     

Integration of five health behaviour models: common strengths and unique contributions to understanding condom use

The purpose of this research was to select from the health belief model (HBM), theories of reasoned action (TRA) and planned behaviour (TPB), information-motivation-behavioural skills model (IMB) and social cognitive theory (SCT) the strongest longitudinal predictors of women's condom use and to combine these constructs into a single integrated model of condom use. The integrated model was evaluated for prediction of condom use among young women who had steady versus casual partners. At Time 1, all constructs of the five models and condom use were assessed in an initial and a replication sample (n?=?193, n?=?161). Condom use reassessed 8 weeks later (Time 2) served as the main outcome. Information from IMB, perceived susceptibility, benefits, and barriers from HBM, self-efficacy and self-evaluative expectancies from SCT, and partner norm and attitudes from TPB served as indirect or direct predictors of condom use. All paths replicated across samples. Direct predictors of behaviour varied with relationship status: self-efficacy significantly predicted condom use for women with casual partners, while attitude and partner norm predicted for those with steady partners. Integrated psychosocial models, rich in constructs and relationships drawn from multiple theories of behaviour, may provide a more complete characterisation of health protective behaviour.     

Understanding physical activity in individuals with prediabetes: an application of social cognitive theory

Despite well-documented evidence implicating physical activity (PA) in the prevention of type 2 diabetes, the overwhelming majority of individuals with prediabetes are not physically active enough. The purpose of this study was to investigate the applicability of the social cognitive theory (SCT) in understanding PA behaviour in individuals with prediabetes. Individuals with prediabetes (N = 232) completed a mailed questionnaire assessing demographics, self-reported PA (MET.min/wk) and SCT constructs for PA MET.min/wk. For PA MET.min/wk, scheduling and task efficacy both had significant effects on PA (β = .30 and .22, respectively). Goal formation also had a direct effect on PA for scheduling, coping and task efficacy (β = .20, .34 and .30, respectively). Task, coping and scheduling efficacy explained a significant portion of the variance in PA behaviour. Overall, SCT appears to have merit as a model for understanding PA in individuals with prediabetes. Further evaluative inquiry is needed to establish support for the use of the SCT as a framework for developing, implementing and evaluating PA behaviour change interventions in this population.     

Depression severity and psychosocial determinants of physical activity behavior in in-patients with major depressive disorders

BackgroundPhysical inactivity is a world-wide health issue. In people with major depressive disorders approximately 68% do not reach the recommended physical activity levels. Psychosocial determinants of and implicit attitudes towards physical activity serve to explain physical activity behavior and may form the basis of interventions to promote physical activity. The aim of this study was to examine, whether psychosocial determinants and implicit attitudes towards physical activity vary according to depression severity.MethodsPhysically inactive, adult in-patients diagnosed with major depressive disorder (according to ICD-10) were recruited from four Swiss psychiatric clinics. Psychosocial determinants of physical activity were assessed with seven questionnaires pertaining to motivational and volitional aspects of physical activity. Implicit attitudes towards physical activity were measured with a computer-based Single Target Implicit Association Test.ResultsIn-patients (N = 215, M_age = 41 ± 13 years, 53% female) with major depressive disorder reporting more severe (n = 52) depression symptomology exhibited less favorable psychosocial determinants for physical activity behavior (self-efficacy, negative outcome expectancies, intention, intrinsic motivation, introjected motivation, external motivation, action planning, perceived barriers, coping planning) compared to those with mild (n = 89) and moderate (n = 74) depression symptomology. Positive outcome expectancies, identified, social support and implicit attitudes towards physical activity did not vary according to depression severity.ConclusionsPsychosocial determinants of physical activity do vary according to depression severity. Attempts to promote physical activity among people with major depressive disorder should take depression severity into account when developing and delivering interventions.Trial registrationISRCTN registry, ISRCTN10469580, registered on 3^rd September 2018, https://www.isrctn.com/ISRCTN10469580.     

Social cognitive theory correlates of moderate-intensity exercise among adults with type 2 diabetes

The purpose of this study was to identify social cognitive theory (SCT) correlates of moderate- to vigorous-intensity exercise (MVPA) among adults with type 2 diabetes. Adults with type 2 diabetes (N = 181) participated in the study. Participants were recruited through ResearchMatch.org to complete an online survey. The survey used previously validated instruments to measure dimensions of self-efficacy, self-regulation, social support, outcome expectations, the physical environment, and minutes of MVPA per week. Spearman Rank Correlations were used to determine the relationship between SCT variables and MVPA. Classification and Regression Analysis using a decision tree model was used to determine the amount of variance in MVPA explained by SCT variables. Due to low levels of vigorous activity, only moderate-intensity exercise (MIE) was analyzed. SCT variables explained 42.4% of the variance in MIE. Self-monitoring, social support from family, social support from friends, and self-evaluative outcome expectations all contributed to the variability in MIE. Other contributing variables included self-reward, task self-efficacy, social outcome expectations, overcoming barriers, and self-efficacy for making time for exercise. SCT is a useful theory for identifying correlates of MIE among adults with type 2 diabetes. The SCT correlates can be used to refine diabetes education programs to target the adoption and maintenance of regular exercise.     

Positive God Images and Positive Emotions toward God: Exploring Variations among Whites,Blacks, and Hispanics

How people view God is an important part of religious life. The purpose of this study is to see if four positive God image measures and two measures of positive emotions toward God vary among Whites, Blacks, and Hispanics. The data come from a recent nationwide survey in the United States (N = 2500). The findings reveal that, compared to Whites and Hispanics, Blacks have more positive image of God scores on all four measures. The data indicate that Blacks are also more likely than Whites and Hispanics to have strong positive emotions toward God. In contrast, consistent differences between Hispanics and Whites failed to emerge across all of the study measures.     

Physical Activity and Social Cognitive Theory: A Test in a Population Sample of Adults with Type 1 or Type 2 Diabetes

The purpose of the study was to test the Social Cognitive Theory (SCT; Bandura, 2004 ) for explaining physical activity (PA) in a large population sample of adults with type 1 or type 2 diabetes. Study objectives: (1) test the fit of the SCT structure in the total sample, and the diabetes sub-types; (2) determine the SCT structural invariance between the type 1 and type 2 groups; and (3) report explained variance and compare strength of association for the SCT constructs in predicting PA for both type 1 and type 2 groups. In all, 2,311 individuals with type 1 or type 2 diabetes were assessed on their self-efficacy, outcome expectancies, impediments, social support, goals, and physical activity at baseline and 1,717 (74.5%) completed these assessments again at 6 months. Multi-group Structural Equation Modeling was conducted. The findings provide evidence for the utility of the SCT in the diabetes samples. The SCT fits individuals with type 1 and type 2 diabetes except for SCT impediments, which appear to be obstructing goal-setting in individuals with type 2 diabetes only. Promotion of health behavior should target self-efficacy to set goals and change behavior. Outcome expectancies and social support are also important factors for setting goals and behavior performance.     

Development and exploratory cluster-randomised opportunistic trial of a theory-based intervention to enhance physical activity among adolescents

This article reports the development and exploratory testing of a school-based intervention programme designed to enhance levels of physical activity in adolescents. The intervention is based on social cognitive theory (SCT), self-regulation theory (SRT) and planning as evidence-based mediators of physical activity changes. Two classes, paired on socio-economic variables, were selected from each of eight Portuguese schools and randomly assigned to an intervention or control group (N = 291). Primary outcome was ‘moderate to vigorous physical activity’ (International Physical Activity Questionnaire) measured pre and post intervention and at three and nine months follow-up. SCT, SRT and planning variables were secondary outcomes measured pre and post intervention. At post test, participants in the intervention group reported 18 min per week more physical activity (PA), adjusted for pre-intervention, age and sex, than those in the control group (95% confidence interval ?10 to 46; p = 0.249). This difference increased to 33 min (95% CI–4 to 71; p = 0.082) at three months and to 57 min (95% CI 13 to 101, p = 0.008) at nine month follow-up. Moreover, the intervention resulted in changes of some of the theoretical target variables, including outcome expectancies and coping planning. However, no evidence was found for the changes in theoretical moderators to mediate the intervention effects on behaviour. Implications for theory and for future research are discussed.     

Structure of outcome beliefs in condom use. The Project RESPECT Study Group.

To study the structure of beliefs about condom use outcomes, the authors derived and tested 4 psychosocial hypothetical models: (a) a 2-factor model of the personal and social outcomes of condom use; (b) a 2-factor model of the pros and cons of the behavior; (c) a 3-factor model (i.e., physical, self-evaluative, and social) of outcome expectancies; and (d) a thematic 4-factor model of the protection, self-concept, pleasure, and interaction implications of the behavior. All 4 models were studied with a confirmatory factor analysis approach in a multisite study of 4,638 participants, and the thematic solution was consistently the most plausible. Self-concept and pleasure were most strongly associated with attitudes toward using condoms, intentions to use condoms, and actual condom use, whereas protection and interaction generally had little influence.     

Coping and physical health outcomes: an overview

The aim of the present study was to investigate longitudinally the sensitivity of optimistic beliefs (positive outcome expectancies, efficacy expectancies, and optimistic bias) to disease-related stress (measured by disease duration, depressive symptoms, physical symptoms, physical impairment, and life-events) in Type 1 diabetes (n = 90) and multiple sclerosis (n = 90). First, we examined whether chronically ill patients were less optimistic than a healthy control group (n = 60), which showed that patients reported lower levels of optimistic bias but similar levels of the two other optimistic beliefs. Next, we analyzed the stability of the three types of optimistic beliefs across time (one year) for both disease groups, which demonstrated that optimistic bias in MS patients decreased. Finally, the impact of disease-related stressors on optimistic beliefs during a one-year period was determined, showing that all three optimistic beliefs decreased when patients reported depressive symptoms. Together, these findings show that positive outcome expectancies and efficacy expectancies were unaffected by being ill and fairly stable unless patients reported depressive symptoms while optimistic bias appeared to decrease as a result of being ill. Results are discussed in terms of the role of control and depression in optimistic bias.     

How social context moderates the self-evaluative emotions experienced due to health risk behaviour

When people are confronted with the potential negative physical outcomes of their own health risk behaviour, they experience a self-threat. This threat is felt as negative self-evaluative emotions. We hypothesise that the threat will lead to more private self-evaluative emotions (e.g. regret) in a private social context, whereas more public self-evaluative emotions (e.g. embarrassment) will be felt in a public social context with negative norms. Consistent with our hypotheses, we show that participants anticipate feeling more private self-evaluative emotions when confronted with the negative consequences of their unhealthy behaviour when alone, and more public self-evaluative emotions when in a group (Study 1). They further anticipate more public self-evaluative emotions in response to a health self-threat when the group norm is negative, and more private self-evaluative emotions when the group norm is lenient (Study 2). Finally, in a cross-sectional study amongst smokers, we show that private but not public negative self-evaluative emotions concerning their own smoking habits are positively correlated with the intent to quit smoking (Study 3). These studies show that a distinction needs to be made between public and private self-evaluative emotions, in terms of their antecedents and effects. Theoretical implications and further lines of research are discussed.     

Social cognitive processes mediating the relationship between exposure to television's sexual content and adolescents' sexual behavior

This study used multiple-group structural equation modeling to test a model explaining the association between exposure to televised sexual content and initiation of intercourse among an ethnically diverse national sample of 1,292 adolescents. The authors hypothesized, on the basis of social-cognitive theory, that exposure to televised sexual content would influence adolescents' safe-sex self-efficacy, sex-related outcome expectancies, and perceived peer norms regarding sex, and that each of these would, in turn, influence intercourse initiation. Findings support a model in which the relationship between exposure to TV's sexual content and intercourse initiation is mediated by safe-sex self-efficacy among African Americans and Whites but not among Hispanics. Outcome expectancies and perceived peer norms may also mediate the link between exposure and intercourse initiation among all 3 racial/ethnic groups, although evidence of this could not be confirmed.     

Own-Ethnicity Bias in the Recognition of Black,East Asian,Hispanic, and White Faces

Black, East Asian, Hispanic, and White young adult Americans were asked to view and later recognize ethnic faces (Black, East Asian, Hispanic, and White) of children and young adults in a study of own-ethnicity and own-age bias. Own-ethnicity and own-age biases were found. Hispanics recognized Hispanic and White faces better than Asian and Black faces, Blacks recognized Black and White faces better than Asian and Hispanic faces, Asians recognized Asian faces better than Black faces and marginally better than White and Hispanic faces, and Whites recognized White faces better than those of other ethnicities. Results are discussed with respect to contact and facial encoding hypotheses.     

Self-esteem development from age 14 to 30 years: a longitudinal study

We examined the development of self-esteem in adolescence and young adulthood. Data came from the Young Adults section of the National Longitudinal Survey of Youth, which includes 8 assessments across a 14-year period of a national probability sample of 7,100 individuals age 14 to 30 years. Latent growth curve analyses indicated that self-esteem increases during adolescence and continues to increase more slowly in young adulthood. Women and men did not differ in their self-esteem trajectories. In adolescence, Hispanics had lower self-esteem than Blacks and Whites, but the self-esteem of Hispanics subsequently increased more strongly, so that at age 30 Blacks and Hispanics had higher self-esteem than Whites. At each age, emotionally stable, extraverted, and conscientious individuals experienced higher self-esteem than emotionally unstable, introverted, and less conscientious individuals. Moreover, at each age, high sense of mastery, low risk taking, and better health predicted higher self-esteem. Finally, the results suggest that normative increase in sense of mastery accounts for a large proportion of the normative increase in self-esteem.     

How social context moderates the self-evaluative emotions experienced due to health risk behaviour

When people are confronted with the potential negative physical outcomes of their own health risk behaviour, they experience a self-threat. This threat is felt as negative self-evaluative emotions. We hypothesise that the threat will lead to more private self-evaluative emotions (e.g. regret) in a private social context, whereas more public self-evaluative emotions (e.g. embarrassment) will be felt in a public social context with negative norms. Consistent with our hypotheses, we show that participants anticipate feeling more private self-evaluative emotions when confronted with the negative consequences of their unhealthy behaviour when alone, and more public self-evaluative emotions when in a group (Study 1). They further anticipate more public self-evaluative emotions in response to a health self-threat when the group norm is negative, and more private self-evaluative emotions when the group norm is lenient (Study 2). Finally, in a cross-sectional study amongst smokers, we show that private but not public negative self-evaluative emotions concerning their own smoking habits are positively correlated with the intent to quit smoking (Study 3). These studies show that a distinction needs to be made between public and private self-evaluative emotions, in terms of their antecedents and effects. Theoretical implications and further lines of research are discussed.     

Self-Handicapping,Expected Evaluation,and Performance: Accentuating the Positive and Attenuating the Negative

Three studies investigated the influence of social- and self-evaluative motives on self-handicapping and performance. In each study, efficacy expectancies were manipulated by varying the difficulty of a preliminary task, and social- and self-evaluation were manipulated orthogonally. In Study 1, participants who self-handicapped performed better than those who did not when a positive or negative evaluation was expected, in some conditions. In Study 2, we used a situationally imposed handicap and found that both social- and self-evaluation participants showed improved performance in the presence of the handicap. In Study 3, when a positive or negative evaluation was expected, high self-handicappers performed better after choosing to self-handicap, for both social- and self-evaluative motives. Little evidence of self-handicapping or effects on subsequent performance was found for low self-handicappers. No evidence was found for self-handicapping among participants who could not be evaluated. Discussion centers around motives to self-handicap and implications for subsequent performance.