Predictors of Health Locus of Control in Older Adults

Health locus of control has been shown to influence how individuals approach their health and health-related decisions. The present study examined the variables predictive of older adults’ health locus of control. A total of 261 adults aged 54–84 years completed a questionnaire about their health, approach to health, and background information about themselves. The results revealed that demographic indicators, health-related variables, and psychological variables—particularly health risk tolerance, future time perspective, health self-efficacy, and emotional instability—were related to older adults’ health locus of control. Findings have implications for programs aimed at modifying older adults’ health locus of control.     

Disability and disasters: the role of self-efficacy in emergency preparedness

Although individuals with physical disabilities have special needs regarding preparedness for a natural or human-made disaster, little is known about the factors involved in motivating members of this population to engage in behaviors which reduce the probability of negative health outcomes. This study proposes and empirically tests an integrated theory-based model for individuals with physical disabilities in which perceived self-efficacy for emergency preparedness moderates the relationship between perceived threat and emergency preparedness behaviors. A nationwide convenience cross-sectional sample of 294 adults self-identifying as having a physical disability completed an online survey. The general linear model was used to assess the effects on preparedness of perceived threat, perceived self-efficacy, and their interaction. In addition to the hypothesized moderating effect of self-efficacy, it was found that minimal (if any) relationship exists between perceived threat and preparedness among those who reported low levels of self-efficacy. Results suggest that self-efficacy and perceived threat operate jointly to motivate individuals with physical disabilities to take precautionary steps to reduce the consequential adverse health effects of natural and human-made disasters. These findings have important implications for the design of effective interventions for individuals with disabilities.     

Young and older adults' beliefs about effective ways to mitigate age-related memory decline

This study investigated whether young and older adults vary in their beliefs about the impact of various mitigating factors on age-related memory decline. Eighty young (ages 18-23) and 80 older (ages 60-82) participants reported their beliefs about their own memory abilities and the strategies that they use in their everyday lives to attempt to control their memory. Participants also reported their beliefs about memory change with age for hypothetical target individuals who were described as using (or not using) various means to mitigate memory decline. There were no age differences in personal beliefs about control over current or future memory ability. However, the two age groups differed in the types of strategies they used in their everyday life to control their memory. Young adults were more likely to use internal memory strategies, whereas older adults were more likely to focus on cognitive exercise and maintaining physical health as ways to optimize their memory ability. There were no age differences in rated memory change across the life span in hypothetical individuals. Both young and older adults perceived strategies related to improving physical and cognitive health as effective means of mitigating memory loss with age, whereas internal memory strategies were perceived as less effective means for controlling age-related memory decline.     

Psychosocial Factors Associated with Quality of Life Among Individuals Attending Genetic Counseling for Hereditary Cancer

The aim of this multicenter study was to explore associations between psychosocial factors (general self-efficacy, perceived availability of social support, cancer-related distress) and health-related quality of life, among individuals at risk for hereditary cancer. One-hundred and twenty one participants with a family history of breast-cancer or colorectal cancer answered a questionnaire 2-4 weeks prior to genetic counseling. The two dimensions of the health-related quality of life measure, mental and physical health were both used as outcome variables. Multiple regression (linear) analyses revealed that increasing degrees of cancer-related distress was related to decreasing degrees of mental health whereas increasing degrees of self-efficacy and social support were related to increasing degrees of this outcome variable. Self-efficacy, self-esteem support and tangible aid seemed to moderate the relationship between cancer-related distress and mental health. These results suggest that self-efficacy and certain resources of social support buffer the negative association between cancer-related distress and mental health, and might be suitable for interventional efforts. Implications for genetic counseling practice are discussed.     

Affective and health-related outcome expectancies for physical activity in older adults

This study tests the effects of affective and health-related outcome expectancies on physical exercise, assuming stronger direct and indirect (via intention) effects from affective outcome expectancy to physical exercise than from health-related outcome expectancy to exercise. Physical exercise and social cognitive variables were assessed at baseline, and 6- and 12-month follow-up in 335 older adults (60-95 years of age). Applying structural equation modelling, there was a direct effect from affective, but not from health-related outcome expectancy on intentions and behaviour. Also, the indirect effect from self-efficacy on physical exercise via affective outcome expectancy was significant, whereas the mediation via health-related outcome expectancy was not. These findings emphasise the relative importance of affective versus health-related outcome expectancies in predicting intentions and physical exercise in older adults and highlight the importance to separate these facets at a conceptual level to enhance both theory development and health promotion.     

Affective and health-related outcome expectancies for physical activity in older adults

This study tests the effects of affective and health-related outcome expectancies on physical exercise, assuming stronger direct and indirect (via intention) effects from affective outcome expectancy to physical exercise than from health-related outcome expectancy to exercise. Physical exercise and social cognitive variables were assessed at baseline, and 6- and 12-month follow-up in 335 older adults (60–95 years of age). Applying structural equation modelling, there was a direct effect from affective, but not from health-related outcome expectancy on intentions and behaviour. Also, the indirect effect from self-efficacy on physical exercise via affective outcome expectancy was significant, whereas the mediation via health-related outcome expectancy was not. These findings emphasise the relative importance of affective versus health-related outcome expectancies in predicting intentions and physical exercise in older adults and highlight the importance to separate these facets at a conceptual level to enhance both theory development and health promotion.     

The influence of self-efficacy on alcohol use among American Indians

The influence of self-efficacy (general and substance use) on alcohol use among 114 American Indian and Native Alaskan adults was examined. Analysis of variance was performed to assess differences between alcohol use groups (nonuse, low use, and medium-high use). Low general self-efficacy (GSE) was associated with higher alcohol use. High substance use self-efficacy (SSE) was associated with higher alcohol use. Moreover, low GSE was associated with higher SSE. Results indicate that alcohol use may be in response to feelings of powerlessness within one's life and may be sustained by perceived feelings of control over use. The study suggests that the concept of self-efficacy appears to relate to empowerment issues and, as such, would have important applications for use with minority individuals.     

Physical fitness and health indices in children, adolescents and adults with high or low motor competence

The overall purpose of the study was to examine if individuals with low motor competence achieve age-adequate fitness and health. A group of 149 children, adolescents, and adults with low or high motor competence participated in motor, fitness, and health assessments. Individuals with low motor competence did not differ on their basic physiological health parameters, but they had less optimal levels of overall health and fitness indices than those with high motor competence. As a function of age, musculoskeletal fitness was significantly compromised for the low motor competence group. The metabolic indices suggested that the low motor competence group had significantly higher BMI's compared to the high motor competence group. Motor skills and static balance were significant predictors of the BMI. Exercise intensity differed between children in the low and high motor competence group. The findings suggest that individuals with low motor competence have compromised health-related fitness. In order to discriminate between individuals with high and low motor competence, fitness assessment should include at least back extension, curl ups, and sit and reach. In addition, health-related fitness measurements such as BMI, waist circumference, blood lipid profile and bone mineral density are also recommended.     

Factors predicting the use of technology: findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE)

The successful adoption of technology is becoming increasingly important to functional independence. The present article reports findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE) on the use of technology among community-dwelling adults. The sample included 1,204 individuals ranging in age from 18-91 years. All participants completed a battery that included measures of demographic characteristics, self-rated health, experience with technology, attitudes toward computers, and component cognitive abilities. Findings indicate that the older adults were less likely than younger adults to use technology in general, computers, and the World Wide Web. The results also indicate that computer anxiety, fluid intelligence, and crystallized intelligence were important predictors of the use of technology. The relationship between age and adoption of technology was mediated by cognitive abilities, computer self-efficacy, and computer anxiety. These findings are discussed in terms of training strategies to promote technology adoption.     

A longitudinal investigation of perceived control and cognitive performance in young, midlife and older adults

Longitudinal associations between generalized control beliefs (one's perceived capacity to influence events) and cognitive test performance were examined in a population-based sample of young, midlife and older adults. Participants provided measures of perceived control, self-assessed health, education and depression and anxiety symptoms, and completed cognitive tests at two assessments, 4 years apart. For each age group, baseline (between-person) control was positively related to performance on tests of memory (immediate recall and digits backwards), speed (Symbol Digit Modalities Test and choice reaction time) and verbal intelligence (Spot-the-Word). Interaction effects indicated stronger associations of between-person control beliefs with indices of speed for the older age group relative to the younger groups. Within-person changes in control were not significantly associated with changes in cognitive test performance over the study interval. Implications of the findings for self-efficacy based interventions designed to promote cognitive functioning are discussed.     

Are exercise social-cognitive factors and behaviours different for adults with diabetes? A randomized community sample

Exercise plays a key role in the prevention and delay of the onset of Type 2 diabetes and in the management of this disorder. To determine if there are differences in key social-cognitive determinants of exercise and self-reported physical activity levels between adults with diabetes and those without the condition, a random selected sample of adults was surveyed. A telephone interview assessed physical activity behaviour and key social-cognitive constructs from major health behaviour change theories/models. The mean energy expenditure was not significantly different between the diabetes (n?=?46) and the non-diabetes (n?=?1556) groups. The diabetes group reported significantly lower scores for self-efficacy and perceived behavioural control, but higher for fear of, and vulnerability to, general health and cardiovascular disease threat. The data suggest that it may not be necessary to promote health threat messages, as threat is already high for this diabetes population and studies have shown that excess threat does not promote recommended exercise and health behaviours. Instead, the low levels of self-efficacy and perceived behavioural control among those with diabetes emphasize the importance of designing specific strategies (e.g., skills, incremental success) to increase their self-confidence in undertaking physical activity.     

Hypnotic discontinuation in chronic insomnia: impact of psychological distress, readiness to change, and self-efficacy.

OBJECTIVE: To compare individuals who were successful in discontinuing hypnotic medications against those who were not on measures of insomnia severity, medication withdrawal symptoms, psychological symptoms, perceived health, readiness to change and self-efficacy. DESIGN: Secondary analyses of a randomized clinical trial comparing a hypnotic taper intervention with or without self-help treatment for insomnia. MAIN OUTCOME MEASURES: Self-report measures of insomnia severity, medication withdrawal symptoms, depression and anxiety symptoms, physical and mental health, stages of change, readiness to change, decisional balance, and general and situational self-efficacy. RESULTS: There were no significant differences at baseline between medication-free individuals and those still using sleep medication at the end of a taper intervention. Group differences emerged midway through the 8-week withdrawal program and were accentuated after the intervention; participants who remained medication-free during the next six months had less severe insomnia and anxiety symptoms, a more positive perception of their health and higher self-efficacy to refrain from hypnotic use in various situations. Contrary to expectations, there were no differences between drug-free and nondrug-free participants on both readiness to change and stages of change. CONCLUSIONS: Chronic users of hypnotic medications entered a taper intervention with equal levels of psychological distress, health, self-efficacy, and readiness to change. Successful hypnotic discontinuation was associated with overall improvement of insomnia, anxiety and distress symptoms, perceived health and self-efficacy. More intensive and individualized therapeutic attention may be warranted for individuals experiencing worsening of insomnia symptoms, more withdrawal symptoms and psychological distress, and lower self-efficacy during medication discontinuation.     

PROMOTING REGULAR EXERCISE IN ORGANIZATIONAL FITNESS PROGRAMS: HEALTH-RELATED DIFFERENCES IN MOTIVATIONAL BUILDING BLOCKS

Hypotheses are proposed about relations among "building block" components of the motivation to attain exercise goals in an organizational fitness program, as well as about health-related individual differences in those components. The hypotheses are tested in a longitudinal field study involving questionnaire, physiological, and behavioral data from 107 participants in such a program. In support of the componential hypotheses, goal attainment was a positive function of goal commitment. Goal commitment was an additive function of goal attractiveness and goal-specific self-efficacy/perceived control. In support of the individual difference hypotheses, physiological variables were associated with work- and health-related perceived barriers to goal attainment. Employees with high health risks ranged from .5 to 1.2 SDs higher in perceived barriers than employees with low risks. Evidence suggests that for goal setting to succeed as a program intervention, managers must concentrate on reducing the perceived work- and health-related barriers to exercise participation and goal attainment, especially for employees with high health risks.     

Desire for control, locus of control, and proneness to depression

Two personality constructs, desire for control and locus of control, were related to depression among college students. Measures of levels of depression, desire for control, and locus of control were taken from subjects. Approximately six months later 71% of these subjects returned a questionnaire concerning their experiences with depression during that six-month period. It was found that locus of control scores, particularly the extent to which subjects perceived that their lives were controlled by chance, were significantly related to the depression levels. It was also found that high desire for control subjects who held external perceptions of control were most likely to seek nonprofessional help for depression. In addition, high desire for control subjects who perceived their lives as generally controlled by chance were most likely to have suicidal thoughts. The results are interpreted in terms of a general style that may promote a proneness to depression for certain individuals.     

Perceived Control Over Aging-Related Declines: Adaptive Beliefs and Behaviors

ABSTRACT— The belief that people are in control of desired outcomes, including those associated with aging, is a hallmark of American culture. Nevertheless, older adults are less likely than the young to believe there are things that can be done to control aging-related declines in areas such as memory. Within age groups, individual differences in control beliefs are related to cognitive performance, health, and well-being. Mechanisms linking perceived control and positive outcomes include adaptive behaviors such as strategy use and physical activity. There is some evidence that control beliefs can be modified in later life, as illustrated in an intervention for fear of falling. Further work is needed to examine the antecedents of perceived control in later life and the implications of control beliefs in other aging-related domains.     

A Longitudinal Investigation of Perceived Control and Cognitive Performance in Young,Midlife and Older Adults

ABSTRACT

Longitudinal associations between generalized control beliefs (one's perceived capacity to influence events) and cognitive test performance were examined in a population-based sample of young, midlife and older adults. Participants provided measures of perceived control, self-assessed health, education and depression and anxiety symptoms, and completed cognitive tests at two assessments, 4 years apart. For each age group, baseline (between-person) control was positively related to performance on tests of memory (immediate recall and digits backwards), speed (Symbol Digit Modalities Test and choice reaction time) and verbal intelligence (Spot-the-Word). Interaction effects indicated stronger associations of between-person control beliefs with indices of speed for the older age group relative to the younger groups. Within-person changes in control were not significantly associated with changes in cognitive test performance over the study interval. Implications of the findings for self-efficacy based interventions designed to promote cognitive functioning are discussed.     

Age-associated predictors of medication adherence in HIV-positive adults: health beliefs, self-efficacy, and neurocognitive status.

OBJECTIVE: Although most agree that poor adherence to antiretrovirals is a common problem, relatively few factors have been shown to consistently predict treatment failure. In this study, a theoretical framework encompassing demographic characteristics, health beliefs/attitudes, treatment self-efficacy, and neurocognitive status was examined in relationship to highly active antiretroviral therapy adherence. DESIGN: Prospective, cross-sectional observational design. MAIN OUTCOME MEASURES: Neuropsychological test performance, health beliefs and attitudes, and medication adherence tracked over a 1-month period using electronic monitoring technology (Medication Event Monitoring System caps). RESULTS: The rate of poor adherence was twice as high among younger participants than with older participants (68% and 33%, respectively). Results of binary logistic regression revealed that low self-efficacy and lack of perceived treatment utility predicted poor adherence among younger individuals, whereas decreased levels of neurocognitive functioning remained the sole predictor of poor adherence among older participants. CONCLUSION: These data support components of the health beliefs model in predicting medication adherence among younger HIV-positive individuals. However, risk of adherence failure in those ages 50 years and older appears most related to neurocognitive status.     

The Roles of Social Support and Self-Efficacy in Physical Health’s Impact on Depressive and Anxiety Symptoms in Older Adults

Physical illness may precipitate psychological distress among older adults. This study examines whether social support and self-efficacy moderate the associations between physical health and depression and anxiety. Predictions were tested in 222 individuals age 60 or older presenting for help with worry. Physical health was assessed through self-report (subjective) and physical diagnoses (objective). Objective physical health did not have a significant association with depression or anxiety. Worse subjective physical health was associated with increased somatic anxiety, but not with depression or worry. The relationship between subjective physical health and depressive symptoms was moderated by self-efficacy and social support. As predicted, when self-efficacy was low, physical health had its strongest negative association with depressive symptoms such that as physical health improved, depressive symptoms also improved. However, the moderation effect was not as expected for social support; at high levels of social support, worse physical health was associated with increased depressive affect.     

Validity of the Perceived Health Competence Scale in a UK primary care setting

The Perceived Health Competence Scale (PHCS) is a measure of self-efficacy regarding general health-related behaviour. This brief paper examines the psychometric properties of the PHCS in a UK context. Questionnaires containing the PHCS, the SF-36 and questions about perceived health needs were posted to 486 patients randomly selected from a GP practice list. Complete questionnaires were returned by 320 patients. Analyses of these responses provide strong evidence for the validity of the PHCS in this setting. Consequently, we conclude that the PHCS is a useful addition to measures of global self-efficacy and measures of self-efficacy regarding specific behaviours in the toolkit of health psychologists. This range of self-efficacy assessment tools will ensure that psychologists can match the level of specificity of the measure of expectancy beliefs to the level of specificity of the outcome of interest.     

The relationship between psychosocial factors and condom use among African-American adolescents

The present investigation explored the relationship between psychosocial factors and condom use by African-American adolescents. Two hundred twenty-nine males, aged 14 to 19 years, responded to a health behavior survey that gathered information on demographics, HIV knowledge, perceived certainty of future condom use, present and past use of condoms, and intention to use condoms in the next six months. Several psychological variables, including sexual self-efficacy and self-esteem, were also measured. It was found that the majority of participants were sexually active by age 13, had four or more lifetime sexual partners, and were using condoms regularly. Multiple linear regression analysis indicated that sexual self-efficacy predicted perceived certainty of condom use. In addition, self-esteem and sexual self-efficacy predicted intention to use condoms. These findings highlight the need to develop HIV prevention curricula for African-American male adolescents that not only emphasize the potential risks associated with having multiple sexual partners, but also include components to enhance self-worth and sexual self-efficacy.