Changes in self-regulatory cognitions as predictors of changes in smoking and nutrition behaviour

Most longitudinal, correlational studies on health-behaviour change examine effects of Time1 social-cognitive predictors on subsequent behaviour. In contrast, our research focusses on associations between changes in predictors with change in behaviour. The Health Action Process Approach (HAPA) distinguishes between motivational predictors for intention formation and volitional predictors for behavioural change and served as theoretical basis. Two online-studies were launched targeting different behaviours (low-fat diet, smoking), different samples (Study 1: N = 469; Study 2: N = 441) and different time spans (Study 1: 3 months, Study 2: 4 weeks). Data were analysed by means of structural equation modelling with latent difference scores. Both studies resulted in almost parallel prediction patterns. Change in risk awareness and change in outcome expectancies did not result in change in intentions, whereas change in self-efficacy was of crucial importance. Change in behaviour was associated with change in action planning and action control over and above the effects of intentions. In one study, increases in self-efficacy yielded increases in behaviour change. Results demonstrate that change in action planning and especially action control was of great importance for behaviour change across two different behaviours. Analysing change in social-cognitive predictors allows drawing precise conclusions for interventions.     

The mediating roles of career self-efficacy and career decidedness in the relationship between contextual support and persistence

Drawing from Social cognitive career theory, we examined how types of contextual support (e.g., parental support and number of career counseling sessions received) influence persistence. In addition, we test the roles of career self-efficacy and career decidedness as mediating mechanisms in the relationship between these types of contextual support and persistence. One hundred forty-six undergraduate students were surveyed over three measurement periods. Data were collected from multiple sources: surveys from students and parents and students' archival data. Results provided support for our hypothesized mediated model. Time 1 student and parent ratings of support and Time 1 number of counseling sessions received were related to greater Time 2 career self-efficacy and Time 2 career decidedness. This in turn was associated with Time 3 persistence (i.e., reduced academic program turnover). Theoretical and applied implications are discussed.     

The Effect of Suspense on Enjoyment Following a Desirable Outcome: The Mediating Role of Relief

Although endemic to many forms of media entertainment, suspense represents a paradox for enjoyment because it is experienced as an aversive state. Three studies are presented across two media contexts demonstrating how outcomes to suspenseful episodes affect viewers' relief. Study 1 shows that relief is elicited only when a film's outcome is unambiguously favorable and under such conditions is positively related to enjoyment. No such relationship was found given an ambiguous outcome. Study 1 provides evidence that relief is distinct from other affective responses (i.e., positive and negative affect, surprise) that may be present following suspense. Studies 2 and 3 use competitive contests as a context and provide evidence that relief mediates the effect of suspense on enjoyment. Study 2 shows that the previously positive effects of suspense and expectation disconfirmation on enjoyment are obviated in the presence of relief. Study 3 varies suspense in real time across 14 simulated races. Also manipulated are affective dispositions toward the racers and race outcome. The results reveal that relief mediates the effect of suspense on enjoyment, but only when the outcome favors a preferred competitor. The research enhances our understanding of the intertwining of cognition and affect in the enjoyment of suspense.     

OUTCOME EXPECTANCIES OF PEOPLE WHO CONDUCT PERFORMANCE APPRAISALS

Outcome expectancies of people who conduct performance appraisals were identified in two disparate industries, newsprint and banking, using two methodologies: interviewing and administering a questionnaire. The alternate hypothesis was that appraisers perceive the consequences to them of conducting a thorough appraisal (i.e., giving negative as well as positive feedback) as aversive. This hypothesis was rejected. Appraisers did not perceive any consequences to them for conducting appraisals. Moderate support for the alternate hypothesis was obtained in the second study.     

Illness perceptions and self efficacy beliefs in adolescents and young adults with insulin dependent diabetes mellitus

Abstract

The study examined the role of illness perceptions and self-efficacy in diabetic regimen adherence and metabolic control among young patients with Insulin Dependent Diabetes Mellitus (IDDM). Sixty-four outpatients with Insulin Dependent Diabetes completed measures of illness perceptions, generalised and diabetes specific self-efficacy and a self-report measure of adherence. Metabolic control (HbAlc) was also assessed. Control, identity and consequences components of illness perceptions were significantly correlated with self-efficacy expectancies. Control beliefs were consistently associated with self-reported adherence across all treatment aspects and accounted for 39% of the predicted variance in total adherence. The associations of the other psychological predictors examined, varied depending on the regimen area. Multiple regression analysis showed that 30.8% of the variance in HbAlc assays was explained by patients' diabetes specific self-efficacy, consequences and identity. Our findings suggest that patients' beliefs are useful predictors of physiological and behavioural outcomes in diabetes self-management and should thus be the focus of routine clinical assessments and future interventions.     

Mishandling the Gift of Life: Noncompliance in Renal Transplant Patients1

Two studies investigating renal transplant patients compliance with their post-transplant medical regimen are presented. Compliance was operationalized as a multidimensional construct incorporating behaviors that represent adherence to the regimen. Study 1 examined the association of noncompliance with clinically significant outcomes and the medical and demographic predictors of noncompliance. Noncompliance was associated with rejection episodes, graft loss, and multiple transplants. The best predictors of noncompliance were medication side effects, age, education, and insurance coverage. Study 2 examined the psychosocial predictors of noncompliance. After age and side-effects complaints, self-efficacy and threat appraisal were the best predictors of compliance. The implications of these results for expectancy-value models of health behaviors (e.g., protection motivation theory; Rogers, 1983) and their ability to predict compliance in patients following long-term regimens are discussed.     

Face-induced expectancies influence neural mechanisms of performance monitoring

In many daily situations, the consequences of our actions are predicted by cues that are often social in nature. For instance, seeing the face of an evaluator (e.g., a supervisor at work) may activate certain evaluative expectancies, depending on the history of prior encounters with that particular person. We investigated how such face-induced expectancies influence neurocognitive functions of performance monitoring. We recorded an electroencephalogram while participants completed a time-estimation task, during which they received performance feedback from a strict and a lenient evaluator. During each trial, participants first saw the evaluator’s face before performing the task and, finally, receiving feedback. Therefore, faces could be used as predictive cues for the upcoming evaluation. We analyzed electrocortical signatures of performance monitoring at the stages of cue processing, task performance, and feedback reception. Our results indicate that, at the cue stage, seeing the strict evaluator’s face results in an anticipatory preparation of fronto-medial monitoring mechanisms, as reflected by a sustained negative-going amplitude shift (i.e., the contingent negative variation). At the performance stage, face-induced expectancies of a strict evaluation rule led to increases of early performance monitoring signals (i.e., frontal-midline theta power). At the final stage of feedback reception, violations of outcome expectancies differentially affected the feedback-related negativity and frontal-midline theta power, pointing to a functional dissociation between these signatures. Altogether, our results indicate that evaluative expectancies induced by face-cues lead to adjustments of internal performance monitoring mechanisms at various stages of task processing.     

Examining predictors of physical activity among inactive middle-aged women: an application of the health action process approach

This study tested several relationships predicted by the Health Action Process Approach (HAPA) in a sample of 175 generally healthy, inactive, middle-aged women (40-65 yrs old) over a 12 week period. Participants' physical activity, risk perceptions, outcome expectancies, action self-efficacy and intention were measured at baseline. Planning and maintenance self-efficacy were measured 4 weeks later. Physical activity behaviour was measured 12 weeks after baseline. The HAPA relationships were examined using a structural equation model. The data fit the model well and revealed several significant relationships. Action self-efficacy was the best predictor of intention. Maintenance self-efficacy was the best predictor of planning and behaviour. Contrary to the tenets of HAPA and to past research, planning did not predict behaviour. Overall, HAPA provides a useful framework for identifying determinants of physical activity intentions and behaviour within a group of inactive, middle-aged women.     

Durability and generalization of attribution-based feedback following failure: Effects on expectations and behavioral persistence

ObjectiveThis experiment investigated, following perceived failure, the immediate, long-term (i.e., durability), and cross-situational (i.e., generalization) effects of attribution-based feedback on expectations and behavioral persistence.DesignWe used a 3 × 2 (Group × Time) experimental design over seven weeks with attributions, expectations of success, and persistence as dependent measures.Method49 novice participants were randomly assigned to one of three treatment (attributional feedback) groups: (a) functional (i.e., controllable and unstable); (b) dysfunctional (i.e., uncontrollable and stable); or (c) no feedback. Testing involved three sessions, in which participants completed a total of five trials across two performance tasks (golf-putting and dart-throwing). In order to track whether the attributional manipulation conducted within the context of the golf-putting task in Session 2 would generalize to a new situation, participants performed a dart-throwing task in Session 3, and their scores were compared with those recorded at baseline (in Session 1).ResultsAnalysis of pre- and post-intervention measures of attributions, expectations, and persistence revealed that the functional attributional feedback led to more personally controllable attributions following failure in a golf-putting task, together with increases in success expectations and persistence. In contrast, dysfunctional attributional feedback led to more personally uncontrollable and stable attributions following failure, together with lower success expectations and reduced persistence. These effects extended beyond the intervention period, were present up to four weeks post intervention, and were maintained even when participants performed a different (i.e., dart-throwing) task.ConclusionsThe findings demonstrate that attributional feedback effects are durable over time and generalize across situations.     

Cognitive and personality factors in the delay of gratification of hemodialysis patients

On the basis of Mischel's (1984) social learning analysis of the process of delay of gratification in children and in line with Bandura's (1977) self-efficacy theory, we developed a model of delay of gratification in adults and tested it on dialysis patients who were continuously required to comply with a stringent regimen of fluid-intake to keep alive. We hypothesized that patients' self-evaluations of their past compliance and their efficacy expectations would be associated with their actual delay behavior. Underlying these process-regulating cognitions would be stable competencies, such as learned resourcefulness (i.e., one's self-control skills). Fifty-three dialysis patients self-evaluated their fluid intake compliance, their efficacy expectations, and their health beliefs. Resourcefulness was assessed by Rosenbaum's Self-Control Schedule. Actual fluid-intake compliance was reliably assessed by the mean body weight increase between dialyses during the 3-month period prior to the study and during two follow-up periods. The results supported the model. On the one hand, self-efficacy expectations were related to persistence with the fluid diet and on the other hand to subjects' self-evaluation of their past adherence behavior as well as to their resourcefulness. Although the path model suggested a causal pattern, the correlational nature of the study precluded any conclusions on cause-effect relationship.     

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.     

Effects of a personified guide on adherence to an online program for alcohol abusers.

The quality of the therapeutic alliance has robust effects on the outcome of psychotherapy and psychopharmacologic interventions. Automated behavioral health programs that are being developed to increase access to mental health treatment are administered in the absence of direct human participation, thereby precluding the development of a traditional therapeutic relationship. The aim of this study was to develop a personified guide designed to stimulate reactions similar to those experienced in a therapeutic relationship, and evaluate the effect of the guide on adherence to and satisfaction with an online alcohol use evaluation program. After completing a battery of four standard questionnaires used to evaluate problem drinking, 288 subjects were randomized to receive feedback on their results in text form or via a multimedia condition involving a personified guide. Those who received feedback via the guide demonstrated greater levels of program adherence by completing more modules. Reported satisfactions levels did not differ between the two conditions. Encouraging the personification of an automated behavioral health intervention may lead to greater levels of engagement with the program.     

Positive emotional expectations predict volunteer outcomes for new volunteers

Emotional expectations are likely to influence behavioral outcomes, even when entering novel situations. In the present study, it was proposed that positive emotional expectations would influence volunteer outcomes for new volunteers. New and experienced volunteers were recruited for a two-part longitudinal study. Study hypotheses were confirmed. The mere anticipation of positive emotions was able to predict volunteer outcomes for new volunteers. Emotional expectations (i.e., sympathy, satisfaction) were positively associated with intentions to continue volunteering, identification with the volunteer role, and predicted volunteer persistence 6 months later for new volunteers. For experienced volunteers, emotional expectations were only significantly and positively associated with volunteer role identity. Moreover, the intent to persist as a volunteer was found to have a stronger positive association with actual persistence for experienced volunteers than for new volunteers.     

Asymmetrical effects of Pavlovian excitatory and inhibitory aversive transfer on Pavlovian appetitive responding and acquisition

Predictions of a theory of Pavlovian motivational transfer, which incorporates principles of both the theory of reciprocal inhibition and the Rescorla-Wagner model, were tested in several Pavlovian aversive to Pavlovian appetitive transfer tasks. As predicted, the presence of a signal for an aversive event, conditioned stimulus (AV CS+), reliably suppressed performance of appetitive conditioned responses (CRs) whether imposed during acquisition or on independently established responding. Acquisition of appetitive responding to a novel CS reinforced in compound with an AV CS+, however, was enhanced (“superconditioning”). This observation suggests that the effects of a discrepancy between expectation and actual outcome on a conditioning trial are influenced by the affective value of both the expectation and the reinforcer. These transfer effects were not symmetrical for an inhibitory aversive stimulus (AV CS?). An AV CS? did not enhance appetitive responding compared to a random control condition, nor did the AV CS? reduce (i.e., block) appetitive conditioning to a novel CS when appetitive reinforcement occurred in the presence of the AV CS?. Comparison of the two shock-exposed conditions with a naive control condition suggests that previous results that were apparently consistent with inhibitory aversive enhancement and blocking of appetitive conditioning may have been due to aversive context conditioning.     

Accelerometer feedback to promote physical activity in adults with type 2 diabetes: a pilot study

This study examined whether giving activity feedback to obese, sedentary adults with Type 2 diabetes would improve their adherence to a home-based walking program. 49 subjects were recruited. Ten failed a treadmill cardiovascular test. Another 9 dropped out before the intervention, and 4 dropped out during the intervention. The remaining 26 adults (14 women, 12 men; age M = 48.1 yr., SD = 7.1) received behavioral counseling monthly for 3 mo. regarding exercise. All subjects wore a triaxial accelerometer during these 3 months. Randomly, half of the subjects were blind to the data from the accelerometers, i.e., no feedback, and had counseling based on their self-report diaries. The other half had access to the accelerometer data, got a computerized graph of their physical activity for the period between counseling sessions, and had counseling based on these objective data, i.e., feedback. The feedback group showed an increase in exercise over the 3 mo. The nonfeedback group showed an increase in activity at 1.5 mo. but reverted to their baseline exercise levels at 3 mo. However, analysis of variance showed there was at least an 8% probability that this effect was due to chance, so the hypothesis that feedback would improve exercise adherence could not be supported. Further studies with larger sample sizes and greater control of experimental conditions are needed to determine the utility of objective activity feedback.     

Motivational effects of enhancing expectancies and autonomy for motor learning: An examination of the OPTIMAL theory

The OPTIMAL theory proposes that enhancing expectancies and autonomy facilitate motor performance and learning (Wulf & Lewthwaite). Present study with two experiments aimed to examine this proposition by using a modified dart throwing as motor task. In both experiments, motor learning (i.e., retention test) was enhanced by practice conditions, which enhance expectancies for future performance and support learners’ autonomy. Moreover, they led to significantly superior self-efficacy scores during all acquisition phase, retention, and transfer tests. Findings of the present study provided support for propositions of the OPTIMAL theory. Results are discussed in terms of motivational aspects of enhancing expectancies and autonomy and their role on facilitating motor learning.     

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.     

Examining Implementation Intentions in an Exercise Intervention: The Effects on Adherence and Self‐Efficacy in a Naturalistic Setting1

Some studies have found positive associations between implementation intentions and exercise, independent of motivational factors. However, most research has not been conducted in actual exercise contexts. In a naturalistic setting, implementation intentions may be associated with self‐efficacy (SE) beliefs. This study examined the effect of implementation intentions on adherence and SE over an 11‐week exercise program. Women (N = 72) were randomly assigned to an experimental (i.e., implementation intention) or a control group, with 52 participants completing the study. Results showed that while adherence decreased over time in both groups, the experimental group had better adherence than did the control group. Scheduling SE was also higher in the experimental group. Implementation intentions may help to maintain adherence and scheduling SE.     

Integrating the Unified Theory and Stages of Change to Create Targeted Health Messages

This study investigates the effects of targeted health messages toward reducing fat consumption by applying the unified theory of behavior change ( Fishbein et al., 2001 ) and the stages of change model. In Study 1, affect and outcome expectancies significantly discriminated individuals within each stage of change. In Study 2, affect was more effective in changing intention for precontemplative individuals, whereas outcome expectancies were more effective in changing intention for contemplative individuals. Gender was a higher-order moderator of this relationship: Precontemplative males were more influenced by an affective message, whereas contemplative males were more affected by a cognitive message. For females, a cognitive message was more effective for precontemplative individuals. There were no differences between the messages for contemplative females.     

Predictors of willingness to register as an organ donor among dutch adolescents

Abstract

In order to identify relevant determinants of organ donor registration among Dutch adolescents, a school-based cross-sectional survey was conducted among 145 high school students. Fifty-one percent of respondents indicated they were willing to register as organ donors and 80% reported a positive general attitude towards registration. Various misconceptions about the registration and donation procedure were identified. On average only moderate knowledge levels related to organ donation were found. In order of strongest association, negative outcome expectancies, past behaviour and experience, positive outcome expectancies, and social outcome expectancies proved to be significant predictors of willingness to register as organ donors. Self-efficacy was indirectly associated with willingness via outcome expectancies. Knowledge about organ donation was not significantly associated with willingness. The results suggest that in order to persuade adolescents to register as organ donors, refutational messages will have to be developed to counterargue the prevailing negative outcome expectancies related to organ donation and registration as an organ donor.