Social cognitive models of health and exercise behavior: An introduction and review of conceptual issues

Abstract

This article reviews the major social cognitive models of adherence or compliance in health and exercise behavior and attempts to show that these models are more similar to each other than different from each other. Self-efficacy theory and the theory of reasoned action/planned behavior have guided most of the theory-based research on exercise behavior. Two other models, protection motivation theory and the health belief model, have guided much research on the role of social cognitive factors in other health behaviors. These models are comprised largely of the same basic set of social cognitive variables: self-efficacy expectancy, outcome expectancy, outcome value, and intention. Two other factors, situational cues and habits, although not common to all the models, round out the theoretical picture by explaining how the relationship between the major social cognitive variables and behavior may change with repeated performance of a behavior over time.An integration of these models is offered using the theory of planned behavior as a foundation. It is suggested that research on health and exercise behavior that pits one model against another to determine which one is the better predictor of behavior is likely to be unproductive due to the striking similarities of the models. It is suggested instead that theorists and researchers focus their efforts on integration of the major social cognitive models and on determining the relative predictive utility of the various social cognitive factors with various health behaviors and in various contexts.     

Causal Models of Physical Exercise Participation: Testing the Predictive Power of the Construct "Pressure to Change"

This study examines 2 different causal models to predict physical exercise motivation and behavior under a longitudinal perspective. The first model includes 5 latent variables that were hypothesized to have an impact on exercise intention and behavior: behavior-specific social support, exercise self-efficacy, perceived health benefits, perceived barriers, and subjective vulnerability to cardiovascular disease. The second model was based on all variables of the first model, but additionally included the new variable "pressure to change." Pressure to change was defined as the extent to which a person feels the necessity that specific personal life circumstances (e.g., health status, social relations) may not remain as they are and ought to be changed. It was hypothesized that the inclusion of health-related pressure to change would result in a better prediction of exercise intention. The proposed causal models were tested separately at the stages of exercise adoption and maintenance. Covariance structure analyses (LISREL) confirmed that pressure to change may be an important factor in the motivational process that leads to the adoption of regular physical exercise. Adding this latent variable to the basic model improved the amount of explained variance in exercise intention by 6%. Furthermore, the results did not support the assumption that cognitive control is critical especially during the acquisition of exercise behaviors, but may be less influential once the behavioral routines have been established. Our data rather indicate that regular physical exercise, even if performed on a regular basis for years, always remains a behavior that requires a high level of cognitive guidance.     

Neurocognitive influences on health behavior in a community sample.

CONTEXT: Dominant models of individual health behavior omit biological variables entirely and are composed almost exclusively of social-cognitive and conative variables. Research from the neurosciences suggests a role for brain function in explaining behaviors that require active self-regulation for consistent performance. However, the association between brain function and health behavior is underexplored. OBJECTIVE: To examine the predictive power of executive function for 2 health risk behaviors and 2 health protective behaviors in healthy adults. DESIGN: A cross-sectional community sample (N = 216) of adults 20-100 years of age were administered a battery of neuropsychological tests and completed self-report questionnaires regarding their health practices. It was hypothesized that poor performance on neuropsychological tests tapping executive function would be associated with poor health behavior tendencies. RESULTS: Errors on the Stroop task were positively associated with health risk behavior and negatively associated with health protective behavior after controlling for demographics, education, and IQ. CONCLUSION: Executive function is associated with health behavior tendencies. If the association is causal, explanatory models of individual health behavior should be revised to account for individual differences in biologically imbued self-regulatory abilities.     

Social support in the workplace: Tests of six theoretical models

Six theoretical models of social support in relation to perceived job stress, burnout, and health were tested both cross-sectionally and longitudinally. Participants at Time 1 were state correctional officers (N = 262) who completed questionnaires in which multiple indicators of each construct were assessed. Time 2 participants (N = 177) were those officers from the Time 1 sample who completed the questionnaire again three months later. Structural equation analyses revealed that only one of the six models was supported by cross-sectional results. In this model a direct negative relationship between the WORKPLACE SOCIAL SUPPORT and BURNOUT latent variables was specified, along with direct, positive relationships between the JOB STRESS and BURNOUT latent variables and the BURNOUT and POOR HEALTH latent variables. However, none of the six models was supported by the longitudinal results. Thus, cross-sectional results were consistent with a model in which social support on the job influences positive health only through its direct and negative effect on burnout symptoms, but such causal connections were not validated longitudinally.     

Protection Motivation Theory and Adolescents' Perceptions of Exercise1

Coping strategies endorsed by adolescents in dealing with a potential threat to their health were assessed in a study which investigated components of protection motivation theory. Year 9 and 10 high school students were presented with information about cardiovascular disease risk and the role of exercise in maintaining cardiorespiratory fitness. Three components specified by the theory were manipulated: response efficacy (effectiveness of exercise in preventing cardiovascular disease), response costs (costs associated with taking up a regular program of exercise) and self-efficacy (belief in ability to carry out a program of exercise) in a 2 × 2 × 2 factorial design with two levels (high vs. low) of each variable. It was hypothesized that such information would affect participants' perceptions of response efficacy, response costs, self-efficacy, and their selection of coping strategies. Six dependent variables were investigated: two adaptive coping strategies (behavioral intention to exercise, rational problem solving) and four maladaptive strategies (avoidance, wishful thinking, hopelessness, arid fatalism). Manipulation checks found significant differences between the high and low conditions of each independent variable. Adaptive strategies were strongly endorsed, whereas endorsement of the maladaptive strategies ranged from minimal to complete disagreement. Participants in the high self-efficacy condition indicated stronger intentions to exercise. Students in the low response efficacy condition demonstrated more endorsement of hopelessness and fatalism than did students in the high response efficacy condition. When exercising status was included as a fourth independent variable, it was found that active adolescents endorsed the adaptive coping strategies more strongly than did inactive adolescents. The cognitive coping strategies adopted by adolescents when dealing with perceived threats to their health may be influenced by information on the efficacy of relevant behavior, by perceptions of their ability to perform such behavior, and by their actual involvement with the behavior of concern.     

Neuropsychological mediators of the links among age, chronic illness, and everyday problem solving

Reductions in everyday problem solving (EPS) are often reported in older age, although the underlying mechanisms remain unclear. The authors examined the role of 2 variables predicted to mediate (neuropsychological abilities and health status) or moderate (health status) the relationship between age and EPS performance. Toward these ends, they compared EPS and neuropsychological performance in 50 functionally independent adults with chronic kidney disease (CKD) and 64 control participants matched on age and education. Both older age and CKD were associated with worse performance on measures of EPS and memory/executive abilities. Neuropsychological abilities were positively associated with EPS performance. In both the full sample and control participants only, memory/executive functioning mediated the association between presence of chronic illness and EPS. Furthermore, memory/executive functioning partially mediated the link between age and EPS. Findings indicate that relations among age, health status, and EPS are not straightforward. Although performance on neuropsychological measures appeared to underlie EPS declines in chronic illness, increasing age remained independently associated with reduced EPS. The authors discuss implications for models of adult developmental changes in everyday cognition.     

Age differences in motivational orientation toward physical activity: an application of social-cognitive theory

According to social-cognitive theory, an individual's motivation to engage in physical activity is based on three postulates: self-efficacy, outcome expectations, and self-evaluated satisfaction or dissatisfaction. The purpose of the present study was to examine age, gender, level of education, and level of activity in relation to those postulates in 2,298 Australians aged between 18 and 78. The authors conducted regression analyses for self-efficacy and for outcome expectations as dependent variables; age, gender, education level, and level of physical activity served as independent variables. Chi-square analyses assessed differences in the health incentive to exercise, the perceived level of activity, and the perceived level of fitness. Results indicated significant age differences on all variables. The older individual felt lower self-efficacy in relation to physical activity and expected fewer benefits from participating in physical activity. However, older individuals who engaged in physical activity rated themselves as more active and fit than nonexercisers of their same age and gender. Physical activity and level of education were positively correlated with self-efficacy, and men were more efficacious than women were. The implications are that interventions aimed at increasing participation in physical activity should take into consideration differences in incentives.     

School context and health in adolescence: The role of sense of coherence

The aim of this study was to examine the role of school variables and sense of coherence (SOC) in the explanation of health. For this purpose, data were collected from a representative sample of adolescents, aged 13 to 18 years, selected for the Health Behavior in School‐aged Children survey in Spain. Using Structural Equation Modelling, three nested models were tested that represented different hypothesized models of the relationships among school factors, SOC and health. According to goodness‐of‐fit indices, in the best model, school‐related stress and SOC mediated the influence of support from classmates and teachers on health, and SOC had a direct effect on stress. The results supported the idea that a supportive school climate and SOC are relevant to adolescents' health. Furthermore, SOC was the most influential variable; apart from its direct positive effect on health, SOC seemed to condition the degree to which students perceived school demands to be stressful. Specifically, students with a high SOC were less likely to suffer from high levels of school‐related stress.     

African Americans' Educational Expectations: Longitudinal Causal Models for Women and Men

The long‐term educational development of African American adolescents was investigated using a national longitudinal sample. The dependent variable was the highest level of education that participants ever expected to achieve. These expectations were assessed when participants were 2 years beyond high school. Background variables and family variables were assessed when students were in the 8th grade. High school behavior variables were assessed when students were high school seniors. Path models revealed differing processes for women and men. Overall, effects of early academic performance variables were strongest, followed by effects of family variables and high school behavior variables. Implications for theory and practice are included.     

Activities, self-referent memory beliefs, and cognitive performance: evidence for direct and mediated relations

In this study, the authors investigated the role of activities and self-referent memory beliefs for cognitive performance in a life-span sample. A factor analysis identified 8 activity factors, including Developmental Activities, Experiential Activities, Social Activities, Physical Activities, Technology Use, Watching Television, Games, and Crafts. A second-order general activity factor was significantly related to a general factor of cognitive function as defined by ability tests. Structural regression models suggested that prediction of cognition by activity level was partially mediated by memory beliefs, controlling for age, education, health, and depressive affect. Models adding paths from general and specific activities to aspects of crystallized intelligence suggested additional unique predictive effects for some activities. In alternative models, nonsignificant effects of beliefs on activities were detected when cognition predicted both variables, consistent with the hypothesis that beliefs derive from monitoring cognition and have no influence on activity patterns.     

Self-regulation and recall: growth curve modeling of intervention outcomes for older adults

Memory training has often been supported as a potential means to improve performance for older adults. Less often studied are the characteristics of trainees that benefit most from training. Using a self-regulatory perspective, the current project examined a latent growth curve model to predict training-related gains for middle-aged and older adult trainees from individual differences (e.g., education), information processing skills (strategy use) and self-regulatory factors such as self-efficacy, control, and active engagement in training. For name recall, a model including strategy usage and strategy change as predictors of memory gain, along with self-efficacy and self-efficacy change, showed comparable fit to a more parsimonious model including only self-efficacy variables as predictors. The best fit to the text recall data was a model focusing on self-efficacy change as the main predictor of memory change, and that model showed significantly better fit than a model also including strategy usage variables as predictors. In these models, overall performance was significantly predicted by age and memory self-efficacy, and subsequent training-related gains in performance were best predicted directly by change in self-efficacy (text recall), or indirectly through the impact of active engagement and self-efficacy on gains (name recall). These results underscore the benefits of targeting self-regulatory factors in intervention programs designed to improve memory skills.     

The role of emotion in bridging the intention–behaviour gap: The case of sports participation

ProblemPsychological models of sports participation frequently draw on the Theory of Planned Behaviour (TPB) in order to predict health-behaviour-related intentions. While these models commonly show high predictive power with respect to intention, they often fall short in the prediction of behaviour (the ‘intention–behaviour gap’). The present study contends that integrating emotional processes into TPB can substantially improve the model's predictive power over and above traditional cognitive predictors.MethodIn a longitudinal study structural equation modelling was employed to test a traditional model (based on TPB) and an extended model including emotion associated with the intention to exercise as a mediator variable. A community sample (N = 237) completed a questionnaire measuring the components of a traditional TPB model. Prior to each of 16 expected exercise sessions (over 8 weeks) intention to exercise and emotion associated with the intention were measured.ResultsResults confirmed a substantial increase of 17% in explained variance of exercise frequency and 20% in exercise duration for the extended model. Emotional appraisal of the intention to exercise thus appears to mediate the traditional intention–behaviour relationship, suggesting that emotionally based interventions aimed at increasing sports participation may be helpful.ConclusionIt is concluded that emotion variables should be added to traditional TPB models in order to predict health behaviour more fully.     

Associations Among Body Mass Index,Depression, and Family Factors Across Two Generations

In this pilot study, we examined the relationship between health factors, sociodemographic factors, and body mass index (BMI) across two generations (n = 41 parent-child pairs). Generation 1 study variables included parent- and family-focused characteristics and health variables, the Generation 2 variables included child demographic factors, and the outcome variable was youths’ physical health (operationalized as BMI). Regression models revealed that Generation 1 variables, taken together, accounted for 26% of the variance in youth BMI. However, only the parent’s mental health symptoms (i.e., depression symptoms) made a unique contribution to the variance in youth BMI. Logistic regression analysis revealed that the youths’ race and age—but no other demographic factor—were significantly related to youth BMI-for-age. Our findings suggest that youth race, age, and parent mental health are each associated with youth physical health (i.e., BMI), confirming previous study findings that parental factors and demographic factors should be considered when exploring youth health outcomes.     

Fruit and Vegetable Intake Predicts Positive Affect

Prior research suggests that fruit and vegetable intake predicts psychological well-being (WB) when controlled for demographic variables such as age, income and education. Using multiple-item measures and including additional diet and health variables as covariates, the current study assessed self-reported well-being in the past week and daily fruit and vegetable consumption over the past 4 weeks for 1270 university students. Mean positive affect increased linearly as a function of number of daily servings of fruits and vegetables; the pattern of this relationship did not differ significantly for males and females. This association remained statistically significant after controlling for demographic variables (age, sex, and parent education levels); other diet variables (consumption of sugar containing beverages, coffee or tea, and fat); and other health behaviors (exercise, sleep quality and smoking). Life satisfaction and negative affect were not significantly related to fruit and vegetable consumption. Analysis of single-item measures similar to those used in past large scale surveys yielded similar results. Possible reasons for the association of fruits and vegetable consumption with well-being are discussed.     

The Measurement of Adult Intelligence,and the Requisites of a General Intelligence Test

Abstract

The relationships were examined between selected socipdemographic variables and perceptions of well-being among residents 60 years and older of metropolitan and nonmetropolitan areas in the United States. Multiple regression models were used in analyzing data from the 1982–1991 NORC General Social Survey. Such sociodemographic variables as gender, race, marital status, education, financial status, place of residence, religious membership, and religious attendance were independent variables. A composite score of perceptions of well-being was the dependent variable. Race, marital status, education, financial status, religious attendance, and place of residence were important to well-being; gender and religious membership were not significant. The effects of nonmetropolitan living also significantly enhanced perceptions of well-being. Other facets of mental health in metropolitan and nonmetropolitan areas were also examined.     

Cigarette Smoking, Physical Activity, and the Health Status of College Students

Research has supported a negative correlation between cigarette smoking and exercise; however, the temporal nature of this association is not obvious. We modeled the relationships among smoking, exercise, and self-perceived health over time, within a college population. We collected 5 waves of data from 1,023 undergraduate students over a 14-month period. The results verified that smoking and exercise each made independent contributions in the prediction of health. Smoking was associated with reduced exercise over time, while no evidence was found for the reverse relationship. Our final mediation model demonstrates that smoking is related to poorer self-perceived health, and that this effect is partially mediated by the fact that smokers are less likely to engage in exercise.     

Regression among factor scores

Structural equation models with latent variables are sometimes estimated using an intuitive three-step approach, here denoted factor score regression. Consider a structural equation model composed of an explanatory latent variable and a response latent variable related by a structural parameter of scientific interest. In this simple example estimation of the structural parameter proceeds as follows: First, common factor models areseparately estimated for each latent variable. Second, factor scores areseparately assigned to each latent variable, based on the estimates. Third, ordinary linear regression analysis is performed among the factor scores producing an estimate for the structural parameter. We investigate the asymptotic and finite sample performance of different factor score regression methods for structural equation models with latent variables. It is demonstrated that the conventional approach to factor score regression performs very badly. Revised factor score regression, using Regression factor scores for the explanatory latent variables and Bartlett scores for the response latent variables, produces consistent estimators for all parameters.     

Assessing the Impact of Relative Social Position and Absolute Community Resources on Depression and Obesity Among Smokers

We tested two competing hypotheses-relative social position and community resources-in regards to their effect on two co-occurring health problems (depression, and obesity) in a sample of smokers participating in an online smoking cessation intervention. Income and education data at the zip code level from the 2000 Census was linked with individual level data. Logistic regression models were used for each co-occurring problem to determine how each SES variable (individually and interactively) was associated with the presence of co-occurring health problems. We found that lower individual education was related to poorer health for all outcomes (Depression: OR = 1.25; Obesity: OR = 1.24; Both: OR = 1.46), lower community education was only related to obesity (OR = 1.20). Lower individual income was related to higher rates of depressive symptoms (OR = 1.64) and both health problems (OR = 1.55); a significant interaction of individual and community income (Wald = 6.13, p < .05) revealed that high income individuals were less likely to be depressed if they lived in lower-income communities and became more likely to be so as community income increased. Relative social position was confirmed for depression, whereas community resources were prominent only for obesity. Higher individual education most consistently predicted positive health outcomes, making it a potentially powerful target to reduce health disparities.     

身体锻炼对高中学生主观幸福感的影响及其心理机制

为了考察身体锻炼与高中学生主观幸福感的关系,采用量表法进行了研究,控制了相关变量后的研究结果表明:(1)经常锻炼的高中学生比锻炼不足的高中学生的主观幸福感更加强烈,这一差异表现在两者之间的情感成份和特殊生活满意感上;一次的身体锻炼对高中学生主观幸福感没有影响,长期性的身体锻炼可以提高高中学生主观幸福感;小锻炼量和中等锻炼量的身体锻炼随着锻炼持续时间的增长,对高中学生主观幸福感影响加深,而大锻炼量随着锻炼持续时间的增长对高中学生主观幸福感的影响,呈现倒“V”型的曲线状;随着锻炼持续时间的增长,中等锻炼量的效果明显优于小锻炼量和大锻炼量的效果;(2)身体锻炼不仅可以直接对高中学生主观幸福感产生影响,而且可以通过身体自尊,人际关系、人格等中介变量对高中学生主观幸福感产生影响     

Body image and exercise: A study of relationships and comparisons between physically active men and women

A group of physically active women (n=112) and men (n=88) of a broad range of ages were compared on a number of variables related to body image, weight and diet concerns, and degree of exercise participation. Interrelationships between these measures were also examined. Results indicated that men and women were equally dissatisfied with their current weight. Although most women wanted to lose weight, the men were evenly divided between those who wanted to lose and those who wanted to gain. Women, however, were more dissatisfied with their bodies and placed greater importance on their appearance as an influence on their feelings of well-being. Although there were no sex differences in degree of physical activity, women were more likely than men to exercise to try and lose weight. Of interest was the finding that age was not related to body focus or body dissatisfaction for either sex. For women and older men, the degree to which they exercised was not associated with any of the body image variables. A very different pattern of relationships was found for young men. Greater body satisfaction was associated with increases in exercise participation and with increased body focus, a variable that was also associated with increased levels of exercise. The profile of results is considered in the context of social influences such as health promotion and sex roles — factors that have likely affected current attitudes to physical appearance and physical attractiveness among both sexes.