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.     

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.     

Cognitive mediation of intervention effects on physical exercise: Causal models for the adoption and maintenance stage

Objective: To investigate how the effects of a group-based intervention program (MoVo-LISA) on exercise behaviour were mediated by cognitive variables. Different causal models mapping the short-term (adoption) and long-term (maintenance) intervention effects were tested using path analyses.

Design: N?=?220 in-patients of a rehabilitation clinic were assigned to an usual care or intervention group (quasi-experimental design). Questionnaire-based assessment was conducted at baseline; discharge; and at six weeks, six months and 12 months post discharge.

Measures: The potential mediator variables were outcome expectations, self-efficacy, strength of goal intention (intention strength), self-concordance, action planning and barrier management.

Results: Observed intervention effects on exercise behaviour (p?<?0.05) were mediated by intention strength at the adoption and maintenance stages, by action planning only at the adoption, and by barrier management only at the maintenance stage. Self-efficacy and outcome expectations were only indirectly involved in these mediations by affecting intention strength and self-concordance.

Conclusion: This is the first study to track the cognitive mediation processes of intervention effects on exercise behaviour over a long time-period by differentiating the adoption and maintenance stages of behaviour change. The findings emphasise the importance of deconstructing intervention effects (modifiability vs. predictive power of a mediator) to develop more effective interventions.     

Bridging the intention–behaviour gap: Planning,self-efficacy,and action control in the adoption and maintenance of physical exercise

Although some people may develop an intention to change their health behaviour, they might not take any action. This discrepancy has been labelled the “intention–behaviour gap.” Detailed action planning, perceived self-efficacy, and self-regulatory strategies (action control) may mediate between intentions and behaviour. This was examined in a longitudinal sample of 307 cardiac rehabilitation patients who were encouraged to adopt or maintain regular exercise. At the first time point, the predictors of intention and intention itself were assessed. Two months and four months later, the mediators and outcomes were measured. Results confirmed that all the three factors (planning, maintenance self-efficacy, and action control) served to mediate between earlier exercise intentions and later physical activity, each of them making a unique contribution. The results have implications for research on the “intention–behaviour gap,” and indicate that planning, maintenance self-efficacy and action control may be important volitional variables.     

Predicting Dental Flossing Behavior: The Role of Implicit and Explicit Responses and Beliefs

The study examined the ability of implicit responses to predict dental flossing behavior. It was hypothesized that adding implicit responses would increase the predictive power of models containing variables suggested by social cognitive theories. To test the hypothesis, 125 participants completed measures of social cognitive variables (e.g., self-efficacy, task-efficacy, planning intention, behavior intention) and performed a procedure designed to measure their implicit responses to flossing. Flossing behavior was measured with retrospective self-reports and a follow-up measure of flossing. As predicted, the addition of implicit responses to models containing the social cognitive variables increased the predictive power of the models for both the self-report and follow-up measures.     

Task and Scheduling Self-efficacy as Predictors of Exercise Behavior

Social cognitive theory (Bandura, 1986, 1995, 1997) has figured prominently among social psychological approaches taken to the investigation of exercise behavior. The present study validated two measures of self-efficacy (scheduling and task) through confirmatory factor analytic procedures. In a separate study, the resultant factors were then used as independent variables in the prediction of exercise behavior and behavioral intention in a structural equation model. Task self-efficacy was found to be more related to behavioral intention than scheduling self-efficacy. Scheduling self-efficacy was found to be more related to behavior than task self-efficacy or behavioral intention. Results support different types and motivational functions of self-efficacy for exercise intentions and behavior.     

The integrated model of smartphone adoption: hedonic and utilitarian value perceptions of smartphones among korean college students

Abstract This study aims to propose an integrated model of smartphone adoption that incorporates social influences (SIs), perceived technicality, as well as hedonic and utilitarian attitudes into the technology acceptance model. The proposed model was empirically evaluated by using survey data collected from 239 Korean college students to investigate their perception and attitudes toward smartphone adoption intention. Our results show that users' attitudes and their adoption intention are highly influenced by SI and positive self-image. This implies that a smartphone is a symbolic product that can signal affiliation and enhance the users' status in a group. The results also indicate that hedonic enjoyment is equally important as utilitarian usefulness in predicting the adoption intention, and the two variables mediate the relationships between SI, positive self-image, perceived technicality, and the intention to use. Consequently, the results reveal that smartphones are convergent media that can be viewed as both task-oriented and entertainment-oriented devices.     

Effects of Dangerous and Competitive Worldviews on Right-Wing Authoritarianism and Social Dominance Orientation over a Five-Month Period

The cross-lagged effects of dangerous and competitive social worldviews on Right-Wing Authoritarianism (RWA) and Social Dominance Orientation (SDO) were examined over a five-month period ( N   =  165). Analyses indicated that the motivational goal for group-based dominance and superiority indexed by SDO changed as a function of the degree to which the social world was perceived as a competitive place characterized by inequality and resource scarcity. The motivational goal for ingroup conformity and collective security indexed by RWA, in contrast, changed as a function of the degree to which the social world was perceived as a dangerous and threatening place prone to high levels of crime and immoral behavior. These findings are consistent with the causal pathways between social worldviews and ideological attitudes predicted by Duckitt's (2001 ) model of the dual motivational and cognitive processes underlying prejudice. An unexpected reciprocal effect in which RWA predicted longitudinal change in dangerous worldview was also identified, suggesting that the relationship between these two constructs may be more complex than previously hypothesized.     

Threshold assessment of attitude,subjective norm,and perceived behavioral control for predicting exercise intention and behavior

According to the theory of planned behavior (TPB), attitude, subjective norm, and perceived behavioral control (PBC) are hypothesized to have linear associations with intention and behavior. However, no previous research has examined this hypothesized linearity across scale responses. Further, no study using social cognitive measures has detailed the incremental increases in the proportion of people meeting the American College of Sports Medicine's (ACSM) exercise guidelines across scale responses. The purpose of this study was to examine mean scores of intention and behavior and detail the proportion of participants meeting ACSM's exercise guidelines for each TPB construct response category (i.e. 1–7). Participants were university undergraduates (N=585) who completed measures of the TPB and a 2-week follow-up of exercise behavior. Results were evaluated using effect sizes (d,w) and p-levels, and provided general support for the linear effects of affective and instrumental attitude, but PBC and subjective norm were identified as having specific thresholds. Further, thresholds of positive, but not negative, exercise social cognition were identified for meeting ACSM's criteria with the exception of affective attitude. Threshold analysis was discussed as a novel way of analyzing TPB data by providing additional information about the expected success of intervention efforts focused on TPB constructs.     

Examining the Relationship Between Exercise Goals,Self‐Efficacy,and Overt Behavior With Beginning Exercisers1

Despite the overwhelming evidence that associates regular physical activity with physical and mental health benefits, millions of North Americans remain sedentary. Previous research by Poag‐DuCharme and Brawley (1993, 1994) and suggestions by Bandura (1989, 1997) led to the hypothesis that goals would influence exercise behavior through the mediating variable of self‐efficacy. Changes to the social cognitions and behavioral patterns of adherers during the exercise program were also assessed. Results demonstrate that at midprogram, self‐efficacy beliefs mediated the relationship between goal influence and exercise frequency. Significant increases were observed in self‐efficacy and perceived exertion from onset to midprogram. Onset goal influence and self‐efficacy significantly discriminated adherers from dropouts. Results are discussed with respect to the need to continue investigating the changing influence of social cognitions on motivating behavior.     

Psychological predictors of eco-driving: A longitudinal study

Eco-driving has well-known positive effects on fuel economy and greenhouse-gas emissions. Moreover, eco-driving reduces road-traffic noise, which is a serious threat to the health and well-being of many people. We investigated the psychological predictors of the adoption of eco-driving from the perspective of road-traffic noise abatement. The data came from 890 car drivers who participated in a longitudinal survey over four months. Specifically, we tested the effects of the intention to prevent road-traffic noise, variables derived from the theory of planned behavior (social norm, perceived behavioral control, and attitude), and variables derived from the health action process approach (implementation intention, maintenance self-efficacy, and action control) on the intention to practice eco-driving and on eco-driving behavior. The intention to prevent road-traffic noise was not linked to the intention to practice eco-driving. The strongest predictors of the intention to practice eco-driving were attitude and perceived behavioral control. The strongest predictor of eco-driving behavior was action control. The link between behavioral intention and behavior was weak, indicating that drivers have difficulties putting their intention to practice eco-driving into action. Therefore, intervention efforts should directly address and support the transition from intention to behavior. This could be accomplished by providing reminders, which help to maintain behavioral intention, and by providing behavior feedback, which helps car drivers to monitor their behavior.     

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.     

Correlates of self-worth in preschoolers: The role of gender-stereotyped styles of behavior

It was hypothesized that gender-stereotyped styles of social interaction are apparent as early as the preschool years, and that the use of these gender-stereotyped behaviors is associated with the child's perceived competence and social support. Using a story-completion method with 47 white middle-class preschoolers, the results of the study confirmed the hypotheses. Boys were more likely to use the male-stereotyped styles of domination and intrusion, while girls were more likely to use the female-stereotyped styles of affiliation and inclusion. In addition, the use of male gender-stereotyped behaviors among boys was significantly related to perceived physical competence and peer acceptance. For girls, use of the female gender-stereotyped behavior of Affiliation was related to perceived cognitive competence and, weakly, to perceived maternal acceptance. For both sexes, use of the feminine-stereotyped behavior of Inclusion was negatively related to competence and acceptance variables.     

Be green and clearly be seen: How consumer values and attitudes affect adoption of bicycle sharing

Environmental concerns have propelled public and private entities to search for ways to increase usage of public bicycle sharing systems. However, usage rates in many cities remain below expectations. Using the theory of perceived value to motivate our hypotheses, this paper evaluates the impact of perceived value on consumer adoption intentions, and assesses the moderating effects of social and personal attitudes towards environmental behavior, on perceived value-adoption intention relationships. Our findings suggest that public bicycle sharing adoption intention is significantly influenced by its perceived functional, conditional, green and social values. Moreover, personal and social attitudes towards “greenness” and bicycle sharing, respectively, are found to moderate the relationship between perceived values and adoption intentions. This research contributes to theory-building in bicycle sharing adoption, and informs business and government leaders on how to promote adoption.     

Relationships among the theory of planned behavior,stages of change,and exercise behavior in older persons over a three year period

Abstract

The present study examined the relationships among the theory of planned behavior (TPB), stages of change, and exercise behavior in 131 older persons over a three year period. Participants completed a baseline questionnaire by mail that assessed attitude, perceived control, subjective norm, intention, and stage and then received a telephone call three years later in which current exercise stage and behavior were assessed. Path analyses showed that (a) TPB constructs were significant predictors of exercise stage, (b) intention mediated the effects of TPB constructs on exercise stage, and (c) exercise behavior was best predicted by intention rather than stage. Results were interpreted as providing evidence for the long term predictive validity of TPB in the exercise domain and as questioning the necessity of combining both intention and stage in a single predictive model.     

An 8-year study of multiple influences on drug use and drug use consequences

Multiple long-term influences on young adult drug use and abuse were tested within an interactionist perspective using latent-variable causal models. Intrapersonal influences included early drug use and social conformity. Proximal interpersonal influences were captured by perceived peer drug use, perceived adult drug use, and family disruption. More distal influences included perceptions of community approval or disapproval for drug use. Outcome measures included not only use of drugs but also disruptive drug use (getting high at work or school) and self-admitted problems with drugs. Data were obtained from 654 participants at three equally spaced time points during an 8-year longitudinal study that began when the subjects were in junior high school. Confirmatory factor analyses were used to test the adequacy of the hypothesized measurement model. Subsequently, a structural equation, or path model, was used to examine the across-time relations among the latent and manifest variables. Stability effects were found for all repeatedly measured latent variables across the 4-year spans. Social conformity strongly influenced other latent variables across time. Early drug use and perceived adult drug use were prominent predictors of young adult drug use, whereas prior drug use predicted disruptive drug use and a lack of social conformity predicted problems with drug use. Early adult alcohol use predicted later disruptive drug use and problems with drug use. Perceived adult drug use generally influenced later alcohol use, whereas peer drug use influenced later cannabis and hard-drug use. Implications for prevention and treatment using a multicausal interactionist perspective are discussed.     

Intrapersonal and Interpersonal Factors Influencing Adolescents' Decisions About Having Sex: A Test of Sufficiency of the Theory of Planned Behavior1

This study tested the theory of planned behavior's (TPB) expectation that attitudes, social norms, and self‐efficacy would mediate other variables' effects on intention for having sex and probability of having sex. Longitudinal data were collected from 790 high‐school‐aged adolescents. In an intrapersonal variable model, sensation seeking, alcohol use, hard work, smoking, and moral beliefs had mediated effects, but the last 2 also had direct effects (on intention and behavior, respectively). In an interpersonal model, school attachment had mediated effects, pressure to have sex had a direct effect on behavior, and parent communication and number of sexually active friends had both. Intrapersonal variable effects were better described by the TPB than those of interpersonal variables. Targeting distal psychosocial factors may enhance intervention efficacy.     

The Impact of Social Influences in the Context of Attitude,Self-Efficacy,Intention, and Previous Behavior as Predictors of Smoking Onset1

Three different constructs for measuring social influence were utilized in the present study to explain adolescents' present and future smoking behavior at 6 (T2), 12 (T3), and 18 months (T4) after the first test. Social influence was assessed by measuring the social norms, perceived smoking behavior, and direct pressure. The impact of the social influence constructs was also assessed in the context of broader models, including attitudes and self-efficacy expectations, intention, and previous behavior. The three social influence measures correlated significantly with intention and behavior. Stepwise regression analyses showed that perceived behavior and pressure made significant contributions, after entering social norms, in explaining actual and future adolescent smoking behavior. Adding attitudes and self-efficacy increased the predictive power of the model significantly. In agreement with the theory of Fishbein & Ajzen (1975), intention was the most powerful predictor in explaining present and future smoking behavior. Attitudes, self-efficacy, and the social influences also made small unique contributions improving the explanatory power by approximately 5%. Previous behavior, however, had a substantial unique contribution in predicting future behavior after attitudes, social influences, self-efficacy, and intention were entered in the equations. Since social influences may exert their impact via different routes, it is recommended that smoking prevention programs discuss not only overt pressures such as direct pressure from peers, parents, and media, but also address the more covert social pressures such as modeling and the adolescents' ability to cope with these covert influences. Furthermore, norms on nonsmoking should be made explicit.     

Mechanisms governing empowerment effects: a self-efficacy analysis

This experiment tested the hypotheses that perceived coping and cognitive control self-efficacy govern the effects of personal empowerment over physical threats. Women participated in a mastery modeling program in which they mastered the physical skills to defend themselves successfully against unarmed sexual assailants. Multifaceted measures of theoretically relevant variables were administered within a staggered intragroup control design to test the immediate and long-term effects of the empowerment program and the mechanisms through which it produced its effects. Mastery modeling enhanced perceived coping and cognitive control efficacy, decreased perceived vulnerability to assault, and reduced the incidence of intrusive negative thinking and anxiety arousal. These changes were accompanied by increased freedom of action and decreased avoidant behavior. Path analyses of causal structures revealed a dual path of regulation of behavior by perceived coping self-efficacy, one mediated through perceived vulnerability and risk discernment and the other through perceived cognitive control self-efficacy and intrusive negative thinking.