健康行为改变中的社会认知因素：HAPA模型述评

HAPA是健康行为领域研究的新取向。认为改变健康行为需要两个分离的过程:动机和意志。首先,基于自我信念的基础上形成改变的意图;随意,行为改变才会被计划、引发并维持。HAPA认为,动机阶段引起行为意图,而意志阶段则产生实际行为。以自我效能为代表的社会认知因素在两个阶段起重要作用,对于健康行为的采纳、引发和维持的产生重要的预测作用。     

Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence

Numerous theories in social and health psychology assume that intentions cause behaviors. However, most tests of the intention- behavior relation involve correlational studies that preclude causal inferences. In order to determine whether changes in behavioral intention engender behavior change, participants should be assigned randomly to a treatment that significantly increases the strength of respective intentions relative to a control condition, and differences in subsequent behavior should be compared. The present research obtained 47 experimental tests of intention-behavior relations that satisfied these criteria. Meta-analysis showed that a medium-to-large change in intention (d = 0.66) leads to a small-to-medium change in behavior (d = 0.36). The review also identified several conceptual factors, methodological features, and intervention characteristics that moderate intention-behavior consistency.     

Planning and Self-Efficacy in the Adoption and Maintenance of Breast Self-Examination: A Longitudinal Study on Self-Regulatory Cognitions

Many women may be reluctant to perform breast self-examination (B.S.E.) regularly due to motivational or self-regulatory deficits. The Health Action Process Approach (Schwarzer, R. (1992). Self-efficacy in the adoption and maintenance of health behaviors: theoretical approaches and a new model. In: Schwarzer, R. (Ed.), Self-efficacy: Thought Control of Action , pp. 217-243. Hemisphere, Washington DC; Schwarzer, R. (2001). Social-cognitive factors in changing health-related behavior. Current Directions in Psychological Science , 10 , 47-51.), a health behavior change model that advocates the separation of motivation and action phases, such as goal setting and goal pursuit, was applied to data from 418 young women whose risk perceptions, outcome expectancies, self-efficacy, intention to perform B.S.E., planning, and reported examination behaviors were examined at two points in time. Risk perception was found to have a negligible influence in a path analysis, whereas self-efficacy emerged as the best predictor of intention and planning. Planning, in turn, appeared to be the best predictor of B.S.E. behaviors, followed by self-efficacy. The results point to the influential role that self-regulatory strategies (such as planning) play in translating goals into action. The study contributes to the current debate on stage theories of health behavior change and the orchestration of self-beliefs and strategies in the context of goal-directed behaviors.     

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.     

Future of Victimized Employees: A Model Based on Long-Run Cascading Effects of Experienced Victimization

ABSTRACT

Victimization has been one of the key research areas in the field of organizational behavior; however, current literature on organizational behavior has not sufficiently discussed the underlying processes that lead to changes in victim's behavior and their life. Proposed framework in this paper discusses long-term effects of victimization in two phases. Phase I elaborates the process through which victimization experiences lead to different emotional responses including anger, fear, and sadness in victimized employees. Phase II discusses the long-run cascading effects of emotions on victim's behavior and health. Overall this study suggests that continuous victimization leads to long-lasting devastating effects on victim's life through development of abusive leadership traits, as well as through destructive effects on their physical and mental health.     

Majority versus minority influence and prediction of behavioral intentions and behavior

Two experiments examined the effects of majority and minority influence on attitude-consistent behavioral intentions. In the first experiment, when attitudes were changed via minority influence there was a greater likelihood to engage in an attitude-consistent behavioral intention than when attitudes were changed via majority influence. This suggests that minority influence leads to stronger attitudes (based on systematic processing) that are more predictive of behavioral intentions, while attitude change via majority influence is due to compliance through non-systematic processing. Further support for this interpretation comes from the finding that the amount of message-congruent elaboration mediated behavioral intention. When there was no attitude change, there was no impact on behavioral intention to engage in an attitude-consistent behavior. Experiment 2 explored the role of personal relevance of the topic and also included a real behavioral measure. When the topic was of low personal relevance, the same pattern was found as Experiment 1. When the topic was of high personal relevance, thus increasing the motivation to engage in systematic processing, attitudes changed by both a majority and minority source increased behavioral intention and actual behavior. The results are consistent with the view that both majorities and minorities can lead to different processes and consequences under different situations.     

Modeling Health Behavior Change: How to Predict and Modify the Adoption and Maintenance of Health Behaviors

Health‐compromising behaviors such as physical inactivity and poor dietary habits are difficult to change. Most social‐cognitive theories assume that an individual's intention to change is the best direct predictor of actual change. But people often do not behave in accordance with their intentions. This discrepancy between intention and behavior is due to several reasons. For example, unforeseen barriers could emerge, or people might give in to temptations. Therefore, intention needs to be supplemented by other, more proximal factors that might compromise or facilitate the translation of intentions into action. Some of these postintentional factors have been identified, such as perceived self‐efficacy and strategic planning. They help to bridge the intention–behavior gap. The Health Action Process Approach (HAPA) suggests a distinction between (a) preintentional motivation processes that lead to a behavioral intention, and (b) postintentional volition processes that lead to the actual health behavior. In this article, seven studies are reported that examine the role of volitional mediators in the initiation and adherence to five health behaviors: physical exercise, breast self‐examination, seat belt use, dietary behaviors, and dental flossing. The general aim is to examine the applicability of the HAPA and its universality by replicating it across different health behaviors, based on various measures, time spans, and samples from different countries. Les comportements nuisibles à la santé tels que le manque d’exercice physique et les mauvaises habitudes alimentaires sont difficiles à modifier. La plupart des théories socio‐cognitives admettent que le meilleur prédicteur d’un réel changement est l’intention que la personne a de changer. Mais la conduite est souvent en contradiction avec les intentions. La divergence entre intention et comportement est due à plusieurs raisons. Par exemple, des obstacles imprévus peuvent apparaître, ou encore les intéressés peuvent succomber à la tentation. L’intention doit donc être associée à d’autres facteurs plus immédiats susceptibles de compromettre ou de faciliter le passage de l’intention à l’action. Certains de ces facteurs ont été identifiés, à savoir la planification stratégique et la perception de l’efficacité personnelle. Ils aident à combler le fossé entre l’intention et le comportement. L’Approche des Processus d’Action en faveur de la Santé (HAPA) établit une distinction entre les processus motivationnels préalables à l’intention qui conduisent à une intention comportementale et les processus volontaires secondaires à l’intention qui débouchent sur un comportement effectivement favorable à la santé. On expose dans cet article sept recherches qui examinent le rôle médiateur de la volition dans l’adoption de et la persévérance dans cinq comportements utiles à la santé: l’exercice physique, l’inspection personnelle de ses seins, l’usage de la ceinture de sécurité, un bon régime alimentaire et l’utilisation du fil dentaire. Il s’agit de mettre à l’épreuve le caractère opérationnel de l’HAPA et son universalité en l’appliquant à différents comportements liés à la santéà partir de mesures et de périodes diversifiées sur des échantillons provenant de différents pays.     

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.     

Intention to Migrate,Job Opportunities and Aspiration for Better Pay: An Information Integration Approach

This study examines (a) the relationship between intention to migrate, aspiration for better pay, and job opportunities in host countries in samples of Portuguese and French adolescents, and young French adults; and (b) the relationship between intention to return to country of origin, pay and job opportunities in Portuguese migrant workers living in France. In the two Portuguese groups, the model that best accounts for intentional processes is multiplicative. This finding partially explains why a minimal change in one of the two parameters can have repercussions that are apparently disproportional with this change. In the two French groups, the models that best account for intentional processes are the additive model (for young adults) and a unifactorial model (in adolescents). The discussion centres on possible links between these cross-cultural differences and recent findings on the effect of task difficulty and perceived stakes on integration rules.     

Health behavior change in transactive systems

Relationship members are frequently concordant on health outcomes; health behavior change is also concordant in close relationships. Despite clear evidence of this influence, relatively little is known about the possible mechanisms by which individuals in densely transactive systems (i.e., relationships with high goal‐related interdependence) influence each other's health. I draw on transactive goal dynamics (TGD) theory to highlight potential processes involved in health behavior change in interdependent systems. I introduce and discuss relevant literature about two related constructs—partner‐directed goal pursuit and partner‐directed goal qualities. I then highlight two areas where drawing on TGD principles may be useful, including unpacking recursive patterns of influence and health behavior change in concordant systems. I conclude with recommendations for future research.     

Relationships between Ambivalent Sexism and the Five Moral Foundations in Domestic Violence: Is it a Matter of Fairness and Authority?

Ambivalent sexism has served to justify and maintain patriarchy and traditional gender roles characterized by inequality and male domination in the intimate partner violence (IPV) literature; according to the Moral Foundation Theory (MFT) there are two specific moral foundations related to inequality and domination: fairness and authority. We connect these separate fields arguing that sexist attitudes can be related to specific patterns of endorsement of the five moral foundations. Our hypothesis is that ambivalent sexism in men convicted of violence against the partner may be rooted in at least these two moral foundations, and that at least these two moral foundations may also serve to predict intention to change the violent behavior against the partner. Controlling for political orientation, the results show that benevolent sexism correlates positively with the authority foundation; and hostile sexism correlates negatively with the fairness foundation. Both foundations contribute to explaining the two dimensions of ambivalent sexism (benevolent and hostile) and only the fairness foundation predict intention to change the violent behavior against the partner. New treatment approaches could be designed to increase moral concerns about fairness and to reduce moral concerns about authority in people who, at least, have once used violence against their partners.     

健康行动过程取向模型的发展与前景

健康行动过程取向(HAPA)模型的提出源于健康行为社会认知模型的发展和Bandura社会认知理论的应用。在HAPA中, 健康行为变化被视为一个包括行为产生、保持和恢复在内的连续过程; 结果预期、危险感知、三种自我效能感和两类计划被用来解释意图的形成及其向行动的转化; 两个阶段的划分有助于区分三类干预对象, 建议实施菜单式干预。HAPA模型具有明显的理论优势, 也引发了有关模型实质的争论。当前和未来的研究旨在考察更多的自我调节变量、检验因果模型, 在健康行为的多个领域开展应用和干预研究。     

Theory-Based Health Behavior Change: Developing, Testing, and Applying Theories for Evidence-Based Interventions

Theories are needed to explain and predict health behavior, as well as for the design and evaluation of interventions. Although there has been a history of developing, testing, applying, and refining health behavior theories, debates and limitations in evidence exist: The component of theories which, for example, predicts change should be better elaborated so that we can more easily understand what actually drives behavior change. Theories need to be empirically testable in two ways. Theories need to specify a set of changeable predictors to describe, explain, and predict behavior change, and they should enable us to design an effective intervention that produces exactly those changes in behavior that are predicted by the relevant theory. To make this possible, theories need to be specified in such a way that they can be rigorously tested and falsified. Moreover, for the design of theory-based interventions it must be possible to derive change techniques from the theory and to use them to generate changes in behavior. Based on eight state-of-the-science articles that make conceptual and empirical contributions to the current debate on health behavior theories, various approaches are discussed to gain further insights into explaining and changing health behaviors and the iterative process of theory development.     

Predicting parental sunscreen use: Disentangling the role of action planning in the intention–behavior relationship

Structural equation modeling was used to examine antecedents of parental sunscreen use (N = 436) in a longitudinal design. The influence of a volitional planning cognition was assessed in several path models, investigating potential mediation and moderation of the intention–behavior relationship. Premotivational and motivational variables accounted for 55.1% of the variance in intention to use sunscreen. Intention emerged as the most powerful predictor of behavior, followed by action planning and self-efficacy expectations, together explaining 35.4% of parental sunscreen use after five months. Strong support was found for both mediating and moderating influences of action planning on the intention–behavior relationship. Action planning also partially mediated the impact of self-efficacy on behavior. The results support theoretical considerations to add postintentional cognitions to current health behavior models. Although action planning is an important component in the transition from intention to behavior, the impact of intention and of other premotivational and motivational variables should not be overlooked when developing health educational interventions.     

Disentangling behavioral intention and behavioral expectation

Social psychologists have extensively researched behavioral intention and its relation to future behavior, usually within the framework of M. Fishbein and I. Ajzen's (1975, Belief, attitude, intention and behavior: An introduction to theory and research, Reading, MA: Addison-Wesley) theory of reasoned action. However, the field has confounded two separate constructs while investigating intention: behavioral intention (BI) and what P. R. Warshaw, B. H. Sheppard, and J. Hartwick (in press, in R. Bagozzi (Ed.), Advances in marketing communication, Greenwich, CT: JAI Press) have coined behavioral expectation (BE), which is the individual's self-prediction of his or her future behavior. In this paper we define both constructs and explain how they differ in terms of the processes by which they are formed, their roles in determining behavior, and their utilities as behavioral predictors. We propose that behavioral expectation is the more accurate overall predictor since many common behaviors are unreasoned (i.e., mindless or habitual) behaviors, goal-type actions, or behaviors where the individual expects his or her intention to change in a foresseable manner. These are all cases where present intention (BI) is not the direct determinant of behavior but where the individual may be capable of appraising whatever additional determinants exist and of including them within his or her behavioral expectation. A study (N = 197) is reported in which student subjects received either a BE (n = 113) or a BI (n = 84) version of a questionnaire pertaining to their performance of 18 common behaviors. Overall, behavioral expectation was the better predictor of self-reported performance.     

Changing Contraceptive Usage Intentions: A Test of the Fishbein Model of Intention1

The Fishbein model of intention suggests that intention may change as a consequence of change in either a related attitudinal or normative component. This hypothesis was tested on intention to use contraceptives. Users and nonusers of contraceptives were exposed to a message designed to change contraceptive-usage attitude, to a message directed toward changing the normative beliefs associated with using contraceptives, or to a no-message control. The messages advocated one of three contraceptive techniques: (a) males were advised to use condoms, (b) males were advised to rely on their partner's use of oral contraceptives, or (c) females were advised to use oral contraceptives. Contraceptive-usage intention changed only in the two conditions where the model's requirements for change were present. Thus, the pattern of change agreed with Fishbein's suggestions and provided moderate support for the intention model and its application to intention change in health care settings.     

Cognitive antecedents to adolescent health risk: Discriminating between behavioral intention and behavioral willingness

Abstract

A model of adolescent health risk behavior that is both cognitive and social-psychological in orientation is described, and an aspect of the model is tested empirically. The model suggests that health risk behaviors (e.g., smoking or drunk driving), especially among adolescents, are not always intended or premeditated, but instead are often reactions to risk-conducive circumstances. Because they are not entirely premeditated, such behaviors are not accurately predicted by “traditional” behavioral intention measures, but are predicted by a central construct in the model labeled behavioral willingness. Results of two studies indicate that both intention (expectation) and willingness measures predict future risk behaviors, and do so independent of one another. Additional analyses provide further evidence of discriminant validity between the two constructs by indicating that they relate differently to perceptions of personal vulnerability to the health risks associated with these behaviors.     

Rethinking barriers: a novel conceptualization of exercise barriers in cancer survivors

Previous research suggests different types of barriers may demonstrate different relationships with intention to engage in health behaviors. This study explored global, practical, and health-related barriers’ relationships with exercise intention and behavior among cancer survivors. The mediating role of intention in the barriers-behavior relationships was also evaluated. Cancer survivors (N = 152) completed self-report measures of exercise barriers, intention, and behavior at baseline and of exercise behavior two months later. Global barriers were negatively related (p < .01) and practical and health-related barriers were unrelated (ps ≥ .07) to exercise intention. Global and practical barriers were negatively related (ps < .01) and health-related barriers were unrelated (p = .48) to subsequent exercise behavior. Exercise intention did not mediate any barriers-behavior relationships. Results suggest that global and practical barriers should be targeted in barriers reduction interventions and highlight the intention-behavior gap problem. Future research should explore multidimensionality of barriers for other health behaviors.     

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.     

Exploring cues to sedentary behaviour as processes of physical activity action control

ObjectiveUnderstanding intention–behaviour relations is important in physical activity (PA) research given the large number of people who intend to be active but fail to translate these intentions into behaviour. The purpose of this study was to evaluate whether processes/cues for popular sedentary leisure-time behaviours and PA explain additional variance in PA behaviour after controlling for PA intention, and to evaluate whether these processes moderate PA intention–behaviour relations.DesignRandom population-based cross-sectional survey.MethodsParticipants were a random sample of 206 adults who completed measures of the processes of change pertaining to physical activity and four popular leisure-time behaviours (TV viewing, computer use, sedentary hobbies, and sedentary socializing) and an adapted Godin Leisure-Time Exercise Questionnaire.ResultsResults using hierarchical ordinary least-squares regression provided evidence that cognitive TV processes explain additional variance in PA behaviour and moderate PA intention–behaviour relations.ConclusionsThese results extend the prior literature on relationships between sedentary cognitions and physical activity and underscore the potential value of adding sedentary control interventions in concert with physical activity promotion.