Active engagement in a web-based tutorial to prevent obesity grounded in Fuzzy-Trace Theory predicts higher knowledge and gist comprehension

We used Sharable Knowledge Objects (SKOs) to create an Intelligent Tutoring System (ITS) grounded in Fuzzy-Trace Theory to teach women about obesity prevention: GistFit, getting the gist of healthy eating and exercise. The theory predicts that reliance on gist mental representations (as opposed to verbatim) is more effective in reducing health risks and improving decision making. Technical information was translated into decision-relevant gist representations and gist principles (i.e., healthy values). The SKO was hypothesized to facilitate extracting these gist representations and principles by engaging women in dialogue, “understanding” their responses, and replying appropriately to prompt additional engagement. Participants were randomly assigned to either the obesity prevention tutorial (GistFit) or a control tutorial containing different content using the same technology. Participants were administered assessments of knowledge about nutrition and exercise, gist comprehension, gist principles, behavioral intentions and self-reported behavior. An analysis of engagement in tutorial dialogues and responses to multiple-choice questions to check understanding throughout the tutorial revealed significant correlations between these conversations and scores on subsequent knowledge tests and gist comprehension. Knowledge and comprehension measures correlated with healthier behavior and greater intentions to perform healthy behavior. Differences between GistFit and control tutorials were greater for participants who engaged more fully. Thus, results are consistent with the hypothesis that active engagement with a new gist-based ITS, rather than a passive memorization of verbatim details, was associated with an array of known psychosocial mediators of preventive health decisions, such as knowledge acquisition, and gist comprehension.     

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.     

Prevention and health promotion: decades of progress, new challenges, and an emerging agenda.

Daily habits (e.g., smoking, diet, and exercise) and their immediate consequences (e.g., obesity) confer risk for most of the major health problems in industrialized nations. Hence, determinants of these behaviors and their modifications have been central topics in health psychology. Considerable scientific and applied progress has been made, but the field faces important challenges and opportunities in the future. These challenges and opportunities include changes in demographics and patterns of health, the need for a more comprehensive model of the domain of health behavior and prevention, the need to integrate behavioral and psychosocial risk and resilience, the incorporation of new technologies, and addressing a variety of professional and economic barriers to the implementation of prevention in health care.     

Intention, perceived control, and weight loss: an application of the theory of planned behavior

Success at attempted weight reduction among college women was predicted on the basis of a theory of planned behavior. At the beginning of a 6-week period, participants expressed their attitudes, subjective norms, perceived control, and intentions with respect to losing weight. In addition, the extent to which they had made detailed weight reduction plans was assessed, as were a number of general attitudes and personality factors. In support of the theory, intentions to lose weight were accurately predicted on the basis of attitudes, subjective norms, and perceived control; perceived control and intentions were together moderately successful in predicting the amount of weight that participants actually lost over the 6-week period. Actual weight loss was also found to increase with development of a plan and with ego strength, factors that were assumed to increase control over goal attainment. Other factors, such as health locus of control, perceived competence, and action control, were found to be unrelated to weight reduction.     

From intentions via planning and behavior to physical exercise habits

ObjectivesIndividuals who enact a health behavior effortlessly with minimal conscious deliberation can be assumed to have formed a healthy habit. This can be reflected by increases in self-reported habit strength of a behavior. We examined whether physical exercise intentions facilitate changes in exercise habit strength by increasing the use of action planning and exercise.DesignTwo field studies investigated the effect of behavioral intentions on changes in habit strength through a sequential path from action planning to exercise.MethodExercise intentions, action planning, habit strength, and exercise were assessed at two measurement points in time in 231 university students (Study 1), and at four points in time in 134 rehabilitation patients (Study 2).ResultsIn multiple-step mediation models in both samples, there were indirect effects of intentions on habit strength through action planning and behavior.ConclusionAction planning and behavior operated as sequential mediators to bridge the gap between intentions and habit strength. Exercise habit strength may increase as a result of conscious action planning and frequent behavior enactment. Including these constructs jointly into behavior change models may improve the understanding of the mechanisms involved in behavior maintenance.     

Social Cognitions and Past Behavior as Predictors of Behavioral Intentions Related to Cardiovascular Health

The present study assessed the usefulness of social cognitions shared by several health behavior models for predicting behavioral intentions regarding cardiovascular health, independent of past/current behavior. Over 800 adolescents were administered a cross-sectional survey measuring intentions (regarding cigarette use, fat consumption, physical exercise), social cognitions (severity, vulnerability, benefits, self-efficacy), and past/current behavior. Hierarchical regression analyses, controlling for past/current behavior, showed a varied predictive profile across behavioral intentions. Severity estimates predicted intended cigarette use and fat consumption, while perceived benefits predicted intended physical activity. However, self-efficacy predicted intentions consistently. Collectively, social cognitions contributed an additional 0.8%, 2.5%, and 11. 6%, of the variance in smoking, dietary fat, and exercise intentions, over and above past/current behavior. Theoretical and practical implications are considered.     

Weight Loss Is Not the Answer: A Well‐being Solution to the “Obesity Problem”

Americans have been gaining weight in recent decades, prompting widespread concern about the health implications of this change. Governments, health practitioners, and the general public all want to know: What is the best way to reduce the health risks associated with higher body weight? The dominant weight‐loss solution to this “obesity problem” encourages individuals to lose weight through behavior change. This solution rests on the assumptions that higher body weight causes health problems, that permanent weight loss is attainable, and that weight loss improves health. But comprehensive reviews of the scientific evidence find mixed, weak, and sometimes contradictory evidence for these premises. We suggest that a different solution to the “obesity problem” is needed – a solution that acknowledges both the multifaceted nature of health and the complex interaction between person and situation that characterizes the connection between weight and health. Thus, we use the lens of social psychological science to propose an alternative, well‐being solution to the “obesity problem”. This solution has the potential to improve health by encouraging eating and exercising for optimal health rather than weight loss, by developing interventions to reduce weight stigma and discrimination, and by helping higher body‐weight people cope with the stress of stigma and discrimination.     

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.     

The Influence of Outcome Expectancy and Self-Efficacy on the Behavioral Intentions of Novice Exercisers

The present study was based upon self-efficacy (SE) theory (Bandura, 1986). Its purpose was to examine whether incentives, defined as the product of outcome expectancy and outcome value, would help to predict the behavioral intentions of novice exercisers when coupled with SE expectations for a specific form of exercise. Fifty- three volunteers who were novices at weight training for exercise, participated in a 2-day learn-to-weight-train clinic offered at a university. They completed pre- and postclinic measures of SE for weight training, expectancy-value ratings of outcomes primary and secondary to 1 month's weight-training participation, and a strength- of-intention measure of multiple actions consequent to clinic participation. Results indicated that primary physical health outcomes expected of postclinic participation independently predicted the variability in pre- and postclinic future intentions beyond the variance predicted by SE. Further, incentives and SE clearly discriminated between individuals extreme in the strength of their intentions at pre- and postclinic. Discussion concerns the inclusion of measures of incentive in studies using self-efficacy theory in order to examine individuals who begin exercise and then move through various decision stages about exercise adoption and maintenance. Rather than merely assuming the influence of incentives necessary and sufficient to encourage a cognitive or behavioral impact of efficacy, arguments are made for actively examining incentive as manifested through outcome expectations.     

The role of affect in the decision to exercise: Does being happy lead to a more active lifestyle?

ObjectiveThis study investigated the influence of affect on individuals' intentions to engage in physical activities such as exercise. Behavior intentions were examined through the Theory of Planned Behavior (TPB).MethodAn experimental survey was conducted among 153 undergraduates randomly assigned to three conditions – positive affect, neutral, and negative affect. Key variables from the TPB were assessed across these conditions.ResultsAnalyses showed that participants in the positive affect and the negative affect conditions reported lower intentions to exercise than those in the neutral condition. Participants in the negative affect condition also reported more unfavorable attitudes toward exercise than their positive or neutral counterparts. Other TPB measures remained stable across the three conditions. In particular, perceived behavioral control and attitude were significant predictors of behavior intention in the pooled sample.ConclusionThese results underline the important role that affect, especially negative affect, plays in individuals' decision to exercise. Rational models for health behavior change, such as the TPB, should take into account the impact of affect.     

Abstractness and Messages Describing Consequences Promote Healthier Behavioral Intentions

Many health-risk behaviors present a self-control conflict in which the short-term outcomes of an action conflict with its long-term consequences. Across three studies, we find that an abstract construal level leads people to focus on long-term rather than short-term consequences when both are described in a message (vs. no message). Studies 1 and 2 explore this hypothesis through a risk behavior (snacking on sugary products), and Study 3 does the same through a health behavior (physical exercise). In Study 1, the Behavioral Identification Form scale is used to measure the construal level as a personal disposition; Studies 2 and 3 use a priming task designed by Freitas, Gollwitzer, and Trope to manipulate the construal level. All these studies show that, under an abstract mindset, people who have read a mixed-outcome message (vs. no message) tend to base their behavioral plans on long-term outcomes. Individually or in small groups (e.g. school class, therapy groups) health messages can be presented along with protocols to change construal level and thus, promote healthier intentions.     

Behavioral Intentions: Which Ones Predict Fertility Behavior in Married Couples?1

The published literature on the relationship between behavioral intentions and fertility behavior exhibits four major problems: inconsistent and confusing use of theoretical constructs, limited use of different types of intentions, use of nonbehavioral outcomes, and failure to explore adequately the couple aspects of the intentions/behavior relationship. The study reported here addresses these problems by using a theoretical framework that characterizes the psychological/behavioral sequence leading to a planned conception, three different types of fertility intentions, a behavioral outcome variable, and data from 196 married couples with no children and 185 married couples with one child. Data analysis results in a simultaneous equation, constrained regression model which indicates that child-timing intentions are the most important predictors of proceptive behavior over a 3-1/2 year period and that childbearing intentions are next in importance; that behavioral intentions are the final common pathway through which fertility motivations, attitudes, beliefs, and desires affect behavior; that the use of proceptive behavior as an outcome variable improves the explanatory power of our models; and that the interaction of couple intentions do not demonstrate greater husband or wife influence over couple proceptive behavior but do demonstrate that disagreement has a delaying effect on the onset of that behavior.     

Predicting Mothers' Intentions to Limit Frequency of Infants' Sugar Intake: Testing the Theory of Planned Behavior1

This study examines the ability of the Theory of Planned Behavior to account for mothers' intentions to limit the frequency of their infants' sugar consumption. One group of mothers (experimental) was exposed to a dental health education program designed to promote this behavior, the other (control) group was not. Each group of mothers was interviewed twice; the intervention was delivered to mothers in the experimental group immediately after their first interview. The interviews incorporated measures of the key constructs in the Theory of Planned Behavior (attitudes to behavior, subjective norms, perceived behavioral control, and behavioral intentions). Results indicated that the addition of perceived behavioral control resulted in small but significant increments in the amount of explained variance in intentions, thereby supporting the theory. Although the change in intentions to perform the advocated behavior was not significantly greater in the experimental group than in the control group, there was a significant change in attitudes to the behavior in the experimental group but no such change in the control group. Moreover, amount of change in behavioral intentions was significantly correlated with amount of change in attitudes, but not with amount of change in subjective norms or perceived behavioral control. Analysis of behavioral beliefs indicated that the attitude change reflected a change in a specific behavioral belief that was targeted in the intervention. Further analyses focused on the role played by direct experience of the behavior and show that such experience tended to enhance the role of perceived behavioral control in intention formation, apparently because mothers who have older children have discovered that they have relatively little control over frequency of child's sugar consumption. The implication of these results for the Theory of Planned Behavior are discussed.     

The relation between the sense of agency and the experience of flow

This article investigates the relation between people’s feelings of agency and their feelings of flow. In the dominant model describing how people are able to assess their own agency—the comparator model of agency—when the person’s intentions match perfectly to what happens, the discrepancy between intention and outcome is zero, and the person is thought to interpret this lack of discrepancy as being in control. The lack of perceived push back from the external world seems remarkably similar to the state that has been described as a state of flow. However, when we used a computer game paradigm to investigate the relation between people’s feelings of agency and their feelings of flow, we found a dissociation between these two states. Although these two states may, in some ways, seem to be similar, our data indicate that they are governed by different principles and phenomenology.     

Big Picture,Bad Outcomes: When Visual Perspectives Harm Health Goal Pursuit

People often fail to achieve health goals, which compromises their well‐being. Prior research suggests that seeing events through an observer's eyes (i.e., adopting a third‐person perspective) should facilitate goal pursuit. However, we find that third‐person perspectives discourage goal‐consistent intentions and behavior for health goals when goal centrality is low (i.e., the goal is peripheral to one's self‐concept). In Experiment 1, people who adopted a third‐person perspective chose more sugary foods if they considered a healthy eating goal to be more peripheral to the self. Experiment 2 examines why a third‐person perspective can hinder goal pursuit; it encourages a breakdown in implemental thinking which, in turn, increases negative self‐conscious emotions. While high goal centrality buffers people from negative effects on goal intentions, low centrality does not. Experiment 3 demonstrates that this effect is robust when goal centrality is manipulated. We recommend that consumers pursuing health goals (and individuals who support them) exercise caution when employing perspective‐based strategies, as they may backfire for people at greatest risk of goal abandonment.     

The impact of stigma on behavioral health care utilization among active duty service members

This study assessed the relationship between the stigma of seeking psychological help and use of outpatient behavioral health services over a 2-year period among active duty military service members initially referred for neuropsychological evaluation secondary to their histories of mild traumatic brain injury. Although research has examined how stigma predicts proxies for help-seeking (i.e., attitudes towards/intentions to use services), very little research has looked at actual behavior, and studies that do have largely focused on previous use. In this study, we examined the relationship between participants’ stigma and subsequent behavioral health use. Our results indicated that whereas greater self-stigma (i.e., negative self-judgments for seeking psychological help) was associated with attending fewer behavioral health care sessions, public stigma (i.e., perceptions of public attitudes towards people who seek psychological help) was not associated with service use. These findings support the need for addressing the self-stigma associated with seeking behavioral health care.     

Physical activity and body image: Intertwined health priorities identified by transmasculine young people in a non-metropolitan area

Abstract

Background: A dearth of research exists about the health behaviors of transgender young people (TYP). As we seek to learn more about transgender (trans) health, community-based participatory research (CBPR) approaches are crucial for incorporating TYP’s needs into the formulation of research questions and development of health behavior programing.

Aim: Explore body image and exercise as priorities among TYP.

Methods: Trans masculine young adults (N?=?16) in a small city in the Midwest took part in semi-structured interviews about their health behaviors and priorities. Theme analysis was used to capture key patterns in participants’ responses. Specific analysis steps included initial and more specific coding, analytical memos, organizational matrices and reports, and discussion about results with participants.

Results: Participants identified exercise and body image as connected primary health concerns. They discussed these issues in terms of three themes: Body shape as motivation for exercise; Poor body image, stigma and fear as exercise barriers, and; Exercise or lack of, as destructive. Participants wanted to exercise to achieve a certain body shape, not for health or as stress relief. They cited gyms as unwelcoming, however. They also worried about discrimination and did not feel sufficiently comfortable with their bodies to exercise. When they could not exercise, they used harmful behaviors, like restricted eating, to achieve a specific male shape.

Conclusions: Using participatory methods allowed us to understand the priorities of a group of Transmasculine young people. Our findings suggest that it is important to continue to explore TYP’s body-related motivations for exercise and understand the balance between exercise as a positive health behavior, and a potentially harmful one, in light of TYP’s complex body image concerns. Trans friendly gyms and gym policies could promote safe exercise and continued anti trans discrimination work and policy advocacy can promote the safety of TYP in all spaces.     

Predicting Exercise and Health Behavioral Intentions: Attitudes,Subjective Norms,and Other Behavioral Determinants1

By comparing exercise and health domains, the current experiment extends recent findings that within‐participant analyses of attitudes and subjective norms predict behavioral intentions well (Finlay, Trafimow, & Moroi, 1999). Within‐participant analyses show that health behaviors are particularly likely to be influenced by subjective norms, and those that are relatively normatively influenced are intended to be performed more than those that are not. However, neither was true of exercise behaviors. Additionally, other potential predictors for exercise (e.g., indirect attitudinal measures and goal‐oriented attitudes and intentions) correlated more strongly with exercise behavioral intentions than did general health attitudes and intentions.