Self-efficacy and reasoned action: Predicting oral health status and behaviour at one,three, and six month intervals

Abstract

This study tested the usefulness of the theory of reasoned action and the addition of self-efficacy to this model for the prediction of oral health behaviour as part of a larger intervention at the State University of New York at Buffalo School of Dental Medicine. Self-efficacy is a belief in one's ability to perform a particular behavior. The theory of reasoned action is an attitudinal model focused on predicting behavior. One hundred and sixty-six patients volunteered for an intervention and assessment program at the Oral Health Enhancement Clinic. Participants visited the clinic 7 times over a 14 month period. Relationships among social cognitive model variables and clinical and self-report outcome measures were examined at three different time points over increasingly longer time spans. Results indicated that the theory of reasoned action model was useful in predicting oral health behavior, and adding self-efficacy to the model significantly increased the reliability of predictions of outcome measures. Relationships for social cognitive variables were stronger for self-report than for clinical indices. Reasons for these differences are suggested.     

Gender differences in social cognitive determinants of exercise adoption

Gender differences in lifestyle-related mortality and morbidity suggest a need to investigate gender-specificity of health behaviour change process and factors influencing it. We tested whether changes in self-efficacy beliefs and planning, as well as the level of social support predict change in exercise. Finnish men and women, aged 50–65 years, at an increased risk for type 2 diabetes were recruited from health care centres to participate in the Good Ageing in Lahti Region (GOAL) Lifestyle Implementation Trial. Psychosocial factors were measured with questionnaires and exercise with 7-day physical activity diaries at baseline and at 3 months. At baseline, no gender differences were found in self-efficacy and planning, but men reported receiving more social support than women. At 3 months, women reported having formed more action plans for changing their exercise routines than men. Among women, increase in self-efficacy and planning predicted increase in exercise. Among men, changes in planning played a less significant role. The more salient role of planning for women than for men, and the fact that women receive less social support, may reflect life circumstances allowing less spontaneous lifestyle decisions and a lower acceptance of lifestyle changes by their social environment.     

Selective review,optimism and HIV risk perception

Abstract

Research suggests that review of risk factors increases optimism about health. The present experimental study explored the effects of reviewing risk increasing and risk decreasing factors on HIV risk perception (own risk, others' risk, optimism), self efficacy and behavioural intentions. 164 heterosexual subjects completed a questionnaire concerning their beliefs about HTV and their sexual behaviour. Subjects were allocated to either the risk increasing condition (eg. since being sexually active how often have you asked your partners HIV status?), the risk decreasing condition (eg. since being sexually active how often have you tried to select your sexual partners carefully?), or a control group. The results suggest that review of risk decreasing factors increased optimism and that this change in optimism was related to an increase in perceived others' risk. The results are discussed in terms of theories of selective focus and egocentricism in risk perception and the implications for health promotion.     

Social cognition models and health behaviour: A structured review

Abstract

A number of social cognition models have been developed to account for socio-demographic variations in health behaviour. This paper distinguishes between: (a) motivational, (b) behavioural enaction, and (c) multi-stage models of health behaviour. The models are evaluated in terms of advancement of existing knowledge and - where appropriate - predictive utility. Common themes that appear within- and between- these categories are discussed, with consideration of ways in which theory may be advanced by future research. Each approach has associated strengths and weaknesses, suggesting that a “consensus” approach to the study of health behaviour may prove fruitful. Identification of the key constructs across different model types would allow coherent integration and promote further understanding of the psycho-social determinants of health behaviour.     

Mediation analysis of decisional balance,sun avoidance and sunscreen use in the precontemplation and preparation stages for sun protection

Objective: Mediation analyses of sun protection were conducted testing structural equation models using longitudinal data with three waves. An effect was said to be mediated if the standardised path between processes of change, decisional balance and sun protection outcomes was significant.

Design: Longitudinal models of sun protection using data from individuals in the precontemplation (N = 964) and preparation (N = 463) stages who participated of an expert system intervention.

Main outcome measures: Nine processes of change for sun protection, decisional balance constructs of sun protection (pros and cons), sun avoidance behaviour and sunscreen use.

Results: With the exception of two processes in the preparation stage, processes of change predicted the pros (r = .126–.614), and the pros predicted the outcomes (r = .181–.272). Three models with the cons as mediator in the preparation stage, and none in the precontemplation stage, showed a mediated relationship between processes and outcomes.

Conclusion: In general, mediation analyses found both the process of change-to-pros and pros-to-behaviour paths significant for both precontemplation and preparation stages, and for both sun avoidance and sunscreen use outcomes. Findings provide support for the importance of assessing the role of underlying risk cognitions in improving sun protection adherence.     

Stability and changes in health behaviours in young adults over a one year period

Abstract

Data concerning 19 health-related behaviours and associated beliefs were collected by questionnaire from 282 students in the Netherlands on two occasions over one year. While all behaviours showed moderate stability, there were variations in the degree of change. The highest stability was reported for sleep time, tooth brushing frequency, seat belt usage and health care service utilization. The least stable behaviours included regular exercise and various dietary measures. Predictors of changes in smoking, dietary fat intake, alcohol consumption and regular exercise were analysed in detail. Beliefs assessed at year 1 in the importance of these activities for health predicted changes in behaviour over the study year independently of prior behaviour levels. Awareness of the risks associated with behaviours, and explicit wishes to modify behaviour patterns (eg stop smoking, exercise more), did not predict change from year 1 to year 2. The results indicated that health behaviours vary in their stability, and that health beliefs may predict future health behaviour changes.     

Health enhancing physical activity as perceived in interviews based on the theory of planned behaviour

Abstract

The perception of behaviours from two categories of health enhancing physical activity (HEPA): outdoor aerobic exercise (OAE) and everyday commuting activity (ECA) was examined in a sample of middle-aged persons (N= 50). A focused semi-standardised interview was constructed on the bases of the components of the Theory of Planned Behaviour (TPB). The participants perceived OAE behaviours predominantly from the viewpoint of exercise and those of the ECA from that of the fluency of daily routines. They considered the OAE as sensible and associated it with positive health or fitness outcomes, but only those practising it also attributed positive psychological effects to OAE behaviours. A slightly better congruence with the TPB was found for the OAE behaviours than for those of the ECA. The difference is discussed in the light of the higher degree of decisional control with the OAE behaviours and the greater psychological heterogeneity of the ECA.     

Predictors of physical activity,healthy eating and being smoke-free in teens: A theory of planned behaviour approach

This paper elicited context specific underlying beliefs for physical activity, fruit and vegetable consumption and smoke-free behaviour from the Theory of Planned Behaviour (TPB), and then determined whether the TPB explained significant variation in intentions and behaviour over a 1 month period in a sample of grade 7–9 (age 12–16 years) adolescents. Eighteen individual interviews and one focus group were used to elicit student beliefs. Analyses of this data produced behavioural, normative and control beliefs which were put into a TPB questionnaire completed by 183 students at time 1 and time 2. The Path analyses from the main study showed that the attitude/intention relationship was moderately large for fruit and vegetable consumption and small to moderate for being smoke free. Perceived behavioural control had a large effect on being smoke free and a moderately large effect for fruit and vegetable consumption and physical activity. Intention had a large direct effect on all three behaviours. Common (e.g. feel better, more energy) and behaviour-specific (e.g., prevent yellow fingers, control my weight) beliefs emerged across the three health behaviours. These novel findings, to the adolescent population, support the importance of specific attention being given to each of the behaviours in future multi-behavioural interventions.     

Antecedents of children's physical activity intentions and behaviour: Predictive validity and longitudinal effects

Abstract

This study examined the predictive validity and time-lagged relationships in a model of children's physical activity intentions, attitudes, perceived behavioural control (PBC), behaviour and past behaviour using the Theory of Planned Behaviour (TPB; Ajzen, 1985) as a framework. In Study 1, 386 children aged 12–14 years completed measures of intentions, attitudes, subjective norm, PBC and past behaviour. Their physical activity behaviour was assessed one week later. Structural equation analyses supported the construct and predictive validity of the TPB with the exception of subjective norms which did not predict intentions. In Study 2,70 children completed measures of their physical activity attitudes, intentions, PBC and past behaviour. Attitudes, intentions, PBC and recent behaviour were re-assessed five weeks later. The cognitions demonstrated a moderate degree of stability over time and there were some cross-lagged effects between attitudes and PBC. Past behaviour demonstrated additive rather than attenuating effects. These results support the use of the TPB cognitions and past behaviour as a framework to examine children's physical activity behaviour.     

From health beliefs to self-regulation: Theoretical advances in the psychology of action control

Abstract

The paper reviews the theoretical concepts included in a range of social cognitive models which have identified psychological antecedents of individual motivation and behaviour. Areas of correspondence are noted and core constructs (derived primarily from the theory of planned behaviour and social cognitive theory) are identified. The role of intention formation, self-efficacy beliefs, attitudes, normative beliefs and self-representations are highlighted and it is argued that these constructs provide a useful framework for modelling the psychological prerequisites of health behaviour. Acknowledging that intentions do not translate into action automatically, recent advances in our understanding of the ways in which prior planning and rehearsal can enhance individual control of action and facilitate the routinisation of behaviour are considered. The importance of engaging in preparatory behaviours for the achievement of many health goals is discussed and the processes by which goals are prioritised, including their links to self-representations, are explored. The implications of social cognitive and self-regulatory theories for the cognitive assessment of individual readiness for action and for intervention design in health-related settings are highlighted.