Structure and content of affective associations with health behaviours: Is the behaviour ‘good OR bad’ or ‘good AND bad’

Objective: The feelings and emotions individuals associate with health-related behaviours influence engagement in those behaviours. However, the structure and the content of these affective associations have not been examined. The studies reported here examined competing hypotheses about the structure (unidimensional or bidimensional) and content (generalised affect or specific emotions) of affective associations with two health-related behaviours: physical activity and fruit/vegetable consumption.

Design: For each behaviour, participants (fruit and vegetable consumption n = 149; physical activity n = 199) completed an assessment of the association of 40 positive and 51 negative affect concepts with the behaviour.

Main outcome measures: Ratings of affective associations with each behaviour.

Results: Confirmatory factor analyses comparing unidimensional and bidimensional affect structure models showed that the structure of individuals’ affective associations was bidimensional for both behaviours – positive and negative affective associations were shown to be separate and distinct constructs. Exploratory factor analyses supported a model of affective associations as generalised affect for both behaviours.

Conclusion: Affective associations with both physical activity and with fruit/vegetable consumption consist of separate positive and negative dimensions of generalised affect. These findings lead to recommendations for research and intervention development based on the implications for how affective associations might operate to influence behavioural decision-making.     

What do people think about changes in health behaviors? Differential perceptions of consequences of increases and decreases in health behaviors

Most health decision-making models posit that cost-benefit analyses underlie decisions to make changes in health-related behavioral practices. In a series of studies, participants imagined either increasing or decreasing the frequency of a variety of health behaviors and estimated the consequences of those changes. In Studies 1 and 2, individuals consistently estimated that increasing a health behavior produced greater consequences than did decreasing the behavior by an equivalent amount. The results of Study 3 demonstrated that this effect is due to differences in how individuals judge the impact of health behavior changes which involve not engaging in the behavior at all versus other types of changes. Taken together, these findings suggest that perceptions of the outcomes afforded by health behavior changes depend on both the behavioral frequency and direction of changes in behavior an individual is considering. This asymmetry has the potential to help explain patterns of behavior in a range of important health domains and may impact the effectiveness of behavior change interventions.     

Differences in eye-movement patterns between anorexic and control observers when judging body size and attractiveness

Attentional biases may influence the eye-movements made when judging bodies and so alter the visual information sampled when making a judgment. This may lead to an overestimation of body size. We measured the eye-movements made by 16 anorexic observers and 16 age-matched controls when judging body size and attractiveness. We combined behavioural data with a novel eye-movement analysis technique that allowed us to apply spatial statistical techniques to make fine spatial discriminations in the pattern of eye-movements between our observer groups. Our behavioural results show that anorexic observers overestimate body size relative to controls and find bodies with lower body mass indexes more attractive. For both judgments, the controls' fixations centre on the stomach, but the anorexic observers show a much wider fixation pattern extending to encompass additional features such as the prominence of the hip and collar bones. This additional visual information may serve to alter their behavioural judgments towards an overestimation of body size and shift their ideal body size towards a significantly lower value.     

The interplay between feelings and beliefs about condoms as predictors of their use

Objective: Negative feelings about condoms are a key barrier to their use. Using the behavioural affective associations model, we examined the joint effects of affective associations and cognitive beliefs about condoms on condom use.

Design: In Study 1 (N = 97), students completed measures of their affective associations and cognitive beliefs about sex and condoms, sexual activity and condom use. In Study 2 (N = 171), a measure of behavioural intentions and condom selection task were added.

Main outcome measures: Condom use measured in Study 1 as (1) current condom use, and (2) willingness to use condoms; in Study 2 as: (1) behavioural intentions, (2) number of condoms selected.

Results: Affective associations with sex and condoms were behaviour-specific, were directly associated with the respective behaviour, and mediated the relations of cognitive beliefs to behaviour, ps < .05. In Study 2, affective associations were associated with behavioural intentions and the number of condoms selected, ps < .05; cognitive beliefs were indirectly associated with these outcomes through affective associations, indirect effects: ps < .05.

Conclusions: Affective associations are a behaviour-specific and proximal predictor of condom use, mediating the effect of cognitive beliefs, suggesting they may be a particularly viable intervention target.     

Issues in Professional Training to Implement Evidence‐based Parenting Programs: The Preferences of Indigenous Practitioners

Indigenous children have elevated risk for poor health, behavioural, emotional, and social outcomes. Significant evidence exists that parenting programs can reduce family risk factors and improve outcomes for children and families; however, mainstream programs have had slower uptake in Indigenous communities than other communities. Culturally sensitive delivery of evidence‐based programs can enhance engagement of parents, yet the development of a workforce to deliver programs to Indigenous parents faces many obstacles. This project seeks to identify professional training processes that enhance Indigenous practitioners’ skills and confidence in delivering an evidence‐based parenting program. A survey of trained parenting practitioners via an online practitioner network assessed their views of the training and post‐training support processes they had experienced. Respondents were 57 Indigenous and 720 non‐Indigenous practitioners from 15 countries. Most training processes were rated equally helpful by Indigenous and non‐Indigenous practitioners. However, several training processes were identified as important for the delivery of culturally competent training, such as tailoring the pace of training and simplifying the language in teaching resources. Practitioners with higher ratings of the helpfulness of peer support following training reported higher program uptake and implementation. Qualitative themes also focused on the helpfulness of program resources, and having a peer support network and mentoring. Increasing access to appropriate, flexibly delivered training and post‐training support for Indigenous professionals will support the development of a skilled workforce with local knowledge and connections, and further increase the reach of evidence‐based services in Indigenous communities.     

Mediation,moderation, and context: Understanding complex relations among cognition,affect, and health behaviour

Objective: Researchers have historically treated cognition and affect as separate constructs in motivating health behaviour. We present a framework and empirical evidence for complex relations between cognition and affect in predicting health behaviour.

Main Outcome, Design and Results: First, affect and cognition can mediate each other’s relation to health behaviour. Second, affect and cognition can moderate the other’s impact. Third, context can change the interplay of affect and cognition. Fourth, affect and cognition may be indelibly fused in some psychological constructs (e.g. worry, anticipated regret and reactance). These four propositions in our framework are not mutually exclusive.

Conclusion: Examination of the types of complex relations described here can benefit theory development, empirical testing of theories and intervention design. Doing so will advance the understanding of mechanisms involved in regulation of health behaviours and the effectiveness of interventions to change health behaviours.     

Does How I Feel About It Matter? The Role of Affect in Cognitive and Behavioral Reactions to an Illness Diagnosis

Individuals often have low rates of compliance with treatment recommendations. We examined the role that experienced affect at the time of illness diagnosis might play in influencing thoughts and feelings relating treatment compliance. Participants were randomly assigned to receive a positive, neutral, or negative affect induction after imagining they were diagnosed with kidney cancer. They then reported on thoughts and feelings about the illness and the treatment regimen. Participants also reported interest in additional information about the illness and behavioral intentions for complying with the treatment regimen. Affect significantly influenced interest in information and behavioral intentions. Both effects were mediated by the influence of affect on participants' self-efficacy beliefs. These mediational findings support a mood-as-resource interpretation of the role of affect in treatment compliance.     

How do I feel about the behavior? The interplay of affective associations with behaviors and cognitive beliefs as influences on physical activity behavior.

Individuals have affective associations with health behaviors. In other domains such associations have been shown to influence behavior, but affective associations with health behaviors are not included in current health decision-making models. The authors examined whether affective associations with exercise predicted individuals' activity behavior and, if so, how they interfaced with other decision-making constructs to influence behavior. Adult participants (N = 433) reported their current physical activity behavior and affective associations with physical activity. Health belief model and theory of planned behavior constructs were also assessed. More positive affective associations with activity significantly predicted greater activity behavior. Moreover, the influence of the health belief model and theory of planned behavior constructs on activity behavior was mediated through affective associations. Affective associations were shown to play a central role in individuals' activity behavior, both as a mediator of the effects of cognitively based decision-making factors and as an independent predictor of activity behavior. The results suggest the need to include affective influences on behavior in formal models of health decision making and, potentially, to explore affectively based intervention routes to change behaviors.