Deciding to exercise: The role of anticipated regret

Objectives: Two studies tested (a) whether anticipated regret (AR) qualifies as an additional predictor of intentions to engage in a health‐enhancing behaviour (exercise) after variables from the Theory of Planned Behaviour (TPB) and past behaviour have been controlled, and (b) whether a manipulation that induces participants to focus on AR causes stronger intentions to exercise. Design: Study 1 employed a cross‐sectional questionnaire design; Study 2 employed a between‐participants experimental design (AR focus vs. no AR focus). Method: Participants (N = 385) completed standard, multi‐item, reliable measures of TPB constructs and AR and also reported their past behaviour (Study 1). Participants in Study 2 (N = 70) completed measures of AR and intention; salience of AR was manipulated by means of item order. Results: Study 1 showed that even though TPB variables and past behaviour were reliable predictors of intention, and explained 51% of the variance, AR contributed a substantial increment in the variance (5%) even after these predictors had been taken into account. Study 2 showed that participants who were induced to focus on AR prior to intention formation had significantly stronger intentions to exercise compared to controls. Conclusion: The findings indicate that AR predicts a health‐enhancing behaviour (as well as the health‐risk behaviours examined in previous research) and that effects of AR are independent of TPB variables and past behaviour. The findings also indicate that a simple and inexpensive manipulation of the salience of AR can be used to promote exercise intentions.     

Genetic screening for Alzheimer's disease: what factors predict intentions to take a test?

The authors investigated factors that predict intention to take a genetic test for Alzheimer's disease (AD). The 449 men and women were surveyed in two groups: (a) those told that a positive result meant a 90% chance of developing AD (increased certainty) and (b) those told that a positive result meant a 50% chance of developing AD (decreased certainty). Participants completed measures of the Theory of Planned Behavior (TPB), anticipated regret, risk perception, likelihood of taking a genetic test for cancer, and AD risk factors. Just over 50% of the variance in intentions was related to TPB variables, likelihood of taking a genetic test for cancer, number of people the participants knew who had AD, experimental condition, and anticipated regret. The subjective norm was the strongest predictor of intention in the increased certainty group, whereas positive belief was the strongest predictor in the decreased certainty group.     

Using past behaviour and spontaneous implementation intentions to enhance the utility of the theory of planned behaviour in predicting exercise

Objectives. This study examined the utility of the theory of planned behaviour (TPB), past behaviour, and spontaneous implementation intentions in predicting exercise behaviour. The psychological correlates of spontaneous implementation intentions and the moderating effects of intention, perceived behavioural control, past behaviour, and implementation intentions at various time points were also examined. Design. Data collection occurred over three phases with a 2‐ and 3‐week interval. The attrition rate was 35.97% leaving a total of 162 participants (63 males, 99 females). In the first wave, participants completed measures of TPB, spontaneous implementation intentions, and past behaviour. Behaviour was assessed in the second and third waves, and a follow‐up measure of spontaneous implementation intentions was completed in Phase 3. Results. Several regression analyses were conducted. Attitude towards exercise and perceived behavioural control made a significant contribution to the prediction of intention. Intention made a significant contribution to the prediction of implementation intentions. Spontaneous implementation intentions reduced the effect of intention and past behaviour for behaviour at 2 weeks and when indexed over a 5‐week period. When behaviour was measured for a 3‐week period (following an initial 2‐week period), the variance that intention and past behaviour accounted for in exercise behaviour decreased, and spontaneous implementation intentions were no longer a significant predictor of behaviour. Spontaneous implementation intentions were found to interact with past behaviour, such that implementation intentions predicted exercise behaviour only among participants who did not exercise frequently in the past. Conclusions. Implications and future research directions are discussed.     

Quitting Smoking: Applying an Extended Version of the Theory of PlannedBehavior to Predict Intention and Behavior1

This study examined the ability of the theory of planned behavior (TPB)to predict students' intentions to quit smoking and the subsequent behavior6 months later. In addition, the impact of past behavior, moral norms, self‐identity, group identity, and positive/negative anticipated affect was examined. The intention‐behavior relationship was examined by dividing the sample in four subgroups: inclined actors/abstainers and disinclined actors/abstainers. Analyses were based on data from a prospective sample of 698 smokers. Attitude, subjective norms, and perceived behavioral control accounted for 36% (adjusted R²) of the variance in intentions. Moral norms, positive anticipated affect, group identity, and past behavior added 9% (adjusted R²) to the explained variance in intention, beyond the effect accounted for by the TPB components. Subsequent behavior was predicted by intentions (adjusted R²= .12). Past behavior, moral norms, self‐identity, and the Past Behavior x Intention and Moral Norm x Negative Affect interactions explained an additional 9% (adjusted R²) of the variance in behavior. Inclined abstainers constituted the main source of the discrepancy between intention and behavior.     

Sleep hygiene behaviours in Iranian adolescents: an application of the Theory of Planned Behavior

Poor sleep quality and inadequate sleep in adolescents are a rising trend globally. The Theory of Planned Behaviour (TPB)—which centres on an individual's attitude toward performing the behaviour, subjective norms and perceived behavioural control—has been applied to examine sleep hygiene behaviours in young adults. We expanded on prior works by using a longitudinal design to examine the effects of TPB factors, together with sleep hygiene knowledge and planning constructs, on sleep hygiene behaviours and on sleep quality and health in a group of Iranian adolescents. A total of 1822 healthy adolescents (mean age = 13.97) from 25 high schools in Qazvin, Iran, completed a self‐reported survey at baseline and 6 months later. Structural equation modelling (SEM) was used to delineate the pathway from adolescents’ sleep hygiene knowledge, TPB constructs of their behavioural intentions and sleep hygiene behaviours and their sleep quality and self‐reported health. The SEM model demonstrated that although behavioural intention, coping planning and action planning predicted the sleep hygiene behaviours positively 6 months later with acceptable model fit [comparative fit index (CFI) = 0.936; Tucker–Lewis index (TLI) = 0.902; root mean square error of approximation (RMSEA) = 0.080; standardized root mean square residual (SRMR) = 0.044], sleep hygiene knowledge did not predict behavioural intentions significantly. Sleep hygiene behaviours were associated with sleep quality and psychiatric wellbeing. Thus, the TPB, combined with coping and action planning, is useful in understanding the sleep hygiene behaviours of adolescents. Health‐care providers may want to emphasize TPB constructs and coping and action planning to improve adolescents’ sleep hygiene behaviours, rather than rely solely upon increasing adolescents’ sleep hygiene knowledge.     

Predicting and explaining transtheoretical model stage transitions in relation to condom‐carrying behaviour

Objectives The stages of change component of the transtheoretical model have been applied to safe sex behaviours in cross‐sectional analyses, but have not yet been subject to prospective analysis. It was predicted that: (a) cross‐sectional analyses would demonstrate good discrimination between the stages of change; (b) prospective analyses would allow for the identification of predictors of stage transitions; and (c) implementation intentions would explain progression from the preparation stage. Design This study employed an experimental longitudinal design. Participants were randomly assigned to the experimental (implementation intention) or control conditions and completed questionnaires at baseline and at 2‐month follow‐up. Methods Five hundred and twenty‐five adolescents who were broadly representative of the UK population completed questionnaires at baseline and follow‐up (N=393) measuring: demographic variables; stage of change; theory of planned behaviour constructs; anticipated regret; and moral norm in relation to condom‐carrying behaviour. The experimental condition completed a self‐generated implementation intention to carry condoms at the end of the baseline questionnaire. Results Discriminant function analyses indicated that the stages of change could be accurately discriminated from one another cross‐sectionally and that, longitudinally, the measured variables were able to predict transitions between most stages. Implementation intentions caused people to progress from the preparation stage. Conclusions Transitions between most stages were reliably predicted, thereby providing potential targets for intervention. The brief implementation intention intervention was effective and could easily be utilized and expanded to encompass a broader range of sexual health behaviours.     

The who,what, and why of research participants’ intentions to request a broad range of secondary findings in a diagnostic genomic sequencing study

PurposeIn a diagnostic exome sequencing study (the North Carolina Clinical Genomic Evaluation by Next-Generation Exome Sequencing project, NCGENES), we investigated adult patients’ intentions to request six categories of secondary findings (SFs) with low or no medical actionability and correlates of their intentions.MethodsAt enrollment, eligible participants (n = 152) completed measures assessing their sociodemographic, clinical, and literacy-related characteristics. Prior to and during an in-person diagnostic result disclosure visit, they received education about categories of SFs they could request. Immediately after receiving education at the visit, participants completed measures of intention to learn SFs, interest in each category, and anticipated regret for learning and not learning each category.ResultsSeventy-eight percent of participants intended to learn at least some SFs. Logistic regressions examined their intention to learn any or all of these findings (versus none) and interest in each of the six individual categories (yes/no). Results revealed little association between intentions and sociodemographic, clinical, or literacy-related factors. Across outcomes, participants who anticipated regret for learning SFs reported weaker intention to learn them (odds ratios (ORs) from 0.47 to 0.71), and participants who anticipated regret for not learning these findings reported stronger intention to learn them (OR 1.61–2.22).ConclusionIntentions to request SFs with low or no medical actionability may be strongly influenced by participants’ desire to avoid regret.     

Autonomy and control: augmenting the validity of the theory of planned behaviour in predicting exercise

This study examined the utility of the theory of planned behaviour (TPB) along with additional constructs in predicting exercise, and explored the motivational antecedents of exercise intentions. Participants included 162 Canadian University College students (61% females). Measures of TPB, autonomous and controlling intention, perceived autonomy support and core autonomous intention were completed during phase 1 of data collection. Two and three weeks later behaviour was assessed. Hierarchical regression analyses revealed that: (a) attitude and perceived behavioural control significantly predicted TPB intention and core autonomous intention; (b) subjective norm predicted controlling intention; and (c) perceived autonomy support predicted autonomous and core autonomous intention. TPB intention significantly predicted behaviour. TPB is a fairly useful model for predicting behaviour and important information can be gained when other measures of intention are explored.     

Integrating the theory of planned behaviour and self‐determination theory in health behaviour: A meta‐analysis

Purpose A meta‐analysis of studies integrating the theory of planned behaviour (TPB) and self‐determination theory (SDT) in health contexts is presented. The analysis aimed to provide cumulative empirical support for a motivational sequence in which self‐determined motivation from SDT predicts the proximal predictors of intentions and behaviour from the TPB. Methods A literature search identified 36 integrated studies providing 45 tests of effects between TPB and SDT variables. Hunter and Schmidt's (1994) methods of meta‐analysis were used to correct the effect sizes across the studies for statistical artifacts. Age (old versus young), publication status (published versus unpublished), study design (correlational versus experimental/intervention), and behaviour type (physical activity versus other health‐related behaviours) were evaluated as moderators of the effects. A path‐analysis using the meta‐analytically derived correlations was conducted to examine the proposed motivational sequence. Results Statistically significant corrected correlations were evident among the perceived autonomy support and self‐determined motivation constructs from SDT and the attitude, subjective norms, perceived behavioural control, intention, and health‐related behaviour constructs from the TPB. Only six of the 28 effect sizes were moderated by the proposed moderators. Path analysis revealed that the significant effects of self‐determined motivation on intentions and behaviour were partially mediated by the proximal predictors from the TPB. Conclusions Evidence from this synthesis supported the theoretical integration and proposed motivational sequence. Results are discussed with reference to the complementary aspects of the TPB and SDT and the need for integrated experimental or intervention studies on a broader range of health behaviours.     

Predicting breakfast consumption: An application of the theory of planned behaviour and the investigation of past behaviour and executive function

Objectives . The objective of the current study is to examine the determinants of breakfast consumption with the application of the Theory of Planned Behaviour (TPB; 1991) and investigate the additional variables of past behaviour and executive function. Design . A prospective 1‐week study investigating the predictive ability of TPB variables, past behaviour and executive function was utilized. Methods . Ninety‐six participants were administered two measures of executive function (response inhibition and planning) and completed self‐report questionnaires regarding their attitudes, subjective norms, perceived control, intentions and past behaviour of breakfast consumption. One week later, participants returned a follow‐up questionnaire on their behaviour. Results . The result of the study showed that the TPB significantly predicted intentions and prospective behaviour of breakfast consumption, however, past behaviour was found to be the strongest predictor of future behaviour. Considering executive function, response inhibition was not found to predict behaviour, however, planning ability explained unique variance in behaviour and moderated the association between intention and behaviour. Conclusions . The findings support the use of the TPB in explaining breakfast eating habits, and suggest that executive function of planning may be somewhat useful to predict this behaviour. The significance of past behaviour also suggests that breakfast consumption may commonly be a stable, habitual behaviour that may undermine the need for self‐regulation. Implications for creating behavioural‐change interventions are discussed.     

Habit, identity, and repetitive action: a prospective study of binge-drinking in UK students

Objectives. Repeated action can lead to the formation of habits and identification as ‘the kind of person’ that performs the behaviour. This has led to the suggestion that identity‐relevance is a facet of habit. This study explores conceptual overlap between habit and identity, and examines where the two constructs fit into an extended Theory of Planned Behaviour (TPB) model of binge‐drinking among university students. Design. Prospective, questionnaire‐based correlational design. Methods. A total of 167 UK university students completed baseline measures of past behaviour, self‐identity, the Self‐Report Habit Index (SRHI), and TPB constructs. One week later, 128 participants completed a follow‐up behaviour measure. Results. Factor analyses of the SRHI and four identity items revealed two correlated but distinct factors, relating to habit and identity, respectively. Hierarchical regression analyses of intention and behaviour showed that identity contributed over and above TPB constructs to the prediction of intention, whereas habit predicted behaviour directly, and interacted with intentions in predicting behaviour. Habits unexpectedly strengthened the intention–behaviour relation, such that strong intenders were more likely to binge‐drink where they also had strong habits. Conclusions. Identity and habit are conceptually discrete and impact differently on binge‐drinking. Findings have implications for habit theory and measurement. Recommendations for student alcohol consumption reduction initiatives are offered.     

The theory of planned behaviour and binge drinking: Assessing the moderating role of past behaviour within the theory of planned behaviour

A sample of 398 undergraduate students completed questionnaires assessing the main constructs of the theory of planned behaviour (TPB) in relation to binge drinking, as well as past binge drinking behaviour. Of these, 273 were followed up at 1 week. Regression analyses revealed attitude, self‐efficacy, and perceived control (negative relationship) to be predictive of binge drinking intentions. Intention and self‐efficacy were, in turn, predictive of binge drinking at 1‐week follow‐up. Past behaviour was found to explain additional variance in intention and behaviour. In addition, past behaviour was found to moderate the attitude–intention and intention–behaviour relationships, such that weaker relationships were observed with increasing frequency of past behaviour. The results are discussed in relation to the need to develop and test alternative measures of habit. The implications of the findings for interventions to encourage more appropriate drinking behaviour are outlined.     

Using an extended theory of planned behaviour to inform interventions aimed at increasing breastfeeding uptake in primiparas experiencing material deprivation

Objectives The theory of planned behaviour (TPB) was employed to investigate infant feeding intentions and subsequent behaviour in women from selected areas of economic hardship in the UK. Underlying beliefs were examined in order to inform future interventions aimed at increasing breastfeeding uptake among women living in such areas, which is associated with low rates of breastfeeding. Design Midwives recruited women from areas meeting study criteria. TPB measures were obtained from 303 primiparas via postal questionnaires completed during pregnancy, and feeding method was subsequently obtained from 286 of these women. Results A model containing age, education, deprivation, attitude, subjective norm (SN), and perceived behavioural control (PBC) predicted intention to breastfeed (R²=.44) and intention to formula feed (R²=.45). A model controlling for age, education and deprivation predicted ever having breastfed (86.1% correctly classified) and ever having formula fed (77.1% correctly classified). MANCOVAs differentiated those who intended to breastfeed and subsequently did (inclined actors), those who intended to breastfeed but did not (inclined abstainers), and those who did not intend to breastfeed and did not (disinclined abstainers). Differentiating outcome beliefs, normative beliefs, and control beliefs are presented. Conclusions The TPB provided a useful framework with which to examine the factors underlying breastfeeding intentions and behaviour amongst primiparas. A grouping system based on the congruence between intentions and subsequent behaviour revealed important differences between beliefs of the three groups. Further research might usefully test the effectiveness of interventions targeting the beliefs identified here in increasing breastfeeding uptake and duration.     

The theory of planned behaviour predicts self‐reports of walking,but does not predict step count

Objectives. This paper compares multiple measures of walking in two studies, and the second study compares how well Theory of Planned Behaviour (TPB) constructs perform in predicting these different measures. Methods. In Study 1, 41 participants wore a New Lifestyles NL‐2000 pedometer for 1 week. Subsequently, participants completed a questionnaire containing measures of the TPB constructs and two self‐report measures of walking, followed by two interview measures of walking. For Study 2, 200 RAF trainee aircraftsmen wore pedometers for 2 weeks. At the end of each week, participants completed the questionnaire and interview measures of walking. Results. Both studies found no significant association between questionnaire measures of walking and pedometer measures. In Study 1, the interview measures produced significant, large correlations with the pedometer measure, but these relationships were markedly weaker in the second study. TPB variables were found to explain 22% of variance in intention to walk in Study 1 and 45% of the variance in Study 2. In Study 2, prediction of subsequent measures of behaviour was found to be weak, except when using a single‐item measure of walking. Conclusions. Recall of walking is poor, and accurate measurement by self‐report is problematic. Although the TPB predicts intentions to walk well, it does not predict actual amount of walking, as assessed by pedometer. Possible reasons for these findings include the unique nature of walking as an activity primarily used to facilitate higher order goals. The use of single‐item measures may exaggerate the effectiveness of the TPB model for walking, and possibly other forms of physical activity.     

Randomized controlled trial of a brief research‐based intervention promoting fruit and vegetable consumption

Objective. The present study sought to test the efficacy of a brief research‐based, leaflet‐like intervention to promote eating the recommended daily intake of fruit and vegetables (RDIFV). Design. A controlled, pre‐ post‐test experimental study with random allocation and a 1 week self‐report behavioural follow‐up was conducted. Method. The intervention employed persuasive communication targeting self‐efficacy and intention, and invited participants to form implementation intentions in relation to acquiring and preparing fruit and vegetables for consumption. Results. Intervention participants had stronger post‐intervention intentions to consume the RDIFV, and higher anticipated regret in relation to failing to do so, compared with controls, controlling for pre‐intervention scores. At follow‐up, the intervention group was found to have eaten more fruit and vegetables and to have consumed the RDIFV more frequently. Discussion. It is concluded that this study supports the previously reported power of implementation intentions to prompt enactment of intentions, and that a brief research‐based leaflet‐like intervention could result in immediate enhancement of intentions and anticipated regret, and promote greater fruit and vegetable consumption.     

A Longitudinal Test of the Theory of Planned Behavior Predicting Smoking Onset among Asthmatic and Non-asthmatic Adolescents

Despite the particularly detrimental health risks of smoking for adolescent with asthma, several studies demonstrated higher smoking rates among asthmatic adolescents than among healthy adolescents. To gain insight into underlying mechanisms, longitudinal studies on differences in smoking predictors between asthmatic and non-asthmatic adolescents are essential. This longitudinal study with two waves with an 18 months interval tests the Theory of Planned Behavior (TPB) among 346 asthmatic adolescents and 3,733 non-asthmatic adolescents aged 12-16 years. Structural equation models were used to test the predictive value of the TPB in these two groups. The results show, consistent with the TPB, that smoking-related cognitions (attitude, perceived behavioral control, and subjective norm) predict smoking onset via intention among both asthmatic and non-asthmatic adolescents. The TPB predicted smoking onset even stronger among adolescents with asthma. These findings may contribute to the development of tailored interventions for the prevention of smoking among asthmatic adolescents.