Factorial validity and invariance of questionnaires measuring social-cognitive determinants of physical activity among adolescent girls

BACKGROUND: There are few theoretically derived questionnaires of physical activity determinants among youth, and the existing questionnaires have not been subjected to tests of factorial validity and invariance. The present study employed confirmatory factor analysis (CFA) to test the factorial validity and invariance of questionnaires designed to be unidimensional measures of attitudes, subjective norms, perceived behavioral control, and self-efficacy about physical activity. METHODS: Adolescent girls in eighth grade from two cohorts (N = 955 and 1,797) completed the questionnaires at baseline; participants from cohort 1 (N = 845) also completed the questionnaires in ninth grade (i.e., 1-year follow-up). Factorial validity and invariance were tested using CFA with full-information maximum likelihood estimation in AMOS 4.0. Initially, baseline data from cohort 1 were employed to test the fit and, when necessary, to modify the unidimensional models. The models were cross-validated using a multigroup analysis of factorial invariance on baseline data from cohorts 1 and 2. The models then were subjected to a longitudinal analysis of factorial invariance using baseline and follow-up data from cohort 1. RESULTS: The CFAs supported the fit of unidimensional models to the four questionnaires, and the models were cross-validated, as indicated by evidence of multigroup factorial invariance. The models also possessed evidence of longitudinal factorial invariance. CONCLUSIONS: Evidence was provided for the factorial validity and the invariance of the questionnaires designed to be unidimensional measures of attitudes, subjective norms, perceived behavioral control, and self-efficacy about physical activity among adolescent girls.     

Psychosocial correlates of physical activity in white and African-American girls.

PURPOSE: To evaluate the relative utility of the Theory of Reasoned Action (TRA) and the Theory of Planned Behavior (TPB) in explaining intentions and physical activity behavior in white and African-American eighth-grade girls. METHODS: One-thousand-thirty white and 1.114 African-American eighth-grade girls (mean age 13.6 +/- 0.7 years) from 31 middle schools in South Carolina completed a 3-day physical activity recall and a questionnaire assessing attitudes, subjective norms, perceived behavioral control, self-efficacy, and intentions related to regular participation in moderate-to-vigorous physical activity (MVPA). RESULTS: Among Whites, 17% of the variance in intentions was contributed by subjective norms and attitude, with intentions accounting for 8% of the variance in MVPA. The addition of perceived behavioral control and self-efficacy to the TRA significantly improved the prediction of intentions and MVPA accounting for 40% and 10% of the variance, respectively. Among African-Americans, subjective norms and attitude accounted for 13% of the variance in intentions, with intentions accounting for only 3% of the variance in MVPA. The addition of perceived behavioral control and self-efficacy to the TRA significantly improved the prediction of intentions and MVPA accounting for 28% and 5% of the variance, respectively. CONCLUSIONS: The results provided limited empirical support for the TPB among white adolescent girls; however, our findings suggest that the planned behavior framework has limited utility among African-American adolescent girls. The relatively weak link between intentions and MVPA observed in both population groups suggest that constructs external to the TPB may be more important mediators of physical activity behavior in adolescent girls.     

Goals and intentions mediate efficacy beliefs and declining physical activity in high school girls

BACKGROUND: According to theory, girls who set goals about increasing their physical activity and who are dissatisfied with their current activity level are likely to form intentions to be active and to carry out those intentions, especially if they have high efficacy and control beliefs about being physically active. We tested those ideas while observing naturally occurring change during high school. METHODS: A cohort of 431 black and white girls was tested at the end of their 9th- and 12th-grade academic years. Confirmatory factor analysis established the structural invariance of the measures across the 3-year study period. Structural equation modeling and panel analysis were used to determine whether changes in goal setting and satisfaction would mediate relations of self-efficacy and perceived behavioral control with changes in intention and physical activity. Testing occurred between February and May in 1999 and 2004. Data were analyzed in 2006. RESULTS: Goal setting and intention mediated the indirect relation between self-efficacy and change in physical activity. Perceived behavioral control and physical activity change were related directly and also indirectly by a path mediated through satisfaction and intention. Black girls had lower self-efficacy, but changes in other variables were unrelated to race. CONCLUSIONS: These observations of longitudinal relations elaborate application of self-efficacy theory and the theory of planned behavior to physical activity by showing that goal setting and satisfaction mediate the relations of self-efficacy and perceived behavioral control with changes in intention and physical activity. The results encourage additional research to identify the sources and development of physical activity goals, and their attainment, among girls, and whether experimental manipulation of goals and intentions can mitigate the decline in girls' physical activity during high school.     

Self-efficacy partially mediates the effect of a school-based physical-activity intervention among adolescent girls

BACKGROUND: This study evaluated the effects of the Lifestyle Education for Activity Program (LEAP), a comprehensive school-based intervention emphasizing changes in instruction and school environment, on variables derived from social-cognitive theory (SCT) as mediators of change in physical activity among black and white adolescent girls. METHODS: Twenty-four high schools paired on enrollment size, racial composition, urban, suburban, or rural location, and class structure were randomized into control (n = 12) or experimental (n = 12) groups. There were 1038 girls in the control group and 1049 girls in the experimental group. The multicomponent intervention emphasized the enhancement of self-efficacy and development of behavioral skills by using curricular activities within physical education classes and health education instruction. The primary outcomes were self-efficacy, outcome-expectancy value, goal setting, satisfaction, and physical activity. RESULTS: Latent variable structural equation modeling indicated that: (1) self-efficacy and satisfaction exhibited synchronous, cross-sectional relationships with physical activity; (2) the intervention had direct effects on self-efficacy, goal setting, and physical activity; and (3) self-efficacy partially mediated the effect of intervention on physical activity. CONCLUSIONS: To our knowledge, this study provides the first evidence from a randomized controlled trial that manipulation of self-efficacy results in increased physical activity among black and white adolescent girls. The results encourage the use of self-efficacy as a targeted, mediator variable in interventions designed to increase physical activity among girls.     

Should Different Marketing Communication Strategies Be Used to Promote Healthy Eating Among Male and Female Adolescents?

A study was conducted to examine how interpersonal norms, media norms, attitudes, perceived behavioral control, perceived barriers, and self-efficacy had an influence on healthy eating intention among adolescents. A probability sample of 544 adolescents aged 12 to 18 was conducted. Results indicated that girls had a more favorable attitude and intention toward healthy eating than boys. Healthy eating intention among boys was predicted by attitude, perceived behavioral control, perceived barriers, and self-efficacy, and among girls was predicted by perceived behavioral control and self-efficacy. Different marketing strategies to promote healthy eating among adolescent boys and girls should be adopted.     

Self-management strategies mediate self-efficacy and physical activity

BACKGROUND: Self-efficacy theory proposes that girls who have confidence in their capability to be physically active will perceive fewer barriers to physical activity or be less influenced by them, be more likely to pursue perceived benefits of being physically active, and be more likely to enjoy physical activity. Self-efficacy is theorized also to influence physical activity through self-management strategies (e.g., thoughts, goals, plans, and acts) that support physical activity, but this idea has not been empirically tested. METHODS: Confirmatory factor analysis was used to test the factorial validity of a measure of self-management strategies for physical activity. Next, the construct validity of the measure was tested by examining whether self-management strategies mediated the relationship between self-efficacy and self-reported physical activity, independently of several social-cognitive variables (i.e., perceived barriers, outcome expectancy value, and enjoyment), among cross-sectional samples of 6th grade (n=309) and 8th grade (n=296) girls tested between February 14 and March 17, 2002. Data were analyzed in 2004. RESULTS: Consistent with theory, self-efficacy had direct effects on the social-cognitive variables. The primary novel finding is that self-management strategies mediated the association of self-efficacy with physical activity in both samples. CONCLUSIONS: The measure of self-management strategies for physical activity yields valid scores among adolescent girls and warrants experimental study as a mediator of the influence of efficacy beliefs on physical activity.     

Family support for physical activity in girls from 8th to 12th grade in South Carolina

OBJECTIVE: To examine the relationship between perceived family support and other selected correlates of physical activity (PA) with changes in PA over time. METHODS: A total of 421 girls in South Carolina completed questionnaires at 8th, 9th and 12th grades (1998-2003). Family support for PA, PA self-efficacy, perceived behavioral control, attitudes, availability of equipment, and PA were measured. RESULTS: Growth curve analysis showed that family support, perceived behavioral control, and self-efficacy were independently related to age-related changes in PA as reflected by total METs. Girls who reported lower family support at the 8th grade measure had more rapid declines in PA, and a unit change in family support was related to approximately 1/3 of a standard deviation change in total METs. CONCLUSIONS: Maintenance of support from family members may reduce the decline in PA independent of girls' self-efficacy and perceived behavioral control.     

Black, Hispanic, and white girls' perceptions of environmental and social support and enjoyment of physical activity

BACKGROUND: This study examines the differences among black, Hispanic, and white adolescent girls in their perceptions surrounding physical activity (PA), including support within the school climate, friend and family social support, and personal enjoyment. METHODS: Participants included 1466 sixth-grade girls from 36 middle schools across the United States. Participants were 20% black, 21% Hispanic, 47% white, and 12% of other or mixed races. Multivariate analyses were performed on each scale, adjusting for body mass index and free and reduced-price lunch status. RESULTS: Results showed racial differences on several variables. Black girls, compared with white girls, perceived significantly lower PA enjoyment (p<.001) and teacher support for PA (p=.004). Hispanic girls experienced less PA enjoyment (p=.003) and perceived less support for PA from boys (p=.001) and their families (p=.008) than white girls. Black girls reported significantly higher levels of physical education (PE) enjoyment than did white girls (p=.003). CONCLUSIONS: Differences in perceived PA support and enjoyment across race raise questions about why these differences exist and how best to address disparities within interventions.     

Applying the theory of planned behavior to women's behavioral attitudes on and consumption of soy products

OBJECTIVE: To identify variables that significantly predict the intention and behavior concerning soy consumption applying the Theory of Planned Behavior and to determine the role of race on women's perspectives and consumption behaviors concerning soy. DESIGN: Cross-sectional survey, with self-administered questionnaires. SETTING: City park service programs, community organizations, black cultural classes, and university offices. PARTICIPANTS: A convenience sample of 205 black (n = 103) and white (n = 102) women. VARIABLES MEASURED: Women's behavioral attitudes, subjective norms, perceived behavioral control, intention, and behavior related to soy consumption. ANALYSIS: Correlation and stepwise regression analysis. RESULTS: All variables in the Theory of Planned Behavior showed significant correlations with behavioral intention, with behavioral attitudes exhibiting the strongest correlation (r = .57, P < .01). Stepwise multiple regression analyses revealed that behavioral attitude toward taste and subjective norms accounted for 47.7% of the variance in behavioral intention. Behavioral attitude toward taste explained 48.6% of the variability in behavior. There was no difference between races for consumption or Theory of Planned Behavior variables. CONCLUSIONS AND IMPLICATIONS: A negative attitude toward the taste of soy was the major predictor for low soy consumption. However, future studies should be undertaken to verify this relationship once more women become aware of and have tasted soy.     

Do ethnicity and gender matter when using the theory of planned behavior to understand fruit and vegetable consumption?

A majority of Americans do not meet the recommendation to eat five servings of fruits and vegetables per day (5-A-Day). The purpose of the present study was to examine the utility of the theory of planned behavior (TPB) for understanding 5-A-Day intentions and behavior and to determine whether any of the TPB relationships were moderated by ethnicity or gender. A total of 413 participants completed a baseline TPB questionnaire and a fruit and vegetable consumption measure 2 weeks later. Path analyses showed that affective attitude and perceived behavioral control significantly predicted intention for blacks, whites, males and females (R(2) ranged from .32 to .40), whereas subjective norm was a significant predictor for blacks, males, and females only. Intention significantly predicted 5-A-Day (R(2) ranged from .17 to .22) for all groups. Follow-up invariance analyses showed that the subjective norm/intention relationship was significantly stronger for black compared to white students. Finally, several key beliefs were identified for all four demographic groups. Therefore, the current results suggest that the TPB may be a useful framework to utilize when developing 5-A-Day interventions.     

The influence of viewing an entertainment-education program on cornea donation intention: a test of the theory of planned behavior

This study was designed to examine the role of issue involvement and the 3 components of the theory of planned behavior in predicting intentions to sign a cornea donor card. This study also compares viewers and nonviewers of an entertainment-education program in terms of issue involvement and the theory of planned behavior. The breakdown of effects for the latent constructs confirms that issue involvement is an important intermediary in the persuasion process. Issue involvement is a common causal antecedent of attitude, subjective norm, and perceived behavioral control, the last 2 of which, in turn, predict intentions, whereas attitude does not. The revised path model confirms that involvement directly influences intentions. In the comparison of viewers with nonviewers, viewers exhibit a significantly higher degree of involvement, attitude toward cornea donation, subjective norm, perceived behavioral control, and intention to sign a cornea donor card. The overall findings of this study suggest that adding issue involvement in the theory of planned behavior enhances the explanatory power of the theory in predicting intentions.     

Exercising for two: examining pregnant women''s second trimester exercise intention and behavior using the framework of the theory of planned behavior

Research examining the motivational determinants of exercising during pregnancy is mostly atheoretical, despite the need for theory-based designs. The study's main objective was to prospectively examine women's exercise intention and behavior from their second to third pregnancy trimester using the theory of planned behavior (TPB). Participants were 89 pregnant women who completed self-reported measures of their exercise attitude, subjective norm, perceived behavioral control, intention, and behavior. Hierarchical regression analyses indicated: 1) intention and not perceived behavioral control significantly predicted exercise behavior; and 2) attitude was the strongest determinant of exercise intention, followed by perceived behavioral control, and subjective norm. The study findings provide preliminary support for the TPB as an effective framework for examining exercising during pregnancy. Understanding women's thoughts, feelings, and beliefs about exercise can assist intervention specialists with developing and implementing effective programs promoting exercise during pregnancy.     

The Influence of Viewing an Entertainment–Education Program on Cornea Donation Intention: A Test of the Theory of Planned Behavior

This study was designed to examine the role of issue involvement and the 3 components of the theory of planned behavior in predicting intentions to sign a cornea donor card. This study also compares viewers and nonviewers of an entertainment–education program in terms of issue involvement and the theory of planned behavior. The breakdown of effects for the latent constructs confirms that issue involvement is an important intermediary in the persuasion process. Issue involvement is a common causal antecedent of attitude, subjective norm, and perceived behavioral control, the last 2 of which, in turn, predict intentions, whereas attitude does not. The revised path model confirms that involvement directly influences intentions. In the comparison of viewers with nonviewers, viewers exhibit a significantly higher degree of involvement, attitude toward cornea donation, subjective norm, perceived behavioral control, and intention to sign a cornea donor card. The overall findings of this study suggest that adding issue involvement in the theory of planned behavior enhances the explanatory power of the theory in predicting intentions.     

Understanding physical activity behavior of Chinese female college students with/without vulnerable conditions: a theory of planned behavior perspective

Guided by the theory of planned behavior (TPB), this study examined the relationships between three constructs of TPB (attitude, subjective norm, perceived behavioral control [PBC]) and physical activity intention and behavior among Chinese female college students, and evaluated whether the relationships differed between healthy and vulnerable individuals within this population. Participants included 436 female college students (301 healthy and 135 vulnerable; Mean age = 19.24 years; SD = 0.97 years) recruited from five universities in China, and the data collection was completed in Fall 2015. Path analysis supported the direct and indirect relations of TPB constructs to physical activity intention and behavior among female college students, and the path model was invariant across the two groups. The vulnerable group reported significantly lower attitude, subjective norm, intention, and physical activity behavior than the healthy group but not for PBC. These findings suggest fostering positive attitudes and intention toward physical activity are important among Chinese female college students, regardless of their health status.     

Psychometric properties of the healthful eating belief scales for persons at risk of diabetes

OBJECTIVE: To examine the validity and reliability of Theory of Planned Behavior (TPB) scales for healthful eating for persons at risk for diabetes. DESIGN: Cross-sectional, using a self-administered questionnaire. SETTING: Community in the Midwest. PARTICIPANTS: 106 adults who self-identified based on one or more American Diabetes Association diabetes risks. VARIABLES MEASURED: Behavioral, normative, and control beliefs; and attitude, subjective norm, perceived behavioral control, and intention to eat a healthful diet. ANALYSIS: Construct validity was assessed with factor analyses and measurement and structural models using structural equation modeling. Reliability of the scales was assessed with Cronbach alpha and a 2-month test-retest. RESULTS: Factor analysis loadings were greater than .37. Cronbach alphas for the behavioral, normative, and control belief scales were .80, .91, and .84, respectively. The measurement model revealed that the measures were significant estimates for the TPB constructs, and they fit well as indirect measures of attitude, subjective norm, and perceived behavioral control in predicting intention to eat a healthful diet. Test-retest revealed 2-month stability of the scales. CONCLUSIONS AND IMPLICATIONS: Scales for measuring TPB behavioral, normative, and control beliefs were valid and reliable for use with adults at risk for diabetes. Further examination with minority persons is warranted.     

Predicting Intentions to Continue Exclusive Breastfeeding for 6 Months: a Comparison Among Racial/Ethnic Groups

The purpose of this study was to explore how mothers of different races/ethnicities make decisions to continue exclusive breastfeeding (EBF) for 6 months under the Theory of Planned Behavior. Participants were recruited from hospitals and WIC clinics in Central Indiana and Southern New Jersey from 2008 to 2009. Mothers (N = 236: 93 non-Hispanic African American, 72 non-Hispanic white, 71 Hispanic/Latina) completed a self-administered questionnaire that measured theoretical constructs and beliefs related to their intention to practice EBF for 6 months. Intentions to continue EBF for 6 months were similar (P = 0.15) across racial/ethnic groups. Significant proportions of the intention (P < 0.001) were explained by the three theoretical constructs (attitude, subjective norm, and perceived behavioral control). The relative importance of each construct in predicting the intention varied by group. The most influential predictors (P < 0.001) were attitude for white mothers, subjective norm for African American mothers, and perceived behavioral control for Latina mothers. Latent beliefs strongly associated with attitude in white mothers were ‘bonding with the baby’ and ‘easy feeding.’ Beliefs held by family members and the general public contributed to the subjective norm of African American mothers. Perceived behavioral control in Latina mothers was highly correlated with ‘pumping breast milk’. Development of policy and intervention programs that focus on shaping strong predictors and beliefs within racial/ethnic groups could reduce disparities in EBF rates and establish EBF for 6 months as a cultural norm.     

Structured physical activity and psychosocial correlates in middle-school girls

OBJECTIVE: Little is known about the types of physical activity (PA) in which adolescent girls participate. Understanding this, along with examining specific psychosocial correlates of PA, may help guide the development of effective interventions to prevent the decline in PA in female youth. METHODS: 2791 sixth grade girls participating in the Trial of Activity for Adolescent Girls from six geographical locations completed surveys assessing participation in sports teams and activity classes/lessons in and out of school, self-efficacy for PA, PA enjoyment, physical education (PE) enjoyment, and perceived school climate for girls' PA (data collection: January-May 2003). Correlates of girls' participation in structured PA and sociodemographic differences were explored. RESULTS: 89.5% of girls participated in structured PA: 39% at school and 86% outside of school. Across race/ethnicity, most reported activities were basketball (44%), cheerleading/dance (41%), and swimming (39%). Controlling for socioeconomic status, geographical location, and race/ethnicity, girls with a higher self-efficacy (OR=3.44, CI=1.72-6.92) and higher enjoyment of PE class (OR=1.97, CI=1.25-3.120) were more likely to participate in structured PA. PA enjoyment and perceived school climate for girls' PA were not associated with participation in structured PA. CONCLUSION: Interventions that increase self-efficacy and enjoyment of PE could result in greater participation in structured PA and higher overall PA levels among adolescent girls.     

Predictors of sexual risk behaviors among adolescent mothers in a human immunodeficiency virus prevention program

PurposeThe purpose of this study was to determine the following: (1) whether adolescent mothers in a human immunodeficiency virus (HIV) prevention program had significantly greater perceived self-efficacy and perceived behavioral control to use condoms, and more favorable outcome expectancies and subjective norms regarding condom use than those in a health education control group, 3 months after intervention; and (2) the impact of the 3-month postintervention theoretical variables on intentions to use condoms at 3 months and sexual risk behaviors at 6 months.MethodsStructural equation modeling with latent variables was used to assess the influence of theoretical variables and treatment condition using data from 496 participants (78% Latinas, 18% African-Americans) who completed questionnaires at baseline and at 3- and 6-month follow-up evaluations.ResultsSubstantial improvements were shown by both groups, with a slight advantage for the HIV prevention group, on all theoretical variables between pretest and the follow-up evaluations. In the predictive model, the intervention group reported significantly fewer sex partners. By using intentions to use condoms as a mediator, greater self-efficacy, hedonistic beliefs, positive subjective norms, and less unprotected sex predicted intentions to use condoms, which, in turn, predicted less unprotected sex. Lower subjective norms modestly predicted multiple partners. Significant indirect paths mediated through intentions to use condoms were observed.ConclusionsThese data support a relationship among several constructs from social cognitive theory and the theory of reasoned action, and subsequent sexual risk behaviors. HIV-prevention programs for adolescent mothers should be designed to include these theoretical constructs and to address contextual factors influencing their lives.     

Explaining the effects of a 1-year intervention promoting a low fat diet in adolescent girls: a mediation analysis

Background  

Although it is important to investigate how interventions work, no formal mediation analyses have been conducted to explain behavioral outcomes in school-based fat intake interventions in adolescents. The aim of the present study was to examine mediation effects of changes in psychosocial determinants of dietary fat intake (attitude, social support, self-efficacy, perceived benefits and barriers) on changes in fat intake in adolescent girls.     

Psychosocial, environmental and behavioral factors associated with bone health in middle-school girls

The purpose of this study was to identify the psychosocial, environmental and behavioral factors associated with calcium intake, physical activity and bone health in a cohort of adolescent girls. Baseline data (N = 718 girls, mean age: 11.6 +/-0.4 years) from the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study conducted in Texas, 2001-03, were utilized for the analyses. Hierarchical linear regression was used to examine the associations of interest. Confounders adjusted for included ethnicity, menarchal status, body mass index and lactose intolerance. Several psychosocial and behavioral factors were significantly associated with bone quality. These included knowledge of calcium content of foods (beta = 0.08, P = 0.016), self-efficacy toward consuming calcium-rich foods (beta = 0.16, P = 0.047), physical activity self-efficacy (beta = 0.20, P = 0.002), physical activity outcome expectations (beta = 0.5, P = 0.004), family encouragement to do physical activity (beta = 0.96, P = 0.027), friend engagement in physical activity (beta = 1.3, P = 0.001) and participation in sports teams (beta = 1.7, P < 0.001). Self-efficacy, social support and participation in sports teams appear to be strongly associated with bone health in adolescent girls. Future health education/health promotion programs need to address these factors for effective primary prevention of osteoporosis in this population.