Helping Middle-Aged Women Translate Physical Activity Intentions Into Action: Combining the Theory of Planned Behavior and Implementation Intentions

The current experiment examined whether women with implementation intentions show greater correspondence between their exercise intentions and behaviors, exercise more frequently, and show changes over time in measures of theory of planned behavior (TPB) constructs and scheduling self-efficacy relative to a control group. Participants were 47 women randomly allocated to an implementation intentions or control condition. Measures of TPB constructs and scheduling self-efficacy were assessed at baseline and 8 weeks later. Regression analyses showed that intentions were a significant predictor of behavior for women in the experimental condition (p .01). A significant Condition * Time interaction was found for scheduling efficacy (p .03) and a nonsignificant interaction was found for perceived behavioral control (p = .06), indicating that only the experimental group increased scheduling self-efficacy and perceived behavioral control. No significant group differences were found for the other TPB constructs or self-reported exercise.     

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.     

The pattern of influence of perceived behavioral control upon exercising behavior: An application of Ajzen's theory of planned behavior

The aim of the present studies was to verify the basic assumptions underlying the theory of planned behavior for the prediction of exercising intentions and behavior among adults of the general population (study 1) and a group of pregnant women (study 2). In both studies, baseline data were collected at home with trained interviewers and with the use of paper-and-pencil questionnaires. The self-report on behavior was obtained 6 months (study 1) and between 8 and 9 months (study 2) after baseline data collection. In study 1, perceived behavioral control influenced behavior only through intention. In study 2, none of the Ajzen model variables was associated to exercising behavior. Nonetheless, intention was influenced by attitude, habit, and perceived behavioral control. The results of the present studies suggest that perceived behavioral control contributes to the understanding of intentions to exercise but not to the prediction of exercising behavior.This study was supported by research grants from the Canadian Fitness and Lifestyle Research Institute (8705-2459-2064) and the Social Sciences and Humanities Research Council of Canada (410-87-1407). The authors are members of the Research Group on Psychosocial Aspects of Health (FCAR-90-ER-0699).     

Understanding Cervical Cancer Screening Intentions among Latinas Using An Expanded Theory of Planned Behavior Model

We examined the utility of an expanded theory of planned behavior (TPB) model in predicting cervical cancer screening intentions among Latinas. The model included acculturation and past cervical cancer screening behavior along with attitude, subjective norms, and perceived behavioral control. This cross-sectional study included a sample of 206 Latinas who responded to a self-administered survey. Structural equation modeling was employed to test the expanded TPB model. Acculturation (p = .025) and past screening behavior (p = .001) along with attitude (p = .019), subjective norms (p = .028), and perceived behavioral control (p = .014) predicted the intention to be screened for cervical cancer. Our findings suggest that the TPB is a useful model for understanding cervical cancer screening intentions among Latinas when both past behavior and culture are included. This research highlights the importance of culture on behavior and indicates a need to develop culturally sensitive, theory-based interventions to encourage screening and reduce cervical cancer-related health disparities in Latinas.     

Social-cognitive determinants of hoist usage among health care workers

Injuries caused by unsafe manual handling of patients are a major source of ill health in health care workers. The present study evaluated the ability of 4 classes of variable to predict use of a hoist when moving a heavily dependent patient. Variables examined were occupational role characteristics, such as hours of work and type of shift worked; biographics, including age and height; aspects of occupational context, such as number of hoists available and number of patients; and motivational variables specified by the theory of planned behavior (Ajzen, 1985) and protection motivation theory (Rogers, 1983). Regression analyses showed that background and social-cognitive variables were able to account for 59% of variance in intention to use a hoist and 41% of variance in use of the hoist assessed 6 weeks later. Height, hoist availability, coworker injunctive norm, perceived behavioral control, response cost, response benefits, and social and physical costs of not using the hoist each explained independent variance in motivation to use a hoist at work.     

Gender Differences in the Self-Regulation of Hypertension

The theory of planned behavior was adapted and revised to explain efforts made by patients to regulate their hypertension. A test of this theory of self-regulation revealed significant differences between men (N = 105) and women (N = 102) in their decision making and goal pursuit activities. For men, attitude toward success had both direct and indirect (through desire and intentions) effects on efforts to regulate hypertension. Attitudes had no influence on effort for women. Perceived behavioral control had both direct and indirect (through desire and intentions) effects on effort for men but no effects for women. Intentions influenced effort for men but not women. In contrast, perceived subjective norms had direct effects on effort for women but not for men. Effort was found also to be a function of past efforts at trying to regulate hypertension for both men and women. The study results confirm the existence of differences in the manner in which men and women perceive health maintenance. Additionally, the theory of self-regulation was found to serve as a useful framework in understanding the role of goal-setting and goal-striving in the management of chronic conditions.     

Action Control of Exercise Behavior: Evaluation of Social Cognition,Cross-Behavioral Regulation,and Automaticity

Intention is considered the proximal determinant of behavior in many popular theories applied to understanding physical activity, yet intention–behavior discordance is high. Thus, an understanding of constructs that facilitate or inhibit the successful translation of intentions into behavior is both timely and important. The action control approach of dividing the intention–behavior relationship into quadrants of successful/unsuccessful intenders has shown utility in the past by demonstrating the magnitude of intention–behavior discordance and allowing for an outcome variable to test predictors. The purpose of this article was to evaluate automaticity and cross-behavioral regulation as predictors of exercise action control, in conjunction with other more standard social cognitive predictors of perceived behavioral control and affective and instrumental attitudes. Participants were a random sample of 263 college students who completed predictor measures at time one, followed by exercise behavior two weeks later. Participants were classified into three intention–behavior profiles: (1) nonintenders (14.1%; n = 31), (2) unsuccessful intenders (35.5%; n = 78), and (3) successful intenders (48.6%; n = 107). Affective attitude, perceived behavioral control, automaticity, and cross-behavioral regulation were predictors of action control. The results demonstrate that automaticity and cross-behavioral regulation, constructs not typically used in intention-based theories, predict intention–behavior discordance.     

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.     

Prediction of Specific Types of Physical Activity Using the Theory of Planned Behavior

Most previous research on physical activity using Ajzen's Theory of Planned Behavior (TPB) has assessed the generic term exercise rather than the specific behaviors involved in physical activity. TPB variables for six common types of physical activity were obtained from 233 participants. Both affective and instrumental components of attitude were assessed. Except in the case of walking, multiple regression analyses revealed that intentions for each physical activity type were influenced by affective attitude and perceived behavioral control. Behavior, however, was predicted by intentions alone. In comparison with other types of activity, the TPB accounted for modest amounts of variance in both walking intentions and behavior, with attitudes making no contribution to walking intentions. Discussion focuses on the measurement of physical activity and the implications for health promotion of the poor modeling of walking.     

Prediction of leisure time exercise behavior among a group of lower-limb disabled adults

The aim of this study was to predict leisure time exercise behavior among a group of 62 lower-limb disabled adults. The theory of reasoned action proposed by Fishbein (Fishbein & Ajzen, 1975) provided a framework for the study. Variables measured included the Fishbein model variables, habit, education, disability type, fitness level, and a 7-day follow-up of exercise behavior. Some 35% of the variance in exercise behavior could be explained; intention was the strongest predictor (.31, p less than .05). In comparison, the ability to predict intentions to exercise by using the other variables was quite poor, with only 7% of the variance explained by habit. None of the Fishbein model variables contributed to this prediction. These results indicated the importance of specific factors, such as the strength of the exercise habit and the cause of disability, on exercise behavior.     

From Intentions to Quit to the Actual Quitting Process: The Case of Smoking Behavior in Light of the TPB

The purpose of the present paper was to examine the path from intentions to quit smoking to the actual quitting process in light of the theory of planned behavior. Data derives from a longitudinal internet survey (N = 939) over a period of 4 months. Attitudes, subjective norms, perceived behavioral control (PBC), and past behavior emerged as significant direct predictors of quitting intention (R² = 34%). Ordinal regression analysis showed that intention, PBC, planning, past quit attempts and habit were significant predictors of the subsequent quitting process. Consistent with previous research the results show that addicted individuals have serious problems in sticking to their initial plans. Theoretical and practical implications of the results are discussed.     

From 'I Wish' to 'I Will': social-cognitive predictors of behavioral intentions

We tested the ability of several social-cognitive models to predict intentions to engage in two different health behaviors (resisting dieting and performing breast self-exam). All constructs from the health belief model (with and without self-efficacy), the theory of planned behavior (with and without perceived behavioral control) and the motivational process of the health action process approach were measured simultaneously in two subject samples. We hypothesized that models that include self-efficacy (or the related construct of perceived behavioral control) would be more effective than the models that do not include it. Our results supported this prediction. The health action process approach was the best predictor of intentions to engage in both behaviors. Implications for selecting appropriate models on which to base interventions are discussed.     

Help‐seeking intentions for breast‐cancer symptoms: A comparison of the self‐regulation model and the theory of planned behaviour

Purpose: Delays in seeking help for symptoms have been found to be associated with poorer outcome in breast‐cancer patients. This study explores symptom perceptions and health beliefs as predictors of intentions to seek medical help in a general female population. The utility of the self‐regulation model of illness cognition and the theory of planned behaviour were examined in predicting help‐seeking intentions for potential symptoms of breast cancer in a general population sample. Methods: A general population sample of 546 women completed a postal questionnaire comprising items examining components of the self‐regulation model and the theory of planned behaviour. Help‐seeking intention was determined by asking participants to rate the likelihood of visiting their GP for a range of breast symptoms. Results: Hierarchical multiple regression analysis revealed that the cognitive component of the self‐regulation model accounted for approximately 22% of the variance in help‐seeking intention. Identity (β = 0.45, p < .001) emerged as a significant predictor of intention to seek help. Inclusion of the components of the theory of planned behaviour accounted for an additional 7% of the variance; the significant predictors were attitude to help‐seeking (β = 0.19, p <.001) and perceived behavioural control (β = 0.12, p <.01). Conclusions: Intention to seek medical help for a potential breast‐cancer symptom may be mediated, partly, by cognitive representations of the identity and consequences of breast cancer and by attitudes towards help‐seeking and perceived behavioural control. Although less than one‐third of the variance was accounted for, these results have important implications for future research (in terms of identifying which variables should be examined) and for the development of a model of help‐seeking behaviour in women with breast‐cancer symptoms.     

The applicability of the Theory of Planned Behaviour in predicting adherence to ART among a South African sample

We sought to determine the extent to which the Theory of Planned Behaviour (TPB) was applicable in predicting medication adherence among South Africans receiving antiretroviral therapy (ART). Regression analyses revealed that the linear combination of attitudes towards adherence, perceived behavioural control and perceived group norms explained 12 percent of the variance in intentions to adhere to ART. We also found a non-significant relationship between intentions to adhere to treatment and self-reported adherence. The results call into question the extent to which TPB is helpful in understanding a health-promoting behaviour such as medication adherence among South Africans receiving ART.     

Reasons for binge drinking among undergraduate students: An application of behavioural reasoning theory

Objectives. This study sought to apply behavioural reasoning theory (BRT) to the prediction of undergraduate students’ binge drinking intentions and behaviour. The reasons students use to justify and defend binge drinking may provide important information on motivations underlying such behaviour. Methods. Undergraduate students (N= 265) completed questionnaires assessing their reasons for and against binge drinking, attitude, subjective norm, perceived behavioural control, intention, and past behaviour. Frequency of binge drinking was assessed at 1‐week follow‐up (N= 172). Results. A series of path analyses were conducted to assess the direct and indirect effects of the BRT variables on binge drinking intentions and behaviour. The variables under consideration accounted for 80% of the variance in binge drinking intentions (with past behaviour, reasons for binge drinking, and attitude having significant direct effects on intention), and 34% of the variance in binge drinking at 1‐week follow‐up (with past behaviour, perceived behavioural control, and intention having significant direct effects on future behaviour). Additional regression analyses revealed that respondents who strongly endorsed being sociable and having fun as reasons for binge drinking were more likely to intend to engage in binge drinking over the subsequent week. Conclusions. The results provide support for BRT as a framework for understanding undergraduate students’ binge drinking intentions and behaviour, and suggest that interventions need to focus on the social reasons for engaging in binge drinking in undergraduate students.     

Application of the Health Belief Model in a study on parents' intentions to utilize prenatal diagnosis of cleft lip and/or palate.

Parents of children with cleft lip and/or palate (42 women and 35 men) participated in a study on intentions to use prenatal diagnosis of cleft by ultrasound in subsequent pregnancies. Based on the Health Belief Model (HBM) [Rosenstock, 1974], parents' cognitions on 4 factors were measured by questionnaires: "susceptibility" and "severity perceptions," "benefits" and "barriers" evaluations. Most parents perceived the defect as severe. Over-estimation of recurrence risks was predominant even among parents who had received genetic counseling. Results showed that most parents intend to utilize prenatal diagnosis but do not intend to abort an affected fetus. Subjects' reported reasons represented 3 thematic categories: cognitive (the need to know), emotional, and behavioral. Parents' intentions to diagnose and to terminate were related to the factors predicted by the HBM model. Regression analyses indicated that 38% of the variance in intentions to diagnose and 56% of the variance in intentions to terminate could be explained by the studied variables. The best predictor of both intentions was the perceived benefits of the diagnosis. Implications of these findings for genetic counseling are discussed.     

Application of Azjen's Theory of Planned Behavior to Predict Sunbathing, Tanning Salon Use, and Sunscreen Use Intentions and Behaviors

Ajzen's (1988) theory of planned behavior (TOPB) was used to examine psychological determinants of high-risk UV radiation exposure-related behaviors (sunbathing, tanning salon use, and sunscreen use). Undergraduates at a midsized southeastern university were assessed on their psychological and behavioral tendencies toward high-risk UV radiation exposure-related behaviors. The results generally supported the utility of the TOPB as an explanatory model for high-risk behavior. Attitudes were strongly associated with high-risk intentions (e.g., not utilize sunscreen, use salons), whereas subjective norms were less so. Perceived behavioral control was found to moderate the relationship among attitudes, norms, and intentions to sunbathe and tan at a salon. Implications for intervention strategies and future model building in this area are discussed.     

Predicting Self-Management Behaviors in Familial Hypercholesterolemia Using an Integrated Theoretical Model: the Impact of Beliefs About Illnesses and Beliefs About Behaviors

Purpose

Patients with familial hypercholesterolemia (FH) are at markedly increased risk of coronary artery disease. Regular participation in three self-management behaviors, physical activity, healthy eating, and adherence to medication, can significantly reduce this risk in FH patients. We aimed to predict intentions to engage in these self-management behaviors in FH patients using a multi-theory, integrated model that makes the distinction between beliefs about illness and beliefs about self-management behaviors.

Methods

Using a cross-sectional, correlational design, patients (N?=?110) diagnosed with FH from a clinic in Perth, Western Australia, self-completed a questionnaire that measured constructs from three health behavior theories: the common sense model of illness representations (serious consequences, timeline, personal control, treatment control, illness coherence, emotional representations); theory of planned behavior (attitudes, subjective norms, perceived behavioral control); and social cognitive theory (self-efficacy).

Results

Structural equation models for each self-management behavior revealed consistent and statistically significant effects of attitudes on intentions across the three behaviors. Subjective norms predicted intentions for health eating only and self-efficacy predicted intentions for physical activity only. There were no effects for the perceived behavioral control and common sense model constructs in any model.

Conclusions

Attitudes feature prominently in determining intentions to engage in self-management behaviors in FH patients. The prominence of these attitudinal beliefs about self-management behaviors, as opposed to illness beliefs, suggest that addressing these beliefs may be a priority in the management of FH.