[Show abstract][Hide abstract] ABSTRACT: Background:
We examined a brief educational intervention addressing hand hygiene self-regulatory mechanisms, and evaluated which psychological mechanisms may lead to hand hygiene behaviours.
Two hundred forty two students (mean age = 21 years, SD = 3.9) received either an experimental (n = 149) or a control condition on action control and planning (n = 93). Hand hygiene, coping planning, and action control were measured at baseline and six weeks later. By applying repeated measures ANOVA, we compared the experimental condition addressing planning to perform hand hygiene with a control condition. Additionally, working mechanisms were evaluated by means of mediation analysis.
The intervention had an effect on action control, as reflected by a time by treatment interaction. The direct effect of the intervention on behaviour was, however, non-significant. Changes in action control led to changes in coping planning. These social-cognitive changes mediated the effect of intervention on behaviour, after controlling for gender, baseline behaviour, and classroom membership.
In spite of the associations between the intervention and self-regulatory strategies, no direct effect was found of the intervention on behaviour. Further research on how to increase hand sanitizing, involving enviromental characteristics, is required.
The intervention led only indirectly to an improvement of hand hygiene via changes in self-regulatory factors. Results indicate the importance of promoting action control and coping planning to initiate changes in hand hygienic behaviours.
BMC Public Health 12/2015; 15(1). DOI:10.1186/s12889-015-2295-z · 2.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objectives:
Adherence to the use of filtering facemask respirators on hazy days to reduce exposure to air pollution is examined with the aim of uncovering psychological mechanisms that may be responsible for individual differences in motivation and behavior.
In a longitudinal survey, 164 young adults from Beijing, China, completed assessments at baseline (Time 1), 2 weeks (Time 2), and 4 weeks later (Time 3). Self-efficacy, risk perception, and outcome expectancies were measured along with intention at Time 1, planning and action control at Time 2, and facemask use at Time 3. A structural equation model was specified to test theory-implied pathways of influence.
Self-efficacy and risk perception jointly predicted behavioral intention at Time 1. Planning and action control at Time 2 jointly predicted behavior at Time 3, serving as parallel mediators between intention (Time 1) and facemask use (Time 3). The model explained 19.5% and 30.2% of the variance in intention and behavior, respectively.
Results support theory-based psychological mechanisms, with a focus on planning and action control, which might be influential in the adoption and maintenance of self-protective facemask wearing. (PsycINFO Database Record
Health Psychology 09/2015; DOI:10.1037/hea0000264 · 3.59 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Unlabelled:
Reduced physical activity and almost unlimited availability of food are major contributors to the development of obesity. With the decline of strenuous work, energy expenditure due to spontaneous physical activity has attracted increasing attention. Our aim was to assess changes in energy expenditure, physical activity patterns and nutritional habits in obese subjects aiming at self-directed weight loss.
Energy expenditure and physical activity patterns were measured with a portable armband device. Nutritional habits were assessed with a food frequency questionnaire.
Data on weight development, energy expenditure, physical activity patterns and nutritional habits were obtained for 105 patients over a six-month period from an initial cohort of 160 outpatients aiming at weight loss. Mean weight loss was -1.5 ± 7.0 kg (p = 0.028). Patients with weight maintenance (n = 75), with substantial weight loss (>5% body weight, n = 20) and with substantial weight gain (>5% body weight, n = 10) did not differ in regard to changes of body weight adjusted energy expenditure components (total energy expenditure: -0.2 kcal/kg/day; non-exercise activity thermogenesis: -0.3 kcal/kg/day; exercise-related activity thermogenesis (EAT): -0.2 kcal/kg/day) or patterns of physical activity (duration of EAT: -2 min/day; steps/day: -156; metabolic equivalent unchanged) measured objectively with a portable armband device. Self-reported consumption frequency of unfavorable food decreased significantly (p = 0.019) over the six-month period.
An increase in energy expenditure or changes of physical activity patterns (objectively assessed with a portable armband device) are not employed by obese subjects to achieve self-directed weight loss. However, modified nutritional habits could be detected with the use of a food frequency questionnaire.
[Show abstract][Hide abstract] ABSTRACT: Objectives
Dietary intentions are supposed to engender planning processes, which in turn stimulate dietary behaviour change. However, some studies failed to find such mediation effects, which suggest more complex and not yet unravelled relationships between these factors. One explanation may be that mediation works better under certain circumstances or only for specific subgroups. This study addresses this reasoning by examining autonomy beliefs and sex as putative moderators of the hypothesized mediation chain.Design and methodsIn a longitudinal design with three measurement points in time (1 week and 1 month apart), 912 women and 214 men were surveyed. Planning, intention, dietary autonomy beliefs, and sex were used to predict fruit and vegetable intake within a conditional process model designed to identify mechanisms of change.ResultsThe intention–planning–behaviour chain was qualified by a triple interaction involving autonomy beliefs and sex as moderators between intention and planning. Higher dietary autonomy resulted in higher levels of planning fruit and vegetable intake. For men, even in case of higher intention, at least medium levels of autonomy beliefs were necessary to facilitate planning processes. For women, already lower levels of autonomy beliefs can engender postintentional planning strategies and seem to even compensate lower intention.Conclusions
Intention and planning are key predictors of dietary change. However, these variables work better under specific conditions (with a sufficient level of autonomy), and differently in subgroups (men vs. women). These results may explain the inconsistent findings of previous studies on the mediating effect of planning and allow for a better description of the mechanisms by which intentions may influence behaviour.Statement of contribution What is already known on this subject? The adoption of health-enhancing dietary behaviours can be facilitated by intentions and planning.Planning to eat more fruit and vegetable helps to translate intentions into actual consumption.Fruit and vegetable intake levels are higher in women than in men. What does this study add? Dietary intentions engender more likely planning processes when perceived autonomy concerning food consumption is high.Dietary autonomy beliefs and sex moderate the intention–planning–behaviour chain.Among men, dietary planning is highest when both intentions and autonomy are high.
British Journal of Health Psychology 07/2015; DOI:10.1111/bjhp.12146 · 2.70 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This longitudinal experimental study compared effects of self-efficacy, planning, and education-based conditions, encouraging adolescents to eat fruit and vegetable in place of energy-dense foods.
Data were collected among 506 adolescents (13-18 years old) who were randomly assigned to control (n = 181), planning (n = 153), or self-efficacy (n = 172) conditions. Measurements were taken at baseline (T1), at a 2-month follow-up (T2), and at a 14-month follow-up (T3). Interventions/control group procedures were delivered at T1 and T2.
Self-reports of fruit and vegetable intake (FVI) and energy-dense foods intake were collected at three times. Cognitive mediators (self-efficacy and planning) were assessed at T1 and T2. Body weight and height were objectively measured at T1 and T3.
Similar significant increases of FVI were found for planning and self-efficacy interventions (T3). The planning intervention did not influence energy-dense food intake (T3), but the self-efficacy intervention tended to result in stabilizing intake (compared to an increase found in the control group). There were no effects on body weight. Similar patterns were found for the total sample and for a subsample of adolescents with overweight/obesity. The effects of interventions on FVI were mediated by respective cognitions.
Psychology & Health 07/2015; DOI:10.1080/08870446.2015.1070156 · 1.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Planning can bridge the gap between intentions and action, but what bridges the gap between planning and action? This study helps to answer the question by disentangling the interrelationships between self-efficacy, planning, and preparatory behaviors in predicting physical activity. Preparatory behaviors are tested as a working mechanism of planning. Moreover, it is tested whether the utility of preparatory behaviors depends on an individual's level of self-efficacy.
A survey assessed planning, self-efficacy, and preparatory behaviors for physical activity. Adults (N = 166) provided data at two measurement points. In a longitudinal model, preparatory behaviors were specified as a mediator between planning and physical activity. Self-efficacy was specified as a possible moderator at two points in the model.
Preparatory behaviors mediated the relationship between planning and physical activity. An interaction between self-efficacy and preparatory behaviors on physical activity was found, indicating that individuals with low self-efficacy beliefs were more active if they engaged more frequently in preparatory behaviors.
Planning seems to stimulate preparatory behaviors, which in turn make future physical activity more likely. Furthermore, as performing preparatory behaviors represent a step forward towards the enactment of behavioral goals, preparatory behaviors may be particular beneficial for individuals afflicted by self-doubts regarding physical activity.
Psychology & Health 07/2015; DOI:10.1080/08870446.2015.1070157 · 1.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Radical prostatectomy, a standard treatment for localized prostate cancer, is often followed by a recommendation to initiate and maintain pelvic floor exercise (PFE), to control postsurgery urinary incontinence. Previous studies showed that planning facilitated the uptake and maintenance of a new behavior. Whereas individual planning addresses the setting of plans by 1 person, dyadic planning refers to creating plans together with a partner on when, where, and how the individual target person will perform a behavior. Individual and dyadic planning of PFE, their development over time, and their associations with PFE were investigated.
In a correlational study, 175 prostate-cancer patients provided data at 1, 3, 5, and 7 months following the onset of incontinence. Individual planning of PFE by patients and dyadic planning of PFE between patients and their partners, PFE, and incontinence were assessed by patients' self-reports.
Two-level models with repeated assessments nested in individuals revealed stable levels of individual planning of PFE over time in patients with higher incontinence severity, whereas patients with receding incontinence showed decreases. Independent of incontinence severity, a curvilinear increase followed by a decrease of dyadic planning of PFE across time emerged. Sequential associations of both planning strategies with PFE were found. Whereas individual planning was steadily associated with PFE, associations between dyadic planning and PFE were nonsignificant in the beginning, but increased over time.
Findings point to the importance of individual planning for the adoption and maintenance of PFE, with dyadic planning being relevant for PFE maintenance only. (PsycINFO Database Record
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[Show abstract][Hide abstract] ABSTRACT: The aim of the study was to investigate the relationship between affective state, pain, and coping in hospitalized women with rheumatoid arthritis, including both between- and within-person perspectives.
Participants were 95 female patients between 24 and 82 years of age (M = 50.91; SD = 13.80). For three consecutive days, they rated each night their state affect (positive and negative), pain level, and coping strategies (emotion-, problem- and meaning-focused ones). Relations among variables were tested with a multilevel approach with time included as a covariate.
Within-person meaning-focused coping suppressed the negative pain effect on emotional state, but only for positive affect (Sobel's z = 2.07, p = .04). Moderators of the pain-affect relationship were between-person differences in pain level (B = -.23, SE = .08, t = -2.884, p = .004) and in meaning-focused coping (B = -.63, SE = .20, t = -2.097, p = .04). Specifically, suppression was significant only for patients who reported lower than sample average pain levels and for patients who reported lower than sample average use of meaning-focused strategies.
Findings indicated that meaning-focused coping can be a crucial strategy for keeping daily positive affect in the face of chronic pain and how this effect is modified by interindividual differences. Even if restricted to the specific context, it may inform an intervention for hospitalized women with rheumatoid arthritis.
Quality of Life Research 06/2015; DOI:10.1007/s11136-015-1031-6 · 2.49 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Often, motivation to be physically active is a necessary precondition of action, but still does not suffice to initiate the target behavior. Instead, motivation needs to be translated into action by a self-regulatory process. Self-efficacy and planning are considered to be useful constructs that help to facilitate such translations.
The aim is to examine the roles of motivation, planning, and self-efficacy as well as the mechanisms that operate in the change of physical activity levels.
In a longitudinal observation study with 249 young adults, self-efficacy, planning, motivation, and physical activity were assessed at two points in time, three months apart.
Planning served as a mediator between self-efficacy and physical activity, controlling for baseline activity. In addition to this indirect effect, a moderator effect was found between self-efficacy and stages of change on planning. The mediation operated only in motivated, but not in unmotivated students.
Only when people are motivated to become more active, a mediation from self-efficacy via planning to physical activity seems to be likely.
Journal of Physical Activity and Health 04/2015; DOI:10.1123/jpah.2014-0555 · 1.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To improve regular hand hygiene in adolescents, educational messages based on medical information have not been very successful. Therefore, a theory-guided self-regulatory intervention has been designed with a particular focus on planning strategies. A randomised controlled trial with 307 adolescents, aged 12-18 years, was conducted in high schools. The control group received educational hand hygiene leaflets, whereas the experimental group received a self-regulatory treatment which required them to generate specific action plans and coping plans. Three times during one month, both groups received verbal reminder messages about planning to wash their hands properly. At one-month follow-up, hand hygiene behaviour as well as planning to practise hand hygiene were higher in the self-regulation than in the education group (p < .01). Moreover, changes in planning levels operated as a mediator between experimental conditions and changes in behavioural outcomes. Teaching self-regulatory planning strategies may constitute a superior approach than educational messages to improve regular hand hygiene practice in adolescents.
Psychology Health and Medicine 03/2015; 20(7):1-8. DOI:10.1080/13548506.2015.1024138 · 1.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background
Frequent handwashing can prevent infections, but non-compliance to hand hygiene is pervasive. Few theory- and evidence-based interventions to improve regular handwashing are available. Therefore, two intervention modules, a motivational and a self-regulatory one, were designed and evaluated.Methods
In a longitudinal study, 205 young adults, aged 18 to 26 years, were randomized into two intervention groups. The Mot-SelfR group received first a motivational intervention (Mot; risk perception and outcome expectancies) followed by a self-regulatory intervention (SelfR; perceived self-efficacy and planning) 17 days later. The SelfR-Mot group received the same two intervention modules in the opposite order. Follow-up data were assessed 17 and 34 days after the baseline.ResultsBoth intervention sequences led to an increase in handwashing frequency, intention, self-efficacy, and planning. Also, overall gains were found for the self-regulatory module (increased planning and self-efficacy levels) and the motivational module (intention). Within groups, the self-regulatory module appeared to be more effective than the motivational module, independent of sequence.Conclusions
Self-regulatory interventions can help individuals to exhibit more handwashing. Sequencing may be important as a motivation module (Mot) first helps to set the goal and a self-regulatory module (SelfR) then helps to translate this goal into actual behavior, but further research is needed to evaluate mechanisms.
BMC Public Health 02/2015; 15(1):79. DOI:10.1186/s12889-015-1453-7 · 2.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abstract Objectives. Maintaining physical exercise levels may not only require motivation and planning but also action control which is supposed to mediate between planning and exercise. Design. Behavioral intention, action planning, coping planning, and past behavior were assessed at baseline, and action control and concurrent exercise were measured one month later in 487 young adults. Method. Three nested structural models were specified to examine different mediation mechanisms. One model reflected the intention-planning-behavior chain, the other one focused on the intention-action control-behavior chain, and the third model comprised the full sequence. Results. Indirect effects from intentions on exercise involved either planning or action control as mediating variables. In model 3, all three constructs (action planning, coping planning, and action control) were sequential mediators between intentions and later physical exercise levels. Action and coping planning were not directly, but indirectly related to exercise via action control. Conclusions. Findings support the sequential mediation for planning and action control as antecedents of physical exercise. Action control is needed for exercise because planning in itself is not always sufficient. Maintaining exercise levels may be attributed to effective self-regulatory strategies such as action control in combination with planning.
Psychology and Health 01/2015; 30(8):1-26. DOI:10.1080/08870446.2015.1006222 · 2.13 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
Self-efficacy and social support are considered relevant predictors of fruit and vegetable intake. This study examines whether the effect of self-efficacy on fruit and vegetable intake is mediated by intention and whether this motivational process is moderated by received dietary social support.
A longitudinal study with two measurement points in time, four weeks apart, on fruit and vegetable intake was carried out with 473 students aged 19 years on average (52% women). In a conditional process analysis, dietary intention was specified as a mediator between self-efficacy and fruit and vegetable intake, whereas received dietary support was specified as a moderator of the self-efficacy-intention association, controlling for baseline fruit and vegetable intake.
Self-efficacy was positively associated with fruit and vegetable intake four weeks later, and intention mediated this process. Moreover, an interaction between received dietary support and self-efficacy on intention emerged.
The effect of self-efficacy on fruit and vegetable intake was fully mediated by intention. Moreover, received support exhibited a moderating role within the motivational process: high dietary support appeared to accentuate the positive relationship between self-efficacy and dietary intention.
[Show abstract][Hide abstract] ABSTRACT: Oral diseases such as dental caries, periodontal disease, and tooth loss are a considerable public health problem. A review of the epidemiological data from many countries indicates that a global increase in dental caries prevalence affects children as well as adults. Despite the improvement in oral health of children in the last few decades, tooth decay remains one of the most common childhood diseases in both industrialized and developing countries.
The study evaluates the effects of a self-regulatory intervention to increase dental flossing among adolescents and examines the mediating mechanisms underlying behavioral changes.
A cluster randomized controlled trial compared a brief intervention arm with a control arm in 166 girls aged 11-15 years. Planning, self-efficacy, and behavioral intention were specified as mediators between treatment conditions and follow-up dental flossing frequency. At baseline, the intervention group received theory-guided materials on oral hygiene. Four weeks later, changes in behavior and social-cognitive variables were assessed.
The brief self-regulatory intervention led to an increase in dental flossing and social-cognitive constructs. A sequential mediator model was identified in which first changes in intention and afterwards changes in self-efficacy mediated between treatment conditions and behavioral outcomes.
Intention formation and self-efficacy seem to play an instrumental role in the mechanism that facilitates dental flossing among adolescent girls. Oral self-care interventions should consider the application of intention formation strategies combined with building confidence in one's ability to adhere to the regimen.
International Journal of Behavioral Medicine 12/2014; DOI:10.1007/s12529-014-9459-6 · 2.63 Impact Factor