Action control bridges the planning-behaviour gap: a longitudinal study on physical exercise in young adults

The relationship between exercise intention and behavior of Chinese college students: A moderated mediation model

Inconsistency between intention and behavior is very common in daily life. This study explored the intention-behavior relationship in exercise, focusing on the mediating effect of action planning and the moderating effects of habit strength and gender. For the purpose of providing theoretical reference for the implementation of intervention strategies in the volitional phase, a total of 489 college students (M-age = 20.61, 57.46% female) from Hubei Province, China, were recruited to complete the questionnaire at two time points. The findings showed that exercise intention could positively predict exercise behavior via the mediating effect of action planning, with the mediating effect accounting for 48.52% of the total effect. The predictive effect of action planning × habit strength interaction on exercise behavior was statistically significant. As individuals’ levels of habitual strength increased, so did the relationship between action plans and exercise behavior. The action planning-exercise behavior relationship was stronger in males than in females. In summary, action planning is a very important predictor of the post-intentional phase and has many advantages. For individuals whose exercise has become habitualized, forming a plan is not counterproductive and can still promote more exercise rather than in a mutually compensating manner.

The effects of health insurance and physical exercise participation on life satisfaction of older people in China-Based on CHNS panel data from 2006 to 2015

Background

In China, the problem of aging population has become more and more serious. The factors influencing life satisfaction of older people are becoming a significant issue. This study explores the effects of health insurance and physical exercise on life satisfaction of older people in China.

Method

This study used an unbalanced panel dataset (n = 6,393, T = 4) of older adults aged 60-80 years from the 2006 to 2015 China Health and Nutrition Survey (CHNS). A panel ordered logistic regression model was developed to examine the effects of health insurance and physical exercise on older people' life satisfaction. Mediation tests were used to examine the mediating role of physical exercise in the effect of health insurance on life satisfaction of older people.

Result

Life satisfaction of older people was positively associated with participation in health insurance (OR = 1.439) and physical exercise (OR = 1.033). Participation in government health insurance, urban employee health insurance (UEBMI), new rural cooperative health insurance (NRCMI), and other commercial health insurance all have positive effects on life satisfaction of older people. Physical exercise plays a masking role in the effect of health insurance on life satisfaction of older people.

Conclusion

Participation in health insurance and physical exercise are important means to promote life satisfaction among older people. Physical exercise affects the impact of health insurance on older people's life satisfaction.

A Smartphone-Based Self-management Intervention for Individuals With Bipolar Disorder (LiveWell): Empirical and Theoretical Framework, Intervention Design, and Study Protocol for a Randomized Controlled Trial

Background

Bipolar disorder is a severe mental illness with high morbidity and mortality rates. Even with pharmacological treatment, frequent recurrence of episodes, long episode durations, and persistent interepisode symptoms are common and disruptive. Combining psychotherapy with pharmacotherapy improves outcomes; however, many individuals with bipolar disorder do not receive psychotherapy. Mental health technologies can increase access to self-management strategies derived from empirically supported bipolar disorder psychotherapies while also enhancing treatment by delivering real-time assessments, personalized feedback, and provider alerts. In addition, mental health technologies provide a platform for self-report, app use, and behavioral data collection to advance understanding of the longitudinal course of bipolar disorder, which can then be used to support ongoing improvement of treatment.

Objective

A description of the theoretical and empirically supported framework, design, and protocol for a randomized controlled trial (RCT) of LiveWell, a smartphone-based self-management intervention for individuals with bipolar disorder, is provided to facilitate the ability to replicate, improve, implement, and disseminate effective interventions for bipolar disorder. The goal of the trial is to determine the effectiveness of LiveWell for reducing relapse risk and symptom burden as well as improving quality of life (QOL) while simultaneously clarifying behavioral targets involved in staying well and better characterizing the course of bipolar disorder and treatment response.

Methods

The study is a single-blind RCT (n=205; 2:3 ratio of usual care vs usual care plus LiveWell). The primary outcome is the time to relapse. Secondary outcomes are percentage time symptomatic, symptom severity, and QOL. Longitudinal changes in target behaviors proposed to mediate the primary and secondary outcomes will also be determined, and their relationships with the outcomes will be assessed. A database of clinical status, symptom severity, real-time self-report, behavioral sensor, app use, and personalized content will be created to better predict treatment response and relapse risk.

Results

Recruitment and screening began in March 2017 and ended in April 2019. Follow-up ended in April 2020. The results of this study are expected to be published in 2022.

Conclusions

This study will examine whether LiveWell reduces relapse risk and symptom burden and improves QOL for individuals with bipolar disorder by increasing access to empirically supported self-management strategies. The role of selected target behaviors (medication adherence, sleep duration, routine, and management of signs and symptoms) in these outcomes will also be examined. Simultaneously, a database will be created to initiate the development of algorithms to personalize and improve treatment for bipolar disorder. In addition, we hope that this description of the theoretical and empirically supported framework, intervention design, and study protocol for the RCT of LiveWell will facilitate the ability to replicate, improve, implement, and disseminate effective interventions for bipolar and other mental health disorders.

Trial Registration

ClinicalTrials.gov NCT03088462; https://www.clinicaltrials.gov/ct2/show/NCT03088462

International Registered Report Identifier (IRRID)

DERR1-10.2196/30710

Predicting hand washing, mask wearing and social distancing behaviors among older adults during the covid-19 pandemic: an integrated social cognition model

BACKGROUND

Older adults are at a higher risk from COVID-19. Individual preventive behaviors including frequent hand washing, mask wearing, and social distancing play important roles in reducing the transmission of COVID-19 in the community. This study aimed to identify the determinants of three preventive behaviors of older adults during the COVID-19 pandemic by using an Integrated Social Cognition Model.

METHODS

Using a prospective study design, 516 Chinese older adults from Hubei province of China (mean age = 67.55 years, SD = 6.60, 57.9% females) completed two online questionnaire surveys. The demographics, social cognition constructs (motivational self-efficacy, risk perception, attitude, subjective norm, health knowledge, intention, volitional self-efficacy, planning, action control) and three preventive behaviors were measured during the first-wave online survey from 18 May 2020 to 7 June 2020. One month later, three preventive behaviors were measured again during the second-wave online survey. Data were analyzed by structural equation modelling.

RESULTS

Models showed attitude, motivational self-efficacy and subjective norm were consistent predictors of intention, motivational self-efficacy was a consistent predictor of volitional self-efficacy, planning and volitional self-efficacy were consistent predictors of action control, and health knowledge was a consistent predictor of behaviors across all three preventive behaviors. In addition, mediating relationships were found in the model of hand washing behavior. In particular, planning (β = .109, p = .042) and action control (β = .056, p = .047) mediated between volitional self-efficacy and hand washing respectively. Action control also mediated between planning and hand washing (β = .087, p = .044). Moreover, the inclusion of past behaviors in three models attenuated most of the structural relations.

CONCLUSIONS

The current study's findings basically supported the Integrated Social Cognition Model and identified key modifiable determinants of preventive behaviors. Based on this model, future interventions aiming to promote COVID-19 preventive behaviors among older adults are warranted.

Autonomous motivation and action planning are longitudinally associated with physical activity during adolescence and early adulthood

We examined the associations of autonomous motivation, controlled motivation, and physical activity (PA) planning with PA participation over six years across the adolescent-to-adult transition. Participants from the NEXT Generation Health Study, a nationally representative cohort study of U.S. 10th graders (N=2785), completed surveys yearly from 2010 to 2016 (four years post-high school). This study used data from Waves 2 (W2) through 7 (W7). Data were analyzed using growth models accounting for the complex survey design and controlling for sex, race/ethnicity, and body mass index. A piecewise growth model with two pieces (Piece 1: W2-W4; Piece 2: W4-W7) indicated that PA declined during late adolescence (W2-W4) (b=-0.31, β=-0.22, p<.001), but did not decline after the transition into early adulthood (W4-W7) (b=-0.08, β=-0.04, p=.052). Autonomous motivation was positively associated with PA at all waves (b=0.23-0.33, β=1.90-4.37, p<.001). Controlled motivation was only positively associated with PA at W3 (12th grade) (b=0.13, β=1.54, p=.011). PA planning varied significantly between individuals and significantly predicted PA (b=0.44, β=0.21, p<.001). Although PA decreased significantly during late adolescence, PA did not decrease significantly after transitioning into early adulthood (one to four years post-high school). Elevated autonomous motivation and PA planning were consistently and significantly associated with higher PA, suggesting that these may be useful intervention targets during this adolescent-to-adult transition.

Systematic Review of Psychological and Behavioral Correlates of Recreational Running

Introduction: The aim of this review was to systematically synthesize the published literature describing the psychological and behavioral correlates of recreational running in adults, defined as running for leisure, with or without a competitive component. Methods: Quantitative research published in peer-reviewed journals until January 2021 were included. Studies were identified through MEDLINE, PsycINFO, SPORTDiscus, and Web of Science and were included in this review if they (1) were aimed at recreational running, (2) included general adult samples (18 years or older, without a diagnosed medical condition or metabolic disorder), and (3) assessed psychological or behavioral correlates of recreational running. Results: Fifty-six articles reporting 58 studies met the eligibility criteria and were included. There were 27 cross-sectional studies, 12 longitudinal studies, and 19 trials (8 non-controlled trials, 5 controlled trials, and 6 randomized controlled trials) (n = 37,501, 1877 years old, 43% women). Twenty-eight studies assessed antecedents of running behavior, and 25 studies used running behavior as treatment or predictor of a given effect or outcome. Four studies examined both predictors and outcomes of running. Thirty-one studies showed poor quality, while 20 had fair and 7 good quality. Motives were the most frequently studied antecedent of running behavior (k = 19), and results suggest that the highest-ranked or more prevalent motives were physical health, psychological motives, and personal achievement. Additionally, perceived control, attitude toward running, intention and subjective norms, self-efficacy, and social support may have also played a role in the adoption of recreational running. Moreover, improvements in mood (k = 10) and well-being (k = 10) were the most frequently reported positive outcomes of running. Reductions in depression, anxiety, and stress were also reported in included studies. Discussion: To our knowledge, this is the first systematic review on this topic. The identification of behavioral and psychological correlates of recreational running across populations can contribute to inform and guide a public policy agenda, focused on helping people sustain regular physical activity, through a modality they have chosen and appear to enjoy. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=68954, identifier: CRD42017068954.

Modelling Longitudinal Directional Associations Between Self-regulation, Physical Activity, and Habit: Results from a Cross-lagged Panel Model

BACKGROUND

The directionality of associations between self-regulatory variables, behavior, and automaticity is seldomly tested. In this study, we aimed to examine a volitional, self-regulatory sequence of variables proposed in the Health Action Process Approach framework (intention → action plans → action control → behavior) and its relationship with the construct of automaticity of the physical activity habit.

METHODS

Longitudinal data was collected from high school students (N = 203, M_age = 15.39 (SD = 1.43), 52% women) at three measurement points. First, a confirmatory factor analysis measurement model was used to examine the study variables across measurement points. Next, a cross-lagged panel model was used to test directionality between variables.

RESULTS

After adequate fit of the measurement model was confirmed, a mechanism integrating self-regulation with behavior and automaticity was examined. The hypothesized directionality between variables was verified overall by cross-lagged analysis. However, for the intention-action plan association, the inverse relationship was found: plans were associated with subsequent intentions, but intentions did not predict plans. Moreover, automaticity was not associated with subsequent physical activity behavior.

CONCLUSIONS

In general, our findings supported the hypothesized longitudinal direction of the associations, confirming that self-regulation may lead to behavior performance and automaticity. Unexpected findings and implications for intervention and future research are discussed.

A longitudinal investigation of older adults' physical activity: Testing an integrated dual-process model

OBJECTIVE

To assess the effects of conscious and non-conscious processes for prediction of older adults' physical activity (PA), we tested a dual-process model that integrated motivational (behavioural intention) and volitional (action planning and coping planning) processes with non-conscious, automatic processes (habit).

METHOD

Participants (N = 215) comprised community-dwelling older adults (M = 73.8 years). A longitudinal design was adopted to investigate direct and indirect effects of intentions, habit strength (Time 1), and action planning and coping planning (Time 2) on PA behaviour (Time 3). Structural equation modelling was used to evaluate the model.

RESULTS

The model provided a good fit to the data, accounting for 44% of the variance in PA behaviour at Time 3. PA was predicted by intentions, action planning, and habit strength, with action planning mediating the intention-behaviour relationship. An effect of sex was also found where males used fewer planning strategies and engaged in more PA than females.

CONCLUSIONS

By investigating an integration of conscious and non-conscious processes, this study provides a novel understanding of older adults' PA. Interventions aiming to promote PA behaviour of older adults should target the combination of psychological processes.

Intervenções comportamentais de prevenção da obesidade infantil: Estado da arte em portugal

Objetivo

A prevenção do excesso de peso e obesidade infantis em Portugal é prioritária e tem sido alvo de vários programas de intervenção. Este estudo teve como objetivo principal desenvolver um registo nacional, caracterizando as intervenções implementadas.

Método

Incluíram-se programas de promoção de estilos de vida saudáveis implementados em Portugal, identificados através do “Google” e de websites Institucionais, que visavam contribuir direta ou indiretamente para a prevenção e controlo da obesidade infantil. A seleção foi realizada pela leitura dos títulos e informação disponibilizada nos websites, e foram depois extraídas informações sobre cada projeto.

Resultados

Foram incluídos na análise 29 programas de promoção de alimentação saudável (n = 19), atividade física (n = 2) ou ambos (n = 8), realizados entre 2001 e 2015. À exceção de um programa, as atividades realizadas são descritas, mas o racional teórico e as técnicas de mudança comportamental utilizadas não são explicitadas. Apenas 16 programas foram avaliados, disponibilizando online os resultados obtidos.

Conclusão

A maioria dos programas não fornece dados relativamente à sua fundamentação teórica e empírica, nem informação detalhada sobre as atividades realizadas e avaliação. Futuros programas devem fornecer maior detalhe sobre o racional teórico e as técnicas de modificação comportamental utilizadas, e a avaliação da eficácia na mudança do comportamento-alvo.

Social-cognitive antecedents of hand washing: Action control bridges the planning-behaviour gap

OBJECTIVES

To examine motivational and volitional factors for hand washing in young adults, using the Health Action Process Approach (HAPA) as a theoretical framework.

DESIGN

In a longitudinal design with two measurement points, six weeks apart, university students (N = 440) completed paper-based questionnaires.

MAIN OUTCOME MEASURES

Prior hand washing frequency, self-efficacy, outcome expectancies, intention and action planning were measured at baseline, and coping planning, action control and hand washing frequency were measured at follow-up.

RESULTS

A theory-based structural equation model was specified. In line with the HAPA, the motivational factors of self-efficacy and outcome expectancies predicted intention, whereas the volitional factors of planning and action control mediated between intention and changes in hand washing frequency. Action control was confirmed as the most proximal factor on hand washing behaviour, thus representing a bridge of the planning-behaviour gap.

CONCLUSIONS

Both motivational and volitional processes are important to consider in the improvement of hand hygiene practices. Moreover, the statistically significant effects for planning and action control illustrate the importance of these key self-regulatory factors in the prediction of hand hygiene. The current study highlights the importance of adopting models that account for motivational and volitional factors to better understand hand washing behaviour.

Promoting action control and coping planning to improve hand hygiene

BACKGROUND

We examined a brief educational intervention addressing hand hygiene self-regulatory mechanisms, and evaluated which psychological mechanisms may lead to hand hygiene behaviours.

METHODS

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.

RESULTS

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.

DISCUSSION

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.

CONCLUSION

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.