Using the theory of planned behaviour and implementation intentions to reduce binge drinking in new university students

Evaluation of an implementation intentions intervention for managing university student stress

University students consistently report high levels of stress, which has been associated with a range of adverse outcomes. Promoting adaptive coping behaviours, such as problem-focused coping for managing university stress, is therefore a timely area of investigation. Current coping intervention approaches target reasoned cognitive processes; however, recent research has suggested that automatic processes are more strongly associated with problem-focused coping behaviour. The current study examined the effect of an implementation intentions intervention, a technique that can support behaviour to be performed automatically by facilitating continued repetition of a plan, on problem-focused coping behaviour under stress and stress-related outcomes. Following a pilot study (N = 21), a preregistered randomized controlled trial was conducted with university students (N = 154) using an online survey. Participants completed baseline measures of problem-focused coping behaviour, behavioural automaticity, behavioural intentions, action planning, perceived stress, procrastination, and psychological wellbeing; before receiving the intervention or control condition stimuli, and then at a 2-week follow-up. Behavioural intention and action planning were also measured immediately post-intervention. The intervention had a significant medium-sized effect on action planning for problem-focused coping, but no other significant effects were detected. Exploratory assessment of plan quality revealed medium-sized correlations between plan quality and changes in problem-focused coping behaviour. Findings indicate that implementation intentions may be a promising approach for increasing planning for the use of problem-focused coping. Indicators of plan quality found to be associated with changes in problem-focused coping provide valuable avenues for intervention optimisation in future research.

A systematic review of binge drinking interventions and bias assessment among college students and young adults in high-income countries

Alcohol is the number one substance used by young people and people of college age. Binge drinking (BD) in this age group is considered one of the most important global health issues, as much harm accrues from it and even lives are lost. This study aimed to review the interventions to curb BD or encourage responsible drinking among college students and young adults. MEDLINE (PubMed), ERIC and APA PsycINFO were searched. The selected articles were published in English and had to evaluate a BD reduction program through a randomized control trial (RCT) among college students or young adults between the ages of 17-24 years. The exclusion criteria included research not published in English, systematic review articles, qualitative studies, designs other than RCTs and discussion articles on college students drinking with no findings. The three reviewers independently screened and extracted the data using the PRISMA guidelines. The overall quality of the studies was assessed. Then, 10 of the 12 interventions studied were found to be successful in reducing BD among college students, though the effect sizes were small to medium. A minority of the studies used behavior change theories. Effective interventions for reducing BD among college students and young adults should include robust behavior change theories, longer follow-up time and the operationalization of multiple outcomes. Process evaluation is needed to be conducted in these studies.

The Relationship between Drunkorexia, Alcohol, and Blackouts Among College Students: An Exploratory Study

College drinkers commonly report blacking out (i.e., alcohol-induced amnesia), and those who drink with the intention to blackout are at risk for harmful consequences. Drunkorexia (i.e., restriction of calories on planned drinking days) is a high-risk behavior potentially associated with blacking out. Informed by the Theory of Planned Behavior (TPB), this study explores blackout experiences and intentions to blackout association with drunkorexia. College students (n=2335) who primarily identified as female and White participated via an online survey. Participants received a $3 coupon for completion of the study. Consistent with the literature, 40% and 60.7% participants reported experiencing blackouts and drunkorexia respectively in the last year. Informed by the TPB, a structural equation model assessed if more frequency blackout experiences (IV) related to drunkorexia behaviors (DV1) and alcohol behaviors (DV2), and if there was a significant indirect effect through blackout intention. The model fit the data well (CFI=.98, TLI=.95) and suggests that more frequent blackout experiences relate to more drunkorexia experiences (R²=.04) and higher levels of alcohol consumption (R²=.44). In addition, the relationship between blackout experiences and drunkorexia flows through intentions to blackout (i.e., a significant indirect effect). Findings are consistent with TPB, which suggests intentions predict health behavior. Future interventions should consider modifying intentions and other possible TPB constructs to minimize high risk alcohol consumption and drunkorexia behaviors.

The effect of forming implementation intentions on alcohol consumption: A systematic review and meta-analysis

ISSUES

Meta-analysis was used to estimate the effect of forming implementation intentions (i.e., if-then plans) on weekly alcohol consumption and heavy episodic drinking (HED). Sample type, mode of delivery, intervention format and timeframe were tested as moderator variables.

APPROACH

Cochrane, EThOS, Google Scholar, PsychArticles, PubMed and Web of Science were searched for relevant publications to 31 March 2021. Random-effects meta-analysis was used to estimate the effect size difference (d) between individuals forming versus not forming implementation intentions on weekly consumption and HED.

KEY FINDINGS

Sixteen studies were included in meta-analyses. The effect size difference for forming implementation intentions on weekly alcohol consumption was d₊  = -0.14 confidence interval (CI) [-0.24; -0.03]. Moderator analyses highlighted stronger effects for: (i) community (d₊  = -0.38, CI [-0.58; -0.18]) versus university (d₊  = -0.04, CI [-0.13; 0.05]) samples; (ii) paper (d₊  = -0.26, CI [-0.43; -0.09]) versus online (d₊  = -0.04, CI [-0.14; 0.06]) mode of delivery; and (iii) volitional help sheet (d₊  = -0.34, CI [-0.60; -0.07]) versus implementation intention format (d₊  = -0.07, CI [-0.16; 0.02]). In addition, effects diminished over time (B = 0.02, SE = 0.01, CI [0.03; 0.01]). Forming implementation intentions had a null effect on HED, d₊  = -0.01 CI [-0.10; 0.08].

IMPLICATIONS

Forming implementation intentions reduces weekly consumption but has no effect on HED.

CONCLUSION

This review identifies boundary conditions on the effectiveness of implementation intentions to reduce alcohol consumption. Future research should focus on increasing the effectiveness of online-delivered interventions and integrating implementation intention and motivational interventions.

Strategies to cut down drinking, alcohol consumption, and usual drinking frequency: Evidence from a British online market research survey

BACKGROUND

Relatively little is known about how risky drinkers attempt to moderate their drinking in the absence of specialist support. The broader literature has identified multiple potential strategies that people use to cope with temptation when trying to control health-risk behaviours. This study aims to identify types of alcohol moderation strategies used by British adults, and to explore how concurrent alcohol consumption differs across moderation strategies, focusing on the important role of usual drinking frequency.

METHODS

We use a continuous repeat cross-sectional survey and one-week drinking diary collected by the market research company Kantar; these provide detailed information on alcohol consumption during a diary week and on how individuals try to moderate alcohol use for 49,204 British adults trying to reduce their drinking from 2013 to 2019. We use Latent Class Analysis (LCA) to identify predominant types of moderation strategies. With a three-step method, we also analyse the associations between adopting different moderation strategies, measures of frequency and intensity of drinking events, and usual drinking frequency.

RESULTS

We found evidence of four alcohol moderation strategies: 29% of individuals use a pre-commitment-focused strategy (having fewer drinking occasions), two set of individuals adopt self-control strategies within drinking occasions (specifically 28% select smaller drinks and 5% have fewer drinks), while 38% adopt a mixed strategy that involves all three. Those using commitment tend to have a higher average consumption per drinking occasion but lower overall weekly consumption compared to those using self-control. Weekly alcohol consumption is particularly high among individuals who are usual everyday drinkers and use self-control to cut down drinking.

CONCLUSION

This analysis provides a useful platform for further work, using prospective or intervention designs, to test the relative effectiveness of different moderation strategies for alcohol consumers who want to reduce their alcohol consumption.

Predicting Construction Workers’ Intentions to Engage in Unsafe Behaviours Using Machine Learning Algorithms and Taxonomy of Personality

Dynamic environmental circumstances can sometimes be incompatible with proactive human intentions of being safe, leading individuals to take unintended risks. Behaviour predictions, as performed in previous studies, are found to involve environmental circumstances as predictors, which might thereby result in biased safety conclusions about individuals’ inner intentions to engage in unsafe behaviours. This research calls attention to relatively less-understood worker intentions and provides a machine learning (ML) approach to help understand workers’ intentions to engage in unsafe behaviours based on the workers’ inner drives, i.e., personality. Personality is consistent across circumstances and allows insight into one’s intentions. To mathematically develop the approach, data on personality and behavioural intentions was collected from 268 workers. Five ML architectures—backpropagation neural network (BP-NN), decision tree, support vector machine, k-nearest neighbours, and multivariate linear regression—were used to capture the predictive relationship. The results showed that BP-NN outperformed other algorithms, yielding minimal prediction loss, and was determined to be the best approach. The approach can generate quantifiable predictions to understand the extent of workers’ inner intentions to engage in unsafe behaviours. Such knowledge is useful for understanding undesirable aspects in different workers in order to recommend suitable preventive strategies for workers with different needs.

Implementation intentions speed up young adults' responses to prospective memory targets in everyday life

Prospective memory (PM), which is the ability to remember to do something in the future, is vitally important for successful everyday functioning. Although young adults demonstrate high PM abilities in laboratory settings, their abilities to complete intended actions in naturalistic settings are surprisingly low. The present study tested the effectiveness of various encoding techniques in improving young adults' performance in everyday life. Ninety-two participants were asked to remember to take photographs of receipts for a duration of seven days. The task instructions were either given alone or followed by: (a) the if-then statement, (b) visualising the task, or (c) the combination of the if-then statement plus visualisation. The if-then statement alone significantly speeded up responses to the prospective memory targets, i.e., less time elapsed between getting a receipt and taking a photograph of it. With no effect of the if-then statement on the proportion of correct PM responses, the results may suggest that the if-then statement strengthened the PM cue-intention association but did not influence the PM cue saliency.

Predicting Decisional Determinants of Physical Activity Among Older Adults: An Integrated Behavior Approach

The present study applied the Integrated Behavior Change Model to investigate how behavioral decisions are predicted, namely, intention, planning, and habits, with respect to physical activity. Methods: Participants were older adults (ages 65+) residing in the U.S. (N = 667) who completed online measures of behavioral determinants (autonomous motivation, perceived behavioral control, subjective norms, attitudes, intention, habit, and consistency), in addition to past behavior. Results: A structural equation model revealed that intention was predicted by past behavior and social-cognitive determinants. Social cognitive determinants mediated between past behavior and habit, as well as between autonomous motivation and habit. Intention mediated between past behavior and planning. Discussion: This study highlights the importance of multiple processes (social cognitive, habit/automatic, and post-intentional/planning) that formulate physical activity intentions. Mediation pathways revealed the importance of autonomous motivation for establishing intentions and habit. Facilitating these processes among older adults could be effective for promoting physical activity.

Integration of the Theory of Planned Behavior and Transtheoretical Model of Change for Prediction of Intentions to Reduce or Stop Alcohol Use among Thai Adolescents

Alcohol use among Thai adolescents has been increasing over the past few decades, and efforts to control consumption by underaged youth have proven largely ineffective. Objectives: This study tested components of the Theory of Planned Behavior (TPB) and Readiness to Change, based on the Transtheoretical Model (TTM), to identify useful constructs for developing alcohol use interventions for youth. Methods: A sample of 825 Thai student drinkers (65% female), between the ages of 14 and 19, were recruited in Bangkok, Thailand. Hierarchical regression analyses were used to test components of the TPB and Readiness to Change as predictors of intention to reduce/stop alcohol use while controlling for age, gender and alcohol use. Results: The model accounted for 58% of the variance of intentions. The TPB components accounted for a significant increase in variance beyond that explained by age, gender and alcohol use, ΔR² = .23, p < .001; Perceived Behavioral Control (PBC) was the strongest predictor (β =.41, p < .001), followed by Attitudes (β=.13, p < .001), and Subjective Norms (β =.09, p = .002). Readiness to Change composite scores (β=.54, p < .001) were added last and accounted for a further significant increase, ΔR² = .24, p < .001. Conclusions: The findings suggest that interventions should assess Readiness to Change and utilize effective processes in facilitating change at each stage. Other suggestions are to improve participants' PBC and to further examine the role of specific social norms and attitudes regarding perceived benefits and disadvantages of alcohol use.

Mediating effect of behavioural intention on podcast acceptance

This research contributes to knowledge in mediating effect of lecturers' behavioural intention towards the acceptance of podcasts technology in universities. A cross-sectional quantitative research design was involved in this study. Also, a total of eight hundred and twenty-nine (829) lecturers participated in this research from three different south-west Nigeria Federal universities. The research instrument was titled lecturer's acceptance questionnaire (LAQ) with a calculated Cronbach's alpha of .919, which confirmed the instrument validity. The gathered data was analysed by using both descriptive and inferential statistics. The formulated hypothesis was tested at .05 level of significance. The result from descriptive analysis of data suggested that behavioural intention was at a low level among lecturers and the results of hypothesis testing revealed the effect of behavioural intention as partial mediator of podcast acceptance. Based on these findings relevant conclusions and recommendations were suggested in this research.

Can service members with mild traumatic brain injury learn to develop implementation intentions for self-identified goals?

PURPOSE

Goal achievement relies heavily on executive functions, which may be compromised following mild traumatic brain injury (mTBI). Implementation intentions (II) have been found to help people act in accordance with their goals. II are written statements that describe a behavior that a person plans to enact when they encounter some form of anticipated trigger or stimulus. We evaluated the feasibility of teaching participants with mTBI to develop II for self-identified goals within the context of cognitive rehabilitation.

METHODS

Soldiers with mTBI were recruited from a traumatic brain injury clinic. During the intervention, participants were assigned to develop an II for one of three self-identified goals every day. Descriptive methods were used to examine implementability and acceptability of the II training protocol as well as the extent to which participants learned to develop II for their own goals.

RESULTS

The II training protocol was found to be highly implementable and acceptable to participants. Overall, participants (n = 16) were able to develop II related to their self-identified goals, which primarily focused on managing cognitive problems. For the most part, participants developed II that involved event- rather than time- or somatic/feeling-based triggers.

CONCLUSION AND IMPLICATIONS

Participants with mTBI were able to learn to develop II for their self-identified goals. Further study is needed to determine whether adding II to cognitive rehabilitation advances patient goal achievement.IMPLICATIONS FOR REHABILITATIONIt is feasible to incorporate training in implementation intentions (predetermined "if/when-then" plans that are intended to link specific situational triggers with actions) in metacognitive strategy instruction for patients with mild traumatic brain injury.Participants with mild traumatic brain injury in this study demonstrated that they were able to develop implementation intentions for multiple self-identified rehabilitation goals, which holds promise for also teaching patients with mild cognitive impairment from other conditions.Learning to develop implementation intentions may help patients with mild traumatic brain injury initiate a range of other cognitive strategies in their everyday lives.Implementation intentions have the potential to help patients enact goal behaviors associated with their rehabilitation goals, making cognitive rehabilitation more "customizable" and relevant to clients' specific needs.

Do preparatory behaviours predict alcohol consumption among UK university students?

OBJECTIVE

This study explored whether the frequency and habitual nature of engagement in three behaviours that may serve as preparation for alcohol consumption on a night out with friends - that is, contacting friends to arrange a night out, buying alcohol, drinking alone at home before going out - predicted consumption on such nights.

DESIGN

Prospective correlational design.

METHODS

One hundred and twenty UK university students (68 female, 50 male, two non-binary, mean age = 20.78 years, SD = 1.52) completed a survey comprising intentions, habits, and frequency and habit for the three preparatory behaviours. One week later, a second survey measured the number of nights out with friends on which alcohol was drunk (i.e., drinking frequency) and the number on which four or more alcoholic drinks were consumed (i.e, excessive drinking). Regression models were run to predict drinking frequency and excessive drinking.

RESULTS

Drinking frequency was predicted only by frequency of contacting friends (B = .28, SE = .12, p = .02), and habitually drinking alone before going out (B = .20, SE = .09, p = .03). Excessive drinking was only predicted by alcohol consumption habit (B = .67, SE = .23, p = .003).

CONCLUSIONS

Preceding actions may influence the frequency of alcohol consumption on nights out, independently of intentions and habits relating to alcohol consumption. While interventions to reduce consumption quantity in a single session might focus on disrupting the habits that sustain drinking episodes, efforts to reduce alcohol consumption frequency on nights out might focus on disrupting behaviours that precede alcohol consumption.

Examining the relationship between social norms, alcohol-induced blackouts, and intentions to blackout among college students

BACKGROUND

Alcohol-induced blackouts are a common high-risk outcome of heavy episodic drinking and are considered a marker of problematic alcohol consumption. One's estimates of the prevalence and peer approval of heavy episodic drinking (i.e., social norm perception, descriptive and injunctive norms, respectively) strongly relate to high-risk alcohol consumption. However, it is unknown whether the intention to blackout and the occurrence of alcohol-induced blackouts also associates with these estimates. Therefore, the purpose of this paper is to explore the relation between participants' social norm perception and alcohol-induced blackout intentions and recent blackout history.

METHOD

A total of 4430 participants completed an online survey with an average age of 19.97 (SD = 1.70) years. A series of ANOVAs and a structural equation model examined the relation between social norm perception, intention to blackout, and recent blackout history.

RESULTS

In the structural equation model, the social norm variables (descriptive and injunctive norms) were associated with higher levels of blackout intentions and recent blackout history. The global fit indices suggest that the data fit the model, χ² (n = 4248, 442) = 7755.90, p < .001, CFI = .96, TLI = .96, RMSEA = .06 (CI90 .061-.064).

CONCLUSIONS

Participants with a higher likelihood of having a past 30-day history of alcohol-induced blackouts and higher blackout intentions believed that many of their peer groups approved of certain alcohol-related behaviors and that their peer groups drink frequently and drink higher quantities. Future interventions may assess the impact of adjusting social norms on both the intention to blackout and experiencing blackouts.