'If they do it, so can I': a test of a moderated serial mediation model of descriptive norms, self-efficacy, and perceived similarity for predicting physical activity

The Mediating Role of Physical Activity Self-Efficacy in Predicting Moderate-Intensity Physical Activity in Pregnant People at High Risk for Gestational Diabetes

INTRODUCTION

Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. Moderate-intensity physical activity during pregnancy can lower the risk of GDM. However, the relationship between moderate-intensity physical activity and correlated factors among pregnant people at high risk for GDM remains unknown.

METHODS

A cross-sectional study was conducted in China. Two hundred fifty-two participants completed the Pregnancy Physical Activity Questionnaire, Pregnancy Physical Activity Self-Efficacy Scale, Physical Activity Knowledge Questionnaire, Physical Activity Social Support Scale, 7-item Generalized Anxiety Disorder Scale, Edinburgh Postnatal Depression Scale, and a sociodemographic data sheet. Structural equation modeling was used to explore the direct and indirect associations between the study variables.

RESULTS

A total of 51.6% of the participants did not meet the current physical activity guidelines. Only physical activity self-efficacy was significantly correlated with moderate-intensity physical activity. Physical activity self-efficacy mediated the relationship between moderate-intensity physical activity and knowledge of physical activity, social support for physical activity, and anxiety symptoms. Furthermore, knowledge of physical activity was also associated with improved moderate-intensity physical activity mediated by reduced anxiety symptoms and increased physical activity self-efficacy.

CONCLUSION

Our study revealed a high prevalence of not meeting current physical activity guidelines among pregnant people at high risk for GDM. Physical activity self-efficacy played an important mediating role in predicting moderate-intensity physical activity. Future studies should focus on enhancing self-efficacy to improve moderate-intensity physical activity for pregnant people at high risk for GDM.

Injunctive norms as social pressures: Does autonomy support moderate the relationship between injunctive norms and autonomy satisfaction in physical activity?

Objective: Despite the usefulness of social norms for changing behaviour, injunctive norms (i.e., perceptions of what others approve) from significant others tend to be a weak predictor of physical activity (PA) engagement. A potential explanation is that injunctive norms encompass pressuring social influence that undermines autonomous PA engagement. This study examined whether injunctive norms from significant others undermine individuals' autonomy satisfaction during the pursuit of PA engagement, and whether this effect is moderated by the degree to which significant others offer concurrent autonomy support. Design: Online questionnaires. Measures: Participants' perceptions of injunctive norms and autonomy support from significant others, autonomy satisfaction, behaviour regulation, PA intentions, and weekly PA frequency were assessed at baseline (N = 497) and after two weeks (N = 351). Results: Autonomy support positively related to autonomy satisfaction, whereas injunctive norms were negatively related to autonomy satisfaction. Though the statistical significance of interaction effects was inconsistent across results, simple slopes suggested that the negative relationship between injunctive norms and autonomy satisfaction was attenuated at higher levels of autonomy support in models focusing on influence from parents and friends. Conclusion: When promoting others' PA, communicating direct social expectations/pressures may be ineffective.

Descriptive Norms and eHealth Use Among Older Adults: A Cross-Country Comparative Study

eHealth use enables older adults to access and manage healthcare resources, and benefits their health; however, older adults' uptake of eHealth remains low across societies. Social influences such as descriptive norms may be of critical importance in promoting the elderly's usage of eHealth. Based on the Integrative Model of Behavioral Prediction, this study investigates how descriptive norms relate to eHealth use among the elderly in China and the United States. Analysis of the combined sample (N = 1,070) showed that descriptive norms were positively related to eHealth use. Also, descriptive norms were indirectly associated with eHealth use via injunctive norms, attitudes and self-efficacy. Moderated mediation analysis indicated that these direct and indirect relationships differed across the two countries. This study highlights the important role of descriptive norms in promoting older adults' eHealth use behavior and addresses potential country differences in how the elderly respond to descriptive norms. Several important theoretical and practical implications are also discussed.

Observing Others' Workouts on Social Network Sites Improves the Observer's Physical Activity: A Moderated-Mediation Model

Many people like to share their physical activity (PA) experiences on social network sites (SNSs). Drawing on social cognitive theory, we examined in two studies whether observing others' workouts on SNSs could improve the observer's PA via the mediation of workout self-efficacy. In study 1, a two-wave longitudinal online survey of 461 participants, exposure to SNS workout posts was positively associated with PA through workout self-efficacy. In study 2, an online experimental study with 124 participants, manipulating perceived similarity revealed that it moderates between exposure to SNS workout posts and workout self-efficacy. Moreover, moderation of the indirect effect between exposure to SNS workout posts and PA via workout self-efficacy was supported. These findings reveal the mechanisms and boundary conditions of social media exposure improving workout self-efficacy and promoting PA.

Development and feasibility of a theory-guided and evidence-based physical activity intervention in pregnant women with high risk for gestational diabetes mellitus: a pilot clinical trial

BACKGROUND

Physical activity has been utilized as an effective strategy to prevent gestational diabetes mellitus (GDM). However, most pregnant women with high risk for GDM did not achieve the recommended physical activity level. Furthermore, relevant physical activity protocols have varied without theory-guided and evidence-based tailored to pregnant women with high risk for GDM. This study aimed to develop and pilot test a theory-guided and evidence-based physical activity intervention protocol for pregnant women with high risk for GDM.

METHODS

The study design was guided by the Medical Research Council Framework for Developing and Evaluating Complex Intervention (the MRC framework). The preliminary protocol for physical activity intervention was developed based on self-efficacy theory, research evidence identified from systematic reviews and clinic trials, stakeholder engagement, context, and economic considerations. The preliminary intervention protocol was validated through a content validity study by an expert panel of 10 experts. A single-blinded randomized controlled trial (RCT) was designed to test the feasibility and acceptability of the intervention.

RESULTS

The validity of the preliminary intervention protocol was excellent as consensus was achieved. The final 13 sessions of self-efficacy enhancing physical activity intervention protocol were developed, including knowledge education, exercise clinic visits and video, and group discussions with face-to-face and online blended sessions. In the feasibility study, 34 pregnant women with high risk for GDM were randomized for the intervention (n = 17) or the control group (n = 17). The recruitment and retention rates were 82.9% and 58.9%, respectively. Women in the intervention group had a lower incidence of GDM (26.7% vs. 36.5%) than the control group (P >0.05). All participants were satisfied with the intervention and agreed that the intervention was helpful.

CONCLUSIONS

The developed self-efficacy-enhancing physical activity intervention is a feasible and acceptable intervention for enhancing physical activity among pregnant women with high risk for GDM and is ready to be tested in a more extensive RCT study.

TRIAL REGISTRATION

The study was registered on 4 February 2022 (ChiCTR2200056355) by the Chinese Clini Trial Registry (CHiCTR).

Attraction toward physical activity as a moderator of socio-cognitive predictors of physical activity

Previous research highlighted gaps between socio-cognitive factors (e.g., intentions, social norms) and physical activity (PA) participation. Recently, researchers have asserted that considering affective processes may help bridge this gap. Leveraging the affective-reflective theory of physical inactivity and exercise, this study examined whether individuals' attraction toward PA moderated the relationship between PA intentions and behaviors, and the relationship between social norms and PA intentions. Analysis of online survey data (NT1 = 582; NT2 = 327) provided evidence that social norms more strongly predicted PA intentions under conditions of lower attraction to PA. However, the results differed depending on how intentions were measured: Moderation was found for intention strength as the outcome, but no moderation was found for decisional intention as the outcome. The intentions-behavior relationship, despite nonsignificant interaction terms, showed patterns of positive moderation based on changes in simple slopes: Intentions more strongly predicted PA behavior at time 2 under conditions of higher attraction to PA. The findings align with recent theorizing that emphasizes the role of affect-related determinants when understanding and promoting PA. Practically, these results suggest that intervention strategies should differ according to the individuals' current levels of attraction toward PA.

The Power of "We": Using Inclusive Pronouns in Norm-Based Messages to Promote PrEP-Related Information Seeking Among Men Who Have Sex With Men

Pre-exposure prophylaxis (PrEP) is an effective medicine preventing HIV transmission. This study designs and tests normative messages that promote PrEP-related information seeking among men who have sex with men (MSM) (n = 410). Two factors were manipulated in normative messaging: type of norm (descriptive ["people do"] vs. injunctive ["people should"]) and type of pronoun (individual "you" vs. collective "we"). The results favored the use of descriptive normative appeal and collective pronouns in normative message design. For health campaigns that target MSM's PrEP-related behaviors, this study suggests that descriptive norms may increase behavioral changes whereas injunctive norms may appear intrusive and backfire. At the same time, using inclusive agency assignment (e.g., pronouns) may encourage HIV prevention through provoking solidarity considerations.

Perceived similarity determines social comparison effects of more and less physically active others

This research tested whether the effects of physical activity (PA) comparisons depend on the perceived similarity to comparison standards. In 3 experimental studies, participants compared themselves to a more or a less physically active person. Results showed that perceived similarity determined comparison outcomes: Participants' PA self-evaluation and self-efficacy were higher when focusing on similarities with more (vs less) (Study 1) and dissimilarities with less (vs more) active others (Study 1 and 2). Considering the opposite of the impression that less active others are similar and more active others are dissimilar increased participants' PA self-evaluation, self-efficacy, and intention (Study 3).