Applying the theory of planned behavior: Examining how communication, attitudes, social norms, and perceived behavioral control relate to healthy lifestyle intention in Singapore

Theory-based obesity intervention program for women: A randomized controlled study

AIMS

To determine the effect of the education and counseling intervention given to overweight and obese women according to the theory of planned behavior on their health behaviors.

METHODS

The study consisted of 78 overweight and obese women in total, between the ages of 18-49. While the women in the intervention group were given a 6-month training program and 6-month counseling service structured according to the theory of planned behavior, the women in the control group were given standard obesity training and were put on hold for 6 months.

RESULTS

There was a decrease in the post-test anthropometric measurement values of the intervention group compared to the pretest. While there was no statistically significant change in the activity status of the control group over time, the inactivity rate of the intervention group decreased; however, the minimal activity rate increased over time. The post-test healthy life style behaviors scale II health responsibility, physical activity, nutrition, stress management and total scores of the intervention group were higher than those of the control group, and the differences were significant.

CONCLUSION

It has been determined that the education and counseling services applied to overweight and obese women based on the theory of planned behavior are effective in gaining positive health behaviors.

Exploring the effects of cannabis health warnings on protective health intentions among US adults in legal recreational states

BACKGROUND

As cannabis policy trends toward liberalization, assessing cannabis health warning effects becomes increasingly important. This study investigated underlying mechanisms accounting for the effectiveness of cannabis health warnings on protective health intentions.

METHOD

A sample of 1,095 adults (21+) living in legal recreational US states who reported using cannabis in the past 12 months participated in an online experiment. Participants were randomly assigned to view cannabis health warnings that described risks of impaired driving, mental health, and smoke exposure and varied pictures and text (vs. text-only) attributes in warnings. Outcomes were message reactions (cognitive elaboration, fear, and hope), attitudes and beliefs (perceived severity of cannabis harms and perceived susceptibility to cannabis harms, and perceived response and self-efficacy to prevent cannabis harms), and protective health intentions (information-seeking about cannabis health effects and having interpersonal discussions about cannabis harms with family, friends, and medical professionals).

RESULTS

MANCOVA results showed no significant differences between text-only vs. pictorial attributes on protective health intentions; thus, warning conditions were controlled and analyzed using structural equation modeling (SEM). SEM results showed that attention to cannabis health warnings (text-only or pictorial) elicited higher cognitive elaboration, fear, and hope-an emotion associated with coping actions that motivate positive expectations of future events. These outcomes, in turn, were associated with greater perceived severity and susceptibility and greater perceived response efficacy, respectively. Hope, perceived severity, and perceived response and self-efficacy were independently associated with greater intentions to seek information about cannabis health effects and to discuss cannabis health harms.

CONCLUSION

Attention to warnings impacted emotions, attitudes, and protective health intentions. Fear is commonly associated with health warning effects, and our results suggest that hope is also an important factor. This research contributes to understanding the effects of cannabis health warnings and can inform regulatory agencies that mandate warnings on cannabis products.

The effect of social media environmental information exposure on the intention to participate in pro-environmental behavior

With the threat of global warming, countries worldwide have enhanced their environmental campaigns on social media to increase users' willingness to take pro-environmental actions. In this study, we examined the direct and indirect effects of exposure to environmental information on Chinese young adults' (18-25 years old) intention to participate in environmental protection actions (e.g., recycling, using public transportation, involvement in an environmental group, and participation in eco-friendly events). Data were collected from a sample of 291 Chinese young adults using a web-based survey and a thoroughly designed questionnaire. The accumulated data were analyzed using SPSS version 20. Hierarchical regression and mediation analysis were performed for testing hypotheses. The results indicated that exposure to environmental information on Chinese social media platforms (WeChat and Xiaohongshu) positively affected individuals' intention to participate in pro-environmental behavior, perceived pro-environmental behavior control, pro-environmental attitude, and fear of victimization. The indirect effect demonstrated that pro-environmental behavior control and attitude mediated the relationship between exposure to environmental information on both WeChat and Xiaohongshu and the intention to participate in pro-environmental behavior. Extending the existing literature, this study provides empirical evidence on the influence of environmental information exposure on the intention to participate in environmental protection among Chinese adults. In addition, it provides valuable insights into the mediating mechanisms involving cognitive, psychological, and emotional factors in this relationship. Policy makers should implement effective pro-environmental promotions on social media to inspire individuals to engage in environmentally friendly actions. In addition, social media managers should strictly authenticate and remove misleading environmental content.

Acceptance of healthy lifestyle nudges in the general population of Singapore

Background

In recent years, behaviourally driven policies such as nudges have been increasingly implemented to steer desired outcomes in public health. This study examines the different nudges and the socio-demographic characteristics and lifestyle behaviours that are associated with public acceptance of lifestyle nudges.

Methods

The study used data from the nationwide Knowledge, Attitudes and Practices study (KAP) on diabetes in Singapore. Three types of nudges arranged in increasing order of intrusiveness were examined: (1) information government campaigns, (2) government mandated information and (3) default rules and choice architecture. Acceptance was assessed based upon how much respondents ‘agreed’ with related statements describing heathy lifestyle nudges. Multivariable linear regressions were performed with socio-demographics and lifestyle behaviours using scores calculated for each nudge.

Results

The percentage of respondents who agreed to all statements related to each nudge were: 75.9% (information government campaigns), 73.0% (government mandated information), and 33.4% (default rules and choice architecture). Respondents of Malay/Others ethnicity (vs. Chinese) were more likely to accept information government campaigns. Respondents who were 18 – 34 years old (vs 65 years and above), female, of Malay/Indian ethnicity (vs Chinese), were sufficiently physically active, and with a healthier diet based on the DASH (Dietary Approach to Stop Hypertension) score were more likely to accept nudges related to government mandated information. Respondents of Malay/Indian ethnicity (vs Chinese), and who had a healthier diet were more likely to accept default rules and choice architecture.

Conclusion

Individuals prefer less intrusive approaches for promoting healthy lifestyle. Ethnicity and lifestyle behaviours are associated with acceptance of nudges and should be taken into consideration during the formulation and implementation of behaviourally informed health policies.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13668-x.

Continuance Intention of Online Healthcare Communities- The Mediation Mechanism of Social Interaction Ties

The purpose of this research is to evaluate the continuance usage intention on online healthcare community (OHC) platform for patients and examine the "doctor-OHC-patient" relationship. The proposed model attempted to integrate social interaction ties, shared value, trust with the indirect effects on the relationship between the determinants and continuous usage intention of the OHC platform. The empirical results showed that perceived critical mass, social identity, and para-social interaction would strengthen continuance intention via the social interaction ties. In addition, this study found that the shared values and trust increase users' willingness to continue usage of OHC. This study provides OHC platform managers with an in-depth understanding of the "doctor-OHC-patient" online social interaction. The results of this study may also help hospitals, health policy makers, and related healthcare practitioners to improve the way they use the web for advocacy and guidance, and provide insight into the intent of promoting the ongoing use of OHC platforms.

Study on the Relationship between Leisure Activity Participation and Wearing a Mask among Koreans during COVID-19 Crisis: Using TPB Model

This study utilizes the Theory of Planned Behavior (TPB) variables-including "attitude," "subjective norms," and "perceived behavioral control"-to understand the relationship between mask-wearing behavior and physical/non-physical leisure activity participation in Koreans as well as the tendencies behind mask-wearing intentions within leisure activities. The measurement tools used attitude, subjective norms, control, and mask use intention factors based on the TPB. Overall, 545 individuals participated, and the non-overlapping regions, sex, and age were considered through the stratified sampling method. The survey was conducted online owing to COVID-19, and collected data were derived through descriptive and multiple linear regression analyses. First, a difference in mask-wearing intention based on physical and non-physical leisure activities was identified; second, attitudes and perceived behaviors were considered in light of the dangers posed by COVID-19. It was found that control influences the tendency of intention to wear a mask depending on whether the group was engaged in physical or non-physical activity. Therefore, it can be stated that mask-wearing must be mandatory during physical and non-physical activities owing to respiratory diseases such as COVID-19. It is also important to simultaneously promote a positive attitude toward mask-wearing to enable people to believe that they can stay in full control of their own health.

Predictive Variables of Adolescents' Intention to Be Physically Active after Graduation. Is Gender a Conditioning Factor?

The acquisition of physical activity habits during adolescence is fundamental to guarantee its adherence throughout life. However, these levels decrease during this stage, with women experimenting a more significant decrease. This paper aims to analyze if there are significant differences in the variables related to the intention to be physically active between men and women and if there is a moderating effect of gender on the variables that predict this intention. The sample is composed of 256 adolescents, aged between 16 and 19 years, 55.50% of whom are men, and 44.50% women. The results show that there are statistically significant differences (p < 0.05), with boys showing higher scores in the intention, athletic identity, and in the strength, condition, and attractiveness. About the predictive variables of the intention, the gender moderates the relationships between the physical attractiveness, condition and strength with the perceived behavioral control (pcfmale-pcfmale = 0.44; −0.48 p < 0.001; 0.27, p < 0.05, respectively), and between the subjective norm and the intention to be physically active (pcmale-female = 0.33, p < 0.01). These results highlight the importance of considering gender when designing specific policies for the promotion of physical-sports practice among adolescents to reduce the existing gender gap.

Personal and Media Factors Related to Citizens' Pro-environmental Behavioral Intention against Haze in China: A Moderating Analysis of TPB

This study extends the theory of planned behavior by taking communication factors into account to examine the determinants of pro-environmental behavioral intention in haze mitigation. Unlike other theory of planned behavior (TPB) extension studies, we shift the focus of inquiry from examining the mediating role of TPB variables to investigating the moderating role in promoting pro-environmental behavior. Using an online survey in China, the results indicated that attitude, subjective norms, perceived behavioral control, and attention to haze-related efficacy messages were positively associated with pro-environmental behavioral intention. Notably, attention to haze-related threat messages had no significant relationship with behavioral intention. Moreover, moderation analyses revealed that the interaction effects between attention to efficacy messages and attention to threat messages on behavioral intention vary among people with different attitude, subjective norms, and perceived behavioral control. Theoretically, this study contributes to the literature of the TPB by analyzing its moderating role in promoting behavior change. Findings from this study suggest the importance of disseminating distinctive media messages to audiences with different personality traits, which is beneficial for practitioners to tailor specific messages in environmental campaigns.