It's Time to Think about Time in Health Psychology

Why we don't eat as intended: Moderators of the short-term intention-behaviour relation in food intake

OBJECTIVES

A healthy diet is essential for preventing chronic disease and promoting overall health. Translating one's intention to eat healthy into actual behaviour has, however, proven difficult with a range of internal and contextual factors identified as driving eating behaviour.

DESIGN

We leverage Temporal Self-Regulation Theory to examine these momentary determinants' direct and moderating effects on the intention-behaviour relation with Ecological Momentary Assessment (EMA).

METHODS

Eighty-seven healthy participants (mage = 24.1 years; 59 women, 28 men) reported, 5 times daily for 10 weekdays, their intentions to stick to a self-set dietary restriction goal for the next 3 hr, the goal congruency of their eating behaviour in the past 3 hr, and a range of factors potentially influencing food intake, such as stress, emotions and environmental eating cues.

RESULTS

Two-part multilevel modelling revealed that craving, availability of goal-incongruent foods, social eating cues, giving in to other temptations and weaker momentary intentions directly increased the risk and severity of goal-incongruent intake within the next 3 hr. Social cues, stress and craving further influence behaviour through altering intention implementation.

CONCLUSIONS

Results imply that people regularly fail to implement intentions for 3-hr periods and that a range of factors influences this, both directly and by disrupting intentional processes. While for some barriers, fostering strong intentions throughout the day could be beneficial, others require different strategies for dietary adherence.

Using Wearables to Study Biopsychosocial Dynamics in Couples Who Cope With a Chronic Health Condition: Ambulatory Assessment Study

BACKGROUND

Technology has become an integral part of our everyday life, and its use to manage and study health is no exception. Romantic partners play a critical role in managing chronic health conditions as they tend to be a primary source of support.

OBJECTIVE

This study tests the feasibility of using commercial wearables to monitor couples' unique way of communicating and supporting each other and documents the physiological correlates of interpersonal dynamics (ie, heart rate linkage).

METHODS

We analyzed 617 audio recordings of 5-minute duration (384 with concurrent heart rate data) and 527 brief self-reports collected from 11 couples in which 1 partner had type II diabetes during the course of their typical daily lives. Audio data were coded by trained raters for social support. The extent to which heart rate fluctuations were linked among couples was quantified using cross-correlations. Random-intercept multilevel models explored whether cross-correlations might differ by social contexts and exchanges.

RESULTS

Sixty percent of audio recordings captured speech between partners and partners reported personal contact with each other in 75% of self-reports. Based on the coding, social support was found in 6% of recordings, whereas at least 1 partner self-reported social support about half the time (53%). Couples, on average, showed small to moderate interconnections in their heart rate fluctuations (r=0.04-0.22). Couples also varied in the extent to which there was lagged linkage, that is, meaning that changes in one partner's heart rate tended to precede changes in the other partner's heart rate. Exploratory analyses showed that heart rate linkage was stronger (1) in rater-coded partner conversations (vs moments of no rater-coded partner conversations: rdiff=0.13; P=.03), (2) when partners self-reported interpersonal contact (vs moments of no self-reported interpersonal contact: rdiff=0.20; P<.001), and (3) when partners self-reported social support exchanges (vs moments of no self-reported social support exchange: rdiff=0.15; P=.004).

CONCLUSIONS

Our study provides initial evidence for the utility of using wearables to collect biopsychosocial data in couples managing a chronic health condition in daily life. Specifically, heart rate linkage might play a role in fostering chronic disease management as a couple. Insights from collecting such data could inform future technology interventions to promote healthy lifestyle engagement and adaptive chronic disease management.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/13685.

Let's Enjoy an Evening on the Couch? A Daily Life Investigation of Shared Problematic Behaviors in Three Couple Studies

Symptom-system fit theory proposes that problematic behaviors are maintained by the social system (e.g., the couple relationship) in which they occur because they help promote positive relationship functioning in the short-term. Across three daily life studies, we examined whether mixed-gender couples reported more positive relationship functioning on days in which they engaged in more shared problematic behaviors. In two studies (Study 1: 82 couples who smoke; Study 2: 117 couples who are inactive), days of more shared problematic behavior were accompanied by higher daily closeness and relationship satisfaction. A third study with 79 couples post-stroke investigating unhealthy eating failed to provide evidence for symptom-system fit. In exploratory lagged analyses, we found more support for prior-day problematic behavior being associated with next-day daily relationship functioning than vice-versa. Together, findings point to the importance of a systems perspective when studying interpersonal dynamics that might be involved in the maintenance of problematic behaviors.

Self-control fluctuates from day to day and is linked to subjective well-being within and between persons

The psychological trait of self-control has been linked to interindividual differences in subjective well-being: Individuals with higher self-control report less negative affect, more positive affect, and higher life satisfaction. However, less is known about how much self-control fluctuates from day to day and how these fluctuations are related to subjective well-being. This intensive longitudinal study describes day-to-day fluctuations in self-control and investigates whether and how they are related to subjective well-being. A sample of 64 undergraduate students at the entry phase of university (M = 22.55 years, SD = 6.51, range = 18-53, 97% female) provided 1459 reports of their self-control and subjective well-being, collected every evening across three 9-day measurement bursts over 6 months. Participants' self-control fluctuated substantially from day to day with less than 40% of the variability in daily self-control being attributable to interindividual differences in self-control. On days with higher self-control, participants reported less negative affect, more serenity, and higher life satisfaction. We found no relationship between self-control and vigor. The findings suggest that researchers need to go beyond current assessment practices and theories treating self-control as a stable trait to help develop tailored well-being interventions for everyday life.

Trajectories of quality of life in people with diabetes mellitus: results from the survey of health, ageing and retirement in Europe

Introduction

Previous longitudinal studies identified various factors predicting changes in Quality of Life (QoL) in people with diabetes mellitus (PwDM). However, in these studies, the stability of QoL has not been assessed with respect to individual differences.

Methods

We studied the predictive influence of variables on the development of QoL in PwDM across three waves (2013-2017) from the cross-national panel dataset Survey of Health, Ageing, and Retirement in Europe (SHARE). To determine clinically meaningful changes in QoL, we identified minimal clinically important difference (MCID). Linear regressions and Linear Mixed Models (LMM) were conducted to determine factors associated with changes in QoL.

Results

On average, QoL remained stable across three waves in 2989 PwDM, with a marginal difference only present between the first and last wave. However, when looking at individual trajectories, 19 different longitudinal patterns of QoL were identified across the three time-points, with 38.8% of participants showing stable QoL. Linear regression linked lower QoL to female gender, less education, loneliness, reduced memory function, physical inactivity, reduced health, depression, and mobility limitations. LMM showed that the random effect of ID had the strongest impact on QoL across the three waves, suggesting highly individual QoL patterns.

Conclusion

This study enhances the understanding of the stability of QoL measures, which are often used as primary endpoints in clinical research. We demonstrated that using traditional averaging methods, QoL appears stable on group level. However, our analysis indicated that QoL should be measured on an individual level.

COVID Protection Behaviors, Mental Health, Risk Perceptions, and Control Beliefs: A Dynamic Temporal Network Analysis of Daily Diary Data

BACKGROUND

To control infections, behavioral non-pharmaceutical interventions (NPIs) such as social distancing and hygiene measures (masking, hand hygiene) were implemented widely during the COVID-19 pandemic. At the same time, adherence to NPIs has also been implied in an increase in mental health problems. However, the designs of many existing studies are often poorly suited to disentangle complex relationships between NPI adherence, mental health symptoms, and health-related cognitions (risk perceptions, control beliefs).

PURPOSE

To separate between- and temporal within-person associations between mental health, health-related cognitions, and NPI adherence.

METHODS

Six-month ecological momentary assessment (EMA) study with six 4-day assessment bouts in 397 German adults. Daily measurement of adherence, mental health symptoms, and cognitions during bouts. We used dynamic temporal network analysis to estimate between-person, as well as contemporaneous and lagged within-person effects for distancing and hygiene NPIs.

RESULTS

Distinct network clusters of mental health, health cognitions, and adherence emerged. Participants with higher control beliefs and higher susceptibility were also more adherent (between-person perspective). Within-person, similar findings emerged, additionally, distancing and loneliness were associated. Lagged findings suggest that better adherence to NPIs was associated with better mental health on subsequent days, whereas higher loneliness was associated with better subsequent hygiene adherence.

CONCLUSIONS

Findings suggest no negative impact of NPI adherence on mental health or vice versa, but instead suggest that adherence might improve mental health symptoms. Control beliefs and risk perceptions are important covariates of adherence-both on between-person and within-person level.

Daily Functioning of Veterans With Type 2 Diabetes: Protocol for an Ambulatory Assessment Study

BACKGROUND

Diabetes impacts nearly 25% of veterans. Many veterans do not engage in recommended physical activity and other diabetes self-management behaviors. Type 2 diabetes is generally asymptomatic; as such, the long-term consequences of inadequate self-management and benefits of consistent self-management are not salient in the short term. Furthermore, self-management behaviors typically take place outside of medical visits; however, self-management-related factors are only assessed during medical visits, likely missing large amounts of variability. Thus, ambulatory assessment methods such as ecological momentary assessment (EMA), accelerometry, and continuous glucose monitoring are needed to understand the dynamics of daily self-management and identify potential intervention targets.

OBJECTIVE

The overarching goal of this study is to understand daily, time-varying factors (comorbid affective symptoms and social context) that influence physical activity, diabetes self-management, glycemic management, daily functioning, and quality of life in participants' natural environments.

METHODS

We are recruiting veterans with type 2 diabetes (target N=100). Participants are required to complete a battery of baseline assessments related to mental health, psychosocial factors, and self-management behaviors. Participants then receive 5 momentary EMA surveys and 1 daily EMA survey per day, in which veterans report comorbid affective symptoms (mood, stress, and pain), social support, social interactions, physical activity, and other self-management behaviors. Momentary surveys are delivered randomly during daily preprogrammed intervals over a 14-day sampling period. Accelerometry and continuous glucose monitoring are also used to assess physical activity and blood glucose, respectively. The first 6 participants also completed interviews assessing their experience in the study and barriers to participation. These test participants informed modifications to the protocol for the remaining participants.

RESULTS

The project received funding in April of 2023. Enrollment began in March of 2023 and is planned to be completed in April 2025. Among the 6 test participants, the overall EMA response rate was 87% (range 74%-95%). The response rate for the EMA survey including daily items (67%, range 21%-93%) was lower than the earlier shorter EMA surveys (89%, range 81%-96%). The mean rate of valid accelerometer wear of at least 20 hours per day was 93% (SD 11%), and continuous glucose monitoring data were available for 91% (SD 17%) of days on average. Participants reported few barriers to completing EMA surveys but noted the random timing of questions made it difficult to plan around, and the end-of-day survey was long. Two participants reported survey items reminded or motivated them to engage in diabetes self-management behaviors.

CONCLUSIONS

Assessment tools developed from this study can inform clinical decision-making by considering barriers to self-management that occur in daily life. Clinical applications include tailored, adaptive technology-supported interventions to improve self-management that provide the right type and amount of support at the right time by adapting to an individual's changing internal and contextual state.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/53874.

Studying Movement-Related Behavioral Maintenance and Adoption in Real Time: Protocol for an Intensive Ecological Momentary Assessment Study Among Older Adults

BACKGROUND

Older adults struggle to maintain newly initiated levels of physical activity (PA) or sedentary behavior (SB) and often regress to baseline levels over time. This is partly because health behavior theories that inform interventions rarely address how the changing contexts of daily life influence the processes regulating PA and SB or how those processes differ across the behavior change continuum. Few studies have focused on motivational processes that regulate the dynamic nature of PA and SB adoption and maintenance on microtimescales (ie, across minutes, hours, or days).

OBJECTIVE

The overarching goal of Project Studying Maintenance and Adoption in Real Time (SMART) is to determine the motivational processes that regulate behavioral adoption versus maintenance over microtimescales, using a dual process framework combined with ecological momentary assessment and sensor-based monitoring of behavior. This paper describes the recruitment, enrollment, data collection, and analytics protocols for Project SMART.

METHODS

In Project SMART, older adults engaging in at least 30 minutes of moderate-to-vigorous intensity PA per week complete 3 data collection periods over 1 year, with each data collection period lasting 14 days. Across each data collection period, participants wear an ActiGraph GT3X accelerometer (ActiGraph, LLC) on their nondominant waist and an ActivPAL micro4 accelerometer (PAL Technologies, Ltd) on their anterior thigh to measure PA and SB, respectively. Ecological momentary assessment questionnaires are randomly delivered via smartphone 10 times per day on 4 selected days in each data collection period and assess reflective processes (eg, evaluating one's efficacy and exerting self-control) and reactive processes (eg, contextual cues) within the dual process framework. At the beginning and end of each data collection period, participants complete a computer-based questionnaire to learn more about their typical motivation for PA and SB, physical and mental health, and life events over the course of the study.

RESULTS

Recruitment and enrollment began in January 2021; enrollment in the first data collection period was completed by February 2022; and all participants completed their second and third data collection by July 2022 and December 2022, respectively. Data were collected from 202 older adults during the first data collection period, with approximate retention rates of 90.1% (n=182) during the second data collection period and 88.1% (n=178) during the third data collection period. Multilevel models and mixed-effects location scale modeling will be used to evaluate the study aims.

CONCLUSIONS

Project SMART seeks to predict and model the adoption and maintenance of optimal levels of PA and SB among older adults. In turn, this will inform the future delivery of personalized intervention content under conditions where the content will be most effective to promote sustained behavior change among older adults.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/47320.

Within-person associations between psychological and contextual factors and lapse incidence in smokers attempting to quit: A systematic review and meta-analysis of ecological momentary assessment studies

AIMS

When attempting to stop smoking, discrete smoking events ('lapses') are strongly associated with a return to regular smoking ('relapse'). No study has yet pooled the psychological and contextual antecedents of lapse incidence, captured in ecological momentary assessment (EMA) studies. This systematic review and meta-analysis aimed to synthesize within-person psychological and contextual predictor-lapse associations in smokers attempting to quit.

METHODS

We searched Ovid MEDLINE, Embase, PsycINFO and Web of Science. A narrative synthesis and multi-level, random-effects meta-analyses were conducted, focusing on studies of adult, non-clinical populations attempting to stop smoking, with no restrictions on setting. Outcomes were the association between a psychological (e.g. stress, cravings) or contextual (e.g. cigarette availability) antecedent and smoking lapse incidence; definitions of 'lapse' and 'relapse'; the theoretical underpinning of EMA study designs; and the proportion of studies with pre-registered study protocols/analysis plans and open data.

RESULTS

We included 61 studies, with 19 studies contributing ≥ 1 effect size(s) to the meta-analyses. We found positive relationships between lapse incidence and 'environmental and social cues' [k = 12, odds ratio (OR) = 4.53, 95% confidence interval (CI) = 2.02, 10.16, P = 0.001] and 'cravings' (k = 10, OR = 1.71, 95% CI = 1.34, 2.18, P < 0.001). 'Negative feeling states' was not significantly associated with lapse incidence (k = 16, OR = 1.10, 95% CI = 0.98, 1.24, P = 0.12). In the narrative synthesis, negative relationships with lapse incidence were found for 'behavioural regulation', 'motivation not to smoke' and 'beliefs about capabilities'; positive relationships with lapse incidence were found for 'positive feeling states' and 'positive outcome expectancies'. Although lapse definitions were comparable, relapse definitions varied widely across studies. Few studies explicitly drew upon psychological theory to inform EMA study designs. One of the included studies drew upon Open Science principles.

CONCLUSIONS

In smokers attempting to stop, environmental and social cues and cravings appear to be key within-person antecedents of smoking lapse incidence. Due to low study quality, the confidence in these estimates is reduced.

Implementation of a Novel Medication Regimen Following Cardiac Rehabilitation: an Application of the Health Action Process Approach

BACKGROUND

Medication adherence is an indispensable prerequisite for the long-term management of many chronic diseases. However, published literature suggests that non-adherence is widely prevalent. Health behavior change theories can help understand the underlying processes and allow the accumulation of knowledge in the field. The present study applied the health action process approach (HAPA) in an intensive longitudinal research design to investigate medication adherence in patients after discharge from inpatient cardiac rehabilitation.

METHOD

In total, n = 139 patients (84.9% male, M_age = 62.2 years) completed n = 2,699 daily diaries in the 22 days following discharge from inpatient cardiac rehabilitation. Patients' intentions to take medication and predictors were assessed in daily end-of-day questionnaires. Adherence to medication was measured subjectively (self-report) and objectively. Multilevel modeling was applied to disentangle the between- and within-person level.

RESULTS

Higher levels of risk awareness and self-efficacy were positively associated with intentions to take medication at both levels of analysis. Contrary to theoretical assumptions, positive outcome expectations were not associated with intention, neither between- nor within-person. In contrast to published literature, patients showed very high medication adherence (95.2% self-report, 92.2% objectively).

CONCLUSION

In line with the theoretical assumptions, the results showed that risk awareness and self-efficacy are promising modifiable factors that could be targeted to motivate patients to take medication as prescribed. Daily measurements revealed that patients took their medication as prescribed; thus, future studies should make every effort to recruit patients vulnerable to non-adherence to avoid ceiling effects.

Testing motivational and self-regulatory mechanisms of action on device-measured physical activity in the context of a weight loss maintenance digital intervention: A secondary analysis of the NoHoW trial

BACKGROUND

To date, few digital behavior change interventions for weight loss maintenance focusing on long-term physical activity promotion have used a sound intervention design grounded on a logic model underpinned by behavior change theories. The current study is a secondary analysis of the weight loss maintenance NoHoW trial and investigated putative mediators of device-measured long-term physical activity levels (six to 12 months) in the context of a digital intervention.

METHODS

A subsample of 766 participants (Age = 46.2 ± 11.4 years; 69.1% female; original NoHoW sample: 1627 participants) completed all questionnaires on motivational and self-regulatory variables and had all device-measured physical activity data available for zero, six and 12 months. We examined the direct and indirect effects of Virtual Care Climate on post intervention changes in moderate-to-vigorous physical activity and number of steps (six to 12 months) through changes in the theory-driven motivational and self-regulatory mechanisms of action during the intervention period (zero to six months), as conceptualized in the logic model.

RESULTS

Model 1 tested the mediation processes on Steps and presented a poor fit to the data. Model 2 tested mediation processes on moderate-to-vigorous physical activity and presented poor fit to the data. Simplified models were also tested considering the autonomous motivation and the controlled motivation variables independently. These changes yielded good results and both models presented very good fit to the data for both outcome variables. Percentage of explained variance was negligible for all models. No direct or indirect effects were found from Virtual Care Climate to long term change in outcomes. Indirect effects occurred only between the sequential paths of the theory-driven mediators.

CONCLUSION

This was one of the first attempts to test a serial mediation model considering psychological mechanisms of change and device-measured physical activity in a 12-month longitudinal trial. The model explained a small proportion of variance in post intervention changes in physical activity. We found different pathways of influence on theory-driven motivational and self-regulatory mechanisms but limited evidence that these constructs impacted on actual behavior change. New approaches to test these relationships are needed. Challenges and several alternatives are discussed.

TRIAL REGISTRATION

ISRCTN Registry, ISRCTN88405328. Registered December 16, 2016, https://www.isrctn.com/ISRCTN88405328.

Understanding health behaviours in context: A systematic review and meta-analysis of ecological momentary assessment studies of five key health behaviours

Ecological Momentary Assessment (EMA) involves repeated, real-time sampling of health behaviours in context. We present the state-of-knowledge in EMA research focused on five key health behaviours (physical activity and sedentary behaviour, dietary behaviour, alcohol consumption, tobacco smoking, sexual health), summarising theoretical (e.g., psychological and contextual predictors) and methodological aspects (e.g., study characteristics, EMA adherence). We searched Ovid MEDLINE, Embase, PsycINFO and Web of Science until February 2021. We included studies focused on any of the aforementioned health behaviours in adult, non-clinical populations that assessed ≥1 psychological/contextual predictor and reported a predictor-behaviour association. A narrative synthesis and random-effects meta-analyses of EMA adherence were conducted. We included 633 studies. The median study duration was 14 days. The most frequently assessed predictors were 'negative feeling states' (21%) and 'motivation and goals' (16.5%). The pooled percentage of EMA adherence was high at 81.4% (95% CI = 80.0%, 82.8%, k = 348) and did not differ by target behaviour but was somewhat higher in student (vs. general population) samples, when EMAs were delivered via mobile phones/smartphones (vs. handheld devices), and when event contingent (vs. fixed) sampling was used. This review showcases how the EMA method has been applied to improve understanding and prediction of health behaviours in context.

Characteristics of smartphone-based dietary assessment tools: a systematic review

Smartphones have become popular in assessing eating behaviour in real-life and real-time. This systematic review provides a comprehensive overview of smartphone-based dietary assessment tools, focusing on how dietary data is assessed and its completeness ensured. Seven databases from behavioural, social and computer science were searched in March 2020. All observational, experimental or intervention studies and study protocols using a smartphone-based assessment tool for dietary intake were included if they reported data collected by adults and were published in English. Out of 21,722 records initially screened, 117 publications using 129 tools were included. Five core assessment features were identified: photo-based assessment (48.8% of tools), assessed serving/ portion sizes (48.8%), free-text descriptions of food intake (42.6%), food databases (30.2%), and classification systems (27.9%). On average, a tool used two features. The majority of studies did not implement any features to improve completeness of the records. This review provides a comprehensive overview and framework of smartphone-based dietary assessment tools to help researchers identify suitable assessment tools for their studies. Future research needs to address the potential impact of specific dietary assessment methods on data quality and participants' willingness to record their behaviour to ultimately improve the quality of smartphone-based dietary assessment for health research.

Analysis of dynamic psychological processes to understand and promote physical activity behaviour using intensive longitudinal methods: a primer

Physical activity behaviour displays temporal variability, and is influenced by a range of dynamic psychological processes (e.g., affect) and shaped by various co-occurring events (e.g., social/environmental factors, interpersonal dynamics). Yet, most physical activity research tends not to examine the dynamic psychological processes implicated in adopting and maintaining physical activity. Intensive longitudinal methods (ILM) represent one particularly salient means of studying the complex psychological dynamics that underlie and result from physical activity behaviour. With the increased recent interest in using intensive longitudinal data to understand specific dynamic psychological processes, the field of exercise and health psychology is well-positioned to draw from state-of-the-art measurement and statistical approaches that have been developed and operationalised in other fields of enquiry. The purpose of this review is to provide an overview of some of the fundamental dynamic measurement and modelling approaches applicable to the study of physical activity behaviour change, as well as the dynamic psychological processes that contribute to such change.

The reciprocal interplay of physical activity and health‐related quality of life in children and adolescents: Evidence for both upward and downward spirals

OBJECTIVE

This study examines the bidirectional effect between physical activity (PA) and health-related quality of life in children and adolescents, focusing on within-person effects.

METHODS

PA and health-related quality of life were assessed in children and adolescents (N = 685, age: M = 10.29 years, SD = 1.35, range = 8-14), via self-report across four waves, each 6 months apart, and a random-intercept cross-lagged panel model with time-invariant cross-lagged effects was calculated.

RESULTS

Positive cross-lagged effects between prior PA and health-related quality of life 6 months later ( γ y  = 0.536, 95% CI [0.016, 1.055], p = .043, d = 0.11) and vice versa ( γ x  = 0.015, 95% CI [0.001, 0.030], p = .039, d = 0.12) were found. Furthermore, the random intercept correlation was significant ( T xy  = 3.622, 95% CI [2.204, 5.041], p < .001, d = 0.27).

CONCLUSIONS

The findings confirm known correlations between PA and health-related quality of life and extends them by indicating both an upward and downward spiral of PA and health-related quality of life in children and adolescents.

Continuous-Time Modeling of the Bidirectional Relationship Between Incidental Affect and Physical Activity

BACKGROUND

Previous research suggests that there is a bidirectional relationship between incidental affect (i.e., how people feel in day-to-day life) and physical activity behavior. However, many inconsistencies exist in the body of work due to the lag interval between affect and physical activity measurements.

PURPOSE

Using a novel continuous-time analysis paradigm, we examined the temporal specificity underlying the dynamic relationship between positive and negative incidental affective states and moderate-to-vigorous physical activity (MVPA).

METHODS

A community sample of adults (n = 126, Mage = 27.71, 51.6% Male) completed a 14-day ambulatory assessment protocol measuring momentary positive and negative incidental affect six times a day while wearing a physical activity monitor (Fitbit). Hierarchical Bayesian continuous-time structural equation modeling was used to elucidate the underlying dynamics of the relationship between incidental affective states and MVPA.

RESULTS

Based on the continuous-time cross-effects, positive and negative incidental affect predicted subsequent MVPA. Furthermore, engaging in MVPA predicted subsequent positive and negative incidental affect. Incidental affective states had a greater relative influence on predicting subsequent MVPA compared to the reciprocal relationship. Analysis of the discrete-time coefficients suggests that cross-lagged effects increase as the time interval between measurements increase, peaking at about 8 h between measurement occasions before beginning to dissipate.

CONCLUSIONS

The results provide support for a recursive relationship between incidental affective states and MVPA, which is particularly strong at 7-9 hr time intervals. Future research designs should consider these medium-term dynamics, for both theory development and intervention.

The Impact of Both Individual and Contextual Factors on the Acceptance of Personalized Dietary Advice

(1) Background: The aim of the current study is to investigate which between- and within-person factors influence the acceptance of personalized dietary advice. (2) Methods: A repeated measurements design was used in which 343 participants (M (SD) age = 48 (17.3), 49% female) filled out a baseline survey and started with nine repeated surveys. (3) Results: The results show that the acceptance of personalized dietary advice is influenced by both within-person and between-person factors. The acceptance is higher at lunch compared to breakfast and dinner, higher at home than out of home, higher at moments when individuals have a high intention to eat healthily, find weight control an important food choice motive and have a high healthy-eating self-efficacy. Moreover, the acceptance is higher when individuals do not see the eating context as a barrier and when individuals believe that personalized dietary advice has more benefits than risks. (4) Conclusions: Future behavioral interventions that use personalized dietary advice should consider the context as well as individual differences.

Perspective: A Framework for Addressing Dynamic Food Consumption Processes

The study of food consumption, diet, and related concepts is motivated by diverse goals, including understanding why food consumption impacts our health, and why we eat the foods we do. These varied motivations can make it challenging to define and measure consumption, as it can be specified across nearly infinite dimensions-from micronutrients to carbon footprint to food preparation. This challenge is amplified by the dynamic nature of food consumption processes, with the underlying phenomena of interest often based on the nature of repeated interactions with food occurring over time. This complexity underscores a need to not only improve how we measure food consumption but is also a call to support theoreticians in better specifying what, how, and why food consumption occurs as part of processes, as a prerequisite step to rigorous measurement. The purpose of this Perspective article is to offer a framework, the consumption process framework, as a tool that researchers in a theoretician role can use to support these more robust definitions of consumption processes. In doing so, the framework invites theoreticians to be a bridge between practitioners who wish to measure various aspects of food consumption and methodologists who can develop measurement protocols and technologies that can support measurement when consumption processes are clearly defined. In the paper we justify the need for such a framework, introduce the consumption process framework, illustrate the framework via a use case, and discuss existing technologies that enable the use of this framework and, by extension, more rigorous study of consumption. This consumption process framework demonstrates how theoreticians could fundamentally shift how food consumption is defined and measured towards more rigorous study of what, how, and why food is eaten as part of dynamic processes and a deeper understanding of linkages between behavior, food, and health.

The Dyadic Health Influence Model

Relationship partners affect one another's health outcomes through their health behaviors, yet how this occurs is not well understood. To fill this gap, we present the Dyadic Health Influence Model (DHIM). The DHIM identifies three routes through which a person (the agent) can impact the health beliefs and behavior of their partner (the target). An agent may (a) model health behaviors and shape the shared environment, (b) enact behaviors that promote their relationship, and/or (c) employ strategies to intentionally influence the target's health behavior. A central premise of the DHIM is that agents act based on their beliefs about their partner's health and their relationship. In turn, their actions have consequences not only for targets' health behavior but also for their relationship. We review theoretical and empirical research that provides initial support for the routes and offer testable predictions at the intersection of health behavior change research and relationship science.

Perceived trajectory of psychological and physical states after breast cancer: An optimistic perception

BACKGROUND

In cancer research, studying the quality of life trajectory helps us understand the complaints but also the cognitive, physical, and emotional aspects that can evolve positively. Examining both the suffering and the improvements expressed by the patients facilitates their care and their recovery knowing that an optimistic perception of the future is important for adaptative functioning after cancer. Through retrospective, present and prospective measures, we sought to characterize the subjective trajectory perceived by women with breast cancer about their cognitive, emotional and physical states, as it relates to quality of life.

METHODS

Nine hundred ninety women survivors of breast cancer (after curative treatments) described, on the appropriate scales, their perceived cognitive, emotional and physical states over three periods of time: from past care (i.e., retrospective analysis) to the future (i.e., projective analysis), including the present period, as a function of their treatment (chemotherapy vs. no chemotherapy) and surgery (lumpectomy vs. mastectomy) using ANCOVA.

RESULTS

The 732 women who had received chemotherapy perceived the most significant consequences, regardless of the type of surgery (η²= .01). Moreover, all survivors expressed an optimistic perception of the change in their states in the anticipated future as a normative optimistic perception.

CONCLUSIONS

Results are discussed in terms of the benefits of specific and early interventions that enable patients to cope better with the disease and its treatments by taking into account their more or less optimistic perception of the future.

Hand Washing and Related Cognitions Following a Brief Behavior Change Intervention During the COVID-19 Pandemic: a Pre-Post Analysis

Background

Effective hand washing (for at least 20 s, with water and soap) is one of the health behaviors protecting against infection transmissions. Behavior change interventions supporting the initiation and maintenance of hand washing are crucial to prevent infection transmissions. Based on the Health Action Process Approach, the aim of this research was to conduct a pre-post analysis of hand washing and related cognitions (i.e., intention, self-efficacy, self-monitoring), measured up to 100 days following an intervention.

Methods

A convenience sample of N = 123 participants (age: M = 23.96 years; SD = 5.82; 80% women) received a brief intervention (key behavior change techniques: information about health consequences of hand washing; action planning) and responded to daily diaries and questionnaires up to a 100-day follow-up. Two-level models were used to analyze data of n = 89 participants who provided longitudinal data.

Results

Hand washing and self-monitoring increased, whereas intention and self-efficacy decreased over time. Only self-monitoring was a consistent positive correlate of hand washing on a between-person level.

Conclusions

Hand washing and self-monitoring considerably increased over several weeks following the intervention. Future research testing the intervention against a control condition is needed to rule out that changes in behavior and cognitions might have been prompted by completing the daily diaries.

Trial Registration

German Clinical Trials Register; https://www.drks.de; registration number: DRKS00022067.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12529-021-10042-w.

Teachers' perceived time pressure, emotional exhaustion and the role of social support from the school principal

Many teachers experience high levels of work-related strain due to time pressure, which over time can lead to various health problems, such as emotional exhaustion. However, there is growing evidence that this could be a reciprocal effect. Moreover, it is known that perceived social support can buffer the negative effects of stress, such as time pressure, on health outcomes. Less is known about buffering effects of received social support. Based on longitudinal data of n = 1071 Swiss primary and secondary school teachers over the course of one school year, the present study examined the reciprocal relationship between teachers’ perceived time pressure and emotional exhaustion and whether received social support from the school principal buffers this relationship. Results of a random intercept cross-lagged panel model show a strong relationship between teachers’ perceived time pressure and emotional exhaustion at the between-person level, but no effects at the within-person level. Further, received social support was directly related to less perceived time pressure and less emotional exhaustion. The results showed neither evidence for reciprocal effects between perceived time pressure and emotional exhaustion nor for a buffering effect of received social support from the school principal. Concluding, present findings indicate that the receipt of social support from the school principal is a central job resource that beneficially relates to teachers’ experience of time pressure and emotional exhaustion.

Connecting Theory to Methods in Longitudinal Research

Advances in methods for longitudinal data collection and analysis have prompted a surge of research on psychological processes. However, decisions about how to time assessments are often not explicitly tethered to theories about psychological processes but are instead justified on methodological (e.g., power) or practical (e.g., feasibility) grounds. In many cases, methodological decisions are not explicitly justified at all. The disconnect between theories about processes and the timing of assessments in longitudinal research has contributed to misspecified models, interpretive errors, mixed findings, and nonspecific conclusions. In this article, we argue that higher demands should be placed on researchers to connect theories to methods in longitudinal research. We review instances of this disconnect and offer potential solutions as they pertain to four general questions for longitudinal researchers: how time should be scaled, how many assessments are needed, how frequently assessments should occur, and when assessments should happen.

Changes in Mental Health and Preventive Behaviors before and after COVID-19 Vaccination: A Propensity Score Matching (PSM) Study

Mass vaccination against the COVID-19 pandemic is ongoing worldwide to achieve herd immunity among the general population. However, little is known about how the COVID-19 vaccination would affect mental health and preventive behaviors toward the COVID-19 pandemic. In this study, we conducted a cross-sectional survey to address this issue among 4244 individuals at several COVID-19 vaccination sites in Guangzhou, China. Using univariate analysis and multiple linear regression models, we found that major demographic characteristics, such as biological sex, age, education level, and family per capita income, are the dominant influencing factors associated with health beliefs, mental health, and preventive behaviors. After propensity score matching (PSM) treatment, we further assessed the changes in the scores of health belief, mental health, and preventive behaviors between the pre-vaccination group and the post-vaccination group. When compared to individuals in the pre-vaccination group, a moderate but statistically significant lower score was observed in the post-vaccination group (p = 0.010), implying possibly improved psychological conditions after COVID-19 vaccination. In addition, there was also a moderate but statistically higher score of preventive behaviors in the post-vaccination group than in the pre-vaccination group (p < 0.001), suggesting a higher probability to take preventive measures after COVID-19 vaccination. These findings have implications for implementing non-pharmaceutical interventions combined with mass vaccination to control the rebound of COVID-19 outbreaks.

Cultivation or enabling? Day-to-day associations between self-efficacy and received support in couples

OBJECTIVE

Theories and empirical findings identify social support and self-efficacy as important variables for behavior change. Two competing hypotheses describe the bidirectional relationship of these two constructs: The cultivation hypothesis assumes that self-efficacy facilitates social support, whereas the enabling hypothesis assumes that social support fosters self-efficacy. To shed more light on the interplay of interpersonal and intrapersonal factors in the behavior change context in daily life, the present study aims to investigate these hypotheses at the within-person level.

METHODS

In total, 99 overweight heterosexual couples intending to increase their physical activity participated in this dyadic intensive longitudinal study. Both partners independently reported on their self-efficacy and their support receipt from their partner in smartphone-based end-of-day diaries across 14 days. To investigate the competing hypotheses prospective lagged multilevel models were applied.

RESULTS

For both partners, higher-than-average levels of self-efficacy on a given day predicted higher support receipt the next day, confirming the cultivation hypothesis. We found no effect of higher-than-average levels of support receipt on a given day on self-efficacy the next day, disconfirming the enabling hypothesis. Same-day support receipt and previous day self-efficacy were positively related to daily physical activity.

CONCLUSIONS

This is the first study investigating the cultivation and the enabling hypothesis on a day-to-day basis using a dyadic intensive longitudinal approach. Findings support the cultivation hypothesis at the within-person level, suggesting that self-efficacy may help to facilitate support receipt close in time. Future studies should use within-person experimental designs and ecological momentary assessments within days to increase our understanding of the temporal dynamics of the cultivation and enabling effect.

Innovative methods for observing and changing complex health behaviors: four propositions

Precision health initiatives aim to progressively move from traditional, group-level approaches to health diagnostics and treatments toward ones that are individualized, contextualized, and timely. This article aims to provide an overview of key methods and approaches that can help facilitate this transition in the health behavior change domain. This article is a narrative review of the methods used to observe and change complex health behaviors. On the basis of the available literature, we argue that health behavior change researchers should progressively transition from (i) low- to high-resolution behavioral assessments, (ii) group-only to group- and individual-level statistical inference, (iii) narrative theoretical models to dynamic computational models, and (iv) static to adaptive and continuous tuning interventions. Rather than providing an exhaustive and technical presentation of each method and approach, this article articulates why and how researchers interested in health behavior change can apply these innovative methods. Practical examples contributing to these efforts are presented. If successfully adopted and implemented, the four propositions in this article have the potential to greatly improve our public health and behavior change practices in the near future.

Context matters: Self-regulation of healthy eating at different eating occasions

Self-regulation plays an important role in healthy eating behaviors. The current research explores temporary fluctuations in self-regulation next to variations between individuals. In an online observational study, 892 participants (M^age  = 44.3, SD^age  = 12.7) monitored their self-regulation three times a week before a meal moment for 3 weeks. To analyze the data, a random intercept and slopes model was used, including variables on within-individual level (i.e. meal moment, tiredness, distractedness, social, and physical environment) and variables on between-individual level (i.e. self-efficacy, intrinsic motivation, and perception of social and physical opportunity). Self-regulation was found to be higher at breakfast compared with dinner (estimate = -0.08, p < .001), higher at home than out-of-home (estimate = -0.08, p < .001) and lower when individuals are more tired (estimate = 0.04, p < .001) and distracted (estimate = 0.07, p < .001). Moreover, self-regulation was higher for individuals with higher levels of intrinsic motivation (estimate = 0.19, p < .001) and self-efficacy (estimate = 0.41, p < .001). Insights from this research advance our knowledge regarding temporal influences on self-regulation and can provide input for behavior change tools such as personalized dietary advice.

The effects on self-efficacy, motivation and perceived barriers of an intervention targeting physical activity and sedentary behaviours in office workers: a cluster randomized control trial

Background

The importance of physical activity on health is clear, but changing behaviour is difficult. Successful interventions aiming to improve physical activity and reduce sedentary behaviour is therefore of importance. The aim of this study was to evaluate effects on motivation, self-efficacy and barriers to change behaviour from two different behavioural intervention focusing either on reducing sedentary behaviour or on increasing physical activity as compared to a waiting list control group.

Methods

The study was designed as a cluster randomized control trial (RCT) within two private companies. Self-efficacy, motivation and perceived barriers were together with demographic variables assessed before and after a 6-month intervention. Participant cluster teams were randomly allocated to either the physical activity intervention (iPA), the sedentary behaviour intervention (iSED), or control group. The intervention was multi componential and included motivational counselling based on Cognitive behaviour therapy and Motivational interviewing, group activities and management involvement. Group differences were determined using Bayesian multilevel modelling (parameter estimate; credible interval (CI)), analysing complete cases and those who adhered to the protocol by adhering to at least 3 out of 5 intervention sessions.

Results

After the intervention, the complete cases analysis showed that the iPA group had significantly higher autonomous motivation (0.33, CI: 0.05–0.61) and controlled motivation (0.27, CI: 0.04–0.51) for physical activity compared with the control group. The iSED group scored less autonomous and controlled motivation compared to the iPA group (0.38, CI: − 0.69- -0.087 respectively − 0.32, CI: − 0.57-0.07) but no significant differences compared with the control group. Among individuals that adhered to the protocol, the results showed higher scores on Exercise (3.03, CI: 0.28–6.02) and Sedentary self-efficacy (3.59, CI: 0.35–7.15) for individuals in the iPA group and on Sedentary self-efficacy (4.77, CI: 0.59–9.44) for the iSED group compared to the control group.

Conclusion

These findings indicate that the interventions were successful in increasing self-efficacy in each intervention group and autonomous motivation for exercise in the iPA group, in particular when actively participating in the motivational counselling sessions.

Daily support seeking as coping strategy in dual-smoker couples attempting to quit

OBJECTIVE

Smoking cessation is a stressful event and lapses are frequent. The dynamic model of relapse has been criticized for not integrating interpersonal factors as phasic influences. Seeking social support, as a coping strategy to deal with cravings, may help to refrain from smoking.

DESIGN

Overall, 83 heterosexual dual-smoker couples reported on their craving, the extent of seeking social support from one's partner regarding smoking cessation, and their number of cigarettes smoked in smartphone-based end-of-day diaries, from a joint self-set quit date on across 22 consecutive days.

MAIN OUTCOME MEASURE

Number of cigarettes smoked.

RESULTS

Multilevel analyses indicated that on days with higher-than-average levels of craving, male and female smokers reported more cigarettes smoked. Higher-than-usual support seeking was related to fewer cigarettes smoked that same day. For women only, we found a within-person interaction between craving and support seeking on smoking. On days with higher-than-average support-seeking, the effect of craving on smoking was attenuated.

CONCLUSION

Findings confirm the relevance of interpersonal processes in the relapse process, such as support seeking as coping behavior. Further, as a 'first act' in initiating supportive interactions, support seeking is an important piece in the social support process and a promising target for interventions.

Characterizing and predicting person-specific, day-to-day, fluctuations in walking behavior

Despite the positive health effect of physical activity, one third of the world's population is estimated to be insufficiently active. Prior research has mainly investigated physical activity on an aggregate level over short periods of time, e.g., during 3 to 7 days at baseline and a few months later, post-intervention. To develop effective interventions, we need a better understanding of the temporal dynamics of physical activity. We proposed here an approach to studying walking behavior at "high-resolution" and by capturing the idiographic and day-to-day changes in walking behavior. We analyzed daily step count among 151 young adults with overweight or obesity who had worn an accelerometer for an average of 226 days (~25,000 observations). We then used a recursive partitioning algorithm to characterize patterns of change, here sudden behavioral gains and losses, over the course of the study. These behavioral gains or losses were defined as a 30% increase or reduction in steps relative to each participants' median level of steps lasting at least 7 days. After the identification of gains and losses, fluctuation intensity in steps from each participant's individual time series was computed with a dynamic complexity algorithm to identify potential early warning signals of sudden gains or losses. Results revealed that walking behavior change exhibits discontinuous changes that can be described as sudden gains and losses. On average, participants experienced six sudden gains or losses over the study. We also observed a significant and positive association between critical fluctuations in walking behavior, a form of early warning signals, and the subsequent occurrence of sudden behavioral losses in the next days. Altogether, this study suggests that walking behavior could be well understood under a dynamic paradigm. Results also provide support for the development of "just-in-time adaptive" behavioral interventions based on the detection of early warning signals for sudden behavioral losses.

Studying Behaviour Change Mechanisms under Complexity

Understanding the mechanisms underlying the effects of behaviour change interventions is vital for accumulating valid scientific evidence, and useful to informing practice and policy-making across multiple domains. Traditional approaches to such evaluations have applied study designs and statistical models, which implicitly assume that change is linear, constant and caused by independent influences on behaviour (such as behaviour change techniques). This article illustrates limitations of these standard tools, and considers the benefits of adopting a complex adaptive systems approach to behaviour change research. It (1) outlines the complexity of behaviours and behaviour change interventions; (2) introduces readers to some key features of complex systems and how these relate to human behaviour change; and (3) provides suggestions for how researchers can better account for implications of complexity in analysing change mechanisms. We focus on three common features of complex systems (i.e., interconnectedness, non-ergodicity and non-linearity), and introduce Recurrence Analysis, a method for non-linear time series analysis which is able to quantify complex dynamics. The supplemental website provides exemplifying code and data for practical analysis applications. The complex adaptive systems approach can complement traditional investigations by opening up novel avenues for understanding and theorising about the dynamics of behaviour change.

Understanding Between-Person Interventions With Time-Intensive Longitudinal Outcome Data: Longitudinal Mediation Analyses

BACKGROUND

Mediation analysis is an important tool for understanding the processes through which interventions affect health outcomes over time. Typically the temporal intervals between X, M, and Y are fixed by design, and little focus is given to the temporal dynamics of the processes.

PURPOSE

In this article, we aim to highlight the importance of considering the timing of the causal effects of a between-person intervention X, on M and Y, resulting in a deeper understanding of mediation.

METHODS

We provide a framework for examining the impact of a between-person intervention X on M and Y over time when M and Y are measured repeatedly. Five conceptual and analytic steps involve visualizing the effects of the intervention on Y, M, the relationship of M and Y, and the mediating process over time and selecting an appropriate analytic model.

RESULTS

We demonstrate how these steps can be applied to two empirical examples of health behavior change interventions. We show that the patterns of longitudinal mediation can be fit with versions of longitudinal multilevel structural equation models that represent how the magnitude of direct and indirect effects vary over time.

CONCLUSIONS

We urge researchers and methodologists to pay more attention to temporal dynamics in the causal analysis of interventions.

Leveraging Daily Social Experiences to Motivate Healthy Aging

Models of healthy aging highlight the motivating influence of social connections. Social experiences constantly shape our thoughts and behaviors throughout daily life, and these daily processes slowly and consistently influence our health and well-being. In this paper, we discuss research that has moved from cross-sectional laboratory designs emphasizing individual behaviors to more naturalistic within-person paradigms linking daily social experiences to emotional, cognitive, and physical well-being. We mention research gaps that need to be filled to advance our knowledge of the powerful forces of the social environment for motivating healthy aging. We also offer future directions to move this research forward. We conclude with an outlook on how to leverage these powerful forces in novel intervention approaches that are sensitive to the constantly changing nature of the person and the environment.

Theory Integration for Lifestyle Behavior Change in the Digital Age: An Adaptive Decision-Making Framework

Despite the growing popularity of digital health interventions, limitations of traditional behavior change theories and a lack of theory integration hinder theory-driven behavior change applications. In this paper, we aim to review theories relevant to lifestyle behavior change from the broader psychology literature and then integrate these theories into a new theoretical framework called adaptive decision-making to address two specific problems. First, our framework represents lifestyle behaviors at two levels-one of individual daily decisions (action level) and one of larger behavioral episodes (reflection level)-to more closely match the temporal characteristics of lifestyle behaviors and their associated digital data. Second, the framework connects decision-making theories and learning theories to explain how behaviors and cognitive constructs dynamically influence each other, making it a suitable scaffold for building computational models. We map common digital intervention techniques onto the behavioral and cognitive processes in the framework and discuss possible contributions of the framework to both theory development and digital intervention design.

Immediate effects of a very brief planning intervention on fruit and vegetable consumption: A randomized controlled trial

Action planning interventions can effectively promote fruit and vegetable (FV) consumption, but not much is known about the day-to-day translation of intervention planning into action. In this randomized controlled trial, immediate intervention effects of a very brief planning intervention on FV consumption during the following 13 days were investigated. After a 13-day pre-intervention diary, N = 206 participants (aged 19-66 years) were randomly allocated to a waiting-list control condition or a planning condition, where they formed one FV plan. Participants from both conditions completed a 13-day post-intervention diary. Self-reported daily FV consumption, FV-specific self-efficacy, and action control were assessed. Segmented linear mixed models estimating a discrete change (i.e. "jump") between diary phases showed a positive "jump" of FV intake and self-efficacy in the planning condition when compared to the control condition. For action control, such effects were not observed. Changes in study variables throughout the post-intervention phase did not differ between both conditions. Present findings extend previous evidence on action planning interventions by showing that increases in self-regulatory (i.e. self-efficacy) and behavioral (i.e. FV intake) outcomes can occur very rapidly and already on the first day for which behavioral increases were planned.

How Do People Experience and Respond to Social Control From Their Partner? Three Daily Diary Studies

Positive and negative forms of social control are commonly used to regulate another person’s health-related behaviors, especially in couples. Social control efforts have been shown to result in desirable, but also undesirable effects on different outcomes. Little is known for which outcomes, when, and under which contextual conditions these different effects unfold in people’s everyday lives. Using the dual-effects model of health-related social control, we predicted that same-day and previous-day positive social control would result in desirable effects on target behavior, and same-day positive control on affect. Same-day and previous-day negative control was assumed to result in undesirable effects on reactant responses (i.e., doing the opposite of what the partner wanted and hiding the unhealthy behavior), and same-day negative control on affect. Further, we explored whether it makes a difference if one or both partners intend to change their health behavior. Three daily diary studies addressed these questions for smoking (Studies 1 and 2), and physical activity (Study 3). Receiving more positive control related to more desirable target behavior, and feeling better; more negative control was associated with more reactant responses and feeling worse. Social control unfolded its effects within 1 day, but hardly across days, indicating that control and its reactions to it are fast-acting processes in daily life. The pattern of results were the same for couples with one and both partners intending to change their behavior. Further, results replicated when using partner-reported provided control. Based on these results, social control cannot be unanimously recommended as a behavior change strategy in couples. Future studies should follow up on dyadic and temporal dynamics of social control in couples’ everyday lives in different contexts.

Goal setting and achievement for walking: A series of N-of-1 digital interventions

OBJECTIVE

Despite evidence that goal setting is valuable for physical activity promotion, recent studies highlighted a potential oversimplification in the application of this behavior change technique. While more difficult performance goals might trigger higher physical activity levels, higher performance goals might concurrently be more difficult to achieve, which could reduce long-term motivation. This study examined (a) the association between performance goal difficulty and physical activity and (b) the association between performance goal difficulty and goal achievement.

METHOD

This study used data from an e-Health intervention among inactive overweight adults (n = 20). The study duration included a 2-week baseline period and an intervention phase of 80 days. During the intervention, participants received a daily step goal experimentally manipulated by taking participants' baseline physical activity median (i.e., number of steps) multiplied by a pseudorandom factor ranging from 1 to 2.6. A continuous measure of goal achievement was inferred for each day by dividing the daily number of steps by the goal prescribed that day. Linear and generalized additive models were fit for each participant.

RESULTS

The results confirm that, for a majority of the participants involved in the study, performance goal difficulty was positively and significantly associated with physical activity (n = 14), but, concurrently, negatively and significantly associated with goal achievement (n = 19). These associations were mainly linear.

CONCLUSION

At the daily level, setting a higher physical activity goal leads to engaging in higher physical activity levels, but concurrently lower goal achievement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A Dieting Facilitator on the Fridge Door: Can Dieters Deliberately Apply Environmental Dieting Cues to Lose Weight?

Individuals exposed to dieting-related environmental cues have been repeatedly shown to be better able to resist tempting food. This especially applies to restrained eaters who hold a chronic dieting goal. Thus far, mainly short-term effects of environmental dieting cues have been examined and the individuals were typically unaware of being influenced. Yet, it is unclear whether individuals can deliberately apply environmental dieting cues for themselves to facilitate the pursuit of the longer-term goal of losing weight. The present longitudinal study applied a 2 (cue: visually dieting-related vs. visually neutral cue) × 2 (awareness: being aware vs. not being aware of the cue’s facilitating influence) between-subjects design for 6 months (N = 166 participants who started the study; M_age = 47.85 years; 69.9% female; M_BMI = 29.07 kg/m²). Our results provide preliminary indications that cue, awareness, and restrained eating interact. The results suggest that high (vs. low) restrained eaters could deliberately apply environmental dieting cues for themselves to facilitate losing weight. However, further studies are needed to explore the effects of environmental dieting cues over a longer period of time.

Predicting smoking behavior: intention and future self-continuity among Austrians

Smoking is a major public health problem in Austria, but relevant research and intervention is limited. Based on the Theory of Planned Behavior (TPB), the present study aimed to test the model utility in an Austrian sample. As future self-continuity is likely to impact on health behavior, we also hypothesized an extended TPB with future self-continuity could further explain the variance in smoking. Using a prospective design, 94 current smokers (74.5% women; M_age = 24.27 years; 61.7% daily smokers) from a university in South Austria completed the baseline and follow-up survey (one month after the baseline). Consistent with the TPB, intention and perceived behavioral control (PBC) significantly predicted smoking behavior; affective attitude and PBC were significantly associated with smoking intention. In contrast, cognitive attitude and subjective norm were unrelated to smoking intention. As hypothesized, the TPB explained 42% variance of smoking behavior and 31% variance of smoking intention. Participants' future self-continuity further explained the variance of smoking behavior. Our study demonstrates the utility of the TPB in understanding Austrian smoking behavior. The role of psychological perception of future self among smokers has been highlighted. Future smoking intervention may target PBC, affective attitude, as well as a life-span perspective.

Do Daily Compensatory Health Beliefs Predict Intention to Quit and Smoking Behavior? A Daily Diary Study during Smoking Cessation

Compensatory health beliefs (CHBs) are a means to cope with motivational conflicts between intended health goals and the temptation for an unhealthy behavior. As CHBs can fluctuate on a daily basis, this study examined how daily CHBs are associated with daily intention to quit smoking and daily number of cigarettes smoked before and after a quit date at the between- and within-person level. The study comprised a prospective longitudinal design and investigated 83 women and 83 men for 32 consecutive days during an ongoing joint self-set quit attempt. Daily CHBs varied from day to day and between individuals. At the between-person level, higher women’s mean CHBs were associated with lower intention (b = −0.23, p = 0.04) and at the 10% level with more cigarettes smoked after the quit date (rate ratio (RR) = 1.92, p = 0.07). At the within-person level, women’s higher than usual CHBs were unrelated to intention to quit, but were related to less smoking before (RR = 0.96, p = 0.03) and at the 10% level after the quit date (RR = 0.91, p = 0.09). A marginally positive association between daily CHBs and smoking at the within-person level emerged for men. The negative effect of daily CHBs at the between-person level on smoking seems to unfold after the quit attempt and for women only.

Time series analysis of intensive longitudinal data in psychosomatic research: A methodological overview

Time series analysis of intensive longitudinal data provides the psychological literature with a powerful tool for assessing how psychological processes evolve through time. Recent applications in the field of psychosomatic research have provided insights into the dynamical nature of the relationship between somatic symptoms, physiological measures, and emotional states. These promising results highlight the intrinsic value of employing time series analysis, although application comes with some important challenges. This paper aims to present an approachable, non-technical overview of the state of the art on these challenges and the solutions that have been proposed, with emphasis on application towards psychosomatic hypotheses. Specifically, we elaborate on issues related to measurement intervals, the number and nature of the variables used in the analysis, modeling stable and changing processes, concurrent relationships, and extending time series analysis to incorporate the data of multiple individuals. We also briefly discuss some general modeling issues, such as lag-specification, sample size and time series length, and the role of measurement errors. We hope to arm applied researchers with an overview from which to select appropriate techniques from the ever growing variety of time series analysis approaches.

Modelling multiple health behavior change with network analyses: results from a one-year study conducted among overweight and obese adults

This study examined the between-person associations of seven health behaviors in adults with obesity participating in a weight loss intervention, as well as the covariations between these behaviors within-individuals across the intervention. The present study included data from a 12-month weight loss trial (N = 278). Seven health behaviors (physical activity, sedentary behavior, sleep duration, and consumption of fruits, vegetables, total fat and added sugar) were measured at baseline, 6- and 12-months. Between- and within-participants network analyses were conducted to examine how these behaviors were associated through the 12-month intervention and covaried across months. At the between-participants level, associations were found within the different diet behaviors and between total fat and sedentary behaviors. At the within-participants level, covariations were found between sedentary and diet behaviors, and within diet behaviors. Findings suggest that successful multiple health behaviors change interventions among adults with obesity will need to (1) simultaneously target sedentary and diet behaviors; and (2) prevent potential compensatory behaviors in the diet domain.

Social cognitions and smoking behaviour: Temporal resolution matters

Objectives Health behaviour theories outline how cognitions predict behaviours, but rarely specify the temporal relation between cognitions and behaviours. It is not known whether these predictive relationships vary depending on temporal resolution or whether the relative influence of cognitions varies with measurement schedules. The current exploratory study therefore investigates whether the associations between behavioural cognitions (self-efficacy, intention, and risk perception) and smoking vary when measured momentarily, at day level, or using the more common baseline-follow-up design. Design EMA study involving 36 continuing smokers over 17 days. Participants logged cigarettes and reported their cognitions at baseline, daily (evening), and in response to momentary surveys. Methods Random-effects models were used to compare the effects of cognitions measured at different time points on (1) the number of cigarettes smoked daily and (2) the time interval until the next cigarette smoked. Results Self-efficacy and risk perception measured at baseline significantly predicted cigarettes smoked each day, but this effect became non-significant when daily measurements of cognitions were included in the model. Momentary smoking behaviour was predicted by momentary measurements of risk perception, with no significant effects of social cognitions at baseline. Conclusions Relationships between cognitions and behaviours vary according to the temporal resolution of the measurement schedule. Ensuring that the temporal resolution of assessment is appropriate for the temporal dynamics of the behaviour being assessed is important. Future research is needed to investigate the potential for leveraging specific cognitive processes depending on temporal importance in order to increase health-promoting behaviours. Statement of contribution What is already known on this subject? Social cognitions including intentions, risk perception, and self-efficacy have been observed to predict smoking. Little is known about the role of time in the cognition-behaviour relationship. Cognitions have been observed to fluctuate, but instability is typically not considered in research design. What does this study add? Daily measurement of social cognitions predicts behaviour better than measurements taken at baseline. Momentary smoking behaviour is predicted by momentary cognitions at the intra-individual level. Temporal resolution of measurement should be considered when investigating cognition-behaviour relationships.

Editor's Choice: Dual-process model of older adults' sedentary behavior: an ecological momentary assessment study

Objective: A 10-day ecological momentary assessment (EMA) study was conducted to test a dual-process model of older adults' sedentary behavior.Design: Older adults (n = 104, 60-98 years) answered 6 EMA questionnaires/day to assess conscious processes (i.e. momentary intentions, self-efficacy to limit sedentary behavior over the next two hours) and wore an activPAL accelerometer to measure sedentary behavior. Habit strength for sedentary behavior, a non-conscious process, was self-reported at an introductory session.Main outcome measure: Time spent sitting in the two hours after the EMA prompt.Results: Older adults engaged in less sedentary behavior on occasions when their intentions (b = -1.63, p = 0.02) and self-efficacy (b = -2.01, p = 0.003) to limit sedentary behavior were stronger than one's average level of intentions or self-efficacy, respectively; however, older adults' average level of intentions (b = -5.30, p = 0.05) or self-efficacy (b = 2.77, p = 0.27) to limit sedentary behavior were not associated with sedentary behavior. Older adults with stronger sedentary behavior habits engaged in greater sedentary behavior in the two hours following the EMA prompt (b = 2.04, p = 0.006).Conclusion: Sedentary behavior is regulated by conscious and non-conscious processes. Interventions targeting older adults' sedentary behavior should promote momentary intention formation and self-efficacy beliefs to limit sitting as well as content to disrupt habitual sedentary behavior.