Psychometric validation of four-item exercise identity and healthy-eater identity scales and applications in weight loss maintenance

BACKGROUND

Identifying as someone who engages in health promoting behaviors like healthy eating and exercising may be associated with sustained engagement in those behaviors, but reliable and valid instruments are needed to improve the rigor of this research. Two studies were conducted to (1) examine the psychometric properties of a four-item exerciser identity measure (4-EI) and an adapted healthy-eater identity measure (4-HEI) and (2) examine differences in identity strengths across categories of weight loss success.

METHODS

Data from 1,709 community dwelling adults in the International Weight Control Registry (IWCR) were used. A random half of the sample was used to assess the proposed unidimensional factor structure of the 4-EI and 4-HEI and examine convergent and discriminant validity using Spearman rank-order correlations. One-way ANOVA was used in the other random half of the sample to compare 4-EI and 4-HEI scores (-3 to + 3) across three self-defined weight loss categories ('Successful', 'Regain', and 'Unsuccessful') and those maintaining ≥ 5% weight loss for > 1 year vs. not.

RESULTS

Results support the unidimensional factor structure with all four items (eigenvalue scores > 2.89) as well as convergent and discriminant validity for both measures. Exercise identity was strongly correlated with self-reported physical activity (r (735) = 0.52, p <.001) and measures of autonomous motivation. Healthy eating identity was moderately correlated with cognitive restraint in eating (r (744) = 0.42, p <.001) and other measures predictive of eating behavior. 4-EI and 4-HEI are stronger in Successful (4-EI: M = 0.90, SD = 1.77; 4-HEI: M = 1.56 SD = 1.37) vs. Regain (4-EI: M=-0.18, SD = 1.68; 4-HEI: M =.57, SD = 1.48) and Unsuccessful (4-EI:M=-0.28, SD = 1.62; 4-HEI: M = 0.51, SD = 1.33) and those maintaining ≥ 5% weight loss (4-EI:M = 0.47, SD = 1.78; 4-HEI: M = 1.13, SD = 1.49) vs. not (4-EI:M=-0.27, SD = 1.66; 4-HEI: M = 0.53, SD = 1.47), p's < 0.001.

CONCLUSIONS

The 4-EI and 4-HEI have acceptable psychometric properties and can advance understanding of the role of identity in exercise and dietary behaviors and weight loss maintenance.

TRIAL REGISTRATION

The parent observational study, International Weight Control Registry (IWCR), for these sub-studies is registered in ClinicalTrials.gov (NCT04907396).

You Are What You Eat… But Do You Eat What You Are? The Role of Identity in Eating Behaviors—A Scoping Review

Background: Identity is a major construct in the fields of psychology and anthropology that can relate to both the maintenance of eating behaviors and cultural sensitivity. However, there has not been any systematic effort to understand the role of identity in eating behaviors and the maintenance of eating behaviors, or to address multiple aspects of identity within an individual across scientific disciplines. This scoping review aims to understand and describe existing research relating identity to eating behaviors and to detail the measurement of identity. Methods: We conducted a systematic search of Ovid, PsychINFO, Embase, and Web of Science for articles on identity and eating behaviors published between January 1946 and March 2022. We utilized the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist, and search methods were developed with the assistance of a research librarian. We rated articles from 1 to 5 based on the depth, complexity, and multi-dimensionality of the identity measurement conducted. Scoring criteria included a review of the number of items directly querying or evaluating identity and the extent of measurement of identity domains. Results: In total, 100 articles were included, examining 10 different identities, 8 identity constructs, 11 eating behaviors, and construct contributions from 26 theories. The mean score of all articles was 2.9 on the scale from 1 to 5. A total of 10 studies scored a “1”; 30 scored a “2”, indicating the use of 1–2 basic questions about identity; 31 received a “3” for use of a common but non-complex identity instrument; 19 received a “4”, meaning they contained strong evaluation and included multiple types of identity but were lacking in terms of depth of measure and/or the comparison of identity effects to constructs; and 10 scored a “5” for their strong, in-depth measure of identity and inclusion of multiple types. Identity was found to be significantly related to eating behaviors in all but one study. Conclusion: Identity measurements seldom accounted for complexities such as multiple identities and identity shifting over time. Nonetheless, our findings indicate that multiple aspects of identity reciprocally reinforce behavior and that change maintenance is associated with identity salience and centrality. Identity is underutilized and heterogeneously applied in eating behavior research. The inclusion of identity assessments may lead to better outcomes being obtained within differing cultural, normative, and environmental scenarios.

Associations of Eating Identities With Self-Reported Dietary Behaviors and Body Mass Index

Objective:

To inform dietary interventions, it is important to understand antecedents of recommended (henceforth: healthy) dietary behaviors, beyond dietary beliefs and self-efficacy. We used the validated “Eating Identity Type Inventory” to assess the extent to which participants identified as healthy eaters, meat eaters, emotional eaters or picky eaters. We examined correlations between participants' race/ethnicity and other socio-demographic characteristics and affinity with these eating identities, how affinity with these eating identities correlated with self-reports of dietary beliefs, self-efficacy, dietary behaviors and Body Mass Index (BMI), and how well affinity with these eating identities predicted self-reported dietary behaviors and BMI, as compared to self-reported dietary beliefs and self-efficacy.

Methods

In an online survey, a diverse sample of 340 Los Angeles County adults reported eating identities, dietary beliefs, and self-efficacy, dietary behaviors and BMI.

Results

Pearson correlations revealed that identifying more as a healthy eater was positively associated with self-reports of being non-Hispanic White, non-Hispanic mixed race, older, and college-educated, while identifying more as a meat eater was positively associated with self-reports of being non-Hispanic Black, younger, and male (α = 0.05). Pearson correlations also showed that healthy eaters had more accurate dietary beliefs and self-efficacy, and emotional eaters had lower self-efficacy (α = 0.05). In linear regressions, identifying more as a healthy eater was associated with self-reporting healthier dietary behaviors and lower BMI, and identifying more as a meat eater and emotional eater was associated with reporting less healthy dietary behaviors and higher BMI, even after accounting for correlations with socio-demographics, dietary beliefs, and self-efficacy (α = 0.05).

Conclusions

Our findings highlight the importance of eating identities in understanding dietary behaviors and outcomes, with implications for dietary interventions.

A relational approach to evaluate food environments finds that the proximate food environment matters for those who use it

Using a relational approach, this study investigates whether shopping close to home moderates the relationship between the proximate food environment and diet. To address this question, we develop the proximate food retail quality (PFRQ) score, an inverse-distance weighted measure of all food retailers within a resident's neighborhood that incorporates audit data of each food retailer. This study relies on data collected through 24-h dietary recalls and psychosocial surveys administered to 449 adults in two socioeconomically matched neighborhoods. Food retailer audits collected data on the availability, price, and quality of healthful foods. Seventy-one percent of study participants report conducting at least 50% of their food shopping within approximately one mile of their home. Household income and education are associated with likelihood to shop close to home, while access to a personal vehicle is not. Finally, results suggest that, for residents who shop primarily close to home, a one unit increase in proximate food retail environment score is associated with a 17.2-point increase in HEI-2010 score, a measure of overall diet quality that ranges from zero to 100. This study suggests that the food environment matters for those who use it and that a low-quality proximate food environment can amplify individual disadvantage.

Who are we testing? Self-selection bias in laboratory-based eating behaviour studies

Research conducted in controlled laboratory settings plays an important role in understanding human eating behaviour. However, participant characteristics may affect motivation to participate in laboratory eating behaviour research and result in self-selection biases. First-year psychology students (n = 207, 90.8% female, m age = 18.8, m BMI = 21.9) were led to believe that they were choosing between enrolling in one of two laboratory-based studies: an 'advertising' study, or an 'advertising and food' study; the latter specified that participants would consume food and answer questions about their eating behaviour. Participants subsequently reported demographic information and completed a series of questionnaires assessing psychological characteristics hypothesised to predict self-selection in laboratory eating studies. The majority of participants preferred to participate in a study unrelated to eating over an eating-related study (70.5%, χ² (1) = 34.90, p < .001). Participants choosing the eating-related study over the non-eating study had higher self-reported external eating tendencies and positive preoccupations with food, lower negative preoccupations with food and social appearance anxiety. Participants choosing the eating related study were also more likely to be male than female, although the number of males in the study was small (n = 19) and this finding should therefore be interpreted with caution. The present study provides some evidence that in university based samples of participants there are likely self-selection biases in laboratory-based eating behaviour studies and researchers may benefit from considering the potential influence of self-selection biases when conducting eating behaviour research.

Effects of a healthy-eater self-schema and nutrition literacy on healthy-eating behaviors among Taiwanese college students

Unhealthy eating behaviors contribute to obesity and chronic illness. This study examined the relative contributions of a healthy-eater self-schema (a self-conception as a healthy eater) and nutrition literacy on healthy-eating behaviors and whether nutrition literacy was a mediator among Taiwanese college students. A total of 1216 undergraduate students from six universities in Taiwan participated in the study from April to June 2016. Healthy-eating behaviors, nutrition literacy, healthy-eater self-schema and known determinants of eating behaviors (e.g. nutrition-related information, health status, nutrition knowledge needs, sex, year in college and residence) were measured by a self-report questionnaire. A hierarchical multiple regression and mediation analysis were conducted with the known determinants of eating behaviors as covariates. Results showed that a healthy-eater self-schema and nutrition literacy explained 9% and 12% of the variance in healthy-eating behaviors, respectively, and both had unique effects on healthy-eating behaviors. The effect of a healthy-eater self-schema on healthy-eating behaviors was partially mediated through nutrition literacy. Findings suggest that both a healthy-eater self-schema and nutrition literacy should be considered when promoting healthy-eating behaviors. Additionally, nutrition literacy interventions should be tailored to the healthy-eater self-schema status and emphasize the personal relevance of being a healthy-eater to improve the intervention's effectiveness.

Elementary school teachers’ behavioral intentions for healthy nutrition

Purpose

The purpose of this paper is to examine the effects of elementary school teachers’ psychological factors on their behavioral intentions for healthy nutrition in their daily life within an extended version of the theory of planned behavior (TPB).

Design/methodology/approach

The design of the study is correlation study.

Findings

Constructs in the proposal model formed accounted for of variance of intentions and behaviors successfully. Considering the entire proposed model, while personal norm is the most influential factor on intention, self-identity is the most consistent effects on teachers’ behavior. However, among the constructs of TPB, perceived behavioral control is the strongest influence on both intention and behavior.

Originality/value

In the literature, factors affecting healthy behaviors by using TPB focused on mainly children (8–10 year old) and adolescents (11–16 year old) all over the world. However, in some countries, several studies were conducted on adults (e.g. Astrøsm and Rise, 2001; Brouwer and Mosack, 2015), to the best of our knowledge, while there is no study conducted on adults including teachers in Turkey. In addition, recently, two meta-analysis studies were published: Riebl et al. (2015) and Mcdermott et al. (2015). These studies suggested that future studies related to healthy nutrition in the scope of TPB should be continued to investigate.

Self-schema as a non-drinker: a protective resource against heavy drinking in Mexican-American college women

Alcohol use is considered less acceptable for women than men in the Mexican culture. However, recent studies of Mexican-American (MA) women show that prevalence and rates of alcohol use are escalating, particularly in those with high acculturation to Western standards. Building on recent studies that demonstrated that drinking-related identities (self-schemas) are important predictors of alcohol use in college populations, this secondary data analysis investigated the association between acculturation, MA cultural values, and acculturative stress, drinking-related self-schemas and heavy drinking over time in college-enrolled MA women. Data were drawn from a 12-month longitudinal study of self-schemas and health-risk behaviors in 477 college-enrolled MA women. Drinking-related self-schemas, acculturation, MA cultural values and acculturative stress were measured at baseline, and heavy drinking was measured at baseline, 3, 6, 9 and 12 months. Thirty-six percent of women had a non-drinker self-schema but only 3% had a drinker self-schema. Higher spirituality was protective against heavy drinking, and this effect can be partially explained by presence of a non-drinker self-schema. Interventions that emphasize the personal relevance of being a non-drinker and support the importance of spirituality may help to prevent heavy drinking in MA college women.

Maternal and child dietary intake: The role of maternal healthy-eater self-schema

BACKGROUND

Mothers play a key role in shaping the dietary intake of their young children through their own dietary intake and the foods they make available at home. Therefore, understanding the mechanisms underlying maternal food choices is crucial. Cognitions about the self as a healthy eater, referred to as healthy-eater self-schema (HESS), predict dietary intake in diverse samples, but the linkage has not been investigated in mothers and their feeding behaviors. This study examined the relationship between a maternal HESS, maternal and child intake of fruits, vegetables, saturated fat, and added sugar, and home food availability.

METHODS

A cross-sectional, descriptive design was used with mothers and their 2-5 year old children (N = 124 dyads). Kendzierski's Healthy-Eater Self-Schema questionnaire was used to measure HESS. Block Food Frequency Screeners were used to measure diets (mother and child) and the Home Environment Survey was used to measure home availability of fruits/vegetables and fats/sweets. Multiple regression and multiple mediation analyses were performed.

RESULTS

Maternal HESS was positively associated with maternal intake of fruits and vegetables, and negatively associated with intake of added sugar. Maternal HESS was not directly associated with child dietary intake, but was indirectly associated with child intake of fruits, vegetables, and added sugar through maternal intake of the same foods. Home food availability was not significantly associated with HESS.

CONCLUSION

This study found that a mother's HESS was positively associated with her diet, which was subsequently associated with aspects of her child's diet. Interventions to foster development of HESS in mothers may be an effective means to promote healthy dietary intake in mothers and their young children.

Effects of drinker self-schema on drinking- and smoking-related information processing and behaviors

BACKGROUND

Co-occurrence of drinking and smoking is prevalent in undergraduate students. A drinker self-schema-cognition about the self as the drinker-is a common identity in undergraduates and a well-known predictor of drinking behaviors. Given that smoking commonly occurs in the context of drinking, a drinker self-schema may be a cognitive mechanism to motivate co-occurring alcohol and tobacco use (i.e., cross-substance facilitation hypothesis). This study was to determine whether the drinker self-schema influences the processing of drinking- and smoking-related information and facilitates the co-occurrence of alcohol and tobacco use in undergraduate students who drink and smoke but do not self-identify as smokers.

METHODS

This study was the second phase of a 2-phase study. Of the 330 who completed phase 1 (online survey), 99 completed the phase 2 study. Phase 2 was an in-person session that included a computerized information processing task to measure endorsements and response latencies for drinking- and smoking-related attributes, and a computerized Timeline Followback that was used to measure 90-day alcohol- and tobacco-use behaviors. The 5-item drinker self-schema scale, administered in phase 1, was used to measure the strength of the drinker self-schema.

RESULTS

A higher drinker self-schema score was associated with more endorsements of positive attributes for drinking and smoking, fewer endorsements of negative attributes for smoking, faster processing of agreements with positive alcohol-use-related attributes, higher levels of drinking and smoking, and more days of co-occurring alcohol and tobacco use.

CONCLUSIONS

Findings provide preliminary evidence to support the cross-substance facilitation hypothesis that the drinker self-schema facilitates the processing of not only drinking-related but also smoking-related stimuli and behaviors. Undergraduates who have higher drinker self-schema scores may be vulnerable to co-occurring alcohol and tobacco use.

What does a person's eating identity add to environmental influences on fruit and vegetable intake?

OBJECTIVE

To evaluate whether knowledge of a person's eating identity (EI) can explain any additional variation in fruit and vegetable intake above and beyond that explained by food environment characteristics, perceptions of the food environment, and shopping behaviors.

DESIGN

Cross-sectional study.

SETTING

A total of 968 adults were recruited for a telephone survey by the Survey Research Laboratory in an eight-county region in South Carolina.

SUBJECTS

The survey queried information on shopping behaviors, perceptions of the food environment, demographic and address information, fruit and vegetable intake, and EI. EI was assessed using the Eating Identity Type Inventory, a 12-item instrument that differentiates four eating identity types: healthy, emotional, meat, and picky. Statistical analyses were restricted to 819 participants with complete data.

RESULTS

Healthy EI and picky EI were significantly and directly related to fruit and vegetable intake, with coefficients of 0.31 (p-value<0.001) for healthy EI and -0.16 (p-value<0.001) for picky EI, whereas emotional EI (β = 0.00, p-value = 0.905) and meat EI (β = -0.04, p-value = 0.258) showed no association. Shopping frequency also directly and significantly influenced fruit and vegetable intake (β = 0.13, p-value = 0.033). With the inclusion of EI, 16.3% of the variation in fruit and vegetable intake was explained.

CONCLUSIONS

Perceptions and GIS-based measures of environmental factors alone do not explain a substantial amount of variation in fruit and vegetable intake. EI, especially healthy EI and picky EI, is an important, independent predictor of fruit and vegetable intake and contributes significantly to explaining the variation in fruit and vegetable intake.

Identifying the Structure and Effect of Drinking-Related Self-Schemas

Self-schemas have received increased attention as favorable targets for therapeutic intervention because of their central role in self-perception and behavior. The purpose of this integrative review was to identify, evaluate, and synthesize existing research pertaining to drinking-related self-schemas. Russell's integrative review strategy guided the search. Sixteen published works were identified, meeting criteria for evaluation ( n = 12 data-based publications and n = 4 models). The retrieved data-based publications rated fair-good using Polit and Beck's criteria; the overall body of literature rated "B" using Grimes and Schulz criteria. Retrieved models rated 4 to 7 using Fitzpatrick and Whall's criteria. The existing literature strongly supports the availability of a drinking-related self-schema among moderate-to-heavy drinking samples, and suggests a positive relationship between elaboration and drinking behavior. The relationship between valenced content of the schema and drinking behavior remains unexplored. Identifying variation in the structural properties of drinking-related self-schemas could lay the foundation for future interventions.

Perceptions and dietary intake of self-described healthy and unhealthy eaters with severe mental illness

The aim of this exploratory study was to examine how community-dwelling adults with severe mental illness describe themselves as eaters and how these eating identities relate to dietary intake. Twenty participants completed one in-depth qualitative interview and three 24-h dietary recalls. Two distinct groups were identified; self-described healthy eaters (n = 10) and self-described unhealthy eaters (n = 10). Healthy eaters emphasized fruits and vegetables, limiting sweets, three meals a day, overcoming cost concerns, and benefits of healthy eating. Unhealthy eaters emphasized junk foods, fried foods, few fruits and vegetables, cost and household barriers to healthy eating, and concerns about consequences of unhealthy eating. Self-described healthy eaters consumed significantly more vegetables and less kilocalories, carbohydrates, fat, and saturated fat than self-described unhealthy eaters. Understanding how eating identities relate to dietary intake provides important insights for development of more effective approaches to promote healthy eating in this high risk population.

The Eating Identity Type Inventory (EITI). Development and associations with diet

People with healthy eating identities report healthier diets and demonstrate greater receptivity to nutrition interventions, but other types of eating identity are likely important. We developed the Eating Identity Type Inventory (EITI) to assess affinity with four eating identity types; healthy, meat, picky, and emotional. This study assessed factorial validity, using confirmatory factor analysis (CFA) and established reliability and convergent validity of the EITI. In a telephone survey, 968 primary household food shoppers completed the EITI and a dietary questionnaire; 101 repeated the EITI approximately 1month later.CFA revealed that an 11-item model provided acceptable fit (χ(2)=206; df=38), CFI=.938, NNFI=.925, RMSEA=.070; SRMR=.059). The EITI demonstrated acceptable internal consistencies with Cronbach alpha's ranging from .61 to .82 and good test-retest reliability for healthy, emotional, and picky types (Pearson's correlations ranging from .78 to .84). Ordinary Least Squares (OLS) used to assess relationships between eating identity type and diet analyses demonstrated significant hypothesized relationships between healthy eating identity and healthier dietary intake and meat and picky eating identities and less healthy dietary intake. The EITI could facilitate behavioral and cognitive research to yield important insights for ways to more effectively design messages, interventions, and policies to promote healthy dietary behaviors.

Deconstructing the concept of the healthy eater self-schematic: relations to dietary intake, weight and eating cognitions

This study investigated differences in dietary intake, weight status, food preoccupation, and attributions about healthy eating lapses between individuals classified as healthy eater self-schematics and nonschematics. The study also assessed whether the separate dimensions of the self-schema construct (self-description as a healthy eater and perceived importance of being a healthy eater to self-image) are related to these health outcomes. College students (N=125; 82% female) completed questionnaires assessing healthy eater self-schema status, dietary intake, weight status, food preoccupation, and lapse attributions. Results revealed that females who were classified as healthy eater self-schematics ate more fruits and vegetables, ate less junk food and had lower BMIs than nonschematics. Healthy eater self-schematics also engaged in more positive thoughts and fewer negative thoughts about food, made less stable attributions about lapses in healthy eating and endorsed more personal control over lapses. When the two dimensions of the self-schema were examined separately, self-description appeared to be more related to these outcomes than perceived importance.

Healthy-eater Identity and Self-efficacy Predict Healthy Eating Behavior: A Prospective View

Identity and Self-efficacy Theories were used to examine the relationship between healthy-eater identity, self-efficacy for healthy eating and healthy eating. Measures of healthy-eater identity, perception of healthy eating, nutrition knowledge, self-efficacy for both intake of fruits and vegetables and foods of low nutritional value were completed by 101 university students and staff. Two weeks later, participants recalled recent consumption of (a) fruits and vegetables and (b) foods of low nutritional value. For both eating outcomes, healthy-eater identity was a significant predictor after controlling for nutrition knowledge. The addition of self-efficacy improved prediction in the case of both eating outcomes.

Healthy-eater self-schema and dietary intake

The types and amounts of foods consumed have been shown to influence the health risks of individuals. Empirical evidence has documented a link between high dietary fat and low fiber intake and the risks for cardiovascular disease, some types of cancer, and obesity. Dietary surveys of Americans show higher fat and lower fiber intake than stipulated in the Dietary Guidelines for Americans, despite the noted increase in public awareness regarding the importance of adopting healthy eating habits. The lack of congruence between the availability of dietary knowledge and behavioral adherence to dietary recommendations suggests a need to further understand the predictors of dietary intake. In this study, the authors used the schema model of the self-concept to explore the role of self-beliefs in predicting dietary intake in community-dwelling, working-class, middle-aged adults.

Reactions to a Perceived Challenge to Identity

Based upon Identity and Social Cognitive theories, two studies examined reactions to challenges to exercise identity (Study 1) and healthy-eater identity (Study 2). For both studies, participants responded to a perceived challenge relative to the health behavior in terms of affect, intentions, self-regulatory efficacy and generated self-regulatory strategies. High identity participants in both studies showed the theory-based, hypothesized response pattern suggesting they were seeking identity-behavior congruency and this response pattern was stronger than exhibited by moderate identity individuals. Collectively, findings support the compatible use of Identity and Social Cognitive theories in studying identity and suggest that identities may be important in understanding health behavior regulation.

The identity impairment model: a longitudinal study of self-schemas as predictors of disordered eating behaviors

BACKGROUND

There is broad consensus that the eating disorders of anorexia nervosa and bulimia nervosa stem from fundamental disturbances in identity development, but theoretically based empirical support is lacking.

OBJECTIVE

To extend work on the identity impairment model by investigating the relationship between organizational properties of the self-concept and change in disordered eating behaviors (DEB) in an at-risk sample of college women transitioning between freshman and sophomore years.

METHODS

The number, valence, and organization of self-schemas; availability of a fat body weight self-schema; and DEB were measured at baseline in the freshman year and 6 and 12 months later in a community-based sample of college women engaged in subthreshold DEB (n = 77; control: n = 41). Repeated-measures analyses of variances were used to examine group differences, and hierarchical regression analyses were used to predict disordered eating behaviors.

RESULTS

Women in the DEB group had more negative self-schemas at baseline and showed information-processing evidence of a fat self-schema compared with the controls. The groups did not differ in the number of positive self-schemas or interrelatedness. The number of negative self-schemas predicted increases in the level of DEB at 6- and 12-month follow-up, and these effects were mediated through the fat self-schema. The number of positive self-schemas predicted the fat self-schema score but was not predictive of increases in DEB. Interrelatedness of the self-concept was not a significant predictor in this model.

DISCUSSION

Impairments in overall collection of identities are predictive of the availability in memory of a fat self-schema, which in turn is predictive of increases in DEB during the transition to college in a sample of women at risk for an eating disorder. Therefore, organizational properties of the self-concept may be an important focus for effective primary and secondary prevention.

Comparing college students' value-, outcome-, and impression-relevant involvement in health-related issues

The purpose of this study was to examine the role of receiver involvement in the context of health communication. Students (N = 277) completed Cho and Boster's (2005) measures of value-, outcome-, and impression-relevant involvement across 6 health behaviors, including cigarette smoking, organ and tissue donation, sunscreen use, alcohol use, sexually transmitted disease testing, and nutrition. Confirmatory factor analyses across all 6 health topics provided evidence of the 3-factor structure conceptualized by Johnson and Eagly (1989) and measured by Cho and Boster (2005). When health behaviors were regressed onto value-, outcome-, and impression-relevant involvement, outcome- and value-involvement, generally speaking, emerged as significant predictors. Results and implications of considering health campaign audience members' levels of involvement are discussed in the domain of preventive medicine.

Dimensions and profiles of the generalized health-related self-concept

OBJECTIVES

We explore the significance of health as a potentially self-relevant category from the perspective of dynamic self-concept theory. Our intention was to describe the dimensional structure of the generalized health-related self-concept, to identify particular prototypes of health-related self-definition, and to see if these prototypes would differ with respect to appraisals of health behaviour and subjective health.

DESIGN

We conducted a cross-sectional questionnaire study involving 545 college students (23.3% male) at the mean age of 22 years.

METHODS

The self-administered questionnaire assessed a relevant spectrum of health-related cognitions denoting their generalized declarative knowledge about their health (the generalized health-related self-concept). Additionally, participants rated their multiple health behaviour, their perceived health, and their anticipated vulnerability.

RESULTS

A principal components analysis of the health-related cognitions revealed the following five dimensions: health-protective dispositions, health-protective motivation, vulnerability, health-risky habits, and external, avoidant motivation. A two-step cluster analysis of the five components identified six profiles of health-related self-concept: careless/carefree, omnipotents, risk-takers, mentally affected, reluctant-avoidant, and medically fragile. These prototypes could be successfully reclassified (97.6%). The six profiles differed with respect to their health behaviour and subjective health appraisals.

CONCLUSIONS

The dimensional structure represents both resources and deficits with respect to an individual's health-related self-concept. An individual's profile of these dimensions might correspond to a characteristic set of particular health needs and motivations. Successful health communications should follow a complementary strategy of affirming the self-concept.