The Importance of Affective Beliefs and Attitudes in the Theory of Planned Behavior: Predicting Intention to Increase Physical Activity1

Motivational and emotional correlates of physical activity and sedentary behavior after cardiac rehabilitation: an observational study

BACKGROUND

The present study assessed physical activity (PA) and sedentary behavior (SB) levels and their motivational and emotional health-related correlates, in outpatients following a cardiovascular rehabilitation (CR) program, and compared these variables with those of a healthy control group.

METHODS

The study included 119 participants: 68 CR outpatients (Mage 57.76 ± 10.76; 86.76% males) and 51 control participants matched on age (Mage 57.35 ± 6.33 years; 45.10% males). PA and SB were assessed using accelerometers during the first week post-discharge for outpatients and during a typical week for controls. Motivational (i.e., perceived capabilities, affective and instrumental attitudes, intention, approach-avoidance tendencies) and emotional health-related variables (i.e., anxiety, depressive symptoms, fatigue, pain intensity) were measured using validated scales. PA and SB data from 17 outpatients and 42 controls were valid for analysis, resulting in a final sample of 59 participants.

RESULTS

CR outpatients engaged an average of 60.21 (± 34.79) min of moderate-to-vigorous PA (MVPA), and 548.69 (± 58.64) min of SB per day, with 18 more minutes of MVPA per day than controls (p = .038). Univariate and multivariate regressions indicated that positive affective attitudes were associated with higher MVPA (b = 10.32, R2 = 0.07, p = .029), and that males spent more time in SB than females (b = 40.54, R2 = 0.09, p = .045). Univariate and multivariate logistic regressions showed that meeting the World Health Organization's weekly guidelines for MVPA was associated with higher perceived capabilities toward PA and more positive affective attitudes (OR = 1.17, p = .030; OR = 1.26, p < .001, respectively). Interaction tests showed no significant differences in these results between outpatients and controls.

CONCLUSION

The study highlights an association between higher perceived capabilities and positive affective attitudes toward PA with higher PA levels after outpatient CR. While these findings suggest that enhancing these motivational variables may be beneficial for increasing PA levels after CR, longitudinal and experimental studies are needed to further establish their role.

The Impact of Exercise Cognition on Exercise Behaviors: The Mediating Role of the Satisfaction of Basic Psychological Needs in Exercise for Adolescents

In recent years, the exercise behavior of Chinese adolescents has been on the decline, which is extremely detrimental to their physical and mental health development. However, few studies have explored the mechanisms by which exercise cognition influences Chinese adolescents' exercise behavior. The present study aimed to investigate the relationship between exercise cognition and exercise behavior among Chinese adolescents and the mediating role of satisfying basic psychological needs for exercise. The study consisted of 996 adolescents (44.6% males, 55.4% females) between the ages of 12 and 15 (M = 13.34, SD = 1.059). Participants' exercise behaviors and the satisfaction of basic psychological needs for exercise data were collected via surveys. Structure equation modeling (SEM) was performed to examine the direct and indirect effects. The results were as follows: (1) adolescents' perceptions of exercise were significantly associated with exercise behavior and (2) the mediation model suggests that the satisfaction of basic psychological needs for exercise is an important mechanism by which exercise cognition influences the occurrence of exercise behavior. Therefore, it is crucial to help adolescents form good exercise cognition. Schools, families, and society should take responsibility for adolescents' formation of good exercise cognition and satisfy adolescents' basic psychological needs for exercise so as to enhance adolescents' exercise behaviors and thereby develop good exercise habits.

Testing the moderative role of automatic-reflective affect divergence in predicting physical activity

Dual process theories postulate that behaviour is the product of two distinct cognitive systems, the automatic and reflective, and that congruence/divergence between the two types of cognitions can influence the predictive strength of either system on behaviour. However, the congruence/divergence hypothesis has yet to experience strong empirical support. The aim of this study was to test a novel dual process model to determine the moderating effect of affect divergence on the relationship between automatic affective evaluations-affective judgements, and physical activity. A sample of 315 university students recruited from an undergraduate research pool completed the Affective Misattribution Procedure and Affective Exercise Experiences Questionnaire, followed by a measure of physical activity behaviour one week later. A path analysis revealed a significant moderation effect such that the predictive strength of affective judgements was stronger when participants' automatic affective evaluations and affective judgements were congruent. Findings support current dual process theory and contributes to calls for more interventions, such as evaluative conditioning that target automatic processes alongside consciously held beliefs.

How Ethical Ideology Influences Mask-Wearing Intention in a Pandemic: The Mediating Role of Moral Norms and Threat to Freedom

The present study examined how two types of ethical ideologies (idealism, and relativism) influenced behavioral intention to wear a mask during the COVID-19 pandemic through two appraisals (moral norms, and threat to freedom) of a mask-wearing issue. A total of 823 responses were collected through a cross-sectional survey, and 776 responses were used for testing hypotheses. The study found that idealism has a significant indirect effect on behavioral intention through increased moral norms and decreased threat to freedom. Also, the study revealed that relativism has a significant indirect effect on behavioral intention through increased threat to freedom.

Predicting behavioral intentions for unsafe off-highway vehicle use

INTRODUCTION

Hundreds of adults are killed or injured each year while operating off-highway vehicles. Four common risk-taking behaviors were identified on off-highway vehicles in the literature and examined intention to engage in such behaviors within the context of the Theory of Planned Behavior.

METHOD

One hundred and sixty-one adults completed measures of experience on off-highway vehicles and injury exposure followed by a self-report created according to the predictive structure of the Theory of Planned Behavior. Behavioral intentions to engage in the four common injury risk behaviors on off-highway vehicles were predicted.

RESULTS

Similar to research on other risk behaviors, perceived behavioral control and attitudes emerged as consistently significant predictors. Subjective norms, the number of vehicles operated, and injury exposure showed varying relationships to the four injury risk behaviors. Results are discussed in the context of similar studies, intrapersonal predictors of injury risk behaviors, and with regard to implications for injury prevention efforts.

Prevalence and associated factors of physical inactivity among adult diabetes mellitus patients in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

Physical inactivity has been viewed as an emerging public health problem in developing countries including Ethiopia. Diabetes mellitus (DM) is a group metabolic disorder characterized by chronic hyperglycemia resulting from defects in insulin secretion, function, or both. Its prevalence increases with changing lifestyles including physical inactivity across the globe. However, there is limited research, and not yet received attention in Ethiopia. This study aimed to assess the prevalence and associated factors of physical inactivity among adult diabetic patients in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. An institutional-based cross-sectional study design was conducted among 308 participants from February to June 2018 at Felege Hiwot Referral Hospital. A face-to-face interview was conducted using a structured questionnaire by trained data collectors. Participants were selected through a systematic random sampling technique. Physical inactivity was assessed by the international physical activity questionnaire (IPAQ). Collected data were entered in Epi info version 7 and transferred to SPSS version 20 for analysis. A summary of descriptive statistics and multiple binary logistic regression analyses were computed to identify associated factors of physical inactivity among adult diabetic patients. P < 0.05 with 95% CI was considered statistically significant. The overall prevalence of physical inactivity among diabetic patients was 30.5% ( 95% CI: 22.8-33.5%). Gender (AOR = 1.5, 95% CI: 1.1, 3.62), Old age (AOR = 18.17, 95% CI: 22.7, 61.9) Residence (AOR = 4.24, 95% CI: 1,12,16.028), Low self-efficacy (AOR = 20.59, 95% CI: 10.598, 41.608), Poor attitude (AOR = 2.75, 95%CI: 1.44,5.28), and Lack of social support (AOR = 4.22, 95% CI: 1.28,4.07) were found significantly predictor factors of physical inactivity. The prevalence of physical inactivity in this study was high. Being female, old age, dwelling in an urban, having low efficacy, poor attitude, and lack of social support was greater risk factors for being physically inactive. Diabetic education should focus on engagement in physical activity by overcoming barriers to performing physical activity. Government and health professionals should emphasize that evidence-based physical activity important to change their attitudes and require reaching a consensus on social support by their families.

The message matters: Advertisement framing and college women's beliefs toward exercise

Objective: This study explores college women's beliefs and experiences about exercise informed by different framing strategies, and how they may influence exercise engagement. Participants: Four focus groups were conducted with 19 undergraduate women at a large public Midwestern university.Methods: Four differently framed group exercise advertisements were used to prompt focus group discussions on beliefs and intentions to exercise. Transcribed data were analyzed with a thematic content approach.Results: Undergraduate female participants described more positive beliefs that influence intention with a well-being-framed advertisement. More negative beliefs were described when the advertisement focused on enhancing appearance. Participants of color believed that seeing more representation of diversity in advertisements would make engaging in exercise easier.Conclusion: Positive beliefs linked to a "well-being" frame and diverse imagery of women in exercise advertisements may improve intention to exercise, increasing physical activity among women.

Bi-dimensional values and attitudes toward online fast food-buying intention during the COVID-19 pandemic: An application of VAB model

The purpose of the study is to determine the factors of online fast food-buying intention among Bangladeshi Millennials during the COVID-19 pandemic. The study adopted the Value-Attitude-Behavior (VAB) model and designed it as a higher-order constructs model to predict buying intention. Using a quantitative method (i.e., cross-sectional survey), data was collected from 325 respondents via a structured questionnaire and subsequently analyzed using Structural Equation Modeling (SEM) through AMOS software. The findings of the study revealed that convenience and food quality generate utilitarian values, while subjective norms and novelty-seeking form hedonic values. Also, utilitarian and hedonic values significantly affect cognitive and affective attitudes. As opposed to food quality, the cognitive attitude, affective attitude, self-identity, and subjective norms were observed to affect behavioral intention, with affective attitude producing the strongest association, albeit with the high explanatory power of the model. Consequently, this study offers a number of theoretical and policy implications to design better interventions that address public health regarding fast food consumption.

A cross-sectional assessment of food practices, physical activity levels, and stress levels in middle age and older adults' during the COVID-19 pandemic

Aim

This cross-sectional study examined how the COVID-19 pandemic impacted the food practices, physical activity (PA) levels, and stress levels of aging adults ages 40 years and older from seven states. It also explored to what extent the COVID-19 outcomes were affected by the social determinants of health (SDH).

Subject and methods

Respondents (n = 1250) completed an online survey. Descriptive statistics were used to analyze the sociodemographic attributes and COVID-19 responses while the multiple llinear regression (MLR) test evaluated to what extent the SDH variables measured were associated with the reported COVID-19 impacts food practices, PA levels, and stress levels.

Results

Respondents were mostly White (75.9%), married (58.7%), age 60 years and older (61.8%), with a high school education or higher (97.4%). Most of the respondents (85.8%) live in areas that respondents perceived as supportive of health and well-being opportunities for older adults. Nearly one-half of the respondents reported maintaining their pre-pandemic grocery shopping/food buying frequency (44.7%) and PA levels (48.1%). However, 48.6% reported being "somewhat or very stressed" due to the pandemic. Findings revealed that the COVID-19 impacts on food-buying, PA levels, and stress levels were significantly influenced by age, gender, race, education, location, community, nutritional risk, quality of life, food security, and income (p < 0.05).

Conclusion

These findings provide valuable information as we continue to confront the impact the COVID-19 pandemic has had on the health and well-being of aging adults. We can use this information to inform future public health programming interventions and opportunities.

Determinants of healthful eating and physical activity among adolescents and young adults with type 1 diabetes in Qatar: A qualitative study

BACKGROUND

In Qatar, as in the rest of the world, the sharp rise in the prevalence of type 1 diabetes (T1D) is a leading cause for concern, in terms associated with morbidity, mortality, and increasing health costs. Besides adhering to medication, the outcome of diabetes management is also dependent on patient adherence to the variable self-care behaviors including healthful eating (HE) and physical activity (PA). Yet, dietary intake and PA in adolescents and young adults (AYAs) with T1D are known to fall short of recommended guidelines. The aim of this study was to develop an in-depth understanding of the behavioral determinants of HE and PA adherence among Arab AYAs within the age range of 17-24 years with T1D attending Hamad General Hospital.

METHODS

Semi-structured, face-to-face individual interviews were conducted with 20 participants. Interviews were based on an integrative health behavior change model, the I-Change model (ICM). All interviews were audio-recorded, transcribed verbatim, and analyzed using the framework method.

RESULTS

More participants reported non-adherence than adherence. Several motivational determinants of adherence to HE and PA were identified. The majority of participants were cognizant of their own behaviors towards HE and PA. Yet, some did not link low adherence to HE and PA with increased risks of health problems resulting from T1D. Facilitators to adherence were identified as being convinced of the advantages of HE and PA, having support and high self-efficacy, a high level of intention, and a good health care system.

CONCLUSION

The suboptimal adherence in AYAs to HE and PA needs more attention. Supportive actions are needed to encourage adherence to a healthy lifestyle to achieve benefits in terms of glycemic control and overall health outcomes, with a special focus on adolescents. Interventions are needed to foster motivation by addressing the relevant determinants in order to promote adherence to these two behaviors in AYAs with T1D.

Parent Intention to Enroll in an Online Intervention to Enhance Health Behavior Change among Youth Treated with Psychotropic Medication Who Are Overweight or Obese: An Elicitation Study

Youth who are prescribed psychotropic medication are disproportionally affected by overweight/obesity (OW/OB), yet few interventions have been tailored to their needs. To develop new interventions, it is important to address the needs, preferences, and intentions of target users. Qualitative methods within the theory of planned behavior (TPB) framework were used in this study to identify salient beliefs which may influence attitudes associated with parents’ intentions to participate in a future online intervention designed to develop behavioral health coaching skills among parents and guardians. Twenty parents and guardians of youth with OW/OB who were taking psychotropic medications, and were eligible for the study, were recruited through TurkPrime. Parents and guardians identified key salient beliefs consistent with the theory of planned behavior including behavioral beliefs (e.g., access and convenience), normative beliefs (e.g., family), and control beliefs (e.g., cost) that may influence their decision to enroll in a future, parent-oriented intervention. The results of this study suggest important salient beliefs which may be included in future research, as well as specific preferences which may be used to guide the development of a future intervention. Future work should focus on the creation of a salient belief quantitative measure and assess the relationships of these beliefs to attitudinal constructs and behaviors.

Perceptions of Safety Around Use of Cannabis and Nicotine/Tobacco in Pregnancy

The perceived safety of cannabis and nicotine/tobacco use contribute to use of these substances in pregnancy. We assessed time trends in self-reported perception of safety of use of cannabis and nicotine/tobacco among US women of reproductive age. We also reviewed qualitative literature to elucidate factors contributing to the perceived safety of use of cannabis and nicotine/tobacco. US women increasingly perceive cannabis use as posing no health risks; whereas cigarette smoking is perceived as posing substantial health risks. Qualitative studies suggest that personal experiences, sociocultural norms, and environmental factors contribute to the perceived safety of cannabis and nicotine/tobacco use in pregnancy.

Adolescents' Physical Activity and Depressive Symptoms: A Psychosocial Mechanism

Guided by the Theory of Planned Behavior (TPB; Ajzen, 1991), this study aimed to test a hypothesized path model of TPB variables (i.e., attitude toward behavior, subjective norm, perceived behavioral control, and intention) with physical activity (PA) and depressive symptoms. A total of 792 Chinese adolescents (M_age = 16.9; SD = 0.82; 54.5% females) completed previously validated questionnaires assessing their TPB variables, PA, and depressive symptoms. Correlation analysis revealed TPB variables were positively associated with PA (p < 0.01), and negatively correlated to depressive symptoms (p < 0.01). The path analyses indicated that the hypothesized model produces a goodness of fit (χ²/df = 16.14/5, CFI = 0.99, RMSEA = 0.06). The findings support the theoretical tenets of TPB and provide empirical evidence of the psychosocial mechanism of PA and depressive symptoms in Chinese adolescents. It suggests that building PA intervention strategies while considering the TPB framework may promote adolescents' physical and mental health.

Do village leaders’ engagement, social interaction and financial incentive affect residents’ solar PV adoption? – an empirical study in rural China?

Purpose

This study aims to analyze those factors affecting the rural resident’s willingness to adopt solar photovoltaic (PV) which is important for accelerating the popularization of clean energy in China.

Design/methodology/approach

This study contained a sample of 653 households in 8 provinces/regions by stratified, and random sampling in rural China. Descriptive analysis, exploratory factor analysis and confirmatory factor analysis techniques have been used for analytical purposes.

Findings

The empirical results indicate that financial incentive and social interaction have positive effects on rural residents’ adoption willingness, while village leaders’ engagement can indirectly influence their adoption willingness through social interaction and residents’ cognition.

Research limitations/implications

This study mainly considers external and internal factors but ignores the effect of technical factors. In addition, the samples are just selected from the residents who have adopted solar PV.

Practical implications

This study is expected to be useful for the government, regulators, village leaders, village leaders and other institutions.

Originality/value

This study conducts a systematic analysis and clarifies the relationship between factors (external and internal) and rural residents’ adoption willingness. The village leaders’ engagement is first added to the conceptual model as an external factor, which is very essential in rural residents’ adoption in China.

Cognitive-bias modification intervention to improve physical activity in patients following a rehabilitation programme: protocol for the randomised controlled IMPACT trial

INTRODUCTION

Being physically active is associated with a wide range of health benefits in patients. However, many patients do not engage in the recommended levels of physical activity (PA). To date, interventions promoting PA in patients mainly rely on providing knowledge about the benefits associated with PA to develop their motivation to be active. Yet, these interventions focusing on changing patients' conscious goals have proven to be rather ineffective in changing behaviours. Recent research on automatic factors (eg, automatic approach tendencies) may provide additional targets for interventions. However, the implementation and evaluation of intervention designed to change these automatic bases of PA are rare. Consequently, little is known about whether and how interventions that target automatically activated processes towards PA can be effective in changing PA behaviours. The Improving Physical Activity (IMPACT) trial proposes to fill this knowledge gap by investigating the effect of a cognitive-bias modification intervention aiming to modify the automatic approach towards exercise-related stimuli on PA among patients.

METHODS AND ANALYSIS

The IMPACT trial is a single-centre, placebo (sham controlled), triple-blinded, phase 3 randomised controlled trial that will recruit 308 patients enrolled in a rehabilitation programme in the Division of General Medical Rehabilitation at the University Hospital of Geneva (Switzerland) and intends to follow up them for up to 1 year after intervention. Immediately after starting a rehabilitation programme, patients will be randomised (1:1 ratio) to receive either the cognitive-bias modification intervention consisting of a 12-session training programme performed over 3 weeks or a control condition (placebo). The cognitive-bias modification intervention aims to improve PA levels through a change in automatic approach tendencies towards PA and sedentary behaviours. The primary outcome is the sum of accelerometer-based time spent in light-intensity, moderate-intensity and vigorous-intensity PA over 1 week after the cognitive-bias modification intervention (in minutes per week). Secondary outcomes are related to changes in (1) automatic approach tendencies and self-reported motivation to be active, (2) physical health and (3) mental health. Sedentary behaviours and self-reported PA will also be examined. The main time point of the analysis will be the week after the end of the intervention. These outcomes will also be assessed during the rehabilitation programme, as well as 1, 3, 6 and 12 months after the intervention for secondary analyses.

ETHICS AND DISSEMINATION

The study will be conducted in accordance with the Declaration of Helsinki. This trial was approved by the Ethics Committee of Geneva Canton, Switzerland (reference number: CCER2019-02257). All participants will give an informed consent to participate in the study. Results will be published in relevant scientific journals and be disseminated in international conferences.

TRIAL REGISTRATION DETAILS

The clinical trial was registered at the German clinical trials register (reference number: DRKS00023617); Pre-results.

Redesigning walking brochures using behaviour change theory: implications for walking intentions in natural environments

Natural environments can be used to promote health through facilitating recreational walking. However, efforts to encourage this often neglect messages identified in psychological research that are effective at influencing intentions to walk. This is despite the National Institute for Health and Care Excellence stating that promotional efforts should utilize theoretical frameworks of behaviour change and be targeted towards less active adults. As an illustrative example, this experiment compared a prototypical recreational walking brochure with an "enhanced" version including such persuasive messages on people's intentions to walk for recreation in natural environments. The enhanced brochure heightened intentions for inexperienced recreational walkers through our hypothesized mechanisms, but appeared to dissuade already-experienced walkers. Optimal messaging strategies in recreational walking brochures require tailoring to more and less active readerships. Guidelines are provided for authors of recreational walking brochures, though the principles and techniques could easily be extended to other means of outdoor walking promotion.

Executive function capacity links future thinking and exercise intent

OBJECTIVE

Environmental barriers limit exercise in adolescents, but the contribution of cognitive barriers are not as well characterized. Previous findings suggest future thinking may predict exercise intent, which has been linked to health and actual exercise. However, these models may be incomplete as they do not systematically incorporate potential cognitive contributions (e.g., executive function capacity) to exercise intent. This study investigated the possible mediating role of executive function capacity in the relation between future thinking and exercise intent.

METHODS

Data for the mediation models was collected from 101 adolescents aged 11-17 (M = 13.09) in a summer enrichment program. Adolescent participants completed self-report measures including Consideration of Future Consequences Scale (CFCS), Intent to Exercise, and Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2).

RESULTS

This study found that self-reported executive function capacity mediated the relation between future thinking and exercise intent even when controlling for age and subjective socioeconomic status.

CONCLUSIONS

While some exercise interventions aim to increase future thinking, this study provides support for additional research into how interventions may benefit from targeting executive function capacity directly to increase exercise intent and actual exercise.

Determinants of Fast-Food Consumption in Romania: An Application of the Theory of Planned Behavior

This study explores drivers of fast-food consumption in Romania using the Theory of Planned Behavior. We analyze 532 responses to an online survey and use partial least squares path modeling to estimate the relationships between the intention to consume fast food and its possible determinants. Our results show that the most significant predictor is the subjective norms (injunctive norms: β = 0.218, p < 0.001; descriptive norms: β = 0.192, p < 0.001). Among the affective and cognitive attitudes, only the latter is statistically significant in predicting the intention (β = 0.088, p = 0.020), while perceived behavioral control is not significantly associated with intention toward fast-food consumption. We explain how our results can help policymakers to design better interventions on public health concerns about fast-food consumption and population obesity, especially children obesity.

Correlates of participation in physical activity among older women in Israel: does ethno-cultural background matter?

Osteoporosis and its related fractures are major public health concerns. Physical activity (PA) is crucial for bone density preservation and fractures prevention. Yet, gaps in understanding exist regarding how ethno-cultural backgrounds might shape attitudes, intentions and actual PA participation. Based on the theory of planned behaviour (TPB) for predicting PA, the aims of this study were: (i) to compare attitudes, subjective norms, perceived control, intentions and knowledge, across four ethno-cultural groups; (ii) to evaluate the fit of the model we constructed across four ethno-cultural groups of women: Israeli-born Jews and Israeli-born Bedouin-Muslims, immigrants from the Former Soviet Union (FSU) and Ethiopian immigrants. Four hundred women (one hundred from each group), aged >65, completed valid and reliable questionnaires assessing knowledge, TPB components and actual PA. The level of knowledge on osteoporosis was relatively low among all four ethno-cultural groups. Intention to participate in PA was the only variable that directly predicted actual PA. Intention to participate in PA served as a mediator among attitudes, subjective norms, perceived control and actual PA. The structural equation models (SEMs) revealed that among Israeli-born Jews and Ethiopian immigrants, TPB components mediated the link between knowledge and intention to participate in PA. Among FSU immigrants and Israeli Bedouin-Muslims, the knowledge variable was not included in the final model, as its contribution was not significant. It is essential to better understand and augment interventions that enhance PA in the community, and to address the unique needs of each ethno-cultural group.

Practicing Green Residence Business Model Based on TPB Perspective

Green residence is the future of urban development, it is also an attempt to implement the green business model in the residential business field. The key to the success of a green business model is that a wide range of customers can accept its green value proposition and react to it through their purchase decisions. This study aims to develop a theory of a planned behavior (TPB) research model to predict individuals’ intention to purchase green residence. This study took steel structure residence as an example, which was widely recognized as one emerging type of green residence. The samples were selected in Baotou city of Inner Mongolia, P.R. China. Data analysis was performed using the structural equation modeling (SEM) with data obtained from a survey of 208 respondents using SPSS19.0 and AMOS17.0. The results found that the individuals’ intention to purchase green residence was significantly affected by attitude, subjective norm, and perceived behavioral control. Moreover, the empirical evidence showed that these influences differed between different gender groups. Specifically, women responders had a stronger effect on the path attitude impact on purchase intention than men. These findings can provide implications for practicing the green business model of real estate enterprise.

Customers response to online food delivery services during COVID-19 outbreak using binary logistic regression

This study aims to empirically measure the distinctive characteristics of customers who did and did not order food through Online Food Delivery services (OFDs) during the COVID-19 outbreak in India. Data are collected from 462 OFDs customers. Binary logistic regression is used to examine the respondents' characteristics, such as age, patronage frequency before the lockdown, affective and instrumental beliefs, product involvement and the perceived threat, to examine the significant differences between the two categories of OFDs customers. The binary logistic regression concludes that respondents exhibiting high-perceived threat, less product involvement, less perceived benefit on OFDs and less frequency of online food orders are less likely to order food through OFDs. This study provides specific guidelines to create crisis management strategies.

Factors Contributing to Adolescents' and Young Adults' Participation in Web-Based Challenges: Survey Study

BACKGROUND

Web-based challenges, phenomena that are familiar to adolescents and young adults who spend large amounts of time on social media, range from minimally harmful behaviors intended to support philanthropic endeavors to significantly harmful behaviors that may culminate in injury or death.

OBJECTIVE

This study aims to investigate the beliefs that lead adolescents and young adults to participate in these activities by analyzing the amyotrophic lateral sclerosis (ALS) ice bucket challenge, representing nonharmful behaviors associated with web-based challenges, and the cinnamon challenge, representing web-based challenges that lead to harmful behaviors.

METHODS

A retrospective quantitative study was conducted with a total of 471 participants aged between 13 and 35 years who either had participated in the ALS ice bucket challenge or the cinnamon challenge, or had never participated in any web-based challenge. Binomial logistic regression models were used to classify those who participated in the ALS ice bucket challenge or cinnamon challenge versus those who did not engage in either challenge using the integrated behavioral model's beliefs as predictors.

RESULTS

The findings showed that participants of both the cinnamon challenge and the ALS ice bucket challenge had significantly greater expectations from the public to participate in the challenge they completed in comparison with individuals who never participated in any challenge (P=.01 for the cinnamon challenge and P=.003 for the ALS ice bucket challenge). Cinnamon challenge participants had greater value for the outcomes of the challenge (P<.001) and perceived positive public opinion about the challenge (P<.001), in comparison with individuals who never participated in any challenge. In contrast, ALS ice bucket challenge participants had significantly greater positive emotional responses than individuals who never participated in any challenge (P<.001).

CONCLUSIONS

The constructs that contribute to the spread of web-based challenges vary based on the level of self-harm involved in the challenge and its purpose. Intervention efforts could be tailored to address the beliefs associated with different types of web-based challenges.

Determinants of Bone Mineral Screening Behavior among Three Ethno-Cultural Groups of Women in Israel

Bone mineral density (BMD) screening is one of the main means to detect and treat osteoporosis. Yet, the manner in which ethno-cultural background is associated with BMD health cognitions and screening behavior remains limited. Several ethno-cultural groups (n = 100 in each group)—Israeli-born Jews, Israeli-born Bedouin-Muslims, and Jewish immigrants from the Former Soviet Union (FSU), mean age 70 (SD = 7.1)—participated in face-to-face interviews in a cross-sectional survey, using valid and reliable questionnaires on BMD screening behavior, knowledge about osteoporosis, and theory of planned behavior (TPB) components. FSU immigrants reported the lowest BMD screening behavior. The multivariate analysis showed that higher knowledge level, positive attitudes, supportive subjective norms, and greater intentions increase the probability of BMD screening behavior. The TPB attitude component had a more pronounced effect on the probability of undergoing BMD screening among Israeli-born Bedouin-Muslims compared to Israeli-born Jews. Our findings contribute to the TPB by deepening our understanding of the associations between TPB components and BMD screening behaviors, from an ethno-cultural perspective. To assure sufficient BMD screening behavior among all ethno-cultural groups, intervention programs—suited to address the unique characteristics of each ethno-cultural group—are required.

Improving Cycling Behaviors of Dockless Bike-Sharing Users Based on an Extended Theory of Planned Behavior and Credit-Based Supervision Policies in China

Motivating users' civilized cycling plays a significant role in alleviating the troubles of dockless bike-sharing programs (DBSPs) and promoting the sustainable development of bike-sharing organizations. Based on the theory of planned behavior (TPB) and observed practices in China, this study develops a theoretical framework to examine how attitudes (ATT), subjective norms (SN), perceived behavioral control (PBC), and personal norms (PN) motivate users' civilized cycling behavior through civilized cycling intentions. Furthermore, the moderating effect of perceived policy effectiveness (PPE) between users' civilized cycling intention and their actual behavior is tested. Using structural equation model-multiple group analysis (SEM-MGA) for a sample of 874 valid questionnaire responses in Beijing and Shanghai, China, our results reveal that (1) ATT, PBC, and PN are positively related to both users' civilized cycling intentions and their actual behavior, while SN positively affect users' civilized cycling intention only; (2) users' civilized cycling intentions mediate the relationship between the four influencing factors and their actual behavior; and (3) PPE plays a moderating role for the effect of users' civilized cycling intentions on their actual civilized cycling behavior. Our results indicate that the four influencing factors can encourage users' civilized cycling behavior, especially when civilized cycling intention exists. Policies like credit-based supervision mechanisms could promote users' civilized-cycling intentions, which could then be transformed into actual behavior.

A Comparison of the Effects of 45-minute Aerobic Training and Cognitive Task Solving on Transient Mood States in a Female Student Sample

BACKGROUND

The beneficial effects of moderate-intensity physical exercise on mood are well established. Students in higher education are a group vulnerable to stress who may benefit from aerobic exercise classes. The present study broadens existing findings by testing the impact on mood of a 45-minute-long aerobic training session, conducted in a naturalistic setting.

METHOD

A three-dimensional mood assessment that distinguished hedonic tone (pleasantness of mood) from energetic and tense arousal dimensions was used for assessment of pre- and post-training mood in a sample of women (n = 120) taking part in a 45-minute aerobic training. A control group (n = 120) performed cognitive tasks.

RESULTS

Physical but not cognitive activity elevated mood on all three dimensions, but the effect size was largest for energetic arousal. It was also found that mood improvements in terms of energy and tension change were strongest for individuals initially low in hedonic tone.

CONCLUSIONS

The finding supports the hypothesis that successful completion of an exercise session in a naturalistic setting may enhance mood in female students. At a practical level, the study suggests that exercise classes may help students cope with the mood impairments resulting from demanding cognitive activities, leading to potential educational benefits.

Feel good now or regret it later? The respective roles of affective attitudes and anticipated affective reactions for explaining health-promoting and health risk behavioral intentions

Evidence supporting the incorporation of affective constructs, such as affective attitudes and anticipated regret, into theoretical models of health behavior has been mounting in recent years; however, the role of positive anticipated affective reactions (e.g., pride) has been largely unexplored. The purpose of the present investigation was to assess how affective attitudes and anticipated affective reactions (both pride and regret for performing a behavior or not) may provide distinct utility for understanding intentions to perform health-promoting and health risk behaviors over and above cognitive attitudes and other established theoretical constructs from the theory of planned behavior (TPB). Participants (N = 210) were recruited via Amazon's Mechanical Turk to complete a one-time online battery assessing TPB and affective constructs. Self-reported intentions served as the main outcome measure, and hierarchical linear modeling was used to examine the effects of TPB and affective constructs across behaviors. Controlling for TPB constructs, more positive affective attitudes and greater anticipated regret, but not anticipated pride, predicted intentions to engage in future health behaviors. Anticipated affective reactions contributed explanatory variance for intentions to perform health risk behaviors, but anticipated pride and regret were not associated with intentions to perform health risk behaviors. Contributions made via the inclusion of both positively and negatively valence anticipated affective reactions for both action and inaction (performing a behavior or not) across a range of health promoting and health risk behaviors are discussed, as well as implications for future intervention work.

'Active'ating thoughts about affect: elicitation of physical activity judgements in insufficiently active women

OBJECTIVE

A growing body of evidence suggests that affective judgements are distinct from, and exert greater influence on, physical activity behaviours than instrumental judgements.

DESIGN

As part of a randomised controlled trial, 110 insufficiently active, female, university students were randomised to (a) an affective mental contrasting condition, (b) an instrumental mental contrasting condition, or (c) a 'standard' mental contrasting intervention (with no modifications). In the analyses concerning the trial's primary outcome, the affective mental contrasting condition was found to be more effective for increasing physical activity than the standard or instrumental conditions. The purpose of this study was to qualitatively examine the physical activity outcomes and obstacles elicited from participants as part of the three mental contrasting interventions within this trial.

RESULTS

32 lower-order physical activity judgement themes, categorised within seven high-order themes, were derived through the use of the mental contrasting intervention. In addition to identifying several affective and instrumental outcomes and obstacles that have previously been recognised, participants in this study also highlighted contextualised responses that describe complicated relationships that exist between affective and instrumental judgements.

CONCLUSIONS

This study provides fine-grained insight into cognitive processes derived from a novel intervention involving insufficiently active women.

Experimental manipulation of affective judgments about physical activity: a systematic review and meta-analysis of adults

The purpose of this meta-analysis was to examine the current effectiveness of physical activity (PA) interventions to change affective judgements (AJ) and subsequent behaviour and explore potential moderators. Eligible studies were published in a peer-reviewed English journal and included an experimental design in the PA domain with a measure of AJ as the dependent variable, among adults (>17 years). Literature searches concluded in July 2017 using 11 common databases, with additional hand searching conducted in February 2018. The search yielded 32 independent studies. Random-effects meta-analysis showed positive changes in AJ favouring intervention over control groups, g = 0.43 (95% CI = 0.26-0.60). These changes predicted (β = 0.64) positive changes in PA, g = 0.38 (95% CI = 0.16-0.60), among a sub-sample (k = 14) of studies that also provided behavioural data. Moderator analyses showed the effects were inflated by potential publication bias, participant gender, baseline PA and focus of the intervention. AJ may show change from intervention but larger sample studies are required to obtain a more reliable effect size estimate. Further, few studies have employed behaviour change techniques that would align with the theoretical reasons for changes in AJ, so our evidence for practical intervention content is limited.

A longitudinal study on how implicit attitudes and explicit cognitions synergistically influence physical activity intention and behavior

Background

Strategies to promote physical activity (PA) focus mainly on changing or fostering explicit cognitions and are only modestly effective. Contemporary studies suggest that, as well as explicit cognitions, implicit cognitions influence health behavior, such as PA, and that implicit processes interact with the intention to be active. Relatively little is known about whether implicit processes interact with other explicit cognitions which determine PA intention and behavior, i.e. self-efficacy. The aim of the current study was to investigate the direct effects of explicit cognitions and implicit attitudes on PA behavior as well as interactions between them regarding intention and behavior prediction.

Methods

In a longitudinal study, participants (N = 340) completed self-report measures of explicit cognitions (perceived pros, perceived cons, social norms, social modeling, self-efficacy, intention) and activity levels, as well as a Single-Category Implicit Association Task to measure implicit attitudes towards PA at baseline (T0), and at one (T1) and 3 months thereafter (T2).

Results

Hierarchical multiple regressions revealed that T0-positive implicit attitudes moderated the relationship between T0 self-efficacy and T1 PA. Similarly, T0-neutral implicit attitudes were associated with the relationship between T0 intention and T1 PA. Negative implicit attitudes strengthened the negative relationship between perceived cons and intention at baseline; neutral or positive implicit attitudes strengthened the positive relationship between self-efficacy and intention. At the follow-ups, the relationship between social modeling and intention was strengthened by negative implicit attitudes.

Conclusion

This study revealed important insights into how implicit attitudes and explicit cognitions synergistically predict PA intention and behavior. As well as targeting explicit cognitions, steering a person’s implicit attitude towards a more positive one, i.e. by implicit cognitive trainings, could help to increase both PA intention and behavior.

Electronic supplementary material

The online version of this article (10.1186/s40359-018-0229-0) contains supplementary material, which is available to authorized users.

Understanding fruit and vegetable consumption in children and adolescents. The contributions of affect, self-concept and habit strength

Affective processes and the role of automaticity are increasingly recognised as critical in determining food choice. This study investigated the association of affective attitude, self-identity and habit with fruit and vegetable (FV) intentions and intake in children. Previous studies have not fully explored their implications for children of different age groups and have not considered their independent contribution as part of a coherent model of behaviour that also controls for other psychosocial and environmental determinants of intake. Data was collected through face-to-face interviews with 362 children, 9-15 years old. Children were asked to report on measures of affective attitude, cognitive attitude, self-concept, social norms and facilitating factors following Triandis' Theory of Interpersonal Behaviour (TIB). Three stage least squares was used to estimate the independent association of affective attitude and self-concept with intentions and of intentions and habit with intake. Self-concept had the most prominent role in explaining intentions irrespective of age for both fruit and vegetables. The importance of affective attitude varied by age and with fruit and vegetables, with greater importance for vegetables and for children aged 11-13 years. Cognitive attitude was more relevant than affective attitude for 14 to 15 year-olds' fruit intentions. Intake was more strongly associated with habit than intentions, with stronger associations for 14 to 15 year-olds. The current findings support the importance of self-concept for FV motivations and provide further evidence on the importance of habit to FV intake in young and older children and adolescents. Results also support a targeted usefulness of affective attitude for fruit and vegetable intentions. The discussion considers potential ways in which these constructs can be incorporated into interventions to increase FV intake in children.

A Conceptual Neurocognitive Affect-Related Model for the Promotion of Exercise Among Obese Adults

PURPOSE OF REVIEW

Obesity remains a prominent societal threat and burden despite well-promoted prevention and treatment strategies, such as regular engagement in physical activity. Obese individuals, in particular, may be prone to inactivity as a result of a variety of displeasure-related parameters resulting from exercise, such as dyspnea, for instance.

RECENT FINDINGS

This brief conceptual review discusses the integral roles of exercise-induced affective responses within a novel conceptual-based neurocognitive affect-related model. Specifically, this model includes three pathways: (1) pathway A proposes that neurocognition, and especially, executive function-based cognition, may play an influential role in fostering exercise-induced affective responses, (2) pathway B connects an individual's affective response from exercise to their future exercise behavior, and (3) pathway C suggests a cyclical, bi-directional relationship with executive function indirectly influencing future exercise behavior via affective responses to exercise, and exercise itself playing an important role in executive functioning. Future studies should empirically test this model, which may have utility for promoting exercise among the obese population.

Understanding caregivers' intentions for their child to walk to school: Further application of the theory of planned behavior

Increases in childhood obesity have coincided with declines in active transportation to school. This research builds on largely atheoretical extant literature examining factors that influence walk-to-school behavior through application of the theory of planned behavior (TPB). Understanding caregivers' decision for their child to walk to/from school is key to developing interventions to promote this cost-effective and accessible health behavior. The results from an online survey of 512 caregivers provide support for the TPB, highlighting the important role of subjective norms. This suggests marketers should nurture caregivers' perception that important others approve of walking to school.

Determinants of Engagement in Leisure-time Physical Activity – Dialogue with Senior Athletes

Cet article explore, en examinant leurs croyances saillants, les facteurs qui déterminent si les personnes âgées participent aux Jeux des aînés et de l’activité physique durant les loisirs connexes. Nous avons mené 10 entrevues en profondeur avec des personnes âgées qui ont participé aux Jeux des aînés. Nous avons exploré trois types de croyance sous-tendus par le cadre théorique de comportement prévu: les avantages et les inconvénients (croyances comportementales), le soutien social et la pression (croyances normatives), et les facilitateurs et les obstacles (croyances de contrôle). Les répondants aux entrevues se sont trouvés à s’engager aux Jeux des aînés et à l’activité physique dans la mesure où ils ont associé divers avantages intangibles avec les Jeux et en ont valorisé la satisfaction psychologique. Ils considéraient leurs pairs et les familles comme soutenant et approuvant leur engagement, tout en reconnaissant les capacités physiques et les contraintes structurelles nécessaires pour se livrer aux Jeux et les activités connexes. Les résultats indiquent comment les croyances pertinentes peuvent être combinées avec des interventions pour encourager pour les personnes âgées des activités physiques des loisirs.

What Do People Think about When They Answer Theory of Planned Behaviour Questionnaires?

Two studies aiming to identify the nature and extent of problems that people have when completing theory of planned behaviour (TPB) questionnaires, using a cognitive interviewing approach are reported. Both studies required participants to `think aloud' as they completed TPB questionnaires about: (a) increasing physical activity (six general public participants); and (b) binge drinking (13 students). Most people had no identifiable problems with the majority of questions. However, there were problems common to both studies, relating to information retrieval and to participants answering different questions from those intended by researchers. Questions about normative influence were particularly problematic. The standard procedure for developing TPB questionnaires may systematically produce problematic questions. Suggestions are made for improving this procedure.

Fulfilled Emotional Outcome Expectancies Enable Successful Adoption and Maintenance of Physical Activity

Although outcome expectancies are regarded as key determinants of health behavior change, studies on the role of their degree of fulfillment in long-term activity changes are lacking. This study investigated the impact of (un-)fulfilled outcome expectancies (OE) on (un-)successful attempts to increase physical activity, assuming that disengagement is the logical consequence of perceived futility. Participants (n = 138) of a longitudinal cohort study with three measurement waves were assigned to eight different groups according to a staging algorithm of their self-reported, 1-year-long physical activity behavior track. Stages were validated by objective changes in objective fitness, e.g., Physical Working Capacity (PWC). Social cognitive variables, self-efficacy, proximal and distal OE, and fulfillment of OE, were assessed via self-report. Discriminant analyses revealed that OE fulfillment was the predominant predictor for differentiating between successful and unsuccessful behavior change. Amongst OE, proximal OE concerning emotional rewards, in conjunction with action self-efficacy, further improved discriminatory power. OE adjustment warranting hedonic rewards appears to be a crucial mechanism as it facilitates long-term changes through interventions aimed at increasing physical activity rates. Theoretical models might benefit by including the concept of fulfilled expectations acting in terms of feedback loops between volitional and motivational processes.

Unraveling the Determinants of Cancer Patients' Intention to Express Concerns

Little is known about the behavioral determinants that underlie cancer patients' intention to express concerns during a consultation. This information can be relevant to developing effective interventions for cancer patients. In this study, the integrative model of behavioral prediction (IMBP) is used as a framework to unravel the determinants of patients' intention to express concerns. The objectives of this study are to examine which of the IMBP determinants (attitude, perceived social norm, and/or self-efficacy) are significantly related to intention and what content of these determinants can be targeted to effect a change in patients' intention. An online survey based on the IMBP determinants was distributed. A total of 236 cancer patients and cancer survivors participated. The results of the survey showed that patients' attitudes and perceived social norm were the most important determinants of their intention to express concerns. The largest change in patients' intention might be achieved by targeting the affective attitude, referring to the extent to which patients believe that expressing concerns is (un)pleasant, and the social norm, referring to the extent to which patients feel (un)supported by significant others in expressing concerns.

Effects of Social Support About Physical Activity on Social Networking Sites: Applying the Theory of Planned Behavior

Despite the physical and mental health benefits of leisure-time physical activity (LTPA), only about half of college students participate in the recommended amount of LTPA. While college students are avid users of social network sites (SNSs), whether SNSs would be an effective channel for promoting LTPA through peer social support is unclear. The aim of this study was to explore the effects of social support from students' contacts on SNSs on their intention to participate in LTPA, applying the Theory of Planned Behavior. Participants were recruited through a mass e-mail sent to undergraduate students at a large Midwestern university in fall 2011. In total, 439 surveys were analyzed. Descriptive analyses and analysis for mediating effects were conducted. Social support about LTPA from contacts on SNSs has indirect effect on intention through affective attitude, instrumental attitude, and perceived behavioral control (PBC). The results indicate that social support about LTPA from contacts on SNSs might not be effective to change students' intention unless attitudes and PBC are changed. Future interventions aiming to promote students' intention to participate in LTPA by increasing support from contacts on SNSs should increase affective attitude, instrumental attitude, and PBC at the same time.

Sport participation among individuals with acquired physical disabilities: group differences on demographic, disability, and Health Action Process Approach constructs

BACKGROUND

Despite numerous physical, social, and mental health benefits of engaging in moderate and vigorous intensity physical activities (e.g., sport), few individuals with acquired physical disabilities currently participate in adapted sport. Theory-based sport promotion interventions are one possible way to increase the amount of individuals who engage in sport.

OBJECTIVES

The primary objective of this study was to examine the profiles of three different sport participation groups with respect to demographic, injury, and Health Action Process Approach (HAPA) constructs.

METHODS

ANOVAs and Chi-square tests were used to determine group differences on demographic and disability-related constructs. A MANCOVA was conducted to determine differences between three sport participation groups (non-intenders, intenders, and actors) with age, years post-injury, mode of mobility, and sex included as covariates.

RESULTS

A cohort of 201 individuals was recruited; 56 (27.9%) were non-intenders, 21 (10.4%) were intenders, and 124 (61.7%) were actors. The MANCOVA revealed significant differences between groups on the HAPA constructs, F(22,370) = 9.02, p < .0001, Pillai's trace = .70, demonstrating that individuals with acquired physical disabilities will rate important health behavior constructs differently based on their sport intentions.

CONCLUSION

These results provide an important framework that adapted sport organizations can use to tailor their sport promotion programs.

Women's concerns about the emotional impact of awareness of heritable breast cancer risk and its implications for their children

Women tested for mutations in BRCA1/2 genes who have minor-aged children confront difficult decisions about if, when, and how to share information about hereditary cancer risk with their children. These choices are often seemingly influenced by how mothers anticipate the emotional burdens they and their children will experience in response to test results. Here, we investigate the association between maternal cognitions, pretest psychological well-being, and coping style with mothers' anticipated emotional reactions to learning that they are BRCA1/2 mutation carriers (N = 205). In a linear regression model adjusted for maternal demographics, stronger tendencies to ruminate about information (B = .14, p = .03), greater psychological strain (B = .14, p < .001), and poorer appraisals of one's ability to cope with genetic test results conveying increased breast cancer risk information (B = -.25, p < .001) were significantly associated with anticipating more negative affect surrounding BRCA1/2 mutation identification in mothers. Our data contribute to the growing awareness of special concerns that mothers have about knowing their BRCA1/2 mutation status and highlight the need for more tailored patient education and counseling resources to improve outcomes among women at risk and their children.

Wii, Myself, and Size: The Influence of Proteus Effect and Stereotype Threat on Overweight Children's Exercise Motivation and Behavior in Exergames

OBJECTIVE

Exercise-based videogames, or exergames, provide a promising and novel way to improve exercise attitudes and behavior among overweight children. These digital interventions often allow for customizations of player characters and weave in narratives and goals. Theoretically, the presence of visual identity cues (e.g., avatars) and social category cues (e.g., stereotypes) within the virtual gaming environment are likely to motivate a player's exercise attitudes and behavior in various ways. This study examined the effects of both visual cues (via the Proteus effect) and social cues (via stereotype threat) on overweight children's exercise attitudes and game performance in a virtual running game.

SUBJECTS AND METHODS

A 2 (avatar body size: Normal versus overweight)×2 (stereotype threat: Present versus absent) factorial design experiment was conducted with 140 overweight children between 9 to 12 years of age. Dependent variables measured were participants' exercise attitudes, exercise motivation, exercise motivation with regard to the Nintendo(®) (Kyoto, Japan) Wii™, and their in-game performance.

RESULTS

Multivariate analysis of covariance tests showed that overweight children assigned to avatars of normal body size scored significantly better on all four variables compared with those assigned to avatars of large body size, whereas overweight children assigned to a stereotype threat absent condition scored significantly better on three of the four variables compared with those assigned to a stereotype threat present condition.

CONCLUSIONS

Using avatars with normal body size and not being subjected to stereotypical messages has the potential to increase the effectiveness of exergames among overweight children. Exergame developers should consider designing avatars that are slim and toned and set "weight neutral" goals and challenges. These may provide more motivation and yield greater attitudinal and behavioral changes among overweight children.