When planning is needed: Implementation intentions and attainment of approach versus avoidance health goals.

Objective: This study tested whether forming implementation intentions is an effective strategy for attaining health goals focused on trying to avoid a negative state. Design: Participants chose to either eat more healthy snacks (i.e., an approach goal) or eat fewer unhealthy snacks (i.e., an avoidance goal) over two weeks and were randomly assigned to create an implementation intention to do this or not. Main outcome measures: The authors measured fat and calorie intake after one week and after two weeks. Results: After two weeks, the participants who ate most unhealthily were those who pursued an avoidance goal and did not form an implementation intention. Conclusion: These results suggest that forming implementation intentions for avoidance goal pursuit can help people attain important health goals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Priming effects of television food advertising on eating behavior.

Objective: Health advocates have focused on the prevalence of advertising for calorie-dense low-nutrient foods as a significant contributor to the obesity epidemic. This research tests the hypothesis that exposure to food advertising during TV viewing may also contribute to obesity by triggering automatic snacking of available food. Design: In Experiments 1a and 1b, elementary-school-age children watched a cartoon that contained either food advertising or advertising for other products and received a snack while watching. In Experiment 2, adults watched a TV program that included food advertising that promoted snacking and/or fun product benefits, food advertising that promoted nutrition benefits, or no food advertising. The adults then tasted and evaluated a range of healthy to unhealthy snack foods in an apparently separate experiment. Main Outcome Measures: Amount of snack foods consumed during and after advertising exposure. Results: Children consumed 45% more when exposed to food advertising. Adults consumed more of both healthy and unhealthy snack foods following exposure to snack food advertising compared to the other conditions. In both experiments, food advertising increased consumption of products not in the presented advertisements, and these effects were not related to reported hunger or other conscious influences. Conclusion: These experiments demonstrate the power of food advertising to prime automatic eating behaviors and thus influence far more than brand preference alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multiple chemical sensitivity: theories of etiopathogenesis

Preferences often fluctuate as a result of transient changes in hunger and other visceral states. When current decisions have delayed consequences, the preferences that should be relevant are those that will prevail when the consequences occur. However, consistent with the notion of an intrapersonal empathy gap (Loewenstein, 1996) we find that an individual's current state of appetite has a significant effect on choices that apply to the future. Participants in our study made advance choices between healthy and unhealthy snacks (i.e., fruit and junk food) that they would receive in 1 week when they were either hungry (late in the afternoon) or satisfied (immediately after lunch). In 1 week, at the appointed time, they made an immediate choice, an opportunity to change their advance choice. Our main predictions were strongly confirmed. First, advance choices were influenced by current hunger as well as future hunger: hungry participants chose more unhealthy snacks than did satisfied ones. Second, participants were dynamically inconsistent: they chose far more unhealthy snacks for immediate choice than for advance choice. An additional hypothesis related to gender differences was also confirmed. Copyright 1998 Academic Press.     

Moral value transfer from regulatory fit: What feels right is right and what feels wrong is wrong.

People experience regulatory fit (E. T. Higgins, 2000) when the strategic manner of their goal pursuit suits their regulatory orientation, and this regulatory fit feels right. Fit violation feels wrong. Four studies tested the proposal that experiences of fit can transfer to moral evaluations. The authors examined transfer of feeling wrong from fit violation by having participants in a promotion or prevention focus recall transgressions of commission or omission (Studies 1 and 2). Both studies found that when the type of transgression was a fit violation, participants expressed more guilt. Studies 3 and 4 examined transfer of feeling right from regulatory fit. Participants evaluated conflict resolutions (Study 3) and public policies (Study 4) as more right when the means pursued had fit. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of an implementation intention intervention for promoting physical activity among individuals with spinal cord injury: A randomized controlled trial.

Objective: To evaluate the efficacy of an 8-week implementation intention intervention for promoting physical activity among individuals with spinal cord injury. Study Design: Randomized clinical trial. Method: Participants were randomly assigned to an implementation intention intervention (n = 26) or control (n = 28) condition and were asked to engage in 30 min of moderate to heavy intensity physical activity 3 times per week. Results: Participants who formed implementation intentions followed through with their physical activity intentions, engaging in more physical activity than participants in the control condition. Participants in the intervention condition also experienced sustained motivation and greater confidence to schedule physical activity compared with participants in the control condition. Implications: These findings suggest a role for implementation intentions in health promotion programs for people with spinal cord injury. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging and Medical Adherence: The Use of Automatic Processes to Achieve Effortful Things.

This research examined whether forming detailed implementation plans for achieving a goal improved older adults' adherence to a health behavior. Nondiabetic participants (N = 31) rehearsed, deliberated, or formed implementation intentions to perform home blood glucose monitoring, 4 times daily for 3 weeks. The implementation group performed tests nearly 50% more often than the 2 comparison groups. Results were not attributable to a priori differences in intentions to perform testing. Findings indicate that implementation intentions can facilitate older adults' performance of important medical self-care tasks in naturalistic settings over sustained periods of time and concur with previous research that implicates automatic cognitive processes that do not show age-related decline. These results support the utility of this technique for improving adherence to health behaviors in clinical populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reflective and reflexive action control in patients with frontal brain lesions.

Two types of action control derived from the model of action phases (H. Heckhausen & P. M. Gollwitzer, 1987) were analyzed in patients with frontal lesions, patients with nonfrontal lesions, and university students. In Study 1, reflective action control in terms of goal selection was assessed, and impaired deliberation was found in patients with frontal lesions. Study 2 assessed reflexive action control in terms of automatic action initiation as a result of forming implementation intentions (P. M. Gollwitzer, 1999). All participants sped up their responses to critical stimuli by forming implementation intentions. Moreover, lesion patients with weak performances on the Tower of Hanoi (TOH) task did worse than patients with strong TOH performances in Study 1 but better than control participants in Study 2. Findings are interpreted as a functional dissociation between conscious reflective action control and automatic reflexive action control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The automatic component of habit in health behavior: Habit as cue-contingent automaticity.

Objective: Habit might be usefully characterized as a form of automaticity that involves the association of a cue and a response. Three studies examined habitual automaticity in regard to different aspects of the cue-response relationship characteristic of unhealthy and healthy habits. Design, Main Outcome Measures, and Results: In each study, habitual automaticity was assessed by the Self-Report Habit Index (SRHI). In Study 1 SRHI scores correlated with attentional bias to smoking cues in a Stroop task. Study 2 examined the ability of a habit cue to elicit an unwanted habit response. In a prospective field study, habitual automaticity in relation to smoking when drinking alcohol in a licensed public house (pub) predicted the likelihood of cigarette-related action slips 2 months later after smoking in pubs had become illegal. In Study 3 experimental group participants formed an implementation intention to floss in response to a specified situational cue. Habitual automaticity of dental flossing was rapidly enhanced compared to controls. Conclusion: The studies provided three different demonstrations of the importance of cues in the automatic operation of habits. Habitual automaticity assessed by the SRHI captured aspects of a habit that go beyond mere frequency or consistency of the behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Goal priming and eating behavior: Enhancing self-regulation by environmental cues.

Objective: Several lines of research have shown that the confrontation with attractive food can trigger overeating, especially in restrained eaters. This effect may be driven by a hedonic orientation toward food which temporarily overrules the goal of dieting in the regulation of behavior. The present study was designed to provide an experimental demonstration of this effect in a naturalistic setting, and to show that reactivating the goal of dieting by a subtle prime in the environment can help restrained eaters to regulate their eating behavior in tempting situations. Design: In a local store where the smell of grilled chicken was present, we observed the number of free meat snacks customers sampled from a tray after they had been primed with the dieting goal or not. Main Outcome Measures: Number of snacks consumed. Results: Consistent with hypotheses, restrained eaters ate more than unrestrained eaters in the control condition. However, they reduced their eating behavior when primed with dieting, whereas this manipulation did not affect unrestrained eaters. Conclusion: This study shows that unobtrusively priming the goal of dieting can enhance self-regulation in tempting eating situations. These results are discussed in the context of recent advances in our understanding of nonconscious behavior regulation and their applications to health behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changing Circumstances, Disrupting Habits.

The present research investigated the mechanisms guiding habitual behavior, specifically, the stimulus cues that trigger habit performance. When usual contexts for performance change, habits cannot be cued by recurring stimuli, and performance should be disrupted. Thus, the exercising, newspaper reading, and TV watching habits of students transferring to a new university were found to survive the transfer only when aspects of the performance context did not change (e.g., participants continued to read the paper with others). In some cases, the disruption in habits also placed behavior under intentional control so that participants acted on their current intentions. Changes in circumstances also affected the favorability of intentions, but changes in intentions alone could not explain the disruption of habits. Furthermore, regardless of whether contexts changed, nonhabitual behavior was guided by intentions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implementation intentions and effective goal pursuit.

The theoretical distinction between goal intentions ("I intend to achieve x") and implementation intentions ("I intend to perform goal-directed behavior y when I encounter situation z"; P. M. Gollwitzer, 1993) is explored by assessing the completion rate of various goal projects. In correlational Study 1, difficult goal intentions were completed about 3 times more often when participants had furnished them with implementation intentions. In experimental Study 2, all participants were assigned the same difficult goal intention. and half were instructed to form implementation intentions. The beneficial effects of implementation intentions paralleled those of Study 1. In experimental Study 3, implementation intentions were observed to facilitate the immediate initiation of goal-directed action when the intended opportunity was encountered. Implementation intentions are interpreted to be powerful self-regulatory tools for overcoming the typical obstacles associated with the initiation of goal-directed actions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Olestra Postmarketing Surveillance Study: design and baseline results from the sentinel site

OBJECTIVE: To describe the design of the Olestra Postmarketing Surveillance Study (OPMSS) and to present baseline results from the sentinel site. The purpose of the OPMSS is to monitor consumption patterns of olestra-containing snacks and to determine whether consumption affects nutritional status. DESIGN: The OPMSS combines repeated cross-section, random-digit dial telephone surveys before and after the market release of olestra-containing foods as well as intensive dietary and clinical assessments on a subsample of survey participants. SUBJECTS: Data are from baseline telephone (n = 1,962) and clinical (n = 1,069) assessment of participants (aged 18 to 74 years) in the Marion County, Indiana, sentinel site. Mean age of participants in the telephone survey was 43.2 years; 19% of respondents were black and 29% had completed college. STATISTICAL ANALYSIS: Analyses examined associations among savory snack use, fruit and vegetable consumption, and demographic and health-related characteristics. Data from the telephone survey were adjusted to be representative of the Marion County population. RESULTS: Almost 96% of the population surveyed had eaten savory snacks in the month before the survey: 74% had eaten regular-fat, 26% fat-reduced, and 78% nonfat types. Total snack consumption did not differ by gender, education, or race. Residents younger than 35 years ate snacks 16 times a month compared with 12 times a month among older residents. Types of snacks consumed differed markedly by demographic characteristics. Male, younger, and less educated residents ate more regular-fat snacks; female, white, and college-educated residents ate more nonfat snacks. In general, residents practicing healthful behaviors, including not smoking, eating fruits and vegetables, and exercising, also ate fewer regular-fat and more nonfat snacks. Fat intake was also related linearly to use of snack foods, ranging from 33.2% of energy among those consuming 1 serving per month or less to 36.8% among those consuming 20 or more servings per month. APPLICATIONS/CONCLUSIONS: Procedures for recruitment and nutrition assessment appear adequate for evaluating the impact of olestra consumption on nutritional status. Nutritionists should be aware that there is potential for relatively high olestra consumption, given that almost 35% of Marion County residents eat snack foods at least 20 times a month. Consumers eating at least 20 servings of snacks per month derived more than 12% of their total energy and fat from snack foods, which suggests that substituting olestra snacks could substantially reduce intakes of fat and energy.     

Effectiveness of experimenter-provided and self-generated implementation intentions to reduce alcohol consumption in a sample of the general population: A randomized exploratory trial.

Objective: To test the effectiveness of implementation intentions to decrease alcohol consumption and control for possible demand characteristics by employing an active control condition and contrasting experimenter-provided with self-generated implementation intentions. Design: Two hundred forty-eight participants were randomly allocated to 1 of 4 conditions: questionnaire-only; questionnaire plus planning instruction; questionnaire, planning instruction plus experimenter-provided implementation intention; or questionnaire, planning instruction plus self-generated implementation intention. Main Outcome Measure: Alcohol intake. Results: There were clinically and statistically significant decreases in alcohol consumption in the 2 experimental conditions, but not in the 2 control conditions, F(3, 237) = 3.34, p p2 = .04. There were no significant differences between experimenter-provided and self-generated implementation intentions (p = .62). Compliance moderated the effects of self-generated implementation intentions only, such that alcohol intake only significantly decreased in participants who complied with the instructions, F(1, 52) = 4.20, p p2 = .07. However, simply choosing an experimenter-provided implementation intention was just as effective as writing it out in full, implying that implementation intentions work even with minimal information processing. Conclusion: The findings further support use of implementation intentions to protect against health risk behaviors and are congruent with laboratory research showing that implementation intentions are a case of strategic automaticity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transfer of value from fit.

People experience regulatory fit when they pursue a goal in a manner that sustains their regulatory orientation (E. T. Higgins, 2000). Five studies tested whether the value experienced from regulatory fit can transfer to a subsequent evaluation of an object. In Studies 1 and 2, participants gave the same coffee mug a higher price if they had chosen it with a strategy that fit their orientation (eager strategy/promotion; vigilant strategy/prevention) than a strategy that did not fit. Studies 3-5 investigated possible mechanisms underlying this effect. Value transfer was independent of positive mood, perceived effectiveness (instrumentality), and perceived efficiency (ease), and occurred for an object that was independent of the fit process itself. The findings supported a value confusion account of transfer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increasing attendance for psychotherapy: Implementation intentions and the self-regulation of attendance-related negative affect.

The present study evaluated an implementation intention intervention that aimed to increase attendance at scheduled, initial appointments for psychotherapy by helping clients to manage negative feelings about attendance. Participants received a postal questionnaire that measured their views about attending psychotherapy. One half of the sample was randomly assigned to an implementation intention induction that was embedded in the questionnaire. Intention-to-treat analysis (N=390) indicated that participants who formed implementation intentions were more likely to attend compared to controls (75% vs. 63%), and this effect was even stronger among participants who returned the questionnaire (83% vs. 57%). Whereas anticipated affective costs (e.g., shame) had a negative impact on attendance for most participants, this effect was attenuated when participants formed implementation intentions and perceived that attendance would be beneficial. Thus, implementation intention formation can help clients to deal effectively with negative feelings that might otherwise prevent them attending their first psychotherapy appointment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Class differences in the food rules mothers impose on their children: a cross-national study

Many studies indicate that children in middle-class families have healthier eating habits than children in lower class families. Class differences in food rules, which parents and especially mothers impose on their children, may underlie these social inequalities in food consumption. The present study uses education as a classifying variable and analyses whether mothers with higher education prescribe more "healthy" foodstuffs for their children and whether they restrict more "unhealthy" food items than less educated mothers. Moreover, the study examines whether higher class mothers consider health aspects more often and the preferences of their family members less often in their choice of food, and whether class differences in these considerations explain class differences in food rules. To answer these questions, questionnaires on the food practices of 849 women living in middle-class or lower class districts in Maastricht (the Netherlands), Liège (Belgium) and Aachen (Germany) were collected and analysed. The majority of mothers in each city prescribed primarily foods that were served at dinner like meat and vegetables, and most mothers limited their children's consumption of sweet foods, soft drinks and snacks. Higher class mothers restricted more foods, but prescribed as many food items as their lower class counterparts. Class differences in the number of restricted foods were partly, but not completely, explained by class differences in health and taste considerations. Despite national variations in dietary habits and possibly in the education of children, class differences in food rules and the explanatory power of health and taste considerations were comparable in the three cities.     

Can implementation intentions and text messages promote brisk walking? A randomized trial.

Objective: To test the efficacy in promoting brisk walking of two theory-based interventions that incorporate implementation intentions and text message (Short Message Service; SMS) reminders directed at one’s walking-related plans or goals. Design: Participants (N = 149) were randomized to one of three conditions (implementation intention + SMS plan reminder, implementation intention + SMS goal reminder, control) before completing measures at baseline and follow-up 4 weeks later. At follow-up, the experimental groups were given a surprise recall task concerning their plans. All participants completed an equivalent goal recall task. Main Outcome Measures: Validated self-report measures of physical activity and measures of implementation intention and goal recall, weight, and waist-to-hip ratio. Results: Both intervention groups increased their brisk walking relative to the control group, without reducing other physical activity. The goal reminder group lost the most weight. The SMS plan reminder group recalled more of their plans than the SMS goal reminder group, but the latter were more successful in goal recall. Conclusion: Both interventions can promote brisk walking in sedentary populations. Text messages aid the recall of, and could enhance interventions that target, implementation intentions and goals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using aversive images to enhance healthy food choices and implicit attitudes: An experimental test of evaluative conditioning.

Objective: To examine the effect of communicating images of energy-dense snack foods paired with aversive images of the potential health consequences of unhealthy eating, on implicit and explicit attitudes and food choice behavior. Design: Participants were randomly allocated to either an evaluative conditioning (EC) procedure that paired images of snack foods with images of potential adverse health consequences or a control condition that featured images of snack foods alone. Main Outcome Measures: Implicit attitudes were assessed pre- and post-intervention. Explicit attitudes and food choice behavior were assessed post-intervention. Results: The conditioning intervention made implicit attitudes toward energy-dense snacks more negative, with this effect greatest in those with relatively more favorable implicit attitudes toward these snacks at baseline. Participants in the conditioning intervention were more likely to choose fruit rather than snacks in a behavioral choice task, a relationship mediated by changes in implicit attitudes. Conclusion: Presenting aversive images of potential health consequences with those of specific foodstuffs can change implicit attitudes, which impacts on subsequent food choice behavior. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Implementation intentions: Strong effects of simple plans.

When people encounter problems in translating their goals into action (e.g., failing to get started, becoming distracted, or falling into bad habits), they may strategically call on automatic processes in an attempt to secure goal attainment. This can be achieved by plans in the form of implementation intentions that link anticipated critical situations to goal-directed responses ("Whenever situation x arises, I will initiate the goal-directed response y!"). Implementation intentions delegate the control of goal-directed responses to anticipated situational cues, which (when actually encountered) elicit these responses automatically. A program of research demonstrates that implementation intentions further the attainment of goals, and it reveals the underlying processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counselor and helpee perceptions of counselor intentions in relation to outcome in a single counseling session.

Determined whether counseling session could be predicted from different variables (i.e., counselor intentions, helpee's perceptions of counselor's intentions, match between counselor and helpee on intentions), focusing on counselors' and helpees' perceptions. Four 32–43 yr old experienced counselors each saw 4 undergraduate helpees for single 50 min counseling sessions. Counselors and helpees evaluated sessions and then reviewed videotapes during which counselors identified their intentions and helpees rated the helpfulness for each counselor turn. Results indicate that helpees perceived more intentions to support, focus, and clarify and less self-control and resistance than counselors had intended. The highest match between counselors and helpees occurred for getting information, setting limits, and clarifying. Helpees' ratings of helpfulness were highest for counselors' intentions involving needs, resistance, cognitions, and relationships, and lowest for setting limits, getting information, supporting, and focusing. Session outcome was related to different counselor and client perceptions, indicating that participants valued different events within sessions. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)