The invisible benefits of exercise.

Objective: To examine whether—and why—people underestimate how much they enjoy exercise. Design: Across four studies, 279 adults predicted how much they would enjoy exercising, or reported their actual feelings after exercising. Main Outcome Measures: Main outcome measures were predicted and actual enjoyment ratings of exercise routines, as well as intention to exercise. Results: Participants significantly underestimated how much they would enjoy exercising; this affective forecasting bias emerged consistently for group and individual exercise, and moderate and challenging workouts spanning a wide range of forms, from yoga and Pilates to aerobic exercise and weight training (Studies 1 and 2). We argue that this bias stems largely from forecasting myopia, whereby people place disproportionate weight on the beginning of a workout, which is typically unpleasant. We demonstrate that forecasting myopia can be harnessed (Study 3) or overcome (Study 4), thereby increasing expected enjoyment of exercise. Finally, Study 4 provides evidence for a mediational model, in which improving people's expected enjoyment of exercise leads to increased intention to exercise. Conclusion: People underestimate how much they enjoy exercise because of a myopic focus on the unpleasant beginning of exercise, but this tendency can be harnessed or overcome, potentially increasing intention to exercise. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Determinants of exercise intention and behavior during and after phase 2 cardiac rehabilitation: An application of the theory of planned behavior.

Objective: To evaluate the theory of planned behavior (TPB) as a framework for understanding exercise motivation during and after Phase 2 cardiac rehabilitation (CR). Design and Participants: Patients (57 men and 24 women) completed a TPB questionnaire that included attitudes, subjective norms, perceived behavioral control, and exercise intentions pre- and post-Phase 2 CR. Results: During Phase 2 CR, regression analyses indicated that attitude, subjective norm, and perceived behavioral control (PBC) explained 38% of the variance in exercise intention while intention explained 23% of the variance in exercise adherence. At postrehabilitation follow-up, attitudes, subjective norm, and PBC explained 51 % of the variance in exercise intention while intention explained 23% of the variance in exercise adherence. Conclusion: The TPB is a useful framework for understanding exercise intentions and behavior both during and after Phase 2 CR. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of intention to reduce stroke risk among people at risk of stroke: An application of an extended health belief model.

Purpose: To examine predictors of intention to reduce stroke risk in a sample of at risk individuals through the application of an expanded Health Belief Model. Research Method: Predictors included stroke knowledge, demographic variables, beliefs about stroke, and measures of subjective norm and self-efficacy. The dependent variable was intention to reduce stroke risk. Of the 276 surveys distributed to bowling clubs, senior citizens clubs or retirement villages, 101 surveys were returned. Data from 76 of these respondents were used for analysis. Results: With regard to exercise intention, a pattern of significant correlations between HBM variables, subjective norm, and self-efficacy was observed. Results of multiple hierarchical regression analyses showed that perceived benefits of undertaking exercise and self-efficacy in relation exercise were the two most important determinants of exercise intentions. Conclusions: Findings suggest that health beliefs may play an important role in stroke prevention. Practice Implications: Stroke education and prevention programs that selectively target beliefs about the perceived benefits of, and self-efficacy related to, exercise to reduce stroke risk may prove most efficacious. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of proxy efficacy and reliance to home-based physical activity after cardiac rehabilitation.

Objective: To examine cardiac rehabilitation program (CRP) participants' beliefs about their interventionists (proxy efficacy and reliance), self-efficacy, and exercise behavior during transition to home-based exercise. Participants and Design: Participants were 44 (16 women and 28 men) CRP outpatients (Mage = 59.43 ± 13.53 years). The design was prospective, with proxy efficacy and reliance as well as self-efficacy being used to predict two outcomes: self-regulatory self-efficacy and home-based exercise. Results: After self-regulatory efficacy reported earlier in the program was controlled for, proxy reliance predicted later program self-regulatory efficacy for home-based exercise (adjusted R2 = .10, p = .02). Proxy efficacy for self-regulation predicted home-based exercise frequency (adjusted R2 = .18, p = .01). Greater proxy efficacy for self-regulation was associated with higher exercise frequency. Conclusion: CRP participants' beliefs in the capabilities of their exercise consultants to help them develop self-regulatory skills play a role in how much exercise they do after supervised rehabilitation. Yet, individuals who strongly rely on their interventionists to assist them in exercising report weaker self-efficacy for exercising on their own. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk perceptions: Assessment and relationship to influenza vaccination.

Objective: Accurate measurement of beliefs about risk probability is essential to determine what role these beliefs have in health behavior. This study investigated the ability of several types of risk perception measures and of other constructs from health behavior theories to predict influenza vaccination. Design: Prospective study in which students, faculty, and staff at 3 universities (N = 428) were interviewed in the fall, before influenza vaccine was available, and again early in the next calendar year. Main Outcome Measure: Self-reported influenza vaccination. Results: Two interview questions that asked about feeling at risk and feeling vulnerable predicted subsequent behavior better (r = .44, p = .001) than 2 questions that asked for agreement or disagreement with statements about risk probability (r = .25, p = .001) or 4 questions that asked respondents to estimate the magnitude of the risk probability (r = .30, p = .001). Of the 4 perceived risk magnitude scales, a 7-point verbal scale was the best predictor of behavior. Anticipated regret was the strongest predictor of vaccination (r = .45, p = .001) of all constructs studied, including risk perceptions, worry, and perceived vaccine effectiveness. Conclusion: Risk perceptions predicted subsequent vaccination. However, perceived risk phrased in terms of feelings rather than as a purely cognitive probability judgment predicted better. Because neither feeling at risk nor anticipated regret is represented in the most commonly used theories of health behavior, the data suggest that these theories are missing important constructs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hostility and hearing protection behavior: the mediating role of personal beliefs and low frustration tolerance

The authors examined whether hostility would negatively be associated with occupational health behavior, namely, the use of hearing protection devices (HPDs). Also examined as possible mediators were the protection motivation theory (PMT) components and low frustration tolerance (LFT). Participants were 226 male industrial workers, all exposed to potentially hearing-damaging noise. Hostility was negatively related to HPD use. It moderately correlated with the PMT components: negatively with perceived susceptibility, severity, effectiveness, and self-efficacy and positively with perceived barriers. Hostility correlated highly with LFT. Regression analyses confirmed the mediating role of perceived barriers, low self-efficacy, and LFT in the negative relationship between hostility and the use of HPDs. Thus, intrapsychic characteristics of hostile people may be significant for hearing protection behavior.     

Relative contributions of protection motivation theory components in predicting exercise intentions and behavior.

Tested the relative effectiveness of the 4 cognitive appraisal processes contained in the revised protection motivation theory (PMT). 160 undergraduate women read persuasive appeals for increasing exercise that varied on these 4 dimensions. As predicted, both the vulnerability and self-efficacy variables enhanced intentions to exercise along with similar effects on self-reported exercising. The obtained interaction between vulnerability, self-efficacy, and response efficacy suggests that individuals employed a precaution strategy. Findings are compared with others obtained using the PMT, and the issue of main and interactive effects produced by the model is also addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotogenicity and N-methyl-D-aspartate receptor antagonism: implications for neuroprotective pharmacotherapy

PURPOSE: Study purpose was to develop a theoretical framework that will explain pharmacists' behavior relative to the provision of pharmaceutical care. The model was developed from four attitude models by testing their predictive validity relative to pharmaceutical care implementation. Four hypotheses and one research question were investigated to identify determinants of behavioral intention and behavior. METHODS: 617 community pharmacists in the state of Florida, U.S.A., were surveyed twice using mail survey methodology to collect data. The first survey assessed community pharmacists' attitude, subjective norm, perceived behavioral control, past behavior recency, self-efficacies, instrumental beliefs and affect. The second survey assessed pharmacists' behavior relative to the implementation of pharmaceutical care. After establishing reliability and validity of measures, regression analysis was used to test hypotheses and research question investigated. RESULTS: The Pharmacists' Implementation of Pharmaceutical Care (PIPC) model developed postulates that (i) behavior is directly determined by past behavior recency, behavioral intention and perceived behavioral control; (ii) psychological appraisal processes-instrumental beliefs, self-efficacies, and affect toward means-influence behavior through past behavior recency; and (iii) behavioral intention is determined by attitude, social norm and perceived behavioral control. CONCLUSIONS: The PIPC model provides a formal scientifically validated theoretical framework which can be used to design successful intervention for pharmaceutical care implementation.     

Sexual misconduct in psychotherapy: Reactions to a consumer-oriented brochure.

Assessed reactions of Ss to a brochure addressing the topic of sexual intimacy in psychotherapy. 54 psychotherapy clients and 52 licensed psychologists responded favorably to the brochure, with the majority indicating that the brochure should be made available before therapy begins or during the 1st session. Potential clients (120 college students) read either the brochure on sexual misconduct or a control brochure containing general information about psychology. Ss who read the sexual misconduct brochure showed increased ability to understand what is appropriate and inappropriate therapist behavior, see unwanted touch as nontherapeutic, regard a therapist talking a lot about his or her own sex life as inappropriate, view sex in the therapeutic relationship as inappropriate, and intend to behave assertively within the session if their therapist's behavior should make them feel uncomfortable. Ss who read the control brochure showed no such changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of behavior from beliefs: An extension and test of a subjective probability model.

Tested a model for the prediction of behavior from beliefs in the context of voting behavior in the 1976 presidential election. A 2-wave panel design was used in a field survey in which voting behavior was predicted from beliefs about candidates in accord with a recent subjective probability model. Ss were 119 23–56 yr old Democrats, Republicans, and independents. Results support the model, yielding an average correlation between predicted and obtained voting behavior of .75. The average correlation between predicted and obtained voting intention was .84. The ability of the model to predict behavior and behavioral intentions was relatively unaffected by the educational level of the respondent and the type of beliefs under consideration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How useful are the stages of change for targeting interventions? Randomized test of a brief intervention to reduce smoking.

Objective: To see whether the stages of change are useful for targeting a brief intervention to reduce smoking based on implementation intentions. A second objective was to rule out demand characteristics as an alternative explanation for the findings of intervention studies based on the transtheoretical model and implementation intentions. Design: Participants (N = 350) were randomized to a passive control condition (questionnaire only), active control condition (questionnaire plus instruction to plan to quit), or experimental condition (questionnaire, plan to quit, form an implementation intention). Their behavior and psychosocial orientation to quit were measured at baseline and at 2-month follow-up. Main Outcome Measures: Theory of planned behavior variables, nicotine dependence, and quitting. Results: Significantly more people quit smoking in the experimental condition than in the control conditions, and the planning instructions changed intention to quit and perceived control over quitting, but not behavior. Stage of change moderated these effects such that implementation intentions worked best for individuals who were in the preparation stage at baseline. Conclusion: Harnessing both motivational and volitional processes seems to enhance the effectiveness of smoking cessation programs, although further work is required to clarify inconsistencies in the literature using the stages of change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding how people process health information: A comparison of tailored and nontailored weight-loss materials.

Health information tailored to meet individuals' unique needs has been shown to be more effective than generic information in promoting risk-reducing behavior changes. To explore mechanisms underlying tailoring's effectiveness, this study randomly assigned 198 overweight adults to receive weight-loss materials that were either (a) tailored to the individual, (b) in an American Heart Association (AHA) brochure, or (c) AHA-content formatted to look like tailored materials. Participants who received tailored materials had more positive thoughts about the materials, positive personal connections to the materials, positive self-assessment thoughts, and positive thoughts indicating behavioral intention than those who received either of the untailored materials. The tailoring of health information can significantly improve the chances the information will be thoughtfully considered and can stimulate prebehavioral changes such as self-assessment and intention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting walking intentions and exercise in individuals with intermittent claudication: An application of the theory of planned behavior.

Objective: To identify determinants of intention and walking activity among individuals with intermittent claudication using the theory of planned behavior. Study Design and Participants: Prospective, correlational study of men and women (n = 62) with intermittent claudication. Method: Baseline questionnaire assessing theory of planned behavior measures regarding walking. Telephone follow-up assessing frequency and duration of walking during the previous week. Results: Attitudes, subjective norms, and perceived behavioral control explained 67% of the variance in intentions. Perceived behavioral control explained 8% of the variance in walking activity. Conclusion: Findings support the theory of planned behavior for predicting intentions and warrant future examination of perceived behavioral control as a determinant of exercise. A basis for developing interventions to facilitate walking among this population is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mind over matter: Internalization of the thinness norm as a moderator of responsiveness to norm misperception education in college women.

The authors examine the effectiveness of norm misperception education in decreasing disordered eating. One hundred seven Ist-year college women completed questionnaires assessing their own and others' actual and ideal body size as well as their own disordered eating and were then randomly assigned to read either a norm misperception or a control brochure. Participants completed questionnaires immediately after reading the brochures and again 3 months later. Although there were no main effects of brochure condition at the follow-up, participants who primarily compared themselves with other college women and who read the norm misperception brochure had higher actual and ideal weight as well as less frequent disordered eating. The discussion focuses on the theoretical and applied implications of these findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Which survey questions change behavior? Randomized controlled trial of mere measurement interventions.

Objective: Evidence indicates that receiving a questionnaire about a behavior increases the likelihood that the person will perform that behavior—a phenomenon termed the mere measurement effect. This research tested the role of (a) the type of questions, and (b) questionnaire completion in optimizing the impact of mere measurement interventions designed to retain novice blood donors. Design: Novice blood donors (N = 4391) were randomly allocated to four conditions that varied the content of a questionnaire about blood donation (behavioral intention-only, behavioral intention plus regret, implementation intention-only, implementation intention plus regret) or to a no-questionnaire control condition. Main Outcome Measures: Objective measures of registration at blood drives were obtained at 6 and 12 months postbaseline. Results: Participants in the implementation intention-only condition donated more frequently at 6 months compared to participants in each of the other conditions. At 12 months both implementation intention conditions outperformed the other conditions. Implementation intentions increased the frequency of donations over 1 year by 12%. Measuring anticipated regret did not augment the impact of interventions whereas questionnaire completion had an important impact on donation behavior. Conclusion: Questions about implementation intentions but not behavioral intentions promote retention of novice blood donors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A connectionist implementation of the theory of planned behavior: Association of beliefs with exercise intention.

The theory of planned behavior suggests attitudes are a product of salient beliefs. This study examined whether aggregating salient beliefs was plausible within a more biologically centered information-processing environment. A neural network was used to examine associations among beliefs relating to exercise intention. Data on intentions and behavioral, normative, and control beliefs from 114 respondents were used to train (by error backpropagation) a neural network to associate beliefs with intention. The R2 between the network's estimated and self-reported intention was .66. The network's representation comprised 6 belief profiles associated with high, moderate, or low behavioral intention. The neural network accommodated complex relationships among beliefs and belief-intention associations and indicated how high-level constructs such as attitudes may be viewed as the best fit (compromise state) between aroused beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using the theory of planned behavior to predict leisure time physical activity among people with chronic kidney disease.

Objective: To evaluate the utility of the theory of planned behavior (TPB) for explaining and predicting leisure time physical activity (LTPA) in the chronic kidney disease population. Study Design: Prospective correlational design. Participants: Eighty men (n=52) and women (n=28) with chronic kidney disease (mean serum creatinine=310.55 [±148.75] μmol/L). Method: Baseline interview assessing attitude, subjective norm, perceived behavioral control, and intention to engage in LTPA. Telephone interview 1 week later assessing frequency and intensity of LTPA. Results: Perceived behavioral control (β=.69) but not attitude (β=.17) or subjective norm (β=.02) was associated with intention to engage in LTPA. Intention (β=.53) but not perceived behavioral control (β=.18) predicted LTPA. Conclusion: These findings provide partial support for the utility of the TPB for explaining LTPA among people with chronic kidney disease. Additional research is required to determine if targeting perceived behavioral control may be an effective means for increasing LTPA in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using the Health Action Process Approach and implementation intentions to increase flu vaccine uptake in high risk Thai individuals: A controlled before-after trial.

Objective: Influenza vaccination rates remain suboptimal in many countries, including Thailand. This study compared the effect of a theory-based educational leaflet, based on the Health Action Process Approach (HAPA), and action planning intervention with a standard government information leaflet designed to increase influenza vaccination uptake among high-risk Thai adults. Design: A controlled before and after trial was conducted. Participants in the intervention (n = 99) received a leaflet based on the HAPA and asking them to form an action plan identifying where, when, and how they would seek vaccination. Those in the comparison condition (n = 102) received a standard government information leaflet. Main Outcomes Measures: There are 2 sets of outcome measures: (a) process measures of HAPA related variables taken at T1 and T2, and (b) vaccination rates during the subsequent 2 months. Results: The HAPA intervention resulted in greater changes on measures of risk perception, outcome expectancies, self-efficacy, and intention than the comparison condition. Stronger intentions to obtain vaccination were explained by changes in outcome expectancies, perceived self-efficacy for arranging time and transportation, and planning. No significant difference in vaccination rates was observed between two groups. Influenza vaccination was directly predicted by self-efficacy and intention. Conclusion: Results demonstrate that a HAPA-based leaflet may be a useful tool to enhance individual's vaccination intention, but larger trials are required to confirm these findings. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Do perceptions of vulnerability and worry mediate the effects of a smoking cessation intervention for women attending for a routine cervical smear test? An experimental study.

Objective: Numerous correlational studies have examined whether perceptions of vulnerability or worry are better predictors of health-related behavior. The aim of this experimental study was to explore some of the potential causal relationships involved: Are the effects of a brief smoking cessation intervention (for women attending for cervical smear tests) on intention to stop smoking mediated by perceived vulnerability or worry about cervical cancer? Design: A mediation analysis of an experimental study. Main outcome measures: Perceived vulnerability to and worry about cervical cancer, and intention to stop smoking in the next month. Results: Questionnaires were completed by 172 (71%) women at 2-week follow-up. Compared with women in the control group, those in the intervention group had higher perceptions of vulnerability, worry, and intention to stop smoking. Personal vulnerability (p Conclusion: Worry may be a less important construct in relation to disease prevention behaviors such as smoking cessation. More experimental studies comparing different behaviors are needed to determine the causal relationship between worry and outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)