Social-Cognitive Factors in Changing Health-Related Behaviors

From 'I Wish' to 'I Will': social-cognitive predictors of behavioral intentions

We tested the ability of several social-cognitive models to predict intentions to engage in two different health behaviors (resisting dieting and performing breast self-exam). All constructs from the health belief model (with and without self-efficacy), the theory of planned behavior (with and without perceived behavioral control) and the motivational process of the health action process approach were measured simultaneously in two subject samples. We hypothesized that models that include self-efficacy (or the related construct of perceived behavioral control) would be more effective than the models that do not include it. Our results supported this prediction. The health action process approach was the best predictor of intentions to engage in both behaviors. Implications for selecting appropriate models on which to base interventions are discussed.

Ernährungsverhalten aus handlungsorientierter Sicht

Zusammenfassung. In diesem Beitrag wird das Multistadienmodell der Gesundheitsverhaltensänderung (MSM) vorgestellt und auf Ernährung angewandt. Das MSM beschreibt Änderungsprozesse von Gesundheitsverhalten als sequentiellen Ablauf über die Stadien Präkontemplation, Kontemplation, Disposition, Präaktion, Implementierung, Fluktuation und Habituation. Zur Erfassung dieser Stadien wird ein interaktiver diagnostischer Algorithmus vorgeschlagen. Um Grundannahmen des Modells zu testen, wird untersucht inwiefern verschiedene sozialkognitive und behaviorale Kontrollvariablen dazu beitragen, zwischen den Stadien des MSMs zu differenzieren. Anhand einer querschnittlichen Online-Studie (N = 812) werden Unterschiede zwischen den untersuchten Kontrollvariablen über die Stufen des MSMs unter Anwendung von Varianzanalysen mit einfachen und polynomialen Kontrasten auf diskontinuierliche Muster hin überprüft. Im Ergebnis zeigen sich diskontinuierliche Muster für die Mehrzahl der untersuchten Variablen. Anhand dieser Unterschiedsmuster lassen sich die im Modell vorgesehenen Stadien begründen. Vor allem die explizite Integration der Planungskognitionen im MSM bewährt sich dabei empirisch. Es zeigt sich, dass für die Bestimmung aktionaler Phasen zeitliche Kriterien nicht sinnvoll sind.

Is self-mastery always a helpful resource? Coping wiith paradoxical findings in relation to optimism and abstinence self-efficacy

This study investigated the relationship between three personal resources (self-mastery, optimism, and abstinence self-efficacy) and ways of coping among recovering substance abusers (n = 52) residing in Oxford Houses. Although residents' scores on optimism and abstinence self-efficacy were significantly correlated in a positive direction, residents' self-mastery scores were significantly and negatively related to both optimism and abstinence self-efficacy scores. However, residents reported using significantly more emotion-focused than problem-focused coping even though there was a significant positive relationship between emotion-focused coping and self-mastery. These paradoxical findings might be due to communal living and 12-step philosophy that is antithetical to a sense of control, which may have facilitated residents' emotional regulation to stress. Furthermore, significant relationships between coping strategies and personal resources imply that active coping strategies are instrumental in recovering substance abusers' use of optimism and abstinence self-efficacy, whereas passive coping strategies are involved with self-mastery. In addition, African American residents reported using significantly more wishful thinking coping, suggesting ethnicity might be an important aspect of the coping process. Overall, findings suggest that optimism and abstinence self-efficacy are effective personal resources for recovering substance abusers in 12-step programs.

Smoking among participants in the childhood cancer survivors cohort: the Partnership for Health Study

PURPOSE

This article describes baseline data collection and the intervention design of Partnership for Health, a smoking cessation intervention for smokers in the Childhood Cancer Survivors Study. The purpose of this article is to evaluate demographic, psychosocial, and cancer-related factors that are associated with smoking behavior and mediators of smoking cessation.

PATIENTS AND METHODS

This study includes 796 smokers from the Childhood Cancer Survivors Study database who were diagnosed with cancer before the age of 21, had survived at least 5 years, and were at least 18 years of age at the time of the baseline survey. Correlates of smoking behaviors included smoking rate, number of recent quit attempts, and nicotine dependence; two key mediators of smoking cessation, readiness to quit smoking and self-efficacy, were also assessed.

RESULTS

Participants smoked, on average, 14 cigarettes/day; 53.2% were nicotine dependent, and 58% had made at least one quit attempt in the past year. Smoking behaviors were primarily associated with demographic variables; mediators of cessation were primarily associated with age at cancer diagnosis and perceived vulnerability to smoking-related illnesses. Severity of psychologic symptoms was associated with increased smoking rate, high nicotine dependence, and low self-efficacy. Support for quitting was related to smoking rate, number of quit attempts, readiness to quit smoking, and self-efficacy.

CONCLUSION

These findings indicate that many cancer survivors who smoke are receptive to smoking cessation interventions. Factors related to mediators of smoking cessation might be particularly good targets for intervention.

Sense of coherence and smoking in a sample of abused women

The Antonovsky thesis (1987) of the relationship between sense of coherence and smoking, a health-related behavior, was investigated in a group of 83 raped and battered women. Analysis indicated that the simple model of "sense of coherence-health-related behavior' relationship (the higher the sense of coherence or its components the healthier behaviors, i.e., lower rates of smoking) cannot be accepted for this sample.

Sense of Coherence and Smoking in a Sample of Abused Women

The Antonovsky thesis (1987) of the relationship between sense of coherence and smoking, a health-related behavior, was investigated in a group of 83 raped and battered women. Analysis indicated that the simple model of “sense of coherence-health-related behavior” relationship (the higher the sense of coherence or its components the healthier behaviors, i.e., lower rates of smoking) cannot be accepted for this sample.