Most longitudinal, correlational studies on health-behaviour change examine effects of Time1 social-cognitive predictors on subsequent behaviour. In contrast, our research focuses on associations between changes in predictors with change in behaviour. The Health Action Process Approach (HAPA) distinguishes between motivational predictors for intention formation and volitional predictors for behavioural change and served as theoretical basis. Two online-studies were launched targeting different behaviours (low-fat diet, smoking), different samples (Study 1: N = 469; Study 2: N = 441) and different time spans (Study 1: 3 months, Study 2: 4 weeks). Data were analysed by means of structural equation modelling with latent difference scores. Both studies resulted in almost parallel prediction patterns. Change in risk awareness and change in outcome expectancies did not result in change in intentions, whereas change in self-efficacy was of crucial importance. Change in behaviour was associated with change in action planning and action control over and above the effects of intentions. In one study, increases in self-efficacy yielded increases in behaviour change. Results demonstrate that change in action planning and especially action control was of great importance for behaviour change across two different behaviours. Analysing change in social-cognitive predictors allows drawing precise conclusions for interventions.
Intervention programs for treating adiposity which focus on dietary change and physical exercise often do not lead to the desired long-term reduction in weight. This article reports on the effectiveness of M.O.B.I.L.I.S., a standardized theory-driven intervention program. Participants are taught cognitive-behavioral strategies of goal setting, action planning, barrier management, and self-monitoring. Persons with obesity (N=316) responded to a public advertisement to participate in the intervention program (IG) or comparison group (CG; quasi-experimental design). Assessments were conducted at four time points, with the last assessment being conducted two years after baseline. At the 24-month follow-up, the IG showed weight loss of 5.57%, whereas the CG lost 1.12% of their weight (t1-t4, p < .01). The results yielded significant interaction terms (group x time), indicating that the intervention had a substantial effect on food choice and level of physical exercise (p < .01). The IG showed significantly enhanced self-efficacy, stronger goal intentions, and more detailed implementation intentions than the CG at follow-ups. The intervention program has the potential to evoke enduring changes in the cognitions we hypothesized to be responsible for inducing obese adults to begin and continue regular exercise and healthy eating behavior, resulting in substantial weight loss.
We developed and evaluated a theory-based intervention programme (MoVo-LISA) that encompasses motivational and volitional strategies aiming to prepare orthopaedic rehabilitation patients to perform physical exercise on a regular basis after discharge. The intervention consists of six units: two group sessions, one one-to-one interview, and three after-care contacts. Two hundred and twenty inactive patients were subsequently assigned to an intervention group (standard care plus MoVo-LISA) and a control group (standard care). Participants filled out questionnaires assessing cognitive antecedents of physical exercise. Measurement took place before and after rehabilitation, 6 weeks and 6 months after discharge, and 1 year after discharge. A 2 ¥ 5 repeated measurement design was applied. Results revealed significant main and interaction effects with regard to cognitive variables; the intervention group reported enhanced self-efficacy and more positive balance of outcome expectations at 6 months as well as stronger goal intentions, more elaborated implementation intentions, and optimised strategies of intention shielding at 12 months after discharge compared to patients of the control group. Our findings demonstrate that a short and inexpensive cognitive-behavioural training programme is an effective tool to enable rehabilitation patients to follow treatment recommendations after discharge. The standardised intervention can be conducted by personnel other than psychologists.
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