Developing a scale to assess health regulatory focus

Abstract

Rationale: Regulatory focus (i.e., focus on motivation to achieve gains or avoid losses and non-gains) is used to tailor health behavior change interventions, improving efficacy, but is currently assessed by scales that are not health-specific and may capture a version of the construct that is not ideally matched to the rationale for tailoring. Objective: We developed and validated a Health Regulatory Focus Scale (HRFS), which assesses tendencies to avoid negative health consequences (prevention focus) or achieve positive health outcomes (promotion focus). Methods: Across four studies (and a scale development study in supplementary online materials), we established convergent, discriminant, and predictive validity for the HRFS. In studies examining predictive validity, main outcome measures were health behavior intentions, including intentions to reduce alcohol use, quit smoking, eat a healthy diet, exercise, be screened for cancer, and engage in general cancer preventive behaviors. Results: The promotion and prevention sub-scales performed well in confirmatory factor analyses. Single-factor models had significantly poorer fit than models delineating promotion and prevention. The sub-scales were differentially (and only modestly) correlated with related constructs (anxiety, optimism, information avoidance, ambiguity/fatalism). Higher HRFS-Promotion focus generally corresponded with greater health behavior intentions. Conversely, higher HRFS-Prevention focus corresponded with lower health behavior intentions. Associations were largely maintained even when controlling for established regulatory focus measures, supporting the assertion that the HRFS would predict unique variance in health behavior intentions. Conclusion: The HRFS has the potential to improve the precision with which framed health messages change behavior, as it may assess a version of regulatory focus that is more ideally matched to rationale for tailoring interventions.

Norm values and psychometric properties for the German health regulatory focus scale – results of a representative survey

“…The HRFS is, as of now, the only reliable and valid tool available to German researchers for the assessment of the health regulatory focus. Ferrer, Lipkus, Cerully, McBride, Shepperd, and Klein [32] developed and tested an alternative version of an HRFS. However, they could not confirm their model in CFA.…”

Understanding the dynamics of physical activity practice in the health context through Regulatory Focus and Self-Determination theories

“…Promotion focus involves a strategic inclination to be 67 enthusiastic by approaching matches with the desired end-states, while prevention focus 68 involves a strategic inclination to be vigilant by avoiding mismatches with the desired end-69 states [6]. In the health context, promotion focus refers to a chronic tendency to seek health-70 related gains and opportunities for improvement of one's health state, while health prevention 71 focus refers to a chronic tendency to avoid health-related losses and threats that could harm the 72 maintenance of one's health state [7,8,9].…”

Identifying a motivational process surrounding adherence to exercise and diet among adults with type 2 diabetes

“…On the other hand, our second aim is to identify for the first time in the literature the motivators which favor the use of this adaptative strategy. Regulatory Focus Theory [15], a well-established motivational model to study health behaviors both among healthy [16,17,18] and patients with type 2 diabetes [19], identifies two kinds of motivational orientations that guide people in their self-care behaviors. The first called "promotion focus" is associated with growth and accomplishment needs [15].…”

“…The first called "promotion focus" is associated with growth and accomplishment needs [15]. In a health-related context, it is reflected by concerns for improving the health state or attaining health-related gains [16,20]. The second called "prevention focus" is associated with security and safety needs [15].…”

“…The second called "prevention focus" is associated with security and safety needs [15]. In a health-related context, it is reflected by concerns for protecting health state or avoiding health-related losses [16,20].…”