The associations between the response efficacy and objective and subjective change in physical activity and diet in the Information and Risk Modification trial.

C Wou,J.A Usher-Smith,B Silarova,S Griffin

doi:10.1016/j.puhe.2018.09.006

C Wou, J.A Usher-Smith + Show 2 more

Open Access

https://doi.org/10.1016/j.puhe.2018.09.006

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Journal: Public health	Publication Date: Dec 1, 2018
Citations: 1	License type: cc-by

Affiliation: University of Cambridge, MRC Epidemiology Unit

Abstract

ObjectivesMany health promotion campaigns and interventions focussing on improving health-related behaviours have been based on targeting response efficacy. This is based on the assumption that response efficacy is an important modifiable determinant of behaviour change. This study aimed to quantify the association between response efficacy and objective and subjective measures of physical activity and diet.Study designProspective cohort analysis of data from a randomised controlled trial.MethodsA total of 953 participants were assessed for response efficacy at baseline and 12 weeks following randomisation to interventions to increase physical activity and improve diet. Subjective measures were collected via a self-report questionnaire that included two questions used to derive the Cambridge Index of physical activity and questions about daily or weekly fruit and vegetable, whole grain, meat and fish intake, based on the dietary guidelines to lower cardiovascular risk. Objective measures were quantified using accelerometers and plasma carotenoids.ResultsThe mean change in response efficacy for physical activity was +0.5 (standard deviation [SD] 2.0) and for diet was +0.5 (SD 2.1).There were no clinically or statistically significant associations between baseline or change in response efficacy and objective and subjective measures of physical activity or objective measures of diet. There was a small statistically significant association between baseline response efficacy and change in self-reported wholegrain consumption, but this is unlikely to be clinically significant.ConclusionsResponse efficacy is not a fundamental determinant of diet and physical activity and should not be the main focus of interventions targeting these behaviours.

Highlights

Premature morbidity and mortality from non-communicable diseases are significant public health problems.[1]
One component common to many of these models is response efficacy: the belief that an intervention or action is effective against a perceived health threat[8] or that changing a behavioural risk factor increases or decreases the risk of developing a disease, for example, increasing physical activity or improving diet reduces the risk of developing cardiovascular disease
There is a large body of evidence reporting an association between response efficacy and intention to change behaviour.8e11 the findings are more mixed for associations between response efficacy and behaviour change with some studies reporting a positive association,[8,12,13] while others do not.14e17 Many of these existing studies include small samples of selected populations, such as young women or undergraduate students,18e20 and all use selfreport measures of behaviour

Summary

Introduction

Premature morbidity and mortality from non-communicable diseases are significant public health problems.[1]. A number of models have been developed to clarify the determinants of health-related behaviours and inform development of interventions. These include the Health Belief Model,[4,5] Protection Motivation Theory[5,6] and the Extended Parallel Process Model.[7,8] One component common to many of these models is response efficacy: the belief that an intervention or action is effective against a perceived health threat[8] or that changing a behavioural risk factor increases or decreases the risk of developing a disease, for example, increasing physical activity or improving diet reduces the risk of developing cardiovascular disease. There are no studies that report the association between response efficacy and objective measures of behaviour change

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