Changes In Outcome Expectations Research Articles

Assessing the influence of warnings with testimonies from former smokers on smoking and quitting behaviour.

Cigarette pack warnings are widely used internationally for reducing smoking behaviour. Current warnings typically consist of a textual or graphic warning that smoking can lead to negative (health) outcomes. Though these warnings have proven benefits, they also have important limitations. Most notably, they do not produce beneficial changes in important cognitive determinants of smoking cessation such as self-efficacy to refrain from smoking and they do not reduce smoking for specific subsets of the target population. Recent studies provide evidence for the effectiveness of health warnings that include health-related testimonies from former smokers. We designed cigarette pack warnings that consist of more general testimonial statements from former smokers, selected in a pilot study for their potential impact on two important cognitive determinants of smoking (i.e., self-efficacy beliefs and outcome expectancies). In the main study, online participants were either exposed to the new testimonial warnings, to graphic health warnings, or to text-only health warnings on four separate occasions during a 24-h window. In a sample of 416 daily smokers, we observed beneficial changes in self-reported cigarette smoking, craving, quit intentions, evaluations of smoking, self-efficacy, and outcome expectancies, immediately after viewing the warnings a first time and after multiple exposures. These effects were comparable for participants in the three warning type groups, with some (small) differences for changes in outcome expectancies and craving. Warnings with general testimonies from former smokers might provide a useful evidence-based addition to currently used cigarette pack health warnings.

Social Cognitive Predictors of Dietary Behavior Among African Americans

Background: This study examined the extent to which social cognitive theory is involved in dietary behavior changes among a sample of African Americans in Georgia. Purpose: We examined whether outcome expectations, barriers, and self-efficacy mediate changes in fruit and vegetable intake behavior. Methods: To accomplish this, we used change scores from the time of baseline (T1) to follow-up (T2). Using self-efficacy as an example, mathematically this is represented by the equation: Self-efficacy T2 − Self efficacy T1 = Δ Self-efficacy. A total of 1011 individuals were recruited across the 14 churches (20% of total population). Three measures of dietary intake were obtained to provide an estimate of actual intake. Participants completed a 7-item fruit and vegetable food frequency questionnaire (FFQ) measuring consumption behavior in the past month, based on the Behavioral Risk Factor Surveillance System. Regression analysis was performed using the fruit and vegetable values from the FFQs and 24-hour recall as the dependent variables. Results: Findings indicate that self-efficacy in isolation significantly predicted changes in fruit and vegetable intake (B = 0.606, P < .001) but accounted for a little less than 3% of the variance (R2 = 0.027). Likewise, changes in outcome expectations for eating more fruits and vegetables (B = 0.517, P < .001) and changes in barriers (B = − 0.812, P < .001) were significant predictors. Translation to Health Education Practice: Results of this study can assist health educators to design, implement, and evaluate health education and health promotion programs related to dietary practices.

Nutrition self-efficacy is unidirectionally related to outcome expectations in children

Objective: To clarify the underlying relationship between nutrition self-efficacy and outcome expectations because the direction of the relationship (unidirectional vs bidirectional) is debated in the literature. Methods: Secondary data analysis of a 10-week, 10-lesson school-based nutrition education intervention among 3rd grade students (N = 952). Nutrition self-efficacy (7 items) and nutrition outcome expectations (9 items) were measured through student self-report at intervention pre- (time 1) and post- (time 2) assessments. A series of two time point, multi-group cross-lagged bivariate change score models were used to determine the direction of the relationship. Results: A cross lag from nutrition self-efficacy at time 1 predicting changes in nutrition outcome expectations at time 2 significantly improved the fit of the model (Model 3), whereas a cross lag from nutrition outcome expectations at time 1 to changes in nutrition self-efficacy at time 2 only slightly improved the fit of the model (Model 2). Furthermore, adding both cross lags (Model 4) did not improve model fit compared to the model with only the self-efficacy cross lag (Model 3). Lastly, the nutrition outcome expectations cross lag did not significantly predict changes in nutrition self-efficacy in any of the models. Conclusions: Data suggest that there is a unidirectional relationship between nutrition self-efficacy and outcome expectations, in which self-efficacy predicts outcome expectations. Therefore, theory-based nutrition interventions may consider focusing more resources on changing self-efficacy because it may also lead to changes in outcome expectations as well.

Weekly variability in outcome expectations: Examining associations with related physical activity experiences during physical activity initiation

Little is known about how outcome expectations change after physical activity initiation and whether changes are associated with physical activity experiences. In a diary study, physically inactive adults (N = 102) initiated an exercise regimen and reported their experiences daily (e.g. progress toward goals) and corresponding outcome expectations weekly (e.g. how much progress they expect this week). Average levels (between-person effects) for eight experiences (ps < .01) and deviations from the average levels (within-person effects) for three experiences (ps < .05) were associated with changes in outcome expectations. The findings demonstrate that outcome expectations for exercise vary over time and are associated with people's subjective experiences.

Beyond the usual suspects: target group- and behavior-specific factors add to a theory-based sun protection intervention for teenagers

Sun protection standards among teenagers are low while sun exposure peaks in this age group. Study 1 explores predictors of adolescent protection intentions and exposure behavior. Study 2 tests the effectiveness of an intervention based on these predictors. Study 1(cross-sectional, N = 207, ages 15-18) and Study 2 (RCT, N = 253, ages 13-19) were conducted in schools. Path models were used to analyze data. Self-efficacy (β = .26, p < .001) and time perspective (β = .17, p = .014) were the strongest predictors of intentions; appearance motivation (β = .54, p < .001) and intention (β = -.18, p = .015) predicted behavior. The intervention effected changes in all predictors except self-efficacy. Changes in outcome expectancies (β = .19, p < .001) and time perspective (β = .09, p = .039) predicted changes in intention, while changes in intention (β = -.17, p = .002) and appearance motivation (β = .29, p < .001) predicted behavior changes. Target group- and behavior-specific intervention components are as important for changes in intentions and behavior as components derived from common health behavior theories.

Changes in social-cognitive variables are associated with stage transitions in physical activity

When it comes to the adoption or maintenance of physical activity, individuals can be placed along a continuum or into stages of change. The Health Action Process Approach proposes three such stages: non-intentional, intentional and actional. Intraindividual differences are reflected by stage transitions: either progression or regression. The present study examines social-cognitive factors of stage transitions: outcome expectancies, self-efficacy and planning. In an online study on physical activity, 660 adults completed questionnaires at baseline and approximately 3 weeks later. Social-cognitive factors were converted into standardized residual change scores to account for changes in outcome expectancies, self-efficacy and planning within the observation period. Discriminant function analyses revealed stage-specific patterns: progression out of non-intentional stage was associated with self-efficacy increases. Out of intentional stage, regression was correlated with decreases in planning, whereas progression was linked to increases in self-efficacy and planning. Regression from action stage was associated with decreases in self-efficacy. Physical activity promotion should focus on improving self-efficacy for non-intending, intending and acting individuals, whereas planning interventions are recommended for intending individuals. Interventions may be more effective by considering specific mechanisms instead of providing generic interventions for all individuals at different stages.

Social Cognitive Influences on Physical Activity Behavior in Middle-Aged and Older Adults

The purpose of the current study was to prospectively test the utility of a social cognitive theory (SCT) model of physical activity behavior over an 18-month period in middle-aged and older adults (N = 321; M age = 63.8 years). Participants completed measures of self-efficacy, disability limitations, goals, outcome expectations, and physical activity at baseline and follow-up. Self-efficacy was hypothesized to influence physical activity both directly and indirectly through goals and outcome expectations. Relationships were examined using panel analysis within a covariance modeling framework. The model provided an excellent fit to the data (χ(2) = 36.16, df = 30, p = .20; comparative fit index = 1.00; root mean square error of approximation = .03). At baseline, self-efficacy was directly related to outcome expectations, disability limitations, goals, and physical activity and indirectly related to physical activity through physical outcome expectations. Changes in self-efficacy were significantly related to residual changes in outcome expectations, disability limitations, goals, and physical activity and indirectly related to residual changes in physical activity through changes in physical and social outcome expectations. These results provide further support for the use of SCT to physical activity behavior in middle-aged and older adults. Self-efficacy influenced physical activity both directly and indirectly via outcome expectations, suggesting that these variables should be targeted in physical activity interventions for middle-aged and older adults.

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

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. 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. 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. 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. 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.

Evaluating three theory-based interventions to increase physicians' recommendations of smoking cessation services.

To evaluate three theory-based interventions aimed at increasing the rate at which primary care physicians recommend smoking cessation services to smokers. Primary care physicians (n = 251) were randomized to one of four conditions: (a) information based on social cognitive theory (SCT) targeting outcome expectations, (b) information based on SCT + elaboration likelihood model, (c) feedback based on self-perception theory, or (d) control. Intentions to recommend and self-reported recommendations of smoking cessation services 1 week postintervention. Data were analyzed using covariance and mean structure analysis. Compared with the control group, only the SCT group reported more frequently recommending services (mean difference = 1.1 recommendations per week, Cohen's d = 0.46) and higher intentions. Mediation analysis was consistent with increased intentions resulting from changes in outcome expectations. There was no evidence that changes in intentions explained self-reported behavior change. The study provides preliminary "proof of principle" for further studies incorporating more robust outcome measures.

Changes in outcome expectancies and criminal thinking following a brief course of psychoeducation

Abstract The purpose of this investigation was to ascertain whether outcome expectancies and criminal thinking would change in offenders participating in a psychoeducational group and whether significant cross-lag (over time) correlations could be identified between outcome expectancies and criminal thinking. A sample of 121 US federal inmates completed the Psychological Inventory of Criminal Thinking Styles (PICTS) and a measure of outcome expectancies for crime (OEC) before and after participating in a 10-week psychoeducational class. As predicted, participants’ positive outcome expectancies for crime (OEC–POS) and scores on the PICTS Current Criminal Thinking Scale fell significantly over the course of the intervention. Alternatively, participants’ negative outcome expectancies for crime and scores on the PICTS Historical Criminal Thinking scale did not change appreciably from pre- to post-test. Structured equation modeling revealed that the “OEC–POS→Current” cross-lag correlation, but not the “Current→OEC–POS” cross-lag correlation, contributed significant variance beyond that supplied by the two contemporaneous correlations. This latter finding suggests that positive outcome expectancies for crime may be particularly important to address during the early stages of intervention with criminally involved clients.

Academic and Vocational Interests as a Function of Outcome Expectancies in Social Cognitive Career Theory

This study examined the function of self-efficacy and outcome expectations as posited in Social Cognitive Career Theory (Lent, Brown, & Hackett, 1994) with a sample of nonpsychology majors (N=85) at a large midwestern university. Interest in, and intent to pursue, an undergraduate psychology degree related significantly and positively to self-efficacy and outcome expectations for that degree. A pre-experimental manipulation to raise participants' outcome expectations for the psychology degree allowed for the examination of the effect of changes in outcome expectations on interest and intent. Increased outcome expectations significantly predicted increased pursuit intentions, but not level of interest. Both self-efficacy and outcome expectations accounted for significant incremental variance in predicting interest and pursuit intentions. Results generally supported the relation of outcome expectations to interest, pursuit intentions, and self-efficacy as hypothesized in Social Cognitive Career Theory.