Health Behavior Change Theories Research Articles

Interventions to improve students’ feedback literacy

Feedback literacy has been identified as a key capability to promote in higher education, such that individuals can make the most of the imperfect feedback situations they find themselves in, both within their studies and the world beyond – work and life inclusive, and increasingly digital. Recent attention has turned to interventions that can improve student feedback literacy. These have largely been context-specific and focused on particular feedback opportunities that have been created within a unit or module of study. However, the enacted components of feedback literacy as established by Dawson et al (2024) are relatively generic, and so it may be possible to support the development of students’ feedback literacy more generally. This symposium will welcome debate on the level of tailoring of feedback literacy interventions, and offer insights into interventions which may improve students’ feedback literacy regardless of context, building on psychological theories of health behaviour change.

Effects of different intensity resistance training on fat level, energy intake, and appetite among overweight and obese female college students

This study examines how different intensity resistance exercises impact fat, energy intake, and appetite regulation in overweight and obese female college students in Jiangsu Province, China. This study used a randomized controlled trial (RCT) design that investigates resistance training intensity-target result causation. The study determines the impact of High-Intensity Interval Training (HIIT) and Moderate-Intensity Resistance Training (MIRT) on body composition, fat level/body composition, and muscle mass them. In Jiangsu Province, China, 515 overweight and obese female college students aged 18–25 were sampled. Intervention groups were assigned randomly to campus recruits based on demographic and anthropometric. This study demonstrated significant correlations between resistance training intensity, body composition, diet, and appetite regulation in overweight and obese colleagues. MIRT and HIIT outperformed Control in weight loss and diet and used valid measures like DEXA (Dual-Energy X-ray Absorptiometry), blood tests and food diaries to regulate appetite hormones. Increased protein and muscle mass minimize resistance exercise intensity-metabolic consequences. The study analyzes these impacts to show how exercise intensity, food, and metabolic health are interconnected. These findings help build evidence-based obesity prevention and treatment strategies for this demographic. Healthcare providers, legislators, and university stakeholders use this study to tackle college student obesity. The results suggest that campus wellness initiatives should focus on resistance exercise and diet to combat obesity. This research promotes exercise science and health behavior change theory for cross-cultural lifestyle interventions.

Assessing the Importance of Theory-Based Correlates of Future HIV Vaccine Intentions Among Black Men Who Have Sex With Men.

In the United States, Black men who have sex with men (BMSM) represent the most vulnerable population for HIV infection. A potential vaccine could ultimately be the most effective HIV prevention strategy. Understanding the factors that may adversely affect HIV vaccine acceptance among BMSM is critical. We conducted two online surveys with BMSM; one recruited 432 respondents, and another recruited 204. Respondents completed a demographic assessment and questions derived from health behavior change theories and the relevant empirical literature. The two surveys yielded similar results. The findings indicate that vaccine uptake self-efficacy, perceived likelihood of important others receiving the vaccine, and susceptibility to HIV were related to intentions to receive a future HIV vaccine. Other potentially important variables include perceived HIV stigma, response efficacy, how much one conceals one's sexual orientation, and perceived HIV discrimination. Future research and health communication campaigns should consider these factors in potential HIV vaccine programs.

Factors influencing engagement in pelvic floor muscle exercise following radical prostatectomy: A scoping review

AbstractInconsistent engagement in pelvic floor muscle exercise (PFME) among patients with prostate cancer (PC) following radical prostatectomy may have contributed to varying effectiveness in improving urinary incontinence across studies. Identifying factors influencing engagement can help develop effective interventions to maximize participation, enhance urinary function and improve quality of life (QoL). This scoping review aims to systematically search for factors influencing PFME engagement among post radical prostatectomy patients managing urinary incontinence. Eligible publications in English were identified from various databases, including PubMed, CINAHL, ProQuest, PsycINFO and Scopus. A health science librarian was consulted to assist in formulating search terms, encompassing PC, PFME terms and influencing factors terms. We employed Colandrapp™ for data extraction, focusing on key themes such as study characteristics, PFME education and training, recommended sessions, engagement rates and factors influencing PFME engagement following radical prostatectomy. Results were presented in tables and supplemented by a narrative discussion addressing gaps in research knowledge. The synthesis drew from a diverse body of literature, blending quantitative and qualitative approaches, to contribute to a comprehensive understanding of PFME engagement factors. Twelve papers, based on 10 studies published between 2011 and 2018, met our inclusion criteria. The reviewed studies primarily employed longitudinal quantitative designs, except for one study that utilized a mixed‐method design. Only three studies incorporated theories to guide the selection of potential factors influencing PFME engagement. The factors examined across the reviewed studies encompassed aspects related to the patient–partner relationship, patient's action control, planning (dyadic or individual), self‐efficacy, perceived urinary incontinence and the patient–provider relationship. We observed conflicting findings regarding the factors influencing PFME engagement across studies. Our review underscores the importance of theory‐informed studies using rigorous methodology and precise theoretical and operational definitions of potential factors. Such studies can help pinpoint the most influential factors to enhance PFME engagement and, ultimately, improve symptoms and QoL for PC patients. The scoping review also showed critical implications for nursing practice. Nurses should develop individualized and culturally sensitive interventions, integrate health behaviour change theories, assess patient–partner relationships and action control and consider intention's mediating role in the enhancement of PFME engagement following radical prostatectomy.

Promoting healthy eating in early pregnancy in individuals at risk of gestational diabetes mellitus: does it improve glucose homeostasis? A study protocol for a randomized control trial.

Healthy eating during pregnancy has favorable effects on glycemic control and is associated with a lower risk of gestational diabetes mellitus (GDM). According to Diabetes Canada, there is a need for an effective and acceptable intervention that could improve glucose homeostasis and support pregnant individuals at risk for GDM. This unicentric randomized controlled trial (RCT) aims to evaluate the effects of a nutritional intervention initiated early in pregnancy, on glucose homeostasis in 150 pregnant individuals at risk for GDM, compared to usual care. Population: 150 pregnant individuals ≥18 years old, at ≤14 weeks of pregnancy, and presenting ≥1 risk factor for GDM according to Diabetes Canada guidelines. Intervention: The nutritional intervention initiated in the first trimester is based on the health behavior change theory during pregnancy and on Canada's Food Guide recommendations. It includes (1) four individual counseling sessions with a registered dietitian using motivational interviewing (12, 18, 24, and 30 weeks), with post-interview phone call follow-ups, aiming to develop and achieve S.M.A.R.T. nutritional objectives (specific, measurable, attainable, relevant, and time-bound); (2) 10 informative video clips on healthy eating during pregnancy developed by our team and based on national guidelines, and (3) a virtual support community via a Facebook group. Control: Usual prenatal care. Protocol: This RCT includes three on-site visits (10-14, 24-26, and 34-36 weeks) during which a 2-h oral glucose tolerance test is done and blood samples are taken. At each trimester and 3 months postpartum, participants complete web-based questionnaires, including three validated 24-h dietary recalls to assess their diet quality using the Healthy Eating Food Index 2019. Primary outcome: Difference in the change in fasting blood glucose (from the first to the third trimester) between groups. This study has been approved by the Ethics Committee of the Centre de recherche du CHU de Québec-Université Laval. This RCT will determine whether a nutritional intervention initiated early in pregnancy can improve glucose homeostasis in individuals at risk for GDM and inform Canadian stakeholders on improving care trajectories and policies for pregnant individuals at risk for GDM. https://clinicaltrials.gov/study/NCT05299502, NCT05299502.

The Medicine Wheel as a public health approach to lifestyle management interventions for indigenous populations in North America.

This analytic essay intends to elevate Medicine Wheel, or generally "four directions" teachings, to encourage a more comprehensive alignment of lifestyle intervention components with traditional ecological knowledge systems of Indigenous cultures in North America. North American Medicine Wheels provided people with a way to orient themselves both within their traditional belief systems and to the seasonal changes in their areas, improving survivability. The wheel or circle is a sacred symbol, indicating the continuity and perpetuity of all of life. The four directions are iconized in many Indigenous cultures across North America with different directions representing different aspects of our world and of ourselves, different seasons of the year and of our lives, different beings of the earth and tribes of humans with a balance among those necessary for health and wellbeing. In the context of public health, teachings of the four directions warn that a lack of balance limits our ability to achieve optimal health. While there is much public health success in lifestyle interventions, existing practice is limited by a siloed and one size fits all approach. Medicine Wheel teachings lay out a path toward more holistic and Indigenous-based lifestyle intervention that is modifiable depending on tribal teachings and needs, may appeal to a variety of Indigenous communities and is in alignment with health behavior change theory. It is a public health imperative that lifestyle management interventions are fully optimized to rigorously determine what can be achieved when interventions are implemented in a holistic and Indigenous-based manner, and in alignment with an Indigenous model of health. This more complete alignment would allow for a stronger foundation to further explore and develop social determinants (i.e., housing, employment, etc.) and structural intervention enhancements to inform public health practice and promote health equity.

The Relationship Between Negative Coping Styles, Psychological Resilience, and Positive Coping Styles in Military Personnel: A Cross-Lagged Analysis.

Military personnel experience prolonged exposure to high-stress environments. Positive coping styles can assist in maintaining their mental and behavioral well-being, whereas negative coping styles cannot. Health behavior change theory specifies that an individual can transition from a negative to a positive coping style. The psychological resilience concept may prove vital in this transition. In a longitudinal study design, two questionnaires were administered to 233 military personnel twice, the first at T1 in April 2023 and the second at T2 in July 2023. The questionnaire measured individual negative coping style, positive coping style and psychological resilience. The data showed that the negative coping style at T1 negatively predicted the level of psychological resilience at T2 (γ= - 0.26, p < 0.001) and the positive coping style at T2 (γ= - 0.16, p < 0.001). The level of psychological resilience at T1 positively predicted the positive coping style at T2 (γ= 0.22, p < 0.01). Psychological resilience played a mediating role between negative coping style and positive coping style. In addition, there was an interaction between psychological resilience and positive coping style in military personnel at the two time points. The negative coping styles that presently exist among military personnel have the potential to diminish their future positive coping styles by lowering their psychological resilience. This highlights the need to focus on the development and training of psychological resilience for military personnel, as it can effectively counteract negative coping styles and promote positive coping styles.

Biomedical Dogmas Still Influence the Delivery of Exercise Therapy in Chronic Low Back Pain Management: Mixed-Methods Study.

Non-specific, chronic low back pain (NSCLBP) is a leading cause of disability, prompting long-term rehabilitation. Positive patient beliefs and expectations towards lasting exercise engagement play a crucial role for a successful management of this condition. The aim was to investigate beliefs, unmet needs and expectations of NSCLBP patients for exercise-related health behaviour change in the context of rehabilitative care. In a mono-centric mixed-methods study, we conducted semi-structured interviews with NSCLBP patients and care providers. We recruited in a rehabilitation clinic which is specialized in orthopaedics and internal medicine. Interviews were analysed deductively by combining health behaviour change theories with Donabedian's quality model of care. In a patient survey, disability (RMDQ), exercise behaviours, fear avoidance beliefs (FABQ), self-efficacy in chronic disease management (SES6G), process- and outcome-expectations (OEE-2) were queried and analysed descriptively. Twenty-two interviews were conducted and 40 questionnaires completed. Qualitative results revealed that NSCLBP patients had persistent biomedical perspectives on their health condition, marked by strong preferences for biomedical diagnostics and beliefs in the superiority of specific exercise regimes. Based on met expectations and positive movement experiences, patients' motivation was successfully fostered in the motivational phase of health behavior change. In the volitional phase, the postulated desire to receive self-management strategies was largely unmet. Psychosocial aspects of care were not widely accepted. The survey study sample showed a disability score (RMDQ) of M = 6.8 (±4.6). Mean scores of validated scales reflecting on attitudes, beliefs and expectations of chronic NSCLBP management were at FABQ-pa M = 15.4 (±6.0), FABQ-w M = 24.0 (±12.1), SES6G M = 6.4 (±2.3), and OEE-2 M = 2.7 (±0.5). In this sample, patients' understanding of NSCLBP was still dominated by biomedical dogmas and perspectives. Inpatient rehabilitation predominantly addressed expectations towards the motivational phase of exercise-related health behaviour change.

Reducing Risk of ADRDs: Innovative Framework to Inform Behavior Change

AbstractBackgroundIn the United States alone, more than six million individuals are living with Alzheimer’s disease and related dementias (ADRDs), with minority groups disproportionately impacted. An estimated one‐third of ADRD cases is associated with eight modifiable risk factors: physical inactivity, smoking, depression, low education, diabetes, midlife obesity, midlife hypertension, and hearing loss. With the ADRD pandemic fast approaching, there is greater urgency to identify and adopt risk reduction behavior changes. Lifestyle interventions have shown efficacy in reducing risk for ADRDs and delaying the onset of symptoms. These interventions are often grounded in traditional theories of health behavior change; however, few intervention frameworks exist that combine constructs from multiple discrete theories, or incorporate concept of stigma, a powerful influence in setting the foundation of risk reduction behavior change.MethodsA review of the literature identified health behavior models from which risk reduction interventions are developed. Insights from these studies informed the development of a new framework to inform ADRD risk reduction interventions. This new framework seeks to leverage constructs from the Social Ecological Model (SEM), Health Belief Model (HBM), Transtheoretical Model (TTM), and the Health Stigma and Discrimination Framework (HSDF) to better inform and understand the factors that influence ADRD risk reduction behaviors.ResultThis framework contains several concepts that predict why individuals will take action to reduce risk of ADRDs: individual factors, social‐environmental factors, self and public stigma, and perceptions. Our model also includes stages of change to integrate processes and principles of change, offering a temporal dimension for understanding behavior change. This novel framework can be utilized to inform both individual and community‐level interventions.ConclusionThis new framework provides an innovative and alternative foundation for new ADRD risk reduction interventions. Applicable across a range of risk reduction behaviors, the model highlights the domains and pathways common across ADRD research and intervention implementation. This crosscutting approach will support a more efficient and effective response to addressing preventable risk factors for ADRDs, with the goal of application and realization. Further research is needed to assess the strengths and limitations of this framework in real‐world settings.

Perceived Risk of Breast Cancer in Relation to Precautionary Behavior among Females in Saudi Arabia

Background: For the last two decades, the number of women with breast cancer in Saudi Arabia increased steadily. Risk perceptions or an individual&amp;#39;s perceived susceptibility to a threat are a key component of many health behavior change theories. Little is known about relationships between risk perceptions of breast cancer and performing preventive practices. &#x0D; &#x0D; This descriptive study highlights the risk perception of breast cancer in relation to preventive interventions among females over 18 years old in Riyadh, Saudi Arabia.&#x0D; &#x0D; Methods: Cross-sectional descriptive correlational design. An online questionnaire was conducted with 500 participants aged 18 years and older. The questionnaire was self-administrated electronic questionnaire designed by using Google Forms and it gated broadcast through social media channels such as WhatsApp and twitter. &#x0D; &#x0D; Results: The study emphasized a low risk perceptions about breast cancer and performing preventive practices. Positive correlation was found between female&amp;#39;s risk perceptions and doing the mammogram screening.&#x0D; &#x0D; Conclusions: Findings will be helpful to use risk perception of breast cancer in the prediction of women adopting preventive measures.

Barriers and facilitators to physical activity prehabilitation in patients with kidney cancer.

Timely and effective physical activity (PA) prehabilitation is an evidence-based approach for improving a patient's health status preoperatively. Identifying barriers and facilitators to PA prehabilitation can help inform best practices for exercise prehabilitation program implementation. We explore the barriers and facilitators to PA prehabilitation in patients undergoing nephrectomy. A qualitative exploratory study was conducted by interviewing 20 patients scheduled for nephrectomy. Interviewees were selected via convenience sampling strategy. The interviews were semi-structured and discussed experienced and perceived barriers/facilitators to PA prehabilitation. Interview transcripts were imported to Nvivo 12 for coding and semantic content analysis. A codebook was independently created and collectively validated. Themes of barriers and facilitators were identified and summarized in descriptive findings based on frequency of themes. Five relevant themes of barriers to PA prehabilitation emerged: 1) mental factors, 2) personal responsibilities, 3) physical capacity, 4) health conditions, and 5) lack of exercise facilities. Contrarily, facilitators potentially contributing to PA prehabilitation adherence in kidney cancer included 1) holistic health, 2) social and professional support, 3) acknowledgment of health benefits, 4) exercise type and guidance, and 5) Communication channels. Kidney cancer patient's adherence to physical activity prehabilitation is influenced by multiple biopsychosocial barriers and facilitators. Hence, adherence to physical activity prehabilitation requires timely adaptation of health beliefs and behavior embedded in the reported barriers and facilitators. For this reason, prehabilitation strategies should strive to be patient-centered and include health behavioral change theories as underlying frameworks for sustaining patient engagement and self-efficacy.

Risk perceptions among high-risk pregnant women in an aspirational district of India: a qualitative study

Background: Attitude and behavior towards health seeking decisions are affected by one’s risk perceptions. This formed a key component in many health behavior-change theories and is responsible for reduction of perinatal mortality. A woman’s perception of risk affects her decisions about seeking obstetric care. This study explored the perceptions of high-risk pregnancy among women with high risk factors. Methods: A qualitative study was conducted in an aspirational district of India. Participants included pregnant women in third trimester with high risk factors. In-depth interviews were conducted with 34 participants using semi-structured interview schedule. Results: Three main themes emerged in this study: (i) knowledge of risk (ii) attitude towards risk (iii) adoption behavior. The study found out women’s lack of understanding on high-risk conditions during pregnancy, especially among younger age group. Majority denied the risk factor and normalized delivery on one’s faith. Conclusions: The findings of this study provide a glimpse into how women perceived risk and the reasons that lead them to deny the risks. Women must understand their risk in the same way as their healthcare providers. If an event is not appraised as severe, there will be no change in behavioral intentions inspite of all the efforts put by the government for reducing perinatal mortality.

Understanding health behavior change by motivation and reward mechanisms: a review of the literature.

The global rise of lifestyle-related chronic diseases has engendered growing interest among various stakeholders including policymakers, scientists, healthcare professionals, and patients, regarding the effective management of health behavior change and the development of interventions that facilitate lifestyle modification. Consequently, a plethora of health behavior change theories has been developed with the intention of elucidating the mechanisms underlying health behavior change and identifying key domains that enhance the likelihood of successful outcomes. Until now, only few studies have taken into account neurobiological correlates underlying health behavior change processes. Recent progress in the neuroscience of motivation and reward systems has provided further insights into the relevance of such domains. The aim of this contribution is to review the latest explanations of health behavior change initiation and maintenance based on novel insights into motivation and reward mechanisms. Based on a systematic literature search in PubMed, PsycInfo, and Google Scholar, four articles were reviewed. As a result, a description of motivation and reward systems (approach/wanting = pleasure; aversion/avoiding = relief; assertion/non-wanting = quiescence) and their role in health behavior change processes is presented. Three central findings are discussed: (1) motivation and reward processes allow to distinguish between goal-oriented and stimulus-driven behavior, (2) approach motivation is the key driver of the individual process of behavior change until a new behavior is maintained and assertion motivation takes over, (3) behavior change techniques can be clustered based on motivation and reward processes according to their functional mechanisms into facilitating (= providing external resources), boosting (= strengthening internal reflective resources) and nudging (= activating internal affective resources). The strengths and limitations of these advances for intervention planning are highlighted and an agenda for testing the models as well as future research is proposed.

PACT: Developing and Evaluating a Digital Sexual Consent Program for Youth

ABSTRACT Understanding affirmative sexual consent is crucial for violence prevention and health promotion, yet few adolescents receive adequate consent education. The current study aimed to evaluate the acceptability and preliminary efficacy of a brief online program designed to teach adolescents information and skills about communicating and interpreting affirmative sexual consent (PACT: Promoting Affirmative Consent among Teens) in a randomized controlled trial with a national sample of 833 U.S. adolescents (ages 14–16; 42% White, 17% Asian, 17% Black, 13% Latinx; 53% girls, 31% boys, 12% non-binary; 45% heterosexual; 29% sexually active). PACT, grounded in health behavior change and persuasion theories, was developed using feedback from youth advisors and usability testers. Participants considered the program generally acceptable. Compared to youth who completed a control program, PACT was efficacious at shifting three measures of affirmative consent cognitions (i.e., knowledge, attitudes, self-efficacy) from baseline to immediate posttest. Youth who completed PACT also demonstrated more accurate affirmative consent knowledge at 3 months post-baseline. PACT’s effects on consent cognitions were generally similar among youth with various gender, racial/ethnic, and sexual identities. We discuss next steps for this program, including the possibilities of expanding to include additional concepts and tailoring to address the unique needs of specific youth.

Theory- and evidence-based best practices for physical activity counseling for adults with spinal cord injury

Objectives This project used a systematic and integrated knowledge translation (IKT) approach to co-create theory- and evidence-based best practices for physical activity counseling for adults with spinal cord injury (SCI). Methods Guided by the IKT Guiding Principles, we meaningfully engaged research users throughout this project. A systematic approach was used. An international, multidisciplinary expert panel (n = 15), including SCI researchers, counselors, and people with SCI, was established. Panel members participated in two online meetings to discuss the best practices by drawing upon new knowledge regarding counselor-client interactions, current evidence, and members’ own experiences. We used concepts from key literature on SCI-specific physical activity counseling and health behavior change theories. An external group of experts completed an online survey to test the clarity, usability and appropriateness of the best practices. Results The best practices document includes an introduction, the best practices, things to keep in mind, and a glossary. Best practices focused on how to deliver a conversation and what to discuss during a conversation. Examples include: build rapport, use a client-centred approach following the spirit of motivational interviewing, understand your client’s physical activity barriers, and share the SCI physical activity guidelines. External experts (n = 25) rated the best practices on average as clear, useful, and appropriate. Conclusion We present the first systematically co-developed theory- and evidence-based best practices for SCI physical activity counseling. The implementation of the best practices will be supported by developing training modules. These new best practices can contribute to optimizing SCI physical activity counseling services across settings.

Addictions treatment mechanisms of change science and implementation science: A critical review.

This manuscript aims to contribute to the next phase of mechanisms of behavior change (MOBC) science on alcohol or other drug use. Specifically, we encourage the transition from a basic science orientation (i.e., knowledge generation) to a translational science orientation (i.e., knowledge application or Translational MOBC Science). To inform that transition, we examine MOBC science and implementation science and consider how these two research areas can intersect to capitalize on the goals, strengths, and key methodologies of each. First, we define MOBC science and implementation science and offer a brief historical rationale for these two areas of clinical research. Second, we summarize similarities in rationale and discuss two scenarios where one draws from the other-MOBC science on implementation strategy outcomes and implementation science on MOBC. We then focus on the latter scenario, and briefly review the MOBC knowledge base to consider its readiness for knowledge translation. Finally, we provide a series of research recommendations to facilitate the translation of MOBC science. These recommendations include: (1) identifying and targeting MOBC that are well suited for implementation, (2) use of MOBC research results to inform broader health behavior change theory, and (3) triangulation of a more diverse set of research methodologies to build a translational MOBC knowledge base. Ultimately, it is important for gains borne from MOBC science to affect direct patient care, while basic MOBC research continues to be developed and refined over time. Potential implications of these developments include greater clinical significance for MOBC science, an efficient feedback loop between clinical research methodologies, a multi-level approach to understanding behavioral change, and reduced or eliminated siloes between MOBC science and implementation science.

A system dynamics model of the COVID-19 pandemic considering risk perception: A case study of Iran.

The new coronavirus disease 2019 (COVID-19) has become a complex issue around the world. As the disease advancing and death rates are continuously increasing, governments are trying to control the situation by implementing different response policies. In order to implement appropriate policies, we need to consider the behavior of the people. Risk perception (RP) is a critical component in many health behavior change theories studies. People's RP can shape their behavior. This research presents a system dynamics (SD) model of the COVID-19 outbreak considering RP. The proposed model considers effective factors on RP, including different media types, awareness, and public acceptable death rate. In addition, the simplifying assumption of permanent immunity due to infection has been eliminated, and reinfection is considered; thus, different waves of the pandemic have been simulated. Using the presented model, the trend of advancing and death rates due to the COVID-19 pandemic in Iran can be predicted. Some policies are proposed for pandemic management. Policies are categorized as the capacity of hospitals, preventive behaviors, and accepted death rate. The results show that the proposed policies are effective. In this case, reducing the accepted death rate was the most effective policy to manage the pandemics. About 20% reduction in the accepted death rate causes about 23% reduction in cumulative death and delays at epidemic peak. The mean daily error in predicting the death rate is less than 10%.

Exercise or not? An empirical illustration of the role of behavioral alternatives in exercise motivation and resulting theoretical considerations.

Individuals' decisions to engage in exercise are often the result of in-the-moment choices between exercise and a competing behavioral alternative. The purpose of this study was to investigate processes that occur in-the-moment (i.e., situated processes) when individuals are faced with the choice between exercise and a behavioral alternative during a computerized task. These were analyzed against the background of interindividual differences in individuals' automatic valuation and controlled evaluation of exercise. In a behavioral alternatives task 101 participants were asked whether they would rather choose an exercise option or a behavioral alternative in 25 trials. Participants' gaze behavior (first gaze and fixations) was recorded using eye-tracking. An exercise-specific affect misattribution procedure (AMP) was used to assess participants' automatic valuation of exercise before the task. After the task, self-reported feelings towards exercise (controlled evaluation) and usual weekly exercise volume were assessed. Mixed effects models with random effects for subjects and trials were used for data analysis. Choosing exercise was positively correlated with individuals' automatic valuation (r = 0.20, p = 0.05), controlled evaluation (r = 0.58, p < 0.001), and their weekly exercise volume (r = 0.43, p < 0.001). Participants showed no bias in their initial gaze or number of fixations towards the exercise or the non-exercise alternative. However, participants were 1.30 times more likely to fixate on the chosen alternative first and more frequently, but this gaze behavior was not related to individuals' automatic valuation, controlled evaluation, or weekly exercise volume. The results suggest that situated processes arising from defined behavioral alternatives may be independent of individuals' general preferences. Despite one's best general intention to exercise more, the choice of a non-exercise alternative behavior may seem more appealing in-the-moment and eventually be chosen. New psychological theories of health behavior change should therefore better consider the role of potentially conflicting alternatives when it comes to initiating physical activity or exercise.

Changes in Gatekeeper Beliefs Following ASIST and Relation to Subsequent Gatekeeper Suicide Prevention Behaviors.

This study examines relations between suicide prevention gatekeeper beliefs and actual helping behaviors following participation in Applied Suicide Intervention Skills Training (ASIST). Participants (n = 434) completed measures examining suicide-related beliefs and behaviors using a naturalistic pre-post design. All beliefs demonstrated significant change from pre- to posttest. Regression analyses indicate that beliefs about perceived barriers to action and the controllability of suicide predicted identification of high-risk youth; perceived barriers to action were also negatively related to helping responses and referrals 6-9months post training. Self-efficacy was not related to suicide prevention behaviors at follow-up. The importance of anchoring training curriculums and measurement to health behavior change theories is discussed.

Study protocol for an adapted personal project analysis to measure vertical inter-goal relations on physical activity and diet

BackgroundThe promotion of multiple healthy lifestyles has been implemented as part of public health efforts to prevent and reduce the burden of non-communicable diseases. However, these interventions have shown a heterogeneity in their effectiveness. The pursuit of multiple daily goals may influence overall progress in achieving health goals. Horizontal inter-goal relations can be conflicting (due to time constraints) or facilitating (due to goal compatibility) and impact progress towards goal achievement. Personal values also play an important role in health promotion. Personal values direct attention towards accomplishing a higher-level goal through goal setting. Identifying the conflicting or facilitating relationships between health goals and personal values would provide insights in how individuals value health and the personal values that may support the adoption of a healthy behavior. The health goals that this study will focus on are physical activity and a healthy diet.MethodsParticipants between 18 and 30 years old residing in Belgium and interested in a healthy diet and/or physical activity, will be recruited. The study will be a mixed-methods research study based on an adapted personal project analysis for goal elicitation, goal appraisal, and rating of inter-goal conflicting or facilitating relations on a cross-impact matrix. The main objectives include examining the conflicting and facilitating relations between health goals and personal values. Secondary objectives include: examining correlations between horizontal and vertical goal relations; and the goal self-concordance score as a method of data triangulation of facilitating relations between goals and personal values.DiscussionThis study will provide insights into how the emerging adult population relate healthy behaviors, specifically physical activity and a healthy diet, to their personal values. The degree to which individuals are able to pursue a health goal is also influenced by other life goals, and therefore the conflicting and facilitating relations between health goals and other life goals will also be examined. This study contributes to multiple health behavior change theories and has implications for the formulation of interventions for the promotion of healthy behaviors.