Social Cognitive Determinants Research Articles

Evaluation of Social-Cognitive Determinants of Patients’ Hand Hygiene Decisions and the Role of Mental Health in a Cross-Sectional and a Longitudinal Study of German Patients

Patients’ effective hand hygiene helps to reduce healthcare-associated infections and prevents the spread of nosocomial infections and communicable diseases, such as COVID-19. Accordingly, this study aimed to describe effective hand hygiene decisions based on the Health Action Process Approach (HAPA) and whether this pattern is invariant for mental health. Data were collected cross-sectionally from patients who had previously been admitted to a hospital (Nstudy 1 = 279; study 1) and longitudinally from psychosomatic rehabilitation patients (Nstudy 1 = 1073; study 2). The fit of the HAPA framework and changes in hand hygiene decisions regarding compliance, social-cognitive variables of the HAPA, and mental health status were examined. The results revealed that the trimmed HAPA framework fitted the data well (χ2 = 27.1, df = 12, p < 0.01, CMIN/df = 2.26, CFI = 0.97, RMSEA = 0.08). According to multi-group structural equation modeling, the HAPA model with hand hygiene behavior was found to be invariant regarding mental health. To conclude, the trimmed HAPA framework was revealed to be a generic framework for explaining social-cognitive processes relating to hand hygiene decisions. Therefore, helping individuals to perform hand hygiene recommendations requires intention formation and bridging the intention–behavior gap. This can be undertaken by promoting planning and self-efficacy. All processes appear generic to participants with and without mental health challenges.

An exploration of dark and light triad personality traits towards situational crime prevention and compliant information security behaviour

Purpose This investigation serves a dual purpose: providing preliminary results and serving as a pilot study to confirm the viability of the hypotheses advanced towards a full-scale study. This paper aims to present the preliminary findings of an investigation that explored the constructs of personality traits and situational crime prevention theory (SCPT) as antecedents to social cognitive determinants (attitude, perceived behavioural control and subjective norms using the theory of planned behaviour [TPB] framing) and how these elements subsequently estimate compliant information security behaviour. Moreover, this paper delves into the contrasting influences of light and dark personality traits on insider information security compliance. Design/methodology/approach A cross-sectional survey was conducted to study SCPT measures and the personality factors dyad using a diverse but limited sample (n = 82). Findings There were ten significant direct relationships between SCPT factors and personality traits related to the components of the TPB. Seventeen hypotheses were not supported. However, these findings highlight the complexity of the topic under study. Practical implications Understanding individual differences within the compliance model could be used for custom training protocols, employee selection, assignment and specific types of information security interventions. Originality/value There is a scarcity of studies considering the effects of situational and personality factors, specifically the dark versus light triad of personality traits within the information security domain. Therefore, this preliminary result provides early insight that could guide further studies. This research could have important implications for organisations at risk of insider attacks.

Synergistic Opportunities for Affective Science and Behavior Change.

Behavior change can be challenging to facilitate and achieve. Behavior change frameworks largely focus on social cognitive determinants, omitting affective determinants or including them in a superficial way. However, evidence points to the role of affect in decision-making and behavior, particularly when the behavior at focus for change is affectively pleasant or when the behavior to be facilitated is affectively unpleasant. This paper identifies challenges and opportunities to further affective science by using behavior change as a context and, relatedly, to further the science of behavior change by leveraging theoretical and methodological innovations in affective science.

The psychological determinants of avoiding crowded areas: An international and political investigation

Social isolation is one of the most important measures to reduce clusters of infections. This research aims to explain why people avoided crowded spaces during periods of high global infection of COVID-19 in a cross-national and politically diverse sample. We conducted a cross-cultural survey using Likert-type scale questions (N = 1,196) in New York (n = 313), Brasilia (n = 283), Tokyo (n = 300), and Taipei (n = 300). We ascertained the validity of a model based on the theory of planned behavior, moral norms, and risk perception while analyzing invariance in its estimates and differences in the component`s mean scores across cultures and political groups. The results showed that the data fit the model well, and we found significant differences across countries by comparing the components` mean scores and estimates. Finally, diverging political views generated contrasting scores in the most politically polarized cultures. This study thus shows how the act of avoiding crowded places is shaped by social-cognitive determinants, cultural background, and political views. These insights are relevant for the formulation of better public health policies. It also calls for the academic community to build an integrative research agenda over psychological phenomena based on social factors and calls for the need for behavioral management in pandemics.

Culture, executive functions, and academic achievement.

Although it is well known that children of East Asian immigrants show higher academic achievement than native-born North American children, the social-cognitive determinants of this difference remain poorly understood. Given the importance of executive functions (EF) for academic achievement, and evidence that EF develops more quickly in East Asian compared to North American cultures, it is conceivable that differences in academic achievement might be rooted in EF differences between these groups. We examine this possibility by reviewing evidence of cross-cultural differences in EF development but find core concepts and findings limited in several key respects. To address these limitations, we propose a framework for relating EF, culture, and academic achievement that draws on new theoretical ideas about the nature of EF and its relation to social context. We conclude by discussing avenues for future research on the relations between culture, executive functions, and academic achievement.

Why People Stayed Home During the COVID-19 Pandemic: Implications for Health Communication Across Four Countries

Staying at home substantially reduces the spread of COVID-19. Moreover, understanding why people stayed at home by addressing its social cognitive determinants can help create more effective communication to change behaviors. This study analyzed this outcome through an extended model of the theory of planned behavior based on risk perception and personal norms in four countries: the United States, Japan, Brazil, and Taiwan. 1,196 individuals participated in this study through a questionnaire focused on planned behavior, moral norms, and risk perception. The data showed that intention and perceived behavioral control influenced behavior significantly, while attitude, injunctive norms, perceived behavioral control, personal norms, and risk perception influenced intention. With multigroup analysis and ANOVA, we verified significant differences in the estimates and mean scores across cultures, revealing the need for scholars to analyze outcomes based on geography and local political culture. Given that health communications played a key role in managing the pandemic, this study clarifies the social cognitive determinants of staying at home and how the local political culture can impact their influence. Thus, we provide an evidence-based prescription for focused communications.

Adolescent sleep duration: associations with social-cognitive determinants and the mediating role of sleep hygiene practices.

Insufficient sleep duration among adolescents is a widespread public health problem. Gaining better insight into social-cognitive determinants associated with adolescent sleep duration is necessary for developing effective preventive interventions to support healthy sleep. This study aimed to explore whether social-cognitive determinants regarding sufficient sleep duration were associated with sleep duration, and if these associations were mediated by collective sleep hygiene practices. Furthermore, we examined these associations for social-cognitive determinants related to not using media before bedtime and doing relaxing activities and considered whether these associations were mediated by specific sleep hygiene practices. Data were collected amongst second- and third-grade adolescents from 10 Dutch high schools. A total of 878 adolescents (mean [SD] age 13.3[0.71]years) completed data on sleep duration, social-cognitive determinants of the Theory of Planned Behaviour (i.e., attitude, subjective norms from parents, subjective norms from peers, perceived behavioural control, intention), and sleep hygiene practices. Single- and multivariable path models were constructed and mediation by sleep hygiene practices was analysed by Monte Carlo simulation. All social-cognitive determinants except for subjective norms from peers were associated with longer sleep duration (p < 0.01). Sleep hygiene practices mediated all associations between social-cognitive determinants and sleep duration (mediation ranging from 16% to 72%). Although some of the significant associations and mediation disappeared in the multivariable model, behavioural arousal was the strongest mediator, but collective sleep hygiene practices and cognitive/emotional arousal also explained parts of the associations. The findings indicate that social-cognitive factors should not be overlooked when targeting adolescent sleep duration.

Why some people do not get vaccinated against COVID-19: Social-cognitive determinants of vaccination behavior.

It is puzzling that a sizeable percentage of people refuse to get vaccinated against COVID-19. This study aimed to examine social psychological factors influencing their vaccine hesitancy. This longitudinal study traced a cohort of 2663 individuals in 25 countries from the time before COVID-19 vaccines became available (March 2020) to July 2021, when vaccination was widely available. Multilevel logistic regressions were used to examine determinants of actual COVID-19 vaccination behavior by July 2021, with country-level intercept as random effect. Of the 2663 participants, 2186 (82.1%) had been vaccinated by July 2021. Participants' attitude toward COVID-19 vaccines was the strongest predictor of both vaccination intention and subsequent vaccination behavior (p< .001). Perceived risk of getting infected and perceived personal disturbance of infection were also associated with higher likelihood of getting vaccinated (p< .001). However, religiosity, right-wing political orientation, conspiracy beliefs, and low trust in government regarding COVID-19 were negative predictors of vaccination intention and behavior (p< .05). Our findings highlight the importance of attitude toward COVID-19 vaccines and also suggest that certain life-long held convictions that predate the pandemic make people distrustful of their government and likely to accept conspiracy beliefs and therefore less likely to adopt the vaccination behavior.

Social cognitive determinants of fire safe behaviour in older adults

Background. Older adults are a high-risk group when it comes to fire in their homes. In this study we aimed to identify the most important predictors of fire safe behaviours among older adults. Methods. A questionnaire, consisting of 42 questions, was used to measure social cognitive determinants of fire safe behaviours. Findings. The findings showed that most respondents reported performing fire safe behaviours in their homes, in particular not connecting powerstrips to each other and cleaning the dryer lint filter. However, older adults do not feel very susceptible to the risk of residential fires as indicated by low scores on risk perception and susceptibility. Perceived behavioural control, attitude and response efficacy were found to be determinants that have unique contributions to the explanation of fire safe behaviours. In addition, this research showed that older adults perceive the emergency services, people who have experienced a house fire themselves, the municipality, and housing companies as reliable sources of communications about home fire prevention. Conclusion. The findings suggest that perceived behavioural control, attitude and response efficacy are important target variables for future interventions promoting fire safe behaviour among older adults. background.

Mitigating Feelings of Loneliness and Depression by Means of Web-Based or Print-Based Physical Activity Interventions: Pooled Analysis of 2 Community-Based Intervention Trials.

BackgroundPhysical activity (PA) is associated with benefits, such as fewer depressive symptoms and loneliness. Web- and print-based PA interventions can help older individuals accordingly.ObjectiveWe aimed to test the following research questions: Do PA interventions delivered in a web- or print-based mode improve self-reported PA stage of change, social-cognitive determinants of PA, loneliness, and symptoms of depression? Is subjective age a mediator and stage of change a moderator of this effect?MethodsOverall, 831 adults aged ≥60 years were recruited and either allocated to a print-based or web-based intervention group or assigned to a wait-list control group (WLCG) in 2 community-based PA intervention trials over 10 weeks. Missing value imputation using an expectation-maximization algorithm was applied. Frequency analyses, multivariate analyses of variance, and moderated mediation analyses were conducted.ResultsThe web-based intervention outperformed (47/59, 80% of initially inactive individuals being adopters, and 396/411, 96.4% of initially active individuals being maintainers of the recommended PA behavior) the print-based intervention (20/25, 80% of adopters, and 63/69, 91% of maintainers) and the WLCG (5/7, 71% of adopters; 141/150, 94% of maintainers). The pattern regarding adopters was statistically significant (web vs print Z=–1.94; P=.02; WLCG vs web Z=3.8367; P=.01). The pattern was replicated with stages (χ24=79.1; P<.001; contingency coefficient 0.314; P<.001); in the WLCG, 40.1% (63/157) of the study participants moved to or remained in action stage. This number was higher in the groups receiving web-based (357/470, 76%) or print-based interventions (64/94, 68.1%). A significant difference was observed favoring the 2 intervention groups over and above the WLCG (F19, 701=4.778; P<.001; η2=0.098) and a significant interaction of time and group (F19, 701=2.778; P<.001; η2=0.070) for predictors of behavior. The effects of the interventions on subjective age, loneliness, and depression revealed that both between-group effects (F3, 717=8.668; P<.001; η2=0.018) and the interaction between group and time were significant (F3, 717=6.101; P<.001; η2=0.025). In a moderated mediation model, both interventions had a significant direct effect on depression in comparison with the WLCG (web-based: c′ path −0.86, 95% CI −1.58 to −0.13, SE 0.38; print-based: c′ path −1.96, 95% CI −2.99 to −0.92, SE 0.53). Furthermore, subjective age was positively related to depression (b path 0.14, 95% CI 0.05-0.23; SE 0.05). An indirect effect of the intervention on depression via subjective age was only present for participants who were in actor stage and received the web-based intervention (ab path −0.14, 95% CI −0.34 to −0.01; SE 0.09).ConclusionsWeb-based interventions appear to be as effective as print-based interventions. Both modes might help older individuals remain or become active and experience fewer depression symptoms, especially if they feel younger.Trial RegistrationGerman Registry of Clinical Trials DRKS00010052 (PROMOTE 1); https://tinyurl.com/nnzarpsu and DRKS00016073 (PROMOTE 2); https://tinyurl.com/4fhcvkwyInternational Registered Report Identifier (IRRID)RR2-10.2196/15168

Living labs for a mobile app-based health program: effectiveness of a 24-week walking intervention for cardiovascular disease risk reduction among female Korean-Chinese migrant workers: a randomized controlled trial

BackgroundThe risk of Cardiovascular disease (CVDs) among adult populations is influenced by environmental factors, and immigrant populations tend to be more vulnerable. This study examined the effectiveness of a 24-week walking program based on social-cognitive determinants through mobile app for CVD risk reduction among female Korean-Chinese middle-aged workers.MethodsThis study used a parallel randomized controlled trial. Participants were recruited by distributing posters and flyers and randomly assigned to either the standard treatment (ST, n = 22) or enhanced treatment group (ET, n = 28). Participants were provided with a mobile app linked to Fitbit Alta for 24 weeks and instructed to walk at least 30 minutes five times a week and moderate-intensity physical activity. The ET group had additional interventions that enhanced social-cognitive determinants such as self-efficacy, social support. All participants were guided to voluntary physical activity during the 12-week maintenance period. Data were analyzed by the Mann Whitney U-test and a generalized estimating equation.ResultsThere were significant between-group differences regarding the number of steps (B = 1.295, P < .001) and moderate physical activity time (OR = 6.396, P = .030) at week 12. ET group had significant changes in high-density lipoprotein cholesterol (B = 10.522, P = .007), low-density lipoprotein cholesterol (B = -16.178, P = .024), total cholesterol (B = -20.325, P = .039), fasting blood sugar (B = − 8.138, P = -.046). In addition, there was a significant reduction of 10-year CVD risk for the ET group over 12 weeks compared to the ST group (B = -0.521, P<. 001).ConclusionsLong-term studies are needed to reduce the risk of cardiovascular disease in large-scale migrant workers and to confirm the direct and insdirect effects of social-cognitive determinants on health outcomes.Trial registrationThe trial was retrospectively registered in WHO ICTRP (KCT0006467) August 19th, 2021. (https://trialsearch.who.int/Trial2.aspx?TrialID=KCT0006467,

One size fits all? Using machine learning to study heterogeneity and dominance in the determinants of early-stage entrepreneurship

Despite the vast number of studies exploring the determinants of entrepreneurship, few have been able to distinguish the relative importance of these factors. Traditional regression-based approaches, upon which such studies are based, are unable to fully capture heterogeneous and complex non-linear patterns in the determinants of entrepreneurship. To address these limitations, we adopt a novel approach, using machine learning to study heterogeneity and dominance in the social-cognitive determinants of early-stage entrepreneurship. We apply decision tree algorithms to a large-scale dataset from the Global Entrepreneurship Monitor. Our results reveal that the dominant determinants, irrespective of entrepreneurial pathway, are individual entrepreneurial self-efficacy and networks, with factors such as cultural perceptions being relatively unimportant, despite substantial attention in the literature. The results also show considerable heterogeneity in the factors contributing to entrepreneurship, highlighting the need for academics and policy makers to consider the likelihood that there is no single set of motivating factors.

0002 Go to bed! A systematic review and meta-analysis of bedtime procrastination determinants and sleep outcomes

Abstract Introduction Bedtime procrastination, the volitional delay of going to bed without any external circumstances causing the delay, is associated with poor sleep outcomes. Alleviating bedtime procrastination is an important target for interventions to promote adequate sleep, yet the social cognitive, biological, and behavioural determinants of bedtime procrastination are poorly understood. The present study aimed to conduct a systematic review, narrative synthesis, and meta-analysis of (1) the underlying determinants of bedtime procrastination, and (2) the strength and direction of the relationship between bedtime procrastination and sleep outcomes. Methods A database search was conducted through CINAHL, EMBASE, PsychINFO, PubMed, Scopus and Web of Science, using keywords related to procrastination, delay, bedtime and sleep. Results A total of 2087 records were identified, and 38 publications met the inclusion criteria. Random-effects meta-analysis for bedtime procrastination and sleep outcomes is ongoing. Preliminary findings suggest self-regulation, self-control and chronotype are the most prominent determinants. Conclusion Future research should expand focus to identify a broader range of determinants. Given that there are multiple benefits to a theory-based approach to behaviour change interventions, further research exploring determinants will be able to guide the development of interventions targeting bedtime procrastination. Support (If Any):

Using intervention mapping to develop and facilitate implementation of a multifaceted behavioural intervention targeting physical activity and sedentary behaviour in stroke survivors: Physical Activity Routines After Stroke (PARAS): intervention development study

ABSTRACT Objectives The benefits of increased physical activity for stroke survivors include improved function and mental health and wellbeing. However, less than 30% achieve recommended physical activity levels, and high levels of sedentary behaviour are reported. We developed a multifaceted behavioural intervention (and accompanying implementation plan) targeting physical activity and sedentary behaviour of stroke survivors. Design Intervention Mapping facilitated intervention development. Step 1 involved a systematic review, focus group discussions and a review of care pathways. Step 2 identified social cognitive determinants of behavioural change and behavioural outcomes. Step 3 linked determinants of behavioural outcomes with specific behaviour change techniques (BCTs) to target behaviours of interest. Step 4 involved intervention development informed by steps 1–3. Subsequently, an implementation plan was developed (Step 5) followed by an evaluation plan (Step 6). Setting Community and secondary care settings, North East England. Participants Stroke survivors and healthcare professionals (HCPs) working in stroke services. Results Systematic review findings informed selection of nine ‘promising’ BCTs (e.g. problem-solving). Focus groups with stroke survivors (n = 18) and HCPs (n = 24) identified the need for an intervention delivered throughout the rehabilitation pathway, tailored to individual needs with training for HCPs delivering the intervention. Intervention delivery was considered feasible within local stroke services. The target behaviours for the intervention were levels of physical activity and sedentary behaviour in adult stroke survivors. Assessment of acceptability and usability with 11 HCPs and 21 stroke survivors/relatives identified issues with self-monitoring tools and the need for a physical activity repository of local services’ and training for HCPs with feedback on intervention delivery. A feasibility study protocol was designed to evaluate the intervention. Conclusions A systematic development process using intervention mapping resulted in a multi-faceted evidence- and theory-informed intervention (Physical Activity Routines After Stroke – PARAS) for delivery by community stroke rehabilitation teams.

Applying Social Cognitive Theory in Predicting Physical Activity Among Chinese Adolescents: A Cross-Sectional Study With Multigroup Structural Equation Model.

This cross-sectional study aimed to assess the applicability of social cognitive determinants among the Chinese adolescents and examine whether the predictability of the social cognitive theory (SCT) model on physical activity (PA) differs across gender (boys and girls) and urbanization (urban and suburban). A total of 3,000 Chinese adolescents ranging between the ages of 12–15 years were randomly selected to complete a set of questionnaires. Structural equation modeling (SEM) was applied to investigate the relationships between social cognitive variables and PA in the urbanization and gender subgroups. The overall model explained 38.9% of the variance in PA. Fit indices indicated that the structural model of SCT was good: root mean square error of approximation (RMSEA) = 0.047, (root mean square residual) RMR = 0.028, goodness of fit index (GFI) = 0.974, adjusted goodness of fit index (AGFI) = 0.960, Tucker–Lewis coefficient (TLI) = 0.971, and comparative fit index (CFI) = 0.978. Regarding the subgroup analysis, social support (critical ratios [CRs] = 2.118; p < 0.001) had a more substantial impact on the PA of adolescents in suburban areas than that in urban areas, whereas self-regulation (CRs = −2.896, p < 0.001) had a more substantial impact on the PA of adolescents in urban areas than in suburban areas. The results indicate that the SCT model predicts the PA of Chinese adolescents substantially. An SCT model could apply over a range of subgroups to predict the PA behavior and should be considered comprehensively when designing interventions. These findings would benefit PA among the Chinese adolescents, especially across genders and urbanization.

Social Cognitive Determinants of Dietary Behavior Change in Children

Social Cognitive Determinants of Dietary Behavior Change in Children

Adherence With Online Therapy vs Face-to-Face Therapy and With Online Therapy vs Care as Usual: Secondary Analysis of Two Randomized Controlled Trials.

BackgroundAdherence to internet-delivered interventions targeting mental health such as online psychotherapeutic aftercare is important for the intervention’s impact. High dropout rates limit the impact and generalizability of findings. Baseline differences may be putting patients at risk for dropping out, making comparisons between online with face-to-face (F2F) therapy and care as usual (CAU) necessary to examine.ObjectiveThis study investigated adherence to online, F2F, and CAU interventions as well as study dropout among these groups and the subjective evaluation of the therapeutic relationship. Sociodemographic, social-cognitive, and health-related variables were considered.MethodsIn a randomized controlled trial, 6023 patients were recruited, and 300 completed the baseline measures (T1), 144 completed T2 (retention 44%-52%), and 95 completed T3 (retention 24%-36%). Sociodemographic variables (eg, age, gender, marital status, educational level), social-cognitive determinants (eg, self-efficacy, social support), health-related variables (eg, depressiveness), and expectation towards the treatment for patients assigned to online or F2F were measured at T1.ResultsThere were no significant differences between the groups regarding dropout rates (χ21=0.02-1.06, P≥.30). Regarding adherence to the treatment condition, the online group outperformed the F2F and CAU conditions (P≤.01), indicating that patients randomized into the F2F and CAU control groups were much more likely to show nonadherent behavior in comparison with the online therapy groups. Within study groups, gender differences were significant only in the CAU group at T2, with women being more likely to drop out. At T3, age and marital status were also only significant in the CAU group. Patients in the online therapy group were significantly more satisfied with their treatment than patients in the F2F group (P=.02; Eta²=.09). Relationship satisfaction and success satisfaction were equally high (P>.30; Eta²=.02). Combining all study groups, patients who reported lower depressiveness scores at T1 (T2: odds ratio [OR] 0.55, 95% CI 0.35-0.87; T3: OR 0.56, 95% CI 0.37-0.92) were more likely to be retained, and patients who had higher self-efficacy (T2: OR 0.57, 95% CI 0.37-0.89; T3: OR 0.52, 95% CI 0.32-0.85) were more likely to drop out at T2 and T3. Additionally, at T3, the lower social support that patients reported was related to a higher likelihood of remaining in the study (OR 0.68, 95% CI 0.48-0.96). Comparing the 3 intervention groups, positive expectation was significantly related with questionnaire completion at T2 and T3 after controlling for other variables (T2: OR 1.64, 95% CI 1.08-2.50; T3: OR 1.59, 95% CI 1.01-2.51).ConclusionsWhile online interventions have many advantages over F2F variants such as saving time and effort to commute to F2F therapy, they also create difficulties for therapists and hinder their ability to adequately react to patients’ challenges. Accordingly, patient characteristics that might put them at risk for dropping out or not adhering to the treatment plan should be considered in future research and practice. Online aftercare, as described in this research, should be provided more often to medical rehabilitation patients.Trial RegistrationClinicalTrials.gov NCT04989842; https://clinicaltrials.gov/ct2/show/NCT04989842

Predicting Decisional Determinants of Physical Activity Among Older Adults: An Integrated Behavior Approach.

ObjectivesThe present study applied the Integrated Behavior Change Model to investigate how behavioral decisions are predicted, namely, intention, planning, and habits, with respect to physical activity. Methods: Participants were older adults (ages 65+) residing in the U.S. (N = 667) who completed online measures of behavioral determinants (autonomous motivation, perceived behavioral control, subjective norms, attitudes, intention, habit, and consistency), in addition to past behavior. Results: A structural equation model revealed that intention was predicted by past behavior and social-cognitive determinants. Social cognitive determinants mediated between past behavior and habit, as well as between autonomous motivation and habit. Intention mediated between past behavior and planning. Discussion: This study highlights the importance of multiple processes (social cognitive, habit/automatic, and post-intentional/planning) that formulate physical activity intentions. Mediation pathways revealed the importance of autonomous motivation for establishing intentions and habit. Facilitating these processes among older adults could be effective for promoting physical activity.

Social-Cognitive Determinants of HIV Testing Among Tuberculosis Infected Patients in Kassala State, Sudan.

Background: Use of HIV testing and counselling (HTC) services remains low among TB patients in Sudan. Identifying the social-cognitive (sub) determinants associated with HTC uptake is essential before developing interventions to promote uptake. This study aims to assess the sub-determinants of intention to use and actual behaviour of using HTC services among TB patients in Sudan and to ascertain the most relevant beliefs to inform future interventions.Methods: A cross-sectional study was carried out in five health facilities selected randomly in Kassala State. First, a small elicitation study (N = 25) was conducted to inform the Reasoned Action Approach (RAA) based questionnaire. A total of 411 TB patients completed the survey questionnaire. Confidence Interval Based Estimation of Relevance analysis (CIBER) was employed to establish the sub-determinants' relevance.Result: The studied beliefs explained 38–52% of the variance in the intention and 20–35% in the behaviour variance. The beliefs that “Using HTC services increases my fear of being tested positive for HIV” and “Using HTC services increases my fear of losing my partner if I have a positive test result” were negatively associated with intentions and use of HTC services; and both were highly relevant for intervention. The belief “If I use HTC services, I would know my HIV status” was positively associated with intentions and use of HTC services. However, it was less relevant for intervention. Perceived susceptibility to HIV infection was not associated with intention and only weakly associated with use of HTC services. Its relevance was low for intervention.Conclusions: The study showed that the social-cognitive beliefs (sub-determinants) vary in their relationship with the intention and use of HTC services among TB patients; with variable relevance for intervention. Interventions to enhance the use of HTC services should address the most relevant beliefs to maximise the effectiveness of interventions. Further studies are needed to identify other relevant sub-determinants of HTC use behaviour.

Examining the social cognitive determinants of collegiate recreational sport involvement and outcomes

ABSTRACT Sedentary behavior and health concerns are rising among young adults, making it necessary to understand antecedents of physical activity to promote health programming. This study integrates multiple theoretical frameworks to holistically test antecedents (self-efficacy, achievement goals) and consequences (social, intellectual, fitness benefits) of recreational sport involvement. Questionnaire responses from collegiate recreational sport (CRS) participants were used to test two structural models, and one good-fitting model was achieved. Additional effects were interpreted, indicating mastery-approach orientations are important for achieving positive benefits of recreational sport. Self-efficacy was found a more important mediator than CRS involvement for achieving positive benefits of recreational sport. These findings extend theoretical debate surrounding self-efficacy and achievement goals as social cognitive determinants of behavior. Practically, since individuals are more likely to find recreational sports beneficial when striving for mastery-related goals, practitioners should develop a motivational climate that encourages participants to strive toward improving past performance on tasks.