Social Cognitive Theories of Exercise Behaviour Hagger & Chatzisarantis, Chapter 2

Outline Social cognitive models of exercise behaviour Social Cognitive Theory Health Belief Model Protection Motivation Theory Theory of Planned Behaviour Self-Determination Theory Transtheoretical model

Recall… The problem Cardiovascular disease (CVD) and diseases related to physical inactivity Physical activity shown to reduce risk to CVD and other diseases Low levels of physical activity among populations in industrialised countries

Role of Exercise Psychology Exercise psychologists aim to: Identify the influential variables (antecedents) that predict physical activity behaviour and Develop a strategy to manipulate such variables and bring about a behaviour change in levels of physical activity

The Problem of Exercise Adherence While many people start exercise regimes, up to 50% relapse Participation Rate Months Source: Dishman (1994)

The Problem of Exercise Adherence Steep drop-off in exercise participation after 6 months Sallis et al. (1990) survey found up to 40% of exercisers had a ‘relapse’ 20% had more than 3 relapses Reasons? Dishman and Buckworth (1997): “People need self-regulatory skills”

A Theoretical Approach to Exercise Behaviour-Models of Social Cognition Assumption that physical activity is a voluntary behaviour under the ‘control’ of the individual, but also external stimuli Atheoretical approaches made no such assumptions and are also limited because: No framework for hypothesis testing Descriptive - interactions neglected No ‘starting point’ for modification Variable ‘fishing expeditions’

Further Assumptions Self-reports of beliefs and expectations are reliable People are rational decision-makers People are information processors Influential variables can be modified but PROCESS can also be identified

Social Cognitive Theory Bandura (1986, 1997) OVERT BEHAVIOUR e.g. Verbal Responses Motor Responses Social Interactions PERSONAL FACTORS e.g. Cognitive abilities Beliefs and attitudes ENVIRONMENTAL FACTORS e.g. Physical surroundings Family and Friends Other social influences Key concepts: Reciprocal determinism Self-efficacy

Social Cognitive Theory Reciprocal determinism: Personal, behavioural and environmental factors act as mutual causes of each other Self-efficacy: Situation specific self-confidence – beliefs that one can execute the behaviour Outcome expectancies: Beliefs that behaviour will result in salient outcomes

Health Belief Model (HBM) Schematic Representation Beliefs about Health Threat General Health Values (“I am concerned about my health”) Perceived Vulnerability (“If I don’t exercise, I may have a heart attack”) Readiness “I will exercise” Perceived Severity (“If I have heart attack, I might die” Beliefs that Specific Behaviour can Reduce Threat Perceived Barriers “There are things that are likely to get in the way of exercising regularly” Perceived Benefits of Behaviour Change Exceed Costs “Even though it will take a lot of effort to exercise regularly, it’s worth it to avoid a heart attack” Source: Rosenstock (1974)

Summary of Research on HBM Research has shown that… Perceived severity Beliefs about the benefits of the health behaviour …are strong predictors of readiness to engage in the behaviour (Quine et al., 1998; Abraham et al., 1999) Only small effects for perceived… vulnerability ▪ benefits severity ▪ barriers susceptibility Limited as it does not account for all influences (e.g., self-efficacy) Also focuses on beliefs that are not relevant to many

Protection Motivation Theory (PMT) Schematic representation Sources of information Cognitive mediating processes Behaviour Environmental Communication Observation Learning Threat appraisal Perceived vulnerability Perceived severity Fear Maladaptive coping Avoidance Denial Fatalism Wishful thinking Hopelessness Protection Motivation Health Protective Behaviour Intrapersonal Personality variables Prior Experience Coping appraisal Perceived self-efficacy Perceived response-efficacy Perceived response-cost Source: Rogers (1983)

Summary of Research on PMT PMT predicts that people will be motivated to exercise (respond) if they … Believe a disease to be severe and likely to occur (vulnerability) Perceive that the health behaviour is effective in reducing the health threat (response efficacy) , is something they feel capable of doing (self-efficacy), and does not cost a lot (response cost) In exercise, self-efficacy, response efficacy, vulnerability, threat appraisals, and coping appraisals are influential in changing protection motivation (Milne et al., 2002) However, effects of coping and threat appraisal have been modest

Interventions Based on HBM and PMT Attempts have been made to change … Threat appraisals Coping appraisals Threat appraisals: Manipulated using fear-arousing communications emphasizing Painful effects of illness (heart disease) (severity) People who do not exercise are more likely to suffer from heart disease (vulnerability) Coping appraisals: Manipulated by providing information on (1) effectiveness of exercise and (2) providing exercises that are easy to do to promote self-efficacy Milne et al. (2000) found that such an intervention changed exercise intentions but not behaviour

Theory of Reasoned Action in Exercise General orientation towards physical activity “good-bad”,“useful-useless”,“harmful-beneficial” Self-reported exercise behaviour Attitudes Intentions Stated volitional motives “I plan…/I intend.../ I expect...” Behaviour Subjective Norms Evaluation of significant others’ evaluation “my mum thinks…”,”my teacher thinks…” Source: Ajzen and Fishbein (1980)

Examples of TRA Questionnaire Items I intend to participate in vigorous physical activities for 20 minutes at a time at least three times per week in the next fortnight. (Please tick one box) Extremely likely Very likely Likely Unlikely Very unlikely Extremely unlikely  For me, doing vigorous physical activities for 20 minutes at a time at least three times per week in the next fortnight is…(Please tick one box) Good Bad   

Types of Measures in the TRA Direct measures: Questions relating to the core TRA components – as in previous example Indirect measures: using expectancy x value model Expectancy x value model: Psychological constructs comprise a belief and a strength or value component for form a combined measure Multiplicative composites: The product of expectancy x value components

Theory of Reasoned Action in Exercise Multiplicative composite of behavioural belief (expectancy) and outcome evaluation (value) Behavioural beliefs x values Attitudes Intentions Behaviour Normative beliefs x values Subjective Norms Multiplicative composite of normative belief (expectancy) and compliance (value) Source: Ajzen and Fishbein (1980)

Expectancy-value Models of Attitudes and Subjective Norms Behavioural beliefs Salient referents Good companionship Parents Weight control Grandparents Benefit overall health Siblings Take too much time Friends Have fun Schoolteachers Stay in shape Improve skills Get an injury Makes you hot and sweaty

Expectancy-value Models of Attitudes and Subjective Norms ‘Behavioural belief’ Behavioural beliefs (expectancy) and outcome evaluations (value) regarding exercise behaviour Normative beliefs (expectancy) and motivation to comply (value) regarding exercise behaviour Attribute Strength of belief Value of belief Result Salient referent Get fit 0.90 X +2 = +1.80 Parents 1.00 +1 +1.00 Socialise with friends +2.00 Friends 0.80 -2 -1.60 Injure myself 0.10 -1 -0.10 Teacher .70 +1.40 Outcome +3.70 +0.80 ‘Outcome evaluation’ Sum of ‘expectancy x value’ statements

Summary of TRA Research in Exercise A meta-analysis (Hagger et al., 2002) shows a strong influence of intentions on exercise behaviour Attitudes have a strong impact on exercise intentions, subjective norms less so The pattern is the same for direct measures and indirect measures (belief-based) of attitudes and subjective norms Behavioural beliefs, outcome evaluations, salient referents, and motivation to comply not all account for unique variance in direct measures

Theory of Planned Behaviour in Exercise Behavioural beliefs x values Attitudes Intentions Behaviour Normative beliefs x values Subjective Norms Perceptions regarding level of volitional control “I have control…” and “easy-difficult” Control beliefs x power Perceived Behavioural Control Source: Ajzen (1985, 1991)

Meta-analytic Evidence for the Prediction of Exercise Behaviour Using the TPB Attitudes .30* Intentions .36* Behaviour Subjective Norms .08* .28* Perceived Control Source: Hagger, Chatzisarantis and Biddle (2002)

Summary of TPB Research in Exercise A meta-analysis (Hagger et al., 2002) have shown the TPB to predict more variance in exercise behaviour than TRA Attitudes and perceived behavioural control have a strong impact on exercise intentions but not subjective norms TPB is more effective in explaining intentions and behaviour that the HBM or PMT (Quine et al., 1998) Control beliefs predict direct measures of perceived behavioural control but vary according to population (Hagger et al., 2001; Godin et al., 1991)

Expectancy-value Models of Perceived Behavioural Control Young populations Adult populations Older populations Bad weather Age Being no good at it Costs Fear of heart attack Doing homework Fatigue Heart pain Going out with friends No time Having other hobbies

Interventions Based on the TPB Interventions based on the TPB should target attitudes and perceived behavioural control in particular (Hagger et al., 2002) Modal, salient beliefs i.e. beliefs about the behaviour that are important to the individuals in the target population and are most frequently cited should be targeted (Ajzen, 1991) Open ended questionnaires used to obtain modal beliefs (Ajzen & Fishbein, 1980) Persuasive communications should target these beliefs in putting forward the ‘case’ for exercise that is meaningful to the person Recent research suggests that an intervention based on the TPB is effective in an exercise context (Chatzisarantis & Hagger, 2005)

Interventions Based on the TPB Example of an intervention ‘script’ for a TPB intervention in exercise: “Participating in regular exercise has many benefits. You might learn how to play a new game or sport as well as improving your general level of fitness and well-being at the same time. Exercise can also be great fun. It does not necessarily cause injuries or make you feel uncomfortably hot and sweaty if you exercise as an intensity you feel comfortable with”

Sufficiency of the TPB Limitations of TPB interventions may be due to… Ceiling effect on attitudes (need for implemental strategy?) Focus on people with low or no intentions - motivational rather than volitional Distal constructs: TPB may not account for other dispositional variables that influence behaviour (e.g., personality) but expected to mediate their effects Research shows that TPB can be modified to explain further variance in exercise intention and behaviour Modified variables must predict unique variance in intention/behaviour (Ajzen, 1991) Attitudinal, normative and control-related modifications shown to be effective (Hagger & Chatzisarantis, 2005)

Extensions of the TPB: Past Behaviour Attitudes .30* .39* Past Behaviour Intentions .36* Behaviour .37* .05* Subjective Norms .08* 23* .28* Perceived Control .10 Source: Hagger, Chatzisarantis and Biddle (2002)

Bozionelos & Bennett (1999) Extensions of the TPB Conner & Abraham (2001) Courneya et al. (2002) Attitude Conscientiousness Personality Trafimow & Finlay (1996) Activity Trafimow & Sheeran (1998) Social support Normatively controlled individuals Terry & O’Leary (1995) Armitage & Conner (2001) Courneya et al. (2000) Moderates Attitudes Cognitive Affective Intentions Exercise Behaviour Subjective Norms Descriptive Norms Injunctive Norms Control Moderates Self- Efficacy Perceived Control Perceived Controllability Bozionelos & Bennett (1999) Attitude strength/ ambivalence Rivis & Sheeran (2003) Anticipated Regret Norms Moral Norms Eagly & Chaiken, 1993 Conner et al., 2003

Summary of Extensions of the TPB TPB does not capture psychological determinants of volitional behaviour, but it is a ‘flexible framework’ Predictions of unique variance in intentions and behaviour by additional variables often modest, context dependent, and reduces TPB parsimony Practical considerations – do interventions based on the extended variables work in changing exercise intentions? Conceptual overlap between additional variables – commonalities amongst variables can often be subsumed by global constructs (Hagger & Chatzisarantis, 2006)

Additional Theories: Model of Goal Directed Behaviour (Perugini & Conner, 2000) Frequency of past behaviour Attitudes Positive affect Desires Intentions Behaviour Negative affect Perceived Behavioural Control Recency of past behaviour Subjective Norms Source: Perugini and Conner (2000)

Summary of Model of Goal Directed Behaviour (MGDB) Desires are important in predicting intention – motivational aspects of attitudes not captured by traditional intentions (Perugini & Bagozzi, 2004) Includes differentiated aspects of past behaviour – frequency and recency Studies using the MGDB have shown that they account for more variance than the TPB (Perugini & Conner, 2000; Perugini & Bagozzi, 2001) Desire is pivotal in mediating effects of attitudes, subjective norms, PBC, and positive and negative anticipated emotions on intentions No interventions based on the MGDB have been conducted

A ‘Stage’ Model of Exercise: The Transtheoretical or ‘Stages of Change’ Model Adopted by the HEA as a ‘theoretical approach’ to understanding exercise behaviour Describes the ‘logical progression’ to adopting exercise Also identifies processes and levels of change

The Transtheoretical Model Pre-Contemplation: People who do not intend to exercise Contemplation: Intent to exercise in the next 6 months, not acting Preparation: May be doing some exercise, ‘in’ and ‘out’ Action: Regular exercisers (3 times per week) – high risk of relapse Maintenance: Regular exercisers for more than 6 months – less risk of relapse

The Transtheoretical Model Schematic Representation Lifelong continuation Action Preparation Contemplation Maintenance Relapse Pre-contemplation

The Transtheoretical Model and Decisional Balance Number of reported reasons Pros Cons Pre-contemplation Contemplation Maintenance Readiness Action

Research with the TTM in Exercise Recent research suggests that SCM’s can be incorporated in the TTM framework Courneya et al. (2000) found that level of intention predicted exercise stage Armitage and Arden (2002) found similar results, but suggested that TTM stages are more like a measure of intention

Problems with the TTM Davis (1993) TTM is not a true cognitive model – mix of behavioural and cognitive variables Armitage and Arden (2002) decisional balance just another measure of intention Sutton (2000) linear changes in cognitive variables across stages means TTM is not a stage model Discontinuity patterns most important to support a ‘stage model’

Linear and Discontinuity Patterns in the TTM (Sutton, 2000) Level of Social Cognitive Variable

Linear and Discontinuity Patterns in the TTM (Sutton, 2000) Level of Social Cognitive Variable

Evidence that TTM is a Stage Model Level of Attitude Ambivalence Armitage, Povey, & Arden (2003)