Efficacious translational research in health psychology relies on specifying why intervention strategies change health behaviors and when, for what behaviors, and for whom, do these strategies ...promote change. Whereas interventions' mechanism of action (the why question) has attracted considerable attention, there is a need to conceptualize and integrate factors that moderate intervention effectiveness. Intervention effects on health behaviors are a function of 2 change processes: how effectively interventions change mechanisms of action (target engagement), and how effectively those mechanisms change behavior (target validity). We outline the Operating Conditions Framework (OCF) to articulate theoretical linkages between mechanisms and moderators and begin the process of specifying circumstances that promote target engagement and target validity. A review of 46 meta-analyses of behavioral interventions offers impetus for the OCF by revealing that heterogeneity of effect sizes is frequent, substantial, and largely unexplained in traditional moderator analyses. We present an approach to moderation grounded on the distinction between 2 foci-engagement moderation and validity moderation-and reveal that little is known about variation in how interventions change targets and how changing targets promotes behavior change. The OCF addresses this need by maintaining researchers' focus on mechanisms of behavior change but doing so while embracing the conditional nature of these processes. Because the OCF prioritizes consideration of contextual factors at the outset of a research program, early-phase translational research will be critical in specifying operating conditions and, ultimately, generating guidelines regarding why, when, for whom, and for what behaviors are intervention strategies effective.
Objective: Several health behavior theories converge on the hypothesis that attitudes, norms, and self-efficacy are important determinants of intentions and behavior. However, inferences regarding ...the relation between these cognitions and intention or behavior rest largely on correlational data that preclude causal inferences. To determine whether changing attitudes, norms, or self-efficacy leads to changes in intentions and behavior, investigators need to randomly assign participants to a treatment that significantly increases the respective cognition relative to a control condition, and test for differences in subsequent intentions or behavior. The present review analyzed findings from 204 experimental tests that met these criteria. Method: Studies were located using computerized searches and informal sources and meta-analyzed using STATA Version 11. Results: Experimentally induced changes in attitudes, norms, and self-efficacy all led to medium-sized changes in intention (d+ = .48, .49, and .51, respectively), and engendered small to medium-sized changes in behavior (attitudes-d+ = .38, norms-d+ = .36, self-efficacy-d+ = .47). These effect sizes generally were not qualified by the moderator variables examined (e.g., study quality, theoretical basis of the intervention, methodological characteristics, and features of the targeted behavior), although effects were larger for interventions designed to increase (vs. decrease) behavioral performance. Conclusion: The present review lends novel, experimental support for key predictions from health behavior theories, and demonstrates that interventions that modify attitudes, norms, and self-efficacy are effective in promoting health behavior change.
How can progress in research on health behavior change be accelerated? Experimental medicine (EM) offers an approach that can help investigators specify the research questions that need to be ...addressed and the evidence needed to test those questions. Whereas current research draws predominantly on multiple overlapping theories resting largely on correlational evidence, the EM approach emphasizes experimental tests of targets or mechanisms of change and programmatic research on which targets change health behaviors and which techniques change those targets. There is evidence that engaging particular targets promotes behavior change; however, systematic studies are needed to identify and validate targets and to discover when and how targets are best engaged. The EM approach promises progress in answering the key question that will enable the science of health behavior change to improve public health: What strategies are effective in promoting behavior change, for whom, and under what circumstances?
Conflicting information surrounding COVID-19 abounds, from disagreement over the effectiveness of face masks in preventing viral transmission to competing claims about the promise of certain ...treatments. Despite the potential for conflicting information about COVID-19 to produce adverse public health effects, little is known about whether the U.S. public notices this information, and whether certain population subgroups are particularly likely to do so. To address these questions, we fielded a nationally representative survey of U.S. adults in late April 2020 (N = 1,007). Results showed substantial self-reported exposure to conflicting information about COVID-19, with nearly 75% of participants reporting having recently heard such information from health experts, politicians, and/or others. Participants perceived disagreement across a range of COVID-19-related issues, though from politicians more than health experts. Factors including political affiliation, information source use, and personal experience with COVID-19 were associated with perceptions of disagreement. Future research should consider potential cognitive and behavioral consequences of such perceptions.
Objectives
The National Institutes of Health, led by the National Heart, Lung, and Blood Institute, organized a working group of experts to discuss the problem of weight regain after weight loss. A ...number of experts in integrative physiology and behavioral psychology were convened with the goal of merging their perspectives regarding the barriers to scientific progress and the development of novel ways to improve long‐term outcomes in obesity therapeutics. The specific objectives of this working group were to: (1) identify the challenges that make maintaining a reduced weight so difficult; (2) review strategies that have been used to improve success in previous studies; and (3) recommend novel solutions that could be examined in future studies of long‐term weight control.
Results
Specific barriers to successful weight loss maintenance include poor adherence to behavioral regimens and physiological adaptations that promote weight regain. A better understanding of how these behavioral and physiological barriers are related, how they vary between individuals, and how they can be overcome will lead to the development of novel strategies with improved outcomes.
Conclusions
Greater collaboration and cross‐talk between physiological and behavioral researchers is needed to advance the science and develop better strategies for weight loss maintenance.
Increasing Vaccination Brewer, Noel T.; Chapman, Gretchen B.; Rothman, Alexander J. ...
Psychological science in the public interest,
12/2017, Letnik:
18, Številka:
3
Journal Article
Odprti dostop
Vaccination is one of the great achievements of the 20th century, yet persistent public-health problems include inadequate, delayed, and unstable vaccination uptake. Psychology offers three general ...propositions for understanding and intervening to increase uptake where vaccines are available and affordable. The first proposition is that thoughts and feelings can motivate getting vaccinated. Hundreds of studies have shown that risk beliefs and anticipated regret about infectious disease correlate reliably with getting vaccinated; low confidence in vaccine effectiveness and concern about safety correlate reliably with not getting vaccinated. We were surprised to find that few randomized trials have successfully changed what people think and feel about vaccines, and those few that succeeded were minimally effective in increasing uptake. The second proposition is that social processes can motivate getting vaccinated. Substantial research has shown that social norms are associated with vaccination, but few interventions examined whether normative messages increase vaccination uptake. Many experimental studies have relied on hypothetical scenarios to demonstrate that altruism and free riding (i.e., taking advantage of the protection provided by others) can affect intended behavior, but few randomized trials have tested strategies to change social processes to increase vaccination uptake. The third proposition is that interventions can facilitate vaccination directly by leveraging, but not trying to change, what people think and feel. These interventions are by far the most plentiful and effective in the literature. To increase vaccine uptake, these interventions build on existing favorable intentions by facilitating action (through reminders, prompts, and primes) and reducing barriers (through logistics and healthy defaults); these interventions also shape behavior (through incentives, sanctions, and requirements). Although identification of principles for changing thoughts and feelings to motivate vaccination is a work in progress, psychological principles can now inform the design of systems and policies to directly facilitate action.
Purpose and Methods
This paper examines the social cognitive processes that regulate people's eating behavior. Specifically, we examine how eating behavior can be regulated by reflective, ...deliberative processes as well as automatic and habitual processes. Moreover, we consider how these processes operate when people are not only initiating a change in behavior but also maintaining the behavior over time.
Results and Discussion
Decomposing action control and behavior change into a 2 (reflective, automatic) × 2 (initiation, maintenance) matrix offers a useful way of conceptualizing the various determinants of eating behavior and suggests that different intervention strategies will be needed to target particular processes during respective phases of behavior change. The matrix also helps to identify key areas of intervention development that deserve attention.
Accelerating advances in health behavior change requires releasing the brake, as well as applying the throttle. This paper discusses six challenges or "brakes" that have slowed progress.
We engage ...with six issues that limit investigators' ability to delineate and test the strategy-target and target-behavior relations that underlie effective interventions according to the experimental medicine approach. We discuss the need for guidance on how to identify the relevant mechanism of action (target) in an intervention and whether a periodic table of health behavior constructs might aid investigators. Experimental and correlational analyses (prospective surveys and behavior change techniques) have been used to test the validity of targets, and we present evidence that there is little agreement among the findings from different research designs. Whereas target engagement is typically analyzed in terms of increasing scores on constructs that impel behavior change, we discuss the role of impeding targets and the benefits of adopting a broader construal of potential targets and approaches to engagement. There is presently a paucity of competitive tests regarding which strategies best engage targets and we discuss empirical criteria and conceptual developments that could enhance the evidence base. Finally, we highlight the need to take "context" or conditional intervention effects more seriously by leveraging the interplay between questions about why interventions work and questions about when and for whom they work.
Candid appraisal of the challenges facing research on health behavior change can generate new opportunities for theoretical development and offer direction and cumulative impetus for empirical work.
Abstract
Background
Understanding links between behaviour change techniques (BCTs) and mechanisms of action (the processes through which they affect behaviour) helps inform the systematic development ...of behaviour change interventions.
Purpose
This research aims to develop and test a methodology for linking BCTs to their mechanisms of action.
Methods
Study 1 (published explicit links): Hypothesised links between 93 BCTs (from the 93-item BCT taxonomy, BCTTv1) and mechanisms of action will be identified from published interventions and their frequency, explicitness and precision documented. Study 2 (expert-agreed explicit links): Behaviour change experts will identify links between 61 BCTs and 26 mechanisms of action in a formal consensus study. Study 3 (integrated matrix of explicit links): Agreement between studies 1 and 2 will be evaluated and a new group of experts will discuss discrepancies. An integrated matrix of BCT-mechanism of action links, annotated to indicate strength of evidence, will be generated. Study 4 (published implicit links): To determine whether groups of co-occurring BCTs can be linked to theories, we will identify groups of BCTs that are used together from the study 1 literature. A consensus exercise will be used to rate strength of links between groups of BCT and theories.
Conclusions
A formal methodology for linking BCTs to their hypothesised mechanisms of action can contribute to the development and evaluation of behaviour change interventions. This research is a step towards developing a behaviour change ‘ontology’, specifying relations between BCTs, mechanisms of action, modes of delivery, populations, settings and types of behaviour.
The development of a formal method to link behaviour change techniques with mechanisms of action to support investigators as they design and evaluate behavioural interventions.
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