Silke Burkert

Increasing Physical Exercise Levels Age-Specific Benefits of Planning

Purpose: This study examines the differential age effects on physical exercise of two planning interventions, action planning (when, where, how) and coping planning (anticipating barriers, mental simulation of success scenarios), and examines the mediating mechanisms of the interventions. Methods: The study assigned the participants, 205 cardiac rehabilitation patients, to one of the intervention groups (action-planning only or combined-planning group) or to a control group. Baseline measurement and follow-up took place 2 months apart. Results: The interventions enhanced physical exercise independently of age. Pretreatment coping planning was higher in older (65-82 years) than in younger (38-54 years) or middle-aged (55-64 years) participants. At Time 2, older participants were the only ones without further increase in coping planning. Advancement in coping planning partially mediated the effect of the intervention. Conclusion: Coping planning facilitates improvement of physical exercise. Implications of age differences in planning are discussed.

Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice

The current article details a position statement and recommendations for future research and practice on planning and implementation intentions in health contexts endorsed by the Synergy Expert Group. The group comprised world-leading researchers in health and social psychology and behavioural medicine who convened to discuss priority issues in planning interventions in health contexts and develop a set of recommendations for future research and practice. The expert group adopted a nominal groups approach and voting system to elicit and structure priority issues in planning interventions and implementation intentions research. Forty-two priority issues identified in initial discussions were further condensed to 18 key issues, including definitions of planning and implementation intentions and 17 priority research areas. Each issue was subjected to voting for consensus among group members and formed the basis of the position statement and recommendations. Specifically, the expert group endorsed statements and recommendations in the following areas: generic definition of planning and specific definition of implementation intentions, recommendations for better testing of mechanisms, guidance on testing the effects of moderators of planning interventions, recommendations on the social aspects of planning interventions, identification of the preconditions that moderate effectiveness of planning interventions and recommendations for research on how people use plans.

Dyadic planning of health-behavior change after prostatectomy : a randomized-controlled planning intervention

In this study, we investigated the role of dyadic planning for health-behavior change. Dyadic planning refers to planning health-behavior change together with a partner. We assumed that dyadic planning would affect the implementation of regular pelvic-floor exercise (PFE), with other indicators of social exchange and self-regulation strategies serving as mediators. In a randomized-controlled trial at a German University Medical Center, 112 prostatectomy-patients with partners were randomly assigned to a dyadic PFE-planning condition or one of three active control conditions. Questionnaire data were assessed at multiple time points within six months post-surgery, measuring self-reported dyadic PFE-planning and pelvic-floor exercise as primary outcomes and social exchange (support, control) and a self-regulation strategy (action control) as mediating mechanisms. There were no specific intervention effects with regard to dyadic PFE-planning or pelvic-floor exercise, as two active control groups also showed increases in either of these variables. However, results suggested that patients instructed to plan dyadically still benefited from self-reported dyadic PFE-planning regarding pelvic-floor exercise. Cross-sectionally, received negative control from partners was negatively related with PFE only in control groups and individual action control mediated between self-reported dyadic PFE-planning and PFE for participants instructed to plan PFE dyadically. Longitudinally, action control mediated between self-reported dyadic PFE-planning and pelvic-floor exercise for all groups. Findings provide support for further investigation of dyadic planning in health-behavior change with short-term mediating effects of behavior-specific social exchange and long-term mediating effects of better self-regulation.

Intrinsic Rewards, Fruit and Vegetable Consumption, and Habit Strength: A Three‐Wave Study Testing the Associative‐Cybernetic Model

BACKGROUND Habit formation is thought to lead to long-term maintenance of fruit and vegetable consumption. Habits develop through context-dependent repetition, but additional variables such as intrinsic reward of behaviour may influence habit strength. Drawing upon the Associative-Cybernetic Model, this exploratory study tested different pathways by which intrinsic reward may influence fruit and vegetable consumption habit strength. METHODS In a three-wave study of fruit and vegetable intake in adults (N = 127) from the general population, intrinsic reward, intention, and self-efficacy were assessed at baseline, fruit and vegetable consumption and intrinsic reward two weeks later, and habit strength another two weeks later. Direct, indirect, and moderation effects of intrinsic reward on habit strength were tested simultaneously in a moderated mediation model. RESULTS Intrinsic reward had a positive indirect effect on habit strength through its influence on the frequency of fruit and vegetable consumption. Further, the relationship between fruit and vegetable consumption and habit was stronger where consumption was considered more intrinsically rewarding. CONCLUSIONS Findings highlight the potential relevance of intrinsic reward to habit. We suggest that intrinsic rewards from behaviour may not only facilitate habit via behaviour frequency, but also reinforce the relationship between behavioural repetition and habit strength.

Enabling or Cultivating? The Role of Prostate Cancer Patients’ Received Partner Support and Self-Efficacy in the Maintenance of Pelvic Floor Exercise Following Tumor Surgery

BackgroundTo manage incontinence following tumor surgery, prostate cancer patients are advised to perform pelvic floor exercise (PFE). Patients’ self-efficacy and support from partners were shown to facilitate PFE. Whereas support may enhance self-efficacy (enabling function), self-efficacy may also cultivate support (cultivation function).PurposeCross-lagged inter-relationships among self-efficacy, support, and PFE were investigated.MethodPost-surgery patient-reported received support, self-efficacy, PFE, and partner-reported provided support were assessed from 175 couples at four times. Autoregressive models tested interrelations among variables, using either patients’ or partners’ reports of support.ResultsModels using patients’ data revealed positive associations between self-efficacy and changes in received support, which predicted increased PFE. Using partners’ accounts of support provided, these associations were partially cross-validated. Furthermore, partner-provided support was related with increases in patients’ self-efficacy.ConclusionPatients’ self-efficacy may cultivate partners’ support provision for patients’ PFE, whereas evidence of an enabling function of support as a predictor of self-efficacy was inconsistent.

Effects of dyadic planning on physical activity in couples: A randomized controlled trial.

Objective: Action planning can help translate physical activity intentions into action by linking situational cues with behavioral responses. Dyadic planning extends action planning and refers to target persons forming plans for their own behavior change together with partners. This study investigated whether a dyadic planning intervention could increase physical activity in target persons and their partners, whether these effects were moderated by relationship quality and mediated by action control, activity-specific received partner support, and control. Method: Couples (n = 338; target persons randomized) were randomly assigned to (a) a dyadic planning condition (DPC); (b) an individual planning condition (IPC), in which target persons planned and partners worked on a distractor task; or (c) a control condition (CC), in which couples worked on a distractor task. During 3 assessments up to 6 weeks postintervention, moderate (primary outcome) and vigorous activity were objectively measured; other variables were self-reported. Multilevel and path models were fit. Results: There were no beneficial direct effects of the intervention for DPC target persons. Over time, DPC partners’ vigorous activity increased, but decreased again. At lower relationship quality, DPC target persons’ activity decreased, whereas IPC target persons’ vigorous activity increased. Mediation hypotheses were not supported. Mutual influence models indicated positive effects of partners’ on target persons’ moderate activity in DPC and CC, whereas for IPC, negative effects of target persons’ on partners’ moderate activity emerged. Conclusions: Findings revealed the complexity of effects of dyadic planning on behavior change. Adding relationship quality to the equation clarified effects of DPC and IPC on physical activity.

Self-regulation following prostatectomy: phase-specific self-efficacy beliefs for pelvic-floor exercise.

OBJECTIVE Beliefs in ones ability to perform a task or behaviour successfully are described as self-efficacy beliefs (Bandura, 1977). Since individuals have to deal with differing demands during a behaviour-change process, they form phase-specific self-efficacy beliefs directed at these respective challenges. The present study, based on the Health Action Process Approach (Schwarzer, 2001), examines the theoretical differentiation, relative importance, and differential effects of four phase-specific self-efficacy beliefs, including task self-efficacy, preactional self-efficacy, maintenance self-efficacy, and recovery self-efficacy. DESIGN In a prospective longitudinal study, 112 prostatectomy-patients received questionnaires at 2 days, 2 weeks, 1 month, and 6 months post-surgery. METHODS Participants provided data on phase-specific self-efficacies as well as phase indicators of health-behaviour change, that is, intentions, planning, and pelvic-floor exercise. Hierarchical regression analyses were conducted to test the study hypotheses. RESULTS Task self-efficacy was not uniquely associated with intentions. Preactional self-efficacy was related to action planning. Maintenance self-efficacy did not predict behaviour. Recovery self-efficacy was associated with re-uptake of pelvic-floor exercise after relapses only. CONCLUSION Findings underline the importance of differentiating between task self-efficacy and preactional self-efficacy during early phases of behaviour change as well as of considering the occurrence of relapses as a moderator of potential effects of recovery self-efficacy on the maintenance of behaviour change. Advanced knowledge on distinct, phase-specific self-efficacy beliefs may facilitate the design of effective tailored interventions for behaviour change.

Self-Directed Weight Loss Strategies: Energy Expenditure Due to Physical Activity Is Not Increased to Achieve Intended Weight Loss

Reduced physical activity and almost unlimited availability of food are major contributors to the development of obesity. With the decline of strenuous work, energy expenditure due to spontaneous physical activity has attracted increasing attention. Our aim was to assess changes in energy expenditure, physical activity patterns and nutritional habits in obese subjects aiming at self-directed weight loss. Methods: Energy expenditure and physical activity patterns were measured with a portable armband device. Nutritional habits were assessed with a food frequency questionnaire. Results: Data on weight development, energy expenditure, physical activity patterns and nutritional habits were obtained for 105 patients over a six-month period from an initial cohort of 160 outpatients aiming at weight loss. Mean weight loss was −1.5 ± 7.0 kg (p = 0.028). Patients with weight maintenance (n = 75), with substantial weight loss (>5% body weight, n = 20) and with substantial weight gain (>5% body weight, n = 10) did not differ in regard to changes of body weight adjusted energy expenditure components (total energy expenditure: −0.2 kcal/kg/day; non-exercise activity thermogenesis: −0.3 kcal/kg/day; exercise-related activity thermogenesis (EAT): −0.2 kcal/kg/day) or patterns of physical activity (duration of EAT: −2 min/day; steps/day: −156; metabolic equivalent unchanged) measured objectively with a portable armband device. Self-reported consumption frequency of unfavorable food decreased significantly (p = 0.019) over the six-month period. Conclusions: An increase in energy expenditure or changes of physical activity patterns (objectively assessed with a portable armband device) are not employed by obese subjects to achieve self-directed weight loss. However, modified nutritional habits could be detected with the use of a food frequency questionnaire.

Healthy Eating at Different Risk Levels for Job Stress: Testing a Moderated Mediation

Health behavior, like fruit and vegetable consumption (FVC), is affected by unfavorable job conditions. However, there is little research to date that combines job stress models and health-behavior change models. This longitudinal study examined the contribution of risk factors associated with job stress to the intention-planning-FVC relationship. In the context of the Health Action Process Approach, action planning (when-where-how plans) and coping planning (plans to overcome anticipated barriers) have been shown to be successful mediators in the translation of health-related intentions into action. Risk factors for job stress are operationalized as the interaction of job demands and job resources in line with the Job Demands-Resources (JD-R) model. Two hundred seventy-two employees (mean age 41.2 years, 73.9% female) from different jobs completed measures of intention at baseline (t1), action planning and coping planning 2 weeks later (t2), and FVC another 2 weeks later (t3). Job demands and job resources were assessed at t1 and t2. A moderated mediation analysis indicated that risk factors for job stress moderate the translation of intention into action planning (B = -0.23, p < .05) and coping planning (B = -0.14, p < .05). No moderation effect of the planning-FVC relationship by risk factors for job stress was found. However, coping planning directly predicted FVC (B = 0.36, p < .001). Findings suggest that employees intending to eat healthily use action planning and coping planning when job demands exceed job resources. For increasing FVC, coping planning appears most beneficial.

Self-regulation following prostatectomy : Phase-specific self-efficacy beliefs in implementing pelvic-floor exercise

OBJECTIVE Beliefs in ones ability to perform a task or behaviour successfully are described as self-efficacy beliefs (Bandura, 1977). Since individuals have to deal with differing demands during a behaviour-change process, they form phase-specific self-efficacy beliefs directed at these respective challenges. The present study, based on the Health Action Process Approach (Schwarzer, 2001), examines the theoretical differentiation, relative importance, and differential effects of four phase-specific self-efficacy beliefs, including task self-efficacy, preactional self-efficacy, maintenance self-efficacy, and recovery self-efficacy. DESIGN In a prospective longitudinal study, 112 prostatectomy-patients received questionnaires at 2 days, 2 weeks, 1 month, and 6 months post-surgery. METHODS Participants provided data on phase-specific self-efficacies as well as phase indicators of health-behaviour change, that is, intentions, planning, and pelvic-floor exercise. Hierarchical regression analyses were conducted to test the study hypotheses. RESULTS Task self-efficacy was not uniquely associated with intentions. Preactional self-efficacy was related to action planning. Maintenance self-efficacy did not predict behaviour. Recovery self-efficacy was associated with re-uptake of pelvic-floor exercise after relapses only. CONCLUSION Findings underline the importance of differentiating between task self-efficacy and preactional self-efficacy during early phases of behaviour change as well as of considering the occurrence of relapses as a moderator of potential effects of recovery self-efficacy on the maintenance of behaviour change. Advanced knowledge on distinct, phase-specific self-efficacy beliefs may facilitate the design of effective tailored interventions for behaviour change.