Theda Radtke

Smoking is ok as long as I eat healthily: Compensatory Health Beliefs and their role for intentions and smoking within the Health Action Process Approach

Compensatory Health Beliefs (CHBs) are defined as beliefs that the negative consequences of unhealthy behaviours can be compensated for by engaging in healthy behaviours. CHBs have not yet been investigated within a framework of a behaviour change model, nor have they been investigated in detail regarding smoking. Thus, the aim of this study was to investigate on a theoretical basis whether smoking-specific CHBs, as a cognitive construct, add especially to the prediction of intention formation but also to changes in smoking behaviour over and above predictors specified by the Health Action Process Approach (HAPA). The sample comprised 385 adolescent smokers (mean age: 17.80). All HAPA-specific variables and a smoking-specific CHB scale were assessed twice, 4 months apart. Data were analysed using structural equation modelling. Smoking-specific CHBs were significantly negatively related to the intention to stop smoking over and above HAPA-specific predictors. Overall, 39% of variance in the intention to quit smoking was explained. For the prediction of smoking, CHBs were not able to explain variance over and above planning and self-efficacy. Thus, smoking-specific CHBs seem mainly important in predicting intentions but not behaviour. Overall, the findings contribute to the understanding of the role of smoking-specific CHBs within a health-behaviour change model.

Smoking-specific compensatory health beliefs and the readiness to stop smoking in adolescents

OBJECTIVE Compensatory health beliefs (CHBs) are defined as beliefs that negative consequences of unhealthy behaviours can be compensated for by engaging in other health behaviours. CHBs have not yet been investigated in detail regarding smoking. Smoking might cause cognitive dissonance in smokers, if they are aware that smoking is unhealthy and simultaneously hold the general goal of staying healthy. Hence, CHBs are proposed as one strategy for smokers to resolve such cognitive dissonance. The aim of the present study was to develop a scale to measure smoking-specific CHBs among adolescents and to test whether CHBs are related to a lower readiness to stop smoking. DESIGN For the main analyses, cross-sectional data were used. In order to investigate the retest-reliability follow-up data, 4 months later were included in the analysis. METHOD A newly developed scale for smoking-specific CHBs in adolescents was tested for its validity and reliability as well as its predictive value for the readiness to stop smoking in a sample of 244 smokers (15-21 years) drawn from different schools. Multilevel modelling was applied. RESULTS Evidence was found for the reliability and validity of the smoking-specific CHB scale. Smoking-specific CHBs were significantly negatively related to an individuals readiness to stop smoking, even after controlling for other predictors such as self-efficacy or conscientiousness. CONCLUSIONS CHBs may provide one possible explanation for why adolescents fail to stop smoking.

Predicting physical activity in adolescents: The role of compensatory health beliefs within the Health Action Process Approach

Objective: Compensatory health beliefs (CHBs), defined as beliefs that healthy behaviours can compensate for unhealthy behaviours, may be one possible factor hindering people in adopting a healthier lifestyle. This study examined the contribution of CHBs to the prediction of adolescents’ physical activity within the theoretical framework of the Health Action Process Approach (HAPA). Design: The study followed a prospective survey design with assessments at baseline (T1) and two weeks later (T2). Method: Questionnaire data on physical activity, HAPA variables and CHBs were obtained twice from 430 adolescents of four different Swiss schools. Multilevel modelling was applied. Results: CHBs added significantly to the prediction of intentions and change in intentions, in that higher CHBs were associated with lower intentions to be physically active at T2 and a reduction in intentions from T1 to T2. No effect of CHBs emerged for the prediction of self-reported levels of physical activity at T2 and change in physical activity from T1 to T2. Conclusion: Findings emphasise the relevance of examining CHBs in the context of an established health behaviour change model and suggest that CHBs are of particular importance in the process of intention formation.

Are diet-specific compensatory health beliefs predictive of dieting intentions and behaviour?

Compensatory Health Beliefs (CHBs) - beliefs that an unhealthy behaviour can be compensated for by healthy behaviour - are hypothesised to be activated automatically to help people resolve conflicts between their desires (e.g. eat chocolate) and their long-term goals (e.g. dieting). The aim of the present research was to investigate diet-specific CHBs within the context of a theoretical framework, the Health Action Process Approach (HAPA), to examine the extent to which diet-specific CHBs contribute to dieting intentions and dietary intake. Seventy-five dieting women were recruited in Switzerland and England and were asked to complete measures of diet-specific CHBs, risk perception, outcome expectancies, self-efficacy, intention, and behaviour. Path modelling showed that, overall, diet-specific CHBs were not related to dieting intentions (β=.10) or behaviour (β=.06) over and above variables specified in the HAPA. However, risk perception moderated the relationship between diet-specific CHBs and intention (β=.26). Diet-specific CHBs positively predicted intention in women with high risk perception, but not in women with low risk perception. This positive relationship might be explained by the assumption that CHBs play different roles at different stages of the health-behaviour change process. Future studies should further examine moderators and stage-specific differences of the associations between CHBs, intention and health-behaviour change.

Web-based alcohol intervention: study of systematic attrition of heavy drinkers

Background Web-based alcohol interventions are a promising way to reduce alcohol consumption because of their anonymity and the possibility of reaching a high numbers of individuals including heavy drinkers. However, Web-based interventions are often characterized by high rates of attrition. To date, very few studies have investigated whether individuals with higher alcohol consumption show higher attrition rates in Web-based alcohol interventions as compared with individuals with lower alcohol consumption. Objectives The aim of this study was to examine the attrition rate and predictors of attrition in a Web-based intervention study on alcohol consumption. Methods The analysis of the predictors of attrition rate was performed on data collected in a Web-based randomized control trial. Data collection took place at the University of Konstanz, Germany. A total of 898 people, which consisted of 46.8% males (420/898) and 53.2% females (478/898) with a mean age of 23.57 years (SD 5.19), initially volunteered to participate in a Web-based intervention study to reduce alcohol consumption. Out of the sample, 86.9% (781/898) were students. Participants were classified as non-completers (439/898, 48.9%) if they did not complete the Web-based intervention. Potential predictors of attrition were self-reported: alcohol consumption in the last seven days, per week, from Monday to Thursday, on weekends, excessive drinking behavior measured with the Alcohol Use Disorder Identification Test (AUDIT), and drinking motives measured by the Drinking Motive Questionnaire (DMQ-R SF). Results Significant differences between completers and non-completers emerged regarding alcohol consumption in the last seven days (B=−.02, P=.05, 95% CI [0.97-1.00]), on weekends (B=−.05, P=.003, 95% CI [0.92-0.98]), the AUDIT (B=−.06, P=.007, 95% CI [0.90-0.98], and the status as a student (B=.72, P=.001, 95% CI [1.35-3.11]). Most importantly, non-completers had a significantly higher alcohol consumption compared with completers. Conclusions Hazardous alcohol consumption appears to be a key factor of the dropout rate in a Web-based alcohol intervention study. Thus, it is important to develop strategies to keep participants who are at high risk in Web-based interventions.

Autonomous Motivation Is Not Enough: The Role of Compensatory Health Beliefs for the Readiness to Change Stair and Elevator Use

Compensatory health beliefs (CHBs) are beliefs that an unhealthy behavior can be compensated with a healthy behavior. In line with the CHBs model, the aim of this study was twofold. First, the study investigated the relationship between autonomous motivation and CHBs that physical inactivity can be compensated by taking the stairs instead of the elevator. Second, the study focused on the associations between CHBs and readiness to use the stairs more often and stair and elevator use. Thus, a cross-sectional online questionnaire was designed that was filled out by 135 participants. Path analysis showed that individuals with stronger autonomous motivation to use the stairs strongly agreed that sedentary behavior could be compensated by taking the stairs instead of the elevator. Moreover, CHBs were positively related to readiness to change behavior, but not to self-reported stair and elevator use. Even though future research is necessary to replicate these findings, autonomous motivation seems to have a positive impact on CHBs which, in turn, might boost an intended behavior change. Thus, promoting possible compensation of physical inactivity might foster the readiness to change the unhealthy behavior.

Transfer or Compensation

This study tested the effects of exercise on eating behavior. The transfer hypothesis proposes that exercise leads to a generalization of healthy behavior and therefore an improved diet. The compensation hypothesis assumes that exercise leads to increased caloric intake in order to “compensate” for the energy expenditure. We tested these hypotheses for actual as well as imagined exercise. Female university employees or students (N = 227) were randomly assigned to three experimental groups: actual exercise vs. imagined exercise vs. control. After baseline data had been obtained, the participants engaged in a 5-minute experimental task and were then left alone with unhealthy snacks. Participants who had imagined themselves exercising (M = 101 kcal, SD = 128 kcal) consumed significantly fewer calories than did controls (M = 129 kcal, SD = 142 kcal), consistent with a transfer effect. Participants who had engaged in actual exercise, but had been distracted from thinking about exercise, consumed quantities (M = 127 kcal, SD = 111 kcal) similar to those consumed by controls. This study suggests that transfer effects are underpinned by psychological processes, such as goal activation, which should be investigated in the future.

What matters, parental or child perceptions of physical activity facilities? A prospective parent-child study explaining physical activity and body fat among children

Objectives: Research explaining childhood obesity has been usually focused on cognitive and behavioral predictors assessed in parents only or in children only. In contrast, the dyadic approach allows to evaluate how parental and child predictors operate together to explain child physical activity (PA) and body fat. This study investigated relationships among: (1) parental and child perceptions of accessibility and safety of exercise facilities for children, (2) parental and child PA, and (3) parental and child body fat percentage. Design: A prospective and dyadic study with two measurement points was conducted. The follow up (Time 2) took place at 7–8‐month after the baseline (Time 1). Methods: Data were collected among 922 dyads of parents (mean age 35.97 years old; 83.9% women) and children (aged 6–11; M = 8.42, 52% girls). Parents and children reported safety and accessibility perceptions (Time 1) and PA (Time 1 and 2). Parental and child body fat were measured objectively (Time 1 and 2). Results: Path analysis showed that parental perceptions of accessibility of PA facilities for children (Time 1) predicted child body fat and PA (Time 2). The associations were significant in a model accounting for longitudinal and cross‐sectional associations between parental and child body fat and PA, controlling for age and gender of parents and children. Similar patterns of associations were found in the subsamples of dyads with children with normal body weight and with children with overweight/obesity. Conclusions: Parental, not child perceptions of accessibility of PA facilities predicted child PA and body fat. HighlightsWe attempted to explain physical activity and body fat among 6–11 years old children.The role of perceptions of the environment (its accessibility and safety) was tested.Longitudinal data (with 7–8‐month follow‐up) were collected in 922 child‐parent dyads.Parental perceptions of accessibility of exercise facilities affected child outcomes.Child perceptions were unrelated to child physical activity or body fat the follow‐up.

From enjoyment to physical activity or from physical activity to enjoyment? Longitudinal associations in parent–child dyads

Abstract Background: This longitudinal dyadic study used cross-lagged analyses to examine reciprocal patterns of associations between physical activity (PA) enjoyment and moderate-to-vigorous PA (MVPA) among children and their parents. Methods: At Time 1 (T1) 879 parent–child dyads provided their data. The follow-up (Time 2, T2) took place 7–8-months later. MVPA and PA enjoyment scales were filled out separately by parents and children at T1 and T2. Findings: Child PA enjoyment (T1) predicted a higher level of child MVPA (T2), parental PA enjoyment (T1) explained a higher level of parental MVPA (T2), and parental MVPA (T1) predicted a higher level of parental PA enjoyment (T2). Furthermore, child PA enjoyment (T1) predicted a higher level of parental PA enjoyment (T2). Conclusions: Child PA enjoyment was the key variable predicting child and parental outcomes. In particular, it explained child MVPA, but also PA enjoyment among parents.

Association between Children's Physical Activity and Parental Practices Enhancing Children's Physical Activity: The Moderating Effects of Children's BMI z-Score

Objective: Parental practices that aim at increasing childrens physical activity were found to be related to childrens physical activity. So far, however, the association between these two sets of variables was studied without considering the moderating role of childrens BMI z-score, which may determine the effectiveness of parental practices. The present study aims at filling this void. Design: Longitudinal data were collected among 879 dyads of children (6–11 years old) and their parents. Seven parental physical activity practices were assessed at baseline. Physical activity, body mass, and height (measured among children) were assessed twice (at baseline and 7-month follow-up). Body mass and height were measured objectively. Seven moderation analyses were conducted. Results: Six parental practices emerged to predict physical activity of children: collaborative social control, overall support, stimulation to be active, general encouragement for physical activity, positive social control, and modeling. Childrens BMI z-score moderated three associations. The relationships between parental positive social control, overall parental support, and general parental encouragement for physical activity (at baseline), and childrens physical activity (at follow-up) were significant only among children with low and medium BMI z-score. In turn, collaborative social control and modeling predicted childrens physical activity at the follow-up regardless childs BMI z-score. Conclusions: Parental positive social control or overall parental support may be ineffective in children with higher body mass who are in need to increase their physical activity.