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Health communication lecture about the (weak) relationship between people\'s good intentions and actual behavior
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Intention-Behavior Relations
‘Geen woorden maar daden’
Actions speak louder than words. Talk is cheap. Practice what you preach. It’s easier said than done. Put your money where your mouth is. The road to hell is paved with good
intentions.
‘It’s a long step from saying to doing.’
(Cervantes)
Sub-assignment : Assessment (1)
Is there a thorough introduction and description of the campaign? Quality of introduction? Adequate description of the issue at stake? Adequate description of the main aim of the
campaign? Adequate description of the intended
outcome?
Sub-assignment : Assessment (2) How well (and creative) is the existing
campaign placed within the theories/models discussed in the syllabus? Is the type of health message properly identified
and discussed? Is the affective appeal used properly identified
and discussed? Is the group introducing alternatives and
different points of view (i.e., are they really discussing different options, or just presenting one)?
In short: How well does the group critically and scientifically reflect on the campaign it selected?
Sub-assignment : Assessment (3) How well is this assignment organized?
Can we trace the logic of the assignment consistently from the opening paragraphs to the conclusion?
Is the writing scientific, clear, concise, and correct? Do the authors communicate their ideas using direct,
straightforward, and unambiguous words and phrases?
Are too many words or paragraphs or sections used to present what could be communicated more simply?
Is the whole sub-assignment well structured (i.e., from ‘Introduction of the campaign’ to ‘Conclusions with respect to the literature’)
Are the quotes and references used properly?
Behavioral intentions
Encompass both the direction (e.g. to study vs. not to study) and the intensity (e.g. how much time and effort the person is prepared to expend in order to study) of a decision (see Sheeran, 2002)
Most of the models of health-related behavior assume that intention are the most important predictor of behavior
PerceivedSusceptibility
PerceivedThreat of Disease
PerceivedBenefitsminus
PerceivedBarriers
Likelihood ofTaking Health
Action
Cues to Action
DemographicVariables
PerceivedSeriousness
Health belief model
HBM: Basic assumptions People will not seek health action
behaviours unless: they possess minimal levels of health
motivation and knowledge view themselves as potentially vulnerable view the condition as threatening are convinced of the efficacy of the
'treatment' see few difficulties in undertaking the action.
Attitudetoward
Behaviour
BEHAVIOURSubjective Norm
Intention
BeliefsRegardingBehaviour
Evaluationof outcomes
Beliefs thatImportant
Others have
Motivation toComply with
Important Others
PerceivedBehavioral
Control
ControlVariables
Power overControl Factors
TRA
TPB
PerceivedSeverity
PerceivedProbability
Efficacy ofPreventiveBehaviour
PerceivedSelf-Efficacy
ProtectiveBehaviour
Threatappraisal
Copingappraisal
Intentionto protect
Protection motivation theory
Intention-behavior relationship?
According to Sheeran (2002) intentions account for 28% of the variance in behavior.
Is this bad (after all 72%, of the variance has not been explained)?
Sheeran, 2002Sheeran, 2002
Intention – behavior gap 6 Studies in Health Domain (Condom Use, Cancer Screening,
Exercise (Sheeran, 2002)
0
10
20
30
40
50
60
70
80
90
100
No YesIntention
Media
n %
across
stu
die
s
Behavior: No
Behavior: YesResponsible for the gap
Responsible for the gap
(Dis)inclined actors and abstainers
So, there are people with positive intentions who fail to act (inclined abstainers) and people who perform the behavior despite negative intentions to do so (disinclined actors)
Are both predominantly responsible for the “gap”?
Sheeran, 2002Sheeran, 2002
Who is responsible for the “Gap”?
Thus, it is those people who fail to act upon their positive intentions who are mainly responsible for the “gap”
Almost one-half of participants who intended to use a condom, attend for cancer screening or exercise at a particular level failed to do so … !
Sheeran, 2002Sheeran, 2002
TPB and the (Dis)inclined actors and
abstainers
Sheeran, 2002Sheeran, 2002
Reasons for failure to carry out
intention Forgetting – Failure of “prospective memory.”
Motivation can be high. Procrastination
Low or moderate motivation. Fails to exceed threshold needed to overcome inertia or distaste for activity.
Ambivalent motivation. Approach-avoidance conflict. Change of mind – due to new information or re-
evaluation of existing information; person no longer motivated to perform the behavior. Behavior on single occasion. New information prior to
behavior. Repeated behavior. New information due to feedback.
Hypothetical vs. Real – Different types of information accessible. Motivation high in hypothetical, low in real.
What can help? Implementation intentions:
When situation Y comes along, I will respond with behavior X with the goal to accomplish Z!
So not only “I have the intention to lose weight”
But also: “Every morning before breakfast, I put on my running shoes and run 30 minutes”
Martijn et al, 2008Martijn et al, 2008
Effect of Implementation Intention Compliance with Intention to Attend a Cervical Cancer Screening
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
Beh
avio
r
No implementationintention
Implementationintention Sheeran & Orbell, 2000Sheeran & Orbell, 2000
How Do Implementation Intentions
Work? Cognitive explanation: Control over initiation of behavior is turned over to stimulus cues (Gollwitzer). Instant habit Less energy and effort
Motivational explanation: Forming an implementation intention enhances motivation to perform the behavior (and thus helps to overcome procrastination).
Exp. (Martijn et al, 2007) ‘Website
down’ N = 131 1st year students Do you want to visit our website? And participate in 10 min. research? Could win 1 of 3 50 Euro coupons?
2 conditions: goal intention (goal)implementation-intention
(imp)
Goal + Imp condition
Strength of intentionDo you have the intention to visit our website and fill in the questionnaire?
5 point scale: 1 = certainly not...5 = certainly yes
Only Imp
“The chance of you visiting the website and filling in the questionnaire will increase if you decide where and when you wil do that. Write this down”
Where? At my computer at homeWhen? After I have read my mail tonight
Website
First name: Sjoerd
Last name: de Vries
Website
Sorry due to problems website is out of order.
We are working on this problem.
The questionnaire will be available at another time.
Please try again later.
Results
Intention goall = 4.32; imp = 4.44, ns
At least 1 webvisit 40.8 % of goal; 65.5 % of imp
Type of intention and webvisits
# webvisits goal Imp
0 45 (59.2 %) 19 (34.5 %)
1 22 (28.9 %) 11 (20.0 %)
2 or more 9 (11.8 %) 25 (45.5 %)
Total 76 (100 %) 55 (100 %)
Amount of Webvisits for each Condition in %
0
10
20
30
40
50
60
0 visits 1 visits 2 visits > 3 visits
DoelImp
Type of behavior Intentions to perform a single action (e.g.
exercise) better predict behavior than intentions to reach a goal (e.g. to lose weight).
A goal = an outcome that can be achieved by performing a variety of single actions.
The extent to which the performance of particular behaviors actually controls whether or not a goal will be achieved is the critical factor
Control factors that moderate the
relation Knowledge Ability Resources Opportunity Availability Cooperation Unexpected situations
Properties of behavioral intentions Temporal stability of intentions Degree of intention formation
Poorly formed intentions (not thought through) will be more likely to encounter unforeseen disadvantages or difficulties with performing the behavior.
Attitudinally versus Normatively controlled intentions Intentions based on own beliefs (autonomous)
are associated with greater likelihood of performing than intentions based on external pressures (controlled).
Stability of the intention to study Behavior: Self-reported studying during winter vacation. Intention: Measured twice, 5 weeks apart prior to winter vacation. Overall intention-behavior correlation: .38** Results of moderated regression analysis:
2
2.5
3
3.5
4
4.5
5
Low High
Intention
Beh
avio
r
Stable intention (r = .58)
Unstable intention (r = .08)
Sheeran, Orbell, & Trafimow, 1999Sheeran, Orbell, & Trafimow, 1999
Stability of the intention to exercise Intention: Measured twice, two weeks apart. Behavior: Self-reported exercise two weeks later. Overall intention-behavior correlation: .67** Results of simple slope analysis:
2
3
4
5
6
7
Low HighIntention
Beh
avio
r
Highly stable intention
Moderately stable intention
Unstable intention
Sheeran & Abraham, 2003Sheeran & Abraham, 2003
Stability of the intention to screen
health
Conner, et al, 2000Conner, et al, 2000
Intention: Measured twice, 1 year apart. Behavior: Attendance at health screening in subsequent month. Overall intention-behavior correlation: .34** Results of simple slope analysis:
3
3.5
4
4.5
5
5.5
6
Low High
Intention
Behavio
r
Highly stable intentionModerately stable intentionUnstable intention
Stability of voting intention?
Conflicting or competing intentions?
The scope of the intention construct
Webb & Sheeran, 2006Webb & Sheeran, 2006
These mediation analyses show that although intentions change significantly attenuated the impact of interventions on behavior, the effect of the intervention remained significant even after controlling for intention.
Thus, it is possible that interventions directly affected behavior because goal activation occurred outside of participants awareness – in a manner that bypassed participants self-reported intentions.
Moderators intention change – behavior
change
Webb & Sheeran, 2006Webb & Sheeran, 2006
Willing to engage in healthy activity?
The social reaction route versus reasoned action route Risky behaviors (e.g. condom nonuse, or
smoking) that are generally performed in social contexts may be determined more by social reaction than by intention.
Intervention characteristics I
Webb & Sheeran, 2006Webb & Sheeran, 2006
Intervention characteristics II
Webb & Sheeran, 2006Webb & Sheeran, 2006
Group assignment
Decide about and shortly describe the type of behavior (‘single
action(s)’ and/or ‘goal(s)’) the campaign focuses on (see pp. 49-
50 of the syllabus).
In the context of the type of behavior identified discuss the
possible role of control factors (e.g. knowledge, ability, etc; see
pp. 50 of the sylabus), with respect to the chance that the target
group actually will perform the behavior?
Sub-assignment 2: Analysis of selected campaign in
relation to the issue of the intention – behavior gap
Group assignment (cont.)
Furthermore discuss the possible influence of habitual control
and social reaction route on the chance that the target group
actually will perform the behavior (see pp. 81 & pp. 86 of the
sylabus) .
Based on your knowledge of the campaign try to identify and
discuss – as good as possible - the most prevalent theoretical
basis of the campaign and the most prevalent behavior change
method used (see Table 4, pp. 88)
Group assignment (cont.) Finally, write down your conclusions about the
possible effectiveness of the campaign based on the
issues identified and discussed in this sub-assignment
(i.e. type of behavior, control factors, habitual control,
social reaction route, theoretical basis, and behavior
change method).
Hand in ‘hard-copy’ Monday 10-11