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Background: There is no known risk-free level of alcohol use in pregnancy. Despite this, many still believe that occasional drinking is safe. To-date, there is limited evidence of the influences on women's decisions about low to moderate alcohol use in pregnancy. The aim of this study was to explore alcohol use intentions during pregnancy, using variables from the theory of planned behavior, the prototype/willingness model and personality variables. The study also investigated whether priming participants with exposure to prototypes describing different alcohol use behaviors had an impact on intentions. Methods: Participants, 746 women aged 20 to 45 years, were randomized to be prompted to think of one of two different "types" of behaviors, i.e., small level of alcohol use in pregnancy and ambiguous level of alcohol use in pregnancy. They then completed measures of theoretical variables, impulsivity, venturesomeness, and self-efficacy. Participants then answered whether they intended to use alcohol during a future pregnancy. Results: Over half of the variance in intentions to consume alcohol while pregnant were predicted by the final model ( R 2 = .527, F (1, 438) = 13.201, p < .001). Positive attitudes toward alcohol use in pregnancy, from the theory of planned behavior, were the most significant predictor of intentions and intentions did not differ between groups according to prototype exposure. Conclusions: Future research should aim to explore the efficacy of interventions to reduce low to moderate alcohol use in pregnancy that utilize both the theory of planned behavior and prototype/willingness model to target determinants of intentions.

Background: Healthy eating behaviours are important for physical and mental well-being and developing healthy eating behaviours early in life is important. As parents are the main providers of preschool children's food the main objective of this study was to use the theory of planned behaviour, expanded to include habit and past behaviour, to predict parents' healthy feeding intention and behaviour., Methods: Theory of planned behaviour, habit strength, and past behaviour were reported at baseline by 443 mothers. One week later, 235 mothers completed a healthy feeding questionnaire on the eating behaviours of their 2-4 year old child. Data were analysed using hierarchical regression analyses to predict parent's general healthy feeding behaviour, and five sub-behaviours: parents' perceptions of their child's fruit and vegetable consumption, healthy and unhealthy snacking behaviour, as well as healthy and unhealthy drinking behaviour., Results: Intention, perceived behavioural control, habit strength and past behaviour were all positively associated with parents' general healthy feeding (47% explained variance). Perceived behavioural control was the only variable positively associated with mothers' perception of their child's fruit and vegetable consumption and unhealthy snacking behaviour. The theory did not explain the other behaviours. Moreover, habit strength only strengthened the intention-behaviour link for fruit and vegetable consumption and child's age was only positively associated with the mothers' perception of their child's unhealthy snacking behaviour., Discussion: The findings suggest important differences in the predictors of different feeding behaviours that can provide direction for future intervention development., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Vitamin and mineral supplement use is increasing worldwide. As evidence of the effects of these practices are equivocal at best, it is important to determine why individuals engage in vitamin and mineral supplement use through the application of a theoretical framework. The aim of this study was to employ temporal self-regulation theory (TST) to establish the determinants of supplement use. A cross-sectional design was used with a sample of 121 individuals who consume vitamins or minerals as dietary supplements. Hierarchical regression analyses were conducted to determine the influence of intention, habit, self-control, and the interaction between intention and habit and self-control on the frequency of supplement use. The model accounted for a significant proportion of variance in behaviour (R 2  = .44) with intention and habit significantly related to supplement use. Self-control moderated the relationship between intention and behaviour indicating that intention was not related to behaviour when self-control was low. The TST model offers a satisfactory account of supplement use and provides avenues for interventions aimed at increasing safe and beneficial supplement use and decreasing potentially harmful supplement use.

Objective: Examine the roles of action and coping planning on the intention-behaviour relationship for mothers' decisions for their young children's dietary behaviours., Design: Prospective design with two waves of data collection, one week apart., Main Outcome Measures: Mothers (N = 197, M age  = 34.39, SD = 5.65) of children aged 2-3 years completed a main questionnaire assessing planning constructs and intentions, and a one-week follow-up of the target behaviours - 'healthy eating' and 'discretionary choices'., Results: Intention was the strongest predictor of behaviour for both dietary behaviours. For healthy eating, intention moderated the indirect relationship between intention-behaviour via planning; coping planning was less important when intention was strong. Further, intention was not a direct predictor of behaviour when intention was relatively low. Action planning was not a direct predictor of either behaviour after accounting for intention and coping planning; action planning on behaviour was mediated by coping planning (only for healthy eating). Intention was not a direct predictor of coping planning; intention on coping planning was mediated by action planning. Neither type of planning predicted discretionary choices., Conclusion: Current findings contribute novel information on the mechanisms underpinning the effect of action and coping planning on the intention-behaviour relationship.

Objective: Many pregnant women do not adhere to physical activity and dietary recommendations. Research investigating what psychological processes might predict physical activity and healthy eating (fruit and vegetable consumption) during pregnancy is scant. We explored the role of intention, habit, and perceived behavioral control as predictors of physical activity and healthy eating., Methods: Pregnant women (N = 195, Mage = 30.17, SDage = 4.46) completed questionnaires at 2 time points. At Time 1, participants completed measures of intention, habit, and perceived behavioral control. At Time 2, participants reported on their behavior (physical activity and healthy eating) within the intervening week. Regression analysis determined whether Time 1 variables predicted behavior at Time 2. Interaction terms also were tested., Results: Final regression models indicated that only intention and habit explained significant variance in physical activity, whereas habit and the interaction between intention and habit explained significant variance in healthy eating. Simple slopes analysis indicated that the relationship between intention and healthy eating behavior was only significant at high levels of habit., Conclusions: Findings highlight the influence of habit on behavior and suggest that automaticity interventions may be useful in changing health behaviors during pregnancy.

Objectives: First generation students transitioning to college experience specific challenges that impact on their engagement in physical activity. Furthermore, this population experiences a context disruption that provides a unique opportunity to examine whether intention and habit predict physical activity. The aim of the current research was to determine the efficacy of the theory of planned behavior in the prediction of intention and behavior within this population, and to determine whether habit contributes to the prediction of physical activity., Methods: In this observational study, a convenience sample of first generation college students (N = 101) completed measures of theory of planned behavior variables and habit strength at Time 1, and one week later reported physical activity., Results: The theory of planned behavior was partially supported in this context, as intention was the only significant predictor of behavior. Habit strength accounted for additional variance in physical activity but did not moderate the relationship between intention and behavior. The hypothesized model accounted for 46.9% of the variance in physical activity, and intention (β = .455) and habit (β = .364) were significant predictors., Conclusions: Intention and habit exert independent effects on physical activity within this population, and are both suitable targets for intervention.

The prototype willingness model (PWM) was designed to extend expectancy-value models of health behaviour by also including a heuristic, or social reactive pathway, to better explain health-risk behaviours in adolescents and young adults. The pathway includes prototype, i.e., images of a typical person who engages in a behaviour, and willingness to engage in behaviour. The current study describes a meta-analysis of predictive research using the PWM and explores the role of the heuristic pathway and intentions in predicting behaviour. Eighty-one studies met inclusion criteria. Overall, the PWM was supported and explained 20.5% of the variance in behaviour. Willingness explained 4.9% of the variance in behaviour over and above intention, although intention tended to be more strongly related to behaviour than was willingness. The strength of the PWM relationships tended to vary according to the behaviour being tested, with alcohol consumption being the behaviour best explained. Age was also an important moderator, and, as expected, PWM behaviour was best accounted for within adolescent samples. Results were heterogeneous even after moderators were taken into consideration. This meta-analysis provides support for the PWM and may be used to inform future interventions that can be tailored for at-risk populations.

Objective: To determine whether changes in theory of planned behaviour (TPB) constructs could predict intention and gluten-free diet (GFD) adherence following participation in an online theory-based intervention designed to improve adherence in coeliac disease., Design: Theory-based process evaluation of the mechanisms of change over the course of a six-week online intervention. Measures of GFD adherence and TPB variables were administered at baseline and follow-up (immediate post-intervention: n = 74; three-month: n = 68; six-month: n = 65). Hierarchical regression analyses using residualised change scores were conducted at each time point (dependent variables: intention and adherence)., Results: Baseline intention and GFD adherence were the strongest predictors of follow-up intention and adherence, respectively. Change in attitude accounted for significant variance in intention. Change in intention accounted for significant variance in GFD adherence immediately post-intervention; by the six-month follow-up change in perceived behavioural control was the stronger predictor., Conclusions: Partial support for the hypotheses suggests that, for certain behaviours, the TPB may be relevant in explaining the mechanism of action responsible for changes in intention and behaviour following participation in a behaviour change intervention. Additional predictive pathways are also likely to exist and, in the area of GFD adherence, may include habit strength and actual behavioural control.

The aim of this study was to explore whether two aspects of self-regulation (impulsivity and temporal orientation) could reduce the intention–behaviour gap for two dietary behaviours: fruit and vegetable consumption and saturated fat consumption. Australian undergraduate students (N = 154) completed questionnaires (the Barratt impulsiveness scale and the consideration of future consequences scale) and intention measures, and 1 week later behaviour was measured using the Block rapid food screener. After controlling for demographics, intention was associated with fruit and vegetable consumption, but the self-regulation measures did not further improve the variance accounted for. For saturated fat, gender was associated with consumption, such that males tended to consume more saturated fat. Intention was significantly associated with consumption, and impulsivity further improved the model such that those who were more impulsive tended to consume more saturated fat. These findings suggest that health protective and health risk behaviours, such as those investigated in the current study, may have different determinants.

Objectives: The aim of the current study is to explore the predictive utility of the temporal self-regulation theory (TST) for maintaining a healthy lifestyle (Hall & Fong, 2007, Health Psychology Review, 1, 6). According to TST, the influence of intention, self-regulation, and behavioural prepotency differs depending on the environmental context in which the behaviour is performed. This study examined the influence of perceptions about the supportiveness of the environmental context on TST-related factors., Design: Temporal self-regulation theory was tested using a prospective design with a 1-week follow-up., Methods: One hundred and fifty-two undergraduates were administered three executive functioning tasks and an online questionnaire regarding their intentions to maintain a healthy lifestyle, environmental responsiveness, and previous behaviour. One week later, they completed a follow-up questionnaire., Results: Participants who were supported by the environment were significantly more likely to maintain a healthy lifestyle than those distracted by the environment. Behavioural prepotency was significantly predictive of behaviour performance for 'supported' participants. Behavioural prepotency, planning, and response inhibition were significantly predictive of 'unsupported' participants' behaviour., Conclusions: These findings provided preliminary support for the use of TST for the prediction of healthy lifestyle behaviour. Importantly, this study provided support for the contention that the influence of TST-related factors would vary according to the perceived supportiveness of the environment. These findings suggest that environmental responsiveness may be an important determinant to close the intention-behaviour gap for maintaining a healthy lifestyle., (© 2012 The British Psychological Society.)

The aim of this study was to investigate whether the theory of planned behaviour (TPB) with the addition of risk awareness could predict breakfast consumption in a sample of adolescents from the UK and Australia. It was hypothesised that the TPB variables of attitudes, subjective norm and perceived behavioural control (PBC) would significantly predict intentions, and that inclusion of risk perception would increase the proportion of variance explained. Secondly it was hypothesised that intention and PBC would predict behaviour. Participants were recruited from secondary schools in Australia and the UK. A total of 613 participants completed the study (448 females, 165 males; mean=14years ±1.1). The TPB predicted 42.2% of the variance in intentions to eat breakfast. All variables significantly predicted intention with PBC as the strongest component. The addition of risk made a small but significant contribution to the prediction of intention. Together intention and PBC predicted 57.8% of the variance in breakfast consumption., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: Two studies were conducted with the aim of closing the intention-behaviour gap for sunscreen use and sun protection behaviours by examining the influence of self-regulatory capacity on the prediction of sunscreen use (Study 1) and self-regulatory capacity and habit on sun protection behaviours (Study 2)., Design: Studies were conducted online. Participants completed questionnaires and cognitive measures and then reported behaviour one week later., Main Outcome Measures: Questionnaires measuring intention and cognitive tasks measuring self-regulatory capacity were administered to 209 university students. One week later, participants reported behaviour. In Study 2, questionnaires measuring intentions, and habit and cognitive tasks measuring self-regulatory capacity were administered to 178 university students who reported behaviour one week later., Results: Intention accounted for 7.1% of variance in sunscreen use, no measures of self-regulation accounted for variance in behaviour or moderated the intention-behaviour gap (Study 1). Intention, self-regulatory capacity and habit accounted for 56.1% of variance in sun protection behaviours (Study 2). Intention, self-regulatory ability and habit predicted behaviour, while habit moderated the intention-behaviour gap., Conclusion: Interventions aimed at increasing sun protection behaviours should take into account level of intention, self-regulatory capacity and habit. Individuals may benefit from habit formation strategies and self-regulation training.

An appropriate theoretical framework may be useful for guiding the development of physical activity interventions. This review investigates the effectiveness of the protection motivation theory (PMT), a model based on the cognitive mediation processes of behavioral change, in the prediction and promotion of physical activity participation. A literature search was conducted using the databases MEDLINE, PsycINFO, PubMed, and Web of Science, and a manual search was conducted on relevant reference lists. Studies were included if they tested or applied the PMT, measured physical activity, and sampled from healthy populations. A total of 20 studies were reviewed, grouped into four design categories: prediction, stage discrimination, experimental manipulation, and intervention. The results indicated that the PMT's coping appraisal construct of self-efficacy generally appears to be the most effective in predicting and promoting physical activity participation. In conclusion, the PMT shows some promise, however, there are still substantial gaps in the evidence.

Consumption of saturated fat (SF) is associated with obesity, cardiovascular disease and cancer; which are among the leading causes of death in Australia and worldwide. A causal relationship between subjective well-being and positive health outcomes has been established, although few studies have specifically focused on health-enhancing or health-risk behaviours. The aim of this research was to develop an improved understanding of the processes underlying SF consumption by exploring the relationship between subjective well-being and SF consumption, within the Theory of Planned Behaviour framework. Questionnaires related to the TPB variables, subjective well-being and SF intake were administered online to 96 participants. Perceived behavioural control (PBC) was found to be a significant predictor of intention to limit SF intake. Intention and PBC accounted for 25% of variance in behaviour; with PBC the only significant predictor of SF consumption. While subjective well-being variables were not significant unique predictors of SF consumption, these variables contributed an additional 2% to the prediction of behaviour, and this model was significant. The addition of subjective well-being to the TPB is novel and the results partially support the potential of subjective well-being in improving the prediction of this health-risk behaviour. Future research will need to replicate and extend these preliminary findings before such a framework may be translated into an intervention targeting SF consumption.

Background: Human papillomavirus (HPV) is a common sexually transmitted infection (STI) known to cause cervical cancer and genital warts. However, making the genital warts aspect explicit may reduce HPV vaccination intention and behaviour due to perceived stigma associated with STIs., Purpose: This study investigated the effect of differential information framing on intention to receive the HPV vaccine using the Theory of Planned Behaviour (TPB) and moral norm construct., Method: Female university students were randomised to receive a fact sheet describing the HPV vaccine as: (1) preventing cervical cancer only (n = 81); or (2) preventing both cervical cancer and genital warts (n = 78). A 2-month follow-up investigated relationships between vaccination intention and actual behaviour., Results: No effect of information framing was detected on intention to receive the HPV vaccine, or vaccine uptake behaviour at 2-month follow-up. The traditional TPB components predicted 54% of the variance in vaccination intention (F (3,155) = 61.580, p < 0.001), and moral norm explained an additional 6.2%. Intention predicted a significant but relatively small proportion of variation (9.6%) in behaviour., Conclusion: The HPV vaccine does not seem to be associated with perceptions of stigma related to genital warts, and has broad acceptance among a female university population. This study demonstrates that TPB is suited to investigate HPV vaccination, and has helped clarify the role of moral norm within the TPB.

This study evaluated the efficacy of a theory of planned behaviour (TPB) based intervention to increase fruit and vegetable consumption. The extent to which fruit and vegetable consumption and change in intake could be explained by the TPB was also examined. Participants were randomly assigned to two levels of intervention frequency matched for intervention content (low frequency n=92, high frequency n=102). Participants received TPB-based email messages designed to increase fruit and vegetable consumption, messages targeted attitude, subjective norm and perceived behavioural control (PBC). Baseline and post-intervention measures of TPB variables and behaviour were collected. Across the entire study cohort, fruit and vegetable consumption increased by 0.83 servings/day between baseline and follow-up. Intention, attitude, subjective norm and PBC also increased (p<.05). The TPB successfully modelled fruit and vegetable consumption at both time points but not behaviour change. The increase of fruit and vegetable consumption is a promising preliminary finding for those primarily interested in increasing fruit and vegetable consumption. However, those interested in theory development may have concerns about the use of this model to explain behaviour change in this context. More high quality experimental tests of the theory are needed to confirm this result., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The current study investigated whether binge drinking in female undergraduates could be reduced by the mere measurement effect (MME), and by altering binge drinker prototypes from the prototype willingness model (PWM). Whether willingness added to the theory of planned behaviour (TPB) was also explored. Female undergraduates aged 17-25 (N=122) were randomly allocated to a prototype manipulation, mere measurement, or control group, and completed two online questionnaires separated by 14-21 days. Controlling for past behaviour, MME group consumed less alcohol than the control group, and this effect was more extreme for those who previously consumed more alcohol. However, the prototype manipulation had no effect. The TPB variables were predictive of intentions and behaviour, but willingness was not. Despite limitations, the MME could be utilised to reduce binge drinking in female undergraduates. The TPB appears to model binge drinking in female undergraduates better than the PWM, implying that binge drinking can be a reasoned behaviour., (Copyright © 2011 Elsevier Ltd. All rights reserved.)