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Abstract: Long-term effects of a self-management intervention on physical activity and depressive symptoms were studied in 198 men and women after cardiac rehabilitation in Germany. Participants were randomly assigned to either an intervention group or a standard-care control group. The intervention group received brief self-regulatory skills training that focused on exercise planning strategies. Four and 12 months later, physical exercise levels were half a standard deviation higher in the intervention group. Depressive symptoms 12 months after discharge were almost half a standard deviation lower in the intervention group than in the control group. Mediation analyses were performed to study the potential mechanism that accounted for the reduction in depression. Perceived attainment of exercise goals, but not physical exercise itself, emerged as a mediator between the intervention and the reduction of depressive symptoms. As such attainment of personal goals appears to be of particular importance for lowering depressive symptoms during health–behavior change. Thus, self-management strategies to help patients attain their goals should be part of rehabilitation programs. [Copyright &y& Elsevier]

Objectives: Xeroderma pigmentosum (XP) is an extremely rare genetic disorder (approximately 100 known cases in the United Kingdom), where DNA damage caused by ultraviolet radiation in daylight cannot be repaired. Adherence to photoprotection is essential to prevent skin cancer. We investigated psychological correlates of photoprotection in the XP population of Western Europe and the United States., Design: Cross-sectional survey of adults with XP and caregivers of patients <16 years and those with cognitive impairment in the United Kingdom, Germany, the United States, and France (n = 156)., Methods: Photoprotection activities to protect the face and body when outdoors; avoidance of going outside during daylight hours; intention; self-efficacy; and social support were assessed using measures developed for this study. Participants answered questions about their illness representations of XP (BIPQ); beliefs about photoprotection (BMQ); automaticity (i.e., without conscious effort) (SRBAI); clinical and demographic characteristics. Ordinal logistic regressions determined factors associated with photoprotection., Results: One third did not achieve optimal face photoprotection. After controlling for demographic and clinical factors, modifiable correlates of higher photoprotection included greater perceived control of XP, stronger beliefs in necessity and effectiveness of photoprotection, and higher intention. Avoidance of going outside was associated with greater photoprotection concerns, more serious illness consequences, and higher XP-related distress. Greater automaticity and higher self-efficacy were associated with better protection across all outcomes., Conclusions: Approximately half of all known cases across three European countries participated. Identified modifiable predictors of photoprotection may be targeted by interventions to reduce the incidence of skin cancers in the immediate future, when a treatment breakthrough is unlikely. Statement of contribution What is already known on this subject? Adherence to photoprotection in other populations at elevated risk from skin cancer is poor; however, the level in XP is unknown. Research across chronic conditions shows that adherence to treatment and lifestyle recommendations are influenced by illness perceptions, self-efficacy, and treatment beliefs. Studies on photoprotection conducted with the general population have found that perceived risk, perceptions of ultraviolet radiation (UVR) protection, self-efficacy for the behaviour, and automaticity (behaviours that are enacted with little conscious awareness) are related to better photoprotection. What does this study add? This is the first international survey to examine adherence and its correlates in people with XP (an under-researched group at very high risk of fatal skin cancer). Adherence varies and at least one third have potential for improvement. Perceptions about XP, photoprotection beliefs, self-efficacy, intention, and automaticity were associated with photoprotection of the face and body when outdoors. Negative emotional representations of XP were associated with avoidance of going outside during daylight hours., (© 2019 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Prevailing social cognition models consider behavioural intentions as immediate precursors of actions. This view ignores the role of more proximal self-regulatory processes, such as action control. The latter emerges after an intention has been formed and is supposed to maintain the level of intentions over time and to translate them into action. Three facets of action control were examined in terms of their predictive power for changes in intentions and for physical exercise: (a) awareness of standards, (b) self-monitoring, and (c) self-regulatory effort. A parsimonious 6-item instrument was administered to 122 cardiac patients at six weekly measurement points in time following rehabilitation. A distinction was made between the level of action control and the degree of change in action control, applying a latent growth model. While awareness of standards remained stable, the other two facets exhibited a linear change over the six-week period. Level and change were distinct predictors of physical exercise and changes in intentions. These findings emphasize the importance of self-regulatory mechanisms in the first weeks of trying to overcome a sedentary lifestyle. Action control may be a promising construct to narrow the intention-behaviour gap.

Objectives: Patterns of changes in social-cognitive variables were investigated in order to test selected stages of the precaution adoption process model (PAPM). It was hypothesized that non-linear trends (discontinuity patterns) in perceived vulnerability, positive and negative outcome expectancies, procrastination, and self-efficacy might be observed across the stages., Design: Cross-sectional data from 808 respondents were employed., Method: Questionnaire data were collected in an on-line study on meat consumption during a livestock epidemic in Germany. Polynomial trends and analyses of variance with post-hoc-contrasts were used to examine the patterns of change., Results: Discontinuity patterns were found for perceived vulnerability, negative outcome expectancies, and procrastination. The data provided partial support for discontinuity patterns in self-efficacy. Continuity patterns were found for positive outcome expectancies., Conclusions: Results provide support for a stage model rather than a pseudo-stage model.