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17/12/15
1
An Integrated Behaviour-Change Model for Physical Activity
Martin Hagger Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology
Curtin University, Perth, Australia
Overview
n Why is theory important? n Integrated behaviour Change Model
– Motivation and intention – Volition and planning – Implicit and automatic processes
n Translation and application n Summary and the way forward
n Explanatory systems – Personal and social factors (‘what’) – Mechanisms responsible (‘how’) – Targets for intervention
n Pose questions/hypotheses n Permits disconfirmation, rejection n Avoids ‘hit and hope’ or ‘variable fishing
expeditions’
Why is theory important? Answering the ‘what’ and ‘how’ questions
Examples of Theories n Self-efficacy/social cognitive theory (Bandura, 1963) n Health belief model (Becker, 1974) n Protection motivation theory (Rogers, 1975) n Theory of interpersonal behaviour (1977) n Theory of reasoned action (Fishbein & Ajzen, 1980) n Self-determination theory (Deci, 1980) n Transtheoretical model (Prochaska & DiClemente, 1982) n Personality systems interaction theory (Kuhl, 1984) n Theory of planned behaviour (Ajzen, 1985) n Self-regulation theory (Bagozzi, 1990) n Health action process approach (Schwarzer, 1992) n The I-change model (De Vries et al., 1998) n Model of goal-directed behaviour (Perugini & Conner, 2000) Hagger, M. S., & Chatzisarantis, N. L. D. (2014). An integrated behavior-change model for
physical activity. Exercise and Sport Sciences Reviews, 42, 62-69.
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The Integrated Behaviour Change (IBC) Model
Source: Hagger & Chatzisarantis, N. L. D. (2014). An Integrated Behaviour-Change Model for Physical Activity. Exercise and Sports Sciences Reviews.
0.12
-0.38
Action Planning
Implicit motivation
Implicit attitudes Attitudes
Perceived Behavioural
Control
Intrinsic Motivation
Subjective Norms Intention Exercise
Behaviour
Motivational
Implicit
Volitional
The Integrated Behaviour Change (IBC) Model
Source: Hagger & Chatzisarantis, N. L. D. (2014). An Integrated Behaviour-Change Model for Physical Activity. Exercise and Sports Sciences Reviews.
0.12
-0.38
Action Planning
Implicit motivation
Implicit attitudes Attitudes
Perceived Behavioural
Control
Intrinsic Motivation
Subjective Norms Intention Exercise
Behaviour
Motivational
Perceived Control
Attitudes
Subjective Norms Intentions Exercise
Behaviour
Theories of Reasoned Action and Planned Behaviour General orientation towards health behaviour
“good-bad”,“useful-useless”,“harmful-beneficial”
Stated volitional plans “I plan…/I intend.../ I expect...”
Evaluation of capacities/barriers/abilities “self-efficacy”/”easy-difficult”
Evaluation of others’ evaluation “my parents think…”,”my friends think…”
n Meta-analysis of studies on exercise adopting TPB
n Path analysis based on averaged corrected correlations
Meta-analysis
Source: Hagger, Chatzisarantis and Biddle (2002)
Perceived Control
Attitudes
Subjective Norms Intentions Behaviour
.40*
.36*
.33*
.09*
Source: Hagger, Chatzisarantis and Biddle (2002)
Theories of Reasoned Action and Planned Behaviour
The theory of planned behaviour: Problems and solutions
c.f. Head & Noar (2014); Noar & Head (2014) Sniehotta (2014) Rhodes (2014); Rhodes & de Bruin (2013)
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Theory of Planned Behaviour and Self-Determination Theory
• What are the origins of constructs like attitudes and perceived control?
• Can individual differences and needs-based motives predict beliefs from TPB?
• Self-determination theory may have the ‘key’
Theory of Planned Behaviour and Self-Determination Theory
• Can SDT assist in explaining the origin of TPB constructs?
“Cognitive theories begin their analysis [of behaviour] with a cognitive representation of some future desired state. What is missing, of course, is a consideration of the conditions of the organism that make these future states desired”
(Deci & Ryan, 1985, p. 228)
For choice, enjoyment, pleasure & fun; not reinforced
For external reinforcement such as rewards or avoiding punishment.
For avoiding guilt or gaining externally referenced approval
For personal values like learning new skills, feelings of competence & satisfaction
Defining Features
SELF-DETERMINED MOTIVES (‘INTRINSIC’)
NON-SELF-DETERMINED MOTIVES (‘EXTRINSIC’)
Intrinsic Motivation
Identification
Introjection
External regulation
Type of Motivation
Self-Determination Theory Theory of Planned Behaviour and Self-Determination Theory
• People distinguish between ‘self-determined’ and ‘non self-determined’ beliefs
• Classification analysis: • Appearance-related reasons = non self-determined (extrinsic)
• Other reasons classified as self-determined (intrinsic)
• Significant correlation (r = .27) between self-determined motivation and dichotomous ‘reasons’ variable
Source: McLachlan & Hagger (2011) Research Quarterly in Exercise & Sport McLachlan & Hagger (2011) Journal of Sport & Exercise Psychology
.63
.56
.23
.50
.35
Sources: Hagger et al. (2006) Personality & Social Psychology Bulletin Hagger & Chatzisarantis (2009) British Journal of Health Psychology
.07 .61
Theory of Planned behaviour and Self-Determination Theory
.06
Self-determined motivation
Intention Behaviour
Attitude
Social Norms
Perceived Control
The Integrated Behaviour Change (IBC) Model
Source: Hagger & Chatzisarantis, N. L. D. (2014). An Integrated Behaviour-Change Model for Physical Activity. Exercise and Sports Sciences Reviews.
0.12
-0.38
Action Planning
Implicit motivation
Implicit attitudes Attitudes
Perceived Behavioural
Control
Intrinsic Motivation
Subjective Norms Intention Exercise
Behaviour
Volitional Motivational
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n Motivation may be a necessary but not sufficient condition for behaviour
n Many people state an intention, motive or desire to participate in exercise….
….but fail miserably to do so! n Intention-behaviour ‘gap’
Intention-behaviour relations Motivation is not enough
Exercise Behaviour Intention
.36
Imperfect!
Inclined Abstainers Unsuccessful intenders
Inclined Abstainers Unsuccessful intenders
Successful
Unsuccessful
Intender
Successful Intenders
(42%)
Unsuccessful Intenders
(36%)
Non-intender
Successful Non-intenders
(2%)
Unsuccessful Non-intenders
(21%)
Behaviour
Intention
Source: Rhodes & de Bruin (2013)
Filling the ‘the gap’ Planning and intention-behaviour relations
Sources: Heckhausen & Gollwitzer (1987) Schwarzer (2008)
■ Dual-phase models of action: motivational vs. volitional
■ Gollwitzer et al. (1999) Implementation intentions: “Strong effects of simple plans”
■ How do we furnish our intentions with actions to achieve the goals?
■ “I intend to do behaviour X will help me to achieve Y” ■ “If condition Z arises I will do behaviour X” ■ This does not change intentions, but strengthens the
intention-behaviour relationship
Filling the ‘the gap’ Planning and implementation intentions
You are more likely to exercise for at least 30 minutes per day if you say when (‘if…’) and where (‘then…’) you will exercise and stick to your plan. In the boxes below write down when and where you plan to exercise in the next week:
What Does an Implementation Intention ‘Look’ Like?
Typically use a ‘pen and paper’ delivery:
….the clock strikes 12:30pm for lunch…
….I will pick up my gym bag and go to the fitness centre
If…
then…
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Implementation Intentions Strong effects of simple plans
Sources: Gollwitzer & Sheeran (2006) Hagger & Luszczynska (2014)
The Integrated Behaviour Change (IBC) Model
Source: Hagger & Chatzisarantis, N. L. D. (2014). An Integrated Behaviour-Change Model for Physical Activity. Exercise and Sports Sciences Reviews.
0.12
-0.38
Action Planning
Implicit motivation
Implicit attitudes Attitudes
Perceived Behavioural
Control
Intrinsic Motivation
Subjective Norms Intention Exercise
Behaviour
Volitional Motivational
Implicit
The problem of past behaviour, habit and behaviour ‘change’
Behaviour Past Behaviour
c.f. Oullette & Wood (1998) Verplanken & Orbell (2003) Gardner (2015) Hagger, Rebar, Mullan, Lipp & Chatzisarantis (2015)
x
Usually a strong effect
Past Behaviour and Behaviour Change
Perceived Control
Attitudes
Subjective Norms
Intentions Behaviour
.40*
.36*
.33*
.09*
Source: Hagger, Chatzisarantis and Biddle (2002)
Past Behaviour
23*
.05*
.37*
.39*
.55*
.05*
.20*
.08*
.28*
Past behaviour, habit, and explaining behaviour change
• Theories need to move beyond mere prediction – focus on ‘behaviour change’
• Theories need to explain past behaviour-future behaviour relations
• Need to make a distinction between past behaviour and ‘habit’ or ‘automatic’ processes
• How do ‘habits’ form?
Habit, past behaviour, and explaining change
Process model of habit development
Exercise Behaviour Intention
Habit
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Habit, past behaviour, and explaining change
Process model of habit development
Exercise Behaviour Intention
Habit Exercise
Behaviour Intention
Habit Exercise
Behaviour Intention
Habit
1.
2.
3.
Source: Rebar & Hagger (2015) in submission
Implicitly Held Attitudes and Motivation
• Relatively recent addition to research in social cognition/motivation (e.g., Greenwald et al. 2002)
• Individuals hold beliefs and motives that are: • Not accessible consciously (Fazio, 1990)
• Stored as ‘knowledge structures’ – schema (Henderson, Hagger, & Orbell, 2007)
• Made active or salient by context or ‘cues’ (e.g., Bargh & Chartrand, 1999)
• Impact action beyond awareness (e.g., Bargh, 1990) • Lighting a cigarette, decision to exercise
The Implicit Association Task
Good Bad +
Activity Attribute Construct
Evil Exercise Happy
The Implicit Association Task
Good Bad
Evil Exercise Happy
+ Activity
n Medium-sized effects of both forms of attitudes
n Correlation between two components of attitudes low
Explicit and Implicit Attitudes Predict Physical Activity
Source: Calitri, R., Lowe, R., Eves, F. F., & Bennett, P. (2009). Associations between visual attention, implicit and explicit attitude and behaviour for physical activity. Psychology and Health, 24, 1105–1123.
The Implicit Association Task
Me Not me Intrinsic Extrinsic
Self Choice Pressure Them
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.73
.37
Sources: Harris & Hagger (2010) Keatley, Clarke & Hagger (2012) Psychology & Health Keetley, Clarke & Hagger (2013) British Journal of Health Psychology
.49
Implicit and Explicit Motives on Physical Activity
Implicit (Automatic)
Motives
Intention Behaviour
Intrinsic Motivation
Extrinsic Motivation .17
The Integrated Behaviour Change (IBC) Model
Source: Hagger & Chatzisarantis, N. L. D. (2014). An Integrated Behaviour-Change Model for Physical Activity. Exercise and Sports Sciences Reviews.
0.12
-0.38
Action Planning
Implicit motivation
Implicit attitudes Attitudes
Perceived Behavioural
Control
Intrinsic Motivation
Subjective Norms Intention Exercise
Behaviour
Volitional Motivational
Implicit
Intervention targets!
Promoting Physical Activity Behaviour Utilizing ‘existing networks’
Source: Chatzisarantis & Hagger (2009). Psychology and Health. See also Hagger & Chatzisarantis (2015). Review of Educational Research.
Behaviour
Autonomy Support
(Intervention)
Intrinsic Motivation
Attitude
Intention
TPB (Intervention)
Perceived Autonomy Support
(Teacher)
.29
.40
.20
.20
.18
.29
Perceived Control
.23
.69
Sources: Teixeira et al. (2015). Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators. BMC Medicine, 13, 84. doi:10.1186/s12916-015-0323-6
Theoretical mediators of obesity interventions
Intervention Behaviour
Controlled Motivation
Autonomous Motivation
Self- efficacy
Coping
Outcome Expectancies
– (0%)
+ (0%)
+ (83%)
+ (67%)
+ (0%)
The Integrated Behaviour Change (IBC) Model
Source: Hagger & Chatzisarantis, N. L. D. (2014). An Integrated Behaviour-Change Model for Physical Activity. Exercise and Sports Sciences Reviews.
0.12
-0.38
Action Planning
Implicit motivation
Implicit attitudes Attitudes
Perceived Behavioural
Control
Intrinsic Motivation
Subjective Norms Intention Health
Behaviour
Intervention targets!
Combining Pre- and Post-Decisional Strategies
Decisional Balance
No Decisional Balance
Implementation Intention
Combined
Imp. Int.
Only No Implementation Intention
Dec. Bal.
Only
Control
Decisional balance
Implementation Intention
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8
Results
8
9
10
11
12
13
Decisional balance No decisionalbalance
ImplementationIntention
NoImplementationIntention
Phy
sica
l act
ivity
beh
avio
ur
Source: Prestwich, A., Lawton, R., & Conner, M. (2003). The use of implementation intentions and the decision balance sheet in promoting exercise behaviour. Psychology and Health, 18, 707-721. doi:10.1080/08870440310001594493.
The Integrated Behaviour Change (IBC) Model
Source: Hagger & Chatzisarantis, N. L. D. (2014). An Integrated Behaviour-Change Model for Physical Activity. Exercise and Sports Sciences Reviews.
0.12
-0.38
Action Planning
Implicit motivation
Implicit attitudes Attitudes
Perceived Behavioural
Control
Intrinsic Motivation
Subjective Norms Intention Health
Behaviour
Intervention target?
n Design: Prime condition: diet vs. ‘fattening’ food vs. control n DV1: Recognising ‘diet’ in decision task n DV2: Choosing healthy over unhealthy ‘parting gift’
Priming implicit goals and attitudes
Source: Fishbach, A., Friedman, R. S., & Kruglanski, A. W. (2003). Leading us not unto temptation: Momentary allurements elicit overriding goal activation. Journal of Personality & Social Psychology.
Rea
ctio
n tim
e (m
s)
480 500 520 540 560 580 600 620
1 2 3 Fattening Diet Control
Hea
lthy
optio
n ch
oice
(%)
0
20
40
60
80
100
1 2 3 Fattening Diet Control
Summary • Theory is important to inform knowledge on
predictors, mechanisms and processes of behaviour change
• Integrated behaviour change model proposes three processes leading to health behaviour • Motivational • Volitional • Implicit
• Model can be used to explain behaviour change • Model can be used to guide interventions
Limitations and the way forward
n More evidence for integrated model is required (Hagger et al., 2009; Hagger & Chatzisarantis, 2015)
n Need to explicitly incorporate process of habit formation
n No role for emotion and affecting responses n Model may apply to other health behaviours n May be a specific form of a ‘tri-process’
framework (Hamilton & Hagger, in preparation)
n More experimental and intervention research needed (Mullan, Todd, Chatzisarantis, & Hagger, 2013)
Thanks n Stuart J. H. Biddle n Nikos L. D. Chatzisarantis n Sheina Orbell n Kyra Hamilton n Derwin K. C. Chan n Amanda Rebar n Adam Lonsdale
n Barbara Mullan n Jemma Harris n David A. Keatley n Sarah McLachlan n Aleks Luszczynska n Ottmar Lipp
Funding n Health Collaborative Research Network n AERC