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1.  Prediction of Sport Adherence Through the Influence of Autonomy-Supportive Coaching Among Spanish Adolescent Athletes 
The purpose of this study was to test a motivational model of the coach-athlete relationship, based on self-determination theory and on the hierarchical model of intrinsic and extrinsic motivation. The sample comprised of 608 athletes (ages of 12-17 years) completed the following measures: interest in athlete's input, praise for autonomous behavior, perceived autonomy, intrinsic motivation, and the intention to be physically active. Structural equation modeling results demonstrated that interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Finally, intrinsic motivation predicted the intention to be physically active in the future. The results are discussed in relation to the importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Further, the results provide information related to the possible objectives of future interventions for the education of coaches, with the goal of providing them with tools and strategies to favor the development of intrinsic motivation among their athletes. In conclusion, the climate of autonomy support created by the coach can predict the autonomy perceived by the athletes which predicts the intrinsic motivation experienced by the athletes, and therefore, their adherence to athletic practice.
Key pointsImportance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes.Interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation.Intrinsic motivation predicted the intention to be physically active in the future.
PMCID: PMC3737975  PMID: 24149380
Autonomy support; perceived autonomy; intrinsic motivation; sport adherence.
2.  Key Beliefs for Targeted Interventions to Increase Physical Activity in Children: Analyzing Data from an Extended Version of the Theory of Planned Behaviour 
Given the high prevalence of overweight and low levels of physical activity among children, a better understanding of physical activity behaviour is an important step in intervention planning. This study, based on the theory of planned behaviour, was conducted among 313 fifth graders and their parents. Children completed a computer-based questionnaire to evaluate theoretical constructs and behaviour. Additional information was obtained from parents by means of a questionnaire. Correlates of children's physical activity were intention and self-identity. Determinants of intention were self-efficacy, self-identity, and attitude. Parental variables were mediated through cognitions. Among girls, practicing sedentary activities was an additional negative determinant of intention. Key beliefs of boys and girls were related to time management and difficulties associated with physical activity. For girls, social identification as an active girl was another important belief related to positive intention. This study provides theory-based information for the development of more effective interventions aimed at promoting physical activity among children.
PMCID: PMC2905955  PMID: 20652005
3.  Motivational Profiles in Physical Education and Their Relation to the Theory of Planned Behavior 
The aim of this study was to establish motivational profiles for doing physical activity according to the variables from the theory of planned action in a sample of 698 students aged 14 to 16. The instruments used were the Questionnaire of Behavioral Regulation in Sport (BRQ-R) and the Questionnaire of the Theory of Planned Behavior (TCP). Cluster analysis revealed two motivational profiles: a “self-determined ”profile with high scores in intrinsic motivation and low scores in extrinsic motivation and amotivation, and a “non self- determined ”profile with low scores in intrinsic motivation and high scores in extrinsic motivation and amotivation. Positive significant differences in attitudes, norms, and intent to control were found for the self-determined profile related to “non self-determined ”profile.
Key PointsA “self-determined ”profile was found with higher scores for the four types of intrinsic motivations (general, knowledge, stimulation and achievement) and identified regulation than for introjected and external regulation.A “non self-determined ”profile was found with higher scores for external, introjected regulation and amotivation than for the four types of intrinsic motivation (general, knowledge, stimulation and achievement).In the context of the “non self-determined profile ”we could encourage programs that adapt to these needs in such a way that they contribute to increasing the rates of doing physical activity in the population.
PMCID: PMC3772601  PMID: 24149164
Adolescents; self-determination; planned behavior; physical education; motivation
4.  An Application of the Theory of Planned Behavior to Sorority Alcohol Consumption 
Addictive behaviors  2007;33(4):538-551.
Greek-affiliated college students have been found to drink more heavily and frequently than other students. With female student drinking on the rise over the past decade, sorority women may be at particular risk for heavy consumption patterns. The current study is the first to apply the Theory of Planned Behavior (TPB) to examine drinking patterns among a sorority-only sample. Two-hundred and forty-seven sorority members completed questionnaires measuring TPB variables of attitudes, norms, perceived behavioral control, and intentions, with drinking behaviors measured one month later. Latent structural equation modeling examined the pathways of the TPB model. Intentions to drink mediated the relationship between attitudes and norms on drinking behavior. Subjective norms predicted intentions to drink more than attitudes or perceived behavioral control. Perceived behavioral control did not predict intentions but did predict drinking behaviors. Interpretation and suggestions from these findings are discussed.
PMCID: PMC2387076  PMID: 18055130
Theory of Planned Behavior; sorority members; female students; college drinking; intentions
5.  Moderators of the intention-behaviour and perceived behavioural control-behaviour relationships for leisure-time physical activity 
Intention is a key determinant of action. However, there is a gap between intention and behavioural performance that remains to be explained. Therefore, the aim of this study was to identify moderators of the intention-behaviour and perceived behavioural control (PBC)- behaviour relationships for leisure-time physical activity.
This was tested in reference to Ajzen's Theory of Planned Behaviour. A sample of 300 volunteers, 192 women and 108 men, aged 18 to 55, participated in the study. At baseline, the participants completed a self-administrated psychosocial questionnaire assessing Ajzen's theory variables (i.e., intention and perceived behavioural control). The behavioural measure was obtained by mail three months later.
Multiple hierarchical regression analyses indicated that age and annual income moderated the intention-behaviour and PBC-behaviour relationships. However, in the final model predicting behaviour (R2 = .46), only the interaction term of PBC by annual income (β = .24, p = 0.0003) significantly contributed to the prediction of behaviour along with intention (β = .49, p = 0.0009) and past behaviour (β = .44, p < 0.0001).
Physical activity promotion programs would benefit not only from focusing on increasing the intention of low intenders, but also from targeting factors that moderate the perceived behavioural control-behaviour relationships.
PMCID: PMC2275296  PMID: 18241339
6.  Does action planning moderate the intention-habit interaction in the exercise domain? A three-way interaction analysis investigation 
Journal of Behavioral Medicine  2011;35(5):509-519.
Both habit strength and action planning have been found to moderate the intention-exercise behaviour relationship, but no research exists that has investigated how habit strength and action planning simultaneously influence this relationship. The present study was designed to explore this issue in a prospective sample of undergraduate students (N = 415): action planning, habit strength, intention, attitudes, subjective norms and perceived behavioural control were assessed at baseline and exercise behaviour was assessed 2 weeks later. Both habit strength and action planning moderated the intention-exercise relationship, with stronger relationship at higher levels of planning or habit strength. Decomposing a significant action planning × habit strength × intention interaction showed that the strength of the intention-exercise relationship progressed linearly through levels of action planning and habit strength. These novel results show that action planning strengthens the intention-habit strength interaction in the exercise domain: exercise interventions should therefore focus on simultaneously bolstering action planning and habit strength.
PMCID: PMC3439603  PMID: 21979328
Exercise behaviour; Intention-exercise relationship; Habit strength; Action planning; Interaction
7.  Hostility, Physical Aggression and Trait Anger as Predictors for Suicidal Behavior in Chinese Adolescents: A School-Based Study 
PLoS ONE  2012;7(2):e31044.
This study explored the extent to which trait aggression is associated with suicidal behavior in a nationwide school-based sample of adolescents.
A nationwide sample of 14,537 high school students in urban areas of China was recruited. Information concerning suicide ideation, plans, attempts, trait aggression and other risk factors was collected by a self-reported questionnaire. Multivariate regression analyses were employed to predict suicidal behavior.
Approximately 18.5% of students reported suicide ideation, 8.7% reported suicide plans, and 4.1% reported attempts during the past one year. Hostility and trait anger had a significant positive association with suicidal ideation. Hostility and physical aggression were positively related to suicide plans. Hostility had a positive correlation with suicide attempts, while trait anger was inversely associated with suicide attempts.
This study suggests that hostility, physical aggression and trait anger may be able to be used to predict suicidal behavior among adolescents. Suicide prevention programs should target at attenuating the severity of hostility, anger and physical aggression. But teachers and parents should also give close attention to students with low trait anger.
PMCID: PMC3281042  PMID: 22359563
8.  Attitudes of asthmatic and nonasthmatic children to physical exercise 
The aim of this study was to examine the physical activity of children with and without asthma in Greece, the factors affecting their intention to exercise, and the influence of gender.
The study involved 50 children with asthma and 50 children without asthma, aged 9–14-years old. We used the leisure time exercise questionnaire to assess the frequency and intensity of exercise. The planned behavior scale examined seven factors affecting physical activity: attitude, intention, self-identity, attitude strength, social role model, information, and knowledge.
Asthmatic children did not differ significantly in mild, moderate, and overall level of physical activity from children without asthma but they participated less in intense and systematic exercise. The two asthmatic groups did not differ in any of the planned behavior factors. Significant differences between genders occurred with respect to self-identity and social role model. Boys appeared to exercise more regularly and intensely compared to girls.
Asthmatic children did not systematically participate in physical activity, preferring mostly mild and moderate intensity activities. Children with and without asthma had comparable positive attitudes and intentions toward exercise.
PMCID: PMC3554104  PMID: 23378744
planned behavior theory; asthma; sports; health behavior
9.  Adolescent Pregnancy Intentions and Pregnancy Outcomes: A Longitudinal Examination 
(a) To examine different methods of assessing pregnancy intention; (b) to identify psychosocial differences between those who indicate pregnancy intentions and those who do not; and (c) to examine the relationship between pregnancy intentions and subsequent pregnancy at 6-month follow-up in nonpregnant (at baseline), sexually experienced adolescent females.
Longitudinal cohort study of 354 sexually experienced female adolescents attending either a STD clinic or HMO adolescent medicine clinic in northern California. Student’s t-tests and regressions examined psychosocial differences between females who reported “any” and “no” pregnancy intentions. ANOVAs examined differences among different combinations of pregnancy plans/likelihood. Chi-square analyses assessed associations between baseline pregnancy intentions and subsequent pregnancy.
Adolescents’ reports of their pregnancy plans and their assessments of pregnancy likelihood differed from one another (χ2 = 50.39, df = 1, p < .001). Pregnancy attitudes and baseline contraceptive use differentiated those with inconsistent pregnancy intentions (Not Planning, but Likely) from those with clear pregnancy intentions (Planning and Likely, and Not Planning and Not Likely) (Pregnancy Attitudes: F [2,338] = 68.96, p < .0001; Contraceptive Use: F [2,308] = 14.87, p < .0001). Suspected pregnancies and positive pregnancy test results were associated with baseline pregnancy intentions (Suspected: χ2 = 19.08, df = 2, p < .01; Positive Results: χ2 = 8.84, df = 2, p = .015).
To reduce adolescent childbearing we must assess pregnancy intentions in multiple ways. Information/education might benefit those female adolescents with inconsistent reports of pregnancy intentions.
PMCID: PMC1602042  PMID: 15581524
Pregnancy intentions; Adolescent females; Attitudes; Intentions; Contraceptive use
10.  Psychosocial Correlates of Adolescent Males’ Pregnancy Intention 
Pediatrics  2005;116(3):e414-e419.
To identify psychosocial differences between sexually experienced male adolescents who indicate intentions to get someone pregnant and those who do not.
Cross-sectional study of 101 sexually experienced adolescent males recruited from an STD clinic in northern California. Student’s t-tests and regressions examined psychosocial differences between males who reported any intention versus no intention to get someone pregnant in the next six months. ANOVAs examined differences among different combinations of pregnancy plans/likelihood.
Adolescents’ reports of their plans for getting someone pregnant differed from their assessments of the likelihood that they would do so (χ2 = 24.33, df = 1, p < .0001). Attitudes toward pregnancy and participants’ mothers’ educational attainment differentiated those with clear pregnancy intentions (Planning, and Likely) from those with clear intentions to avoid pregnancy (Not Planning & Not Likely)
To reduce the rates of adolescent childbearing, males’ pregnancy intentions must be assessed and asked about in multiple ways.
PMCID: PMC1351209  PMID: 16140687
Adolescent Males; Pregnancy Intentions; Psychosocial Variables
11.  Self-Control Constructs Related to Measures of Dietary Intake and Physical Activity in Adolescents 
To test self-regulation concepts in relation to dietary intake and physical activity patterns in adolescence, which we predicted to be influenced by components of a self-control model.
A survey was conducted with a multiethnic sample of 9th grade public school students in a metropolitan area (N = 539). Confirmatory analysis tested the measurement structure of self-control. Structural equation modeling tested the association of self-control constructs with measures of fruit and vegetable intake, saturated-fat intake, physical activity, and sedentary behavior.
Confirmatory analysis of 14 indicators of self-control showed best fit for a two-factor structure, with latent constructs of good self-control (planfulness) and poor self-control (impulsiveness). Good self-control was related to more fruit and vegetable intake, more participation in sports, and less sedentary behavior. Poor self-control was related to more saturated-fat intake and less vigorous exercise. These effects were independent of gender, ethnicity, and parental education, which themselves had relations to diet and exercise measures. Multiple-group modeling indicated that effects of self-control were comparable across gender and ethnicity subgroups.
Self-control concepts are relevant for patterns of dietary intake and physical activity among adolescents. Attention to self-control processes may be warranted for prevention programs to improve health behaviors in childhood and adolescence.
PMCID: PMC2190087  PMID: 18023783
self-control; diet; exercise; adolescents; gender; ethnicity
12.  Mapping the protective pathway of emotional intelligence in youth: From social cognition to smoking intentions 
The purpose of this study was to test perceptions of the social consequences of smoking as a mediator of the relationship between emotional intelligence (EI) and intentions to smoke cigarettes among youth. Upper elementary school students (N = 255, Mage = 10.9 years, 49% male) completed measures of EI, verbal intelligence, smoking-related intentions, past behavior, and perceived social consequences. Mediation was tested using the Sobel test. Perceived social consequences was a marginally significant mediator of the impact of total EI on intentions to smoke (Z = 1.91, p = .057). Follow-up analyses showed that perceived social consequences significantly mediated the effect of 2 EI abilities on smoking intentions: using emotions (Z = 2.02, p = .043) and managing emotions (Z = 2.28, p = .023). The results indicate that the role of higher EI in deterring smoking among youth may be related to social processing ability (i.e., greater perceptions of the negative social consequences of smoking). These findings contribute to a growing body of research demonstrating that EI may reduce cigarette smoking among youth by influencing their social perceptions.
PMCID: PMC3607544  PMID: 23539325
Emotional intelligence; Smoking; Social perception; Children
13.  Determinants of Fast Food Consumption among Iranian High School Students Based on Planned Behavior Theory 
Journal of Obesity  2013;2013:147589.
Objective. This study was conducted to identify some factors (beliefs and norms) which are related to fast food consumption among high school students in Isfahan, Iran. We used the framework of the theory planned behavior (TPB) to predict this behavior. Subjects & Methods. Cross-sectional data were available from high school students (n = 521) who were recruited by cluster randomized sampling. All of the students completed a questionnaire assessing variables of standard TPB model including attitude, subjective norms, perceived behavior control (PBC), and the additional variables past behavior, actual behavior control (ABC). Results. The TPB variables explained 25.7% of the variance in intentions with positive attitude as the strongest (β = 0.31, P < 0.001) and subjective norms as the weakest (β = 0.29, P < 0.001) determinant. Concurrently, intentions accounted for 6% of the variance for fast food consumption. Past behavior and ABC accounted for an additional amount of 20.4% of the variance in fast food consumption. Conclusion. Overall, the present study suggests that the TPB model is useful in predicting related beliefs and norms to the fast food consumption among adolescents. Subjective norms in TPB model and past behavior in TPB model with additional variables (past behavior and actual behavior control) were the most powerful predictors of fast food consumption. Therefore, TPB model may be a useful framework for planning intervention programs to reduce fast food consumption by students.
PMCID: PMC3723084  PMID: 23936635
14.  The eHealth Behavior Management Model: A Stage-based Approach to Behavior Change and Management 
Preventing Chronic Disease  2004;1(4):A14.
Although the Internet has become an important avenue for disseminating health information, theory-driven strategies for aiding individuals in changing or managing health behaviors are lacking. The eHealth Behavior Management Model combines the Transtheoretical Model, the behavioral intent aspect of the Theory of Planned Behavior, and persuasive communication to assist individuals in negotiating the Web toward stage-specific information. It is here — at the point of stage-specific information — that behavioral intent in moving toward more active stages of change occurs.
The eHealth Behavior Management Model is applied in three demonstration projects that focus on behavior management issues: parent-child nutrition education among participants in the U.S. Department of Agriculture Special Supplemental Nutrition Program for Women, Infants and Children; asthma management among university staff and students; and human immunodeficiency virus prevention among South African women. Preliminary results have found the eHealth Behavior Management Model to be promising as a model for Internet-based behavior change programming. Further application and evaluation among other behavior and disease management issues are needed.
PMCID: PMC1277954  PMID: 15670446
15.  Predictors of Intention to Smoke among Junior High School Students in Shanghai, China: An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model 
PLoS ONE  2013;8(11):e80482.
Adolescent smoking is a worldwide problem that is particularly severe in low- and middle-income countries. Many endogenous and environmental factors affect the intention to smoke, so a comprehensive model is needed to understand the significance and relationship of predictors. The study aimed to test the associations among information-motivation-behavioral skills (IMB) model constructs as predictors of intention to smoke in junior high school students in Shanghai, China.
We conducted a cross-sectional study of 16,500 junior high school students in Shanghai, China. Data on tobacco-related information, motivation, behavioral skills, and behaviors were collected from students. Structural equation model (SEM) was used to assess the IMB model.
The mean age of participants was 13.8 years old (standard deviation = 1.02; range 11–17). The experimental smoking rate among junior high school students was 6.6% and 8.7% of the participants expected that they would be smokers in 5 years. The IMB model provided acceptable fit to the data (comparative fit index = 0.984, root mean square error of approximation = 0.04). Intention to smoke was predicted by behavioral skills (β= 0.670, P < 0.001) and motivation (β= 0.095, P<0.001) among junior high school students.
The IMB model provides a good understanding of the predictors of intention to smoke and it suggests future interventions among junior high school students should focus on improving motivation and behavioral skills.
PMCID: PMC3828279  PMID: 24244690
Nature  2012;483(7389):331-335.
The ability to learn new skills and perfect them with practice applies not only to physical skills but also to abstract skills1, like motor planning or neuroprosthetic actions. Although plasticity in corticostriatal circuits has been implicated in learning physical skills2–4, it remains unclear if similar circuits or processes are required for abstract skill learning. We utilized a novel behavioral paradigm in rodents to investigate the role of corticostriatal plasticity in abstract skill learning. Rodents learned to control the pitch of an auditory cursor to reach one of two targets by modulating activity in primary motor cortex irrespective of physical movement. Degradation of the relation between action and outcome, as well as sensory-specific devaluation and omission tests, demonstrated that these learned neuroprosthetic actions were intentional and goal-directed, rather than habitual. Striatal neurons changed their activity with learning, with more neurons modulating their activity in relation to target-reaching as learning progressed. Concomitantly, strong relations between the activity of neurons in motor cortex and the striatum emerged. Specific deletion of striatal NMDA receptors impaired the development of this corticostriatal plasticity, and disrupted the ability to learn neuroprosthetic skills. These results suggest that corticostriatal plasticity is necessary for abstract skill learning, and that neuroprosthetic movements capitalize on the neural circuitry involved in natural motor learning.
PMCID: PMC3477868  PMID: 22388818
17.  Trajectories of Objectively Measured Physical Activity among Secondary Students in Canada in the Context of a Province-Wide Physical Education Policy: A Longitudinal Analysis 
Journal of Obesity  2014;2014:958645.
Lower levels of physical activity are associated with childhood obesity. School physical education (PE) policies have been identified as critical to improve child and adolescent physical activity levels but there has been little evaluation of such policies. In the province of Manitoba, Canada, the government implemented a mandatory PE policy in secondary schools designed to increase the daily physical activity levels of adolescents. The objective of this study was to examine the longitudinal changes in and the factors associated with the physical activity trajectories of adolescents in Manitoba during their tenure as secondary school students in the context of this school PE policy. The results found, despite the PE policy, a grade-related decline in the physical activity trajectories of adolescents; however, the decline in physical activity was attenuated among adolescents with low and moderate baseline physical activity compared to adolescents with high baseline physical activity and among adolescents who attended schools in neighbourhoods of low compared to high socioeconomic status. There are several possible explanations for these findings, including the influence of the PE policy on the PA patterns of adolescent subpopulations that tend to be at higher risk for inactivity in both childhood and adult life.
PMCID: PMC3942104  PMID: 24672714
18.  Psychological theory in an interdisciplinary context: psychological, demographic, health-related, social, and environmental correlates of physical activity in a representative cohort of community-dwelling older adults 
Physical activity (PA) in older adults is influenced by a range of environmental, demographic, health-related, social, and psychological variables. Social cognitive psychological models assume that all influences on behaviour operate indirectly through the models constructs, i.e., via intention and self-efficacy. We evaluated direct, indirect, and moderating relationships of a broad range of external variables with physical activity levels alongside intention and self-efficacy.
We performed a cross-sectional survey of a representative and stratified (65–80 and 80+ years; deprived and affluent) sample of 584 community-dwelling people, resident in Scotland. Objectively measured physical activity and questionnaire data were collected.
Self-efficacy showed unique relationships with physical activity, controlling for demographic, mental health, social, environmental, and weather variables separately, but the relationship was not significant when controlling for physical health. Overall, results indicating support for a mediation hypothesis, intention and self-efficacy statistically mediate the relationship of most domain variables with physical activity. Moderation analyses show that the relationship between social cognitions and physical activity was stronger for individuals with better physical health and lower levels of socio-economic deprivation.
Social cognitive variables reflect a range of known environmental, demographic, health-related and social correlates of physical activity, they mediate the relationships of those correlates with physical activity and account for additional variance in physical activity when external correlates are controlled for, except for the physical health domain. The finding that the social cognition-physical activity relationship is higher for participants with better health and higher levels of affluence raises issues for the applicability of social cognitive models to the most disadvantaged older people.
PMCID: PMC3847689  PMID: 24011129
Physical activity; Older adults; Social ecological model
19.  Scale Development for Measuring and Predicting Adolescents’ Leisure Time Physical Activity Behavior 
The aim of this study was to develop a scale for assessing and predicting adolescents’ physical activity behavior in Spain and Luxembourg using the Theory of Planned Behavior as a framework. The sample was comprised of 613 Spanish (boys = 309, girls = 304; M age =15.28, SD =1.127) and 752 Luxembourgish adolescents (boys = 343, girls = 409; M age = 14.92, SD = 1.198), selected from students of two secondary schools in both countries, with a similar socio-economic status. The initial 43-items were all scored on a 4-point response format using the structured alternative format and translated into Spanish, French and German. In order to ensure the accuracy of the translation, standardized parallel back-translation techniques were employed. Following two pilot tests and subsequent revisions, a second order exploratory factor analysis with oblimin direct rotation was used for factor extraction. Internal consistency and test-retest reliabilities were also tested. The 4-week test-retest correlations confirmed the items’ time stability. The same five factors were obtained, explaining 63.76% and 63.64% of the total variance in both samples. Internal consistency for the five factors ranged from α = 0.759 to α = 0. 949 in the Spanish sample and from α = 0.735 to α = 0.952 in the Luxembourgish sample. For both samples, inter-factor correlations were all reported significant and positive, except for Factor 5 where they were significant but negative. The high internal consistency of the subscales, the reported item test-retest reliabilities and the identical factor structure confirm the adequacy of the elaborated questionnaire for assessing the TPB-based constructs when used with a population of adolescents in Spain and Luxembourg. The results give some indication that they may have value in measuring the hypothesized TPB constructs for PA behavior in a cross-cultural context.
Key pointsWhen using the structured alternative format, weak internal consistency was obtained. Rephrasing the items and scoring items on a Likert-type scale enhanced greatly the subscales reliability.Identical factorial structure was extracted for both culturally different samples.The obtained factors, namely perceived physical competence, parents’ physical activity, perceived resources support, attitude toward physical activity and perceived parental support were hypothesized as for the original TPB constructs.
PMCID: PMC3761526  PMID: 24149606
Psychology; public health; behavior; assessment; physical activity.
20.  High Risk Sexual Behaviors for HIV among the In-School Youth in Swaziland: A Structural Equation Modeling Approach 
PLoS ONE  2013;8(7):e67289.
Global efforts in response to the increased prevalence of the human immunodeficiency virus (HIV) are mainly aimed at reducing high risk sexual behaviors among young people. However, knowledge regarding intentions of young people to engage in protective sexual behaviors is still lacking in many countries around the world, especially in Sub-Saharan Africa where prevalence of human immunodeficiency virus is the highest. The objective of this study was to test the theory of planned behavior (TPB) for predicting factors associated with protective sexual behaviors, including sexual abstinence and condom use, among in-school youths aged between 15 and 19 years in Swaziland.
This cross-sectional survey was conducted using a anonymous questionnaire. A two-stage stratified and cluster random sampling method was used. Approximately one hundred pupils from each of four schools agreed to participate in the study, providing a total sample size of 403 pupils of which 369 were ultimately included for data analysis. The response rate was 98%. Structural equation modeling was used to analyse hypothesized paths.
The TPB model used in this study was effective in predicting protective sexual behavior among Swazi in-school youths, as shown by model fit indices. All hypothesized constructs significantly predicted intentions for abstinence and condom use, except perceived abstinence controls. Subjective norms were the strongest predictors of intention for premarital sexual abstinence; however, perceived controls for condom use were the strongest predictors of intention for condom use.
Our findings support application of the model in predicting determinants of condom use and abstinence intentions among Swazi in-school youths.
PMCID: PMC3701534  PMID: 23861756
21.  Sixth Grade Students Who Use Alcohol 
Young adolescent alcohol users drink at higher rates than their peers throughout adolescence and appear to be less amenable to intervention. This study compares those who reported alcohol use in the past year to those who reported no use in a multiethnic, urban sample of sixth graders in 61 schools in Chicago in 2002 (N = 4,150). Demographic, behavioral, intrapersonal, and socioenvironmental factors were identified based on behavioral theories and potential mediators of the Project Northland Chicago intervention. Single and multiple regression models were created for users and nonusers to determine associations between these factors and alcohol use behavior and intentions. The multiple regression models explained 35% and 56% of the variance in alcohol use behavior and intentions between students for nonusers and users, respectively. Results suggest that primary prevention programs for alcohol use should occur prior to sixth grade, particularly for the substantial group at high risk for early use.
PMCID: PMC2717188  PMID: 18303109
alcohol use; adolescents; nonusers
22.  The Prediction of Physical Activity Intention and Behavior in Elderly Male Residents of a Nursing Home: A Comparison of Two Behavioral Theories 
Background: Regular physical activity is ranked as a leading health indicator. Despite the extensive benefits of physical activity, elder people are much less active than desired. Using Theory of Planned Behavior (TPB) and the self-efficacy construct, this study examined the prediction of physical activity intention and behavior in a sample of elderly male resident of a nursing home.
Methods: In a cross-sectional study of the residents of Kahrizak Nursing Home in Tehran, Iran, elderly men who were 60 years or older, capable of independent living, mobility, and verbal communication were asked to complete measures of the TPB, self-efficacy and physical activity behavior.
Results: A hierarchical step-wise multiple regression analysis indicated that affective/instrumental attitude, subjective norm, and perceived behavioral control (PBC) explained 32.8% of the variance in physical activity intention, and self-efficacy provided an additional 2.7%. In a reverse step regression, the TPB variables explained an additional 12.2% of physical activity intention. In a multiple regression analysis on physical activity behavior, affective/instrumental attitude, subjective norm, perceived behavioral control (PBC) and intention explained 15.7% of the variance in physical activity behavior while self-efficacy contributed an additional 5.6%. In the reverse step regression, TPB predictors contributed an additional 3.0% in explaining the variance in physical activity behavior.
Conclusion: The results indicate that in addition to the TPB, self-efficacy may also play an important role in the prediction of behavior, and should be included in the design of physical activity programs for elderly men of nursing home residents.
PMCID: PMC3470291  PMID: 23115427
Attitude; intention; elderly; self-efficacy
23.  Effect of educational intervention on physical activity-related knowledge, attitude and behavior of among first-grade students of male high schools 
Regular physical activity has positive effects on physical, mental and social aspects of individual and community health. Considering the prevalence of noncommunicable diseases such as primary hypertension, osteoporosis and cardiovascular diseases for which sedentary lifestyle is a responsible factor, health policy makers have planned to encourage people to do more physical activities. Development of beneficial health habits during childhood and early adolescence are very important because the behaviors, which start at adolescence tend to continue into adulthood, too. This study aimed to determine the effect of educational intervention on physical activity-related knowledge, attitude and behavior of the first grade students in male high schools of Bavanat in 2010.
Materials and Methods:
In this prospective experimental study, after selecting two qualified schools from five high schools, all students of one school (two classes including 42 individuals) were randomly assigned to the experimental group and all the students of another high school (two classes including 43 individuals) were randomly assigned to the control group. The data gathering tool was a 4-section questionnaire which included demographic questions, knowledge- and attitude-related questions and the questionnaire of physical activity performance. The first three sections of the questionnaire were the researcher-designed and validated by face and content validity. Test-retest and internal consistency (Cronbach's Alpha) methods were used to determine the reliability of knowledge questionnaire and attitude questionnaire, respectively. For the measurement of physical activity behavior, a self-reporting questionnaire (valid and reliable Garcia scale) was used in this study. After conducting the pretest, the educational intervention was done for the experimental group. Post-tests were conducted immediately and 1 month after intervention. The collected data were analyzed using SPSS18 statistical software (independent t-test, paired t-test, chi-square, Mann-Whitney test and repeated measures ANOVA). The participants voluntarily and consciously participated in this study.
The findings indicated no significant differences between the groups in terms of mean scores of knowledge (P = 0.934), attitude (P = 0.155) and behavior (P = 0.387) before the intervention. There was a significant difference between mean scores of knowledge in the immediate follow-up (P< 0.001) and 1 month after intervention follow-up (P < 0.001), and also between mean scores of attitude immediately (P < 0.001) and 1 month after intervention (P = 0.01) follow-ups in the experimental group compared with the control one. Mean scores of physical activity 1 month after the intervention in both experimental and control groups significantly increased (P < 0.001, P = 0.01, respectively), but the mean scores of physical activity between two groups were not significantly different (P = 0.390).
Discussion and Conclusion:
The results indicated the effectiveness of educational intervention, consequently increased knowledge and improved attitude of students, in the experimental group compared with the control one in terms of physical activities; thus, physical activity behavior of intervention group increased. Although the mean scores of physical activity in the control group significantly increased, other studies should be done which can control and consider confounding variables.
PMCID: PMC3778575  PMID: 24083254
Attitude; behavior; knowledge; physical activity
24.  Association Between Sedentary Behavior, Physical Activity, and Obesity: Inactivity Among Active Kids 
Preventing Chronic Disease  2008;6(1):A26.
Sedentary behavior and physical activity are not mutually exclusive behaviors. The relative risk of overweight for adolescents who are highly sedentary and highly physically active is unclear. A better understanding of the relationship between sedentary behaviors, physical activity, and body mass index (BMI) would provide insight for developing interventions to prevent or reduce overweight.
Using the physical activity module of the School Health Action, Planning and Evaluation System (SHAPES), we collected data from 25,060 students in grades 9 through 12 from 76 secondary schools in Ontario, Canada. Sex-specific logistic regression analyses were performed to examine how BMI, weight perceptions, social influences, team sports participation, and smoking behavior were associated with being 1) high active-high sedentary, 2) low active-low sedentary, and 3) low active-high sedentary.
Low active-high sedentary boys were more likely to be overweight than high active-low sedentary boys (adjusted odds ratio [AOR], 1.60; 95% confidence interval [CI], 1.01-2.58). When compared with high active-low sedentary girls, girls who were low active-high sedentary (OR, 2.24; 95% CI, 1.23-4.09) or high active-high sedentary (OR, 1.91; 95% CI, 1.01-3.61) were more likely to be overweight.
Sedentary behavior may moderate the relationship between physical activity and overweight. Developing a better understanding of sedentary behavior in relation to physical activity and overweight is critical for preventing and reducing overweight among youth.
PMCID: PMC2644601  PMID: 19080032
25.  Temperament, Context and Sexual Risk among College Students 
Nursing Research and Practice  2011;2011:504571.
Much is known about predictors of risky sexual behaviors in young adults. Little is known; however, about the contribution of temperament and how temperament interacts with context to influence sexual risk intentions and actual behaviors. Since intentions are closely linked to behavior, knowing how temperament influences these decisions is important in planning interventions. The purpose of this quasiexperimental study was to examine the effect of gender, temperament, and context on sexual risk intentions and behaviors among college students (N = 145). Although individual components of temperament were associated with sexual risk intentions, temperament did not predict sexual risk intentions in a safer or risky context or actual behaviors. There were also no differences by gender. In this study, temperament did not interact with context to influence sexual risk intentions or behaviors. According to these results, interventions promoting safer sexual behaviors may not have to be tailored to individuals with different temperament styles.
PMCID: PMC3169902  PMID: 21994829

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