Self-Efficacy, Planning, or a Combination of Both? A Longitudinal Experimental Study Comparing Effects of Three Interventions on Adolescents' Body Fat

Aleksandra Luszczynska, Martin S Hagger, Anna Banik, Karolina Horodyska, Nina Knoll, Urte Scholz, Aleksandra Luszczynska, Martin S Hagger, Anna Banik, Karolina Horodyska, Nina Knoll, Urte Scholz

Abstract

Background: The superiority of an intervention combining two sets of theory-based behavior change techniques targeting planning and self-efficacy over an intervention targeting planning only or self-efficacy only has rarely been investigated.

Purpose: We compared the influence of self-efficacy, planning, and self-efficacy+planning interventions with an education-based control condition on adolescents' body fat, assuming mediating effects of respective social cognitive variables and moderate-to-vigorous physical activity (MVPA). The moderating role of the built environment was examined.

Methods: Participants (N = 1217, aged 14-18 years) were randomly assigned to four conditions: planning (n = 270), self-efficacy (n = 311), self-efficacy+planning (n = 351), and control (n = 285). The measurement was conducted at baseline (T1), two-month follow-up (T2), and fourteen-month follow-up (T3). Interventions/control group procedures were delivered at T1 and T2. Percent of body fat tissue (measured at T1 and T3) was the main outcome. Social cognitive mediators (self-efficacy and planning) were assessed at T1 and T2. The behavioral mediator (MVPA) and the presence of built MVPA facilities (the moderator) were evaluated at T1 and T3.

Results: Similar small increases of body fat were found across the three intervention groups, but the increment of body fat was significantly larger in the control group. On average, differences between control and intervention groups translated to approximately 1% of body fat. Effects of the interventions on body fat were mediated by relevant social cognitive variables and MVPA. A lower increase of body fat was found among intervention group participants who had access to newly-built MVPA facilities.

Conclusions: We found no superiority of an intervention targeting two social cognitive variables over the intervention targeting one cognition only.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. The flowchart.
Fig 1. The flowchart.
Fig 2. Effects of the group assignment…
Fig 2. Effects of the group assignment (self-efficacy or self-efficacy + planning versus control) on body fat (14-month follow-up) mediated by self-efficacy and moderate-to-vigorous physical activity.
Solid lines represent significant associations. MVPA–moderate-to-vigorous physical activity.
Fig 3. Effects of the group assignment…
Fig 3. Effects of the group assignment (planning or self-efficacy + planning versus control) on body fat (14-month follow-up) mediated by planning and moderate-to-vigorous physical activity.
Solid lines represent significant associations. MVPA–moderate-to-vigorous physical activity.

References

    1. World Health Organization. Global strategy on diet, physical activity and health [Internet]. [cited 2016 Oct 17]. Available:
    1. Ramires VV, Dumith SC, Gonçalves H. Longitudinal Association Between Physical Activity and Body Fat During Adolescence: A Systematic Review. J Phys Act Health. 2015. September;12(9):1344–58. 10.1123/jpah.2014-0222
    1. Safron M, Cislak A, Gaspar T, Luszczynska A. Effects of school-based interventions targeting obesity-related behaviors and body weight change: a systematic umbrella review. Behav Med. 2011. January;37(1):15–25. 10.1080/08964289.2010.543194
    1. Rothman KJ. BMI-related errors in the measurement of obesity. Int J Obes(Lond). 2008; 32(3 Suppl):S56–9. 10.1038/ijo.2008.87
    1. Moliner-Urdiales D, Ruiz JR, Ortega FB, Rey-Lopez JP, Vincente-Rodriguez G, España-Romero V, et al. Association of objectively assessed physical activity with total and central body fat in Spanish adolescents; the HELENA Study. Int J Obes (Lond). 2009. October;33(10):1126–35. 10.1038/ijo.2009.139
    1. Schwarzer R. Modeling Health Behavior Change: How to Predict and Modify the Adoption and Maintenance of Health Behaviors. Applied Psychology. 2008. January;57(1):1–29. 10.1111/j.1464-0597.2007.00325.x
    1. Warner LM, Schüz B, Wolff JK, Parschau L, Wurm S, Schwarzer R. Sources of self-efficacy for physical activity. Health Psychol. 2014. November;33(11):1298–308. 10.1037/hea0000085
    1. Craggs C, Corder K, van Sluijs EM, Griffin SJ. Determinants of change in physical activity in children and adolescents: a systematic review. Am J Prev Med. 2011. June;40(6):645–58. 10.1016/j.amepre.2011.02.025
    1. French DP, Olander EK, Chisholm A, Mc Sharry J. Which behaviour change techniques are most effective at increasing older adults’ self-efficacy and physical activity behaviour? A systematic review. Ann Behav Med. 2014. October;48(2):225–34. 10.1007/s12160-014-9593-z
    1. Olson EA, McAuley E. Impact of a brief intervention on self-regulation, self-efficacy and physical activity in older adults with type 2 diabetes. J Behav Med. 2015. December;38(6):886–98. 10.1007/s10865-015-9660-3
    1. Gollwitzer PM, Sheeran P. Implementation intentions and goal achievement: A meta-analysis of effects and processes. Adv Exp Soc Psychol. 2006;38:69–119. 10.1013/S0065-2601(06)38002-1
    1. Bélanger—Gravel A, Godin G, Amireault S. A meta-analytic review of the effect of implementation intentions on physical activity. Health Psychol Rev. 2013. March;7(1):23–54. 10.1080/17437199.2011.560095
    1. Hagger MS, Luszczynska A . Implementation intention and action planning interventions in health contexts: state of the research and proposals for the way forward. Appl Psychol Health Well Being. 2014. March;6(1):1–47. 10.1111/aphw.12017
    1. Sniehotta FF, Schwarzer R, Scholz U, Schüz B. Action planning and coping planning for long-term lifestyle change: theory and assessment. Eur J Soc Psychol. 2005. July;35(4):565–576. 10.1002/ejsp.258
    1. Carraro N, Gaudreau P. Spontaneous and experimentally induced action planning and coping planning for physical activity: A meta-analysis. Psychol Sport Exerc. 2013. March;14(2):228–248. 10.1016/j.psychsport.2012.10.004
    1. Luszczynska A, Schwarzer R, Lippke S, Mazurkiewicz M. Self-efficacy as a moderator of the planning-behaviour relationship in interventions designed to promote physical activity. Psychol Health. 2011. February;26(2):151–66. 10.1080/08870446.2011.531571
    1. Schwarzer R, Luszczynska A, Ziegelmann JP, Scholz U, Lippke S. Social-cognitive predictors of physical exercise adherence: three longitudinal studies in rehabilitation. Health Psychol. 2008. January;27(1 Suppl):S54–63. 10.1037/0278-6133.27.1(Suppl.).S54
    1. Luszczynska A, Horodyska K, Zarychta K, Liszewska N, Knoll N, Scholz U. Planning and self-efficacy interventions encouraging replacing energy-dense foods intake with fruit and vegetable: A longitudinal experimental study. Psychol Health. 2016;31(1):40–64. 10.1080/08870446.2015.1070156
    1. Teixeira PJ, Carraça EV, Marques MM, Rutter H, Oppert JM, De Bourdeaudhuij I, et al. Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators. BMC Med. 2015. April;13:84 10.1186/s12916-015-0323-6
    1. Abraham C, Johnson BT, de Bruin M, Luszczynska A. Enhancing reporting of behavior change intervention evaluations. J Acquir Immune Defic Syndr. 2014. August;66(3 Suppl):S293–9. 10.1097/QAI.0000000000000231
    1. Conner M, Higgins AR . Long-term effects of implementation intentions on prevention of smoking uptake among adolescents: a cluster randomized controlled trial. Health Psychol. 2010. September;29(5):529–38. 10.1037/a0020317
    1. Guillaumie L, Godin G, Manderscheid JC, Spitz E, Muller L. The impact of self-efficacy and implementation intentions-based interventions on fruit and vegetable intake among adults. Psychol Health. 2012. January;27(1):30–50. 10.1080/08870446.2010.541910
    1. Guillaumie L, Godin G, Manderscheid JC, Spitz E, Muller L. Self-efficacy and implementation intentions-based interventions on fruit and vegetable intake among adults: impact at 12-month follow-up. Glob Health Promot. 2013. June;20(2 Suppl):83–7. 10.1177/1757975913483336
    1. Horodyska K, Luszczynska A, van den Berg M, Hendriksen M, Roos G, De Bourdeaudhuij I, et al. Good practice characteristics of diet and physical activity interventions and policies: an umbrella review. BMC Public Health. 2015. January;15:19 10.1186/s12889-015-1354-9
    1. Bandura A. Self-efficacy: The Exercise of Control 1st ed. New York, NY: W.H. Freeman and Co.; 1997.
    1. Safron M, Cislak A, Gaspar T, Luszczynska A. Micro-environmental characteristics related to body weight, diet, and physical activity of children and adolescents: a systematic umbrella review. Int J Environ Health Res. 2011. October;21(5):317–30. 10.1080/09603123.2011.552713
    1. McGrath LJ, Hopkins WG, Hinckson EA. Associations of objectively measured built-environment attributes with youth moderate-vigorous physical activity: a systematic review and meta-analysis. Sports Med. 2015. June;45(6):841–65. 10.1007/s40279-015-0301-3
    1. Oreskovic NM, Perrin JM, Robinson AI, Locascio JJ, Blossom J, Chen ML, et al. Adolescents’ use of the built environment for physical activity. BMC Public Health. 2015. March;15:251 10.1186/s12889-015-1596-6
    1. Cerin E, Vandelanotte C, Leslie E, Merom D. Recreational facilities and leisure-time physical activity: An analysis of moderators and self-efficacy as a mediator. Health Psychol. 2008. March;27(2 Suppl):S126–35. 10.1037/0278-6133.27.2(Suppl.).S126
    1. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000. May;320(7244):1240–3. 10.1136/bmj.320.7244.1240
    1. Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Manuel Gómez J, et al. Bioelectrical impedance analysis-part II: utilization in clinical practice. Clin Nutr. 2004. December;23(6):1430–53. 10.1016/j.clnu.2004.09.012
    1. Cleary J, Daniells S, Okely AD, Batterham M, Nicholls J. Predictive validity of four bioelectrical impedance equations in determining percent fat mass in overweight and obese children. J Am Diet Assoc. 2008. January;108(1):136–9. 10.1016/j.jada.2007.10.004
    1. Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985. September;10(3):141–6.
    1. Demographic yearbook of Poland, year 2014 [Internet]. . [cited 2015 Nov 20]. Available:
    1. Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health. 2011. November;26(11):1479–98. 10.1080/08870446.2010.540664
    1. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach 1st ed. New York: Guilford Press; 2013.

Source: PubMed

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