Identifying key beliefs underlying QR code check-in and compliance behaviours in the COVID-19 pandemic.

ISSUE ADDRESSED: The implementation of quick response (QR) code check-in compliance behaviour during the COVID-19 pandemic featured in infection control strategies in several global jurisdictions, but was of particular interest in the Australian context, where it became mandated on a nationwide scale. We aimed to identify the salient beliefs people hold toward complying with the QR code check-in using a Theory of Planned Behaviour belief-based framework. METHODS: An elicitation study using open-ended questions (Queensland; N = 93, Mage = 4.77 years, SD = 13.62 and Victoria; N = 76, Mage = 44.92 years, SD = 11.63) and a prospective correlational study using a two-wave online survey (Queensland; N = 290, Mage = 38.99, 46.6% female and Victoria; N = 290, Mage = 38.27, 53.4% female) were conducted. RESULTS: Qualitative data were coded through an iterative content analysis, while quantitative data were analysed using linear multiple regression. Behavioural, normative and control beliefs were associated with intention and behaviour in both samples. Variation in beliefs across the states also were observed. CONCLUSIONS: Across both samples, beliefs in positive outcomes consistently exhibited stronger associations with both intention and behaviour than the reported negative outcomes. Distinct differences emerged between the two samples in terms of regression effects. SO WHAT?: Results indicate individual experience may affect the beliefs which guide behaviour, supporting the potential efficacy of health promotion campaigns tapping into context specific beliefs and experiences if QR code check-in is to be implemented as an infection control measure in future.

Open Science in Health Psychology and Behavioral Medicine: A Statement From the Behavioral Medicine Research Council.

ABSTRACT: Open Science practices include some combination of registering and publishing study protocols (including hypotheses, primary and secondary outcome variables, and analysis plans) and making available preprints of manuscripts, study materials, de-identified data sets, and analytic codes. This statement from the Behavioral Medicine Research Council (BMRC) provides an overview of these methods, including preregistration; registered reports; preprints; and open research. We focus on rationales for engaging in Open Science and how to address shortcomings and possible objections. Additional resources for researchers are provided. Research on Open Science largely supports positive consequences for the reproducibility and reliability of empirical science. There is no solution that will encompass all Open Science needs in health psychology and behavioral medicine's diverse research products and outlets, but the BMRC supports increased use of Open Science practices where possible.

Open Science in Health Psychology and Behavioral Medicine: A Statement From the Behavioral Medicine Research Council.

Open Science practices include some combination of registering and publishing study protocols (including hypotheses, primary and secondary outcome variables, and analysis plans) and making available preprints of manuscripts, study materials, de-identified data sets, and analytic codes. This statement from the Behavioral Medicine Research Council (BMRC) provides an overview of these methods, including preregistration; registered reports; preprints; and open research. We focus on rationales for engaging in Open Science and how to address shortcomings and possible objections. Additional resources for researchers are provided. Research on Open Science largely supports positive consequences for the reproducibility and reliability of empirical science. There is no solution that will encompass all Open Science needs in health psychology and behavioral medicine's diverse research products and outlets, but the BMRC supports increased use of Open Science practices where possible.

Health action process approach: promoting physical activity, and fruit and vegetable intake among Australian adults.

Based on the health action process approach (HAPA) this study examined whether changes in social cognition constructs could predict change in physical activity and fruit and vegetable intake for adult participants in My health for life, an Australian health promotion behaviour change program. Variance-based structural equation modelling was used to analyse data obtained from Australian adult program participants (n = 167) at baseline (T1), week 14 (T2), week 26 (T2), and 6-month post-program (T4). Change scores were calculated for the social cognition constructs and behaviour. Changes in action self-efficacy and outcome expectancies positively predicted changes in intentions. Action self-efficacy changes also predicted changes in maintenance self-efficacy which, in turn, mediated the effect of action self-efficacy on recovery self-efficacy and planning. Planning was predicted by changes in intentions and maintenance self-efficacy. Findings support the use of the HAPA model in designing complex health behaviour change interventions to achieve sustained behaviour change.

Young children's motivations and social cognitions toward swimming: Testing direct and moderation effects of sport competence in two large-scale studies.

Direct and moderation effects of swimming competence using an integrated model of self-determination theory (SDT) and theory of planned behaviour (TPB) were examined in two large-scale studies among young children. Specifically, we examined whether swimming competence had direct and moderation effects on social psychological variables of perceived need support, autonomous motivation, TPB social cognition constructs, and intention. In Study 1, using a cross-sectional survey of 4959 primary school children, swimming competence formed significant positive relationships with all model variables (ß =.061 to.330, p < .05) except intention (ß = -.009, p > .05), and its moderation effect on model parameters were small in size or not statistically significant. In Study 2, using a pre-post-test quasi-experiment among 1,609 primary school children, improvement of swimming competence was associated with change-scores in all model variables (ß =.046 to.230, p < .05) except subjective norm (ß =.049, p > .05). Swimming competence did not significantly moderate the parameter estimates of the integrated model (p > .05) at the change-score level. Findings indicate that swimming competence is associated with higher autonomous motivation; TPB social cognitions of attitude, subjective norm, and perceived behavioural control; and intention. However, swimming competence did not moderate the parameter estimates of the integrated model.

Optimizing behavior change through integration of individual- and system-level intervention approaches.

We contend that individual-level ("i-frame") intervention strategies can be appropriately integrated with system-level ("s-frame") strategies to optimize population-level behavior change. We outline instances of effective "i-frame" interventions, and how coordinated, integrated, well-resourced interventions that encompass components at both levels, and has organizational and user-group support, may optimize sustained behavior change intervention efforts, and allay practices that undermine "s-frame" components.

Improving Hand Hygiene Behavior Using a Novel Theory-Based Intervention During the COVID-19 Pandemic.

BACKGROUND: Promoting the adoption of personal hygiene behaviors known to reduce the transmission of COVID-19, such as avoiding touching one's face with unwashed hands, is important for limiting the spread of infections. PURPOSE: We aimed to test the efficacy of a theory-based intervention to promote the avoidance of touching one's face with unwashed hands to reduce the spread of COVID-19. METHODS: We tested effects of an intervention employing imagery, persuasive communication, and planning techniques in two pre-registered studies adopting randomized controlled designs in samples of Australian (N = 254; Study 1) and US (N = 245; Study 2) residents. Participants were randomly assigned to theory-based intervention or education-only conditions (Study 1), or to theory-based intervention, education-only, and no-intervention control conditions (Study 2). The intervention was delivered online and participants completed measures of behavior and theory-based social cognition constructs pre-intervention and one-week postintervention. RESULTS: Mixed-model ANOVAs revealed a significant increase in avoidance of touching the face with unwashed hands from pre-intervention to follow-up irrespective of intervention condition in both studies, but no significant condition effects. Exploratory analyses revealed significant effects of the theory-based intervention on behavior at follow-up in individuals with low pre-intervention risk perceptions in Study 2. CONCLUSIONS: Results indicate high adoption of avoiding touching one's face with unwashed hands, with behavior increasing over time independent of the intervention. Future research should confirm risk perceptions as a moderator of the effect theory-based interventions on infection-prevention behaviors.

Evidence That Habit Moderates the Implicit Belief-Behavior Relationship in Health Behaviors.

BACKGROUND: Theory suggests that implicit beliefs are more likely to be associated with spontaneous, impulsive health behaviors (e.g., smoking, snacking), while controlled, consciously accessible beliefs are more likely to be associated with behaviors that require deliberation and reasoned decision-making (e.g., physical activity, healthy food selection). Consistent with these predictions, we proposed that as behaviors become habitual, they require less deliberation to enact and are thus more likely to be controlled by non-conscious processes, as indicated by stronger associations with implicit beliefs. The present study tested the moderating effect of habit on the effects of implicit beliefs on two health behaviors. METHOD: Two samples of university students completed measures of attitude, habit, and implicit beliefs for free-sugar intake (sample 1) and heavy episodic drinking (sample 2) at an initial time point, with follow-up behavioral measures taken at 2 and 4 weeks later, respectively. RESULTS: Path analyses indicated that attitude and habit predicted behavior in both samples, and habit moderated the implicit belief-behavior relationship in both samples. The effect of implicit beliefs on behavior was larger among participants reporting strong habits. Implicit beliefs did not moderate the effect of explicit attitudes on behavior. CONCLUSION: Findings provide preliminary evidence that experiencing health behaviors as habitual is associated with a stronger implicit beliefs-health behavior relationship.

Habit Facilitates Actioning Sun Protective Behavior Intentions.

Skin cancer is highly burdensome, but preventable with regular engagement in sun protective behaviors. Despite modest effectiveness of sun-protective behavior promotional efforts thus far, rates of engagement in sun-protective behaviors remain low. More is needed to understand motivation for using sunscreen, wearing sun-protective clothing, and seeking shade. This study tested whether the links of intention and habit strength with behavior differed between sun-protective behaviors. It was hypothesized that sun protective behaviors would be predicted by both habit and intention and that intention-behavior associations would be weaker for people with stronger habits. Participants residing in Queensland, Australia (N = 203; 75.96% female; M age = 37.16 years, SD = 14.67) self-reported their intentions and habit strength about sun-protective behavior for the next 7 days. Participants were followed-up 7 days later to self-report their sun-protective behavior. Multilevel modeling, accounting for nesting of multiple behaviors within-person, revealed that habit moderated the intention strength - behavior association and this moderation effect did not differ as a function of which behavior was being predicted. People with strong or moderate habit strength tended to act in line with their intentions; however, for people with very weak habits (2 SD < M), there was less alignment between their intention and behavior. These findings suggest that habit plays a facilitative role in the implementation of strong sun protective behavior intentions. Interventions should consider how to encourage intention and habit to enhance sun-protective behaviors and reduce the burden of skin cancer from sun exposure.Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.1903380 .

A cross-lagged model of habits, implicit attitudes, autonomous motivation, and physical activity during COVID-19.

Although the relationship between autonomous motivation and impulsive processes has been acknowledged in the context of physical activity, the directionality of this relationship is not clearly understood. The COVID-19 pandemic provides a unique opportunity to investigate such relationships due to the fact that contextual changes brought about by government restrictions (e.g., stay at home orders, indoor gymnasium closures) may have influenced people's physical activity habits and motivation. The purpose of this study was to therefore investigate the bi-directional relationships between physical activity and previously established correlates: autonomous motivation, implicit attitudes, and habit. A sample of university students completed measures that assessed autonomous motivation, implicit attitude, habit and behaviors towards meeting physical activity guidelines each week during the coronavirus period at two time points, two weeks apart in a cross-lagged panel design. Path analysis found a significant reciprocal relationship between habits and autonomous motivation. There were no significant reciprocal relationships between autonomous motivation and implicit attitude, or with any study constructs and behavior. Current findings provide important preliminary formative evidence of associations between autonomous motivation and impulsive behavioral correlates, indicating a bi-directional relationship between autonomous motivation and physical activity habits.

Social Psychological Predictors of Sleep Hygiene Behaviors in Australian and Hong Kong University Students.

BACKGROUND: Sleep hygiene behaviors in undergraduate students are associated with night-time sleep duration and quality, daytime sleepiness, and psychological distress. This study aimed to identify the social psychological factors that impact on university students' sleep hygiene behaviors in samples from two countries. METHOD: Participants were undergraduate students from Australia (N = 201, MAge = 22.82, SDAge = 8.89; 165 female) and Hong Kong (N = 161, MAge = 20.47, SDAge = 7.80; 84 female). The study used a correlational-prospective design. Individuals self-reported their intention, attitude, subjective norms, perceived behavioral control, and past behavior with respect to sleep hygiene behaviors. Four weeks later, the students self-reported their action plans and participation in sleep hygiene behaviors. RESULTS: Analysis indicated acceptable model fit to data for both the Australian and Hong Kong samples. Results showed significant direct effects of attitude, subjective norms, perceived behavioral control, and past behavior on intention, and significant direct effects of action planning and past behavior on prospectively measured sleep hygiene behavior. There were also significant indirect effects of attitude, subjective norms (Hong Kong sample only), and perceived behavioral control on behavior mediated by intention and action planning. Overall, the model predicted a large portion of the variance in sleep hygiene behavior for both the Australian (R2 = .524) and Hong Kong (R2 = .483) samples. Schenker and Gentleman t tests found no parameters significantly differed between samples. CONCLUSION: Results indicate that university students' sleep hygiene behaviors are a function of both motivational and volitional processes. This formative data can inform future interventions to improve the sleep hygiene practices of university students.

The Baby Steps Web Program for the Well-Being of New Parents: Randomized Controlled Trial.

BACKGROUND: New parents face increased risks of emotional distress and relationship dissatisfaction. Digital interventions increase support access, but few preventive programs are optimized for both parents. OBJECTIVE: This study aims to conduct the first randomized controlled trial on universal self-guided digital programs to support positive perinatal adjustment of both mothers and fathers. Effects of childcare information (Baby Care) and information plus an interactive program (Baby Steps Wellbeing) were compared from the third trimester baseline to 3 and 6 months subsequently. METHODS: The study recruited 388 co-parenting male-female adult couples expecting their first single child (26-38 weeks' gestation), using web-based registration. Most (337/388, 86.8%) were obtained from prenatal hospital classes. Couples' randomization was automated and stratified by Edinburgh Postnatal Depression Scale (EPDS) scores (50% couples scored high if either mother >7, father >5). All assessments were web-based self-reports: the EPDS and psychosocial quality of life were primary outcomes; relationship satisfaction, social support, and self-efficacy for parenting and support provision were secondary. Linear mixed models provided intention-to-treat analyses, with linear and quadratic effects for time and random intercepts for participants and couples. RESULTS: Selection criteria were met by 63.9% (248/388) of couples, who were all randomized. Most participants were married (400/496, 80.6%), tertiary educated (324/496, 65.3%), employed full time (407/496, 82%), and born in Australia (337/496, 67.9%). Their mean age was 32.2 years, and average gestation was 30.8 weeks. Using an EPDS cutoff score of 13, 6.9% (18/248) of men, and 16.1% (40/248) of women screened positive for depression at some time during the 6 months. Retention of both partners was 80.6% (201/248) at the 6-month assessments, and satisfaction with both programs was strong (92% ≥50). Only 37.3% (185/496) of participants accessed their program more than once, with higher rates for mothers (133/248, 53.6%) than fathers (52/248, 20.9%; P<.001). The EPDS, quality of life, and social support did not show differential improvements between programs, but Baby Steps Wellbeing gave a greater linear increase in self-efficacy for support provision (P=.01; Cohen d=0.26) and lower reduction in relationship satisfaction (P=.03; Cohen d=0.20) than Baby Care alone. Mothers had greater linear benefits in parenting self-efficacy over time than fathers after receiving Baby Steps Wellbeing rather than Baby Care (P=.01; Cohen d=0.51). However, the inclusion of program type in analyses on parenting self-efficacy and relationship satisfaction did not improve model fit above analyses with only parent gender and time. CONCLUSIONS: Three secondary outcomes showed differential benefits from Baby Steps Wellbeing, but for one (parenting self-efficacy), the effect only occurred for mothers, perhaps reflecting their greater program use. Increased engagement will be needed for more definitive testing of the potential benefits of Baby StepsWellbeing for perinatal adjustment. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12614001256662; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367277.

Predicting Social Distancing Intention and Behavior During the COVID-19 Pandemic: An Integrated Social Cognition Model.

BACKGROUND: Social distancing is a key behavior to minimize COVID-19 infections. Identification of potentially modifiable determinants of social distancing behavior may provide essential evidence to inform social distancing behavioral interventions. PURPOSE: The current study applied an integrated social cognition model to identify the determinants of social distancing behavior, and the processes involved, in the context of the COVID-19 pandemic. METHODS: In a prospective correlational survey study, samples of Australian (N = 365) and U.S. (N = 440) residents completed online self-report measures of social cognition constructs (attitude, subjective norm, moral norm, anticipated regret, and perceived behavioral control [PBC]), intention, action planning, habit, and past behavior with respect to social distancing behavior at an initial occasion. Follow-up measures of habit and social distancing behavior were taken 1 week later. RESULTS: Structural equation models indicated that subjective norm, moral norm, and PBC were consistent predictors of intention in both samples. Intention, action planning, and habit at follow-up were consistent predictors of social distancing behavior in both samples. Action planning did not have consistent effects mediating or moderating the intention-behavior relationship. Inclusion of past behavior in the model attenuated effects among constructs, although the effects of the determinants of intention and behavior remained. CONCLUSIONS: Current findings highlight the importance of subjective norm, moral obligation, and PBC as determinants of social distancing intention and intention and habit as behavioral determinants. Future research on long-range predictors of social distancing behavior and reciprocal effects in the integrated model is warranted.

Testing an app-based intervention to improve insomnia in patients with epilepsy: A randomized controlled trial.

PURPOSE: Insomnia has adverse effects on people with epilepsy. We aimed to test a novel cognitive behavioral therapy for insomnia (CBT-I) app-based intervention on insomnia symptoms and social psychological factors in people with epilepsy and to examine the possible mechanisms among the factors. METHODS: Participants were recruited from neurology clinics in Iran and comprised individuals diagnosed with epilepsy and having moderate to severe insomnia. A two-arm randomized controlled trial design was used, consisting of a treatment group (CBT-I; n = 160) and control group (patient education; n = 160). Primary outcomes were self-reported sleep quality, insomnia severity, and sleep hygiene behavior and objective sleep characteristics measured by actigraphy. Secondary outcomes were attitude, perceived behavioral control, intention, action planning, coping planning, behavioral automaticity, self-monitoring, anxiety, depression, and quality of life (QoL). All outcomes were measured at baseline, and at one, three, and six months postintervention, except objective sleep, which was assessed at baseline, and one and six months postintervention. Data were analyzed using linear mixed models. RESULTS: Current findings showed that sleep quality, insomnia severity, sleep hygiene behavior, and sleep onset latency were significantly improved in the CBT-I group compared with the patient education group at all measurement points. Also, the CBT-I group had significantly improved anxiety, depression, and QoL compared with the patient education group. Mediation analyses showed that attitude, intention, coping planning, self-monitoring, and behavioral automaticity significantly mediated the effect of the intervention on sleep outcomes. CONCLUSION: Results support the use of the CBT-I app to improve sleep outcomes among people with epilepsy.

Predicting limiting 'free sugar' consumption using an integrated model of health behavior.

Excess intake of 'free sugars' is a key predictor of chronic disease, obesity, and dental ill health. Given the importance of determining modifiable predictors of free sugar-related dietary behaviors, we applied the integrated behavior change model to predict free sugar limiting behaviors. The model includes constructs representing 'reasoned' or deliberative processes that lead to action (e.g., social cognition constructs, intentions), and constructs representing 'non-conscious' or implicit processes (e.g., implicit attitudes, behavioral automaticity) as predictors of behavior. Undergraduate students (N = 205) completed measures of autonomous and controlled motivation, the theory of planned behavior (TPB) measures of explicit attitude, subjective norms, perceived behavioral control (PBC), and intentions, past behavior, implicit attitude, and behavioral automaticity at an initial point in time, and free sugar limiting behavior and behavioral automaticity two weeks later. A Bayesian structural equation model indicated that explicit attitude, subjective norms, and PBC predicted behavior via intention. Autonomous motivation predicted behavior indirectly through all TPB variables, while controlled motivation predicted behavior only via subjective norms. Implicit attitudes and behavioral automaticity predicted behavior directly and independently. Past behavior predicted behavior directly and indirectly through behavioral automaticity and intentions, but not implicit attitudes. Current findings suggest pervasive effects of constructs representing both reasoned and non-conscious processes and signpost potential targets for behavioral interventions aimed at minimizing free sugar consumption.

Descriptive epidemiology and correlates of children's swimming competence.

This study examined the swimming competence of primary school children, and how it was related to swimming activity, non-fatal aquatic events, and demographic factors. Primary school students (N = 4959; female = 2705, male = 2241; age range = 5 to 14 years) across 28 schools in the 15 districts of Hong Kong completed the Swimming Competence Questionnaire, and questions about their swimming experience, non-fatal aquatic events, and demographic variables. Descriptive statistics showed that over 60% of children could swim more than 5m, but less than 50% could swim over 25m. Over 50% of children were able to perform some basic swimming skills (e.g., holding breath underwater, floating, poolside/kickboard kicking, and treading water). Swimming competence was positively predicted by the demographic factors (i.e., age, sex, family income, and parents' highest education level), swimming experience, learning experience, and swimming location. Treading water was the only factor of swimming competence that established asignificant negative association with non-fatal aquatic events. Current results can be used to target key groups to improve children's swimming competence and reduce non-fatal aquatic events; children from lower socio-economic backgrounds and with less swimming experience should be encouraged to participate in more formal learn to swim lessons.

Validation of the swimming competence questionnaire for children.

Two studies were employed to test the reliability and validity of the Swimming Competence Questionnaire (SCQ) among primary school children. Study 1 was a cross-sectional survey in 4959 primary school children. Study 2 was a pre-post-test quasi-experiment among 1609 primary school children who underwent a 20-lesson learn-to-swim programme. In Study 1, exploratory structural equation modelling revealed excellent goodness-of-fit and scale reliability for a two-factor model comprising distance and skill factors, which supported the construct and convergent validity. SCQ scores were significantly and positively correlated with swimming outcomes (i.e., self-efficacy, intention, swimming frequency), which supported SCQ's concurrent and criterion validity. Average variance extracted for the SCQ factors exceeded cut-off criteria supporting discriminant validity. In Study 2, pre-test SCQ scores correlated significantly and positively with the SCQ scores, self-efficacy, intention, and swimming frequency at post-test, which supported SCQ's test-retest reliability and predictive validity. Positive intraclass correlation between SCQ scores and coach ratings at post-test provided evidence for SCQ's inter-rater reliability. SCQ scores significantly improved at post-test, which supported SCQ's ecological validity. In conclusion, findings indicate that the SCQ is a valid and reliable measure to assess primary school children's swimming competence, in terms of swimming distance and basic water survival skills.

Effectiveness of a theory-based sun-safe randomised behavioural change trial among Australian adolescents.

OBJECTIVE: Sun safety is crucial for preventing skin cancer. This study evaluated a school-based intervention based on the theory of planned behaviour (TPB), which aimed to encourage sun-protective behaviour among adolescents. METHODS: Secondary school students (N = 382; 61.1% female; Mage  = 13.73 y) in Queensland, Australia, participated in the study. Schools were randomly allocated to an intervention or control group. The intervention focussed on fostering positive attitudes, increasing perceptions of normative support, and strengthening control perceptions. Participants completed questionnaires assessing the TPB variables and sun-protective behaviour (weekday and weekend) 1 week before intervention (time 1), 1 week after intervention (time 2), and 4 weeks after intervention (time 3). RESULTS: With baseline between-group differences in TPB variables matched, repeated-measures multivariate analysis of variance was used to evaluate the Time × Condition effects across time. Multigroup comparisons using path models traced the intervariable changes. From times 1 to 3, a significant improvement in weekend sun-protective behaviour was identified in the intervention group (but not the control group), whereas cognitions showed no significant changes across time for either conditions. Multigroup comparisons on path coefficients between the intervention and control group participants indicated that the intervention group members formed stronger positive associations between perceived behavioural control and intention at time 2 and between perceived control and behaviour at time 3. CONCLUSION: The significant behavioural change on weekends highlights the value of targeting control perceptions, which may encourage adolescents' sun-protective behaviour. Further studies are needed to understand the absence of significant changes in weekday sun-safe behaviour among this at-risk cohort.

Predicting what mothers feed their preschoolers: Guided by an extended theory of planned behaviour.

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.

Adolescent sugar-sweetened beverage consumption: An extended Health Action Process Approach.

OBJECTIVE: Consumption of excess added sugar in the form of sugar-sweetened beverages (SSBs) contributes to a wide range of health concerns in adolescents. Identification of modifiable determinants of SSB consumption based on behavioral theory may inform development of interventions aimed at reducing SSB consumption. The aim of the current study was to test the efficacy of an extended version of the Health Action Process Approach to predict adolescent SSB consumption. METHODS: Using a prospective design, adolescent students (N = 450) self-reported their outcome expectancies, perceived behavioral control, intentions, habit, action, maintenance, and recovery self-efficacy, action and coping planning, perceived affordability, and past behavior with respect to SSB consumption. One month later, participants self-reported their SSB consumption. RESULTS: A structural equation model revealed significant direct effects of action self-efficacy, outcome expectancies, and perceived behavioral control on intentions to reduce SSB consumption. Significant direct effects of action self-efficacy on maintenance self-efficacy, and maintenance self-efficacy on recovery self-efficacy, were also identified. There were significant direct effects of intentions and maintenance self-efficacy on action and coping planning. Only intentions and perceived affordability had significant direct effects on SSB consumption. There were also indirect effects of outcome expectancy and perceived behavioral control on SSB consumption mediated by intentions. Inclusion of past behavior attenuated model effects, with past behavior the only remaining predictor of SSB consumption. CONCLUSIONS: Findings indicate that adolescent SSB consumption is predicted by intentions and perceived affordability, but effects were extinguished by the inclusion of past behavior. The pervasive effects of past behavior point to the importance of identifying potential mediators of past behavior in future research, and that interventions targeting non-conscious rather than intentional processes may be most effective in reducing SSB consumption.