Predicting intention to participate in self-management behaviors in patients with Familial Hypercholesterolemia: A cross-national study.

RATIONALE: Familial Hypercholesterolemia (FH) is a genetic condition that predisposes patients to substantially increased risk of early-onset atherosclerotic cardiovascular disease. FH risks can be minimized through regular participation in three self-management. BEHAVIORS: physical activity, healthy eating, and taking cholesterol lowering medication. OBJECTIVE: The present study tested the effectiveness of an integrated social cognition model in predicting intention to participate in the self-management behaviors in FH patients from seven countries. METHOD: Consecutive patients in FH clinics from Australia, Hong Kong, Brazil, Malaysia, Taiwan, China, and UK (total N = 726) completed measures of social cognitive beliefs about illness from the common sense model of self-regulation, beliefs about behaviors from the theory of planned behavior, and past behavior for the three self-management behaviors. RESULTS: Structural equation models indicated that beliefs about behaviors from the theory of planned behavior, namely, attitudes, subjective norms, and perceived behavioral control, were consistent predictors of intention across samples and behaviors. By comparison, effects of beliefs about illness from the common sense model were smaller and trivial in size. Beliefs partially mediated past behavior effects on intention, although indirect effects of past behavior on intention were larger for physical activity relative to taking medication and healthy eating. Model constructs did not fully account for past behavior effects on intentions. Variability in the strength of the beliefs about behaviors was observed across samples and behaviors. CONCLUSION: Current findings outline the importance of beliefs about behaviors as predictors of FH self-management behaviors. Variability in the relative contribution of the beliefs across samples and behaviors highlights the imperative of identifying sample- and behavior-specific correlates of FH self-management behaviors.

Social-cognitive antecedents of hand washing: Action control bridges the planning-behaviour gap.

OBJECTIVES: To examine motivational and volitional factors for hand washing in young adults, using the Health Action Process Approach (HAPA) as a theoretical framework. DESIGN: In a longitudinal design with two measurement points, six weeks apart, university students (N = 440) completed paper-based questionnaires. MAIN OUTCOME MEASURES: Prior hand washing frequency, self-efficacy, outcome expectancies, intention and action planning were measured at baseline, and coping planning, action control and hand washing frequency were measured at follow-up. RESULTS: A theory-based structural equation model was specified. In line with the HAPA, the motivational factors of self-efficacy and outcome expectancies predicted intention, whereas the volitional factors of planning and action control mediated between intention and changes in hand washing frequency. Action control was confirmed as the most proximal factor on hand washing behaviour, thus representing a bridge of the planning-behaviour gap. CONCLUSIONS: Both motivational and volitional processes are important to consider in the improvement of hand hygiene practices. Moreover, the statistically significant effects for planning and action control illustrate the importance of these key self-regulatory factors in the prediction of hand hygiene. The current study highlights the importance of adopting models that account for motivational and volitional factors to better understand hand washing behaviour.