Generating and predicting high quality action plans to facilitate physical activity and fruit and vegetable consumption: results from an experimental arm of a randomised controlled trial

BMC Public Health, Apr 2016

Background In order to improve the transition from an intention to a change in health behaviour, action planning is a frequently used behavioural change method. The quality of action plans in terms of instrumentality and specificity is important in terms of supporting a successful change in health behaviour. Until now, little has been known about the predictors of action plan generation and the predictors of high quality action plans and, therefore, the current study investigates these predictors. Method A randomised controlled trial was conducted to improve physical activity (PA) and fruit and vegetable (FV) consumption using a web-based computer tailored intervention. During the 8-week intervention period, participants in the intervention arm (n = 346) were guided (step-by-step) to generate their own action plans to improve their health behaviours. Demographic characteristics, social cognitions, and health behaviour were assessed at baseline by means of self-reporting. Whether participants generated action plans was tracked by means of server registrations within two modules of the intervention. Results The action planning component of the intervention regarding physical activity and fruit and vegetable consumption was used by 40.9 and 20.7 % of the participants, respectively. We found that participants who were physically active at baseline were less likely to generate action plans concerning physical activity. With regards to generating fruit and vegetable action plans, participants with a high risk perception and a strong intention to eat fruit and vegetables on a daily basis made more use of the action planning component for this behaviour. Finally, the large majority of the action plans for physical activity (96.6 %) and fruit and vegetable consumption (100 %) were instrumental and about half of the action plans were found to be highly specific (PA = 69.6 %/FV = 59.7 %). The specificity of the action plans is associated with having a relationship and low levels of negative outcome expectancies. Conclusion Risk perception and intention are predictors of using the application of action planning. Increasing the motivation to change behaviour should be prioritised in interventions concerning changes in health behaviour before participants are asked to generate action plans. This would also make the intervention suitable for unmotivated people. For those participants who already perform the desired health behaviour prior to the intervention, action plans might be less relevant. Nevertheless, using a guided step-by-step approach to generate action plans resulted in highly instrumental and specific action plans and might be integrated into other interventions concerning changes in health behaviour. Trial Registration Netherlands Trial Register: NTR 3706, ClinicalTrials.gov: NCT01909349.

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Generating and predicting high quality action plans to facilitate physical activity and fruit and vegetable consumption: results from an experimental arm of a randomised controlled trial

Reinwand et al. BMC Public Health Generating and predicting high quality action plans to facilitate physical activity and fruit and vegetable consumption: results from an experimental arm of a randomised controlled trial Dominique Alexandra Reinwand 0 1 Rik Crutzen 0 Vera Storm 1 Julian Wienert 2 Tim Kuhlmann 3 Hein de Vries 0 Sonia Lippke 1 0 CAPHRI, Department of Health Promotion, Maastricht University , P. O. Box 616, Maastricht 6200 MD , The Netherlands 1 Department of Psychology and Methods, Jacobs University Bremen , Campus Ring 1, Bremen 28759 , Germany 2 Institute for Social Medicine and Epidemiology, University of Lübeck , Ratzeburger Allee 160, 23562 Lübeck , Germany 3 Department of Psychology, University of Konstanz , 78457 Konstanz , Germany Background: In order to improve the transition from an intention to a change in health behaviour, action planning is a frequently used behavioural change method. The quality of action plans in terms of instrumentality and specificity is important in terms of supporting a successful change in health behaviour. Until now, little has been known about the predictors of action plan generation and the predictors of high quality action plans and, therefore, the current study investigates these predictors. Method: A randomised controlled trial was conducted to improve physical activity (PA) and fruit and vegetable (FV) consumption using a web-based computer tailored intervention. During the 8-week intervention period, participants in the intervention arm (n = 346) were guided (step-by-step) to generate their own action plans to improve their health behaviours. Demographic characteristics, social cognitions, and health behaviour were assessed at baseline by means of self-reporting. Whether participants generated action plans was tracked by means of server registrations within two modules of the intervention. Results: The action planning component of the intervention regarding physical activity and fruit and vegetable consumption was used by 40.9 and 20.7 % of the participants, respectively. We found that participants who were physically active at baseline were less likely to generate action plans concerning physical activity. With regards to generating fruit and vegetable action plans, participants with a high risk perception and a strong intention to eat fruit and vegetables on a daily basis made more use of the action planning component for this behaviour. Finally, the large majority of the action plans for physical activity (96.6 %) and fruit and vegetable consumption (100 %) were instrumental and about half of the action plans were found to be highly specific (PA = 69.6 %/FV = 59.7 %). The specificity of the action plans is associated with having a relationship and low levels of negative outcome expectancies. (Continued on next page) - (Continued from previous page) Conclusion: Risk perception and intention are predictors of using the application of action planning. Increasing the motivation to change behaviour should be prioritised in interventions concerning changes in health behaviour before participants are asked to generate action plans. This would also make the intervention suitable for unmotivated people. For those participants who already perform the desired health behaviour prior to the intervention, action plans might be less relevant. Nevertheless, using a guided step-by-step approach to generate action plans resulted in highly instrumental and specific action plans and might be integrated into other interventions concerning changes in health behaviour. Trial Registration: Netherlands Trial Register: NTR 3706, ClinicalTrials.gov: NCT01909349. Background Even highly motivated people can have problems in translating their intentions into a successful change in health behaviour [ 1 ]. Action planning has been identified as an important method to overcome this “intention-behaviour-gap” [ 2, 3 ] by improving self-regulatory skills [4]. Action plans (AP) specify precisely when, where, and how an intended health behaviour will be carried out [ 5–7 ]. When asking people to generate APs, such people should be encouraged to think about the context in which the desired behaviour will be performed. Due to these cues to action, such APs should work as a reminder to act (in terms of time and place) [ 8 ]; even when other self-regulatory skills and memory capacity are low, planning contributes to habit formation [ 9, 10 ]. Generating APs has been demonstrated to increase the translation from intention to behaviour for different health behaviours such as PA [ 11–14 ] and a healthy diet [ 15, 16 ]. The theoretical method of action planning is derived from several social-cognitive health theories such as the Health Action Process Approach (HAPA) [ 4, 17, 18 ]. It can be easily applied [ 19 ] and its application is understandable to users [ 8 ] and, hence, it is often applied to web-based interventions to encourage a change in health behavi (...truncated)


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Dominique Reinwand, Rik Crutzen, Vera Storm, Julian Wienert, Tim Kuhlmann, Hein de Vries, Sonia Lippke. Generating and predicting high quality action plans to facilitate physical activity and fruit and vegetable consumption: results from an experimental arm of a randomised controlled trial, BMC Public Health, 2016, pp. 317, 16, DOI: 10.1186/s12889-016-2975-3