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PubMed2006

Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence.

Numerous theories in social and health psychology assume that intentions cause behaviors. However, most tests of the intention- behavior relation involve correlational studies that preclude causal inferences. In order to determine whether changes in behavioral intention engender behavior change, participants should be assigned randomly to a treatment that significantly increases the strength of respective intentions relative to a control condition, and differences in subsequent behavior should be compared. The present research obtained 47 experimental tests of intention-behavior relations that satisfied these criteria. Meta-analysis showed that a medium-to-large change in intention (d = 0.66) leads to a small-to-medium change in behavior (d = 0.36). The review also identified several conceptual factors, methodological features, and intervention characteristics that moderate intention-behavior consistency.

Attitude↗

PubMed2003

Can psychological models bridge the gap between clinical guidelines and clinicians' behaviour? A randomised controlled trial of an intervention to influence dentists' intention to implement evidence-based practice.

OBJECTIVE: The lag between publication of evidence for clinical practice and implementation by clinicians may be decades. Research using psychological models demonstrates that changing intention is very important in changing behaviour. This study examined an intervention (rehearsing alternative actions) to change dentists' intention to implement evidence-based practice (EBP) for third molar (TM) management. DESIGN: Randomised controlled trial / postal. SETTING: Primary care. SUBJECTS AND METHODS: Dentists were randomly selected from the Scottish Dental Practice Board Register, then randomly allocated to intervention or control groups, and sent a questionnaire. The intervention group listed management alternatives to TM extraction prior to their TM extraction intention, and the control group did not. Based on psychological models for reducing a behaviour's frequency (EBP is weighted against TM extraction), prior listing of alternatives should decrease extraction intention. MAIN OUTCOME MEASURES: Intention to extract TMs. RESULTS: A total of 99 dentists - 70 Males, 29 Females; mean age = 41.42 years (SD = 8.62) participated in the study. The intervention significantly influenced intention to extract TMs, as desired. Despite similar background and knowledge of management alternatives, participants in the intervention group had significantly lower intention to extract: control group mean (SD) = 0.39 (1.99); intervention group mean (SD) = -0.78 (1.89); mean difference (SE) = 1.17 (0.42); 95% confidence interval for the difference = 0.34 to 1.99. CONCLUSION: Results suggest this intervention, which successfully influenced a proximal predictor of behaviour pertinent to dental EBP, may result in improved EBP in a service-level trial. Basing implementation interventions and trial methodology on psychological models may effectively bridge the gap between clinical guidelines and practice.

Adult↗

PubMed2004

Intentional weight loss and smoking in young adults.

OBJECTIVE: To investigate whether current smoking and lifetime snuff use are associated with a lifetime history of major (>/=5 kg) intentional weight loss in young adults, and to examine the dependence of this association on familial factors. DESIGN: Cross-sectional population-based questionnaire survey of young adult Finnish twins participating in the fourth wave of the longitudinal FinnTwin-16-study in 2000-2002. SUBJECTS: A total of 4521 young adult Finnish twins aged 23-27 y. MEASUREMENTS: Questionnaire data on the number of intentional weight-loss episodes and on body mass index (BMI), cigarette smoking and snuff use, educational level, and number of subjects' own children. RESULTS: Current daily smoking was strongly associated with a history of two or more intentional major weight-loss episodes (lost >/=5 kg twice or more lifetime) both in women odds ratio (OR 1.87; 95%; confidence interval (CI) 1.39-2.50) and in men (OR 2.00; 95% CI 1.37-2.90). Frequent lifetime snuff use was statistically significantly associated with recurrent intentional weight loss episodes in men (OR 1.51; 95% CI 1.08-2.13). Among the twin pairs discordant for daily smoking, the smoking twin was more likely than the nonsmoking co-twin to have recurrent intentional weight-loss episodes (OR 1.57; 95% CI 1.03-2.41). These episodes were also strongly associated with high BMI. Education was inversely related to recurrent intentional weight-loss episodes in men. CONCLUSION: Tobacco use is strongly associated with a lifetime history of recurrent intentional major weight-loss episodes in early adulthood. This represents a major challenge to existing attitudes on smoking prevention and the promotion of healthful weight control.

Adult↗

PubMed2003

Measuring implementation intentions in the context of the theory of planned behavior.

The usefulness of measuring implementation intentions in the context of the theory of planned behavior (TPB) was explored among 112 Norwegian college students. They responded to a questionnaire measuring past behavior, perceived behavioral control, behavioral intentions, implementation intentions, and actual performance of regular exercising and recycling of drinking cartons. Implementation intentions were measured using five items relating to recycling and four items relating to exercise, which showed satisfactory internal consistencies. Consistent with the main prediction, the presence of implementation intentions was related to performing the two behaviors, although behavioral intentions were the strongest determinant for both behaviors. The results suggest that the TPB may benefit from inclusion of the concept of implementation intentions to provide a more complete understanding of the psychological process in which motivation is translated into action.

Exercise↗

PubMed2005

The intention of future mammography screening among Korean women.

The purpose of this study was to understand factors that influence future mammography intention and to differentiate significant factors influencing future mammography intention between those who have past mammography experience and those who do not. A cross-sectional study design was used to analyze characteristics and factors that influence the intention to have a mammogram among middle-aged Korean women. A total of 310 women, aged 30 and older, participated in the study. The study results indicated that a combination of the Health Belief Model and the Theory of Reasoned Action was effective in predicting mammography intention of Korean women. It found that knowledge, perceived benefits, self-efficacy, and the subjective norm were significant factors affecting mammography intention in women who have past mammography experience. For women who have never had a mammogram, age, knowledge, perceived benefits, and self-efficacy provided a significant contribution to predicting mammography intention. Thirty-three to 43% of the variability in mammography intention can be explained by the combined influence of these independent variables. The findings from this study can be used to guide the design and implementation of tailored health education and promotion programs for Korean women according to their mammography experience, so as to increase mammography screening.

Adult↗

PubMed2004

Does perceived behavioural control mediate the relationship between power beliefs and intention?

OBJECTIVES: In order to determine whether the relationship between power beliefs (Sigma(p)) and health-related behavioural intentions is mediated by perceived behavioural control (PBC) we used structural equation modelling of eight cross-sectional data sets. METHOD: Eight studies that examined health-related behaviours and employed representative samples totalling N = 4663 participants were analysed. All studies involved power belief items derived from pilot testing and employed standard multi-item measures of power beliefs, PBC and intention that were highly reliable. RESULTS: Confirmatory factor analysis confirmed the discriminant validity of power beliefs, PBC and intention. Structural equation modelling of relevant paths indicated that PBC only partially mediated the relationship between power beliefs and intention (Z(Sobel) = 5.15, p < .001; Z(Baron&Kenny) = 5.16, p < .001). Power beliefs had a significant direct relationship with intention even after PBC had been taken into account. CONCLUSION: The findings undermine Ajzen's contention that PBC mediates the power beliefs-intention relationship and suggests that it is important to employ measures of power beliefs in addition to measures of PBC in order to enhance the prediction of intentions to perform health-risking, or health-promoting, behaviours.

Adolescent↗

PubMed2003

Can women's childbearing and contraceptive intentions predict contraceptive demand? Findings from a longitudinal study in Central India.

CONTEXT: To predict the need for contraceptive services, family planning program managers often rely on levels of unmet need derived from measures of childbearing intentions. However, women's intention to use a method has not received as much attention as a measure of contraceptive demand. METHODS: A survey was conducted in 1999 in rural Madhya Pradesh, India, among a subsample of women who had participated in the 1992-1993 National Family Health Survey (NFHS). The women's childbearing and contraceptive behaviors were compared with the intentions they had stated in the NFHS, and logistic regression was performed to analyze the association between socioeconomic and demographic variables and inconsistent behavior. RESULTS: Among women who were fecund and married in 1992-1993, 29% of those who intended to have children and 61% of those who intended not to have children failed to adhere to their intentions by 1999. Furthermore, 51% of women who were not practicing contraception at the time of the NFHS but planned to do so acted against their intention by 1999, as did 29% of those who planned not to use a method. NFHS respondents who intended both not to have children and to use a method were more likely than others to have used a method by 1999 (63% vs. 25-41%). Age and history of child death were key factors associated with inconsistency between women's intentions and behavior. CONCLUSIONS: In India, use of both contraceptive and childbearing intentions predicts contraceptive demand better than use of either indicator alone, and may thus help program planners estimate future demand for contraceptive services.

Adolescent↗

PubMed2003

The risk of intentional injury with acute and chronic alcohol exposures: a case-control and case-crossover study.

OBJECTIVE: Alcohol is associated with intentional injury, but most studies have operationalized it as alcoholism and have not examined acute exposure. The study aimed to clarify the relative contributions of drinking over a few hours and of alcohol use disorders to the risk of intentional injury inflicted by another person. METHOD: The study used a case-control design with two control groups: (1) Community controls matched to cases, and (2) the cases themselves, comparing consumption on the day of injury with consumption on previous days, in a case-crossover comparison. Cases were patients with an acute injury presenting to any of the three emergency departments in one county; 102 had an intentional injury. Community controls (N = 1,856) were recruited by random-digit dialing. Recent alcohol consumption was recorded in self-reported standard drinks. Current alcohol use disorders were defined using DMS-IV criteria. RESULTS: In the case-control analysis, drinking in a 6-hour window was associated with risk of intentional injury (odds ratio [OR] = 10, 95% confidence interval [CI]: 4.7-22). In case-cross-over comparison of the cases' own drinking in the 6 hours prior to injury with their own drinking the day before, the OR was 34 (95% CI: 4.7-250). In case-control analyses, alcohol dependence was associated with intentional injury (OR = 6.0, 95% CI: 3.5-10), but alcohol abuse was not (OR = 0.7, 95% CI: 0.4-1.3). CONCLUSIONS: Drinking over a few hours is strongly associated with intentional injury. Current alcohol dependence is also, but with a lower OR. The findings may have implications for efforts to prevent intentional injury.

Adolescent↗

PubMed2026

The Impact of Chatbot Type and Normative Messaging on Chatbot Usage Intention Based on the Health Technology Acceptance Model: Randomized Controlled Trial.

BACKGROUND: Digital health tools, such as health chatbots, may improve access to scalable health support, but adoption remains inconsistent. Existing models do not fully integrate technology acceptance factors with health motivation factors relevant to digital health use. OBJECTIVE: This study proposed and tested the health technology acceptance model and examined whether normative message framing and chatbot type were associated with health motivation, technology acceptance, and intention to use a health chatbot. METHODS: In October 2025, we conducted a 4 × 2 between-participants online experiment with 1000 US adults recruited from a nationally representative YouGov panel. Participants were randomized to 1 of 8 conditions varying norm message type (self-oriented, peer-oriented, expert-oriented, or family-oriented) and chatbot type (AI-powered or rule-based) in a cancer prevention and genetic risk information scenario. Outcomes included descriptive norms, injunctive norms, perceived susceptibility, perceived severity, perceived benefits, self-efficacy, perceived ease of use, trust, privacy concerns, and usage intention. Data were analyzed using a multivariate ANOVA with Bonferroni-adjusted post hoc tests and multiple linear regression. RESULTS: Peer-oriented and family-oriented messages produced higher usage intention than expert-oriented messages, and peer-oriented messages also increased descriptive norms, injunctive norms, self-efficacy, and trust. AI-powered chatbots were associated with higher usage intention (P=.02) and greater trust (P=.008) than rule-based chatbots. In regression analyses, the model explained 50.8% of the variance in usage intention. Usage intention was positively associated with descriptive norms (β=0.087; P=.003), injunctive norms (β=0.078; P=.009), perceived susceptibility (β=0.051; P=.03), perceived benefits (β=0.253; P<.001), and trust (β=0.33; P<.001), and negatively associated with perceived severity (β=-0.047; P=.049) and privacy concerns (β=-0.11; P<.001). Perceived ease of use and self-efficacy were not significant predictors. CONCLUSIONS: The health technology acceptance model was a useful framework for explaining the intention to use a health chatbot by combining technology acceptance and health motivation constructs. Both social design features and chatbot design features shaped adoption-related beliefs, with peer-oriented and family-oriented framing and AI-powered chatbots showing particular promise. Trust and privacy concerns remained central determinants of intended use.

Humans↗

PubMed1995

History of intentional and unintentional weight loss in a population-based sample of women aged 55 to 69 years.

Although both overweight and body weight fluctuation are related to chronic disease risk, little is known about the history of and reasons for body weight change in the general population. This paper reports the incidence of intentional and unintentional weight loss episodes during adulthood in a population-based sample of 26,261 women aged 55 to 69 years. Intentional weight loss episodes of each of four amounts (5-9, 10-19, 20-49, 50+ lbs.) and unintentional weight loss episodes of 20 or more lbs. were recalled for each of three age periods (18-39, 40-54, 55+ years). At least one intentional weight loss episode of 5 or more lbs. was reported by 69% of women, 46% reported at least one intentional weight loss episode of 10 or more lbs, and 25% reported at least one intentional weight loss episode 20 or more lbs. At least one unintentional weight loss episode of 20 or more lbs. was reported by 29% of the women. Reasons for weight losses of 20 or more lbs. were also recalled. Women who had intentionally lost 20 or more lbs. were more likely to report weight losses due to low-calorie diets, exercise and weight loss groups, while women who had unintentionally lost 20 or more lbs. were more likely to report weight losses due to depression or stress. These findings question the common assumption that weight losses in adult women are primarily intentional and emphasize the need to distinguish the reasons for weight loss in studies examining the relationship between body weight changes and health outcomes.

Aged↗

PubMed2000

Adolescents hospitalised with deliberate self-harm: the significance of an intention to die.

All suicide attempters admitted to medical wards in the greater Oslo area, (n = 91) aged 13-19 years, were dichotomised on the basis of one item in the Motives for Parasuicide Questionnaire (MPQ) and one item in the Suicide Intent Scale (SIS): if the intent was to die (n = 57), or not (n = 34). The two groups were compared regarding the attempt, mental health problems, and psychosocial risk factors. The attempt of adolescents with an intent to die were more serious, rated with SIS (15.7 vs. 5.7, p < 0.001), with Risk Rescue Rating (p = 0.003) or rated medically (p < 0.05). They were clinically more often depressed (61% vs. 32%, p < 0.01), felt more hopeless (Hopelessness Scale) (10.8 vs. 8.2, p < 0.05), were less disruptive (11% vs. 32%, p < 0.05) and less often abused substances (0 vs. 12%, p < 0.05). Both groups were equally burdened with other factors. Differentiation on the basis of suicidal intent delineated two groups, both with considerable psychosocial problems. Those with suicide intent had more internalising problems including depression, while those with other intents showed more externalising behaviour. The need for help in the group with no intent to die may be underestimated.

Adolescent↗

PubMed2005

Identifying the public's knowledge and intention to use human cloning in Greek urban areas.

PURPOSE: The understanding of the public's knowledge on human cloning (HC) and its acceptability are considered important for the development of evidence-based policy making. The aim of this research study was to investigate the demographic and socioeconomic variables that affect the public's knowledge and intention to use HC in urban areas of Greece. Additionally, the possible association of religiousness with the knowledge and the intention to use HC were also investigated. METHODS: Individual interviews were conducted with 1020 men and women of urban areas in Greece. Stratified random sampling was performed to select the respondents. Several scientists, experts in HC, evaluated the content of the instrument initially developed. The final questionnaire was consequently the result of a pilot study. RESULTS: Almost half of the respondents (51.5%) believed that "HC is a sort of in vitro fertilization" and 42.9% that "it has already been applied to human being." They were not aware that "the cloned fetus grows in the woman's uterus" (41.5%) and that "HC could regenerate human organs" (41.7%). The acceptability of human cloning for the cure of terminal diseases and transplantation need is very high (70.7% and 58.6%, respectively). The public's intention to have recourse to cloning on the grounds of "bringing" back to life a loved person or because of reproductive disorders was reported as desire by 35% and 32.5%, respectively. The occupational category (scientists, self-employed, and artists), the Intention to use HC, and the number of children are highly significant predictors of valid knowledge about HC. Low rates of church attendance appeared to relate with high reported Intention to use HC, and increasing scores of valid knowledge about HC increased the public's Intention to use HC. CONCLUSIONS: A number of specific demographic and socioeconomic characteristics and high scores of knowledge provide a persuasive justification in demonstrating intention toward HC. The current study suggests that these findings should receive further attention by policymakers and scientists within the Greek context.

Adult↗

PubMed2006

Where and how could intentional programs be generated in the brain? A hypothetical model based on glial-neuronal interactions.

Based on glial-neuronal interaction a formalism (negative language) for the generation of intentional programs is proposed. An intentional program generates a specific multirelational structure in an inner or outer appropriate environment according to the principle of feasibility. After description of the glial spatio-temporal boundary-setting function in its interaction with the neuronal system, it is hypothesized that intentional programs may be generated in glial networks (syncytia) in line with the formalism of negative language. Gap junctions are interpreted as multirelational negation operators, generating cycles in a permutation system. These cycles could represent intentional programs that can either be realized or not in neuronal networks embodying a permutation system. The feasibility of these intentional programs is essentially dependent on appropriate environmental information. Since the realization of intentional programs in neuronal networks allows high degrees of freedom, the problem of free will is tackled, as well. Free will is defined as the subjective freedom to choose between the inner determination of intentional programs and the overdetermination of their feasibility in an appropriate environment. Finally, the possible implementation of the proposed brain model in robot brains is briefly discussed.

Cell Communication↗

PubMed2004

Do doctors act on their self-reported intention to computerize? A follow-up population-based survey in Hong Kong.

BACKGROUND AND OBJECTIVES: We performed a follow-up survey to document changes in the level of computerization among physicians in Hong Kong between 2000 and 2001, specifically examining whether their self-reported intention to computerize various clinical or administrative tasks actually translated into computerization of these tasks 1 year later. Determining such a relationship will indicate the reliability, and thus the utility of questions regarding self-reported intention to computerize clinical practice. METHODS: A self-completed follow-up postal questionnaire was sent to all 949 physicians who responded to the original questionnaire. Pairwise repeated dichotomous responses from 2000 and 2001 on the computerization of specific functions were compared using McNemar test. Wilcoxon sign-ranked test was employed to compare the total number of tasks computerized in the 2 years. Multivariate logistic regression modeling was carried out to determine predictors for the translation of intention to computerize into actual computerization. RESULTS: The response rate was 77.0%. There was a significant increase in the number of tasks computerized for both "corporate" and "individual" practices between 2000 and 2001. The proportion of physicians who intended to computerize and actually computerized ranged from 7.7 to 51.0% for different tasks. For five clinical tasks, more than 50% respondents in corporate practices translated the intention to implementation, compared to fewer than 20% in individual practices. Predictors found to be associated with the translation of intention to computerize into actual computerization included higher number of tasks intended to computerize, higher number of tasks already computerized, and more positive physicians' attitudes on the impact of computerization to clinical practice. CONCLUSIONS: We conclude that physicians' self-reported intention to computerize the clinical practice 12 months previously was moderately associated with actual implementation, with varying degrees of concordance for different clinical and administrative tasks. The identified predictors for the translation of intention to actual computerization may be useful in targeting specific strategies to promote computerization of clinical practice.

Adult↗

PubMed2006

Sexual behaviors and procreational intentions of adolescents and young adults with perinatally acquired human immunodeficiency virus infection: experience of an urban tertiary center.

PURPOSE: To assess sexual knowledge, behaviors, and procreational intentions of adolescents and young adults with perinatally acquired human immunodeficiency virus (PNA HIV) infection. Increasingly, children with PNA HIV infection survive to adolescence and become sexually active. Understanding their procreational intentions could aid in designing reproductive health and secondary prevention programs. METHODS: A cross-sectional survey of adolescents and young adults with PNA HIV infection at an urban tertiary center was conducted. From June 2003 through September 2004, participants completed a questionnaire that inquired about their sexual knowledge and behaviors. Participants aware of their diagnoses also completed items regarding procreational intentions. RESULTS: Seventy-four percent (57/77) of eligible participants completed the survey. Thirty-three percent (19/57) of participants reported having had penile-vaginal intercourse, 89.4% of them after learning of their HIV status. Fifty percent (5/10) of sexually active female participants had been pregnant. Among the 50 participants who were aware of their diagnosis, 70% (n = 35) expressed intent to have children. A majority of those aware of the risk of maternal-to-child transmission (MTCT) (71.1%) expressed intent to procreate. Participants who perceived MTCT as low were more likely to express intent to procreate than those who perceived the risk of MTCT as high. CONCLUSIONS: Adolescents with PNA HIV infection are becoming sexually active and express intent to have children. This has important implications for secondary prevention of HIV infection. These adolescents need innovative intervention programs offering reproductive health education including procreational choices and considerations.

Adolescent↗

PubMedDate not supplied

Attitudes and intentions toward purchasing novel foods enriched with omega-3 fatty acids.

OBJECTIVE: To identify the nature, strength, and relative importance of influences on intentions to consume foods that are enriched with omega-3 fatty acids using the Theory of Planned Behavior (TPB). DESIGN: A cross-sectional self-administered questionnaire. SETTING: Community-based residents living in the Illawarra region of New South Wales, Australia. SUBJECTS: Two subsamples were surveyed via questionnaire: community members who responded to a local media advertisement (n = 79), and subjects in a dietary intervention trial for type 2 diabetes mellitus (n = 50). VARIABLES MEASURED: Using the TPB variables-intention, attitude, subjective norm, and perceived behavioral control-questionnaire items were constructed to measure intention to consume omega-3-enriched novel foods. ANALYSIS: The results from subsamples did not differ and were combined for analysis. The determinants of intention defined in the TPB were investigated using multiple linear regressions. RESULTS: Regression analysis showed that the model was a significant determinant of intention (R2 = .725; P < .001). Attitude was a significant determinant of intention, whereas subjective norms and control beliefs were not. DISCUSSION: With attitude having the greatest influence on intentions, immediate prospects for modifying behavior are likely to come through a change in attitude, specifically in beliefs about the effectiveness of enriched products in achieving specific health benefits. CONCLUSIONS AND IMPLICATIONS: Promoters of omega-3-enriched foods would be advised to direct their promotions toward changing the attitudes of consumers about the effectiveness of the functional ingredient.

Adolescent↗

PubMed1984

Suicidal intent and repeated self-harm.

The value of identifying self-harm patients who repeat with rising suicidal intent is discussed. A study is described measuring changes in intent with repetition by means of an intent scale. Patients repeating once in 5 years scored significantly higher in intent for their second episodes, while multiple repeaters tended to score lower for second episodes. Patients under the age of 35 were most at risk for repetition with increasing intent within 2 years. No correlation emerged between the rise in intent and the time interval between episodes over a 7-year period. The 5-year suicide rate was higher among rising intent repeaters than other cases. These findings are discussed.

Follow-Up Studies↗

PubMed2001

Determinants of change in the intention to use benzodiazepines.

OBJECTIVE: To examine attitudes and beliefs associated with changes in the intention to use benzodiazepines during the six-month period after first benzodiazepine use. DESIGN: Population-based 6-month follow-up with 3 measurement points (baseline, 2 weeks after inclusion, 6 months after inclusion). SETTING: Starting or initial benzodiazepine users were included during a period of 4 months from November 1994 in the only pharmacy of a Dutch community of 13,500 people. MEASURES: Variables proposed by the Model of Planned Behaviour and the Health Belief Model. Drug exposure data from automated pharmacy records. RESULTS: At baseline, the intention to use benzodiazepines was primarily predicted by the perceived norm of the general practitioner regarding benzodiazepine use, and by the participants' own attitudes. After fourteen days, the determinants of change in the intention to use benzodiazepines were the initially perceived norm of the general practitioner and the change in the severity of participants' illnesses. After six months, the change in the severity of the illness and the perceived health benefits of benzodiazepines at the time of inclusion were the main determinants of the change in the intention to use benzodiazepines between the second and third measurement point. The intention to use benzodiazepines showed a decrease during follow-up. The three intention measures were significant predictors of actual benzodiazepine use during the year following baseline assessment. CONCLUSION: The study sheds light on interesting determinants of decrease or increase in the intention to use during the six-month period after first benzodiazepine use.

Adult↗