Welcome to the Behavior Change Measures Research Hub! Below you will find commonly used behavior change theories, descriptions of their key constructs, and common measures used to assess them. We also provide recommendations for which measures to use.
Health Belief Model
The Health Belief Model (HBM) was developed by applied researchers in the Public Health Service in the 1950s and 60s (Rosenstock, 1974). The HBM portends that the manner in which people approach health-promoting behavior is due to a combination of the perceived severity, susceptibility, benefits, and barriers to a disease and treatment. The model also accounts for self-efficacy and cues to action.
CONSTRUCTS & MEASURES
Percieved Severity
An individual’s belief about the consequences of an illness
Measurement
Percieved severity is measured using three items: (1) The results of physical inactivity can be quite severe, (2) A lack of physical activity could have a major negative impact on my health, and (3) A lack of physcal activity could have a major negative impact on my life style. All rated on a 7-point Likert-type scale.
Pros: short, free.
Cons: different severity aspects measured with only one item, low internal reliability (.74), and is specific to exercise
Reference: Courneya, 1995
Our Recommendation: We recommend choosing a measure that pertains to the specific condition that is being assessed as measures are likely not generalizable.
Perceived Susceptibility
Perceived susceptibility is an individual’s belief about their risk of contracting an illness.
Percieved susceptibility is assessed by how worried are you about getting the following diseases: (1) Obesity, (2) diabetes, (3) cardiovascular disease, (4) osteoporosis.
Meausrement
Pros: short, reduces participant burden, unidimensional, can adapt and add to it.
Cons: low reliability (.74)
Reference: Kim, Ahn, No, 2012
Our recommendation: We recommend choosing a measure that pertains to the specific condition that is being assessed as measures are likely not generalizable.
Percieved Benefits
Percieved benefits are characterized as an individual’s belief in the effectiveness of prescribed action for reducing the risk of contracting an illness or the effectiveness of prescribed action for reducing symptoms of a current illness.
Meausrement
Benefits and Barriers to Exercise Scale: is a 43-item measure (examples for barriers include: it costs too much to exercise, exercise tires me; examples of benefts include: exercising will keep me from having high blood pressure, my muscle tone is improve with exercise.
Pros: can be used as one total score or as separate scores for benefits and barriers, has different categories (e.g., time, physical).
Cons: long, specific to exercise
Reference: Sechrist, Walker, & Pender, 1987
Our Recommendation: We recommend choosing a measure that pertains to the specific condition that is being assessed as measures are likely not generalizable.
Self-Efficacy
Self-efficacy is an individual’s belief that one is capable of performing a behavior.
Meausrement
(1)Theory of Planned Behavior Self-efficacy. Item: ‘ I am confident that if I wanted to I could ‘INSERT BEHAVIOR HERE’ on a regular basis.
Pros: Free to use, brief measure should reduce participant burden, easily adaptable to a variety of behaviors
Cons: 1-item measures cannot be assessed for internal consistency
Reference: http://www.midss.org
(2) Preactional Self-Efficacy. Item stem:’ It is always hard to get started. How sure are you that you can start exercising regularly? I am sure I can start being physicall activity immediately, even if…’. Items: (1)’…I initially have to reconsider my views on physical activity, (2)’…I have to force myself to start immediately, (3)’…I have to push myself.
Pros: free to use, brief measure may reduce particpant burden, may be generalizeable to other behavior if item stem and items are changed
Cons: to our knowledge this measure has not been assessed in terms of reliability or validity
Reference: http://www.hapa-model.de
Our Recommendation: We recommend the (2) Pre-actional Self-Efficacy measure for assessing exercise. However, a measure pertaining to the specific behavior of interest – other than exercise – should be chosen. If measures are adpated to assess other behaviors than psychometrics should be examined.
Cues to Action
Cues to action are triggers for people to act. Can be physiological (e.g., pain) or external cues (e.g., media, education).
Measurement
The CHAQ (The Cues to Health Action Questionnaire): 32-item measure, each referring to a possible cue. Examples include: news story in a newspaper, public service announcement on TV, specific advice from a friend based on information on your health status. Items are rated on a 3-point scale from ‘Not at All’ to ‘Very Likely’.
Pros: covers a wide range of possible cues, high internal consistency.
Cons: some of the cues occur after behavior, meaning they cannot be an initial cue to action.
Reference: Jones, Fowler, Hubbard, 2000
Our Recommendation: We recommend choosing a measure that pertains to the specific condition that is being assessed as measures are likely not generalizable.
Health Action Process Approach
Health Action Process Approach (HAPA; Schwarzer, 2008). Is a dual-phase model insofar that it includes both motivation constructs – which predict behavioral intention – and voltional constructs which directly predict behavior and moderate the intention-behavior gap. The HAPA was designed to be used as a stage model and thus it overcomes the one-size-fits all interventions that are proposed by typical continuum models. The HAPA was not created with regards to a specific behavioral outcome.
CONSTRUCTS & MEASURES
Risk Perception
Risk perception (motivational phase) is the perception of a health threat relevant to the self. Risk perception is composed of perceived serverity of the threat and perceived personal susceptibility to the threat. Risk perception in and of itself cannot change behavior, however it is an antecedant of other motivational predictors.
Measurement
Item stem: ‘How likely is it you will have a something in your life…’. Items: (1)’…a high cholesterol level’, (2)’…a heart attack’, (3)’…a high blood pressure’, (4)’…a stroke’, and (5)’…a cardiovascular disease’.
Pros: free to use, brief measure should reduce participant burden, could pertain to a variety of behaviors for which heart disease is relevant such as exercise or healthy eating
Cons: to our knowledge reliability and validity information is not available for this measure, measure is specific to cardiovascular disease and symptoms likely do not generalize to other diseases, may not be relevant to some populations such as younger adults or children.
Reference: http://www.hapa-model.de
Our recommendation: We recommend choosing a measure that pertains to the specific behavioral outcome and poplation that is being studied. Risk perception scales will vary widely – in terms of items – depending on the outcome of interest and the population of interest.
Outcome Expectancies
Outcomes expectancies (motivational phase) are beliefs about potential consequences (both positive and negative) deriving from behavioral enactment. If the individual perceives more pros than cons related to behavioral enactment they will be more likely to form an intention to engage in said behavior.
Measurement
(1)Alchohol Outcome Expectancies Scale: Item stem: ‘When I drink alchohol how likely is it that this would happen’. The scale contains 34-items pertaining to positive effects (i.e., social, fun, sex, tension reduction) and negative effeects (i.e., social, emotional, physical, cognitive/performance).
Pros: free to use, high internal consistency among subscales, assesses multiple facets of positive and negative outcome expectations, positive and negative aspects are discriminantly valid
Cons: specific to alchohol use and likely cannot be generalized to other behaviors, scale is not short and may increase participant burden
Reference: Leigh & Stacy (1993)
(2)Outcome Expectations for Exercise Scale: Item stem: ‘Exercise…’ This scale contains 9-items (e.g., (1)’…makes me feel better physically’, and (2)’…is an activity I enjoy doing’) pertaining to outcome expectations of engaging in exercise.
Pros: Free to use, brief measure will likely reduce participant burden, high internal consistency, high predictive validity, test-dimensionality has been previously confirmed
Cons: specific to exercise and likely cannot be generalized to other behaviors
Reference: Resnick, Zimmerman, Orwig, Furstenberg, & Magaziner (2000)
Our recommendation: We recommend choosing a measure that pertains to the specific behavioral outcome that is being studies. Outcomes of behavior change will vary depending on the type of behavior that is being measured. For example, a person may expect to become more lean with exercise but not from quitting smoking – where weight gain would likely be expected.
(Pre)Action Self-Efficacy
(Pre)Action Self-efficacy (motivational phase) is an optimistic belief that one can successfully perform a behavior that occurs prior to actual behavioral enactment.
Measurement
(1)Theory of Planned Behavior Self-efficacy. Item: ‘ I am confident that if I wanted to I could ‘INSERT BEHAVIOR HERE’ on a regular basis.
Pros: Free to use, brief measure should reduce participant burden, easily adaptable to a variety of behaviors
Cons: 1-item measures cannot be assessed for internal consistency
Reference: http://www.midss.org
(2) Preactional Self-Efficacy. Item stem:’ It is always hard to get started. How sure are you that you can start exercising regularly? I am sure I can start being physicall activity immediately, even if…’. Items: (1)’…I initially have to reconsider my views on physical activity, (2)’…I have to force myself to start immediately, (3)’…I have to push myself.
Pros: free to use, brief measure may reduce particpant burden, may be generalizeable to other behavior if item stem and items are changed
Cons: to our knowledge this measure has not been assessed in terms of reliability or validity
Reference: http://www.hapa-model.de
Our recommendation: We recommend the (2) Pre-actional Self-Efficacy measure for assessing exercise. However, a measure pertaining to the specific behavior of interest – other than exercise – should be chosen. If measures are adpated to assess other behaviors than psychometrics should be examined.
Intention
Intention (motivational phase) is the reflective resolution to perform a given behavior.
Measurement
(1) Intentions. Item stem: ‘ Which intentioons do you have for the next weeks and months? I intend to…’. 10-item scale measuring a variety of health behaviors (e.g., (1)’…eat as little fat as possible (i.e., avoid fatty meat, cheese, etc.), (2)’…quit smoking’, and (3)’…exercise regularly’.
Pros: free to use, brief measure likely reduces participant burden, provides general internetions to live a healthy lifestyle, each item could be examined individuall for specific behaviors
Cons: not specific to one behavior, using behaviors individual would not allow for internal consistency assessments, to our knowledge this scale has not been assessed for reliability or validity.
Reference: http://www.hapa-model.de
(2) Intentions. Items: (1)’I intend to exercise regularly over the next two weeks, (2)’ i plan to exercise regularly over the next two weeks’.
Pros: free to use, brief measure will likely reduce participant burden
Cons: Internal consistency of .99 may indicate that items are not tapping into unique variance, has not been assessed for other reliability or validity indices
Reference: Rhodes & Matheson (2005)
(3) Decisional Intentions to be Physically Active. Instructions: ‘The following will ask you about your intention to be regularly physically active’. Item: ‘I tend to engage in physical activity____times per week during the next XX (specify study period or assessment period).
Pros: free to use, short scale is likely to reduce participant burden, open ended measures of intention have been found to be preferable to close ended measures, the behavioral assessment period can be changed as per study protocol, the behavior can be changed to the studies needs
Cons: 1-item measures cannot be assessed for internal consistency
Reference: Courneya (1994)
Our recommendation: We recommend use of the third measure described: (3) Decisional Intentions to be Physically Active. This measure can be adpated for use in other behavioral domains.
Maintenance Self-Efficacy/Coping Self-Efficacy
Maintenance Self-Efficacy/Coping Self-Efficacy (volitional phase) is the optimistic belief that one can successfully overcome barriers to maintaining a behavior.
Measurement
(1)The Nutrition Self-efficacy Scale: Item stem: ‘ I can manage to stick to healthful foods…’. Five-item scale (e.g., (1)’…even if I have to make a detailed plan’, and (2)’…even if I have to try several times until it works’ pertaining to the belief that one can overcome barriers to healthy eating.
Pros: free to use, short measure will likely reduce participant burden, high test-retest reliability, demonstrated predictive validity in terms of intention to engage in healthy eating
Cons: specific to nutrition
Reference: Schwarzer & Renner (n.d.)
(2) The Physical Exercise Self-efficacy Scale: Item stem ‘I can manage to carry out my exercise intentions…’. Five-item scale (e.g., (1)’…even when I have worries or problems’, and (2)’…even if I feel depressed’) pertaining to the belief that one can overcome barriers to exercising.
Pros: free to use, short measure will likely reduce participant burden, high test-retest reliability, demonstrated predictive validity in terms of intention to exercise.
Cons: specific to exercise
Reference: Schwarzer & Renner (n.d.)
Our Recommendation: We recommend choosing a measure that pertains to the specific behavior that is being assessed as measures are likely not generalizable across behaviors.
Recovery Self-Efficacy
Recovery Self-Efficacy (volitional phase) is the optimistic belief that one can successfully re-initiate a behavior after a relapse in action.
Measurement
(1) Recovery Self-Efficacy: Item stem: ‘It may happen that you give up running/jogging for some time. Do you believe that you are able to resume regular running? I am confident that I am able to start regular jogging/running again even if….. Items: (1) ‘…I did not run for some time because I felt weak’, (2) ‘…I did not run for some time because I had no time for doing it on a regular basis’ (3) ‘…I would have to reschedule my running’, (4) ‘…I had a break from my running due to my vacation.’
Pros: free to use, short measure will reduce participant burden. Has moderate reliability and predictive validity.
Cons: specifically pertains to running/jogging behavior. May not tap into all of the reasons that someone may stop running/jogging.
Reference: Luszczynska, Mazurkiewicz, Ziegelmann, & Schwarzer (2007)
Our recommendation: We recommend use of the Recovery Self-Efficacy Measure
Action Planning
Action Plannning (volitional phase) is the reflective process of creating plans to engage in a behavior after a a specified cue. These plans include of the components of when, where, and how behaviors should be conducted. In the case of action planning several cues may be identified. If these plans are repeated then enactment may become habitual or reflexive.
Measurement
(1) Action Planning: Item stem: ‘Do you already have concrete plans with regard to exercising? I already have concrete plans… Items: (1)’…when to exercise’, (2)’…where to exercise’, (3)’…how to exercise’, (4)’…how often to exercise’, and (5)’…with whom to exercise’.
Pros: free to use, brief measure will reduce participant burden, easily adaptable to other behaviors by modifying the item stem.
Cons: To our knowledge, this measure has not be assessed for reliability or validity, additionally the addition of the item ‘with whom to exercise’ could lead to lower scores for those who do not have regular exercise partners, is not a general scale
Source: http://www.hapa-model.de
(2)Action Planning: Item stem: ‘I have a detailed plan regarding…’. Items: (1)’…when to exercise’, (2)’…where to exercise’, (3)’…how to exercise’, and (4)’…how often to exercise’.
Pros: Free to use, brief measure will reduce participant burden, easily adaptable to other behaviors by modifying the items behavioral target, shows divergent validity from intentions and coping planning, is characterized by high internal consistency, and shows high predictive validity with short and long-term exercise assessments.
Cons: is not a general scale
Reference: Sniehotta, Schwarzer, Scholz, & Schüz (2005)
Our Recommendation: We recommend use of the second scale listed: (2) Action Planning
Coping Planning
Coping Planning (volitional phase) is planning how one will overcome potential barriers to behavioral enactment.
Measurement
(1) Coping Planning: Item stem: ‘I have made a detailed plan regarding…’. Items: (1) ‘…what to do if something interferes with my plans’, (2) ‘…how to cope with possible setbacks’, (3) what to do in difficult situations in order to act according to my intentions’, (4) ‘…which good opportunities for action to take’, (5) ‘…when I have to pay extra attention to prevent lapses’.
Pros: Free to use, brief measure will reduce participant burden, easy to adjust to specific behaviors. Predictive validity.
Cons: is a general scale and any specific scale use would require validation.
Reference: Sniehotta, Schwarer, Scholz, & Schuz (2005)
Our Recommendation: We recommend use of this Coping Planning Measure.
Behavioral Initiation
Behavioral Initiation (outcome) is beginning a new behavior.
Measurement
Outcome dependent and can be assessed using both self-report or objective measures. For example, one could assess exercise using accelermoters (e.g., fitbits) or self-report (e.g., International Physical Activity Questionnaire)
Behavioral Maintenance
Behavioral Maintenance (outcome) is sustaining behavioral engagement over time.
Measurement
Outcome dependent and can be assessed using both self-report or objective measures. For example, one could assess exercise using accelermoters (e.g., fitbits) or self-report (e.g., International Physical Activity Questionnaire)
Behavioral Recovery
Behavioral Recovery (outcome) is the return to a behavior after a relapse in action.
Measurement
Outcome dependent and can be assessed using both self-report or objective measures. For example, one could assess exercise using accelermoters (e.g., fitbits) or self-report (e.g., International Physical Activity Questionnaire)
Integrated Behavior Change Model
Integrated Behavior Change Model (IBCM; Hagger & Nikos, 2014): is a dual proccess mode – including both reflective and reflexive predictors of behavior. The IBCM is also a dual-phase model insofar that model is split into motivational components which predict intention and volitional components which predict behavior directly and moderate the intention-behavior gap. The IBCMhas been proposed to predict physical activity, however this theory has also been used to test additional outcomes such as pre-drinking behavior.
CONSTRUCTS & MEASURES
Autonomous Motivation
Autonomous Motivation (motivational phase) is the reflective drive to perform a behavior because it is aligned with one’s intrinsic goals, interests and values which are completely self-determined.
Measurement
Behavioral Regulation in Exercise Questionnaire -Version 3; Available from: (http://pages.bangor.ac.uk/~pes004/exercise_motivation/breq/breq.htm)
The BREQ-3 measures motivation to engage in exercise ranging from amotivation – intrinsic motivation. Scoring procedures, including the relative autonomy index, are available on the aforementioned website website.
Pros: Free to use; multi-item allows for the assessmnet of internal relibaility
Cons: Behavior specific
Reference: Markland & Tobin, 2004
Our Recommendation: We recommend use of the Behavioral Regulation in Exercise Questionnaire.
Attitude
Attitude (motivational phase) is a reflective belief that a given behavior can lead to desired outcomes.
Measurement
Affective and instrumental attitudes both preceeded by the following stem: Over the _ (time) engaging in physical activity would be: For affective attitudes: (1) Interest-boring, (2) enjoyable-unenjoyable, (3) relaxing-stressful (rated on a 7-point Likert scale). For instrumental attitudes: (1) beneficial-harmful, (2) useful-useless, (3) wise-foolish.
Pros: free, short, internally consistent, predicitve validity.
Cons: N/A
Reference: Rhodes & Courneya, 2003
Our Recommendation: We recommend use of the Affective and Instrumental Attitudes Measure.
Perceived Behavioral Control
Perceived Behavioral Control (motivational phase) is the reflective belief that one is capable of performing a behavior.
Measurement
(1)Theory of Planned Behavior Self-efficacy. Item: ‘ I am confident that if I wanted to I could ‘INSERT BEHAVIOR HERE’ on a regular basis.
Pros: Free to use, brief measure should reduce participant burden, easily adaptable to a variety of behaviors
Cons: 1-item measures cannot be assessed for internal consistency
Reference: http://www.midss.org
(2) Preactional Self-Efficacy. Item stem:’ It is always hard to get started. How sure are you that you can start exercising regularly? I am sure I can start being physicall activity immediately, even if…’. Items: (1)’…I initially have to reconsider my views on physical activity, (2)’…I have to force myself to start immediately, (3)’…I have to push myself.
Pros: free to use, brief measure may reduce particpant burden, may be generalizeable to other behavior if item stem and items are changed
Cons: to our knowledge this measure has not been assessed in terms of reliability or validity
Reference: http://www.hapa-model.de
Our Recommendation: We recommend the (2) Pre-actional Self-Efficacy measure for assessing exercise. However, a measure pertaining to the specific behavior of interest – other than exercise – should be chosen. If measures are adpated to assess other behaviors than psychometrics should be examined.
Intention
Intention (motivational phase) is the reflective resolution to perform a given behavior.
Measurement
(1) Intentions. Item stem: ‘ Which intentioons do you have for the next weeks and months? I intend to…’. 10-item scale measuring a variety of health behaviors (e.g., (1)’…eat as little fat as possible (i.e., avoid fatty meat, cheese, etc.), (2)’…quit smoking’, and (3)’…exercise regularly’.
Pros: free to use, brief measure likely reduces participant burden, provides general internetions to live a healthy lifestyle, each item could be examined individuall for specific behaviors
Cons: not specific to one behavior, using behaviors individual would not allow for internal consistency assessments, to our knowledge this scale has not been assessed for reliability or validity.
Reference: http://www.hapa-model.de
(2) Intentions. Items: (1)’I intend to exercise regularly over the next two weeks, (2)’ i plan to exercise regularly over the next two weeks’.
Pros: free to use, brief measure will likely reduce participant burden
Cons: Internal consistency of .99 may indicate that items are not tapping into unique variance, has not been assessed for other reliability or validity indices
Reference: Rhodes & Matheson (2005)
(3) Decisional Intentions to be Physically Active. Instructions: ‘The following will ask you about your intention to be regularly physically active’. Item: ‘I tend to engage in physical activity____times per week during the next XX (specify study period or assessment period).
Pros: free to use, short scale is likely to reduce participant burden, open ended measures of intention have been found to be preferable to close ended measures, the behavioral assessment period can be changed as per study protocol, the behavior can be changed to the studies needs
Cons: 1-item measures cannot be assessed for internal consistency
Reference: Courneya (1994)
Our Recommendation: We recommend the (3) Decisional Intentions to be Physically Active.
Implicit Attitudes
Implicit Attitudes (volitional phase) is the reflexive evaluation of a behavior that occurs without conscious awareness. These evaluations can be positive or negative and do not necessarily align with their reflective or explicit attitudes.
Measurement
Implicit Association Test: measures strength of associations between mental representations of concepts (e.g., black people or white people) and evaluations (e.g., good or bad; attitude).
Pros: Easy to create word-based and picture-based IATs with the iatgen program which can be embedded in qualtrics (Carpenter et al, 2018); Stimuli are customizeable; Can be created in other programs such as EPrime to give the user more control; Quick to administer; the IAT has a strandardized scoring algorithm which is computed automatically using iatgen.
Cons: the IAT is susceptible to participants using deliberate processing to fake responses; the use of difference scores (IAT outcome) is psychometrically suspect; the use of stregnth of association between a concept and its evaluation is only an indriect measure of implicit attitudes
References: Greenwald, A. G., McGhee, D. E., Schwartz, J. L. K. (1998); Carpenter, et al. (2018)
Our Recommendation: We recommend use of the Implicit Association Test.
Implicit Motivation
Implicit Motivation (volitional phase) is the reflexive drive to perform a behavior. Implicit motivation can be autonomous or controlled (i.e., driven by sources outside the self) and is a traitlike difference in individuals’ self-determined orientation towards behavioral enactment that is not specific to any given behavior.
Measurement
Implicit Association Test: measures stregnth of associations between mental representations of concepts (e.g., black people or white people) and evaluations (e.g., autonomous or controlled; motivation).
Pros: Easy to create word-based and picture-based IATs with the iatgen program which can be embedded in qualtrics (Carpenter et al, 2018); Stimuli are customizeable; Can be created in other programs such as EPrime to give the user more control; Quick to administer; the IAT has a strandardized scoring algorithm which is computed automatically using iatgen.
Cons: the IAT is susceptible to participants using deliberate processing to fake responses; the use of difference scores (IAT outcome) is psychometrically suspect; the use of stregnth of association between a concept and its evaluation is only an indriect measure of implicit attitudes
References: Greenwald, A. G., McGhee, D. E., Schwartz, J. L. K. (1998); Carpenter, et al. (2018).
Our Recommendation: We recommend use of the Implicit Association Test.
Action Planning
Action Planning (volitional phase) is the reflective process of creating plans to engage in a behavior after a a specified cue. These plans include of the components of when, where, and how behaviors should be conducted. In the case of action planning several cues may be identified. Additionally, coping planning is usually included in action planning – that is planning how one will overcome potential barriers to behavioral enactment. If these plans are repeated then enactment may become habitual or reflexive.
Measurement
(1)Action Planning: Item stem: ‘Do you already have concrete plans with regard to exercising? I already have concrete plans… Items: (1)’…when to exercise’, (2)’…where to exercise’, (3)’…how to exercise’, (4)’…how often to exercise’, and (5)’…with whom to exercise’.
Pros: free to use, brief measure will reduce participant burden, easily adaptable to other behaviors by modifying the item stem.
Cons: To our knowledge, this measure has not be assessed for reliability or validity, additionally the addition of the item ‘with whom to exercise’ could lead to lower scores for those who do not have regular exercise partners, is not a general scale
Source: http://www.hapa-model.de
(2) Action Planning: Item stem: ‘I have a detailed plan regarding…’. Items: (1)’…when to exercise’, (2)’…where to exercise’, (3)’…how to exercise’, and (4)’…how often to exercise’.
Pros: Free to use, brief measure will reduce participant burden, easily adaptable to other behaviors by modifying the items behavioral target, shows divergent validity from intentions and coping planning, is characterized by high internal consistency, and shows high predictive validity with short and long-term exercise assessments.
Cons: is not a general scale
Reference: Sniehotta, Schwarzer, Scholz, & Schüz (2005)
Our Recommendation: We recommend use of the (2)Action Planning Scale.
Behavior
Behavior (outcome varibale) is the enactment of a given action. In the case of the original IBCM model, this action would be physical activity or exercise.
Measurement
Outcome dependent and can be assessed using both self-report or objective measures. For example, one could assess exercise using accelermoters (e.g., fitbits) or self-report (e.g., International Physical Activity Questionnaire)
Self-Determination Theory
Self-Determination Theory (SDT; Deci & Ryan, 1985) is a meta-theory of human motivation towards behavior. In SDT individuals are thought to be active agents in determining their behavior. In this sense, individuals are thought to have evolved to be growth-orientated, seek challenges in terms of mastery experiences, and to integrate growth-related and mastery-related experiences into one’s sense of self. These tendencies are required for psychological well-being and can be frustrated in an unsupportive environment. SDT is composed of six mini-theories: cognitive evaluation theory, organismic integration theory, causality orientations theory, basic psychological needs theory, goal content theory, and relationships motivation theory. The first five of these theories are related to physical health outcomes.
CONSTRUCTS & MEASURES
1. Cognitive Evaluation Theory (CET)
CET is concerned with the role of autonomy and competence in the formation of intrinsic moativation.
1a. Intrinsic Motivation is the drive to perform a behavior because one finds it enjoyable and satisfying.
1b. Autonomy is one of the three basic psychological needs. It is characterized by having free choice in terms of behavioral enactment.
1c. Competence is one of the three basic psychological needs. It is characterized by the ability to carry out a task successfully.
Measurement
Behavioral Regulation in Exercise Questionnaire -Version 3; Available from: (http://pages.bangor.ac.uk/~pes004/exercise_motivation/breq/breq.htm)
The BREQ-3 measures motivation to engage in exercise ranging from amotivation – intrinsic motivation. Scoring procedures, including the relative autonomy index, are available on the aforementioned website website.
Pros: Free to use; multi-item allows for the assessmnet of internal relibaility
Cons: Behavior specific
Reference: Markland & Tobin, 2004
Psychological Need Satisfaction in Exercise Scale: each of three needs is measured by six items (e.g., competence: capable of doing challenging exercises, autonomy: free to choose exercises I participate in, relatedness: close to my exercise companions).
Pros: has excellent internal consistency, free to use, short.
Cons: exercise specific
Reference: Wilson, Rogers, Rodgers, & Wild, 2006
Our Recommendation: We recommend use of the Behavioral Regulation in Exercise Questionnaire and the Psychological Need Satisfaction in Exercise Scale
2. Organismic Integration Theory (OIT)
Briefly, OIT is concerned withe the role of autonomy and relatedness in the formation of extrinsic motivation.
2a. External Regulation is the drive to perform a behavior in order to satisfy an external source.
2b. Introjected Regulation is the drive to perform a behavior to attain pride or to avoid guilt.
2c. Identified Regulation is the drive to perform a behavior because one personally values the associated outcomes.
2d. Integrated Regulation is the drive to perform a behavior one identifies with the behavior and values the behavior in and of itself, regardless of outcomes
2e. Autonomy is one of the three basic psychological needs. It is characterized by having free choice in terms of behavioral enactment.
2f. Relatedness is one of the three basic psychological needs. It is characterized by the development and maintenance of close relationships with signifigant others.
Measurement
Behavioral Regulation in Exercise Questionnaire -Version 3; Available from: (http://pages.bangor.ac.uk/~pes004/exercise_motivation/breq/breq.htm)
The BREQ-3 measures motivation to engage in exercise ranging from amotivation – intrinsic motivation. Scoring procedures, including the relative autonomy index, are available on the aforementioned website website.
Pros: Free to use; multi-item allows for the assessmnet of internal relibaility
Cons: Behavior specific
Reference: Markland & Tobin, 2004
Psychological Need Satisfaction in Exercise Scale: each of three needs is measured by six items (e.g., competence: capable of doing challenging exercises, autonomy: free to choose exercises I participate in, relatedness: close to my exercise companions).
Pros: has excellent internal consistency, free to use, short.
Cons: exercise specific
Reference: Wilson, Rogers, Rodgers, & Wild, 2006
Our Recommendation: We recommend use of both the Behavioral Regulation in Exercise Questionnaire and Psychological Need Satisfaction in Exercise Scale
3. Causality Orientations Theory (COT)
Breifly, COT is concered with trait-like tendencies to regulate behavior in general.
3a. Autonomy Orientation is regulating behavior in order to satisfy all three of the basic needs (i.e., autonomy, competence, and relatedness). In this regard, motivation to peform a behavior can become internalized (i.e. intrinsic)
3b. Control Orientation is regulating behavior in order to satisfy the needs for competence and relatedness needs only. In this regard, motivation to perform behavior is never fully internalized (i.e., intrinsic)
3c. Amotivated Orientation is not concerned with meeting autonomy or competence. Rather, success is thought to be related to ‘fate’ or ‘luck’.
Measurement
The General Causality Orientations Scale (GCOS): is a 36-item scale that measures autonomy orientation, control orientation, and amotivated orientation.
Pros: Free to use, breif measure that captures all three theoretical orientations, has been adpated to specific behaviors such as exercise, is well-validated.
Cons: N/A
Source: selfdeterminationtheory.org
Reference: Deci & Ryan (1985)
Our Recommendation: We recommend use of the General Causality Orientation Scale.
4. Basic Psychological Needs Theory (BPNT)
Briefly, BPNT postits that the achievemnt of the three basic needs (i.e. autonomy, competence, and relatedness) are necessary to obtain psychological well-being and optimal functioning. The three needs are thought to be universal.
4a. Autonomy is one of the three basic psychological needs. It is characterized by having free choice in terms of behavioral enactment.
4b. Competence is one of the three basic psychological needs. It is characterized by the ability to carry out a task successfully.
4c. Relatedness is one of the three basic psychological needs. It is characterized by the development and maintenance of close relationships with signifigant others
Measurement
The Basic Psychological Need Satisfaction Scale – General Measure: is a 21-item scale that assesses the need for competence, autonomy and relatedness.
Pros: Free to use, has been adapted to several domains such as physical education and work.
Cons: Only assesses needs satisfaction and need frustrated is not measured; Some research has found that the three factor structure proposed by this measure is not supported (Johnston & Finney, 2010)
Source: selfdeterminationtheory.org
Reference: Dec i& Ryan, 2000 & Gagne, 2003
The Basic Psychological Need Satisfaction and Frustration Scale – General Measure: is a 24-item measure that assesses need and frustrtaion of autonomy, competence, and relatedness.
Pros: free to use; has been translated into dutch, english, chinese, and spanish, is psychometrically valid insofar that need satisfaction predicts positive outcomes and need frustrtaion predicts negative outcomes, has been translated to other domains such as physical education and work outcomes, high internal consistency, the hypotheszied 6-factor measure is supported by data.
Cons: N/A
Source: selfdeterminationtheory.org
Reference: Chen et al., (2015)
Our Recommendation: We recommend use of the The Basic Psychological Need Satisfaction and Frustration Scale.
5. Goal Contents Theory (GCT)
Briefly, GCT posits that intrinsic goals are more internalized in terms of motivational orientation and lead to better psychological wellbeing in comparison with extrinsic goals.
5a. Extrinsic Goals are goals that have outcomes that are external to the self such as money, or attractiveness.
5b. Intrinsic Goals are goals that have outcomes that are internal to the self such as being productive or personal-growth.
5c. Autonomy is one of the three basic psychological needs. It is characterized by having free choice in terms of behavioral enactment.
5d. Competence is one of the three basic psychological needs. It is characterized by the ability to carry out a task successfully.
5e. Relatedness is one of the three basic psychological needs. It is characterized by the development and maintenance of close relationships with signifigant others.
Measurement
Goal Content for Exercise Questionnaire: 20-item scale including three facets of intrinsic goals: health management, skill development, and social affiliation, and two facets of extrinsic gols: image and social recognition. Rated on a 7-Point scale from ‘Not at all’ to ‘Extremey Important’.
Pros: good internal consistency, short, free, factoral invariance across genders, external validity.
Cons: exercise specific
Reference: Sebire, Standage, & Vansteenkiste, 2008; 2009
Psychological Need Satisfaction in Exercise Scale: each of three needs is measured by six items (e.g., competence: capable of doing challenging exercises, autonomy: free to choose exercises I participate in, relatedness: close to my exercise companions).
Pros: has excellent internal consistency, free to use, short.
Cons: exercise specific
Reference: Wilson, Rogers, Rodgers, & Wild, 2006
Our Recommendation: We recommend use of the Goal Content for Exercise Questionnaire and the Psychological Need Satisfaction in Exercise Scale
Common-Sense Model of Self-Regulation (CSM-SR)
The commonsense self-regulation model (CS-SRM) is a dual-process (i.e., including both controlled and automatic factors) theoretical model that was developed to help comprehend how individuals perceive and cope with illness (Leventhal, 1970). The CS-SRM portends that illness outcomes are due to cognitive and emotional illness representations.
CONSTRUCTS & MEASURES
Cognitive Illness Representations
Cognitive illness representations: consists of five fundamental aspects including: (1) identity, (2) timeline, (3) cause, (4) consequences, and (5) perceived control. Identity is labeling a symptom as belong to an illness whereas timeline refers to a threats trajectory. Meanwhile, cause refers to the perceived reasons for the occurrence of a given illness. Alternatively, consequences refer to how one believes an illness will impact their life. Finally, perceived control is a belief about an individual’s ability to impact the outcome of a given illness.
Measurement
Revised Illness Perception Questionnaire: is a measure used to assess aspects of the CS-SRM including: Identity, timeline, consequences, personal control, treatment control, illness coherence, emotional representations, and causes. Identity is measured using a ‘yes/no’ scale whereas other items are measured using a 5-point Likert-type scale.
Pros: covers the CS-SRM, good test, re-test reliability, website has it prepped for various diseases including diabetes, chronic pain, and asthma.
Cons: lengthy if the entire CS-SRM theory is not of interest
Reference: Moss-Morris et al., 2002
Website: https://www.uib.no/ipq/
Our Recommendations: We recommend choosing a measure that pertains to the specific condition that is being assessed as measures are likely not generalizable.
Emotional Illness Representations
Emotional illness representations are an individual’s emotional response to symptoms (e.g., fear).
Measurement
Revised Illness Perception Questionnaire: is a measure used to assess aspects of the CS-SRM including: Identity, timeline, consequences, personal control, treatment control, illness coherence, emotional representations, and causes. Identity is measured using a ‘yes/no’ scale whereas other items are measured using a 5-point Likert-type scale.
Pros: covers the CS-SRM, good test, re-test reliability, website has it prepped for various diseases including diabetes, chronic pain, and asthma.
Cons: lengthy if the entire CS-SRM theory is not of interest
Reference: Moss-Morris et al., 2002
Website: https://www.uib.no/ipq/
Our Recommendations: We recommend choosing a measure that pertains to the specific condition that is being assessed as measures are likely not generalizable.
Coping Responses
Coping responses refer to the manner in which an individual deals with an illness (e.g., avoidance, problem-focused)
Measurement
Revised Illness Perception Questionnaire: is a measure used to assess aspects of the CS-SRM including: Identity, timeline, consequences, personal control, treatment control, illness coherence, emotional representations, and causes. Identity is measured using a ‘yes/no’ scale whereas other items are measured using a 5-point Likert-type scale.
Pros: covers the CS-SRM, good test, re-test reliability, website has it prepped for various diseases including diabetes, chronic pain, and asthma.
Cons: lengthy if the entire CS-SRM theory is not of interest
Reference: Moss-Morris et al., 2002
Website: https://www.uib.no/ipq/
Our Recommendations: We recommend choosing a measure that pertains to the specific condition that is being assessed as measures are likely not generalizable.
Body Image
Body Image is not specific to one theory of health behavior. Rather, body image is an important intrapersonal factor that has been shown to impact important health outcomes such as exercise and eating behaviors. Body image is composed of four components (1. perceptual, 2. affective, 3.cogtive, and 4.behavioral) and can fall into one of two categories: psotive body image and negative body image
CONSTRUCTS
- Perceptual Body Image is what one believes their body looks like
- Affective Body Image is how one feels about the appearance of their body
- Cognitive Body Image is how one thinks about their body
- Behavioral Body Image is any behaviors that an individual engages in as a result of their perceptual, affective, and cognitive body image