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Behavior performed in the presence of consistent cues is a core element for successful habit development, with the repeated presence of consistent cues facilitating the activation of automatic responses in future. Yet, little is known about the effects of different cue types on habit. Using a two-wave prospective PLS-SEM model with a sample of 68 undergraduate students, we assessed the mediating effects of habit on the past-behavior-to-physical-activity relationship, and how the mediating effects of habit were moderated by the consistent presence of different forms of cues. Habit mediated the effects of past behavior on physical activity, with a significantly stronger mediating effect of habit in those reporting undertaking physical activity at the same time of day, doing the same activity, and in the same mood. Consistent place, people, and part of routine did not moderate the effects of habit. The results provide formative evidence for a key assertion of the habit theory that consistent contextual and internal cues are a cornerstone of habitual development and action, but they also indicate the importance of examining different forms of cues and their impact on the formation and enaction of habits as some cues may be more relevant than others.

OBJECTIVE: Container deposit schemes are often hailed as a useful avenue to increase consumer recycling rates. Yet, there is little research investigating within-person changes in peoples beliefs and behavior following the implementation of these schemes, or tests of the mechanisms by which such change has occurred. METHODS: The current study fills this knowledge gap and assessed container recycling behavior and habits as well as the social cognition factors of attitudes, subjective norms, perceived behavioral control, and intentions in a sample of 90 Queenslanders before the implementation of the container deposit scheme and one and three months post-implementation. RESULTS: Analysis of variance indicated more frequent recycling behavior following the implementation of the scheme, as well as stronger habits, intentions, and perceived behavioral control. CONCLUSIONS: Such a concomitant change in behavior, beliefs, and habits provides support for behavior change theory, while also flagging potential targets for strategies that can be paired with container deposit schemes to enhance their efficacy and uptake.

The current study assessed cross-lagged relationships between binge drinking, implicit beliefs, and habit in undergraduate university students (N = 105). Students completed self-report survey and implicit measures in lab visits 3 months apart. A structural equation model revealed cross-lagged relations between habit and behavior, and some evidence for a reciprocal relationship between implicit beliefs and habit. Implicit beliefs were related to alcohol behavior across time, but no cross-lagged relationship was observed. Findings provide preliminary support for recent advances in habit theory, suggesting that implicit beliefs and habit may develop in tandem or even share common knowledge structures and schemas.

INTRODUCTION: High levels of sugar intake are associated with multiple maladaptive health outcomes in adult and younger populations. Identifying the psychological determinants of sugar intake in adolescents, and the processes involved, may help identify potentially modifiable targets and inform intervention development. We tested the predictions of an extended theoretical model based on the theory of planned behavior (TPB), which specified social cognition constructs, habit, and self-control as correlates of sugar intake in an adolescent sample. METHODS: Adolescents aged 12 to 14 years (N = 88) recruited via a survey panel company and consenting to participate in the study completed online self-report measures of constructs from the TPB alongside measures of habit and self-control. One month later, participants completed a follow-up measure of free-sugar intake. Hypothesized effects of our proposed extended model were tested using partial least squares structural equation modeling. RESULTS: We found statistically significant effects of attitude, subjective norm, and perceived behavioral control on sugar intake intentions. We also found significant effects of habit and self-control on sugar intake measured at follow-up, but no effect for intention. Perceived behavioral control moderated the intention-behavior relationship such that intention effects on behavior were larger when perceived behavioral control was high. However, self-control did not moderate the intention-behavior relationship. CONCLUSION: Results indicate that sugar intake in this sample was a function of habits and self-control, and the effect of sugar intake intentions was conditional on perceived behavioral control. Results contribute to an evidence base of determinants and associated processes that relate to sugar intake in adolescents and may signal potentially modifiable targets for intervention.

Achieving broad immunity through vaccination is a cornerstone strategy for long-term management of COVID-19 infections, particularly the prevention of serious cases and hospitalizations. Evidence that vaccine-induced immunity wanes over time points to the need for COVID-19 booster vaccines, and maximum compliance is required to maintain population-level immunity. Little is known of the correlates of intentions to receive booster vaccines among previously vaccinated individuals. The present study applied an integrated model to examine effects of beliefs from multiple social cognition theories alongside sets of generalized, stable beliefs on individuals' booster vaccine intentions. US residents (N = 479) recruited from an online survey panel completed measures of social cognition constructs (attitude, subjective norms, perceived behavioral control, and risk perceptions), generalized beliefs (vaccine hesitancy, political orientation, and free will beliefs), and COVID-19 vaccine intentions. Social cognition constructs were related to booster vaccine intentions, with attitude and subjective norms exhibiting the largest effects. Effects of vaccine hesitancy, political orientation, and free will beliefs on intentions were mediated by the social cognition constructs, and only vaccine hesitancy had a small residual effect on intentions. Findings provide preliminary evidence that contributes to an evidence base of potential targets for intervention messages aimed at promoting booster vaccine intentions.

The COVID-19 pandemic has had unprecedented health, economic, and social consequences worldwide. Although contact reductions and wearing face coverings have reduced infection rates, and vaccines have reduced illness severity, emergence of new variants of the coronavirus that causes COVID-19, and the shift from pandemic to endemic patterns of infection, highlights the importance of ongoing preventive behavior adherence to manage future outbreaks. Research applying social cognition theories may assist in explaining variance in these behaviors and inform the development of efficacious behavior change interventions to promote adherence. In the present article, we summarize research applying these theories to identify modifiable determinants of COVID-19 preventive behaviors and the mechanisms involved, and their utility in informing interventions. We identify limitations of these applications (e.g., overreliance on correlational data, lack of long-term behavioral follow-up), and suggest how they can be addressed. We demonstrate the virtue of augmenting theories with additional constructs (e.g., moral norms, anticipated regret) and processes (e.g., multiple action phases, automatic processes) to provide comprehensive, parsimonious behavioral explanations. We also outline how the theories contribute to testing mechanisms of action of behavioral interventions. Finally, we recommend future studies applying these theories to inform and test interventions to promote COVID-19 preventive behavior adherence.

Vaccines are highly effective in minimizing serious cases of COVID-19 and pivotal to managing the COVID-19 pandemic. Despite widespread availability, vaccination rates fall short of levels required to bring about widespread immunity, with low rates attributed to vaccine hesitancy. It is therefore important to identify the beliefs and concerns associated with vaccine intentions and uptake. The present study aimed to develop and validate, using the AMEE Guide, the Vaccination Concerns in COVID-19 Scale (VaCCS), a comprehensive measure of beliefs and concerns with respect to COVID-19 vaccines. In the scale development phase, samples of Australian (N = 53) and USA (N = 48) residents completed an initial open-response survey to elicit beliefs and concerns about COVID-19 vaccines. A concurrent rapid literature review was conducted to identify content from existing scales on vaccination beliefs. An initial pool of items was developed informed by the survey responses and rapid review. The readability and face validity of the item pool was assessed by behavioral science experts (N = 5) and non-experts (N = 10). In the scale validation phase, samples of Australian (N = 522) and USA (N = 499) residents completed scaled versions of the final item pool and measures of socio-political, health beliefs and outcomes, and trait measures. Exploratory factor analysis yielded a scale comprising 35 items with 8 subscales, and subsequent confirmatory factor analyses indicated acceptable fit of the scale structure with the data in each sample and factorial invariance across samples. Concurrent and predictive validity tests indicated a theoretically and conceptually predictable pattern of relations between the VaCCS subscales with the socio-political, health beliefs and outcomes, and trait measures, and key subscales predicted intentions to receive the COVID-19 vaccine. The VaCCS provides a novel measure to assess beliefs and concerns toward COVID-19 vaccination that researchers and practitioners can use in its entirety or select specific sub-scales to use according to their needs.

While there is good evidence supporting the positive effect of planning strategies like implementation intentions on the relationship between intention and behavior, there is less evidence on the moderating role of individual differences in planning capacity on this effect. This study aimed to examine the role of individual differences in planfulness on the effect of planning strategies on the intention-behavior gap. Specifically, this study investigated the influence of planfulness on the effectiveness of implementation intentions on goal-directed behavior using an experimental design. Undergraduate university students (N = 142) with high and low levels of planfulness based on a priori scores on a planfulness measure were randomized to either a planning (implementation intention) or familiarization (control) condition prior to completing a computerized go no-go task. We predicted that individuals reporting low levels of planfulness would be more effective in executing goal-directed behavior when prompted to form an implementation intention compared to individuals who do not receive a prompt. Additionally, we predicted that individuals reporting high planfulness would be equally effective in enacting goal-directed behaviour regardless of whether they formed an implementation intention. The results revealed no main or interaction effects of implementation intention manipulation and planfulness on task reaction times. The current results do not provide support for the moderating effect of planfulness on the implementation effect. The findings of this study were inconsistent with previous literature. This research has implications for the effectiveness of implementation intentions, as well as opportunities for further replication in a novel research area.

Causality orientations theory, a key sub-theory of self-determination theory, identifies three distinct causality orientations: autonomy, control, and impersonal orientation. The theory proposes generalized effects of the orientations on motivation and behavior. We meta-analyzed studies ( k = 83) testing relations between causality orientations, forms of motivation from self-determination theory, and behavior. Pooled data were used to test a process model in which autonomous and controlled forms of motivation mediated relations between causality orientations and behavior. Results revealed that autonomy and control orientations were positively correlated with autonomous and controlled forms of motivation, respectively. Impersonal orientation was correlated negatively with autonomy orientation and autonomous forms of motivation, and positively with control orientation and controlled forms of motivation. Process model tests revealed total effects of autonomy orientation on behavior, comprising direct and indirect effects through autonomous motivation, and a positive direct effect of control orientation on behavior and a negative indirect effect through controlled motivation, resulting in a zero total effect. Analysis of age, gender, behavior type, study design, and study quality revealed few moderator effects on model relations. Findings support effects of autonomy orientation on motivation and behavior, and the processes involved, and identify constructs that could be targeted, or circumvented, in behavioral interventions.

IntroductionBeliefs about the consequences of stress, stress mindsets, are associated with health and performance outcomes under stress. This article reports the development and examination of the psychometric properties of a measure of stress mindset: The Stress Control Mindset Measure (SCMM). The measure is consistent with theory on mindsets about self-attributes and conceptualizes stress mindset as the extent to which individuals endorse beliefs that stress can be enhancing.MethodsThe study adopted a correlational cross-sectional survey design in two student samples. Undergraduate students from an Australian university (Sample 1, N = 218) and a UK university (Sample 2, N = 214) completed the SCMM and measures of health and well-being outcomes.ResultsConfirmatory factor analyses supported a four-factor structure and strict measurement invariance across samples (ΔCFI

We tested a dual process model incorporating constructs that reflect both performing the target behaviour (behaviour directed habit) and habits that run counter to the target behaviour (opposing behaviour habit) in accounting for variance in two health behaviours: eating the recommended serves of fruits and vegetables a day and restricting sugar-sweetened beverage consumption. A prospective correlational design with two waves of data collection separated by one week was adopted. Participants (N = 606) comprising middle school students (n = 266) and university students (n = 340) completed an initial survey comprising self-report measures of past behaviour, intention, and habit to perform the target behaviour and habits that run counter to the target behaviour. One week later, participants (N = 414) completed a self-reported measure of behaviour. Results revealed that behaviour directed habits predicted fruit and vegetable consumption in both samples, while opposing behaviour habits predicted restriction of sugar-sweetened beverages in the middle-school sample only, with a moderating effect also observed. Current findings indicate that habits specifying avoidance of the target behaviour did not predict future behaviour. However, the moderating effect observed provides preliminary evidence that strong habits to perform a behaviour may override habit to avoid the behaviour.

The present study aimed to examine effects of motivational and social cognition constructs on children's leisure-time physical activity participation alongside constructs representing implicit processes using an extended trans-contextual model. The study adopted a correlational prospective design. Secondary-school students (N = 502) completed self-report measures of perceived autonomy support from physical education (PE) teachers, autonomous motivation in PE and leisure-time contexts, and social cognition constructs (attitudes, subjective norms, perceived behavioral control), intentions, trait self-control, habits, and past behavior in a leisure-time physical activity context. Five weeks later, students (N = 298) self-reported their leisure-time physical activity participation. Bayesian path analyses supported two key premises of the model: perceived autonomy support was related to autonomous motivation in PE, and autonomous motivation in PE was related to autonomous motivation in leisure time. Indirect effects indicated that both forms of autonomous motivation were related to social cognition constructs and intentions. However, intention was not related to leisure-time physical activity participation, so model variables reflecting motivational processes did not account for substantive variance in physical activity participation. Self-control, attitudes, and past behavior were direct predictors of intentions and leisure-time physical activity participation. There were indirect effects of autonomous motivation in leisure time on intentions and physical activity participation mediated by self-control. Specifying informative priors for key model relations using Bayesian analysis yielded greater precision for some model effects. Findings raise some questions on the predictive validity of constructs from the original trans-contextual model in the current sample, but highlight the value of extending the model to incorporate additional constructs representing non-conscious processes.

BackgroundThis study examined the social cognition determinants of social distancing behavior during the COVID-19 pandemic in samples from Australia and the US guided by the health action process approach (HAPA).MethodsParticipants (Australia: N = 495, 50.1% women; US: N = 701, 48.9% women) completed HAPA social cognition constructs at an initial time-point (T1), and one week later (T2) self-reported their social distancing behavior.ResultsSingle-indicator structural equation models that excluded and included past behavior exhibited adequate fit with the data. Intention and action control were significant predictors of social distancing behavior in both samples, and intention predicted action and coping planning in the US sample. Self-efficacy and action control were significant predictors of intention in both samples, with attitudes predicting intention in the Australia sample and risk perceptions predicting intention in the US sample. Significant indirect effects of social cognition constructs through intentions were observed. Inclusion of past behavior attenuated model effects. Multigroup analysis revealed no differences in model fit across samples, suggesting that observed variations in the parameter estimates were relatively trivial.ConclusionResults indicate that social distancing is a function of motivational and volitional processes. This knowledge can be used to inform messaging regarding social distancing during COVID-19 and in future pandemics.

ObjectivesRates of novel coronavirus disease 2019 (COVID-19) infections have rapidly increased worldwide and reached pandemic proportions. A suite of preventive behaviours have been recommended to minimize risk of COVID-19 infection in the general population. The present study utilized an integrated social cognition model to explain COVID-19 preventive behaviours in a sample from the Iranian general population.DesignThe study adopted a three-wave prospective correlational design.MethodsMembers of the general public (N = 1,718, Mage  = 33.34, SD = 15.77, male = 796, female = 922) agreed to participate in the study. Participants completed self-report measures of demographic characteristics, intention, attitude, subjective norm, perceived behavioural control, and action self-efficacy at an initial data collection occasion. One week later, participants completed self-report measures of maintenance self-efficacy, action planning and coping planning, and, a further week later, measures of COVID-19 preventive behaviours. Hypothesized relationships among social cognition constructs and COVID-19 preventive behaviours according to the proposed integrated model were estimated using structural equation modelling.ResultsThe proposed model fitted the data well according to multiple goodness-of-fit criteria. All proposed relationships among model constructs were statistically significant. The social cognition constructs with the largest effects on COVID-19 preventive behaviours were coping planning (β = .575, p

BackgroundSocial 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.PurposeThe 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.MethodsIn 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.ResultsStructural 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.ConclusionsCurrent 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.

ObjectivePast behavior has been consistently shown to predict and explain future behavior. It has been proposed that past behavior effects reflect both reasoned action and automatic processes. The current study sought to explore the mediation of past behavior-future behavior relationship via constructs reflecting these processes across three populations and behaviors: binge drinking in university students, flossing in adults, and parental sun safety behavior of children 2 - 5 years of age. Furthermore, this study used a measure of past behavior that combined long-term, recent, and routine patterns of behavioral engagement.MethodA prospective design with two waves of data collection spaced six weeks apart was adopted. Participants (total N = 754) completed an initial survey containing measures of past behavior (frequency, recency, and routine), social cognition (attitudes, subjective norms, perceived behavioral control), and behavioral automaticity. Six weeks later, participants (N = 454) completed a self-report measure of behavior and behavioral automaticity.ResultsStructural equation modelling revealed that automatic, but not reasoned-action processes, mediated the past-to-future relationship, across the three behaviors. Results further revealed that long-term, recent, and routine patterns of behavioral engagement were highly correlated and indicated a second-order past behavior latent variable.ConclusionsWhile both reasoned-action and automatic factors can predict a range of health behaviors, automatic processes appear to explain the effect of past behavior on future behavior. Further investigations should focus on exploring the role of other non-conscious and automatic processes such as counter-intentional habits and implicit beliefs in explaining engagement in heath behaviors.

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.

Objective: Hand washing and sleep hygiene are two important health behaviors. The purpose of the current study was to identify the motivational and volitional antecedents of college students' hand washing and sleep hygiene behaviors based on an integrated model of behavior that combined social-cognition constructs from the Theory of Planned Behavior (TPB) and Health Action Process Approach (HAPA). Methods: Using a prospective design, college students (N = 1106) completed a survey assessing the motivational constructs of action self-efficacy, attitudes, subjective norm, perceived behavioral control, intentions, and behaviors of hand washing and sleep hygiene at Time 1. Demographic variables were also collected. One month later, at Time 2, college students (N = 524) self-reported on their volitional factors of maintenance self-efficacy, action planning, coping planning, and behaviors of hand washing and sleep hygiene. A further 2 months later, at Time 3, college students (N = 297) were asked to self-report on their hand washing and sleep hygiene behaviors over the past month. Findings: Data were analyzed using variance-based structural equation modelling. Results showed significant direct effects of attitudes, subjective norm, and perceived behavioral control on intentions; significant direct effects of action self-efficacy on maintenance self-efficacy; and significant direct effects of maintenance self-efficacy on action planning and coping planning. Significant direct effects of intention on action planning (sleep hygiene only), and significant direct effects of intention, maintenance self-efficacy (hand washing only), action and coping planning on behavior were also observed. Action planning also moderated the intention-behavior relationship, but only for hand washing. There were also significant total indirect effects of action self-efficacy on behavior mediated by maintenance self-efficacy, action planning, and coping planning for both behaviors, and significant total indirect effects of subjective norm and perceived behavioral control on behavior mediated by intention for sleep hygiene. When past behavior was included in the integrated model predicting all the psychological variables and behavior, all of the structural relations were attenuated. Discussion: Current findings indicate that college students' hand washing and sleep hygiene behaviors are a function of both motivational and volitional factors. Findings also indicate that the TPB and HAPA pathways might differ for the two health behaviors. Implications of the current findings for future health interventions aimed at improving college students' hand washing and sleep hygiene are discussed.

Objectives University students commonly engage in heavy episodic drinking (HED), which contributes to injury risk, deleterious educational outcomes, and economic costs. Identification of the determinants of this risky behaviour may provide formative evidence on which to base effective interventions to curb HED in this population. Drawing from theories of social cognition and dual-process models, this study tested key hypotheses relating to reasoned and implicit pathways to action for HED in a sample of Australian university students who drink alcohol. Design A two-wave correlational design was adopted. Methods Students (N = 204) completed self-reported constructs from social cognition theories with respect to HED at an initial time point (T1): attitude, subjective norm, perceived behavioural control, intentions, habit, past behaviour, and implicit alcohol identity. Four weeks later (T2), students self-reported their HED behaviour and habit. Results An initial path model indicated attitude and subjective norm predicted intentions, and intentions and implicit alcohol identity predicted HED. Inclusion of past behaviour and habit revealed direct effects of these on HED. Effects of T1 habit on HED were indirect through T2 habit, and there were indirect effects of past behaviour on HED through habit at both time points and the social cognition constructs. Direct effects of intentions and implicit alcohol identity, and indirect effects of attitude and subjective norm, on HED, were attenuated by the inclusion of past behaviour and habit. Conclusion Results indicate that university students' HED tends to be governed by non-conscious, automatic processes than conscious, intentional processes. Statement of contribution What is already known on this subject? Social cognitive factors are associated with risky alcohol consumption behaviours. Dual-process models are being used to explain health behaviours, such as heavy episodic drinking (HED). What does this study add? Past HED behaviour and HED habits have direct and indirect effects on students' HED behaviour. Past behaviour and habit attenuate the effects of intentions and implicit alcohol identity on HED.

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.

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.

Background: Initiatives aimed at increasing participation in preventive health behaviors has been identified as a priority for addressing the increasing incidence of non-communicable chronic disease. General practice is an existing network that can be leveraged to intervene and promote messages for health behavior change. We aimed to explore the extent to which 'lifestyle' behaviors are discussed by general practitioners (GPs) with their patients in their practices, and the context and content of these discussions. Methods: GPs (N = 26) practising in Australian clinics participated in semi-structured interviews. Data were analyzed using an inductive thematic analysis. Results: Results showed discussions of lifestyle behaviors were brief, but relatively frequent and often initiated by the GP. GPs generally provided basic advice and education that was often ad-hoc and in reaction to prompts from the patient. GPs recognized the importance of addressing lifestyle behaviors in practice, but also highlighted substantive barriers that limit the initiation of these discussions. These included patient readiness for change, patient acceptance and openness, patient accountability and responsibility, patient background factors, GPs' role and knowledge, GP financial implications, GP-patient relationship, and lack of time. Conclusions: Current findings provide important preliminary knowledge on the extent to which Australian GPs discuss lifestyle behavior change with patients during routine consultations, the context and content of these discussions, and barriers to initiating these discussions. Further research should seek to gain a better understanding of barriers and identify strategies to mitigate their impact. This might maximize the potential for GPs to promote adaptive lifestyle behavior change for improving patient health.

IntroductionDrowning due to driving into floodwater accounts for a significant proportion of all deaths by drowning. Despite awareness campaigns such as 'If it's flooded, forget it', people continue to drive into floodwater. This causes loss of life, risk to rescuers and damage to vehicles. The aim of this study was to develop and evaluate an online e-health intervention to promote safe driving behaviour during flood events.Methods and analysisThe study will use a 2×3 randomised controlled trial in which participants are randomised into one of two conditions: (1) education about the risks of driving into floodwater or (2) education about the risks of driving into floodwater plus a theory-based behaviour change intervention using planning and imagery exercises. The effect of the intervention on the primary outcome, intention to drive through floodwater and the secondary outcomes will be assessed using a series of mixed-model analysis of covariances.Ethics and disseminationThe study has been approved by the Griffith University Human Research Ethics Committee. Participants will review a study information sheet and provide informed consent prior to commencing participation. Results will be disseminated through peer-reviewed publications, industry reports, media releases and at academic conferences. Deidentified data will be made publicly available following publication of the results.Trial registration numberACTRN12618001212246.

BackgroundEmerging evidence indicates that holding particular stress mindsets has favorable implications for peoples' health and performance under stress.PurposeThe aim of the current study was to examine the processes by which implicit and explicit stress mindsets relate to health- and performance-related outcomes. Specifically, we propose a stress beliefs model in which somatic responses to stress and coping behaviors mediate the effect of stress mindsets on outcomes.MethodsUndergraduate university students (N = 218, n = 144 females) aged 17- 25 years completed measures of stress mindset, physical and psychological wellbeing, perceived stress, perceived somatic responses to stress, proactive behaviors under stress, and an implicit association test assessing an implicit stress mindset. At the end of the semester, students' academic performance was collected from university records.ResultsPath analysis indicated significant indirect effects of stress mindset on psychological wellbeing and perceived stress through proactive coping behaviors and perceived somatic symptoms. Stress mindset directly predicted perceived stress and physical wellbeing, and physical wellbeing and academic performance were predicted by stress mindset through perceived somatic symptoms. Implicit stress mindset did not predict proactive behavior as anticipated.ConclusionsCurrent findings indicate that behaviors with the goal of proactively meeting demands under stress and perceived somatic symptoms are important mediators of the effect of stress mindset on health- and performance-related outcomes. The findings from this study provide formative data that can inform the development of future interventions aiming to encourage more adaptive responses to stress.

ObjectiveDrowning claims 7% of the global burden of injury-related deaths. Lifejackets are routinely recommended as a drowning prevention strategy; however, a review of related factors regarding lifejacket wear has not previously been investigated.MethodsThis systematic review examined literature published from inception to December 2016 in English and German languages. The personal, social, and environmental factors associated with lifejacket wear among adults and children were investigated, a quantitative evaluation of the results undertaken, and gaps in the literature identified.ResultsTwenty studies, with sample sizes of studies ranging between 20 and 482,331, were identified. Fifty-five percent were cross-sectional studies. All studies were scored IV or V on the Australian National Health and Medical Research Council (NHMRC) grading system indicating mostly descriptive and cross-sectional levels of evidence. Factors associated with increased wear included age (mostly children), gender (mostly female), boat type (non-motorised), boat size (small boats), role modelling (children influenced by adult lifejacket wear), and activity (water-skiing, fishing). Factors not associated or inconsistent with lifejacket wear included education, household income, ethnicity, boating ability, confidence in lifejackets, waterway type, and weather and water conditions. Factors associated with reduced lifejacket wear included adults, males, discomfort, cost and accessibility, consumption of alcohol, and swimming ability. Three studies evaluated the impact of interventions.ConclusionThis review identified factors associated with both increased and decreased lifejacket wear. Future research should address the motivational factors associated with individuals' decisions to wear or not wear lifejackets. This, combined with further research on the evaluation of interventions designed to increase lifejacket wear, will enhance the evidence base to support future drowning prevention interventions.