Prediction of Exercise in Patients Across Various Stages of Bariatric Surgery: A Comparison of the Merits of the Theory of Reasoned Action Versus the Theory of Planned Behavior
Restricted accessResearch articleFirst published online November, 2009
Prediction of Exercise in Patients Across Various Stages of Bariatric Surgery: A Comparison of the Merits of the Theory of Reasoned Action Versus the Theory of Planned Behavior
Obesity is a world-wide health concern approaching epidemic proportions. Successful long-term treatment involves a combination of bariatric surgery, diet, and exercise. Social cognitive models, such as the Theory of Reasoned Action (TRA) and the Theory of Planned Behavior (TPB), are among the most commonly tested theories utilized in the prediction of exercise. As exercise is not a completely volitional behavior, it is hypothesized that the TPB is a superior theoretical model for the prediction of exercise intentions and behavior. This study tested validity of the TPB in a sample of bariatric patients and further validated its improvement over the TRA in predicting exercise adherence at different operative stages. Results generally confirmed research hypotheses. Superiority of the TPB model was validated in this sample of bariatric patients, and Perceived Behavioral Control emerged as the single-best predictor of both exercise intentions and self-reported behavior. Finally, results suggested that both subjective norms and attitudes toward exercise played a larger role in the prediction of intention and behavior than previously reported.
Ajzen, I. ( 1985). From intentions to actions: A theory of planned behavior . In J. Kuhl & J. Beckmann (Eds.), Action-control: From cognition to behavior (pp. 11-39), Heidelberg: Springer .
2.
Ajzen, I. ( 1988). From intentions to actions. In I. Ajzen, (Ed.), Attitudes, personality, and behavior (pp. 112-145), Homewood, IL: Dorsey.
3.
Ajzen, I. ( 2002). Construction of a standardized questionnaire for the theory of planned behavior. Retrieved September 18, 2004, from http://www~unix.oit.umass.edu/~aijen/
4.
Ajzen, I., & Fishbein, M. ( 1980). Understanding attitudes and predicting social behavior . Englewood Cliffs, NJ: Prentice Hall.
5.
Blanchard, C.M., Rhodes, R.E., Nehl, E., Fisher, J., Sparling, P., & Courneya, K. ( 2003). Ethnicity and the theory of planned behavior in the exercise domain. American Journal of Health Behavior, 27, 579-591.
6.
Blue, C.L. ( 1996). Theory of planned behavior and self-efficacy and exercise behaviors in blue-collar workers. Unpublished Dissertation: University of Illinois, Chicago, Health Sciences Center.
7.
Bocchieri, L., Meana, M., & Fisher, B. ( 2002). A review of psychosocial outcomes of surgery for morbid obesity. Journal of Psychosomatic Research, 52, 155-165.
8.
Bryan, A.D., & Rocheleau, C.A. (2002). Predicting aerobic versus resistance exercise using the theory of planned behavior. American Journal of Health Behavior, 26, 83-94.
9.
Buddeberg-Fischer, B., Klaghofer, R., Sigrist, S., & Buddeberg, C. ( 2004). Impact of psychosocial stress and symptoms on indication for bariatric surgery and outcome in morbidly obese patients. Obesity Surgery, 14, 361-369.
10.
Choban, P.S., Poplawski, S., Jackson, B., & Bistolarides, P. (2002). Bariatric surgery for morbid obesity: Why, who, when, how, where, and then what?Cleveland Clinic Journal of Medicine, 69, 897-903.
11.
Courneya, K.S., Plotnikoff, R.C., Hotz, S.B., & Birkett, N.J. ( 2000). Social support and the theory of planned behavior in the exercise domain. American Journal of Health Behavior, 24, 300-308.
12.
Dixon, J.B., & O’Brien, P.E. (2002). Changes in comorbidities and improvements in quality of life after LAP-BAND placement. American Journal of Surgery, 184, 51S-54S.
13.
Fishbein, M., & Ajzen, I. ( 1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.
14.
Gatch, C.L., & Kendzierski, D. (1990). Predicting exercise intentions: The theory of planned behavior. Research Quarterly for Exercise and Sport, 61, 100-102.
15.
Godin, G. ( 1993). The theories of reasoned action and planned behavior: Overview of findings, emerging research problems, and usefulness for exercise promotion. Journal of Applied Sport Psychology, 5, 141-157.
16.
Godin, G., & Kok, G. ( 1996). The theory of planned behavior: A review of its applications to health-related behaviors. American Journal of Health Promotion , 11, 87-98.
17.
Godin, G., & Shephard, R.J. (1985). Psycho-social predictors of exercise intentions among spouses. Canadian Journal of Applied Sport Science, 10, 36-43.
18.
Godin, G., & Shephard, R.J. (1997). Godin leisure-time exercise questionnaire. Official Journal of the American College of Sports Medicine, 29, S36-S38.
19.
Ham, O.K. ( 2005). The intention of future mammography screening among Korean women. Journal of Community Health Nursing, 22, 1-13.
20.
Hausenblaus, H.A., Carron, A.B., & Mack, D.E. ( 1997). Application of the theories of reasoned action and planned behavior to exercise behavior: A meta-analysis. Journal of Sport & Exercise Psychology, 19, 36-51.
21.
Herron, D.M. ( 2004). The surgical management of severe obesity. Mount Sinai Journal of Medicine, 71, 63-71.
22.
Higgins, A., & Conner, M. ( 2003). Understanding adolescent smoking: The role of the theory of planned behaviour and implementation intentions. Psychology, Health, & Medicine, 8, 173-186.
23.
International Physical Activity Questionnaire. Retrieved December 15, 2004 , from www.ipaq.ki.se/
24.
Masalu, J.R., & Amstrom, A.N. ( 2003). The use of the theory of planned behavior to explore beliefs about sugar restriction. American Journal of Health Behavior, 27, 15-24.
25.
McMillan, B., & Conner, M. ( 2003). Using the theory of planned behavior to understand alcohol and tobacco use in students. Psychology, Health, & Medicine , 8, 317-328.
26.
Mokdad, A.H., Bowman, B.A., Ford, E.S., Vinicor, F., Marks, J.S., & Koplan, J.P. ( 2001). The continuing epidemics of obesity and diabetes in the United States. Journal of the American Medical Association , 286, 1195-1200.
27.
Norman, P., Conner, M., & Bell, R. ( 2000). The theory of planned behavior and exercise: Evidence for the moderating role of past behavior. British Journal of Health Psychology, 5, 249-261.
28.
Pierro, A., Mannetti, L., & Livi, S. ( 2003). Self-identity and the theory of planned behavior in the prediction of health behavior and leisure activity. Self and Identity, 2, 47-60.
29.
Reto, C.S. ( 2003). Psychological aspects of delivering nursing care to the bariatric patient. Critical Care Nursing Quarterly, 26, 139-149.
30.
Rhodes, R.E., & Courneya, K.S. (2003). Investigating multiple components of attitude, subjective norm, and perceived control: An examination of the theory of planned behavior in the exercise domain. British Journal of Social Psychology, 42, 129-146.
31.
Rhodes, R.E., & Courneya, K.S. (2004). Differentiating motivation and control in the theory of planned behavior. Psychology, Health, & Medicine, 9, 205-215.
32.
Rippe, J.M., & Hess, S. ( 1998). The role of physical activity in the prevention and management of obesity. Journal of the American Dietetic Association, 98, S31-S38.
33.
Schifter, D.E., & Ajzen, I. ( 1985). Intention, perceived control, and weight loss: An application of the theory of planned behavior. Journal of Personality and Social Psychology, 49, 843-851.
34.
Schulze, R., & Wittmann, W.W. (2003). A meta-analysis of the theory of reasoned action and the theory of planned behavior: The principle of compatibility and multidimensionality of beliefs as moderators. In R. Schulze, H Holling, and D. Böhning, (Eds.), Meta analysis: New developments and applications in medical and social sciences (pp. 219-250). Göttingen: Hogrefe & Huber.
35.
Tremblay, L., & Frigon, J.Y. ( 2004). Biobehavioral and cognitive determinants of adolescent girls’ involvement in sexual risk behaviours: A test of three theoretical models. Canadian Journal of Human Sexuality, 13, 29-43.
36.
Votruba, S.B., Horvitz, M.A., & Schoeller, D.A. (2000). The role of exercise in the treatment of obesity. Nutrition, 16, 179-188.
37.
World Health Organization. (2000). Obesity: preventing and managing the global epidemic. Report of a WHO consulation. WHO Technical Report Series, 894.
38.
Wysoker, A. ( 2005). The lived experience of choosing bariatric surgery to lose weight. Journal of the American Psychiatric Nurses Association , 11, 26-34.
39.
Yordy, G.A., & Lent, R.W. ( 1993). Predicting aerobic exercise participation: Self-control, reasoned action, and planned behavior models. Journal of Exercise and Sport Psychology, 15, 363-374.
