Table 4.
Support for theories of health behavior
| Analysis of support | Additional information | ||||
|---|---|---|---|---|---|
| Support for theory | Findings from RCT a*b pathway |
Findings from RCT a pathway |
Meta-analysis of experiments [8] a pathway |
Systematic reviews of observational studies [3, 5] a pathway |
|
| Theory | |||||
| Construct (measure in RCT) | |||||
| Health Belief Model [20] | No support | ||||
| Perceived likelihood | ◯ | ◯ | ◯ | ◯ | |
| Perceived severity | ◯ | ◯ | ● 1 | ● 1 | |
| Perceived threat (PL*PS) | ◯ | ◯ | — | — | |
| Perceived benefit of quitting | ◯ | ◯ | — | — | |
| Perceived costs of quitting | ◯ | ◯ | — | — | |
| Transtheoretical Model [52] | Modest support | ||||
| Perceived benefits (pros of quitting) | ◯ | ◯ | — | — | |
| Perceived costs (cons of quitting) | ◯ | ◯ | — | — | |
| Processes of change | — | — | — | — | |
| Self efficacy | ● | ● | ◯ | — | |
| Stage of change (quit stage) | ● | ● | — | — | |
| Theory of Planned Behavior [21] | Modest support | ||||
| Attitudes (attitudes toward smoking) | ◯ | ◯ | ● | ● 1 | |
| Subjective norms | ◯ | ◯ | — | — | |
| Perceived behavioral control (SE+RE) | ● | ● | ◯SE | — | |
| Intentions (quit intentions) | ● | ● | ● | ⌾ | |
| Constructs added to theory | No support | ||||
| Anticipated regret | ◯ | ◯ | — | — | |
| Smoker prototypes | ◯ | ⌾ | — | — | |
| Behavioral willingness | — | — | — | — | |
| Tripartite Model of Risk Perceptions [22] | Modest support | ||||
| Deliberative risk (perceived likelihood) | ◯ | ◯ | ◯ | ◯ | |
| Affective risk (negative affect) | ● | ● | ● | ⌾ 1 | |
| Experiential risk | — | — | — | — | |
| Elaboration Likelihood Model (9) | |||||
| Attention/noticing | Modest support | ● | ● | ● | ● |
| Recall/recognition | — | — | ● | ⌾ | |
| Perceived understandability | ◯ | ● | — | — | |
| Cognitive processing (cognitive elaboration) | ● | ● | ● | ● | |
| Attitude change | ◯ | ◯ | ● | ● | |
| Extended Parallel Process Model [23] | Modest support | ||||
| Perceived threat (PL*PS) | ◯ | ◯ | — | — | |
| Perceived efficacy (SE+RE) | ● | ● | ◯SE | — | |
| Perceived threat*Perceived efficacy | ◯ | ◯ | — | — | |
| Protection motivation (quit intentions) | ● | ● | ● | ⌾ | |
| Fear (negative affect) | ● | ● | ● | ⌾ 1 | |
| Defensive motivation (reactance) | ● | ● | ● | — | |
| Maladaptive changes (avoidance) | ◯* | ● | — | ● | |
Analysis for support of the theory is based largely on the mediational findings from the trial (a*b pathway). ○ = no support for prediction. ⌾ = mixed support for prediction. ● = support for prediction. — = mediator not assessed. 1 = based on only 1 study in the reviews. SE = self-efficacy. RE = response efficacy of quitting smoking to lower risk of health problems. *Path goes in the opposite direction predicted (prediction from theory: avoidance undermines effect of warnings; finding in RCT: avoidance reinforces/mediates impact of warnings). PL*PS = perceived likelihood * perceived severity.