Elsevier

Preventive Medicine

Volume 56, Issue 5, May 2013, Pages 245-253
Preventive Medicine

Review
Social cognitive theories used to explain physical activity behavior in adolescents: A systematic review and meta-analysis

https://doi.org/10.1016/j.ypmed.2013.01.013Get rights and content

Abstract

Purpose

To systematically review and examine the explanatory power of key social-cognitive theories used to explain physical activity (PA) intention and behavior, among adolescents.

Methods

A systematic review and meta-analysis of the literature was performed using the electronic databases Medline, Cumulative Index to Nursing and Allied Health Literature, SPORTdiscus, EBSCO and Education Resources Information Center, Proquest Education Journals Collection, Science Direct, Web of Science and Scopus for social-cognitive theories (i.e., Health Promotion Model, Theory of Planned Behavior, Theory of Reasoned Action, Protection Motivation Theory, Social Cognitive Theory/Self-Efficacy Theory, Health Belief Model, Self-Determination Theory, Transtheoretical Model) used to explain PA intention and behavior. Related keywords in titles, abstracts, or indexing fields were searched.

Results

Twenty-three studies satisfied the inclusion criteria and were retained for data extraction and analysis; 16 were cross-sectional studies and seven were longitudinal studies. Most studies employed self-report measures. In general, the models explained greater proportions of variance for intention compared to behavior. The meta-analyses revealed 33% and 48% of the variance respectively for PA and intention were explained by social cognitive models.

Conclusions

Few studies have tested the predictive capacity of social cognitive theories to explain objectively measured PA. The majority of PA variance remains unexplained and more theoretical research is needed.

Highlights

► Few studies have tested the predictive capacity of SCT's to explain objective PA. ► TPB appears to be the strongest theory for explaining PA for youth. ► Most PA variance remains unexplained, more theoretical research is needed.

Introduction

Considerable evidence exists supporting the health benefits of engaging in regular physical activity (PA) for youth (Strong et al., 2005, Warburton et al., 2007, World Health Organization, 2005). Current PA guidelines in Australia recommend youth engage in 60 min of daily moderate-to-vigorous PA (Department of Health and Aging, 2004). Similar guidelines exist in the United States of America (U.S. Department of Health and Human Services, 2008), United Kingdom (Department of Health, 2011) and Canada (Public Health Agency of Canada, 2011). Despite extensive evidence supporting the protective effects of PA, physical inactivity during adolescence remains widespread (Heitzler et al., 2011; Khunti et al., 2007, Sisson et al., 2010). Furthermore, PA declines steeply during adolescence (Brodersen et al., 2007) and behaviors established during this period are likely to track into adulthood (Heitzler et al., 2011). Considering the extensive benefits of participation in regular PA and the existing low levels among youth, there is an urgent need to enhance our understanding of PA behavior within this population.

Many reviews of the correlates of PA in children and adolescents have been conducted (Biddle et al., 2011; Sallis et al., 2000, Van der Horst et al., 2007); such reports present a diverse range of psychological, behavioral, environmental and social factors associated with participation in PA including motivation, enjoyment, barriers to PA, previous PA, social support, family support and access to facilities. These reviews however, did not test specific theories nor report the explained variance for specific social cognitive models. Further, these reviews did not specify the magnitude of the associations between social cognitive constructs with behavior (the studies only dichotomized if constructs were statistically associated with PA or not).

Social cognitive theories are useful for explaining health behaviors such as PA. Social cognitive theories propose that behavior is influenced by social and psychological determinants. A focus of social cognitive theories is on the self-regulation processes and how various social-cognitive possesses relate to behavior (Conner & Norman, 2005). Self-regulation processes can be defined as those cognitive and behavioral processes by which people enact their self-conceptions, revise their behavior, or alter the environment to bring about outcomes matched with their self-perceptions and personal goals (Conner & Norman, 2005). These theories are important for guiding interventions to foster positive behavior change (e.g., increased participation in regular PA). Indeed, evidence exists to suggest that theory-based interventions are more effective than atheoretical approaches (Anderson-Bill et al., 2011, Michie and Abraham, 2004, Noar et al., 2008, Taylor et al., 2012, Webb et al., 2010).

To date, current adolescent literature investigating the explanatory ability of social-cognitive models, regarding PA intention and behavior, is limited. Research examining social-cognitive theories in the PA domain has largely focused on adult populations, which limits our current knowledge regarding the generalizability of social cognitive theories' power in predicting PA in the general adolescent population. Such findings will help guide effective theoretically-based interventions in this population. The aim of this paper was to systematically review studies that have tested specific (non-integrated) social-cognitive theories to predict adolescents' PA intention and behavior. To the authors' knowledge this is the first review specifically focused on the utility of social cognitive theories to explain PA among adolescent populations.

Section snippets

Search strategy and data sources

Studies were identified through a structured electronic database search of all publication years (until March 2012) in Medline, CINAHL, SPORTdiscus, EBSCO, ERIC, Proquest Education Journals Collection, Science Direct, Web of Science and Scopus. The following search strings were used: (Physical activit* or exercise*) AND (adolesce* or youth* or teen*) AND (Health Promotion Model* or HPM, Theory of Planned Behavior or TPB, Theory of Reasoned Action or TRA, Protection Motivation Theory or PMT,

Study characteristics

Fig. 1 describes the progress through the stages of study selection. Table 1 reports selected characteristics of all eligible studies. Our search identified 23 studies which evaluated the utility of social cognitive theories to explain PA in adolescents. In terms of theories and/or models used to develop the study, 12 studies assessed the TPB, four studies evaluated the SDT, two studies evaluated the HPM, three studies reported on the utility of the SCT and two studies evaluated the TTM. No

Discussion

The objective of this review was to examine the explanatory power of key social-cognitive theories in explaining PA intention and behavior in adolescent populations. We identified 23 eligible studies, of which the majority of studies had a high to moderate risk of bias. A very limited number of studies (Kim, 2004; Maddison and Prapavessis, 2006, Wu and Pender, 2002) reported acceptable reliability for both internal consistency and test–re-test reliability for social cognitive measures; this may

Conclusion

The meta-analyses revealed 48% and 33% of the variance respectively for intention and PA were respectively explained by social cognitive models. Intention consistently emerged as the strongest construct associated with PA behavior; however, the strongest construct associated with PA intention varied between studies and theories. Few studies have tested the predictive capacity of social cognitive theories to explain objectively measured PA. The majority of PA variance remains unexplained and

Conflict of interest

The authors declare that there are no conflicts of interest.

Acknowledgments

RCP is supported by a Senior Research Fellowship Salary Award from the National Health and Medical Research Council (NHMRC), Australia.

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