The effects of temporal distance on health behavior intention formation

Abstract

The aim of my dissertation is to understand how people make decisions about their health. Decision-making is a complex psychological process. Health behavior change theories have suggested a number of factors that inform decision-making and lead to behavior change. One of the factors that influences the decision-making process is the time at which behavioral performance is relevant, but this has not been tested and replicated in a health behavior context. Time refers to when we are asking people to engage in a health behavior (i.e. exercise this week or a year from now). It is essential to explore the role of time reference, because any systematic differences time reference produces in the decision-making process will affect whether and how we address time references in designing persuasive health messages. Alternately, if it produces no systematic differences, this will affect persuasive message design as well in that we may not have to consider it when designing health messages. We can use theory to guide us in understanding and predicting health behavior. The more we understand about how people make decisions about engaging in certain health behaviors, the more accurately we can predict these health behaviors. Accurately predicting health behaviors has implications for communication research and health message design. Using a theory-based approach helps us better understand and predict health behavior decision-making, which is a necessary first step to persuasive health message design. In the present research, I use reasoned action theory and construal level theory. Reasoned action theory is a behavioral theory that has proven efficacy in identifying factors that underlie any given behavior. Construal level theory is a social cognitive psychological theory that argues that people construe a behavior abstractly when framed in distal, far future terms and concretely when framed in proximal, near future terms. These theories are being used in concert to test how temporal distance affects intention formation. To this end, my research is a series of three nested studies, beginning with formative research on my target audience and several health behaviors and ending with suggestions for persuasive message design. Study 1 The primary goal of Study 1 was to identify two health behaviors that resonated with my target audience from a set of four to move forward with. Because behavioral decision making is belief-dependent, and thus beliefs are my units of analysis in this dissertation, I needed to identify a behavior that primed enough salient beliefs to make meaningful comparisons. Though no standard exists for the exact number of beliefs necessary to make meaningful comparisons, I decided to move forward with the two health behaviors that primed the greatest mean beliefs per participant. The secondary goal of Study 1 was to begin testing time frame effects on desirability and feasibility beliefs. To do this, I conducted an open-ended survey meant to elicit people’s beliefs about two health behaviors (exercise and flossing) and two behavioral goals (sleep and fruit and vegetable consumption). Each participant was randomly assigned to one time condition (near or distant) and two behaviors. Results indicated more beliefs per participant for the behaviors than for the behavioral goals. Exercise and flossing produced the greatest mean number of beliefs per participant and were behaviors (not goals), which reasoned action is better at predicting. They were therefore used in both subsequent studies. Preliminary time frame analyses showed more beliefs generated in the near relative to the distant time condition for exercise, flossing, and sleep. Additionally, more desirability than feasibility beliefs were generated across all behaviors and goals. The expectation that the proportion of desirability (behavioral/normative) beliefs would be larger in the far relative to the near time condition (H1) was partially supported. The expectation that the proportion of feasibility (control) beliefs would be larger in the near relative to the far time condition (H2) was also partially supported. Both hypotheses were confirmed by the sleep behavioral goal, but not by either of the behaviors (exercise or flossing). There were a few methodological issues in this study. First, the phrasing of the distant time frame caused confusion among participants, which could have induced similar construals in both the near and distant time conditions. Similar construals across time conditions would have obscured evidence in support of my hypotheses. Second, it is possible that I did not have enough participants to capture most relevant salient beliefs, given my sample’s diversity. Third, consistent with lack of clarity regarding normative beliefs as desirability or feasibility concerns, they were not included in this study. And finally, the phrasing of “150 minutes of moderate exercise in the next year” caused some confusion among participants, as some forgot the recommendation was for weekly moderate exercise and interpreted this to mean exercise spread out over a year. Study 2 provided an opportunity to fix these methodological issues. This study provided evidence that behaviors and behavioral goals function differently in belief elicitations, that people have thought about exercise and flossing behaviors enough to form intentions, and that time frame does affect the generation of desirability and feasibility beliefs. Study 2 The goals of Study 2 were to test two different versions of the distant time frame phrasing, identify desirability and feasibility belief themes for use in Study 3, and test time frame effects on desirability and feasibility beliefs. To do this, I conducted an open-ended survey meant to elicit people’s beliefs about exercise and flossing. Each participant was randomly assigned to one time condition (near or distant) and saw questions about both behaviors in random order. The methodological issues present in Study 1 were addressed in this study. First, two distant time conditions were tested to see if they mitigated the confusion caused by the phrasing in Study 1. Second, the distant definition of exercise included “weekly” to mitigate confusion as well. And finally, normative beliefs were included as desirability concerns in this study consistent with their probable conceptual similarity to desirability over feasibility concerns. Results first indicated that the distant time condition phrasing “a year from now” did not produce confusion as the “in a year” phrasing did and produced more pronounced effects when moving from the week condition. Therefore, I chose to move forward with “a year from now” as the distant time condition phrasing in Study 3. Results next indicated that time frame affected belief totals and proportions of desirability and feasibility beliefs. For exercise, participants generated more desirability beliefs in both distant time conditions relative to the near time condition. Fewer feasibility beliefs were generated in “year from now”, but not “in a year”, distant time condition relative to the near time condition. For flossing, participants generated more desirability beliefs in the “in a year”, but not “a year from now”, distant time condition relative to the near time condition. Fewer feasibility beliefs were generated in both distant time conditions relative to the near time condition, but effects were most pronounced moving from the near to the “year from now” distant time condition. The expectation that the proportion of desirability (behavioral/normative) beliefs would be larger in the far relative to the near time condition (H1) was supported for both exercise and flossing. The expectation that the proportion of feasibility (control) beliefs would be larger in the near relative to the far time condition (H2) was also supported for both exercise and flossing. And finally, several desirability and feasibility belief themes were identified for exercise and flossing to be used in Study 3 as determinants of intention. For exercise, 33 desirability and 23 feasibility belief themes were identified for the distant time condition and 27 desirability and 20 feasibility themes were identified for the near time condition. For flossing, 18 desirability and 18 feasibility belief themes were identified for the distant time condition and 31 desirability and 22 feasibility belief themes were identified for the near time condition. This study provided evidence that time frame effects are partially dependent on the phrasing of the distant time condition, that belief themes differ as functions of time, and that time frame does affect the generation of desirability and feasibility beliefs. Study 3 The goal of Study 3 was to test the influence of desirability and feasibility considerations on behavioral intention as a function of time and test differences in beliefs across time frames. To do this, I conducted a closed-ended survey meant to capture determinants of exercise and flossing intentions. Each participant was randomly assigned to one time condition (near or distant) and answered questions about exercise and then flossing. Results indicated instrumental and experiential attitude, injunctive and descriptive norms, and perceived capacity and autonomy explained large proportions of variance in intention in exercise and flossing behaviors in both the near and distant time conditions. For exercise, these determinants explained more variance in intention in the near than in the distant time condition. For flossing, these determinants explained more variance in intention in the distant than the near time condition. The expectation that attitudes (experiential and instrumental) and perceived norms (injunctive and descriptive) would be more strongly associated with intention in the distant relative to the near time condition (H3) was partially supported by exercise instrumental attitude and flossing experiential attitude, instrumental attitude, and descriptive norms. The expectation that perceived behavioral control (autonomy and capacity) would be more strongly associated with intention in the near relative to the distant time condition (H4) was partially supported by exercise perceived autonomy and flossing perceived autonomy and capacity. Results from tests of time frame effects on beliefs indicated higher behavioral and normative belief means in the distant relative to the near time condition for similar beliefs across the time frames. This study provided evidence that: (1) time frame affects the relative proportion of variance in intention explained by attitudes, perceived norms, and perceived behavioral control, (2) time frame affects the relative importance of attitudes, perceived norms, and perceived behavioral control in intention formation, (3) time frame affects belief strength, (4) and that time effects are behavior-specific. Results from all three studies indicate temporal distance appears to affect intention formation, though not as consistently as predicted. These results can be due to methodological or conceptual explanations and have implications for health message design.