Bridging the intention–behaviour gap
The third approach to address the limited way in which research has predicted behaviour
has been to suggest variables that may bridge the gap between intentions to behave
and actual behaviour. In particular, some research has highlighted the role of plans
for action, health goals commitment and trying as a means to tap into the kinds of
cognitions that may be responsible for the translation of intentions into behaviour
(Bagozzi and Warshaw 1990; Schwarzer 1992; Bagozzi 1993; Luszczynska and
Schwarzer 2003). Most research, however, has focused on Gollwitzer’s (1993) notion of
implementation intentions. According to Gollwitzer, carrying out an intention involves
the development of specific plans as to what an individual will do given a specific set of
environmental factors. Therefore, implementation intentions describe the ‘what’ and the
‘when’ of a particular behaviour. For example, the intention ‘I intend to stop smoking’
will be more likely to be translated into ‘I have stopped smoking’ if the individual makes
the implementation intention ‘I intend to stop smoking tomorrow at 12.00 when I have
finished my last packet’. Further, ‘I intend to eat healthily’ is more likely to be translated
into ‘I am eating healthily’ if the implementation intention ‘I will start to eat healthily by
having an apple tomorrow lunchtime’ is made. Some experimental research has shown
that encouraging individuals to make implementation intentions can actually increase
the correlation between intentions and behaviour for behaviours such as taking a
vitamin C pill (Sheeran and Orbell 1998), performing breast self-examination (Orbell
et al. 1997) and writing a report (Gollwitzer and Brandstatter 1997). This approach is
also supported by the goal-setting approach of cognitive behavioural therapy. Therefore,
by tapping into variables such as implementation intentions it is argued that the models
may become better predictors of actual behaviour.
Developing theory based interventions
The cognition and social cognition models have been developed to describe and predict
health behaviours such as smoking, screening, eating and exercise. Over recent years
there has been a call towards using these models to inform and develop health behaviour
interventions. This has been based upon two observations. First, it was observed that
many interventions designed to change behaviour were only minimally effective. For
example, reviews of early interventions to change sexual behaviour concluded that these
interventions had only small effects (e.g. Oakley et al. 1995) and dietary interventions
for weight loss may result in weight loss in the short term but the majority show a return
to baseline by follow up (e.g. NHS Centre for Reviews and Dissemination 1997). Second,
it was observed that many interventions were not based upon any theoretical frame-
work nor were they drawing upon research which had identified which factors were
correlated with the particular behaviour (e.g. Fisher and Fisher 1992). One interesting
illustration of this involved the content analysis of health promotion leaflets to assess
their theoretical basis. Abraham et al. (2002) collected sexual health leaflets from
general practitioners’ surgeries and clinics for the treatment of sexually transmitted
diseases (STDs) across Germany (37 leaflets) and the UK (74 leaflets). They included
those which promoted the use of condoms and/or prevention of STDs including HIV
HEALTH BELIEFS 41