Helping people to act on their intentions

Chapter 38 Helping people to act on their intentions

The theory of planned behaviour (see pp. 72–73) highlights intention as an important cognitive antecedent of action. Strength of intention is a good indicator of how motivated individuals are to act and how much effort they will put into trying to enact that intention. If people do not intend to change their behaviour, they are unlikely to do so. For example, across a series of studies of health-related behaviours, Sheeran (2002) found that only 7% of those who did not intend to act subsequently did so. Thus, if a patient leaves a consultation without intending to pick up a prescription and then take prescribed medication as directed, she is very unlikely to do so. Consequently, a crucial first step in health promotion (whether encouraging exercise, smoking cessation or adherence to medication regimens) is persuading people to decide to change, that is, motivating them to act.

Even when people intend to change they do not always succeed. Sometimes this is because they have diminished control. For example, approximately half of all smokers intend to quit over the next year but only about 30% of them try and only about 2% succeed. In this case both pharmaceutical (e.g. nicotine patches) and behavioural interventions (e.g. support groups) can help translate quitting intentions into action (Fiore et al., 1996). Even when there are no issues of dependence, people often fail to act on their intentions. Across studies of screening attendance, exercise and condom use, Sheeran (2002) found that 47% of intenders failed to act on their intentions. This has been called the intention–behaviour gap and has prompted psychologists to investigate cognitive processes that make it more likely that people will act on their intentions. Increased self-efficacy, anticipated regret and task analysis have been found to increase the likelihood that people act on their intentions (Fig. 1).

Fig. 1 Bridging the intention–behaviour gap.

If we lack prerequisite behavioural skills then we may fail in our attempt and abandon our intention. However, even when we just lack confidence, this low perceived self-efficacy may result in reduced effort or poorer performance (see pp. 72–73). Consequently, it is helpful to focus on past successes, the ease with which others like oneself accomplish tasks and small steps towards a goal when learning a new skill or trying to change an established behaviour. For example, Fisher & Johnston (1996) manipulated self-efficacy by inviting chronic pain patients to reflect on past experiences of high or low control and found that this manipulation altered levels of self-efficacy which, in turn, accounted for different performances on a lifting task. Those who had focused on past success were more successful at the task.

Anticipated regret can also prompt people to act on their intentions rather than remaining inactive. Regret is a powerful negative emotion that people want to avoid. Consequently, making future regret salient can help people maintain and enact intentions. In a series of studies, Abraham & Sheeran (2003) found that people with higher anticipated regret were more likely to sustain their intentions to exercise over time and to take more exercise as a result. Even amongst those with strong intentions to exercise, people with high levels of anticipated regret exercised more often than those with low levels of anticipated regret. Thus prompting people to think about the regret they will feel if they do not seize opportunities to act can help them bridge the intention–behaviour gap.

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