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Predicting Self-Management Behaviors in Familial Hypercholesterolemia Using an Integrated Theoretical Model: the Impact of Beliefs About Illnesses and Beliefs About Behaviors

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Abstract

Purpose

Patients with familial hypercholesterolemia (FH) are at markedly increased risk of coronary artery disease. Regular participation in three self-management behaviors, physical activity, healthy eating, and adherence to medication, can significantly reduce this risk in FH patients. We aimed to predict intentions to engage in these self-management behaviors in FH patients using a multi-theory, integrated model that makes the distinction between beliefs about illness and beliefs about self-management behaviors.

Methods

Using a cross-sectional, correlational design, patients (N = 110) diagnosed with FH from a clinic in Perth, Western Australia, self-completed a questionnaire that measured constructs from three health behavior theories: the common sense model of illness representations (serious consequences, timeline, personal control, treatment control, illness coherence, emotional representations); theory of planned behavior (attitudes, subjective norms, perceived behavioral control); and social cognitive theory (self-efficacy).

Results

Structural equation models for each self-management behavior revealed consistent and statistically significant effects of attitudes on intentions across the three behaviors. Subjective norms predicted intentions for health eating only and self-efficacy predicted intentions for physical activity only. There were no effects for the perceived behavioral control and common sense model constructs in any model.

Conclusions

Attitudes feature prominently in determining intentions to engage in self-management behaviors in FH patients. The prominence of these attitudinal beliefs about self-management behaviors, as opposed to illness beliefs, suggest that addressing these beliefs may be a priority in the management of FH.

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Acknowledgments

This research was supported by a grant from the International Atherosclerosis Society and Pfizer (grant #10839501).

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Authors and Affiliations

  1. Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Faculty of Health Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia

    Martin S. Hagger, Sarah J. Hardcastle, Catherine Hingley & Ella Strickland

  2. The Metabolic Research Centre and Lipid Disorders Clinic, Cardiovascular Medicine, Royal Perth Hospital and the School of Medicine and Pharmacology, The University of Western Australia, Perth, Australia

    Jing Pang & Gerald F. Watts

  3. Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland

    Martin S. Hagger

  4. School of Applied Psychology and Menzies Health Institute, Queensland, Griffith University, Brisbane, Queensland, Australia

    Martin S. Hagger

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  1. Martin S. Hagger
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Correspondence to Martin S. Hagger.

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Hagger, M.S., Hardcastle, S.J., Hingley, C. et al. Predicting Self-Management Behaviors in Familial Hypercholesterolemia Using an Integrated Theoretical Model: the Impact of Beliefs About Illnesses and Beliefs About Behaviors. Int.J. Behav. Med. 23, 282–294 (2016). https://doi.org/10.1007/s12529-015-9531-x

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