@phdthesis{Baumann2016,
  author    = {Sophie Baumann},
  title     = {Testing a stage and a non-stage tailored model as frameworks for understanding longitudinal drinking patterns in individuals with unhealthy alcohol use},
  journal    = {Untersuchung eines stadienbasierten und eines nicht stadienbasierten Modells zur Erkl{\"a}rung l{\"a}ngsschnittlicher Trinkmuster bei Personen mit riskantem Alkoholkonsum},
  url       = {https://nbn-resolving.org/urn:nbn:de:gbv:9-002476-6},
  year      = {2016},
  abstract  = {Background: Common to most theory-based intervention approaches is the idea of supporting intentions to increase the probability of behavior change. This principle works only if (a) intentions can be explained by the hypothesized socio-cognitive constructs, and (b) people actually do what they intend to do. The overall aim of this thesis was to test these premises using two health behavior theories applied to reducing at-risk alcohol use. Method: The three papers underlying this thesis were based on data of the randomized controlled “Trial Of Proactive Alcohol interventions among job-Seekers” (TOPAS). A total of 1243 job-seekers with at-risk alcohol use were randomized to stage tailored intervention (ST), non-stage tailored intervention (NST), or control group. The ST participants (n = 426) were analyzed in paper 1. Paper 2 was based on the baseline and 3-month data provided by the NST participants (n = 433). Paper 3 was based on baseline, 3-, 6-, and 15-month data provided by the control and ST group not intending to change alcohol use (n = 629). Latent variable modeling was used to investigate the associations of social-cognitive constructs and intentional stages (paper 1), the extent to which intentions were translated into alcohol use (paper 2), and the different trajectories of alcohol use among people not intending to change as well as the ST effect on the trajectories (paper 3). Results: Persons in different intentional stages differed in the processes of change in which they engaged, in the importance placed by them on the pros and cons of alcohol use, and in the perceived ability to quit (ps < 0.01). The association between intentions and alcohol use was weak. The magnitude of this intention-behavior gap depended on the extent to which normative expectations have changed over time (p < 0.01) and was reduced when controlling for the mediating effect of temporal stability of intentions. The gap was also present among people not intending to change: Even without intervention, 35\% of the persons reduced the amount of alcohol use after 15 months (p < 0.05) and 2\% achieved abstinence. Persons with heavier drinking (33\%) and persons with low but frequent use (30\%) did not change. Persons with frequent alcohol use seem to benefit less from ST than those with occasional use, although differences were not statistically significant. Conclusions: Intentions can be quite well explained by the hypothesized socio-cognitive constructs. In a sample of persons who were, as a whole, little motivated to change, the precision of how well intentions predict subsequent alcohol use was modest though. Time and socio-contextual influences should be considered.},
  language  = {en}
}