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Socioeconomic status moderates the effects of health cognitions on health behaviors within participants: two multibehavior studies


Schuz, B and Brick, C and Wilding, S and Conner, M, Socioeconomic status moderates the effects of health cognitions on health behaviors within participants: two multibehavior studies, Annals of Behavioral Medicine, 54, (1) pp. 36-48. ISSN 0883-6612 (2020) [Refereed Article]

Copyright Statement

Copyright 2019 Society of Behavioral Medicine

DOI: doi:10.1093/abm/kaz023


Background: Socioeconomic differences in health-related behaviors are a major cause of health inequalities. However, the mechanisms (mediation/moderation) by which socioeconomic status (SES) affects health behavior are a topic of ongoing debate.

Purpose: Current research on SES as moderator of the health cognitions-health behavior relation is inconsistent. Previous studies are limited by diverse operationalizations of SES and health behaviors, demographically narrow samples, and between-person designs addressing within-person processes. This paper presents two studies addressing these shortcomings in a within-person multibehavior framework using hierarchical linear models.

Methods: Two online studies, one cross-sectional and one 4 week longitudinal, assessed 1,005 (Study 1; Amazon MTurk; USA only) and 1,273 participants (Study 2; Prolific; international). Self-reports of multiple SES indicators (education, income, occupation status; ZIP code in Study 1), health cognitions (from the theory of planned behavior), and measures of six health behaviors were taken. Multilevel models with cross-level interactions tested whether the within-person relationships between health cognitions and behaviors differed by between-person SES.

Results: Education significantly moderated intention-behavior and attitude-behavior relationships in both studies, with more educated individuals showing stronger positive relationships. In addition, ZIP-level SES (Study 1) moderated attitude-behavior effects such that these relationships were stronger in participants living in areas with higher SES.

Conclusions: Education appears to be an important resource for the translation of intentions and attitudes into behavior. Other SES indicators showed less consistent effects. This has implications for interventions aiming at increasing intentions to change health behaviors, as some interventions might inadvertently increase health inequalities.

Item Details

Item Type:Refereed Article
Keywords:attitudes, education, health behavior, lifestyle, SES, theory of planned behavior
Research Division:Psychology
Research Group:Social and personality psychology
Research Field:Social psychology
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Health status (incl. wellbeing)
UTAS Author:Schuz, B (Dr Benjamin Schuez)
ID Code:140201
Year Published:2020
Web of Science® Times Cited:25
Deposited By:Medicine
Deposited On:2020-07-31
Last Modified:2021-04-16

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