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Oba T, Takano K, Katahira K, Kimura K. Revisiting the Transtheoretical Model for Physical Activity: A Large-Scale Cross-Sectional Study on Japanese-Speaking Adults. Ann Behav Med 2024; 58:167-178. [PMID: 38166169 DOI: 10.1093/abm/kaad069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND The Transtheoretical Model (TTM) has been the basis of health promotion programs, which are, for example, used to tailor behavioral interventions according to the stages of change. Empirical studies have shown that the TTM effectively describes the processes of behavioral adaptation to acquire healthier lifestyles; however, it has been argued that TTM-based interventions are not superior to non-TTM-based interventions for promoting physical activity (PA). Evidence has also highlighted some inconsistencies with theoretical assumptions, especially regarding how each process-of-change strategy emerges across the stages. PURPOSE Therefore, we investigated (a) how well the TTM describes the distributional characteristics of PA levels as well as other relevant variables (e.g., process of change, self-efficacy) across stages, and (b) how predictive the TTM variables are of PA levels within each stage. METHODS We analyzed data from 20,573 Japanese-speaking adults who completed online questionnaires on PA and TTM variables. RESULTS The results replicated previous findings that stage membership is associated with PA, the process of change, decisional balance, and self-efficacy, albeit with inconclusive evidence of temptations. Regression analyses revealed that some processes of change (self-reevaluation, reinforcement management, and self-liberation) were more predictive of PA in pre-active stages than in post-action stages; self-efficacy was predictive of PA only in the maintenance stage but not in the other stages. CONCLUSIONS Overall, the data support the theoretical assumptions of the TTM, but the stage specificity of the active processes may not always be consistent with the theory.
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Affiliation(s)
- Takeyuki Oba
- Human Informatics and Interaction Research Institute, the National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - Keisuke Takano
- Human Informatics and Interaction Research Institute, the National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - Kentaro Katahira
- Human Informatics and Interaction Research Institute, the National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - Kenta Kimura
- Human Informatics and Interaction Research Institute, the National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
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Wanjau MN, Möller H, Haigh F, Milat A, Hayek R, Lucas P, Veerman JL. The Potential Impact of Physical Activity on the Burden of Osteoarthritis and Low Back Pain in Australia: A Systematic Review of Reviews and Life Table Analysis. J Phys Act Health 2023:1-12. [PMID: 37268300 DOI: 10.1123/jpah.2022-0541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/13/2023] [Accepted: 04/16/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The objectives were (1) to establish the strength of the association between incident cases of osteoarthritis (OA) and low back pain (LBP), and physical activity (PA) and to assess the likelihood of the associations being causal; and (2) to quantify the impact of PA on the burden of OA and LBP in Australia. METHODS We conducted a systematic literature review in EMBASE and PubMed databases from January 01, 2000, to April 28, 2020. We used the Bradford Hill viewpoints to assess causality. We used a proportional multistate life table model to estimate the impact of changes in the PA levels on OA and LBP burdens for the 2019 Australian population (aged ≥ 20 y) over their remaining lifetime. RESULTS We found that both OA and LBP are possibly causally related to physical inactivity. Assuming causality, our model projected that if the 2025 World Health Organization global target for PA was met, the burden in 25 years' time could be reduced by 70,000 prevalent cases of OA and over 11,000 cases of LBP. Over the lifetime of the current adult population of Australia, the gains could add up to approximately 672,814 health-adjusted life years (HALYs) for OA (ie, 27 HALYs per 1000 persons) and 114,042 HALYs for LBP (ie, 5 HALYs per 1000 persons). The HALY gains would be 1.4 times bigger if the 2030 World Health Organization global target for PA was achieved and 11 times bigger if all Australians adhered to the Australian PA guidelines. CONCLUSION This study provides empirical support for the adoption of PA in strategies for the prevention of OA and back pain.
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Affiliation(s)
- Mary Njeri Wanjau
- Public Health & Economics Modelling Group, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD,Australia
| | - Holger Möller
- School of Population Health, University of New South Wales, Sydney, NSW,Australia
| | - Fiona Haigh
- Health Equity Research and Development Unit (HERDU), University of New South Wales, Sydney, NSW,Australia
| | - Andrew Milat
- Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, NSW,Australia
- School of Public Health, University of Sydney, Sydney, NSW,Australia
| | - Rema Hayek
- Health Infrastructure, NSW Health, Sydney, NSW,Australia
| | - Peta Lucas
- Centre for Population Health, NSW Ministry of Health, Sydney, NSW,Australia
| | - J Lennert Veerman
- Public Health & Economics Modelling Group, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD,Australia
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Wanjau MN, Möller H, Haigh F, Milat A, Hayek R, Lucas P, Veerman JL. Physical Activity and Depression and Anxiety Disorders: A Systematic Review of Reviews and Assessment of Causality. AJPM FOCUS 2023; 2:100074. [PMID: 37790636 PMCID: PMC10546525 DOI: 10.1016/j.focus.2023.100074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Globally, depressive and anxiety disorders are the leading contributors to mental ill health. Physical activity reduces symptoms of depression and anxiety and has been proposed as an adjunct treatment therapy for depression and anxiety. Prospective studies suggest that physical activity may reduce the incidence of depression and anxiety. We conducted a systematic review of reviews with the aim to provide a comprehensive overview of available epidemiologic evidence on the strength of the association between physical activity and incident cases of depression and anxiety and to assess the likelihood of these associations being causal. Methods We searched Embase and PubMed databases for systematic reviews published between January 1, 2000 and March 19, 2020 that reported findings on the strength of association between physical activity and incidence of depression and anxiety. We updated this search to October 15, 2022. Two reviewers independently assessed the methodologic quality of the included reviews using the Assessment of Multiple Systematic Reviews rating scale. We carried out a narrative synthesis of the evidence. We used the Bradford Hill criteria to assess the likelihood of associations being causal. Results The initial search yielded 770 articles, of which 4 remained for data extraction. Two of the included reviews were scored as high quality, and 2 were scored as low quality. From the 2 included reviews that reported pooled estimates, people with high physical activity levels were found to have a decreased risk of incident depression (adjusted RR=0.83, 95% CI=0.76, 0.90) and reduced odds of developing anxiety (adjusted OR=0.74,95% CI=0.62, 0.88) when compared with those with low physical activity levels. We assessed physical activity to be probably causally related to both depression and anxiety. Discussion Our evidence is drawn from systematic reviews of observational data. Further high-quality studies, such as randomized control trials, would help to strengthen the evidence base of the associations between physical activity and depression and anxiety. Nonetheless, our findings provide empirical support for the consideration of physical activity in strategies for the prevention of mental ill health.
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Affiliation(s)
- Mary Njeri Wanjau
- Public Health & Economics Modelling Group, School of Medicine and Dentistry, Griffith University, Southport, Australia
| | - Holger Möller
- School of Population Health, University of New South Wales Sydney, Kensington, Australia
- The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Fiona Haigh
- Health Equity Research and Development Unit (HERDU), University of New South Wales Sydney, Kensington, Australia
| | - Andrew Milat
- Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, Australia
- School of Public Health, University of Sydney, Sidney, Australia
| | - Rema Hayek
- Health Infrastructure, NSW Health, Sydney, Australia
| | - Peta Lucas
- Centre for Population Health, NSW Ministry of Health, Sydney, Australia
| | - J. Lennert Veerman
- Public Health & Economics Modelling Group, School of Medicine and Dentistry, Griffith University, Southport, Australia
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Ratz T, Pischke CR, Voelcker-Rehage C, Lippke S. Distinct physical activity and sedentary behavior trajectories in older adults during participation in a physical activity intervention: a latent class growth analysis. Eur Rev Aging Phys Act 2022; 19:1. [PMID: 34986783 PMCID: PMC8903622 DOI: 10.1186/s11556-021-00281-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/08/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND This study aimed to identify latent moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior (SB) trajectories in older adults participating in a randomized intervention trial and to explore associations with baseline social-cognitive predictors. METHODS Data were assessed at baseline (T0, participants were inactive or had recently become active), after a ten-week physical activity intervention (T1), and a second 24-week intervention phase (T2). Latent class growth analysis was used on accelerometer-assessed weekly MVPA and daily SB, respectively (n = 215 eligible participants). Activity changes within trajectory classes and baseline social-cognitive predictor differences between trajectory classes were analyzed. RESULTS A "stable insufficient MVPA" (n = 197, p for difference in MVPA level at T0 and T2 (pT0-T2) = .789, effect size (Cohen's d) = .03) and a "stable high MVPA" trajectory (n = 18, pT0-T2 = .137, d = .39), as well as a "slightly decreasing high SB" (n = 63, p for difference in SB (pT0-T2) = .022, d = .36) and a "slightly increasing moderate SB" trajectory (n = 152, pT0-T2 = .019, d = .27) emerged. Belonging to the "stable high MVPA" trajectory was associated with higher action planning levels compared to the "stable insufficient MVPA" trajectory (M = 5.46 versus 4.40, d = .50). Belonging to the "decreasing high SB" trajectory was associated with higher action self-efficacy levels compared to the "increasing moderate SB" trajectory (M = 5.27 versus 4.72, d = .33). CONCLUSIONS Change occurred heterogeneously in latent (not directly observed) subgroups, with significant positive trajectories only observed in the highly sedentary. TRIAL REGISTRATION German Registry of Clinical Trials, DRKS00016073 , Registered 10 January 2019.
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Affiliation(s)
- Tiara Ratz
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany.
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Muenster, Muenster, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
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Dishman RK, McDowell CP, Herring MP. Customary physical activity and odds of depression: a systematic review and meta-analysis of 111 prospective cohort studies. Br J Sports Med 2021; 55:926-934. [DOI: 10.1136/bjsports-2020-103140] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 12/21/2022]
Abstract
ObjectiveTo explore whether physical activity is inversely associated with the onset of depression, we quantified the cumulative association of customary physical activity with incident depression and with an increase in subclinical depressive symptoms over time as reported from prospective observational studies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, PsycINFO, PsycARTICLES and CINAHL Complete databases, supplemented by Google Scholar.Eligibility criteriaProspective cohort studies in adults, published prior to January 2020, reporting associations between physical activity and depression.Study appraisal and synthesisMultilevel random-effects meta-analysis was performed adjusting for study and cohort or region. Mixed-model meta-regression of putative modifiers.ResultsSearches yielded 111 reports including over 3 million adults sampled from 11 nations in five continents. Odds of incident cases of depression or an increase in subclinical depressive symptoms were reduced after exposure to physical activity (OR, 95% CI) in crude (0.69, 0.63 to 0.75; I2=93.7) and adjusted (0.79, 0.75 to 0.82; I2=87.6) analyses. Results were materially the same for incident depression and subclinical symptoms. Odds were lower after moderate or vigorous physical activity that met public health guidelines than after light physical activity. These odds were also lower when exposure to physical activity increased over time during a study period compared with the odds when physical activity was captured as a single baseline measure of exposure.ConclusionCustomary and increasing levels of moderate-to-vigorous physical activity in observational studies are inversely associated with incident depression and the onset of subclinical depressive symptoms among adults regardless of global region, gender, age or follow-up period.
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Kawae T, Iwaki D, Nakashima Y, Fudeyasu K, Ishiguro T, Kimura H, Sekikawa K, Hamada H, Ohno H, Yoneda M. Effect of the use of passive body trunk exercise equipment on oxygen consumption and self-efficacy for carrying out exercise in patients with type 2 diabetes. J Diabetes Investig 2020; 11:1265-1271. [PMID: 32052593 PMCID: PMC7477500 DOI: 10.1111/jdi.13234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/04/2020] [Accepted: 02/09/2020] [Indexed: 12/04/2022] Open
Abstract
AIMS/INTRODUCTION Considering the difficulty in inculcating the habit of exercise among patients with type 2 diabetes, devising an easily maintained means of exercise is preferable. Passive body trunk exercise equipment (PBTE) developed for home use might solve several problems related to exercise therapy, both for patients and clinical staff involved in diabetes treatment; however, its efficacy as a therapeutic exercise device for patients with diabetes has not been ascertained. The purpose of this study was to measure the exercise intensity and self-efficacy of PBTE, and to determine whether PBTE is a useful tool for exercise therapy. MATERIALS AND METHODS The participants were 20 patients with type 2 diabetes, and the duration of exercise using the PBTE was set to 10 min. Oxygen consumption during exercise was measured, and self-efficacy for continuing to exercise using the PBTE and for walking was evaluated after completion of the study. RESULTS The average exercise intensity using the PBTE was 1.7 metabolic equivalents, whereas the maximum exercise intensity was an average of 2.0 metabolic equivalents; the reported self-efficacy for continuing to exercise using the PBTE was significantly higher than for walking. CONCLUSIONS Exercise intensity using the PBTE is similar to low-intensity walking, and thus, it might be a useful therapeutic exercise device for patients with type 2 diabetes. Furthermore, it could be an effective exercise device for diabetes patients who do not have regular exercise habits, especially with reduced motor function or lower leg muscle strength.
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Affiliation(s)
- Toshihiro Kawae
- Division of RehabilitationDepartment of Clinical Practice and SupportHiroshima University HospitalHiroshimaJapan
| | - Daisuke Iwaki
- Division of RehabilitationDepartment of Clinical Practice and SupportHiroshima University HospitalHiroshimaJapan
| | - Yuki Nakashima
- Division of RehabilitationDepartment of Clinical Practice and SupportHiroshima University HospitalHiroshimaJapan
| | - Kenichi Fudeyasu
- Division of RehabilitationDepartment of Clinical Practice and SupportHiroshima University HospitalHiroshimaJapan
| | - Tomoyasu Ishiguro
- Makuhari Human Care FacultyDepartment of Physical TherapyTohto UniversityChibaJapan
| | - Hiroaki Kimura
- Department of RehabilitationHiroshima University HospitalHiroshimaJapan
| | - Kiyokazu Sekikawa
- Department of Physical Analysis and Therapeutic SciencesGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hironobu Hamada
- Department of Physical Analysis and Therapeutic SciencesGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Haruya Ohno
- Department of Molecular and Internal MedicineGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Masayasu Yoneda
- Department of Preventive Medicine for Diabetes and Lifestyle‐related DiseasesGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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Gaesser VJ, Maakestad WM, Hayes ES, Snyder SJ. Motivational Coaching Improves Intrinsic Motivation in Adult Fitness Program Participants. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2020; 13:1167-1178. [PMID: 32922645 PMCID: PMC7449323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The purpose of this study was to measure intrinsic motivation following the implementation of motivational coaching strategies in a semester long personalized adult fitness program. Sixty individuals (40 female/ 20 male, age= 48 ± 15 yrs) participated as clients in an undergraduate exercise training program led by student trainers at Taylor University. The program took place during two consecutive semesters, therefore subject participation ranged from one to two semesters. In addition to personalized exercise prescription, student trainers implemented motivational strategies using a motivational coaching guide aimed at increasing individuals' overall intrinsic motivation. Trainers utilized a coaching checklist to record the motivational strategies used with their client each session. Intrinsic motivation was assessed before and after each program semester using an Intrinsic Motivation Inventory (IMI) and Motivational Client Scale (MCS). Clients' scores on the IMI increased from 3.38 ± 0.37 to 3.58 ± 0.31 (p<0.001; d= 0.587). Particularly, perceived competence increased from 3.01 ± 0.52 to 3.41 ± 0.49 (p<0.001; d= 0.793). Correspondingly, MCS scores also increased from 3.47 ± 0.72 to 3.87 ± 0.60 (p<0.001; d= 0.608). Specifically, clients' response to challenge increased from 3.48 ± 0.98 to 4.15 ± 0.65 (p<0.001; d=0.809). Our data indicate that it is possible to improve intrinsic motivation by implementing motivational strategies into a supervised adult fitness program. This finding suggests motivational coaching may be an important part of a standard training protocol for fitness trainers to help combat a public health concern: initiation and adherence to exercise.
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Affiliation(s)
| | | | - Erik S Hayes
- Department of Kinesiology, Taylor University, Upland, IN, USA
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Hidrus A, Kueh YC, Bachok N, Kuan G. The Processes of Change Scale: A Confirmatory Study of the Malay Language Version. Malays J Med Sci 2020; 27:125-136. [PMID: 32684813 PMCID: PMC7337943 DOI: 10.21315/mjms2020.27.3.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 06/01/2020] [Indexed: 10/25/2022] Open
Abstract
Background Processes of change (POC) comprise one of the psychological constructs in the Transtheoretical Model. The objective of this study is to test the validity and reliability of the Malay version of the POC scale among university students by using a confirmatory approach. Method A cross-sectional study design with a convenience sampling method using a self-administered questionnaire was carried out. University undergraduate students were approached to fill in the questionnaire, which consisted of demographic information and a POC scale. The POC scale consisted of 30 items and two main factors (i.e., cognitive and behavioural). The POC scale was translated into the Malay language using a standard procedure of forward and backward translation. Confirmatory factor analysis (CFA) was performed, and composite reliability was computed using Mplus version 8. Results A total of 620 respondents with a mean age of 20 years (standard deviation = 1.15) completed the questionnaire. Most of the participants were female (74.7%) and Malay (78.2%). The initial CFA model of the POC scale did not exhibit fit based on several fit indices (comparative fit index (CFI) = 0.880, Tucker Lewis index (TLI) = 0.867, standardised root mean square residual (SRMR) = 0.075 and root mean square error of approximation (RMSEA) = 0.058). Several re-specifications of the model were conducted and the modification included adding correlation between the items' residuals. The final model for the Malay version of the POC scale showed acceptable values of model fit indices (CFI = 0.922, TLI = 0.911, SRMR = 0.064 and RMSEA = 0.048). The composite reliability of both the cognitive and behavioural processes was acceptable at 0.856 and 0.752, respectively. Conclusion The final model presented acceptable values of the goodness of fit indices, indicating that the scale is fit and acceptable to be adopted for future study.
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Affiliation(s)
- Aizuddin Hidrus
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Malaysia.,Community and Family Medicine Department, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Malaysia
| | - Yee Cheng Kueh
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Malaysia
| | - Norsa'adah Bachok
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Malaysia
| | - Garry Kuan
- Exercise and Sports Science, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.,Department of Life Sciences, Brunel University London, United Kingdom
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Nigg CR, Harmon B, Jiang Y, Ginis KAM, Motl RW, Dishman RK. Temporal Sequencing of Physical Activity Change Constructs within the Transtheoretical Model. PSYCHOLOGY OF SPORT AND EXERCISE 2019; 45:101557. [PMID: 34421367 PMCID: PMC8376077 DOI: 10.1016/j.psychsport.2019.101557] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Studies support the Transtheoretical Model's (TTM) ability to describe behavior change processes and guide interventions; however, the temporal sequencing of constructs is less understood. This cohort study tested five sequences to identify TTM construct changes related to physical activity. METHODS A random sample provided baseline data (n=689; 63% female; M age (SD)=47(17); 37% white), with 401 participants providing 24-month data, at six-month intervals. RESULTS Structural equation models revealed processes to cognitions to stage (AIC=29313.093, BIC=29514.883, CFI=0.999, RMSEA=0.006, SRMR=0.026); processes to stage to cognitions (AIC=27788.651, BIC=27973.268, CFI=0.978, RMSEA=0.024, SRMR=0.038), self-efficacy/temptations to processes to decisional balance to stage (AIC=13914.771, BIC=14031.169, CFI=0.981, RMSEA=0.018, SRMR=0.034), and stage to processes to cognitions (AIC=22048.324, BIC=22212.986, CFI=0.976, RMSEA=0.026, SRMR=0.029) all fit well. However, cognitions to processes to stage did not fit the data well (AIC=10353.555, BIC=10444.179, CFI=0.937, RMSEA=0.038, SRMR=0.035). CONCLUSIONS Integrating results revealed a cyclical model so that intervention efforts should focus on processes to change cognitions related to barrier self-efficacy and decisional balance, which then lead to change in stage and then renew focus on the processes.
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Affiliation(s)
- Claudio R. Nigg
- Office of Public Health Studies, University of Hawaii, 1960 East-West Road Honolulu, HI 96822, USA & Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Brook Harmon
- School of Public Health, University of Memphis, Robison Hall, Memphis, TN 38152, USA
| | - Yu Jiang
- School of Public Health, University of Memphis, Robison Hall, Memphis, TN 38152, USA
| | - Kathleen A. Martin Ginis
- School of Health and Exercise Science, The University of British Columbia, ART360 1147 Research Road, Kelowna, BC Canada V1V 1V7
| | - Robert W. Motl
- School of Health Professions, University of Alabama at Birmingham, 1716 9th Avenue South SHPB 336 Birmingham, AL 38233, USA
| | - Rodney K. Dishman
- College of Education, University of Georgia, 115I Ramsey Center, 330 River Road Athens, Georgia 30602, USA
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McDowell CP, Dishman RK, Gordon BR, Herring MP. Physical Activity and Anxiety: A Systematic Review and Meta-analysis of Prospective Cohort Studies. Am J Prev Med 2019; 57:545-556. [PMID: 31542132 DOI: 10.1016/j.amepre.2019.05.012] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 01/04/2023]
Abstract
CONTEXT Anxiety symptoms and disorders are highly prevalent and costly. Prospective studies suggest that physical activity may prevent anxiety development; however, this body of literature has not been reviewed comprehensively. EVIDENCE ACQUISITION Studies measuring physical activity at baseline and anxiety at a designated follow-up at least 1 year later were located using MEDLINE, PsycINFO, and CINAHL Complete through June 2018. EVIDENCE SYNTHESIS Data were analyzed July-December 2018. Study quality was assessed using Q-Coh. Among studies of adults, a random-effects meta-analysis was conducted for crude and the most fully adjusted models for three outcomes: self-reported anxiety symptoms, a diagnosis of any anxiety disorder, and a diagnosis of generalized anxiety disorder. As there were few studies with diverse samples and outcome measures, findings were elaborated with a critical narrative review of all studies. Twenty-four studies (median follow-up, 4.75 years) of >80,000 unique individuals were included in the systematic review; thirteen were included in the meta-analyses. Six studies were assessed as low quality, nine as acceptable, and nine as good. From adjusted models, odds of elevated anxiety symptoms (OR=0.8742, 95% CI=0.7731, 0.9886, n=9), any anxiety disorder (OR=0.6626, 95% CI=0.5337, 0.8227, n=3), and generalized anxiety disorder specifically (OR=0.5438, 95% CI=0.3231, 0.9153, n=3) were significantly lower after physical activity exposure. CONCLUSIONS Available evidence suggests that engaging in physical activity protects against anxiety symptoms and disorders. However, notable challenges in the current evidence base include issues regarding exposure and outcome measures, consistent adjustment for putative confounders, representativeness of samples, and attrition bias, which warrant further research.
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Affiliation(s)
- Cillian P McDowell
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Rodney K Dishman
- Department of Kinesiology, University of Georgia, Athens, Georgia
| | - Brett R Gordon
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Matthew P Herring
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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Lounassalo I, Salin K, Kankaanpää A, Hirvensalo M, Palomäki S, Tolvanen A, Yang X, Tammelin TH. Distinct trajectories of physical activity and related factors during the life course in the general population: a systematic review. BMC Public Health 2019; 19:271. [PMID: 30841921 PMCID: PMC6404287 DOI: 10.1186/s12889-019-6513-y] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 02/04/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND In recent years, researchers have begun applying a trajectory approach to identify homogeneous subgroups of physical activity (PA) in heterogeneous populations. This study systematically reviewed the articles identifying longitudinal PA trajectory classes and the related factors (e.g., determinants, predictors, and outcomes) in the general population during different life phases. METHODS The included studies used finite mixture models for identifying trajectories of PA, exercise, or sport participation. Three electronic databases, PubMed (Medline), Web of Science, and CINAHL, were searched from the year 2000 to 13 February 2018. The study was conducted according to the PRISMA recommendations. RESULTS Twenty-seven articles were included and organized into three age group: youngest (eleven articles), middle (eight articles), and oldest (eight articles). The youngest group consisted mainly of youth, the middle group of adults and the oldest group of late middle-aged and older adults. Most commonly, three or four trajectory classes were reported. Several trajectories describing a decline in PA were reported, especially in the youngest group, whereas trajectories of consistently increasing PA were observed in the middle and oldest group. While the proportion of persistently physically inactive individuals increased with age, the proportion was relatively high at all ages. Generally, male gender, being Caucasian, non-smoking, having low television viewing time, higher socioeconomic status, no chronic illnesses, and family support for PA were associated either with persistent or increasing PA. CONCLUSIONS The reviewed articles identified various PA subgroups, indicating that finite mixture modeling can yield new information on the complexity of PA behavior compared to studying population mean PA level only. The studies also provided novel information how different factors relate to changes in PA during life course. The recognition of the PA subgroups and their determinants is important for the more precise targeting of PA promotion and PA interventions. TRIAL REGISTRATION PROSPERO registration number: CRD42018088120 .
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Affiliation(s)
- Irinja Lounassalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kasper Salin
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Anna Kankaanpää
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Mirja Hirvensalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sanna Palomäki
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Asko Tolvanen
- Methodology Center for Human Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Xiaolin Yang
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Tuija H. Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
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12
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Hashemzadeh M, Rahimi A, Zare-Farashbandi F, Alavi-Naeini AM, Daei A. Transtheoretical Model of Health Behavioral Change: A Systematic Review. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:83-90. [PMID: 30820217 PMCID: PMC6390443 DOI: 10.4103/ijnmr.ijnmr_94_17] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background: Transtheoretical model (TTM) is one of the most commonly used methods in behavioral change modeling. The aim of this study was to conduct a systematic review (SR) to determine research gaps with regard to this template with an emphasis on intervention for patients with chronic diseases (CDs). Materials and Methods: ISI-WOS, Scopus, PubMed, SID, and Magiran databases were examined systematically and on the basis of defined criteria. Titles, abstracts, and full texts of articles retrieved were examined for the presence of defined criteria. Then finalized articles were analyzed in consensus meetings. After that, references of selected articles and full text of those meeting the criteria were also analyzed. Results: We screened 103 articles, excluded 27 in abstract review and 34 in full-text review, leaving 42 articles for critical appraisal. Then the references of these 42 articles were also screened. Fifty articles were excluded on abstract review and 5 on full-text review, leaving 15 articles. The result of the analysis of 57 final articles of this SR determined that 28 articles were about aspects of TTM and 5 stages of change were the most commonly used aspect. Eight articles used TTM in intervention about CDs. A total of 21 articles examined TTM's pros and cons, most of which were about TTM's pros. Conclusions: The majority of studies focused on the effectiveness of TTM on the behavioral change management. This finding supported the hypothesis that TTM can be applied in the prevention of CDs.
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Affiliation(s)
- Mozhdeh Hashemzadeh
- School of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Rahimi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Mansur Alavi-Naeini
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azra Daei
- Department of Community Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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13
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Teague S, Youssef GJ, Macdonald JA, Sciberras E, Shatte A, Fuller-Tyszkiewicz M, Greenwood C, McIntosh J, Olsson CA, Hutchinson D. Retention strategies in longitudinal cohort studies: a systematic review and meta-analysis. BMC Med Res Methodol 2018; 18:151. [PMID: 30477443 PMCID: PMC6258319 DOI: 10.1186/s12874-018-0586-7] [Citation(s) in RCA: 220] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 10/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Participant retention strategies that minimise attrition in longitudinal cohort studies have evolved considerably in recent years. This study aimed to assess, via systematic review and meta-analysis, the effectiveness of both traditional strategies and contemporary innovations for retention adopted by longitudinal cohort studies in the past decade. METHODS Health research databases were searched for retention strategies used within longitudinal cohort studies published in the 10-years prior, with 143 eligible longitudinal cohort studies identified (141 articles; sample size range: 30 to 61,895). Details on retention strategies and rates, research designs, and participant demographics were extracted. Meta-analyses of retained proportions were performed to examine the association between cohort retention rate and individual and thematically grouped retention strategies. RESULTS Results identified 95 retention strategies, broadly classed as either: barrier-reduction, community-building, follow-up/reminder, or tracing strategies. Forty-four of these strategies had not been identified in previous reviews. Meta-regressions indicated that studies using barrier-reduction strategies retained 10% more of their sample (95%CI [0.13 to 1.08]; p = .01); however, studies using follow-up/reminder strategies lost an additional 10% of their sample (95%CI [- 1.19 to - 0.21]; p = .02). The overall number of strategies employed was not associated with retention. CONCLUSIONS Employing a larger number of retention strategies may not be associated with improved retention in longitudinal cohort studies, contrary to earlier narrative reviews. Results suggest that strategies that aim to reduce participant burden (e.g., flexibility in data collection methods) might be most effective in maximising cohort retention.
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Affiliation(s)
- Samantha Teague
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia
| | - George J Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Australia
| | - Emma Sciberras
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Adrian Shatte
- School of Engineering & Information Technology, Faculty of Science & Technology, Federation University, Melbourne, Australia
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia
| | - Chris Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia
| | - Jennifer McIntosh
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia. .,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia. .,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Australia. .,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
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14
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Mooney SJ, Joshi S, Cerdá M, Kennedy GJ, Beard JR, Rundle AG. Longitudinal Patterns of Physical Activity Among Older Adults: A Latent Transition Analysis. Am J Epidemiol 2018; 187:1549-1558. [PMID: 29762655 DOI: 10.1093/aje/kwy027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 02/01/2018] [Indexed: 11/13/2022] Open
Abstract
Most epidemiologic studies of physical activity measure either total energy expenditure or engagement in a single type of activity, such as walking. These approaches may gloss over important nuances in activity patterns. We performed a latent transition analysis to identify patterns of activity, as well as neighborhood and individual determinants of changes in those activity patterns, over 2 years in a cohort of 2,023 older adult residents of New York, New York, surveyed between 2011 and 2013. We identified 7 latent classes: 1) mostly inactive, 2) walking, 3) exercise, 4) household activities and walking, 5) household activities and exercise, 6) gardening and household activities, and 7) gardening, household activities, and exercise. The majority of subjects retained the same activity patterns between waves (54% unchanged between waves 1 and 2, 66% unchanged between waves 2 and 3). Most latent class transitions were between classes distinguished only by 1 form of activity, and only neighborhood unemployment was consistently associated with changing between activity latent classes. Future latent transition analyses of physical activity would benefit from larger cohorts and longer follow-up periods to assess predictors of and long-term impacts of changes in activity patterns.
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Affiliation(s)
- Stephen J Mooney
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, Washington
| | - Spruha Joshi
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Magdalena Cerdá
- Department of Emergency Medicine, School of Medicine, University of California, Davis and UC Davis Health System, Davis, California
| | | | - John R Beard
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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15
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Rahimi A, Hashemzadeh M, Zare-Farashbandi F, Alavi Naeini AM, Hasanzadeh A. The effect of nutrition education course on awareness of obese and overweight female 1 st-year High School students of Isfahan based on transtheoretical model of behavioral change. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:76. [PMID: 29963569 PMCID: PMC6009135 DOI: 10.4103/jehp.jehp_120_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 11/04/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND/AIM Today, the problem of obesity is a chronic condition that affects all age groups in developed and developing countries. Since adolescence is a transitional period and behavioral patterns formed in this period affect people in their adult years, attention to obesity and extra weight in this age group is more important than other groups. Therefore, this study aims to investigate the effects of nutrition education course on awareness of female 1st-year high school students of Isfahan based on transtheoretical model ( TTM) of behavioral change. MATERIALS AND METHODS In this semi-empirical study, 64 female 1st-year high school students with weight problem were selected using nonpercent stratified sampling and divided into two control and test groups. Data gathering was carried out using researcher-made nutrition awareness and stages of change questionnaire whose validity and reliability was confirmed. Participants in the test group participated in a 2-month education with sessions every 2 weeks and received one brochure and 3 educational massages each week. Data were analyzed using independent t-test and Mann-Whitney test. RESULTS The results showed that the average nutrition awareness score of students in test group was significantly higher than control group after intervention. Students in test group were also in higher stages of change compared to control group after intervention. CONCLUSION The results show that TTM was effective in changing nutritional behavior in students.
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Affiliation(s)
- Alireza Rahimi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mozhdeh Hashemzadeh
- Department of Medical Librarianship and Information Science , School of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Mansur Alavi Naeini
- Department of Community Nutrition and Food Sciences. Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hasanzadeh
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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16
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Shang B, Duan Y, Huang WY, Brehm W. Fluctuation - a common but neglected pattern of physical activity behaviour: An exploratory review of studies in recent 20 years. Eur J Sport Sci 2018; 18:266-278. [PMID: 29334317 DOI: 10.1080/17461391.2017.1417486] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Regular physical activity (PA) is beneficial for physical and psychological well-being, yet many people do not achieve these health benefits due to irregular PA participation which is also known as fluctuation. Limited attention has been given to the phenomenon of fluctuation in the PA behaviour literature. OBJECTIVE The aim of this review was to explore and to map definitions, measurements, behavioural evidence, and factors related to PA fluctuation. METHODS Eligible studies were initially identified by a systematic search of articles conducted in four databases: Scopus, PubMed, PsycINFO, and SPORTDiscus between January 1996 and March 2016. Inclusion and exclusion criteria were set to check the eligibility of all articles. Additional articles were included by manual searching and expert recommendation. RESULTS Fifteen articles were finally included. Definitions of fluctuation are understood from two perspectives, either as a stage in the process of behaviour change, or as a particular PA phenomenon consisting of lapse and readoption. Common features were extracted: behavioural irregularity, high risk of drop-out, intention and readiness for PA, low automaticity, and limited self-regulation. Furthermore, fluctuation identification was summarised in three approaches such as stage algorithm, self-identified PA lapse and readoption, and prospective within-person variation in meeting the PA guidelines. Regarding the empirical evidence, this review found that people in PA fluctuation were significantly distinct from those in preparation and maintenance of PA behavioural performance, as well as distinct in psychosocial features. CONCLUSIONS Notwithstanding the limitations, this review has provided valuable insight into the phenomenon of PA fluctuation.
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Affiliation(s)
- Borui Shang
- a Department of Physical Education , Hong Kong Baptist University , Hong Kong , People's Republic of China
| | - Yanping Duan
- a Department of Physical Education , Hong Kong Baptist University , Hong Kong , People's Republic of China
| | - Wendy Yajun Huang
- a Department of Physical Education , Hong Kong Baptist University , Hong Kong , People's Republic of China
| | - Walter Brehm
- b Institute of Sports Science, University of Bayreuth , Bayreuth , Germany
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17
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Scruggs S, Mama SK, Carmack CL, Douglas T, Diamond P, Basen-Engquist K. Randomized Trial of a Lifestyle Physical Activity Intervention for Breast Cancer Survivors: Effects on Transtheoretical Model Variables. Health Promot Pract 2017. [PMID: 28627254 DOI: 10.1177/1524839917709781] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined whether a physical activity intervention affects transtheoretical model (TTM) variables that facilitate exercise adoption in breast cancer survivors. Sixty sedentary breast cancer survivors were randomized to a 6-month lifestyle physical activity intervention or standard care. TTM variables that have been shown to facilitate exercise adoption and progress through the stages of change, including self-efficacy, decisional balance, and processes of change, were measured at baseline, 3 months, and 6 months. Differences in TTM variables between groups were tested using repeated measures analysis of variance. The intervention group had significantly higher self-efficacy ( F = 9.55, p = .003) and perceived significantly fewer cons of exercise ( F = 5.416, p = .025) at 3 and 6 months compared with the standard care group. Self-liberation, counterconditioning, and reinforcement management processes of change increased significantly from baseline to 6 months in the intervention group, and self-efficacy and reinforcement management were significantly associated with improvement in stage of change. The stage-based physical activity intervention increased use of select processes of change, improved self-efficacy, decreased perceptions of the cons of exercise, and helped participants advance in stage of change. These results point to the importance of using a theory-based approach in interventions to increase physical activity in cancer survivors.
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Affiliation(s)
- Stacie Scruggs
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Cindy L Carmack
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tommy Douglas
- 3 The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Pamela Diamond
- 3 The University of Texas Health Science Center at Houston, Houston, TX, USA
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18
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Romain AJ, Horwath C, Bernard P. Prediction of Physical Activity Level Using Processes of Change From the Transtheoretical Model: Experiential, Behavioral, or an Interaction Effect? Am J Health Promot 2017; 32:16-23. [DOI: 10.1177/0890117116686900] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: The purpose of the present study was to compare prediction of physical activity (PA) by experiential or behavioral processes of change (POCs) or an interaction between both types of processes. Design: A cross-sectional study. Setting: This study was conducted using an online questionnaire. Participants: A total of 394 participants (244 women, 150 men), with a mean age of 35.12 ± 12.04 years and a mean body mass index of 22.97 ± 4.25 kg/m2 were included. Measures: Participants completed the Processes of Change, Stages of Change questionnaires, and the International Physical Activity Questionnaire to evaluate self-reported PA level (total, vigorous, and moderate PA). Analysis: Hierarchical multiple regression models were used to test the prediction of PA level. Results: For both total PA (β = .261; P < .001) and vigorous PA (β = .297; P < .001), only behavioral POCs were a significant predictor. Regarding moderate PA, only the interaction between experiential and behavioral POCs was a significant predictor (β = .123; P = .017). Conclusion: Our results provide confirmation that behavioral processes are most prominent in PA behavior. Nevertheless, it is of interest to note that the interaction between experiential and behavioral POCs was the only element predicting moderate PA level. Experiential processes were not associated with PA level.
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Affiliation(s)
- Ahmed Jérôme Romain
- EA 4556 Laboratory Epsylon, University of Montpellier, Montpellier, France
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Caroline Horwath
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Paquito Bernard
- EA 4556 Laboratory Epsylon, University of Montpellier, Montpellier, France
- Research Center of the University Hospital of Quebec, Quebec, Quebec, Canada
- Cancer Research Center, University of Laval, Quebec, Quebec, Canada
- School of psychology, University of Laval, Quebec, Quebec, Canada
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19
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Partridge SR, McGeechan K, Bauman A, Phongsavan P, Allman-Farinelli M. Improved confidence in performing nutrition and physical activity behaviours mediates behavioural change in young adults: Mediation results of a randomised controlled mHealth intervention. Appetite 2016; 108:425-433. [PMID: 27818304 DOI: 10.1016/j.appet.2016.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 10/29/2016] [Accepted: 11/02/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The burden of weight gain disproportionally affects young adults. Understanding the underlying behavioural mechanisms of change in mHealth nutrition and physical activity interventions designed for young adults is important for enhancing and translating effective interventions. PURPOSE First, we hypothesised that knowledge, self-efficacy and stage-of-change for nutrition and physical activity behaviours would improve, and second, that self-efficacy changes in nutrition and physical activity behaviours mediate the behaviour changes observed in an mHealth RCT for prevention of weight gain. METHODS Young adults, aged 18-35 years at risk of weight gain (n = 250) were randomly assigned to an mHealth-program, TXT2BFiT, consisting of a three-month intensive phase and six-month maintenance phase or to a control group. Self-reported online surveys at baseline, three- and nine-months assessed nutrition and physical activity behaviours, knowledge, self-efficacy and stage-of-change. The mediating effect of self-efficacy was assessed in multiple PROCESS macro-models for three- and nine-month nutrition and physical activity behaviour change. RESULTS Young adults randomised to the intervention increased and maintained knowledge of fruit requirements (P = 0.029) compared to controls. Intervention participants' fruit and takeaway behaviours improved to meet recommendations at nine months, with a greater proportion progressing to action or maintenance stage-of-change (P < 0.001 and P = 0.012 respectively) compared to controls. Intervention participants' vegetable and physical activity behaviours did not meet recommendations, thereby halting progress to action or maintenance stage-of-change. Indirect effects of improved nutrition and physical activity behaviours at three- and nine-months in the intervention group were explained by changes in self-efficacy, accounting for 8%-37% of the total effect. CONCLUSIONS This provides insights into how the mHealth intervention achieved part of its effects and the importance of improving self-efficacy to facilitate improved eating and physical activity behaviours in young adults.
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Affiliation(s)
- Stephanie R Partridge
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Kevin McGeechan
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Adrian Bauman
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Philayrath Phongsavan
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Margaret Allman-Farinelli
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
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20
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Parrish DE, von Sternberg K, Castro Y, Velasquez MM. Processes of change in preventing alcohol exposed pregnancy: A mediation analysis. J Consult Clin Psychol 2016; 84:803-812. [PMID: 27176661 PMCID: PMC5061601 DOI: 10.1037/ccp0000111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine mechanisms of the treatment effect for CHOICES, a motivational intervention to reduce risk of alcohol exposed pregnancy (AEP). Grounded in constructs from the transtheoretical model (TTM) and motivational interviewing (MI), the intervention targeted: risk drinking (>4 drinks/day or >7 drinks/week); ineffective contraception; and AEP risk (both behaviors). The experiential and behavioral processes of change (POC), posited to describe the mechanisms through which individual behavior change occurs, were examined. It was hypothesized that each of the targeted treatment outcomes at 9-month follow-up would be mediated by the experiential POC at 3 months, and that these would then be mediated by the behavioral POC at 9 months. METHOD Eight hundred thirty women at-risk for AEP were randomized to CHOICES (information plus counseling; IPC) condition (n = 416) or information only (IO) condition (n = 414). Primary outcomes and proposed mediators (POC) were assessed at 3 and 9 months. Path analyses using weighted least squares estimation with mean- and variance-adjusted chi-square statistic were conducted separately for each outcome. RESULTS Model fit indices indicated good fit, and the indirect effect of treatment on outcome via POC was significant for hypothesized models predicting risky drinking and ineffective contraception. The indirect effect of treatment on AEP risk through POC for ineffective contraception was significant, but the indirect effect of POC for risky drinking was not. CONCLUSIONS These findings support the temporal relationship between experiential and behavioral POC consistent with the TTM. Opportunistic, motivation-based interventions may benefit from directly targeting experiential POC early in treatment and behavioral POC later in treatment. (PsycINFO Database Record
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Affiliation(s)
- Danielle E. Parrish
- Associate Professor, University of Houston, Graduate College of Social Work, Phone: (713) 743-8105, Fax: (713) 743-8149
| | - Kirk von Sternberg
- Associate Professor, Associate Director, Health Behavior, Research and Training Institute, University of Texas at Austin, School of Social Work, Phone: (512) 232-0633, Fax: (512) 232-0638
| | - Yessenia Castro
- Assistant Professor, University of Texas at Austin, School of Social Work, Phone: (512) 232-0778, Fax: (512) 232-0638
| | - Mary M. Velasquez
- Centennial Professor in Leadership for Community, Professional and Corporate, Excellence; Director, Health Behavior, Research and Training Institute, University of Texas at Austin, School of Social Work, Phone: (512) 471-7019, Fax: (512) 232-0638
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Romain AJ, Bernard P, Hokayem M, Gernigon C, Avignon A. Measuring the Processes of Change From the Transtheoretical Model for Physical Activity and Exercise in Overweight and Obese Adults. Am J Health Promot 2016; 30:272-8. [DOI: 10.1177/0890117116633829] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: This study aimed to test three factorial structures conceptualizing the processes of change (POC) from the transtheoretical model and to examine the relationships between the POC and stages of change (SOC) among overweight and obese adults. Design: Cross-sectional study. Setting: This study was conducted at the University Hospital of Montpellier, France. Subjects: A sample of 289 overweight or obese participants (199 women) was enrolled in the study. Measures: Participants completed the POC and SOC questionnaires during a 5-day hospitalization for weight management. Analysis: Structural equation modeling was used to compare the different factorial structures. Results: The unweighted least-squares method was used to identify the best-fit indices for the five fully correlated model (goodness-of-fit statistic = .96; adjusted goodness-of-fit statistic = .95; standardized root mean residual = .062; normed-fit index = .95; parsimonious normed-fit index = .83; parsimonious goodness-of-fit statistic = .78). The multivariate analysis of variance was significant ( p < .001). A post hoc test showed that individuals in advanced SOC used more of both experiential and behavioral POC than those in preaction stages, with effect sizes ranging from .06 to .29. Conclusion: This study supports the validity of the factorial structure of POC concerning physical activity and confirms the assumption that, in this context, people with excess weight use both experiential and behavioral processes. These preliminary results should be confirmed in a longitudinal study.
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Affiliation(s)
- Ahmed Jerôme Romain
- Department of Sport and Exercise Science, Laboratory Epsylon EA4556, University of Montpellier, Montpellier, France
- Unit of Nutrition and Diabetes, University Hospital of Lapeyronie, Montpellier, France
| | - Paquito Bernard
- Department of Sport and Exercise Science, Laboratory Epsylon EA4556, University of Montpellier, Montpellier, France
| | - Marie Hokayem
- Unit of Nutrition and Diabetes, University Hospital of Lapeyronie, Montpellier, France
- Department of Nutrition, Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Christophe Gernigon
- Department of Sport and Exercise Science, Laboratory Epsylon EA4556, University of Montpellier, Montpellier, France
| | - Antoine Avignon
- INSERM U1046, Physiology and Experimental Medicine of Heart and Muscle, University of Montpellier, Montpellier, France
- Unit of Nutrition and Diabetes, University Hospital of Lapeyronie, Montpellier, France
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Middelkamp J, Van Rooijen M, Steenbergen B. Attendance Behavior of Ex-members in Fitness Clubs: A Retrospective Study Applying the Stages of Change. Percept Mot Skills 2016; 122:350-9. [PMID: 27420326 DOI: 10.1177/0031512516631075] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The transtheoretical model of behavior change (TTM) is often used to understand and predict health-related behavior. The objective of this study is to apply the TTM's stages of change to examine patterns of attendance behavior at fitness clubs. A retrospective study was performed to study the later stages of change, using attendance data of members who cancelled their membership in 2012 in two European fitness chains, including 259,355 ex-members of 267 clubs. A sample of 400 was selected at random for analyses, M age = 32.1 yr. (SD = 10.9; 64% males) and 34.7 yr. (SD = 11.0; 51% males) for BasicFit and HealthCity. Regular attendance behavior was defined by at least four visits per month. In the past, all ex-members had purchased a membership and by that were considered to have entered the preparation stage, but 19.5% had never attended the club in 24 months. Of the ex-members, 10% demonstrated regular attendance behavior for six months, and 2.3% had regular attendance for 24 months. 49% did not attend the club for one full month but started regular attendance again. Significant positive correlations were found in attendance behavior between the 6th and 12th months (r = .61), and the 12th and 24th months (r = .45), suggesting that ex-members who attended for more than six months were more likely to have maintained their attendance behavior. With only 10% of the members demonstrating regular attendance behavior, it is evident that appropriate strategies have to be developed to improve attendance behavior and facilitate exercise behavior in fitness clubs.
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Loprinzi PD, Kane C, Sigler S, Brown K, Walker JF. Free-living physical activity characteristics, activity-related air trapping and breathlessness, and utilization of transtheoretical constructs in COPD: A pilot study. Physiol Behav 2015; 152:79-84. [DOI: 10.1016/j.physbeh.2015.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/13/2015] [Accepted: 09/14/2015] [Indexed: 11/16/2022]
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Jiménez Castuera R, Moreno Navarrete B, Leyton Román M, Claver Rabaz F. Motivación y estadios de cambio para el ejercicio físico en adolescentes. REVISTA LATINOAMERICANA DE PSICOLOGIA 2015. [DOI: 10.1016/j.rlp.2014.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Malekshahi F, Hidarnia A, Niknami S, Aminshokravi F. The Determination of Predictive Construct of Physical Behavior Change on Osteoporosis Prevention Women Aged 30-50: A Trans-Theoretical Method Study. Glob J Health Sci 2015; 8:183-92. [PMID: 26493413 PMCID: PMC4804030 DOI: 10.5539/gjhs.v8n3p183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/30/2015] [Accepted: 05/21/2015] [Indexed: 11/24/2022] Open
Abstract
Osteoporosis is a major public health priority in Iran and throughout the world. The prevention of osteoporosis has recently become the ultimate goal of many health professionals. Behavior change is one of the most powerful strategies to prevent osteoporosis. This study aimed to determine the predictive construct of physical preventive behavior of osteoporosis in women aged 30-50 in Khorramabad, west of Iran. This study included 269 women selected from all the health centers of Khorramabad city according to the inclusion criteria of the study and through random cluster and systematic sampling. The data gathering tools were valid and reliable questionnaires of demographic information, stages of change, decisional balance, self-efficacy, and physical activity. Data were analyzed using descriptive and inferential statistics. The mean of the subjects’ age was 38.72±7.003, and the mean of light weekly physical activity was 38.83±56.400. The results showed that the construct of self-efficacy had the highest predictive power of the preventive behavior. The results also showed that self-efficacy among the constructs of the Trans-theoretical Model was the only predictive construct for osteoporosis prevention behavior. Therefore, the findings of this study can serve as a base for educational interventions in behavioral changes to prevent of osteoporosis by health authorities.
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Affiliation(s)
- Farideh Malekshahi
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University.
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Abstract
BACKGROUND Regular physical activity (PA) is foundational to human health, yet most people are inactive. A sound understanding of the determinants of PA may be instructive for building interventions and/or identifying critical target groups to promote PA. Most research on PA correlates has been biased by cross-sectional or passive prospective designs that fail to examine within-person analysis of PA change. OBJECTIVE The purpose of this review was to collect and appraise the available literature on the predictors of PA change conceived broadly in terms of increases/decreases from baseline assessment as well as specifically in terms of adoption and maintenance. METHODS Eligible studies were from English, peer-reviewed published articles that examined predictors of natural change of PA over 3 months + using observational (non-experimental) data in adult samples. Searches were performed from June 2012 to January 2014 in eight databases. RESULTS Sixty-seven independent data-sets, from 12 countries, primarily of medium quality/risk of bias, were identified with 26 correlates spanning demographic, behavioral, intra-individual, inter-individual, and environmental categories. Only intention and the onset of motherhood could reliably predict overall PA change. Among datasets configured to predict PA adoption, affective judgments and behavioral processes of change were the only reliable predictors, although both only have a small number of available studies. There were no reliable predictors of maintenance when compared to PA relapse. CONCLUSION The results underscore the importance of individual-level motivation and behavioral regulation in PA change, but also denote critical social variables. These findings, however, are constrained by PA measurement bias and limited studies that employed time-varying covariation between predictor variables and PA.
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Affiliation(s)
- Ryan E Rhodes
- Behavioural Medicine Laboratory, Faculty of Education, University of Victoria, STN CSC, PO Box 3015, Victoria, BC, V8W 3P1, Canada,
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Fast HV, Kennett DJ. Development and practical implications of the Exercise Resourcefulness Inventory. PATIENT EDUCATION AND COUNSELING 2015; 98:627-632. [PMID: 25727284 DOI: 10.1016/j.pec.2015.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/19/2014] [Accepted: 02/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To determine the validity and reliability of the Exercise Resourcefulness Inventory (ERI) designed to assess the self-regulatory strategies used to promote regular exercise. METHODS In Study 1, the inventory's relationship with other established scales in the exercise behavior change field was examined. In Study 2, the test-retest reliability and predictive validity of the ERI was established by having participants from Study 1 complete the inventory a second time. RESULTS Internal consistency, and convergent, discriminant, and concurrent validity were supported in both studies. The test-retest correlation of the ERI was .80. As well, participants scoring higher on the ERI in Study 1 were more likely to be at a higher stage of change in Study 2, and greater increases in exercise resourcefulness over time were predictive of advancement to higher stages of change. CONCLUSIONS ERI is a reliable and valid measure to assess the self-regulatory strategies used to promote regular exercise. PRACTICAL IMPLICATIONS Facilitators may want to tailor exercise programs for individuals scoring lower in resourcefulness to prevent them from relapsing.
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Affiliation(s)
- Hilary V Fast
- Department of Psychology, Trent University, Peterborough, Canada
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Dishman RK, Jackson AS, Bray MS. Self-regulation of exercise behavior in the TIGER study. Ann Behav Med 2015; 48:80-91. [PMID: 24311018 DOI: 10.1007/s12160-013-9573-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to test experiential and behavioral processes of change as mediators of the prediction of exercise behavior by two self-regulation traits, self-efficacy and self-motivation, while controlling for exercise enjoyment. METHODS Structural equation modeling was applied to questionnaire responses obtained from a diverse sample of participants. Objective measures defined adherence (928 of 1,279 participants attended 80 % or more of sessions) and compliance (867 of 1,145 participants exercised 30 min or more each session at their prescribed heart rate). RESULTS Prediction of attendance by self-efficacy (inversely) and self-motivation was direct and also indirect, mediated through positive relations with the typical use of behavioral change processes. Enjoyment and self-efficacy (inversely) predicted compliance with the exercise prescription. CONCLUSIONS The results support the usefulness of self-regulatory behavioral processes of the transtheoretical model for predicting exercise adherence, but not compliance, extending the supportive evidence for self-regulation beyond self-reports of physical activity used in prior observational studies.
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Affiliation(s)
- Rod K Dishman
- Department of Kinesiology, The University of Georgia, Ramsey Student Center, 330 River Road, Athens, GA, 30602-6554, USA,
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Romain AJ, Attalin V, Sultan A, Boegner C, Gernigon C, Avignon A. Experiential or behavioral processes: which one is prominent in physical activity? Examining the processes of change 1 year after an intervention of therapeutic education among adults with obesity. PATIENT EDUCATION AND COUNSELING 2014; 97:261-268. [PMID: 25181999 DOI: 10.1016/j.pec.2014.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 07/08/2014] [Accepted: 08/04/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Although physical activity (PA) is essential, most obese people will not engage in its practice. The transtheoretical model (TTM) and its processes of change (POC) contribute to the understanding of behavior change regarding PA. The present study aimed to test how POC are associated with a progression through the stages of change (SOC) and whether they predict BMI change. METHODS Interventional study. A total of 134 subjects participated in an education program, were called at 1 year and 62 of them provided follow-up data. Participants completed the SOC and POC questionnaires at baseline, at 1 year and were classified according to their SOC progression. RESULTS Participants who progressed through SOC lost more weight (p<0.001). Significant interactions were found for three out of five POC (p<0.05). Progression through SOC was associated with an increased use of POC. Weight loss was predicted by two behavioral POC. CONCLUSION Results support the previous cross-sectional studies showing that physically active people use more frequently POC. PRACTICE IMPLICATIONS The present findings support the development of TTM-grounded behavioral interventions targeted to obese patients. Identifying methods to promote POC use to improve adherence to weight guidelines may lead to improved clinical outcomes and quality of life.
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Affiliation(s)
- A J Romain
- Department of Sport and Exercise Science, Laboratory Epsylon EA4556, University of Montpellier, Montpellier, France; Unit of Nutrition and Diabetes, University Hospital of Lapeyronie, Montpellier, France.
| | - V Attalin
- Unit of Nutrition and Diabetes, University Hospital of Lapeyronie, Montpellier, France
| | - A Sultan
- Unit of Nutrition and Diabetes, University Hospital of Lapeyronie, Montpellier, France; INSERM U1046, Physiology and Experimental Medicine of Heart and Muscle, University of Montpellier, Montpellier, France
| | - C Boegner
- Unit of Nutrition and Diabetes, University Hospital of Lapeyronie, Montpellier, France
| | - C Gernigon
- Department of Sport and Exercise Science, Laboratory Epsylon EA4556, University of Montpellier, Montpellier, France
| | - A Avignon
- Unit of Nutrition and Diabetes, University Hospital of Lapeyronie, Montpellier, France; INSERM U1046, Physiology and Experimental Medicine of Heart and Muscle, University of Montpellier, Montpellier, France
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Sport participation among individuals with acquired physical disabilities: group differences on demographic, disability, and Health Action Process Approach constructs. Disabil Health J 2014; 8:216-22. [PMID: 25458978 DOI: 10.1016/j.dhjo.2014.09.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 09/20/2014] [Accepted: 09/27/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Despite numerous physical, social, and mental health benefits of engaging in moderate and vigorous intensity physical activities (e.g., sport), few individuals with acquired physical disabilities currently participate in adapted sport. Theory-based sport promotion interventions are one possible way to increase the amount of individuals who engage in sport. OBJECTIVES The primary objective of this study was to examine the profiles of three different sport participation groups with respect to demographic, injury, and Health Action Process Approach (HAPA) constructs. METHODS ANOVAs and Chi-square tests were used to determine group differences on demographic and disability-related constructs. A MANCOVA was conducted to determine differences between three sport participation groups (non-intenders, intenders, and actors) with age, years post-injury, mode of mobility, and sex included as covariates. RESULTS A cohort of 201 individuals was recruited; 56 (27.9%) were non-intenders, 21 (10.4%) were intenders, and 124 (61.7%) were actors. The MANCOVA revealed significant differences between groups on the HAPA constructs, F(22,370) = 9.02, p < .0001, Pillai's trace = .70, demonstrating that individuals with acquired physical disabilities will rate important health behavior constructs differently based on their sport intentions. CONCLUSION These results provide an important framework that adapted sport organizations can use to tailor their sport promotion programs.
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Validation of the TTM processes of change measure for physical activity in an adult French sample. Int J Behav Med 2014; 21:402-10. [PMID: 23385489 DOI: 10.1007/s12529-013-9292-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Processes of change (POC) are constructs from the transtheoretical model that propose to examine how people engage in a behavior. However, there is no consensus about a leading model explaining POC and there is no validated French POC scale in physical activity PURPOSE This study aimed to compare the different existing models to validate a French POC scale. METHOD Three studies, with 748 subjects included, were carried out to translate the items and evaluate their clarity (study 1, n = 77), to assess the factorial validity (n = 200) and invariance/equivalence (study 2, n = 471), and to analyze the concurrent validity by stage × process analyses (study 3, n = 671). RESULTS Two models displayed adequate fit to the data; however, based on the Akaike information criterion, the fully correlated five-factor model appeared as the most appropriate to measure POC in physical activity. The invariance/equivalence was also confirmed across genders and student status. Four of the five existing factors discriminated pre-action and post-action stages. CONCLUSION These data support the validation of the POC questionnaire in physical activity among a French sample. More research is needed to explore the longitudinal properties of this scale.
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Maruf FA, Ibikunle PO, Raji NO. Relationships between transtheoretical model stages of change, decisional balance, self-efficacy, and physical activity level among Nigerian market vendors. Am J Health Promot 2013; 28:e118-26. [PMID: 23971521 DOI: 10.4278/ajhp.121024-quan-519] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study explored decisional balance, self-efficacy, and physical activity (PA) level in relation to stages of change (SoC) for PA among Nigerian vendors. The study explored associations among decisional balance, self-efficacy, and PA level, and examined differences, by stage, in decisional balance, self-efficacy, and PA level. DESIGN Cross-sectional survey. SETTING Outdoor markets located in Eke Amobi, Nkwo, and Okpuno Egbu in Nnewi, southeastern Nigeria. SUBJECTS Participants were 499 market vendors (98 males and 401 females). MEASURES Self-efficacy, perceived barrier and benefit, PA level, and SoC for PA. ANALYSIS Spearman rank-order and partial correlations; analysis of variance by gender with Bonferroni post hoc adjustment. RESULTS Self-efficacy (r = 0.69; p = 0.000), perceived benefit (r = .12; p = .007), and perceived barrier (r = -.11; p = .017) for PA were related to the SoC. Adjusting for age, gender, and marital status, only self-efficacy (r = .48; p = .000) remained correlated with the SoC. In males, significant differences in perceived barrier (p = .003) and benefit (p = .003) lay between stages of contemplation and preparation and between stages of precontemplation and contemplation for self-efficacy (p = .006). In females, there were significance differences in self-efficacy across stages of precontemplation and contemplation (p = .000) and preparation and action (p = .007). CONCLUSION When designing PA interventions, age, gender, and marital status should be considered in explaining the relationships between outcome constructs of transtheoretical model (TTM) and SoC in vendors. It is also important to note that the stages at which outcome constructs of TTM change during PA interventions vary in males and females.
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Hebden L, Balestracci K, McGeechan K, Denney-Wilson E, Harris M, Bauman A, Allman-Farinelli M. 'TXT2BFiT' a mobile phone-based healthy lifestyle program for preventing unhealthy weight gain in young adults: study protocol for a randomized controlled trial. Trials 2013; 14:75. [PMID: 23506013 PMCID: PMC3610110 DOI: 10.1186/1745-6215-14-75] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 03/07/2013] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Despite international efforts to arrest increasing rates of overweight and obesity, many population strategies have neglected young adults as a target group. Young adults are at high risk for unhealthy weight gain which tends to persist throughout adulthood with associated chronic disease health risks. METHODS/DESIGN TXT2BFiT is a nine month two-arm parallel-group randomized controlled trial aimed at improving weight management and weight-related dietary and physical activity behaviors among young adults. Participants are recruited via general practice (primary medical care) clinics in Sydney, New South Wales, Australia. All participants receive a mailed resource outlining national physical activity and dietary guidelines and access to the study website. Additional resources accessible to the intervention arm via the study website include Smartphone mobile applications, printable handouts, an interactive healthy weight tracker chart, and a community blog. The study consists of two phases: (1) Intensive phase (weeks 1 to 12): the control arm receives four short message service (SMS) text messages; the intervention arm receives eight SMS messages/week tailored to their baseline stage-of-change, one Email/week, and personalized coaching calls during weeks 0, 2, 5, 8, and 11; and (2) Maintenance phase (weeks 14 to 36): the intervention arm receives one SMS message/month, one Email/month and booster coaching calls during months 5 and 8. A sample of N = 354 (177 per arm) is required to detect differences in primary outcomes: body weight (kg) and body mass index (kg/m2), and secondary outcomes: physical activity, sitting time, intake of specific foods, beverages and nutrients, stage-of-change, self-efficacy and participant well-being, at three and nine months. Program reach, costs, implementation and participant engagement will also be assessed. DISCUSSION This mobile phone based program addresses an important gap in obesity prevention efforts to date. The method of intervention delivery is via platforms that are highly accessible and appropriate for this population group. If effective, further translational research will be required to assess how this program might operate in the broader community. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12612000924853.
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Affiliation(s)
- Lana Hebden
- School of Molecular Bioscience, University of Sydney, Sydney, NSW 2006, Australia
| | - Kate Balestracci
- School of Molecular Bioscience, University of Sydney, Sydney, NSW 2006, Australia
| | - Kevin McGeechan
- Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia
| | | | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia
| | - Adrian Bauman
- Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia
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Horwath CC, Schembre SM, Motl RW, Dishman RK, Nigg CR. Does the transtheoretical model of behavior change provide a useful basis for interventions to promote fruit and vegetable consumption? Am J Health Promot 2013; 27:351-7. [PMID: 23398135 DOI: 10.4278/ajhp.110516-quan-201] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine whether Transtheoretical Model (TTM) constructs differ between individuals making successful versus unsuccessful stage transitions for consumption of five or more servings of fruit and vegetables each day and thus provide a useful basis for designing health promotion interventions. DESIGN Longitudinal, observational study. A randomly selected, multiethnic cohort of adults assessed at 6-month intervals over 2 years. SETTING General community, Hawaii. SUBJECTS There were 700 participants (62.6% female; mean = 47 ± 17.1 years; 31.1% Asian, 22.1% Native Hawaiian/Pacific Islander, 35.0% Caucasian; 25.1% participation rate). MEASURES Stage of readiness, experiential and behavioral processes of change, pros, cons, self-efficacy, and self-reported fruit and vegetable consumption. ANALYSIS The study used t-tests to determine which TTM variable scores differed consistently between those making "successful" versus "unsuccessful " stage transitions from precontemplation, preparation, and maintenance. Sample sizes for contemplation and action prohibited similar analyses. RESULTS Compared to those remaining in precontemplation, individuals successfully progressing from precontemplation showed significantly greater use of behavioral processes (collectively and self-liberation) and consciousness raising (p < .001). However, only self-liberation demonstrated significant differences consistently over time. CONCLUSION This longitudinal investigation reveals that TTM behavioral processes, particularly self-liberation, predict successful transition out of precontemplation for adult fruit and vegetable consumption, suggesting that public health messages tailored according to these TTM variables may be effective for this group. However, for adults prepared to adopt or maintain fruit and vegetable consumption, tailoring based on variables from other theories is needed.
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Sanaeinasab H, Saffari M, Nazeri M, Karimi Zarchi A, Cardinal BJ. Descriptive analysis of Iranian adolescents' stages of change for physical activity behavior. Nurs Health Sci 2012; 15:280-5. [PMID: 23210905 DOI: 10.1111/nhs.12020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Revised: 10/23/2012] [Accepted: 10/29/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Hormoz Sanaeinasab
- Department of Health Education; Baqiyatallah University of Medical Sciences; Tehran; Iran
| | - Mohsen Saffari
- Department of Health Education; Baqiyatallah University of Medical Sciences; Tehran; Iran
| | - Mojtaba Nazeri
- Department of Health Education; Baqiyatallah University of Medical Sciences; Tehran; Iran
| | - Aliakbar Karimi Zarchi
- Department of Epidemiology and Biostatistics; Baqiyatallah University of Medical Sciences; Tehran; Iran
| | - Bradley J. Cardinal
- Department of Exercise and Sport Science; Oregon State University; Corvallis; Oregon; USA
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Driver S, Irwin K, Woolsey A, Pawlowski J. Creating an effective physical activity-based health promotion programme for adults with a brain injury. Brain Inj 2012; 26:1482-92. [PMID: 22721492 DOI: 10.3109/02699052.2012.694568] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To describe the processes involved with developing and implementing a physical activity-based health promotion programme for people with a brain injury, summarize previous health promotion research efforts and provide an actual example of a programme entitled P.A.C.E, a 'Physical Activity Centred Education' programme. REASONING BEHIND LITERATURE SELECTION: Brain injury is a serious public health issue due to the incidence, complexity and high healthcare costs. Health promotion programmes that incorporate physical activity have been shown to improve the health of people with a disability. However, if programmes are to be successful they have to be appropriately designed, otherwise individuals will not adopt and maintain the desired health behaviours. MAIN OUTCOMES AND RESULTS Readers will have an understanding of (1) how a theoretical framework drives programme development, (2) the strategies required to facilitate behaviour change, (3) how previous research supports the use of a physical activity-based health promotion programme and (4) how to implement a programme. CONCLUSIONS Future research ideas are provided so as to stimulate research in the area of physical activity-based health promotion programmes for people with a brain injury.
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Affiliation(s)
- Simon Driver
- Oregon State University, Corvallis, OR 97331, USA.
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