Understanding Physical Activity Intentions and Behavior in Postmenopausal Women: An Application of the Theory of Planned Behavior

Differential patterns of lifestyle behaviors among low- and high-income postmenopausal women in Korea: a latent class analysis

BACKGROUND

Healthy lifestyle behaviors among postmenopausal women are important to prevent chronic diseases and improve health later in life. Heterogeneous lifestyle patterns may exist among postmenopausal women, and socioeconomic status (SES) is a critical determinant of lifestyle behaviors. However, little is known about distinct SES-specific patterns of lifestyle behaviors among postmenopausal women. Thus, this study used latent class analysis to identify subgroups of postmenopausal women with different health behaviors according to income and to examine the predictors of income-specific subgroups.

METHODS

We analyzed nationally representative data from the Eighth Korea National Health and Nutrition Examination Survey, collected in 2019 and 2020. We used nine lifestyles (i.e., current smoking and drinking, high-risk drinking, walking, muscle-strengthening exercise, sleep, vegetable and fruit intakes, and weight control efforts). We conducted a multiple-group latent class analysis using monthly household income as a proxy for SES. The monthly household income variable was calculated by standardizing monthly household income by the number of family members and then divided into quintiles. We classified the participants into low- (i.e., Q1 and Q2) and high-income (i.e., Q3, Q4, and Q5) groups.

RESULTS

Although the three-class models best fit the data of low- and high-income groups, we found differential patterns by income: (a) for low-income group, "relatively healthy (RH)," "lowest physical activity, insufficient fruit intake, and no intention to control weight," and "high-risk drinking and insufficient fruit intake" classes and (b) for high-income group, "RH," "lowest physical activity," "high-risk drinking and insufficient fruit intake and sleep" classes. The proportion of the RH class was largest in both groups. However, lifestyle patterns in low-income group showed multiple and unhealthy characteristics than those in high-income group.

CONCLUSIONS

This study suggests that different underlying lifestyle patterns exist in postmenopausal women with low- and high-income. To promote healthy behaviors among postmenopausal women, health professionals should develop and apply lifestyle interventions tailored to lifestyle pattern characteristics according to income.

Determinants of supplementation among Canadian university students: a theory of planned behavior perspective

OBJECTIVE

The purpose of this study was to identify the psychosocial determinants of (1) intention to use dietary supplements (DS) and (2) the behavior of engaging in supplementation by testing the fit of the Theory of Planned Behavior (TPB).

METHODS

A total of 778 students at a Canadian university in Ontario completed a cross-sectional survey assessing participants' attitude, injunctive norm, descriptive norm, perceived behavioral control and intention toward DS use. Data were analyzed using independent sample t-tests and linear and logistic regressions.

RESULTS

Attitude, injunctive norm and perceived behavioral control were significant predictors of intention to use DS. Attitude, injunctive norm and intention were significant predictors of engaging in supplementation. The model explained 75.5% of the variance and correctly classified 89.6% of cases. The odds of using DS doubled with every one-unit increase in intention.

CONCLUSIONS

This study confirms the utility of the TPB in predicting university students' supplementation habits.

Facilitators and Inhibitors of Lifestyle Modification and Maintenance of KOREAN Postmenopausal Women: Revealing Conversations from FOCUS Group Interview

Modifiable lifestyle behaviors, such as lack of physical activity, smoking, and unhealthy diet, are associated with the risk of cardiovascular diseases in postmenopausal women, in addition to other risk factors, such as aging and physiological changes. Therefore, it is necessary to emphasize the importance of encouraging healthy lifestyles and health-promoting behaviors among postmenopausal women, to achieve a better health status. However, it is difficult to modify lifestyle and maintain that change. This study was aimed at identifying the factors that affect the maintenance of healthy lifestyle habits in postmenopausal women, using various theoretical models. This qualitative study included focus-group interviews with 21 Korean postmenopausal women aged 54 to 69 years. A theory-guided thematic analysis was performed based on the Health Belief Model, Self-Determination Theory, Social Cognitive Theory, and Theory of Planned Behavior. As a result, facilitators and inhibitors to healthy lifestyle modification and maintenance are identified. Various sources of motivation and reinforcement are important for menopausal women to maintain a healthy lifestyle. Autonomy support and self-regulation strategies play an important role in integrating health-promoting behaviors into a daily routine. In addition to personal effort, a social support system is also important to help individuals maintain a healthy lifestyle

Effect of a Physical Activity Program on Serum Biochemical Parameters among the Elderly Women

BACKGROUND

The present study examined the efficacy of the walking program on biochemical parameters among the elderly women.

METHODS

A total of one hundred elderly women participated in this randomized clinical trial study. The intervention group attended a 24-week walking exercise meeting five times per week. The control group continued with their routine activities. The subjects were assessed in Fasting blood glucose (FBS) and lipid profile before and after 12 and 24 weeks of the program.

RESULTS

The mean age of the elderly participants in the study was 68.33 ± 4.55 years. The results of repeated measures ANOVA showed a significant difference between the intervention and the control group in FBS, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol after completing the program (for all p < 0.001).

CONCLUSION

The low-cost physical activity intervention could be effective for reducing chronic vascular disease risk factors among community-dwelling elderly women.

Exercise and Prospective Memory

The purpose of this paper was to review the literature to evaluate the potential effects of exercise on prospective memory (PM). A narrative review was employed. In this review, we provide a brief description of PM; indicate the effects of PM on health; evaluate the effects of age and neurological impairment on PM; examine the neural correlates of PM; provide a description of specific components that subserve PM; identify non-behavioral strategies used to enhance PM; and evaluate the literature and plausibility through which exercise behavior may influence PM. Regarding the latter, this paper aims to burgeon the development of a new research paradigm that will play a critical role in patient health, given that memory function, and in particular, the prospective (vs. retrospective) component of memory, is highly sensitive to aging and is critically associated with health status. This is an emerging line of research that has critical implications for patient health.

Experimental Effects of Acute Exercise on Prospective Memory and False Memory

Research demonstrates that acute exercise can enhance retrospective episodic memory performance. However, limited research has examined the effects of acute exercise on prospective memory, and no studies have examined the effects of exercise on false memory performance. This study examined the potential effects of acute exercise on prospective memory and false memory performance. A between-group randomized controlled trial was employed, with participants (college students; M_age = 20 years) randomized into an exercise group (15-minute acute bout of treadmill walking; N = 25) or a control group (15 minutes of sitting; N = 26). Prospective memory was assessed from two laboratory and two naturalistic assessments outside the lab. False memory was assessed using a word-list trial. There were no statistically significant differences in prospective memory based on group allocation (F_Group×Time = 1.17; P = 0.32; η²= 0.06). However, the control group recalled more false words and had a higher rate of false memory recognition (F_Group×Time = 3.15; P = 0.01; η²= 0.26). These findings indicate that acute moderate-intensity aerobic exercise is not associated with prospective memory performance but provides some suggestive evidence that acute exercise may reduce the rate of false memories.

The effect of a randomized controlled physical activity trial on health related quality of life in metabolically unhealthy African-American women: FIERCE STUDY

PURPOSE

African-American women (AAW) are more likely to be metabolically unhealthy than White women (WW). Metabolic syndrome (MetS) is associated with increased breast cancer risk and mortality from breast cancer is greater in AAW compared to WW. Data show MetS affects health-related quality of life (HRQoL). Exercise studies report improvements in MetS, however, no study to date has examined HRQoL in metabolically unhealthy AAW enrolled in an exercise trial.

METHODS

This report examined the effect of a 6-month, 3-arm (supervised exercise, home-based exercise, control) randomized exercise controlled trial on HRQoL among 213 obese, metabolically unhealthy, postmenopausal AAW at high risk for breast cancer.

RESULTS

Certain baseline participant characteristics were related to baseline HRQoL dimensions. The "exercise group" (supervised group combined with the home-based group) showed significantly greater improvement in health change scores (M = 13.6, SD = 3.1) compared to the control group (M = 0.7, SD = 4.4) (p = 0.02) over the 6-month study period. There were no significant differences in HRQoL change scores between the 3 study groups, however, although non-significant, data indicated most HRQoL change scores were more favorable in the supervised group.

CONCLUSION

While significant improvement occurred in health change scores in the combined supervised and home-based group compared to the control group, we did not observe any significant differences on HRQoL change scores between all three study groups. However, while non-significant, there was a trend for more favorable HRQoL change scores in the supervised group versus the home-based and control groups. Additional research is needed to further explore this topic.

Understanding pre-, peri- and post-menopausal women's intentions to perform muscle-strengthening activities using the Theory of Planned Behaviour

Although physical activity guidelines recommend muscle-strengthening activities (MSA), public health initiatives tend to focus on increasing aerobic activity and fail to mention MSA. This study sought to identify the issues influencing pre-, peri- and post-menopausal women's intentions to perform MSA with a view to informing future interventions for these populations. Mixed methods guided by the Theory of Planned Behaviour (TPB) were used to explore factors that influence women's intentions to perform MSA. In stage one, 34 women participated in either a focus group or interview. Discussions were transcribed verbatim and analysed based on menopausal status using a deductive approach. In stage two, 186 women (M = 47 years, SD = 9) completed a questionnaire to assess participant demographics, levels of MSA, affective and instrumental attitudes, injunctive and descriptive norms, self-efficacy and perceived behavioural control. Quantitative data were analysed using descriptive statistics, bivariate correlations, regression analyses and analysis of variances. Behavioural beliefs were: improved muscular health; psychological benefits; improved body shape. Normative beliefs were: health professionals; family members; work colleagues. Control beliefs were: equipment; motivation; time constraints; knowledge; physical capability; fear of judgement. However, these beliefs were not well established. Self-efficacy was the strongest predictor of intentions (spc² = 0.11) followed by affective attitudes (spc² = 0.09), with no significant differences on TPB variables between groups. If rising rates of musculoskeletal conditions in women are to be prevented, there is an urgent need to increase women's knowledge of recommended levels of muscle strengthening, with a view to promoting positive attitudes and enhancing women's sense of self-efficacy across all menopausal phases.

Using the Theory of Planned Behaviour to examine enrolled nursing students' intention to care for patients with alcohol dependence: A survey study

BACKGROUND

Nurses are often the first point of contact for patients hospitalized due to alcohol-related causes. Alcohol dependence is highly stigmatized and as a result healthcare professionals often have low behavioural intentions, meaning low willingness to care for these patients. This can have a direct influence on quality of care.

OBJECTIVES

The purpose of this study was to explore enrolled nursing students' intention to care for patients with alcohol dependence and the antecedents, preliminary factors, that predict this within the Theory of Planned Behaviour; specifically attitudes, subjective norms, self-efficacy and controllability.

DESIGN

The study was a cross-sectional survey using the Theory of Planned Behaviour.

SETTING

Two Technical and Further Education South Australia campuses across metropolitan Adelaide.

PARTICIPANTS

n=86 enrolled nursing students completed the survey (62% response rate).

METHODS

Enrolled nursing students' intention, attitudes, subjective norms, self-efficacy and controllability were measured using a Theory of Planned Behaviour Questionnaire. The Short Alcohol and Alcohol Problems Perception Questionnaire investigated attitudes in more detail and a short knowledge scale assessed alcohol-related knowledge.

RESULTS

Subjective norms and attitudes had a significant, positive effect on intention to care within the final model, accounting for 22.6% of the variance, F2,83=12.12, p<0.001. Subjective norms were the strongest predictor. External factors such as age, previous alcohol training and alcohol-related knowledge held direct paths to antecedents of intention.

CONCLUSIONS

Subjective norms were the strongest predictor of intention to care for patients with alcohol dependence, followed by attitudes. The study provides an understanding of enrolled nursing students' intention to care for alcohol dependent patients. These findings can assist in developing tailored alcohol training for students, to increase attitudes and foster behavioural change, in order to improve the quality of care for these patients.

Rationale, design and baseline characteristics of a randomized controlled trial of a web-based computer-tailored physical activity intervention for adults from Quebec City

BACKGROUND

The relationship between physical activity and cardiovascular disease (CVD) protection is well documented. Numerous factors (e.g. patient motivation, lack of facilities, physician time constraints) can contribute to poor PA adherence. Web-based computer-tailored interventions offer an innovative way to provide tailored feedback and to empower adults to engage in regular moderate- to vigorous-intensity PA. To describe the rationale, design and content of a web-based computer-tailored PA intervention for Canadian adults enrolled in a randomized controlled trial (RCT).

METHODS/DESIGN

244 men and women aged between 35 and 70 years, without CVD or physical disability, not participating in regular moderate- to vigorous-intensity PA, and familiar with and having access to a computer at home, were recruited from the Quebec City Prospective Urban and Rural Epidemiological (PURE) study centre. Participants were randomized into two study arms: 1) an experimental group receiving the intervention and 2) a waiting list control group. The fully automated web-based computer-tailored PA intervention consists of seven 10- to 15-min sessions over an 8-week period. The theoretical underpinning of the intervention is based on the I-Change Model. The aim of the intervention was to reach a total of 150 min per week of moderate- to vigorous-intensity aerobic PA.

DISCUSSION

This study will provide useful information before engaging in a large RCT to assess the long-term participation and maintenance of PA, the potential impact of regular PA on CVD risk factors and the cost-effectiveness of a web-based computer-tailored intervention.

TRIAL REGISTRATION

ISRCTN36353353 registered on 24/07/2014.

Hip Hop HEALS: Pilot Study of a Culturally Targeted Calorie Label Intervention to Improve Food Purchases of Children

OBJECTIVES

We explored the effect of a culturally targeted calorie label intervention on food purchasing behavior of elementary school students.

METHOD

We used a quasi-experimental design with two intervention schools and one control school to assess food purchases of third through fifth graders at standardized school food sales before and after the intervention (immediate and delayed) in schools. The intervention comprised three 1-hour assembly-style hip-hop-themed multimedia classes.

RESULTS

A mean total of 225 children participated in two baseline preintervention sales with and without calorie labels; 149 children participated in immediate postintervention food sales, while 133 children participated in the delayed sales. No significant change in purchased calories was observed in response to labels alone before the intervention. However, a mean decline in purchased calories of 20% (p < .01) and unhealthy foods (p < .01) was seen in immediately following the intervention compared to baseline purchases, and this persisted without significant decay after 7 days and 12 days.

CONCLUSION

A 3-hour culturally targeted calorie label intervention may improve food-purchasing behavior of children.

Predictors of physical activity at 12 month follow-up after a supervised exercise intervention in postmenopausal women

Background

Few studies have examined recreational physical activity (RPA) after participating in a structured exercise intervention. More specifically, little is known about the long-term effects of exercise interventions in post-menopausal women. This study had two objectives: 1) To compare RPA in postmenopausal women in the exercise group and the control group 12 months after the end of the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial; and 2) To apply the Theory of Planned Behaviour (TPB) to identify predictors of RPA 12 months post-intervention among women in the exercise group.

Methods

Self-reported RPA 12-months post-intervention from a validated questionnaire was used to estimate RPA levels for control group (118/160, 74% response) and exercise group participants (126/160, 79% response). Bivariate analysis was used to compare RPA between exercise and control group participants and to identify TPB variables for multivariate analysis. Logistic regression was applied to TPB data collected from self- administered questionnaires at end of trial by exercise group participants (126/160, 79% response) to identify predictors of long-term RPA.

Results

At 12 months post-intervention, 62% of women in the exercise group were active compared to 58% of controls (p = 0.52). Of the TPB constructs examined, self-efficacy (OR =2.98 (1.08-8.20)) and behavioural beliefs (OR = 1.46 (1.03-2.06)) were identified as predictors of RPA for exercise group participants.

Conclusions

Levels of RPA in the exercise and control groups were comparable 12 months post intervention, indicating that participation in the ALPHA trial was associated with increased physical activity in previously inactive women, regardless of randomization into either the exercise group or in the control group. Exercise interventions that promote self-efficacy and positive behavioural beliefs have the potential to have long-term impacts on physical activity behaviour, although further research is needed to examine additional psychological, social and environmental predictors of long-term RPA in post-menopausal women.

Trial registration

ClinicalTrials.gov NCT00522262.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-015-0219-z) contains supplementary material, which is available to authorized users.

Ecological momentary assessment of the relationship between intention and physical activity behavior in bariatric surgery patients

BACKGROUND

Performing habitual physical activity (PA) is challenging for many bariatric surgery patients.

PURPOSE

We used electronic ecological momentary assessment to naturalistically examine whether insufficient PA among bariatric surgery patients was due to infrequent PA intentions or inadequate follow through on PA intentions.

METHOD

Twenty-one patients 6-months post-bariatric surgery were recruited from multiple clinics in Providence, Rhode Island, USA. Participants used a palmtop computer upon waking for 6 days to indicate whether they intended to be active, and if so, the amount of PA they intended to perform in bouts ≥10 min. Each evening, participants reported PA minutes and barriers encountered that day.

RESULTS

All 21 participants reported intending to be active on at least 1 day but only 9 (42%) intended to be active on ≥70% of days. Twelve (57%) participants performed PA on each of the days they intended, but none achieved the amount of PA they intended on all of these days. Overall, participants had PA intentions on 81 of 123 days (66%); these were partially implemented (≥10 PA minutes) on 49 days, but fully implemented on only 15 days. Participants spent 34 min in PA, or 20 fewer minutes than intended. "Lack of time" was the only frequently cited barrier, particularly on days that PA was neither intended nor performed.

CONCLUSION

Few patients intended to be active on a near daily basis and all patients had difficulty in implementing their intentions. Interventions that target planning strategies may help facilitate PA intentions and limit discrepancy between intended and actual PA.

Perceptions of Midwest rural women related to their physical activity and eating behaviors

The study aim was to describe the perceptions of 65 Midwestern rural women related to healthy eating, physical activity, and weight management. A semistructured interview guide was used to elicit data. Theory of planned behavior constructs were used to categorize the data into 4 predominant themes related to healthy lifestyle behaviors, (a) knowledge and attitudes, (b) rural cultural influences, (c) facilitators, and (d) barriers. Analyses revealed that facilitators and barriers consisted of social and environmental factors, and personal life situations. Results suggest key elements for developing and implementing effective physical activity and weight management interventions for Midwestern rural women.

Examining the influence of noncognitive variables on the intention of minority baccalaureate nursing students to complete their program of study

Retention of minority baccalaureate nursing students is imperative to resolving the absence of minority representation within the nursing profession and to aid in the elimination of health disparities among minority health care recipients. Improving minority nursing student retention requires a closer examination of the impact of noncognitive variables that contribute to attrition. This study explored the predictive value of select noncognitive variables on the intention of minority baccalaureate nursing students to complete their degree. A survey was sent to 1,519 students enrolled in generic, prelicensure baccalaureate nursing programs in the North Carolina University System. Unique data characteristics required the use of both parametric and nonparametric statistical analyses. The regression model included variables of age, race, gender, academic development, faculty interaction, peer interaction, hours worked, and faculty concern and accounted for 29% of the variation in student intention to complete their degree.

[Level of physical activity in the prevention of excess visceral fat in postmenopausal women: how much is needed?]

OBJECTIVE

To analyze the level of physical activity (kcal/week) needed to prevent excess visceral fat in postmenopausal women.

SUBJECTS AND METHODS

The sample included 239 women with a mean age of 57.2 years. Visceral fat area (VFA) was measured by octopolar bioelectrical impedance, and physical activity, by the long version IPAQ. ROC Curves (Receiver Operating Characteristic) were drawn, and a 95% confidence interval was used.

RESULTS

The areas under the ROC curve for moderate physical activity and walk proved to be significant. Weekly expenditure of 1,601 kcal in walking, or 2,283 kcal in moderate physical activity were identified as good cutoff values to prevent excess VFA.

CONCLUSION

Mild to moderate physical activity, with a caloric expenditure between 1,601 and 2,283 kcal/week, prevents excess central adiposity in postmenopausal women.

Validation of persuasive messages for the promotion of physical activity among people with coronary heart disease

OBJECTIVE

to validate the content of persuasive messages for promoting walking among patients with coronary heart disease (CHD). The messages were constructed to strengthen or change patients' attitudes to walking.

METHOD

the selection of persuasive arguments was based on behavioral beliefs (determinants of attitude) related to walking. The messages were constructed based in the Elaboration Likelihood Model and were submitted to content validation.

RESULTS

the data was analyzed with the content validity index and by the importance which the patients attributed to the messages' persuasive arguments. Positive behavioral beliefs (i.e. positive and negative reinforcement) and self-efficacy were the appeals which the patients considered important. The messages with validation evidence will be tested in an intervention study for the promotion of the practice of physical activity among patients with CHD.

Examining predictors of physical activity among inactive middle-aged women: an application of the health action process approach

This study tested several relationships predicted by the Health Action Process Approach (HAPA) in a sample of 175 generally healthy, inactive, middle-aged women (40-65 yrs old) over a 12 week period. Participants' physical activity, risk perceptions, outcome expectancies, action self-efficacy and intention were measured at baseline. Planning and maintenance self-efficacy were measured 4 weeks later. Physical activity behaviour was measured 12 weeks after baseline. The HAPA relationships were examined using a structural equation model. The data fit the model well and revealed several significant relationships. Action self-efficacy was the best predictor of intention. Maintenance self-efficacy was the best predictor of planning and behaviour. Contrary to the tenets of HAPA and to past research, planning did not predict behaviour. Overall, HAPA provides a useful framework for identifying determinants of physical activity intentions and behaviour within a group of inactive, middle-aged women.