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Vlcek C, Greenberg D, Yardley JE, Klaprat N, MacIntosh A, Greenberg M, Brandt J, Gregoire N, Dostie S, Boutin D, Pow C, Archibald M, McGavock J. "How we do it": A qualitative study of strategies for adopting an exercise routine while living with type 1 diabetes. Front Endocrinol (Lausanne) 2023; 13:1063859. [PMID: 36686448 PMCID: PMC9849595 DOI: 10.3389/fendo.2022.1063859] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction For people living with type 1 diabetes (T1D) the challenge of increasing daily physical activity (PA) is compounded by the increased risks of hypoglycemia and glucose variability. Little information exists on the lived experience of overcoming these barriers and adopting and maintaining an active lifestyle while living with T1D. Research Design and Methods We conducted a patient-led qualitative study consisting of semi-structured interviews or focus groups with 22 individuals at least 16 years old living with T1D. We used existing patient co-researcher networks and snowball sampling to obtain a sample of individuals who reported being regularly physically active and had been diagnosed with T1D for at least one year. We used an interpretive description analysis to generate themes and strategies associated with maintaining an active lifestyle while living with T1D. We involved patient co-researchers in study design, data collection, and interpretation. Results 14 self-identified women and 8 self-identified men (ages 19-62, median age 32 years) completed the study, led by either a researcher, or a patient co-researcher and research assistant regarding their strategies for maintaining an active lifestyle. We identified five themes that facilitate regular sustained PA: (1) Structure and organization are important to adopt safe PA in daily life "I can't do spontaneous exercise. I actually need a couple hours of warning minimum"; (2) Trial and error to learn how their body responds to PA and food "Once you put the time and effort into learning, you will have greater success"; (3) Psychosocial aspects of PA "…because it's not just your body, it's your soul, it's your mind that exercise is for"; (4) Diabetes technology and (5) Education and peer support. Strategies to overcome barriers included (1) Technology; (2) Integrating psychosocial facilitators; (3) Insulin and carbohydrate adjustments; and (4) Planning for exercise. Conclusions Living an active lifestyle with T1D is facilitated by dedicated structure and organization of routines, accepting the need for trial and error to understand the personalized glycemic responses to PA and careful use of food to prevent hypoglycemia. These themes could inform clinical practice guidelines or future trials that include PA interventions.
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Affiliation(s)
- Cristine Vlcek
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | | | - Jane E. Yardley
- Diabetes Action Canada, Toronto, ON, Canada
- Augustana Faculty, University of Alberta, Camrose, AB, Canada
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
- Alberta Diabetes Institute, Edmonton, AB, Canada
- Women and Children’s Health Research Institute, Edmonton, AB, Canada
| | - Nika Klaprat
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, Winnipeg, MB, Canada
| | - Andrea MacIntosh
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, Winnipeg, MB, Canada
| | | | | | | | | | | | - Conrad Pow
- Diabetes Action Canada, Toronto, ON, Canada
| | - Mandy Archibald
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, Winnipeg, MB, Canada
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Jonathan McGavock
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
- Diabetes Action Canada, Toronto, ON, Canada
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, Winnipeg, MB, Canada
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Determinants associated with self-management behavior among type 2 diabetes patients in China: A structural equation model based on the theory of planned behavior. Int J Clin Health Psychol 2023; 23:100332. [PMID: 36168599 PMCID: PMC9471452 DOI: 10.1016/j.ijchp.2022.100332] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/14/2022] [Accepted: 07/27/2022] [Indexed: 12/03/2022] Open
Abstract
Background Diabetes self-management (DSM) is essential for patients to achieve better health outcomes. However, previous studies have demonstrated that the performance of DSM is not optimal. This study was designed to identify the significant determinants of self-management behavior in type 2 diabetes(T2DM) patients to improve DSM. Method A convenient sampling method was employed in this study. Data were collected from a community health center from January to February 2021 in Nanjing city, China. A total of 431 patients completed the self-administered questionnaires. A structural equation model based on the theory of planned behavior(TPB) was adopted for analysis. Results TPB model presents excellent goodness of fit of data. Attitude (β=0.161, P < 0.01), subjective norms (SN) (β=0.239, P < 0.001), and perceived behavior control (PBC) (β=0.197, P < 0.001) were strong predictors of intention. Intention (β=0.230, P < 0.001) and PBC (β=0.259, P < 0.001) had a direct effect on self-management behavior. The impact of attitude and SN on behavior was significantly mediated via behavioral intention. Conclusion The application of TPB to self-management behavior in T2DM patients can significantly enhance our understanding of theory-based self-management behavior. This predictive model could potentially be a valuable tool and provide a feasible approach for formulating more targeted and population-specific DSM interventions in future research.
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Wang W, Wu M, Hua Y, Zhang X, Feng G. Using an integrated model of the theory of planned behavior and the temporal self-regulation theory to explain physical activity in patients with coronary heart disease. Front Psychol 2023; 14:1049358. [PMID: 36874847 PMCID: PMC9975550 DOI: 10.3389/fpsyg.2023.1049358] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/13/2023] [Indexed: 02/17/2023] Open
Abstract
Background This study aimed to explore the psychosocial determinants of the physical activity (PA) levels in patients with coronary heart disease (CHD) using an integrated theoretical model based on the theory of planned behavior (TPB) and the temporal self-regulation theory (TST). Method This was a prospective study conducted at the Affiliated Hospital of Hangzhou Normal University, Zhejiang, China. A total of 279 patients with CHD [176 men aged 26-89 years, mean (M) = 64.69, standard deviation (SD) = 13.17] were selected under the study inclusion criteria by convenience sampling. The data on attitude, subjective norm (SN), perceived behavioral control (PBC), and intention variables for the TPB model and consideration of future consequences (CFC), habit, and self-control (SC) variables for the TST model were collected 1-2 days before the discharge (Time 1, T1) of the participants, and a telephone follow-up was made to assess the participants' self-reported PA levels 1 week after their discharge (Time 2, T2). Results The results revealed that only 39.8% of the patients with CHD met the guidelines' recommendations on PA. The data analyses using structural equation modeling (SEM) in the Mplus 8.3 modeling program showed that, in the simple mediation model, attitude, PBC, and CFC were positively related to the intention to practice guideline-recommended levels of PA but SN was not. In addition, intention was shown to mediate the relationships between attitude, PBC, CFC, and PA levels. Furthermore, based on the moderated mediating model, intention and habit were shown to be positively associated with PA levels but SC was not. Moreover, SC played a significant moderating role between intention and PA levels. However, habit strength did not moderate the relationship between intention and PA levels. Conclusion An integration of the TPB and TST models offers a good theoretical tool for understanding PA levels in patients with CHD.
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Affiliation(s)
- Wenqin Wang
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Minjuan Wu
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Yun Hua
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Xingwei Zhang
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Guohe Feng
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China
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Esferjani SV, Naghizadeh E, Albokordi M, Zakerkish M, Araban M. Effectiveness of a mobile-based educational intervention on self-care activities and glycemic control among the elderly with type 2 diabetes in southwest of Iran in 2020. Arch Public Health 2022; 80:201. [PMID: 36057609 PMCID: PMC9441036 DOI: 10.1186/s13690-022-00957-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 08/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background The elderly constitute a large fraction of patients with type 2 diabetes worldwide. It has been well documented that the elderly’s adherence to disease control is not adequate. The present study aimed to evaluate the impact of a mobile-based educational intervention on self-care behaviors and glycemic control among elderly with type 2 diabetes. Methods The present study was conducted on 118 older people (59 in the intervention group and 59 in the control group) with type 2 diabetes who referred to Golestan Hospital in Ahvaz, southwest of Iran in 2020. Participants were randomly divided into experimental and control groups. Data were collected at baseline and after a 3-month follow-up. At baseline, the participants completed a valid and reliable multi-section questionnaire including items on attitude, the multidimensional scale of perceived social support (MSPSS), the Coping Self-Efficacy Scale (CSES), self-care constructs, and HBA1C. After analyzing the pre-test data, we designed a training program which was offered to the intervention group online via mobile phone in three online sessions. The control group, however, received no intervention except diabetes routine care. Data were analyzed using SPSS-15 at a significance level of 0.05. Results Before the intervention, the mean scores of CSES, attitudes towards self-care, MSPSS, and self-care were not statistically significant between study groups (P > 0.05), but after intervention, the study found significant differences between the groups in terms of CSES, attitude, MSPSS, and self-care (P = 0.001). Furthermore, after implementation of the intervention, the mean value of HbA1C in the intervention group was significantly less than that of the control group (7.00 vs. 7.32%) (P = 0.001). Conclusion The present results indicated that implementing an educational intervention via mobile phone can improve self-care practice and reduce HbA1C in the elderly with type 2 diabetes. The study also showed a moderate to large effect on the outcome variables. However, further studies with longer follow-up periods are recommended to confirm the results. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00957-5. - The study provided a framework for developing a targeted mobile phone health education intervention. - Mobile phone education can improve both behavioral and clinical indexes. This intervention increased the scores of perceived social support (MSPSS) and Coping Self-Efficacy Scale (CSES), and self-care practice and reduced HbA1C in the elderly with type 2 diabetes. - Further studies with longer follow-up periods are warranted.
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Cuy Castellanos D, Daprano CM, Blevins C, Crecelius A. The theory of planned behavior and strength training in college-aged women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:837-842. [PMID: 32569505 DOI: 10.1080/07448481.2020.1775606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/13/2020] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Abstract
ObjectivesUsing Theory of Planned Behavior, the objective of this study was to determine how attitudes, subjective norms and perceived behavior control related to intent to strength training by college-aged women. Participants: Participants were college-aged females (N = 162) from a mid-sized private university in the Midwestern United States who were divided into three groups: non-exercisers, cardiovascular-only exercisers, and strength or strength and cardiovascular exercisers. Methods: Participants completed a questionnaire assessing attitudes, subjective norms and perceived behavior control in relation to strength training behavior. MANOVA was utilized to examine the differences between groups. Results: The MANOVA was significant at p < .01. Post hoc analysis indicated strength training participation was significantly higher for non-exercisers and cardiovascular-only exercisers for the attitude and perceived behavior control constructs (p<.05) but not for subjective norm. Conclusions: Perceived behavior control and direct attitude factors may be strong contributors to college-aged women's participation in strength training.
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Affiliation(s)
| | - Corinne M Daprano
- Department of Health and Sport Science, University of Dayton, Dayton, Ohio, USA
| | - Clarissa Blevins
- Department of Health and Sport Science, University of Dayton, Dayton, Ohio, USA
| | - Anne Crecelius
- Department of Health and Sport Science, University of Dayton, Dayton, Ohio, USA
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6
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Gao M, Chen P, Sun X, Feng X, Fisher EB. Integrating the Extended Theory of Planned Behavior With the Stages of Change to Predict Exercise Among Chinese People With Type 2 Diabetes. Front Public Health 2021; 9:772564. [PMID: 34869183 PMCID: PMC8640452 DOI: 10.3389/fpubh.2021.772564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background: There have been very limited prospective studies examining social-cognitive models within stages of behavior change in the exercise domain. Purpose: We examined the utility of the theory of planned behavior (TPB), incorporating self-identity and descriptive norm constructs, to predict exercise behavior across the stages of change, in individuals with type 2 diabetes. Methods: Data were obtained from a longitudinal study. Multi-group structural equation modeling was used to estimate the association between extended TPB constructs and exercise within different stages groups. Results: 647 individuals completed a self-report questionnaire at baseline and at 3 months follow-up. The extended TPB model explained 8-15% variance of exercise behavior and 42-81% variance of exercise intention within three stages groups in the cross-sectional design. The extended TPB model explained 4%-13% variance of exercise behavior and 42-66% variance of exercise intention in the longitudinal design. Intention was significantly related to exercise behavior in the pre-action and action stages. Self-identity, perceived behavioral control and descriptive norms were stronger predictors of intention in different stages. Conclusion: Discontinuity patterns in the extended theory of planned behavior for the different stages groups were found. Intention was a significant predictor of exercise in the pre-action and action stages at 3 months.
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Affiliation(s)
- Min Gao
- School of Public Health, Peking University Health Science Center, Beijing, China
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Ping Chen
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Xinying Sun
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - XingLin Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Edwin B. Fisher
- Department of Health Behavior, Gillings School of Global Public Health University, Chapel Hill, NC, United States
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7
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Dilekler İ, Doğulu C, Bozo Ö. A test of theory of planned behavior in type II diabetes adherence: The leading role of perceived behavioral control. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-019-00309-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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8
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Lee BK. Comparison of Prevalence of Hyperlipidemia, Medical Expenses, Inpatient, Emergency and Outpatient According to the Level of Physical Activity of Korean Adults: A Cross-Sectional Study of 2018 Korea Medical Panel. THE ASIAN JOURNAL OF KINESIOLOGY 2021. [DOI: 10.15758/ajk.2021.23.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study is to compare the difference in the prevalence of hyperlipidemia according to the level of physical activity in adults, and to compare the difference between annual personal medical expenses, hospitalization, emergency and outpatient use depending on the level of physical activity for hyperlipidemia patients.METHODS The 2018 Korea medical panel data was used (14,489 adults and 2,559 Hyperlipidemia). Physical activity was measured with short form of IPAQ and converted to MET-minutes per week. The days of hospitalization, and personal medical expenses were compared, and frequency analysis, logistic regression, ANOVA and chi-square were performed.RESULTS The prevalence of hyperlipidemia based on the inactive group were decreased both minimally active group (OR = 0.94) and the active group (OR = 0.74, p<0.01). Annual personal medical expenses I (p<.01) and II (p<.01) with hyperlipidemia were all showed significant differences depending on the level of physical activity. On active group basis, medical expenses showed slight differences of 3.0 to 3.2% with the minimally activity group, but that of the inactive group were 19.3 ~ 21.7% higher. The annual days of hospitalization were 6.8 ± 7.2 days in activity group, minimally activity group 7.1 ± 7.2 days, inactive group 11.7 ± 26.0 days. There was no significant difference in the annual days of hospitalization and emergency between the three groups. In particular, the annual days of outpatient increased sharply at the inactive group. Participation in physical activity has been shown to have a significant effect on hospitalization and decreasing use of emergency rooms.CONCLUSIONS Hyperlipidemia prevalence was similar to inactive groups and minimally activity groups, and that of activity groups was 0.74. On medical expenses of hyperlipidemia, the activity and minimally activity group was similar, the inactivity group was 19.3 to 21.7% higher. Physical activity was found to have a positive effect on hospitalization and emergency use reduction.
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Cheval B, Maltagliati S, Sieber S, Beran D, Chalabaev A, Sander D, Cullati S, Boisgontier MP. Why Are Individuals With Diabetes Less Active? The Mediating Role of Physical, Emotional, and Cognitive Factors. Ann Behav Med 2021; 55:904-917. [PMID: 33491067 DOI: 10.1093/abm/kaaa120] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite the key role of physical activity in the management of diabetes, many individuals with diabetes do not engage in the recommended levels of physical activity. However, our knowledge of the mechanisms underlying the relationship between diabetes and physical inactivity is limited. PURPOSE To investigate the associations between diabetes and the levels and evolution of physical activity across aging, and to determine whether physical, emotional, and cognitive factors mediate these associations. METHODS Data from 105,622 adults aged 50-96 years from the Survey of Health, Ageing and Retirement in Europe (SHARE) were used in adjusted linear mixed models to examine whether diabetes was associated with physical activity levels and variations across aging. The potential mediators were subjective energy, muscle strength, physical and cognitive disability, sleep problems, depressive symptoms, and cognitive functions. The variables were measured up to seven times over a 13-year period. RESULTS Individuals with diabetes demonstrated a lower level and a steeper decrease in physical activity across aging than individual without diabetes. Mediators explained ~53% and 94% of the association of diabetes with the level of physical activity and with the linear evolution of physical activity across aging, respectively. All mediators were significantly associated with physical activity. Physical and cognitive disability as well as depressive symptoms were the strongest mediators, while sleep was the lowest one. CONCLUSIONS These findings suggest that the etiology of physical inactivity in individuals with diabetes can result from several physical, emotional, and cognitive changes associated with the emergence of this disease.
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Affiliation(s)
- Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Switzerland.,Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
| | | | - Stefan Sieber
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Switzerland
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Switzerland
| | | | - David Sander
- Swiss Center for Affective Sciences, University of Geneva, Switzerland.,Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
| | - Stéphane Cullati
- Population Health Laboratory, University of Fribourg, Switzerland.,Department of Readaptation and Geriatrics, University of Geneva, Switzerland
| | - Matthieu P Boisgontier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
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Brennan MC, Brown JA, Ntoumanis N, Leslie GD. Barriers and facilitators of physical activity participation in adults living with type 1 diabetes: a systematic scoping review. Appl Physiol Nutr Metab 2020; 46:95-107. [PMID: 32835497 DOI: 10.1139/apnm-2020-0461] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
To identify and map barriers and facilitators of physical activity (PA) in adults living with type 1 diabetes (T1D) in any care setting or environment. A scoping review was conducted in accordance with the PRISMA-ScR guidelines to address the aim of this review. Exclusion/inclusion criteria were determined a priori. Articles captured in the search were subject to title and abstract screening before full-text articles were assessed for eligibility against the exclusion/inclusion criteria. Included articles underwent critical appraisal before being charted, mapped, and discussed. Forty-six articles were included in the final synthesis. Most commonly, articles reported cross-sectional survey studies (46%), then qualitative designs (17%), and opinion or text (17%). Experimental studies accounted for 13% of included articles. Hypoglycaemia/fear of hypoglycaemia was the most commonly reported barrier and patient education the most commonly discussed facilitator. Quality appraisal revealed methodological issues among included articles. Higher quality research with theoretically sound behaviour-change interventions combined with targeted patient education is needed to address hypoglycaemia/fear of hypoglycaemia as a barrier to PA. Novelty: Hypoglycaemia and fear of hypoglycaemia were the most commonly reported barriers to PA in adults with T1D. Powered randomised controlled trials are required to establish efficacy of behaviour change interventions targeting these barriers to PA.
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Affiliation(s)
- Marian C Brennan
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,Health Services, Diabetes WA, Subiaco, Australia.,Physical Activity and Well-being Research Group, Curtin University, Perth, WA 6845, Australia
| | - Janie A Brown
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,St John of God Midland Public and Private Hospital, Midland, WA 6056, Australia
| | - Nikos Ntoumanis
- School of Psychology/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.,Physical Activity and Well-being Research Group, Curtin University, Perth, WA 6845, Australia
| | - Gavin D Leslie
- School of Nursing, Midwifery and Paramedicine/Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia
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Gao M, Chen X, Sun X, Wang F, Fan L, Sun X. Predicting Stage of Exercise Among Patients with Type 2 Diabetes: A Test of the Extended Theory of Planned Behavior. Patient Prefer Adherence 2020; 14:277-285. [PMID: 32103912 PMCID: PMC7027828 DOI: 10.2147/ppa.s236813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/01/2020] [Indexed: 12/21/2022] Open
Abstract
PURPOSE This study aimed to predict stage of exercise among Chinese patients with type 2 diabetes by using an extended theory of planned behavior model (TPB) incorporating descriptive norm and self-identity. PATIENTS AND METHODS Participants (N=791) were included in a cross-sectional study. Structural equation modeling was used to explain how the extended TPB could predict the stage of exercise. RESULTS The model accounted for 41% of the variance in stage of exercise and 81.1% of the variance in intention. Intention (β=0.359, P<0.01) and self-identity (β=0.236, P<0.001) had a direct effect on stage of exercise. Self-identity (β=0.261, P<0.001), descriptive norm (β=0.035, P<0.05) and PBC (β=0.683, P<0.001) were strong predicators of intention. The effects of self-identity and PBC on behavior were significantly mediated via intention. Age, BMI and stage of diet behavior were found to be significantly related to intention and behavior. CONCLUSION This study has tested the usefulness of the extended TPB for explaining exercise in Chinese diabetic patients. To promote patients to start or continue exercising, interventions should target self-identity and controllability for physical activity.
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Affiliation(s)
- Min Gao
- School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Xueying Chen
- School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Xin Sun
- School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Fengbin Wang
- School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Lishi Fan
- School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Xinying Sun
- School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China
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Messer LH, Sousa K, Cook PF. Applying two minds theory to self-management of Type 1 diabetes. Res Nurs Health 2019; 42:500-508. [PMID: 31587327 DOI: 10.1002/nur.21983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 09/20/2019] [Indexed: 11/10/2022]
Abstract
Two minds theory (TMT) offers a new approach to changing health behavior. Here, TMT is applied to self-management of Type 1 diabetes. TMT can be conceptualized as a cycle where a stimulus produces an immediate Intuitive system response leading to health behavior, followed by a conscious narrative system response that is temporally delayed. Narrative responses do not produce behaviors directly but instead lead to conscious beliefs about past events and behavioral intentions for the future, both of which become part of the material considered by the intuitive system in selecting future behaviors. Because of the temporal delay between intuitive behavior and narrative interpretation, and the nonconscious nature of intuitive thought, there is often a gap between intentions and behaviors. This has implications for nursing practice. First, nurses should consider that patient-reported impressions of the past or future are fundamentally narrative system responses and understand that these may be less predictive of behavior than biopsychosocial measures that are more temporally immediate. Second, nurses can use TMT to inform new strategies for behavior change interventions. For diabetes self-management, nurses can encourage individuals to leverage environmental cues to prompt self-management (tricking the intuitive system), provide rewards for self-management (training the intuitive system), or engage the narrative system via planning, reframing, or attention practices for healthier future decisions. Overall, the TMT addresses the gap between intentions and behavior and should be further developed to inform behavioral health interventions.
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Affiliation(s)
- Laurel H Messer
- College of Nursing, University of Colorado Anschutz, Aurora, Colorado
| | - Karen Sousa
- College of Nursing, University of Colorado Anschutz, Aurora, Colorado
| | - Paul F Cook
- College of Nursing, University of Colorado Anschutz, Aurora, Colorado
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Wilczynska M, Lubans DR, Paolini S, Plotnikoff RC. Mediating Effects of the 'eCoFit' Physical Activity Intervention for Adults at Risk of, or Diagnosed with, Type 2 Diabetes. Int J Behav Med 2019; 26:512-521. [PMID: 31270732 DOI: 10.1007/s12529-019-09800-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The study aim was to examine the mechanisms of physical activity behaviour change in the multi-component eCoFit randomised controlled trial (RCT) among adults diagnosed with, or at risk of, T2D. METHOD The RCT included two phases: phase 1 (weeks 1-10) integrated group sessions (outdoor physical activity and cognitive mentoring) and the use of the eCoFit smartphone application (app), and phase 2 (weeks 11-20), which included the use of the eCoFit smartphone application only. Participants (n = 84) were assessed at baseline and 10 and 20 weeks from baseline. Physical activity was assessed using pedometers, and the following mediators were tested: action self-efficacy, barrier self-efficacy, recovery self-efficacy, implementation intentions, intention to have regular physical activity, outcome expectations, risk perception and implicit associations related to physical activity. The PROCESS INDIRECT Macro was used to perform mediation analyses. RESULTS Significant mediation pathways were found for implementation intention measured at 10 weeks, AB (95% CI = 486.04 [128.19, 1073.42]). No significant pathways were found for the other social-cognitive and implicit attitudinal mediators. CONCLUSION Increased daily steps among the intervention participants were explained by increased implementation intentions. The eCoFit study successfully operationalised implementation intentions in the smartphone app designed to promote outdoor physical activity. TRIAL REGISTRATION The trial was approved by a University Human Research Committee and is registered with the Australian New Zealand Clinical Trial Registry (ACTRN12615000990527).
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Affiliation(s)
- Magdalena Wilczynska
- Priority Research Centre for Physical Activity and Nutrition, Advanced Technology Center, The University of Newcastle, Level 3, University Drive, Callaghan, NSW, 2308, Australia
- School of Psychology, Faculty of Science, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - David R Lubans
- Priority Research Centre for Physical Activity and Nutrition, Advanced Technology Center, The University of Newcastle, Level 3, University Drive, Callaghan, NSW, 2308, Australia
| | - Stefania Paolini
- School of Psychology, The University of Newcastle, SO E1.22 Science Offices, Ourimbah, NSW, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, Advanced Technology Center, The University of Newcastle, Level 3, University Drive, Callaghan, NSW, 2308, Australia.
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Sparapani VDC, Fels S, Kamal N, Nascimento LC. Conceptual framework for designing video games for children with type 1 diabetes. Rev Lat Am Enfermagem 2019; 27:e3090. [PMID: 30916223 PMCID: PMC6432989 DOI: 10.1590/1518-8345.2764.3090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/17/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE to present a theoretically based conceptual framework for designing video games for children with type 1 diabetes mellitus. METHODS this was a methodological study that developed a conceptual framework with nine steps in view of health behavior change theories and the user-centered design approach as theoretical and methodological frameworks, respectively. Twenty-one children, aged 7 to 12 years, participated by expressing their needs and preferences related to diabetes and video games. Data were analysed following content analysis guidelines. Then, a choice of appropriate health behavioral change theories and their determinants that should be capable of influencing children's behaviors and preferences. RESULTS the conceptual framework proposes a video game that consists of six phases, each addressing one stage of behavioral change and specific determinants, aligned with the needs and preferences identified by the participating children. This study shows the applicability of this framework in view of each proposed phase presenting examples and the children's ideas. CONCLUSION the results of this study contribute to advance the discussion on how behavioral theories and their determinants should be related to the design of creative and funny video games considering the profile of the target population as well as its needs and preferences.
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Affiliation(s)
| | - Sidney Fels
- University if British Columbia, Department of Electrical and Computer Engineering, Vancouver, BC, Canada
| | - Noreen Kamal
- University of Calgary, Department of Clinical Neurosciences, Calgary, AB, Canada
| | - Lucila Castanheira Nascimento
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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15
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Hosseini-Marznaki Z, Tabari-Khomeiran R, Taheri-Ezbarami Z, Kazemnejad E. Adherence to treatment and its predictive factors among adults with type 2 diabetes in northern Iran. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2019. [DOI: 10.3233/mnm-180241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Zohreh Hosseini-Marznaki
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Rasoul Tabari-Khomeiran
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Taheri-Ezbarami
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazemnejad
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Downie GA, Mullan BA, Boyes ME, McEvoy PM. The effect of psychological distress on self-care intention and behaviour in young adults with type 1 diabetes. J Health Psychol 2019; 26:543-555. [PMID: 30666886 DOI: 10.1177/1359105318824795] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
An extended theory of planned behaviour including psychological distress was used to predict blood glucose monitoring in young adults with type 1 diabetes. Participants completed two surveys, a week apart (n = 167). Attitudes and perceived behavioural control were significantly associated with intention but subjective norm was not. Intention predicted blood glucose monitoring at T2. Higher scores in psychological distress significantly predicted poorer blood glucose monitoring at T2 but did not moderate the intention-behaviour relationship. Findings demonstrate some concerns with the theory of planned behaviour to predict self-care behaviour, yet highlight the importance of addressing psychological distress in diabetes self-management.
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Abbasi YF, See OG, Ping NY, Balasubramanian GP, Hoon YC, Paruchuri S. Diabetes knowledge, attitude, and practice among type 2 diabetes mellitus patients in Kuala Muda District, Malaysia - A cross-sectional study. Diabetes Metab Syndr 2018; 12:1057-1063. [PMID: 30017505 DOI: 10.1016/j.dsx.2018.06.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 06/29/2018] [Indexed: 11/26/2022]
Abstract
Diabetes is among leading public health concerns in Malaysia due to premature and preventable mortality involving macro and microvascular complications. Diabetes knowledge, attitude, and practice (KAP) are vital in diabetes management. The present study assessed the level of diabetes KAP among type 2 diabetes patients with associated and correlated factors through a self-administered questionnaire-based study on a convenience sample of 386 type 2 diabetes mellitus patients in Kuala Muda District, Kedah, Malaysia. Majority of the respondents possessed levels above the cut-off points for poor levels in knowledge (63.21%), attitude (62.69%), and practices (58.03%). Age, academic qualification, occupation, monthly income, current therapy type, comorbid diseases, and therapy preference were associated with KAP whereas the associations of disease duration, the best source of information about diabetes, and health status satisfaction were witnessed for attitude and practice. Academic qualification had strongest correlation for knowledge (r = 0.785), attitude (r = 0.725), and practice (r = 0.709). Knowledge level was significantly correlated with attitude level (r = 0.735), practice level (r = 0.786), income (r = 0.556), occupation (r = 0.358), age (r = 0.173), current therapy type (r = 0.133), and diabetes education exposure (r = 0.113). Attitude level had significant correlations with practice level (r = 0.679), income (r = 0.357), occupation (r = 0.348), health status satisfaction (r = 0.147), age (r = 0.145), and gender (r = 0.109). Practice level correlated significantly with income (r = 0.448), occupation (r = 0.317), age (r = 0.173), health status satisfaction (r = 0.167), and current therapy type (r = 0.118). All associations and correlations were significant at P < 0.005. Although overall having good levels of diabetes KAP, educational interventions are required to further improve diabetes KAP.
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Affiliation(s)
- Yasir Faraz Abbasi
- Master of Clinical Pharmacy candidate, Faculty of Pharmacy, AIMST University, Kedah, Malaysia
| | - Ooi Guat See
- Clinical Pharmacy Unit, Faculty of Pharmacy, AIMST University, Kedah, Malaysia
| | - Ng Yen Ping
- Clinical Pharmacy Unit, Faculty of Pharmacy, AIMST University, Kedah, Malaysia
| | | | | | - Sireesha Paruchuri
- Clinical Pharmacy Unit, Faculty of Pharmacy, AIMST University, Kedah, Malaysia
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Lee BK. Comparison of Prevalence of Hypertension and Medical Expenses According to the Level of Physical Activity of Korean Adults. THE ASIAN JOURNAL OF KINESIOLOGY 2018. [DOI: 10.15758/ajk.2018.20.4.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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19
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Lee LT, Bowen PG, Mosley MK, Turner CC. Theory of Planned Behavior: Social Support and Diabetes Self-Management. J Nurse Pract 2017. [DOI: 10.1016/j.nurpra.2016.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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20
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Bani Salameh A, Al-sheyab N, El-hneiti M, Shaheen A, Williams LM, Gallagher R. Effectiveness of a 12-week school-based educational preventive programme on weight and fasting blood glucose in “at-risk” adolescents of type 2 diabetes mellitus: Randomized controlled trial. Int J Nurs Pract 2017; 23. [DOI: 10.1111/ijn.12528] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 10/24/2016] [Accepted: 12/10/2016] [Indexed: 11/27/2022]
Affiliation(s)
| | - Nihaya Al-sheyab
- Faculty of Nursing, Midwifery and Health; Jordan University of Science and Technology; Irbid Jordan
| | - Mamdouh El-hneiti
- Department of Community Health Nursing; The University of Jordan; Amman Jordan
| | - Abeer Shaheen
- Department of Community Health Nursing; The University of Jordan; Amman Jordan
| | - Leonie M. Williams
- Faculty of Science, Health and Education; The University of the Sunshine Coast; Australia
| | - Robyn Gallagher
- Charles Perkins Centre and Faculty of Nursing and Midwifery; The University of Sydney Australia
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Fai EK, Anderson C, Ferreros V. Role of attitudes and intentions in predicting adherence to oral diabetes medications. Endocr Connect 2017; 6:63-70. [PMID: 28087609 PMCID: PMC5424778 DOI: 10.1530/ec-16-0093] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 01/13/2017] [Indexed: 11/21/2022]
Abstract
The purpose of this quantitative study was to investigate the extent to which patient attitudes and intentions predict adherence to the use of oral antihyperglycemic regimens in African Americans. This cross-sectional study of 115 participants used correlation analysis to establish relationships among patient attitudes, intentions and adherence. Data analyses showed significant correlations between the variables. Multiple regression analysis was used to establish predictions between the variables. A prediction model containing attitudes, subjective norms and perceived behavioral control (PBC) explained 37% of the variance to behavioral intention. Intentions accounted for 8.5% of the variance to adherence. Attitudes predicted behavioral intentions. The findings support the theory of planned behavior model and identify important correlations between attitudes, intentions and behaviors. In addition, the results underscore the need for promoting positive attitudes and positive intentions in effective adherence to the use of oral antihyperglycemic regimens. Achieving adequate adherence through behavioral counseling can effect positive social change by reducing the mortality and morbidity that are associated with inadequate adherence to the use of oral diabetic agents.
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Affiliation(s)
- Emmanuel K Fai
- University of Maryland Medical Center Midtown CampusBaltimore, Maryland, USA
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Jha V, Brockbank S, Roberts T. A Framework for Understanding Lapses in Professionalism Among Medical Students: Applying the Theory of Planned Behavior to Fitness to Practice Cases. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:1622-1627. [PMID: 27355781 DOI: 10.1097/acm.0000000000001287] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Fitness to practice decisions are often based on a student's digression from the regulations, with limited exploration of the reasoning behind the student's behavior. However, behavior is underpinned by complex, "hidden" variables, including an individual's attitudes and social norms. Examining hidden determinants of professionalism, such as context, interpersonal relationships, social norms, and local cultures, then allows medical educators to develop a richer understanding of unprofessional behavior.In this article, the authors propose the use of the theory of planned behavior (TPB) as a framework to help evaluate unprofessional behavior in students. The TPB is a deliberative processing model that explains how an individual's behavior is underpinned by his or her cognitions, with behavior being primarily dependent on the intention to perform the behavior (behavioral intention). Intention, in turn, is determined by three variables: attitude, subjective norm, and perceived behavioral control.To understand the practical use of the TPB, the authors present four complex, anonymized case studies in which they employed the TPB to help deal with serious professionalism lapses among medical students. The outcomes of these cases as well as the student and program director perspectives, all explained via the TPB variables, are presented. The strengths and limitations of the TPB are discussed.
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Affiliation(s)
- Vikram Jha
- V. Jha is professor of medical education and head of undergraduate school, School of Medicine, University of Liverpool, Liverpool, United Kingdom. S. Brockbank is clinical teaching fellow, School of Medicine, University of Liverpool, Liverpool, United Kingdom. T. Roberts is professor of medical education and director, Leeds Institute of Medical Education, University of Leeds, Leeds, United Kingdom
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Determinants of Engagement in Leisure-time Physical Activity – Dialogue with Senior Athletes. Can J Aging 2016; 35:513-525. [DOI: 10.1017/s071498081600057x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
RÉSUMÉCet article explore, en examinant leurs croyances saillants, les facteurs qui déterminent si les personnes âgées participent aux Jeux des aînés et de l’activité physique durant les loisirs connexes. Nous avons mené 10 entrevues en profondeur avec des personnes âgées qui ont participé aux Jeux des aînés. Nous avons exploré trois types de croyance sous-tendus par le cadre théorique de comportement prévu: les avantages et les inconvénients (croyances comportementales), le soutien social et la pression (croyances normatives), et les facilitateurs et les obstacles (croyances de contrôle). Les répondants aux entrevues se sont trouvés à s’engager aux Jeux des aînés et à l’activité physique dans la mesure où ils ont associé divers avantages intangibles avec les Jeux et en ont valorisé la satisfaction psychologique. Ils considéraient leurs pairs et les familles comme soutenant et approuvant leur engagement, tout en reconnaissant les capacités physiques et les contraintes structurelles nécessaires pour se livrer aux Jeux et les activités connexes. Les résultats indiquent comment les croyances pertinentes peuvent être combinées avec des interventions pour encourager pour les personnes âgées des activités physiques des loisirs.
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Johnson ST, Lubans DR, Mladenovic AB, Plotnikoff RC, Karunamuni N, Johnson JA. Testing social-cognitive mediators for objective estimates of physical activity from the Healthy Eating and Active Living for Diabetes in Primary Care Networks (HEALD-PCN) study. PSYCHOL HEALTH MED 2016; 21:945-53. [DOI: 10.1080/13548506.2016.1140900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Adaptation of the Godin Leisure-Time Exercise Questionnaire into Turkish: The Validity and Reliability Study. ADVANCES IN PUBLIC HEALTH 2016. [DOI: 10.1155/2016/3756028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study was conducted with the aim of determining whether the Turkish form of the “Leisure-Time Exercise Questionnaire” developed by Godin is a valid and reliable tool for diabetic patients in Turkey. The study was conducted as a methodological research on 300 diabetic patients in Turkey. The linguistic equivalence of the questionnaire was assessed through the back-translation method, while its content validity was assessed through obtaining expert opinions. Cronbach’s alpha value was found to assess the reliability of the questionnaire. The test-retest analysis and the correlation between independent observers were examined. The content validity index (CVI) was found to be .82 according to the expert assessments, and no statistical difference was found between them (Kendall’sW=.17,p=.235). Cronbach’s alpha was found to beα=.64, the result of the test-retest analysis wasr=.97, and the correlation between independent observers (ICC) was .98. This study found that the Turkish form of the Leisure-Time Exercise Questionnaire is a valid and reliable tool that can be used to define and assess the exercise behaviors of Turkish diabetic patients.
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Abstract
Purpose To systematically review the Theory of Planned Behaviour studies predicting self-care intentions and behaviours in populations with and at-risk of diabetes. Methods A systematic review using six electronic databases was conducted in 2013. A standardised protocol was used for appraisal. Studies eligibility included a measure of behaviour for healthy eating, physical activity, glucose monitoring, medication use (ii) the TPB variables (iii) the TPB tested in populations with diabetes or at-risk. Results Sixteen studies were appraised for testing the utility of the TPB. Studies included cross-sectional (n = 7); prospective (n = 5) and randomised control trials (n = 4). Intention (18%–76%) was the most predictive construct for all behaviours. Explained variance for intentions was similar across cross-sectional (28–76%); prospective (28–73%); and RCT studies (18–63%). RCTs (18–43%) provided slightly stronger evidence for predicting behaviour. Conclusions Few studies tested predictability of the TPB in populations with or at-risk of diabetes. This review highlighted differences in the predictive utility of the TPB suggesting that the model is behaviour and population specific. Findings on key determinants of specific behaviours contribute to a better understanding of mechanisms of behaviour change and are useful in designing targeted behavioural interventions for different diabetes populations. Intention was the most predictive construct for diabetes self-care behaviours (18% – 76% of explained variance). Studies included cross-sectional (n = 7); prospective (n = 5) and randomised control trials (n = 4). Explained variance for intentions were similar across the study designs and RCTs provided slightly stronger evidence for predicting diabetes-related behaviour. The predictive utility of the TPB is behaviour specific and depends largely on the target population.
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Moreau M, Gagnon MP, Boudreau F. Development of a fully automated, web-based, tailored intervention promoting regular physical activity among insufficiently active adults with type 2 diabetes: integrating the I-change model, self-determination theory, and motivational interviewing components. JMIR Res Protoc 2015; 4:e25. [PMID: 25691346 PMCID: PMC4376153 DOI: 10.2196/resprot.4099] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/23/2015] [Accepted: 01/23/2015] [Indexed: 12/24/2022] Open
Abstract
Background Type 2 diabetes is a major challenge for Canadian public health authorities, and regular physical activity is a key factor in the management of this disease. Given that fewer than half of people with type 2 diabetes in Canada are sufficiently active to meet the recommendations, effective programs targeting the adoption of regular physical activity (PA) are in demand for this population. Many researchers argue that Web-based, tailored interventions targeting PA are a promising and effective avenue for sedentary populations like Canadians with type 2 diabetes, but few have described the detailed development of this kind of intervention. Objective This paper aims to describe the systematic development of the Web-based, tailored intervention, Diabète en Forme, promoting regular aerobic PA among adult Canadian francophones with type 2 diabetes. This paper can be used as a reference for health professionals interested in developing similar interventions. We also explored the integration of theoretical components derived from the I-Change Model, Self-Determination Theory, and Motivational Interviewing, which is a potential path for enhancing the effectiveness of tailored interventions on PA adoption and maintenance. Methods The intervention development was based on the program-planning model for tailored interventions of Kreuter et al. An additional step was added to the model to evaluate the intervention’s usability prior to the implementation phase. An 8-week intervention was developed. The key components of the intervention include a self-monitoring tool for PA behavior, a weekly action planning tool, and eight tailored motivational sessions based on attitude, self-efficacy, intention, type of motivation, PA behavior, and other constructs and techniques. Usability evaluation, a step added to the program-planning model, helped to make several improvements to the intervention prior to the implementation phase. Results The intervention development cost was about CDN $59,700 and took approximately 54 full-time weeks. The intervention officially started on September 29, 2014. Out of 2300 potential participants targeted for the tailored intervention, approximately 530 people visited the website, 170 people completed the registration process, and 83 corresponded to the selection criteria and were enrolled in the intervention. Conclusions Usability evaluation is an essential step in the development of a Web-based tailored intervention in order to make pre-implementation improvements. The effectiveness and relevance of the theoretical framework used for the intervention will be analyzed following the process and impact evaluation. Implications for future research are discussed.
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Affiliation(s)
- Michel Moreau
- Interdisciplinary Group of Health Applied Research, Nursing Department, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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Mesters I, Wahl S, Van Keulen HM. Socio-demographic, medical and social-cognitive correlates of physical activity behavior among older adults (45-70 years): a cross-sectional study. BMC Public Health 2014; 14:647. [PMID: 24965940 PMCID: PMC4089561 DOI: 10.1186/1471-2458-14-647] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 06/19/2014] [Indexed: 11/24/2022] Open
Abstract
Background Present study aimed to identify socio-demographic, medical and social-cognitive correlates of physical activity among Dutch older individuals. Methods A systematic random sample of 2,568 Dutch participants aged 45–70 years filled out the validated modified Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire on physical activity. Socio-demographic and social-cognitive correlates were measured with validated instruments; medical correlates were checked by a general practitioner. The study had a cross-sectional design and the data collection ran from March 2005 until August 2006. Linear regression analyses were conducted to identify correlates of PA. We separated the findings for men from those for women to explore potential gender-specific associations. Results Being female, living in North Limburg or North-Brabant, having a higher educational level, a higher perceived behavioral control, more knowledge about PA advantages, a stronger habitual PA behavior, having more action plans and a stronger intention to engage in PA were significantly associated with higher PA levels. Being older, being a smoker, having a higher body mass index (BMI), having a paid job, observing others being physically active and overestimating one's PA level were associated with being less physically active. Socio-demographic and medical correlates significantly explained 20% of the variance of PA behavior while social-cognitive correlates as attitude explained an additional 4% and intention together with actual control explained another 1% of the variance of PA behavior. Conclusion There may be stable individual differences that influence PA in view of the fact that several socio-demographic and medical factors were not completely mediated by the socio-cognitive factors. The current study may help to focus PA interventions for individuals aged 45–70 years on influential socio-demographic, medical and social-cognitive correlates. Physical activity was significantly associated with age, gender, education, BMI, work situation, region of residence, smoking, awareness, advantages, descriptive norm, perceived behavioral control, habit, action plans and intention.
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Affiliation(s)
- Ilse Mesters
- School for Public Health and Primary Care (Caphri), Department of Epidemiology, Maastricht University, PO Box 616, Maastricht 6200 MD, The Netherlands.
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Participation in Regular Leisure-Time Physical Activity Among Individuals with Type 2 Diabetes Not Meeting Canadian Guidelines: the Influence of Intention, Perceived Behavioral Control, and Moral Norm. Int J Behav Med 2014; 21:918-26. [DOI: 10.1007/s12529-013-9380-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Plotnikoff RC, Lubans DR, Penfold CM, Courneya KS. Testing the utility of three social-cognitive models for predicting objective and self-report physical activity in adults with type 2 diabetes. Br J Health Psychol 2013; 19:329-46. [PMID: 24308845 DOI: 10.1111/bjhp.12085] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 11/11/2013] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Theory-based interventions to promote physical activity (PA) are more effective than atheoretical approaches; however, the comparative utility of theoretical models is rarely tested in longitudinal designs with multiple time points. Further, there is limited research that has simultaneously tested social-cognitive models with self-report and objective PA measures. The primary aim of this study was to test the predictive ability of three theoretical models (social cognitive theory, theory of planned behaviour, and protection motivation theory) in explaining PA behaviour. METHODS Participants were adults with type 2 diabetes (n = 287, 53.8% males, mean age = 61.6 ± 11.8 years). Theoretical constructs across the three theories were tested to prospectively predict PA behaviour (objective and self-report) across three 6-month time intervals (baseline-6, 6-12, 12-18 months) using structural equation modelling. PA outcomes were steps/3 days (objective) and minutes of MET-weighted PA/week (self-report). RESULTS The mean proportion of variance in PA explained by these models was 6.5% for objective PA and 8.8% for self-report PA. Direct pathways to PA outcomes were stronger for self-report compared with objective PA. CONCLUSIONS These theories explained a small proportion of the variance in longitudinal PA studies. Theory development to guide interventions for increasing and maintaining PA in adults with type 2 diabetes requires further research with objective measures. Theory integration across social-cognitive models and the inclusion of ecological levels are recommended to further explain PA behaviour change in this population. Statement of contribution What is already known on this subject? Social-cognitive theories are able to explain partial variance for physical activity (PA) behaviour. What does this study add? The testing of three theories in a longitudinal design over 3, 6-month time intervals. The parallel use and comparison of both objective and self-report PA measures in testing these theories.
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Affiliation(s)
- Ronald C Plotnikoff
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, New South Wales, Australia
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Brazeau AS, Gingras V, Leroux C, Suppère C, Mircescu H, Desjardins K, Briand P, Ekoé JM, Rabasa-Lhoret R. A pilot program for physical exercise promotion in adults with type 1 diabetes: the PEP-1 program. Appl Physiol Nutr Metab 2013; 39:465-71. [PMID: 24669988 DOI: 10.1139/apnm-2013-0287] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Physical inactivity is highly common in adults with type 1 diabetes (T1D) as specific barriers (i.e., hypoglycemia) may prevent them from being active. The objective of this study was to examine the efficacy of the Physical Exercise Promotion program in type 1 diabetes (PEP-1) program, a group program of physical activity (PA) promotion (intervention) compared with an information leaflet (control), to improve total energy expenditure (TEE) in adults with T1D after 12 weeks. TEE was measured with a motion sensor over a 7-day period at inclusion, after the program (12 weeks) and 1-year after inclusion. The 12 weekly sessions of the program included a 30-min information session (glycemic control and PA) and 60 min of PA. A total of 48 adults, aged 18 to 65 years with a reported PA practice <150 min per week, were recruited (45.8% men; aged 44.6 ± 13.3 years; 8.0% ± 1.1% glycated hemoglobin (A1c)) and randomized in this pilot trial. Ninety percent of participants completed the program and 88% completed the 1-year follow-up. No change was observed for TEE and A1c in both groups. After the 12-week program, the mean peak oxygen uptake increased (14%; p = 0.003) in the intervention group; however, at the 1-year follow-up, it was no longer different from baseline. In the control group, no difference was observed for the peak oxygen uptake. These results suggest that the PEP-1 pilot program could increase cardiorespiratory fitness. However, this benefit is not sustained over a long-term period. The PEP-1 program did not increase TEE in patients with T1D and other strategies remain necessary to counteract physical inactivity in this population.
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Affiliation(s)
- Anne-Sophie Brazeau
- a Montreal Institute for Clinical Research, 110 Avenue des Pins Ouest, Montreal, QC H2W 1R7, Canada
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Steed L, Barnard M, Hurel S, Jenkins C, Newman S. How does change occur following a theoretically based self-management intervention for type 2 diabetes. PSYCHOL HEALTH MED 2013; 19:536-46. [DOI: 10.1080/13548506.2013.845301] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Liz Steed
- Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Maria Barnard
- Department of Diabetes, The Whittington Hospital, London, UK
| | - Steven Hurel
- Department of Diabetes, University College London Hospitals, London, UK
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Wang HC, Chao YFC, Tsai JC, Chung MH, Yu YH, Hang LW, Lee SD. Development and preliminary validation of a questionnaire on regular exercise beliefs among patients with chronic obstructive pulmonary disease. J Clin Nurs 2013; 23:1133-43. [PMID: 24033794 DOI: 10.1111/jocn.12300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2013] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To develop a Regular Exercise Belief Questionnaire and test its psychometric properties for patients with chronic obstructive pulmonary disease. BACKGROUND Regular exercise has been shown to significantly improve physical capacity and the quality of life of patients with chronic obstructive pulmonary disease. However, their adherence to long-term exercise is low. To develop an effective strategy for promoting good exercise behaviours, it is important to have a validated instrument to evaluate factors related to engaging in exercise. DESIGN AND METHODS A cross-sectional design was used for the study. Construction of the Regular Exercise Belief Questionnaire was based on the Theory of Planned Behaviour Reliability and validity were assessed using a sample of 136 male patients with chronic obstructive pulmonary disease. The construct validity of the questionnaire was confirmed through exploratory factor analysis and known group technique. RESULTS Exploratory factor analysis resulted in an eight-factor solution that explained 70·4% of the total variance. The internal consistency of the Regular Exercise Belief Questionnaire was 0·83-0·93. The Regular Exercise Belief Questionnaire was preliminarily found to be reliable and exhibited satisfactory validity for patients with chronic obstructive pulmonary disease. CONCLUSION The Regular Exercise Belief Questionnaire is the first theory-based measure of exercise beliefs among patients with chronic obstructive pulmonary disease. The questionnaire provides an effective method to examine behaviour beliefs, normative beliefs and control beliefs about regular exercise. CLINICAL RELEVANCE The measure can be used to periodically evaluate the exercise beliefs in clinics and to examine the effectiveness of exercise programmes in patients with chronic obstructive pulmonary disease. The result of the evaluation could also apply to identify strategies related to promoting exercise behaviours.
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Affiliation(s)
- Hsiao-Chiao Wang
- Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; School of Nursing, College of Health Care, China Medical University, Taichung, Taiwan
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Gwin S, Taylor EL, Branscum P, Hofford C. Assessment of factors that predict physical activity among Oklahoma clergy: a theory of planned behavior approach. FAMILY & COMMUNITY HEALTH 2013; 36:193-203. [PMID: 23718955 DOI: 10.1097/fch.0b013e3182931578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The purpose of this study was to examine predictors of physical activity among clergy members in Oklahoma, using the theory of planned behavior. A 51-item valid and reliable instrument, measuring theory of planned behavior constructs and physical activity, was developed and administered to 141 clergy members. Results indicated that the majority of those surveyed were white (93%), college educated (97%), and overweight or obese (84%). Stepwise multiple regression analysis found that intentions accounted for 13.8% of the variance of physical activity whereas attitudes, subjective norms, and perceived behavioral control accounted for 54.8% of the variance of intention. Implications for intervention development are discussed.
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Affiliation(s)
- Shannon Gwin
- Department of Health and Exercise Science, The University of Oklahoma, Norman, OK 73019, USA.
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Helmink JHM, Gubbels JS, van Brussel-Visser FN, de Vries NK, Kremers SPJ. Baseline predictors of maintenance of intervention-induced changes in physical activity and sitting time among diabetic and pre-diabetic patients: a descriptive case series. BMC Res Notes 2013; 6:190. [PMID: 23656718 PMCID: PMC3655840 DOI: 10.1186/1756-0500-6-190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 04/22/2013] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study was to explore the predictive value of baseline characteristics in relation to changes in physical activity (PA) and sedentary behaviour among diabetic and pre-diabetic patients participating in a primary care based exercise intervention. We used a descriptive case series among diabetic and pre-diabetic patients (n = 119, 50.8% male, mean age 65.5 (SD = 7.8)). Measurements took place with questionnaires at baseline and two years after the start of the intervention. Predictor variables included demographic factors, Body Mass Index, baseline PA and sitting time, and baseline socio-cognitive profile. Results At follow-up, respondents spent more time being physically active than at baseline. For the total group, the average sitting time remained almost unchanged between the two measurements. Further exploration showed that respondents who had relatively high levels of PA at the start of the intervention, increased their total sitting time, while respondents with relatively low levels of PA at the start decreased their sitting time. The socio-cognitive profile did not predict behaviour change. The intervention appeared to be suitable for people with a low-education level, but the results should be interpreted in view of the limitations of the study such as the non-controlled design, self-reported outcomes and selective drop-out of participants. Conclusions Interventions for this specific target group may need to put more emphasis on the prevention of increased sitting time. The finding that the socio-cognitive profile did not predict behaviour change may underline the proposition that decisions to initiate and maintain PA behaviour change are to a large extend non-linear events. Acknowledging the possible non-linearity of the relationship between socio-cognitive determinants and behaviour change will help our understanding of this complex and dynamic process.
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Affiliation(s)
- Judith H M Helmink
- Department of Health Promotion, Maastricht University, School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht, MD 6200, the Netherlands.
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Gibson B, Marcus RL, Staggers N, Jones J, Samore M, Weir C. Efficacy of a computerized simulation in promoting walking in individuals with diabetes. J Med Internet Res 2012; 14:e71. [PMID: 22576226 PMCID: PMC3799542 DOI: 10.2196/jmir.1965] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Revised: 02/23/2012] [Accepted: 02/22/2012] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Regular walking is a recommended but underused self-management strategy for individuals with type 2 diabetes mellitus (T2DM). OBJECTIVE To test the impact of a simulation-based intervention on the beliefs, intentions, knowledge, and walking behavior of individuals with T2DM. We compared two versions of a brief narrated simulation. The experimental manipulation included two components: the presentation of the expected effect of walking on the glucose curve; and the completion of an action plan for walking over the next week. Primary hypotheses were (1) intervention participants' walking (minutes/week) would increase more than control participants' walking, and (2) change in outcome expectancies (beliefs) would be a function of the discrepancy between prior beliefs and those presented in the simulation. Secondary hypotheses were that, overall, behavioral intentions to walk in the coming week and diabetes-related knowledge would increase in both groups. METHODS Individuals were randomly assigned to condition. Preintervention measures included self-reported physical activity (International Physical Activity Questionnaire [IPAQ] 7-day), theory of planned behavior-related beliefs, and knowledge (Diabetes Knowledge Test). During the narrated simulation we measured individuals' outcome expectancies regarding the effect of exercise on glucose with a novel drawing task. Postsimulation measures included theory of planned behavior beliefs, knowledge, and qualitative impressions of the narrated simulation. The IPAQ 7-day was readministered by phone 1 week later. We used a linear model that accounted for baseline walking to test the main hypothesis regarding walking. Discrepancy scores were calculated between the presented outcome and individuals' prior expectations (measured by the drawing task). A linear model with an interaction between intervention status and the discrepancy score was used to test the hypothesis regarding change in outcome expectancy. Pre-post changes in intention and knowledge were tested using paired t tests. RESULTS Of 65 participants, 33 were in the intervention group and 32 in the control group. We excluded 2 participants from analysis due to being extreme outliers in baseline walking. After adjustment for baseline difference in age and intentions between groups, intervention participants increased walking by 61.0 minutes/week (SE 30.5, t(58 = 1.9, )P = .05) more than controls. The proposed interaction between the presented outcome and the individual's prior beliefs was supported: after adjustment for baseline differences in age and intentions between groups, the coefficient for the interaction was -.25, (SE 0.07, t(57 = -3.2, )P < .01). On average participants in both groups improved significantly from baseline in intentions (mean difference 0.66, t(62 = 4.5, )P < .001) and knowledge (mean difference 0.38, t(62 = 2.4, )P = .02). CONCLUSIONS This study suggests that a brief, Internet-ready, simulation-based intervention can improve knowledge, beliefs, intentions, and short-term behavior in individuals with T2DM.
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Affiliation(s)
- Bryan Gibson
- George E Whalen Salt Lake City Veterans Affairs Healthcare System, IDEAS center, Salt Lake City, UT, USA.
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An extended theory of planned behavior intervention for older adults with type 2 diabetes and cardiovascular disease. J Aging Phys Act 2011; 20:281-99. [PMID: 22190336 DOI: 10.1123/japa.20.3.281] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A randomized controlled trial evaluated the effectiveness of a 4-wk extended theory of planned behavior (TPB) intervention to promote regular physical activity and healthy eating among older adults diagnosed with Type 2 diabetes or cardiovascular disease (N = 183). Participants completed TPB measures of attitude, subjective norm, perceived behavioral control, and intention, as well as planning and behavior, at preintervention and 1 wk and 6 wk postintervention for each behavior. No significant time-by-condition effects emerged for healthy eating. For physical activity, significant time-by-condition effects were found for behavior, intention, planning, perceived behavioral control, and subjective norm. In particular, compared with control participants, the intervention group showed short-term improvements in physical activity and planning, with further analyses indicating that the effect of the intervention on behavior was mediated by planning. The results indicate that TPB-based interventions including planning strategies may encourage physical activity among older people with diabetes and cardiovascular disease.
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Richert J, Lippke S, Ziegelmann JP. Intervention-engagement and its role in the effectiveness of stage-matched interventions promoting physical exercise. Res Sports Med 2011; 19:145-61. [PMID: 21722003 DOI: 10.1080/15438627.2011.583164] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Intervention-engagement has received little attention in sports medicine as well as research and promotion of physical exercise. The construct is important, however, in the understanding of why interventions work. This study aimed at shedding more light on the interplay of engagement and the subsequent effectiveness of physical exercise interventions. A three-stage model differentiating among nonintenders, intenders, and actors informed the intervention design in this study. In an Internet-based randomized controlled trial (RCT) with two measurement points, N = 326 participants received a stage-matched, stage-mismatched, or control treatment. Assessed variables were goal setting, planning, behavior, and intervention-engagement. It was found that regarding goal setting, nonintenders in the stage-matched intervention and those who engaged highly in the stage-matched intervention improved significantly over time. Regarding planning, intenders in the matched condition as well as all actors increased their levels over time. Regarding behavior, nonintenders and intenders having engaged highly in the intervention improved more than those having engaged little. In order to help nonintenders progress on their way toward goal behavior, it is necessary that they engage highly in a stage-matched intervention. Implications for exercise promotion are that interventions should also aim at increasing participants' intervention-engagement.
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Affiliation(s)
- Jana Richert
- Department of Psychology, Freie Universität Berlin, Berlin, Germany.
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McEachan RRC, Conner M, Taylor NJ, Lawton RJ. Prospective prediction of health-related behaviours with the Theory of Planned Behaviour: a meta-analysis. Health Psychol Rev 2011. [DOI: 10.1080/17437199.2010.521684] [Citation(s) in RCA: 718] [Impact Index Per Article: 55.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hardeman W, Kinmonth AL, Michie S, Sutton S. Theory of planned behaviour cognitions do not predict self-reported or objective physical activity levels or change in the ProActive trial. Br J Health Psychol 2011; 16:135-50. [DOI: 10.1348/135910710x523481] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Ghazanfari Z, Niknami S, Ghofranipour F, Hajizadeh E, Montazeri A. Development and psychometric properties of a belief-based Physical Activity Questionnaire for Diabetic Patients (PAQ-DP). BMC Med Res Methodol 2010; 10:104. [PMID: 21062466 PMCID: PMC2998522 DOI: 10.1186/1471-2288-10-104] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2010] [Accepted: 11/09/2010] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This study carried out to develop a scale for assessing diabetic patients' perceptions about physical activity and to test its psychometric properties (The Physical Activity Questionnaire for Diabetic Patients-PAQ-DP). METHODS An item pool extracted from the Theory of Planned Behavior literature was generated. Then an expert panel evaluated the items by assessing content validity index and content validity ratio. Consequently exploratory factor analysis (EFA) was performed to indicate the scale constructs. In addition reliability analyses including internal consistency and test-retest analysis were carried out. RESULTS In all a sample of 127 women with diabetes participated in the study. Twenty-two items were initially extracted from the literature. A six-factor solution (containing 19 items) emerged as a result of an exploratory factor analysis namely: instrumental attitude, subjective norm, perceived behavioral control, affective attitude, self-identity, and intention explaining 60.30% of the variance observed. Additional analyses indicated satisfactory results for internal consistency (Cronbach's alpha ranging from 0.54 to 0.8) and intraclass correlation coefficients (ranging from 0.40 to 0.92). CONCLUSIONS The Physical Activity Questionnaire for Diabetic Patients (PAQ-DP) is the first instrument that applies the Theory of Planned Behavior in its constructs. The findings indicated that the PAQ-DP is a reliable and valid measure for assessing physical activity perceptions and now is available and can be used in future studies.
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Affiliation(s)
- Zeinab Ghazanfari
- Department of Health Education, Tarbiat Modares University, Tehran, Iran
- Department of Public Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Shamsaddin Niknami
- Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | | | - Ebrahim Hajizadeh
- Department of Biostatistics, Tarbiat Modares University, Tehran, Iran
| | - Ali Montazeri
- Department of Mental Health, Institute for Health Sciences Research, ACECR, Tehran, Iran
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Physical Activity and Stages of Change: A Longitudinal Test in Types 1 and 2 Diabetes Samples. Ann Behav Med 2010; 40:138-49. [DOI: 10.1007/s12160-010-9193-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Plotnikoff RC, Courneya KS, Sigal RJ, Johnson JA, Birkett N, Lau D, Raine K, Johnson ST, Karunamuni N. Alberta Diabetes and Physical Activity Trial (ADAPT): a randomized theory-based efficacy trial for adults with type 2 diabetes--rationale, design, recruitment, evaluation, and dissemination. Trials 2010; 11:4. [PMID: 20067626 PMCID: PMC2824703 DOI: 10.1186/1745-6215-11-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 01/12/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The primary aim of this study was to compare the efficacy of three physical activity (PA) behavioural intervention strategies in a sample of adults with type 2 diabetes. METHOD/DESIGN Participants (N = 287) were randomly assigned to one of three groups consisting of the following intervention strategies: (1) standard printed PA educational materials provided by the Canadian Diabetes Association [i.e., Group 1/control group)]; (2) standard printed PA educational materials as in Group 1, pedometers, a log book and printed PA information matched to individuals' PA stage of readiness provided every 3 months (i.e., Group 2); and (3) PA telephone counseling protocol matched to PA stage of readiness and tailored to personal characteristics, in addition to the materials provided in Groups 1 and 2 (i.e., Group 3). PA behaviour measured by the Godin Leisure Time Exercise Questionnaire and related social-cognitive measures were assessed at baseline, 3, 6, 9, 12 and 18-months (i.e., 6-month follow-up). Clinical (biomarkers) and health-related quality of life assessments were conducted at baseline, 12-months, and 18-months. Linear Mixed Model (LMM) analyses will be used to examine time-dependent changes from baseline across study time points for Groups 2 and 3 relative to Group 1. DISCUSSION ADAPT will determine whether tailored but low-cost interventions can lead to sustainable increases in PA behaviours. The results may have implications for practitioners in designing and implementing theory-based physical activity promotion programs for this population. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov identifier: NCT00221234.
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Affiliation(s)
- Ronald C Plotnikoff
- School of Education, University of Newcastle, Callaghan, NSW Australia
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Ronald J Sigal
- Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Nicholas Birkett
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - David Lau
- Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Kim Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Steven T Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Nandini Karunamuni
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Hagger M. Current issues and new directions inPsychology and Health: Physical activity research showcasing theory into practice. Psychol Health 2010. [DOI: 10.1080/08870440903268637] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Boudreau F, Godin G. Understanding physical activity intentions among French Canadians with type 2 diabetes: an extension of Ajzen's theory of planned behaviour. Int J Behav Nutr Phys Act 2009; 6:35. [PMID: 19531261 PMCID: PMC2708123 DOI: 10.1186/1479-5868-6-35] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Accepted: 06/16/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regular physical activity is considered a cornerstone for managing type 2 diabetes. However, in Canada, most individuals with type 2 diabetes do not meet national physical activity recommendations. When designing a theory-based intervention, one should first determine the key determinants of physical activity for this population. Unfortunately, there is a lack of information on this aspect among adults with type 2 diabetes. The purpose of this cross-sectional study is to fill this gap using an extended version of Ajzen's Theory of Planned Behavior (TPB) as reference. METHODS A total of 501 individuals with type 2 diabetes residing in the Province of Quebec (Canada) completed the study. Questionnaires were sent and returned by mail. RESULTS Multiple hierarchical regression analyses indicated that TPB variables explained 60% of the variance in intention. The addition of other psychosocial variables in the model added 7% of the explained variance. The final model included perceived behavioral control (beta = .38, p < .0001), moral norm (beta = .29, p < .0001), and attitude (beta = .14, p < .01). CONCLUSION The findings suggest that interventions aimed at individuals with type 2 diabetes should ensure that people have the necessary resources to overcome potential obstacles to behavioral performance. Interventions should also favor the development of feelings of personal responsibility to exercise and promote the advantages of exercising for individuals with type 2 diabetes.
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Affiliation(s)
- François Boudreau
- Canada Research Chair on Behaviour and Health, Faculty of Nursing, Laval University, Pavillon Ferdinand-Vandry, 3e étage, 1050 rue de la Médecine, Québec (Québec), G1V 0A6, Canada.
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Plotnikoff RC, Courneya KS, Trinh L, Karunamuni N, Sigal RJ. Aerobic physical activity and resistance training: an application of the theory of planned behavior among adults with type 2 diabetes in a random, national sample of Canadians. Int J Behav Nutr Phys Act 2008; 5:61. [PMID: 19055725 PMCID: PMC2633303 DOI: 10.1186/1479-5868-5-61] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Accepted: 12/02/2008] [Indexed: 01/15/2023] Open
Abstract
Background Aerobic physical activity (PA) and resistance training are paramount in the treatment and management of type 2 diabetes (T2D), but few studies have examined the determinants of both types of exercise in the same sample. Objective The primary purpose was to investigate the utility of the Theory of Planned Behavior (TPB) in explaining aerobic PA and resistance training in a population sample of T2D adults. Methods A total of 244 individuals were recruited through a random national sample which was created by generating a random list of household phone numbers. The list was proportionate to the actual number of household telephone numbers for each Canadian province (with the exception of Quebec). These individuals completed self-report TPB constructs of attitude, subjective norm, perceived behavioral control and intention, and a 3-month follow-up that assessed aerobic PA and resistance training. Results TPB explained 10% and 8% of the variance respectively for aerobic PA and resistance training; and accounted for 39% and 45% of the variance respectively for aerobic PA and resistance training intentions. Conclusion These results may guide the development of appropriate PA interventions for aerobic PA and resistance training based on the TPB.
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Affiliation(s)
- Ronald C Plotnikoff
- Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
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