Stages of Change in Physical Exercise and Social Support: An Integrated Socio-Psycho-Economic Approach

Improving Stage of Change in an Employee Wellness Program

Physical activity readiness of front-line employees caring for adults with disabilities (N = 381) improved during a two-phase project based on stages of change (SOC) theory. In Phase 1, we assessed barriers to, and readiness for, participation in an employee wellness program. We collected data from workers using focus groups and a preintervention physical activity readiness survey. Focus groups (N = 14) identified barriers, including lack of communication about the employee wellness program. With respect to their SOC (N = 82), 7% were in precontemplation, 16% in contemplation, 52% preparation, 5% in action, and 20% in maintenance SOC. In Phase 2, we aimed to improve readiness for participation in the program. We used SOC-based employee Facebook group messages, a health education fair, and measurement through a postintervention physical activity readiness survey. The mean number of "views" in which the workers saw the 16 theory-based messages was 12.2 (range = 0-27). Fourteen adults and 17 children attended the fair. Postintervention survey results (N = 125) indicated physical activity readiness improvement with 1% in precontemplation, 21% in contemplation, 33% in preparation, 33% in action, and 12% in maintenance SOC.

Listening to Immokalee moms

Purpose

The purpose of this paper is to present a case study of the research steps taken to identify message directions for a community-wide health communication campaign aimed at supporting healthier eating behaviors among Latino farmworker families in the Immokalee community in Florida. Latino mothers were targeted to understand their beliefs about children’s healthy eating needs and identify communication campaign opportunities that would reinforce choices made in the home, surrounding meal planning, food selection and preparation and portion sizes.

Design/methodology/approach

A sequential mixed-methods approach using focus group, group interview and qualitative message concept testing was used in three distinct stages of research exploration. An independent sample was recruited at each stage through convenience sampling and snowball sampling methods. The stages of change theory provided a framework for research inquiry in the context of healthy eating-at-home practices.

Findings

In general, mothers were aware and participatory in the effort to serve healthy meals for their children at home. The time and money associated with buying nutritious foods and cooking healthy meals daily was stressful, but they were receptive to communication efforts to help them maintain their commitment to give their children healthy foods. These findings provided directional opportunities for the discovery and implementation of health communication strategies. Test results found that the target was most receptive to message strategies that acknowledged the responsibility of both parents to model healthy eating practices to children.

Research limitations/implications

Recruiting resulted in small sample sizes at each stage of the investigation. The reliability of quantitative measurement was a limitation to the research conclusions.

Practical implications

Partnership with the audience from discovery to conceptualization resulted in messages that uniquely resonated with the audience for which they were aimed. Understanding about the target stage of readiness improves message effectiveness to the target group.

Social implications

Health communication campaigns planned and developed with the target audience at its center will generate message strategies that effectively address issues of greatest relevance to those communication agents that seek to change.

Originality/value

The study provides a unique exploration of the steps that health communication agents should pursue to establish a thorough profile of their target audience and the issues that resonate when considering healthy eating behavior at home. The application of the stages of the change model encouraged the discovery of issues surrounding the challenge and highlighted potential obstacles that would mitigate the behavior change efforts.

Factors Associated with Exercise Motivation among African-American Men

OBJECTIVE

The primary aims of this study were to: (1) characterize exercise stages of change among a sample of African-American men, (2) determine if exercise motivation was associated with self-reported exercise behavior, and (3) examine if groups of personal (i.e., age, BMI, income, educational attainment, and perceived health), psycho-social (i.e., exercise self-efficacy, personality type, social influence), and environmental factors (i.e., neighborhood safety) predicted stages of change for physical exercise among African-American men.

METHODS

One hundred seventy African-American male participants were recruited for this study (age: 47.63(10.23) years). Participants completed a self-report questionnaire assessing study variables. Multinomial logistic regression models were used to examine the association of exercise stages of change with an array of personal, psychosocial, and environmental factors.

RESULTS

BMI, exercise self-efficacy, and nighttime neighborhood safety were entered as independent variables in the full model. BMI and exercise self-efficacy continued to be significant predictors of exercise stages of change in the full model. Obese men had a 9.24 greater odds of being in the action stage of change than in the maintenance stage. Also, men reporting greater exercise self-efficacy had lower odds of being in the lower stages of change categories (pre-preparation, preparation, and action) than in the maintenance stage.

CONCLUSION

Our results confirmed that using an ecological framework explained more of the variance in exercise stages of change than any of the individual components alone. Information gleaned from this study could inform interventionists of the best ways to create tailored exercise programs for African-American men.