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Monahan K, Paiva A, Blissmer B, Sacco A, Robbins M. Transtheoretical Model for Exercise: Measure Redevelopment and Assessing the Role of Barriers in a Diverse Population. Am J Health Promot 2024; 38:186-196. [PMID: 37955178 DOI: 10.1177/08901171231213692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
PURPOSE To redevelop and improve Transtheoretical Model (TTM) exercise measures for Black and Hispanic/Latinx adults. The redeveloped scales will address barriers to exercise potentially relevant to populations of color in the United States (US). DESIGN Cross-sectional, split-half measure development. SETTING Online survey in the US. SUBJECTS 450 Black and/or Hispanic/Latinx adults. MEASURES Demographics, exercise engagement (IPAQ-SF), stage of change (SOC), decisional balance (DCBL), self-efficacy (SE), and barriers to exercise. ANALYSIS Split-half exploratory (EFA) and confirmatory factor analyses (CFA) were executed to establish measurement structure and fit, followed by multivariate analyses to assess constructs by SOC. RESULTS EFA/CFA for DCBL revealed three factors (α = .85, .70, .75) which represented Pros of exercise, Cons of exercise related to time and safety, and Cons of exercise related to physical or emotional discomfort. Model fit was adequate (CFI = .89). For SE, two factors (α = .85, .77) resulted with good model fit (CFI = .91). These factors reflected self-efficacy to exercise when confronted with generally challenging situations, and self-efficacy to exercise when specifically experiencing affective difficulties, such as depression or anxiety. Lastly, a novel Barriers measure resulted in three factors (α = .82, .77, .76), representing barriers encountered due to family responsibilities, work obligations, and health challenges, with good model fit (CFI = .95). Shifts in the core TTM constructs by SOC largely mapped onto the theoretical trends expected under the TTM. CONCLUSION This study produced systematically developed TTM exercise measures for Black and Hispanic/Latinx adults in the US that address and incorporate important barriers to exercise. This research represents an important step forward in broadening the inclusion of diverse populations to TTM measure development processes and may lead to a better understanding of relevant factors impeding exercise engagement in the US.
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Affiliation(s)
- Katie Monahan
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Andrea Paiva
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Bryan Blissmer
- Department of Kinesiology, University of Rhode Island, Kingston, RI, USA
| | - Allegra Sacco
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Mark Robbins
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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Saidi L, Godbout PD, Morais-Savoie C, Registe PPW, Bélanger M. Association between physical activity education and prescription during prenatal care and maternal and fetal health outcomes: a quasi-experimental study. BMC Pregnancy Childbirth 2023; 23:496. [PMID: 37407926 DOI: 10.1186/s12884-023-05808-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 06/22/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Physical activity (PA) during pregnancy is associated with healthy gestational weight gain (GWG) and a reduced risk of developing gestational diabetes (GD), gestational hypertension (GHT) and fetal macrosomia. However, in Canada, less than 20% of pregnant women meet PA recommendations. This study assessed associations between an intervention including PA education by prenatal nurses and a PA prescription delivered by physicians and fetal and maternal outcomes. METHODS This is a quasi-experimental study. Two groups of women who received their prenatal care at the obstetrics clinic of a university hospital were created. In the first group, 394 pregnant women followed at the clinic received standard care. In the second group, 422 women followed at the clinic received standard care supplemented with education on the relevance of PA during pregnancy and a prescription for PA. Data for both study groups were obtained from the medical records of the mothers and their newborns. Logistic regressions were used to compare the odds of developing excessive GWG, GD, GHT, and fetal macrosomia between the two study groups. RESULTS The addition of PA education and PA prescription to prenatal care was associated with 29% lower odds of developing excessive GWG (adjusted odds ratios (OR) 0.71, 95% confidence intervals (CI) 0.51-0.99), 73% lower odds of developing GHT (0.27, 0.14-0.53), 44% lower odds of fetal macrosomia (> 4 kg) (0.56, 0.34-0.93), and 40% lower odds of being large for gestational age (0.60, 0.36-0.99). The intervention was not associated with a difference in odds of developing GD (0.48, 0.12-1.94). CONCLUSIONS The inclusion of education and prescription of PA as part of routine prenatal care was associated with improvements in maternal and fetal health outcomes, including significantly lower odds of GWG, GHT and macrosomia.
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Affiliation(s)
- Latifa Saidi
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, 2500, boul. de l 'Université, Sherbrooke, Québec, J1K 2R1, Canada.
| | - Pierre D Godbout
- School of Nursing, Université de Moncton, Campus de Shippagan, 725, Rue du Collège, Bathurst, NB, E2A 3Z2, Canada
| | - Camille Morais-Savoie
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Sherbrooke, Pavillon J-Raymond-Frenette, 50 Rue de La Francophonie St, Moncton, NB, E1A 7R1, Canada
| | - Pierre Philippe Wilson Registe
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, 2500, boul. de l 'Université, Sherbrooke, Québec, J1K 2R1, Canada
| | - Mathieu Bélanger
- Department of Family and Emergency Medicine, Université de Sherbrooke, Centre de Formation Médicale du Nouveau-Brunswick, Vitalité Health Network, Pavillon J-Raymond-Frenette, 18, Avenue Antonine-Maillet, Moncton, NB, E1A 3E9, Canada
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de Camargo EM, da Costa CG, Piola TS, Bacil EDA, López-Gil JF, de Campos W. Is Greater Social Support from Parents and Friends Related to Higher Physical Activity Levels among Adolescents? CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040701. [PMID: 37189950 DOI: 10.3390/children10040701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/29/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023]
Abstract
Increasing physical activity levels during adolescence have been put on the agenda by several researchers. This study verified the association between social support from parents and friends and different amounts of moderate-to-vigorous physical activity (MVPA) among adolescents in public school. The present study had a cross-sectional design and included a representative sample of 1984 adolescents (aged 15-17). The ASAFA (Apoio Social para prática de Atividade Física para Adolescentes) scale and the QAFA (Questionário de Atividade Física para Adolescentes) were used to determine social support and physical activity, respectively. For statistical analysis, a conceptual model for structured equations and weighted least squares mean and variance adjusted were applied. Social support from parents increased the odds of engaging in 180 min/week of MVPA by 46.7%, 47.8% for 300 min/week, and 45.5% for 420 min/week. Social support from friends showed similar relations trends: 23.8% for 180 min/week, 23.6% for 300 min/week, and 21.2% for 420 min/week. Social support from parents and friends increased the probability of adolescents reaching the amounts of physical activity investigated. The results indicate that greater social support (from parents and friends) was associated with a higher level of MVPA in Brazilian adolescents.
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Affiliation(s)
- Edina Maria de Camargo
- Department of Physical Education, Universidade Federal do Paraná (UFPR), Curitiba 81531-980, Paraná, Brazil
| | - Cristiane Galvão da Costa
- Department of Physical Education, Universidade Federal do Paraná (UFPR), Curitiba 81531-980, Paraná, Brazil
| | - Thiago Silva Piola
- Department of Physical Education, Universidade Federal do Paraná (UFPR), Curitiba 81531-980, Paraná, Brazil
| | - Eliane Denise Araújo Bacil
- Department of Physical Education, Universidade Federal do Paraná (UFPR), Curitiba 81531-980, Paraná, Brazil
| | - José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31008 Pamplona, Spain
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
- One Health Research Group, Universidad de Las Américas, Quito 170124, Ecuador
| | - Wagner de Campos
- Department of Physical Education, Universidade Federal do Paraná (UFPR), Curitiba 81531-980, Paraná, Brazil
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Buchmann M, Jordan S, Loer AKM, Finger JD, Domanska OM. Motivational readiness for physical activity and health literacy: results of a cross-sectional survey of the adult population in Germany. BMC Public Health 2023; 23:331. [PMID: 36788515 PMCID: PMC9930360 DOI: 10.1186/s12889-023-15219-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Health literacy, defined as the knowledge, motivation, and competences to use health information to improve health and well-being, is associated with regular physical activity. However, there is limited evidence on whether health literacy is also related to the motivational readiness for physical activity in a general population. The aim of this study was to investigate whether motivational readiness for leisure-time physical activity is associated with health literacy. METHODS Analyses were based on data of 21,895 adults from the cross-sectional German Health Update and European Health Interview Survey 2014/2015 (GEDA 2014/2015-EHIS). Motivational readiness for leisure-time physical activity was assessed with stages of change for physical activity with a set of validated items. It was then classified, according to an established algorithm, into five stages: precontemplation, contemplation, preparation, action, and maintenance. Health literacy was measured with the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and categorised as low, medium, and high. For bivariate and multinomial logistic regression analyses, the stages were categorised in three phases as: (1) no intention (precontemplation), (2) planning (contemplation or preparation), and (3) in activity (action or maintenance). The models were adjusted for sex, age, education, health consciousness, self-efficacy, and self-perceived general health status. RESULTS High compared to low health literacy was associated with a 1.65-times (95% CI = 1.39-1.96) greater probability of being in activity than planning. High compared to low health literacy was associated with a reduced risk of having no intention to change physical activity behaviour (relative risk ratio, RRR = 0.84, 95% CI = 0.75-0.95). The associations persisted after adjusting for covariates. CONCLUSION High health literacy was positively associated with more advanced phases of motivational readiness for leisure-time physical activity. Therefore, taking health literacy into account in interventions to promote motivational readiness for leisure-time physical activity could be a useful approach.
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Affiliation(s)
- Maike Buchmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.
| | - Susanne Jordan
- grid.13652.330000 0001 0940 3744Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Anne-Kathrin Mareike Loer
- grid.13652.330000 0001 0940 3744Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Jonas David Finger
- Senate Department for Higher Education and Research, Long-Term Care and Gender Equality, Department of Health, Oranienstraße 106, 10969 Berlin, Germany
| | - Olga Maria Domanska
- grid.13652.330000 0001 0940 3744Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
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The Transtheoretical Model based psychoeducation's effect on healthy lifestyle behaviours in schizophrenia: A randomized controlled trial. Arch Psychiatr Nurs 2022; 41:51-61. [PMID: 36428075 DOI: 10.1016/j.apnu.2022.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/15/2022] [Accepted: 07/09/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The study was conducted with the pretest-posttest randomized controlled trial design to detect the psychoeducation's effect, based on the Transtheoretical Model, on the healthy lifestyle behaviours of individuals with schizophrenia. METHODS The data were collected from 82 participants, as 41 intervention and 41 control. The data were collected via personal information form, behavioural change stage diagnosis form and healthy lifestyle scale II. 6-week psychoeducation, consisting of 6 modules, based on the Transtheoretical Model, was applied to the intervention group. No interventions were applied to the control group. Pretests and posttests were applied to both groups. RESULTS When the healthy lifestyle scale II of intervention and control groups and final test results arranged according to ANCOVA analysis are compared, average final test results were meaningfully positive for the intervention group with taking control of the pretest and other covariants. When the pretest-posttest results in terms of behavioural change of the intervention group are evaluated; a meaningful difference among nutrition, physical exercises, spiritual self-improvement and stress management, which all are the stages of behavioural change, was detected. CONCLUSION It was determined that psychoeducation on a healthy lifestyle, based on the Transtheoretical Model in an individual with schizophrenia affected physical exercises, spiritual self-improvement and interpersonal relationships sub-dimension in medium level, and had a drastic influence on health responsibility, nutrition, stress management sub-dimensions and all healthy lifestyle behaviours. Progress in behavioural change stages was detected. CLINICAL TRIALS ID NCT05259748.
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Ujiie Y, Takahashi K. Association of personality with habituation of physical and non-physical activities among Japanese adults: Results from questionnaire research before COVID-19 pandemic. DIALOGUES IN HEALTH 2022; 1:100076. [PMID: 36785624 PMCID: PMC9670675 DOI: 10.1016/j.dialog.2022.100076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/02/2022] [Accepted: 11/07/2022] [Indexed: 11/18/2022]
Abstract
Background Physical activity has benefits for public health as it reduces the risk of non-communicable diseases and improves the quality of life. Previous studies have shown that health conditions, lifestyle, and socioeconomic status influence one's tendency to engage in physical activity. However, the influence of psychological traits on engagement in physical activity is not yet fully understood. In this study, we explored personality traits associated with the habituation of physical activity and compared them with personality traits associated with the habituation of non-physical activity. Methods We recruited 1600 Japanese adult volunteers and conducted an online survey just before the spread of COVID-19. We collected data for the prevalence of physical and non-physical activities, and various aspects of personality traits including the Big Five personality traits, sensitivity to behavioral activation, dark triad personality, levels of internal locus of control, and the degree of just-world belief. Findings The results demonstrated that high levels of extraversion, sensitivity to behavioral activation, and an internal locus of control had a positive influence on the habituation of physical activity. Moreover, our results were contradictory as they also showed that high levels of openness, sensitivity to behavioral activation, and just world belief related to the habituation of non-physical activity. Interpretation These results suggest that the personality traits that influenced the habituation of activities depend on the characteristics of the activity and reveal extraversion and internal locus of control as the personality traits specific to the habituation of physical activity. Fundings This study was supported by Senryakuteki-kenkyu from Chukyo University, a Grant-in-Aid for Early-Career Scientists (Grant No. 19 K20650 and 22 K13880), the Promotion of Joint International Research (Grant No. 20KK0054). This work was also supported by a Grant-in-Aid for Scientific Research on Innovative Areas "Construction of the Face-Body Studies in Transcultural Conditions" (Grant No. 17H06342).
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Affiliation(s)
- Yuta Ujiie
- Department of Psychology, College of Contemporary Psychology, Rikkyo University, 1-2-26 Kitano,Niiza-shi, Saitama Japan 352-8558, Japan
- Research Organization of Open Innovation and Collaboration, Ritsumeikan University, 2-150 Iwakura-cho, Ibaraki, Osaka 567-8570, Japan
| | - Kohske Takahashi
- Research Organization of Open Innovation and Collaboration, Ritsumeikan University, 2-150 Iwakura-cho, Ibaraki, Osaka 567-8570, Japan
- College of Comprehensive Psychology, Ritsumeikan University, 2-150 Iwakura-cho, Ibaraki, Osaka 567-8570, Japan
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Weishaupt I, Mages-Torluoglu J, Kunze C, Weidmann C, Steinhausen K, Bailer AC. Mobile Digital Health Intervention to Promote Nutrition and Physical Activity Behaviors Among Long-term Unemployed in Rural Areas: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e40321. [DOI: 10.2196/40321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background
Long-term unemployed have poor nutritional and physical activity statuses, and, therefore, special health promotion needs. Particularly in rural areas, however, they often do not have access to health promotion service. Thus, new promising strategies to improve the health of long-term unemployed are needed. Hence, a digital health intervention to promote nutritional and physical health behaviors was conceived, and the effectiveness of the intervention in combination with face-to-face sessions will be evaluated in a randomized controlled trial.
Objective
The aim of this study is to elucidate the effectiveness of a mobile digital health intervention to promote the nutritional and physical activity behaviors of long-term unemployed in the rural areas of Germany.
Methods
The 9-week intervention aims to promote nutritional or physical activity behavior by improving drinking habits, increasing the consumption of fruits, vegetables, and whole grains, increasing daily step count, strengthening muscles, and improving endurance. The intervention design is based on the transtheoretical model and is implemented in a mobile app using the MobileCoach open-source platform. The effectiveness of the intervention will be elucidated by a 9-week, 2-armed, parallel-designed trial. Therefore, long-term unemployed will be recruited by employees of the German social sector institutions and randomized either to receive information brochures; the digital intervention in the form of a mobile app; and 3 face-to-face sessions regarding technical support, healthy eating, and physical activity (n=100) or to receive a control treatment consisting of solely the hand over of information brochures (n=100). The effectiveness of the intervention will be assessed using questionnaires at baseline, after 9 weeks in face-to-face appointments, and after a 3-month follow-up period by postal contact. The use of the mobile app will be monitored, and qualitative interviews or focus groups with the participants will be conducted. Incentives of €50 (US $49.7) will be paid to the participants and are tied to the completion of the questionnaires and not to the use of the mobile app or progress in the intervention.
Results
The effectiveness of the intervention in promoting the nutritional and physical activity behaviors of long-term unemployed participants will be elucidated. The adherence of the participants to and the acceptance and usability of the mobile device app will be evaluated. Recruitment started in March 2022, and the final publication of the results is expected in the first half of 2023.
Conclusions
Positive health-related changes made by the intervention would display the potency of digital health interventions to promote nutritional and physical activity behaviors among long-term unemployed in the rural areas of Germany, which would also contribute to an improved health status of the German population in general.
Trial Registration
German Clinical Trials Register DRKS00024805; https://www.drks.de/DRKS00024805
International Registered Report Identifier (IRRID)
PRR1-10.2196/40321
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Lee C, Park H. Effects of a Fall Prevention Program Based on Goal Attainment Theory for Homebound Older Adults With Osteoarthritis of the Lower Extremities. Orthop Nurs 2022; 41:414-427. [PMID: 36413667 DOI: 10.1097/nor.0000000000000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This study implemented and evaluated a community-based fall prevention program based on goal attainment theory that targeted older adults with osteoarthritis. The program included education, exercise, and one-on-one counseling during which the participant and the provider set individual fall prevention goals. This study used a nonequivalent control group pre-/posttest design. Participants were older adults in senior centers with lower extremity osteoarthritis. A fall prevention program in the experimental group included group (70 minutes, once/week; education and exercise) and individual counseling (10 minutes, twice/week; emotional support and goal setting). Data analysis was conducted using SPSS/WIN 22.0 with the χ2 test, Fisher's exact test, independent t test, and Mann-Whitney U test. The experimental group experienced significantly fewer falls, less stiffness, less difficulty performing activity; more muscular strength, walking ability, and balance; as well as less fear of falling and higher falls efficacy in comparison with the control group. However, pain did not improve in either of the two groups. Fall prevention programs need to include the active involvement of carers in ensuring environmental changes to reduce fall risks. In addition, health professionals who care for community patients with osteoarthritis could strengthen interactions and exchanges to prevent falls and actively modify home hazards.
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Affiliation(s)
- Chunhee Lee
- Chunhee Lee, PhD, RN , PhD Student, Graduate School, Keimyung University, Daegu, South Korea, and Assistant Professor, Department of Nursing, Pohang University, Pohang, South Korea
- Heeok Park, PhD, RN , Associate Professor, College of Nursing, Research Institute of Nursing Science, Keimyung University, Daegu, South Korea
| | - Heeok Park
- Chunhee Lee, PhD, RN , PhD Student, Graduate School, Keimyung University, Daegu, South Korea, and Assistant Professor, Department of Nursing, Pohang University, Pohang, South Korea
- Heeok Park, PhD, RN , Associate Professor, College of Nursing, Research Institute of Nursing Science, Keimyung University, Daegu, South Korea
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Bell K, Conde M, Hendry G, Rafferty D, Steultjens M. Barriers and facilitators to physical activity in people with an inflammatory joint disease: a mixed methods study. BMC Musculoskelet Disord 2022; 23:897. [PMID: 36199050 PMCID: PMC9533590 DOI: 10.1186/s12891-022-05847-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Physical activity has been shown to be of great benefit to people with an inflammatory joint disease (IJD), however people with an IJD have been shown to be very inactive compared to the general population. The aims of this study were to explore 1) whether the transition from a National Health Service (NHS)-run exercise programme into exercising in the community could be achieved successfully; and 2) the barriers and facilitators during the transition period. Methods This study adopted a complementary mixed-methods study design including a qualitative approach using focus groups and a prospective cohort study. Descriptive statistics were used to summarise the cohort study data. All variables were assessed for normality of distribution using the Sharpiro-Wilk test. Paired t-tests or Wilcoxon tests were undertaken for two consecutive assessment timepoints; one-way repeated measures ANOVAs or Friedman’s tests for three consecutive assessment timepoints. Micro-interlocutor analysis was used to analyse the focus group data. Areas of congruence and incongruence were explored by confirming the statistical results against the qualitative results. The adapted ecological model of the determinants of physical activity was then used as a framework to describe the findings. Results A successful transition was defined as still exercising in the community 6-months post discharge from the NHS-run Inflammatory Arthritis Exercise Programme. This was self-reported to be 90% of the cohort. An individual barrier to physical activity in people with an IJD was found to be the unpredictable nature of their condition. Other barriers and facilitators found were similar to those found in the general population such as recreation facilities, locations, transportation and cost. Other facilitators were similar to those found in people living with other chronic long-term conditions such as the importance of peer support. Conclusions 90% of the cohort data were defined as a successful transition. People with an IJD have similar barriers and facilitators to exercise as the general population and those living with other chronic long-term conditions. A barrier which appears to be unique to this population group is that of the unpredictable nature of their condition which needs to be considered whenever tailoring any intervention. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05847-z.
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Affiliation(s)
- Kirsty Bell
- NHS Tayside, Physiotherapy Department Crieff Community Hospital, King Street, Crieff, PH7 3HR, UK.
| | - Monserrat Conde
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Gordon Hendry
- Institute of Health Research, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK
| | - Danny Rafferty
- Institute of Health Research, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK
| | - Martijn Steultjens
- Institute of Health Research, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK
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Ersin F, Tülüce D, Enzin F. Examination of exercise benefit/barrier perceptions of individuals with diabetes and affecting factors. Afr Health Sci 2022; 22:275-285. [PMID: 36910343 PMCID: PMC9993258 DOI: 10.4314/ahs.v22i3.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Exercise, which is one of the health promotion behaviors, is extremely important in healthy life. This study was conducted to examine exercise benefit/barrier perceptions of individuals with diabetes and influencing factors. Method This descriptive study was conducted in the Endocrine Polyclinics of a University Hospital with 285 individuals with Type 2 Diabetes between January and June 2020. Results In this study, the average score of the exercise benefits subscale was 61.69 +14.79, the barriers subscale was 35.83 + 5.99, and the total score of the exercise benefits/barriers scale was 99.79 + 12.58. The total self-efficacy scale score was reported to be 59.74 + 9.46. A significant relationship was reported between the total mean score of the exercise benefits/barriers scale and having the opportunity to exercise, exercising regularly, and having a disease that prevents exercising. A significant difference was reported between the total mean score of the self-efficacy scale and the regular exercise status. Conclusion Because of this study, the number of individuals who regularly exercised is insufficient, the mean exercise benefits/barriers scale score is not at the desired level, and exercise benefit/barrier perceptions are positively affected by the self-efficacy level.
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Affiliation(s)
- Fatma Ersin
- Harran University, Faculty of Health Sciences, Public Health Nursing Department
| | - Derya Tülüce
- Harran University, Faculty of Health Sciences, Department of Internal Medicine Nursing
| | - Fatih Enzin
- Harran University, Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation
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Yeh PG, Reininger BM, Mitchell-Bennett LA, Lee M, Xu T, Davé AC, Park SK, Ochoa-Del Toro AG. Evaluating the Dissemination and Implementation of a Community Health Worker-Based Community Wide Campaign to Improve Fruit and Vegetable Intake and Physical Activity among Latinos along the U.S.-Mexico Border. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4514. [PMID: 35457382 PMCID: PMC9025101 DOI: 10.3390/ijerph19084514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 11/17/2022]
Abstract
This study evaluated the dissemination and implementation of a culturally tailored community-wide campaign (CWC), Tu Salud ¡Si Cuenta! (TSSC), to augment fruit and vegetable (FV) consumption and physical activity (PA) engagement among low-income Latinos of Mexican descent living along the U.S.-Mexico Border in Texas. TSSC used longitudinal community health worker (CHW) home visits as a core vehicle to enact positive change across all socioecological levels to induce behavioral change. TSSC's reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) was examined. A dietary questionnaire and the Godin-Shepherd Exercise Questionnaire measured program effectiveness on mean daily FV consumption and weekly PA engagement, respectively. Participants were classified based on CHW home visits into "low exposure" (2-3 visits) and "high exposure" (4-5 visits) groups. The TSSC program reached low-income Latinos (n = 5686) across twelve locations. TSSC demonstrated effectiveness as, compared to the low exposure group, the high exposure group had a greater FV intake (mean difference = +0.65 FV servings daily, 95% CI: 0.53-0.77) and an increased PA (mean difference = +185.6 MET-minutes weekly, 95% CI: 105.9-265.4) from baseline to the last follow-up on a multivariable linear regression analysis. Multivariable logistic regression revealed that the high exposure group had higher odds of meeting both FV guidelines (adjusted odds ratio (AOR) = 2.03, 95% CI: 1.65-2.47) and PA guidelines (AOR = 1.36, 95% CI: 1.10-1.68) at the last follow-up. The program had a 92.3% adoption rate, with 58.3% of adopting communities meeting implementation fidelity, and 91.7% of communities maintaining TSSC. TSSC improved FV consumption and PA engagement behaviors among low-income Latinos region wide. CHW delivery and implementation funding positively influenced reach, effectiveness, adoption, and maintenance, while lack of qualified CHWs negatively impacted fidelity.
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Affiliation(s)
- Paul Gerardo Yeh
- Division of Health Promotion & Behavioral Sciences, Brownsville Regional Campus, School of Public Health, University of Texas Health Science Center, 80 Fort Brown, Brownsville, TX 78520, USA; (B.M.R.); (L.A.M.-B.)
- Department of Physician Assistant, College of Health Professions, University of Texas Rio Grande Valley, 1201 West University Blvd., Edinburg, TX 78539, USA
- Postdoctoral Fellow, National Cancer Institute Cancer Control Research Training Program, School of Public Health, University of Texas Health Science Center, 1200 Pressler Street, Houston, TX 77030, USA
| | - Belinda M. Reininger
- Division of Health Promotion & Behavioral Sciences, Brownsville Regional Campus, School of Public Health, University of Texas Health Science Center, 80 Fort Brown, Brownsville, TX 78520, USA; (B.M.R.); (L.A.M.-B.)
| | - Lisa A. Mitchell-Bennett
- Division of Health Promotion & Behavioral Sciences, Brownsville Regional Campus, School of Public Health, University of Texas Health Science Center, 80 Fort Brown, Brownsville, TX 78520, USA; (B.M.R.); (L.A.M.-B.)
- Hispanic Health Research Center, School of Public Health, University of Texas Health Science Center, 1 West University Blvd., Brownsville, TX 78520, USA; (A.C.D.); (A.G.O.-D.T.)
| | - Minjae Lee
- Division of Biostatistics, Department of Population & Data Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, USA;
| | - Tianlin Xu
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, 1200 Pressler Street, Houston, TX 77030, USA; (T.X.); (S.K.P.)
| | - Amanda C. Davé
- Hispanic Health Research Center, School of Public Health, University of Texas Health Science Center, 1 West University Blvd., Brownsville, TX 78520, USA; (A.C.D.); (A.G.O.-D.T.)
| | - Soo Kyung Park
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, 1200 Pressler Street, Houston, TX 77030, USA; (T.X.); (S.K.P.)
| | - Alma G. Ochoa-Del Toro
- Hispanic Health Research Center, School of Public Health, University of Texas Health Science Center, 1 West University Blvd., Brownsville, TX 78520, USA; (A.C.D.); (A.G.O.-D.T.)
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da Rosa MC, Rosa CB, Boff RDM, Oliveira MS, Schwanke CHA. Transtheoretical model for lifestyle changes in older persons: a systematic review protocol. Ann N Y Acad Sci 2021; 1508:172-177. [PMID: 34741550 DOI: 10.1111/nyas.14714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/08/2021] [Indexed: 11/26/2022]
Abstract
Adherence to lifestyle changes is a major challenge for healthcare professionals. The transtheoretical model (TTM) was proposed to promote behavioral changes, used in different health conditions (smoking, alcoholism, drug addiction, and obesity) and age groups. However, the effectiveness of the model in older persons is not yet known. This systematic review protocol follows the PRISMA-P guidance. The question the review will address is, Are interventions based on the TTM, compared with conventional interventions, associated with lifestyle changes in older adults? Databases MEDLINE/PubMed, EMBASE, LILACS, CENTRAL, WoS, and PsycINFO will be searched. Randomized clinical controlled trials and quasi-experimental studies describing the effectiveness of TTM-based interventions in changing the lifestyle of individuals aged 65 and over, compared with conventional interventions for lifestyle changes, will be included. Studies that do not address the stages of change characteristic of TTM or that use pharmacological interventions as a comparator will be excluded. Reviewers independently will screen papers for eligibility criteria, and, extracting data, assess the risk of bias for included studies and will evaluate the overall quality of evidence (GRADE system). If possible, a meta-analysis will be conducted. Otherwise, a narrative synthesis will be prepared according to the SWiM guideline.
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Affiliation(s)
- Melissa Côrtes da Rosa
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Rio Grande do Sul, Brazil
| | - Carolina Böettge Rosa
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Rio Grande do Sul, Brazil
| | | | - Margareth Silva Oliveira
- Graduate Program in Psychology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Rio Grande do Sul, Brazil
| | - Carla Helena Augustin Schwanke
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Rio Grande do Sul, Brazil.,Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Rio Grande do Sul, Brazil
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Jiménez-Zazo F, Romero-Blanco C, Castro-Lemus N, Dorado-Suárez A, Aznar S. Transtheoretical Model for Physical Activity in Older Adults: Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249262. [PMID: 33322327 PMCID: PMC7763623 DOI: 10.3390/ijerph17249262] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 12/11/2022]
Abstract
Healthy aging makes the practice of physical activity (PA) a necessity. However, PA guidelines achievement in older adults is scarce. The use of behavioral theories such as Transtheoretical Model (TTM), helps in older adults PA promotion. The aim of this review was to identify the use of TTM for PA in older adults (>60 years). PubMed, SPORTdiscus, and Medline databases were used to conduct the search. All steps of the process followed the recommendations of the PRISMA flow-diagram. We identified eight studies: Six were descriptive cross-sectional studies, one prospective-cohort study and one with a quasi-experimental design. Only two papers evaluated the four behavior change dimensions within the same study, three evaluated the processes of change and the decisional balance, four evaluated the exercise self-efficacy and all assessed the stages of change for PA behavior. From this review, we can conclude that TTM is a useful and suitable behavior model in creating, developing, and evaluating interventions with the aim of acquiring and improving PA habits in the older adults. However, there is paucity of research in this area, and more studies including the four behavioral change dimensions are needed to analyze the effect of TTM on the promotion of PA in the older adults.
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Affiliation(s)
- Fabio Jiménez-Zazo
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (F.J.-Z.); (A.D.-S.)
| | - Cristina Romero-Blanco
- PAFS Research Group, Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | - Nuria Castro-Lemus
- FENIX Research Group, Faculty of Sports Sciences, University of Sevilla, 41004 Sevilla, Spain;
| | - Alberto Dorado-Suárez
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (F.J.-Z.); (A.D.-S.)
| | - Susana Aznar
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (F.J.-Z.); (A.D.-S.)
- Correspondence:
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14
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The Effectiveness of the Transtheoretical Model to Improve Physical Activity in Healthy Adults: A Systematic Review. J Phys Act Health 2020; 18:94-108. [PMID: 33260143 DOI: 10.1123/jpah.2020-0334] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Despite the known risks of physical inactivity, only 50% of adults meet the recommended guidelines for physical activity (PA). Therefore, numerous interventions have been designed to increase PA across a lifespan. The purpose of this systematic review was to determine the effectiveness of interventions based on the transtheoretical model to improve PA in healthy adults. METHODS Electronic databases (CINAHL, MEDLINE, Psychology & Behavioral Sciences Collection, PsycINFO, Sociological Collection, and SPORTDiscus) were systematically searched from January 2001 to May 2020. RESULTS A total of 11 randomized pretest-posttest studies were included in this review. Ten studies utilized a subjective measurement of PA, and 3 studies included an objective measure. Five studies demonstrated significant improvements in PA for the transtheoretical model-based intervention groups compared with control/comparison groups; however, 6 studies demonstrated no differences between groups. CONCLUSION The findings suggest that there is inconsistent evidence to support the use of interventions based on the transtheoretical model to improve PA in adult populations. Interventions were more successful when materials were delivered via in-person counseling and when study participants were in the precontemplation or contemplation phases at baseline.
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Taylor AH, Taylor RS, Ingram WM, Anokye N, Dean S, Jolly K, Mutrie N, Lambert J, Yardley L, Greaves C, King J, McAdam C, Steele M, Price L, Streeter A, Charles N, Terry R, Webb D, Campbell J, Hughes L, Ainsworth B, Jones B, Jane B, Erwin J, Little P, Woolf A, Cavanagh C. Adding web-based behavioural support to exercise referral schemes for inactive adults with chronic health conditions: the e-coachER RCT. Health Technol Assess 2020; 24:1-106. [PMID: 33243368 DOI: 10.3310/hta24630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND There is modest evidence that exercise referral schemes increase physical activity in inactive individuals with chronic health conditions. There is a need to identify additional ways to improve the effects of exercise referral schemes on long-term physical activity. OBJECTIVES To determine if adding the e-coachER intervention to exercise referral schemes is more clinically effective and cost-effective in increasing physical activity after 1 year than usual exercise referral schemes. DESIGN A pragmatic, multicentre, two-arm randomised controlled trial, with a mixed-methods process evaluation and health economic analysis. Participants were allocated in a 1 : 1 ratio to either exercise referral schemes plus e-coachER (intervention) or exercise referral schemes alone (control). SETTING Patients were referred to exercise referral schemes in Plymouth, Birmingham and Glasgow. PARTICIPANTS There were 450 participants aged 16-74 years, with a body mass index of 30-40 kg/m2, with hypertension, prediabetes, type 2 diabetes, lower limb osteoarthritis or a current/recent history of treatment for depression, who were also inactive, contactable via e-mail and internet users. INTERVENTION e-coachER was designed to augment exercise referral schemes. Participants received a pedometer and fridge magnet with physical activity recording sheets, and a user guide to access the web-based support in the form of seven 'steps to health'. e-coachER aimed to build the use of behavioural skills (e.g. self-monitoring) while strengthening favourable beliefs in the importance of physical activity, competence, autonomy in physical activity choices and relatedness. All participants were referred to a standard exercise referral scheme. PRIMARY OUTCOME MEASURE Minutes of moderate and vigorous physical activity in ≥ 10-minute bouts measured by an accelerometer over 1 week at 12 months, worn ≥ 16 hours per day for ≥ 4 days including ≥ 1 weekend day. SECONDARY OUTCOMES Other accelerometer-derived physical activity measures, self-reported physical activity, exercise referral scheme attendance and EuroQol-5 Dimensions, five-level version, and Hospital Anxiety and Depression Scale scores were collected at 4 and 12 months post randomisation. RESULTS Participants had a mean body mass index of 32.6 (standard deviation) 4.4 kg/m2, were referred primarily for weight loss and were mostly confident self-rated information technology users. Primary outcome analysis involving those with usable data showed a weak indicative effect in favour of the intervention group (n = 108) compared with the control group (n = 124); 11.8 weekly minutes of moderate and vigorous physical activity (95% confidence interval -2.1 to 26.0 minutes; p = 0.10). Sixty-four per cent of intervention participants logged on at least once; they gave generally positive feedback on the web-based support. The intervention had no effect on other physical activity outcomes, exercise referral scheme attendance (78% in the control group vs. 75% in the intervention group) or EuroQol-5 Dimensions, five-level version, or Hospital Anxiety and Depression Scale scores, but did enhance a number of process outcomes (i.e. confidence, importance and competence) compared with the control group at 4 months, but not at 12 months. At 12 months, the intervention group incurred an additional mean cost of £439 (95% confidence interval -£182 to £1060) compared with the control group, but generated more quality-adjusted life-years (mean 0.026, 95% confidence interval 0.013 to 0.040), with an incremental cost-effectiveness ratio of an additional £16,885 per quality-adjusted life-year. LIMITATIONS A significant proportion (46%) of participants were not included in the primary analysis because of study withdrawal and insufficient device wear-time, so the results must be interpreted with caution. The regression model fit for the primary outcome was poor because of the considerable proportion of participants [142/243 (58%)] who recorded no instances of ≥ 10-minute bouts of moderate and vigorous physical activity at 12 months post randomisation. FUTURE WORK The design and rigorous evaluation of cost-effective and scalable ways to increase exercise referral scheme uptake and maintenance of moderate and vigorous physical activity are needed among patients with chronic conditions. CONCLUSIONS Adding e-coachER to usual exercise referral schemes had only a weak indicative effect on long-term rigorously defined, objectively assessed moderate and vigorous physical activity. The provision of the e-coachER support package led to an additional cost and has a 63% probability of being cost-effective based on the UK threshold of £30,000 per quality-adjusted life-year. The intervention did improve some process outcomes as specified in our logic model. TRIAL REGISTRATION Current Controlled Trials ISRCTN15644451. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 63. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Adrian H Taylor
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Rod S Taylor
- University of Exeter Medical School, University of Exeter, Exeter, UK.,Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Wendy M Ingram
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Nana Anokye
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Sarah Dean
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Jeffrey Lambert
- University of Exeter Medical School, University of Exeter, Exeter, UK.,Department for Health, University of Bath, Bath, UK
| | - Lucy Yardley
- School of Social and Community Medicine, University of Bristol, Bristol, UK.,Centre for Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Colin Greaves
- University of Exeter Medical School, University of Exeter, Exeter, UK.,School of Sport, Exercise and Rehabilitation, University of Birmingham, Birmingham, UK
| | - Jennie King
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Chloe McAdam
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Mary Steele
- Centre for Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Lisa Price
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Adam Streeter
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | | | - Rohini Terry
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Douglas Webb
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK.,Bristol Medical School, University of Bristol, Bristol, UK
| | - John Campbell
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Lucy Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Ben Ainsworth
- Centre for Applications of Health Psychology, University of Southampton, Southampton, UK.,Department of Psychology, University of Bath, Bath, UK
| | - Ben Jones
- Faculty of Health, Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Ben Jane
- School of Sport, Health and Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Jo Erwin
- Bone and Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - Paul Little
- Centre for Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Anthony Woolf
- Bone and Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
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Xu Z, Geng J, Zhang S, Zhang K, Yang L, Li J, Li J. A Mobile-Based Intervention for Dietary Behavior and Physical Activity Change in Individuals at High Risk for Type 2 Diabetes Mellitus: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e19869. [PMID: 33141092 PMCID: PMC7671838 DOI: 10.2196/19869] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/22/2020] [Accepted: 10/02/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Intensive lifestyle modifications have proved effective in preventing type 2 diabetes mellitus (T2DM), yet the efficiency and effectiveness of these modifications need to be improved. Emerging social media interventions are considered useful in promoting these lifestyles; nevertheless, few studies have investigated the effectiveness of combining them with behavior theory. OBJECTIVE This study aims to examine the effectiveness of a 6-month mobile-based intervention (DHealthBar, a WeChat applet) combined with behavioral theory compared with a printed intervention in improving dietary behaviors, physical activity, and intention to change these behaviors among populations at high risk for T2DM. METHODS Participants aged 23 to 67 years were recruited offline in Beijing, China, and were randomized into the intervention group or the control group, which received educational content via DHealthBar or a printed handbook, respectively. Educational materials were culturally tailored recommendations on improving dietary behaviors, physical activity, and intention to change based on the transtheoretical model. Participants in the intervention arm received push notifications twice per week on WeChat and had access to the educational content for the 6-month study period. Participants in the control arm received the same intervention content through printed materials. The outcomes of participants' behavior change, intention to change behavior, and anthropometric characteristics were collected via online measuring tools at baseline, 3 months, and 6 months. RESULTS In this study, 79 enrolled individuals completed baseline information collection (control: n=38 vs intervention: n=41), and 96% (76/79) completed the 6-month follow-up visit. Attrition rates did not differ significantly between the 2 groups (χ21=0.0, P=.61). Baseline equivalence was found. Participants in both groups reported a statistically significant decrease in energy intake at the 2 follow-up assessments compared with baseline (3 months, control: exp[β]=0.83, 95% CI 0.74-0.92 vs intervention: exp[β]=0.76, 95% CI 0.68-0.85; 6 months, control: exp[β]=0.87, 95% CI 0.78-0.96 vs intervention: exp[β]=0.57, 95% CI 0.51-0.64). At 6 months, a significantly larger decrease was observed in the intervention group in energy, fat, and carbohydrate intake, accompanied with a significantly larger increase in moderate-intensity physical activity compared with the control group (energy: exp[β]=0.66, 95% CI 0.56-0.77; fat: exp[β]=0.71, 95% CI 0.54-0.95; carbohydrates: exp[β]=0.83, 95% CI 0.66-1.03; moderate-intensity physical activity: exp[β]=2.05, 95% CI 1.23-3.44). After 6 months of the intervention, participants in the intervention group were more likely to be at higher stages of dietary behaviors (exp[β]=26.80, 95% CI 3.51-204.91) and physical activity (exp[β]=15.60, 95% CI 2.67-91.04) than the control group. CONCLUSIONS DHealthBar was initially effective in improving dietary behavior, physical activity, and intention to change these behaviors among populations who were at high risk of developing T2DM, with significant differences in the changes of outcomes over the 6-month intervention period. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000032323; https://tinyurl.com/y4h8q4uf.
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Affiliation(s)
- Zidu Xu
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,School of Nursing, Peking Union Medical College, Beijing, China
| | - Ji Geng
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Shuai Zhang
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Kexin Zhang
- Nursing Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Yang
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Li
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Jiao Li
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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17
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André N, Agbangla NF. Are Barriers the Same Whether I Want to Start or Maintain Exercise? A Narrative Review on Healthy Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176247. [PMID: 32867337 PMCID: PMC7504162 DOI: 10.3390/ijerph17176247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/15/2020] [Accepted: 08/24/2020] [Indexed: 11/16/2022]
Abstract
To help older adults begin or adhere to regular physical exercise, several studies have endeavored to identify barriers to active behavior. However, there is a lack of information about barriers for active older people. In addition, most of the reviews of the literature compare only active people to inactive or sedentary people without examining in detail the barriers with respect to the degree of commitment to behavioral change. Finally, there is no consistency in the results of studies investigating the effects of barriers on the relationship between stages of change and exercise behavior. The first aim of this narrative review is to compare barriers that affect exercise stages of change from those that affect levels of exercise behavior in a healthy older population and the factors that can lead to relapse or dropout; the second aim is to identify the extent to which barriers hinder the relationships between stages of change and exercise behaviors. The results showed that barriers are well identified in sedentary people and in the first two stages of change (pre-contemplation and contemplation) compared to active seniors and other stages of change (preparation, action and maintenance). Consistency between the formulations of the different stages in comparison with the transtheoretical model and the definition of barriers and the limitations of measuring physical activity in the different studies are discussed. Finally, novel perspectives of research are proposed to address the flaws in the reviewed studies.
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Affiliation(s)
- Nathalie André
- Centre de Recherches sur la Cognition et l’Apprentissage (UMR CNRS 7295), Université de Poitiers, 86000 Poitiers, France
- Maison des Sciences de l’Homme et de la Société, USR CNRS 3565, Université de Poitiers, 86000 Poitiers, France
- Correspondence: (N.A.); (N.F.A.); Tel.: +33-549-454-679 (N.A.)
| | - Nounagnon Frutueux Agbangla
- Université de Paris, EA 3625-Institut des Sciences du Sport-Santé de Paris (I3SP), 75015 Paris, France
- Unité de Recherche Pluridisciplinaire Sport Santé Société (URePSSS), ULR 7369, Univ. Artois, Univ. Lille, Univ. Littoral Côte d’Opale, F-59000 Lille, France
- Correspondence: (N.A.); (N.F.A.); Tel.: +33-549-454-679 (N.A.)
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Davergne T, Rakotozafiarison A, Servy H, Gossec L. Wearable Activity Trackers in the Management of Rheumatic Diseases: Where Are We in 2020? SENSORS (BASEL, SWITZERLAND) 2020; 20:E4797. [PMID: 32854412 PMCID: PMC7506912 DOI: 10.3390/s20174797] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/14/2020] [Accepted: 08/24/2020] [Indexed: 12/26/2022]
Abstract
In healthcare, physical activity can be monitored in two ways: self-monitoring by the patient himself or external monitoring by health professionals. Regarding self-monitoring, wearable activity trackers allow automated passive data collection that educate and motivate patients. Wearing an activity tracker can improve walking time by around 1500 steps per day. However, there are concerns about measurement accuracy (e.g., lack of a common validation protocol or measurement discrepancies between different devices). For external monitoring, many innovative electronic tools are currently used in rheumatology to help support physician time management, to reduce the burden on clinic time, and to prioritize patients who may need further attention. In inflammatory arthritis, such as rheumatoid arthritis, regular monitoring of patients to detect disease flares improves outcomes. In a pilot study applying machine learning to activity tracker steps, we showed that physical activity was strongly linked to disease flares and that patterns of physical activity could be used to predict flares with great accuracy, with a sensitivity and specificity above 95%. Thus, automatic monitoring of steps may lead to improved disease control through potential early identification of disease flares. However, activity trackers have some limitations when applied to rheumatic patients, such as tracker adherence, lack of clarity on long-term effectiveness, or the potential multiplicity of trackers.
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Affiliation(s)
- Thomas Davergne
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (UMRS 1136), 75013 Paris, France;
| | | | - Hervé Servy
- E-Health Services Sanoïa, 13420 Gémenos, France;
| | - Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (UMRS 1136), 75013 Paris, France;
- APHP, Rheumatology Department, Pitié Salpêtrière Hospital, 75013 Paris, France;
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Honda H, Igaki M, Tanaka SI, Ono K, Hirota Y. Impact of Self-Reported Sitting Time and Transtheoretical Model Based on Exercise Behavior Change on Glycemic and Weight Control in Japanese Adults with Type 1 Diabetes: A Cross-Sectional Study. Healthcare (Basel) 2020; 8:healthcare8020105. [PMID: 32331210 PMCID: PMC7348764 DOI: 10.3390/healthcare8020105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/11/2020] [Accepted: 04/20/2020] [Indexed: 12/04/2022] Open
Abstract
This cross-sectional study aimed to examine the associations among self-reported sitting time (ST), transtheoretical model (TTM) based on exercise behavior change, and glycemic and weight control in Japanese adults with type 1 diabetes (T1D). Forty-two adults (age, 44.0 (33.3–56.8) years) with uncomplicated T1D answered questions regarding their lifestyles, including ST per day, and TTM using self-administered questionnaires. The glycated hemoglobin (HbA1c) level correlated with age and ST (p < 0.05, p < 0.01, respectively), whereas body mass index correlated with duration of T1D and TTM (p < 0.05, p < 0.01, respectively). Logistic regression analysis showed that poor glycemic control (HbA1c, >7%) was associated with ST (odds ratio, 3.53 (95% confidence interval, 1.54–8.11), p < 0.01). In addition, the cut-off points for quartiles of ST were 4.6, 6.0, and 8.0 h/day, and the HbA1c level in the lowest quartile was 15% lower than that in the highest quartile (p < 0.01). Although further studies with larger samples are needed, these results implied that expanded self-reported ST might be related to poor glycemic control in Japanese T1D adults, most of whom were lean, young and middle-aged, regardless of TTM based on exercise behavior change.
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Affiliation(s)
- Hiroto Honda
- Department of Physical Therapy, Aino University, Ibaraki 567-0012, Japan
- Correspondence: ; Tel.: +81-72-627-1711
| | - Makoto Igaki
- Department of Rehabilitation, Toyooka Hospital Hidaka Medical Center, Toyooka 669-5392, Japan
| | - Shin-ichiro Tanaka
- Department of Internal Medicine, Toyooka Hospital Hidaka Medical Center, Toyooka 669-5392, Japan
| | - Kumiko Ono
- Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan
| | - Yushi Hirota
- Division of Diabetes and Endocrinology, The Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
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Kuan G, Sabo A, Sawang S, Kueh YC. Factorial validity, measurement and structure invariance of the Malay language decisional balance scale in exercise across gender. PLoS One 2020; 15:e0230644. [PMID: 32187222 PMCID: PMC7080256 DOI: 10.1371/journal.pone.0230644] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/04/2020] [Indexed: 11/18/2022] Open
Abstract
Background This study examined the psychometric properties of the Malay version of the decisional balance (DB-M) for exercise (i.e. perceived benefits and perceived barriers) using a cross-sectional design. Also, this study assessed the measurement and structural invariance of the DB-M across gender. Methods The study sample consisted of 750 students (female: 51.7%, male: 48.3%), with a mean age of 20.2 years (SD = 1.2). Decision balance (DB) scale was assessed with the 10-item DB-M. Standard forward-backward translation was performed to translate the English version of the DB into Malay version (DB-M). Results The confirmatory factor analysis (CFA) results based on the hypothesised measurement model of two factors and ten items demonstrated adequate factor structure after the addition of some correlated item residuals (comparative fit index (CFI) = .979, Tucker and Lewis index (TLI) = .969, standardised root mean square residual (SRMR) = .037, root mean square error of approximation (RMSEA) = .047). The construct reliability and average variance extracted values were .850 and .839, and .542 and .538, for perceived benefits and perceived barriers, respectively. Meanwhile, the Cronbach’s alpha was .857 and .859, and the intraclass correlation coefficient for test-retest reliability was .979 and .960 for perceived benefits and perceived barriers respectively. The findings provided evidence for measurement invariance of DB-M for the male and female samples. The final CFA model fit the data well for both male sample (CFI = .975, TLI = .964, SRMR = .040, RMSEA = .052) and female sample (CFI = .965, TLI = .949, SRMR = .044, RMSEA = .058). Conclusions The translated version of the DB-M was valid and reliable for assessing the level of perceived benefits and perceived barriers in exercise among university students in Malaysia.
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Affiliation(s)
- Garry Kuan
- Exercise and Sports Science, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
- * E-mail: (GK); (YCK)
| | - Abdulwali Sabo
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Sukanlaya Sawang
- International Centre for Transformational Entrepreneurship, Coventry University, Coventry, United Kingdom
| | - Yee Cheng Kueh
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- * E-mail: (GK); (YCK)
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Alzeidan R, Shata Z, Hassounah MM, Baghdadi LR, Hersi A, Fayed A, Kashour T, Elmorshedy H. Effectiveness of digital health using the transtheoretical model to prevent or delay type 2 diabetes in impaired glucose tolerance patients: protocol for a randomized control trial. BMC Public Health 2019; 19:1550. [PMID: 31752774 PMCID: PMC6873582 DOI: 10.1186/s12889-019-7921-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/08/2019] [Indexed: 01/22/2023] Open
Abstract
Background There is high prevalence of prediabetes and type 2 diabetes mellitus (T2DM) in Saudi Arabia that is still increasing. Early diagnosis of prediabetes, and immediate, effective intervention is yet unestablished. Conventional health promotion approaches are used to educate prediabetic patients. Behavior modification is very effective in prediabetics to delay T2DM. Thus, the main objective of this study is to examine the effect of the new behavioral model, the Transtheoretical Model short messages (text 4 change) to modify lifestyle to prevent or delay the onset of T2DM, through promotion of a healthy diet and increased physical activity, in impaired glucose tolerance patients. Another objective is to estimate the impact of this model on markers of cardiovascular and metabolic risks as T2DM is one of the modifiable risk factors to prevent cardiovascular diseases. Methods This is a randomized controlled trial. One thousand and sixteen, eligible Saudi adults will be recruited from the Heart Health Promotion study (HHP), which was conducted at the King Saud University from July 2013 to April 2014. These adults were at a higher risk of developing T2DM within 2–3 years. The research team’s database has a contact list and they will recruit individuals over 6–8 weeks. All participants will be randomized at a 1:1 ratio into two groups, receive group education about lifestyle modifications and written information about diet and physical activity. Text 4 change SMS texts will be sent only to the intervention group. All participants will be assessed at baseline, 6, 12, 18, 24, 30, and 36 months for behavioral change using a World Health Organization (WHO) STEPS questionnaire and for glycated hemoglobin, biochemical and anthropometric measurements using standard methods. Discussion This new approach for promoting the importance of behavior modification in prediabetics is expected to delay and/or prevent the development of T2DM in Saudi Arabia, subsequently reducing the risk of cardiovascular morbidity and mortality too. Results from this study will promote an innovative and high-tech way to decrease the burden of cardiovascular diseases in Saudi Arabia. Trial registration International Standard Randomized Control Trial, registration number ISRCTN10857643. Registered 4 June, 2018.
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Affiliation(s)
- Rasmieh Alzeidan
- Cardiac Sciences Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Zeinab Shata
- High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Marwah Mazen Hassounah
- Community Medicine Unit, Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Leena Rashad Baghdadi
- Department of Family and Community Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia.
| | - Ahmad Hersi
- Cardiac Sciences Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amel Fayed
- High Institute of Public Health, Alexandria University, Alexandria, Egypt.,Princess Nourah Bint Abdulrahman University, College of Medicine, Riyadh, Saudi Arabia
| | - Tarek Kashour
- Cardiac Sciences Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hala Elmorshedy
- High Institute of Public Health, Alexandria University, Alexandria, Egypt.,Princess Nourah Bint Abdulrahman University, College of Medicine, Riyadh, Saudi Arabia
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The Effect of Brain Breaks on Physical Activity Behaviour among Primary School Children: A Transtheoretical Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214283. [PMID: 31690004 PMCID: PMC6862123 DOI: 10.3390/ijerph16214283] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 11/17/2022]
Abstract
Brain Breaks Physical Activity Solutions (BBPAS) is a web-based structured physical activity (PA) video that is specifically designed for school settings and can stimulate a student’s health and learning. The purpose of this study is to measure the effect of BBPAS on the stages of change, decisional balance, processes of change, self-efficacy and leisure-time exercise among Malay ethnic primary school children. A validated Malay version of three of the five constructs was derived with sound validity and was used in the present study. A total of 159 male and 163 female children aged 10 to 11 years old, mean (SD) = 10.53 (0.50), were recruited from two schools in Kelantan, Malaysia. Purposive sampling was used to divide the children into intervention (n = 177) and control (n = 145) groups. Children in the intervention group underwent BBPAS activity for an accumulated 30 min per week, while children in the control group were not involved in the BBPAS intervention. Mixed factorial analysis of variance (ANOVA) was used to examine the effect of BBPAS on the study variables. A mixed ANOVA showed significant changes (time effect) on cognitive process, F(1, 320) = 5.768, p-value = 0.017; behavioural process, F(1, 313) = 5.736, p-value = 0.017; and internal feeling, F(1, 312) = 6.050, p-value = 0.014. There was also a significant difference between groups on cons, F(1, 316) = 7.504, p-value = 0.007. A significant interaction effect was observed for stages of change, F(1, 319) = 7.861, p-value = 0.005; pros, F(1, 316) = 31.311, p-value = 0.001; internal feeling, F(1, 312) = 4.692, p-value = 0.031; and behavioural process, F(1, 313) = 7.312, p-value = 0.007. In conclusion, BBPAS was successful in improving four of the five constructs, and thus, should be recommended to be used in schools throughout Malaysia.
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Nigg CR, Harmon B, Jiang Y, Ginis KAM, Motl RW, Dishman RK. Temporal Sequencing of Physical Activity Change Constructs within the Transtheoretical Model. PSYCHOLOGY OF SPORT AND EXERCISE 2019; 45:101557. [PMID: 34421367 PMCID: PMC8376077 DOI: 10.1016/j.psychsport.2019.101557] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Studies support the Transtheoretical Model's (TTM) ability to describe behavior change processes and guide interventions; however, the temporal sequencing of constructs is less understood. This cohort study tested five sequences to identify TTM construct changes related to physical activity. METHODS A random sample provided baseline data (n=689; 63% female; M age (SD)=47(17); 37% white), with 401 participants providing 24-month data, at six-month intervals. RESULTS Structural equation models revealed processes to cognitions to stage (AIC=29313.093, BIC=29514.883, CFI=0.999, RMSEA=0.006, SRMR=0.026); processes to stage to cognitions (AIC=27788.651, BIC=27973.268, CFI=0.978, RMSEA=0.024, SRMR=0.038), self-efficacy/temptations to processes to decisional balance to stage (AIC=13914.771, BIC=14031.169, CFI=0.981, RMSEA=0.018, SRMR=0.034), and stage to processes to cognitions (AIC=22048.324, BIC=22212.986, CFI=0.976, RMSEA=0.026, SRMR=0.029) all fit well. However, cognitions to processes to stage did not fit the data well (AIC=10353.555, BIC=10444.179, CFI=0.937, RMSEA=0.038, SRMR=0.035). CONCLUSIONS Integrating results revealed a cyclical model so that intervention efforts should focus on processes to change cognitions related to barrier self-efficacy and decisional balance, which then lead to change in stage and then renew focus on the processes.
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Affiliation(s)
- Claudio R. Nigg
- Office of Public Health Studies, University of Hawaii, 1960 East-West Road Honolulu, HI 96822, USA & Institute for Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Brook Harmon
- School of Public Health, University of Memphis, Robison Hall, Memphis, TN 38152, USA
| | - Yu Jiang
- School of Public Health, University of Memphis, Robison Hall, Memphis, TN 38152, USA
| | - Kathleen A. Martin Ginis
- School of Health and Exercise Science, The University of British Columbia, ART360 1147 Research Road, Kelowna, BC Canada V1V 1V7
| | - Robert W. Motl
- School of Health Professions, University of Alabama at Birmingham, 1716 9th Avenue South SHPB 336 Birmingham, AL 38233, USA
| | - Rodney K. Dishman
- College of Education, University of Georgia, 115I Ramsey Center, 330 River Road Athens, Georgia 30602, USA
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Jansson ASB, Carlsson G. Physical activity on prescription at the time of stroke or transient ischemic attack diagnosis - from a patient perspective. Disabil Rehabil 2019; 43:1121-1128. [PMID: 31522573 DOI: 10.1080/09638288.2019.1650296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Physical activity is known to reduce the risk of recurrent stroke. Despite this many individuals diagnosed with stroke have an insufficient level of physical activity. Physical activity on prescription is provided within healthcare to encourage increased physical activity. PURPOSE To examine individuals' experiences of physical activity on prescription at the time of stroke or transient ischemic attack diagnosis and explore various factors affecting the ability to follow the prescription. MATERIAL AND METHOD A qualitative approach was undertaken; using interviews, analyzed with content analysis to elicit information from individuals who had been admitted to a stroke unit due to stroke or transient ischemic attack. RESULTS Five women and five men (median age 60.5 years), eight with stroke and two with TIA (median NIHSS at onset 2.5), participated and the analysis resulted in an overall theme Change of life-style through physical activity on prescription - a multifaceted process containing the categories Experience of support, Barriers and opportunities and Personal motivators. CONCLUSION Individuals need to participate in the prescription process when prescription on physical activity is initiated in acute stroke care and clinicians need to reflect on how the prescription is implemented and followed-up; creating good conditions for long-term effects.IMPLICATIONS FOR REHABILITATIONWhen prescribing physical activity on prescription healthcare providers in acute stroke care need to consider:• The right timing: when and how physical activity on prescription should be given.• How to create opportunities for individuals to participate in the prescription process.• How to create individual adaptation of the prescription.• How to ensure that follow-up is conducted by registered healthcare professionals with knowledge of physical activity as disease prevention.
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Affiliation(s)
- Ann-Sofie B Jansson
- Department of Occupational Therapy and Physiotherapy, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunnel Carlsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Nagaraju AS, Tondare D, Gopichandran V. What makes patients with diabetes adopt physical activity behaviors?—a transtheoretical model approach. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00730-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Engl E, Sgaier SK. CUBES: A practical toolkit to measure enablers and barriers to behavior for effective intervention design. Gates Open Res 2019. [DOI: 10.12688/gatesopenres.12923.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A pressing goal in global development and other sectors is often to understand what drives people’s behaviors, and how to influence them. Yet designing behavior change interventions is often an unsystematic process, hobbled by insufficient understanding of contextual and perceptual behavioral drivers and a narrow focus on limited research methods to assess them. We propose a toolkit (CUBES) of two solutions to help programs arrive at more effective interventions. First, we introduce a novel framework of behavior, which is a practical tool for programs to structure potential drivers and match corresponding interventions. This evidence-based framework was developed through extensive cross-sectoral literature research and refined through application in large-scale global development programs. Second, we propose a set of descriptive, experimental, and simulation approaches that can enhance and expand the methods commonly used in global development. Since not all methods are equally suited to capture the different types of drivers of behavior, we present a decision aid for method selection. We recommend that existing commonly used methods, such as observations and surveys, use CUBES as a scaffold and incorporate validated measures of specific types of drivers in order to comprehensively test all the potential components of a target behavior. We also recommend under-used methods from sectors such as market research, experimental psychology, and decision science, which programs can use to extend their toolkit and test the importance and impact of key enablers and barriers. The CUBES toolkit enables programs across sectors to streamline the process of conceptualizing, designing, and optimizing interventions, and ultimately to change behaviors and achieve targeted outcomes.
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Engl E, Sgaier SK. CUBES: A practical toolkit to measure enablers and barriers to behavior for effective intervention design. Gates Open Res 2019; 3:886. [PMID: 31294419 PMCID: PMC6601426 DOI: 10.12688/gatesopenres.12923.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2019] [Indexed: 02/04/2023] Open
Abstract
A pressing goal in global development and other sectors is often to understand what drives people’s behaviors, and how to influence them. Yet designing behavior change interventions is often an unsystematic process, hobbled by insufficient understanding of contextual and perceptual behavioral drivers and a narrow focus on limited research methods to assess them. We propose a toolkit (CUBES) of two solutions to help programs arrive at more effective interventions. First, we introduce a novel framework of behavior, which is a practical tool for programs to structure potential drivers and match corresponding interventions. This evidence-based framework was developed through extensive cross-sectoral literature research and refined through application in large-scale global development programs. Second, we propose a set of descriptive, experimental, and simulation approaches that can enhance and expand the methods commonly used in global development. Since not all methods are equally suited to capture the different types of drivers of behavior, we present a decision aid for method selection. We recommend that existing commonly used methods, such as observations and surveys, use CUBES as a scaffold and incorporate validated measures of specific types of drivers in order to comprehensively test all the potential components of a target behavior. We also recommend under-used methods from sectors such as market research, experimental psychology, and decision science, which programs can use to extend their toolkit and test the importance and impact of key enablers and barriers. The CUBES toolkit enables programs across sectors to streamline the process of conceptualizing, designing, and optimizing interventions, and ultimately to change behaviors and achieve targeted outcomes.
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Affiliation(s)
- Elisabeth Engl
- Surgo Foundation, Washington, District of Columbia, 20001, USA
| | - Sema K Sgaier
- Surgo Foundation, Washington, District of Columbia, 20001, USA.,Department of Global Health & Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Global Health, University of Washington, Seattle, Washington, USA
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Wen S, Li J, Wang A, Lv M, Li H, Lu Y, Zhang J. Effects of transtheoretical model‐based intervention on the self‐management of patients with an ostomy: A randomised controlled trial. J Clin Nurs 2019; 28:1936-1951. [PMID: 30549366 DOI: 10.1111/jocn.14731] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 10/06/2018] [Accepted: 11/30/2018] [Indexed: 01/22/2023]
Affiliation(s)
- Sha‐Li Wen
- Department of Organ Transplantation SurgeryThe Second Xiangya Hospital of Central South University Changsha Hunan China
| | - Juan Li
- Xiangya Nursing School of Central South University Changsha Hunan China
| | - An‐Ni Wang
- Xiangya Nursing School of Central South University Changsha Hunan China
| | - Meng‐Meng Lv
- Xiangya Nursing School of Central South University Changsha Hunan China
| | - Hui‐Yuan Li
- Xiangya Nursing School of Central South University Changsha Hunan China
| | - Yan‐Fang Lu
- Department of Organ Transplantation SurgeryThe Second Xiangya Hospital of Central South University Changsha Hunan China
| | - Jing‐Ping Zhang
- Xiangya Nursing School of Central South University Changsha Hunan China
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Drigny J, Joussain C, Gremeaux V, Morello R, Van Truc PH, Stapley P, Touzé E, Ruet A. Development and Validation of a Questionnaire to Assess Barriers to Physical Activity After Stroke: The Barriers to Physical Activity After Stroke Scale. Arch Phys Med Rehabil 2019; 100:1672-1679. [PMID: 30684487 DOI: 10.1016/j.apmr.2018.12.034] [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] [Received: 03/14/2018] [Revised: 10/23/2018] [Accepted: 12/19/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To develop and validate a self-reported questionnaire assessing the barriers to physical activity (PA) among stroke survivors. DESIGN Psychometric study. SETTING Ambulatory stroke care. PARTICIPANTS A total of one hundred and forty-six (N=146) individuals were included in this study. In stage 1, community-living stroke survivors (n=37; 13 women) with low-moderate disability (modified Rankin Score 0-3, stroke >3mo) were included. In stage 2, participants (n=109; 40 women) with same characteristics were included. Nine professionals experienced in PA for poststroke patients formed an expert panel. INTERVENTIONS In stage 1, semistructured interviews identified perceived barriers to PA, which were then selected by the expert panel and grouped on a Barriers to Physical Activity After Stroke (BAPAS) scale. In stage 2, stroke participants completed a personal information questionnaire and the BAPAS scale. MAIN OUTCOME MEASURES An item selection process with factor analysis was carried out. The suitability of the data set was analyzed using the Kaiser-Meyer-Olkin coefficient, internal consistency was evaluated by Cronbach α, and concurrent validity was assessed with Spearman correlation coefficients between the BAPAS scale and the modified Rankin Scale. Test-retest repeatability was estimated using 2-way random effects intraclass correlation coefficient model 2,1 at 4-6 day follow-up (n=21). RESULTS Factor analysis supported a 14-item BAPAS that explained 62% of total variance (Kaiser-Meyer-Olkin=0.82) and total score calculated higher than 70 (higher scores for higher barriers). Cronbach α was 0.86, Spearman correlation with the modified Rankin Scale was r=0.65 (P<.001), and test-retest intraclass correlation coefficient was 0.91 (95% CI, 0.79-0.97). The BAPAS scores were higher in patients with greater disabilities and in those with a longer time since the stroke event (P<.01). CONCLUSION We developed and validated the BAPAS scale to assess barriers to PA in stroke survivors with low-moderate disability with promising psychometric properties.
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Affiliation(s)
- Joffrey Drigny
- Service de Médecine Physique et de Réadaptation, CHU de Caen, France.
| | - Charles Joussain
- Université de Versailles St-Quentin en Yvelines, INSERM UMR 1179, Montigny-le-Bretonneux, France
| | - Vincent Gremeaux
- Institute of Sport Sciences of University of Lausanne, Lausanne, Switzerland; Swiss Olympic Medical Center, Sport Medicine Unit, Lausanne University Hospital, Lausanne, Switzerland; CIC-P-INSERM 1432, Technological Platform, University Hospital Dijon, France
| | - Remy Morello
- Unité fonctionnelle de Biostatistique et Recherche Clinique (UBRC) CHU de Caen, France
| | - Patrick H Van Truc
- IMPR du Bois-de-Lébisey, allée des Boisselles, 14200 Hérouville Saint-Clair, France
| | - Paul Stapley
- Neural Control of Movement Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Emmanuel Touzé
- Université de Normandie UNICAEN, INSERM UMR-S U1237, Physiopathologie et imagerie des troubles neurologiques PhIND, Cyceron, Caen, France et Service de Neurologie, CHU de Caen, France
| | - Alexis Ruet
- Service de Médecine Physique et de Réadaptation, CHU de Caen, France; Université de Normandie UNICAEN, INSERM UMR-SU1077, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
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Abula K, Gröpel P, Chen K, Beckmann J. Does knowledge of physical activity recommendations increase physical activity among Chinese college students? Empirical investigations based on the transtheoretical model. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:77-82. [PMID: 30356484 PMCID: PMC6180551 DOI: 10.1016/j.jshs.2016.10.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 08/10/2016] [Accepted: 10/08/2016] [Indexed: 06/08/2023]
Abstract
BACKGROUND Based on the transtheoretical model, the current study investigated whether awareness of physical activity (PA) recommendations had an impact on the stages of PA behavior change and levels of PA among Chinese college students. METHODS In Study 1, with a cross-sectional study design, 9826 students were recruited, and their knowledge of international PA recommendations, PA stage distribution, and self-reported PA level were surveyed. Pearson's χ 2 test was used to test whether those participants who were aware and not aware of PA guidelines were equally distributed across the stages of PA behavior, and independent t test was conducted to test the group difference in the actual levels of PA. In Study 2, 279 students who were not aware of the PA recommendations were randomly allocated to either an intervention group or a control group, and only those in the intervention group were presented with international PA guidelines. In both groups, students' PA stages and PA level were examined before the test and then 4 months post-test. McNemar's test for correlated proportions and repeated-measures analysis of variance were conducted to examine the changes in PA stage membership and PA level after the intervention. RESULTS Study 1 results revealed that only 4.4% of the surveyed students had correct knowledge of PA recommendations. Those who were aware of the recommendations were in later stages of PA behavior (χ 2(4) = 167.19, p < 0.001). They were also significantly more physically active than those who were not aware of the recommendations (t(443.71) = 9.00, p < 0.001, Cohen's d = 0.53). Study 2 results demonstrated that the intervention group participants who were at the precontemplation and contemplation stages at the pre-test each progressed further in the PA stages in the post-test (χ 2(1) = 112.06, p < 0.001; χ 2(1) = 118.76, p = 0.03, respectively), although no significant change in PA level was observed (t(139) < 1, p = 0.89). CONCLUSION The results showed that awareness of the PA recommendations was associated with higher stages and levels of PA behavior, and a brief educational exposure to PA recommendations led to improved stages of PA behavior but no change in the levels of PA among Chinese college students. More effective public health campaign strategies are needed to promote the dissemination of the PA recommendations and to raise the awareness of the Chinese student population.
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Affiliation(s)
- Kahar Abula
- Technical University of Munich, München 80992, Germany
| | - Peter Gröpel
- Technical University of Munich, München 80992, Germany
| | - Kai Chen
- South West Jiao Tong University, Chengdu 611756, China
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Romain AJ, Bortolon C, Gourlan M, Carayol M, Decker E, Lareyre O, Ninot G, Boiché J, Bernard P. Matched or nonmatched interventions based on the transtheoretical model to promote physical activity. A meta-analysis of randomized controlled trials. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:50-57. [PMID: 30356472 PMCID: PMC6180552 DOI: 10.1016/j.jshs.2016.10.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 05/24/2016] [Accepted: 08/25/2016] [Indexed: 06/08/2023]
Abstract
PURPOSE The aim of this study was to examine whether the efficacy of transtheoretical model (TTM)-based interventions on physical activity (PA) varied according to the following criteria: (1) interventions targeted the actual stages of change (SOCs) or did not; (2) participants were selected according to their SOC or were not; and (3) its theoretical constructs (decisional balance, temptation, self-efficacy, processes of change). METHODS Thirty-three randomized controlled trials assessing TTM-based interventions promoting PA in adults were systematically identified. RESULTS The between-group heterogeneity statistic (Qb) did not reveal any differential efficacy either in interventions targeting the actual SOC compared with those that did not (Qb = 1.48, p = 0.22) or in interventions selecting participants according to their SOC compared with those that did not (Qb = 0.01, p = 0.91). TTM-based interventions enhanced PA behavior whether they targeted the actual SOC (Cohen's d = 0.36; 95% confidence interval (CI): 0.22-0.49) or not (d = 0.23; 95%CI: 0.09-0.38) and whether they selected their participants according to their SOC (d = 0.33; 95%CI: 0.13-0.53) or not (d = 0.32; 95%CI: 0.19-0.44). The moderators of the efficacy of TTM-based interventions were the number of theoretical constructs used to tailor the intervention (Qb = 8.82, p = 0.003), the use of self-efficacy (Qb = 6.09, p = 0.01), and the processes of change (Qb = 3.51, p = 0.06). CONCLUSION TTM-based interventions significantly improved PA behavior, and their efficacy was not moderated by SOC but by the TTM theoretical constructs.
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Affiliation(s)
- Ahmed Jerôme Romain
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
- University of Montreal Hospital Research Centre, Montreal, Quebec H2X 0A9, Canada
| | - Catherine Bortolon
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
- Unit of Adult Psychiatry, La Colombière, University Hospital of Montpellier, Montpellier 34295, France
| | - Mathieu Gourlan
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
- Prevention Department of Institut Regional du Cancer de Montpellier, Epidaure, Montpellier 34298, France
| | - Marion Carayol
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
| | - Emmanuelle Decker
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
| | - Olivier Lareyre
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
- Prevention Department of Institut Regional du Cancer de Montpellier, Epidaure, Montpellier 34298, France
| | - Grégory Ninot
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
| | - Julie Boiché
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
| | - Paquito Bernard
- EA4556 Laboratory Epsylon–Dynamics of Human Abilities and Health Behaviours, University of Montpellier, Montpellier 34000, France
- Challenge for the Change of Behaviour (CCB) Group, Montpellier 34000, France
- Research Centre of the University Hospital of Quebec, Quebec G1R 2J6, Canada
- Cancer Research Centre, University of Laval, Quebec G1R 3S3, Canada
- School of Psychology, University of Laval, Quebec G1C 0A6, Canada
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McGuckin T, Sealey R, Barnett F. The use and evaluation of a theory-informed, multi-component intervention to reduce sedentary behaviour in the workplace. COGENT PSYCHOLOGY 2017. [DOI: 10.1080/23311908.2017.1411038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Teneale McGuckin
- Sport & Exercise Science, James Cook University, Townsville, Australia
| | - Rebecca Sealey
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Fiona Barnett
- Sport & Exercise Science, James Cook University, Townsville, Australia
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Lemos FMFD, Corte-Real N, Dias C, Fonseca AM. The behavior of practicing sports among nursing students. Rev Esc Enferm USP 2017; 51:e03281. [PMID: 29267733 DOI: 10.1590/s1980-220x2016041003281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 09/04/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Analyzing the frequency patterns of practicing sports, the stages of change phases and the pros and cons of decision-making balance in nursing students related to gender and which year of study they are in. METHOD A cross-sectional, descriptive and exploratory study. RESULTS 535 students of both genders participated in the study. An analysis of the results revealed that 27.6% of the students did not present any frequency of practicing sports; 55.3% of the students did not have a consistent or continuous habit of practicing sports; students overall exhibited a non-existing frequency of practicing sports at similar levels throughout the study cycle; male students presented similar percentages in their positioning in the precontemplation and contemplation stages throughout the study cycle; and throughout all the stages of change phases students showed higher values for pros over cons related to practicing sports. CONCLUSION The results reinforce the relevance for implementing mechanisms for promoting and monitoring nursing students' involvement and regular participation in practicing sports.
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Affiliation(s)
| | - Nuno Corte-Real
- Universidade do Porto, Faculdade de Desporto, Centro de Investigação, Formação, Inovação e Intervenção em Desporto, Porto, Portugal
| | - Cláudia Dias
- Universidade do Porto, Faculdade de Desporto, Centro de Investigação, Formação, Inovação e Intervenção em Desporto, Porto, Portugal
| | - António Manuel Fonseca
- Universidade do Porto, Faculdade de Desporto, Centro de Investigação, Formação, Inovação e Intervenção em Desporto, Porto, Portugal
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Heredia NI, Lee M, Reininger BM. Exposure to a community-wide campaign is associated with physical activity and sedentary behavior among Hispanic adults on the Texas-Mexico border. BMC Public Health 2017; 17:883. [PMID: 29145821 PMCID: PMC5689162 DOI: 10.1186/s12889-017-4893-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/06/2017] [Indexed: 12/21/2022] Open
Abstract
Background Despite evidence for the use of community-wide campaigns to promote physical activity, few evaluations of community–wide campaigns in Hispanic communities exist. This study assessed the associations of exposure to a community-wide campaign with physical activity and sedentary behavior among Hispanic adults living on the Texas-Mexico border. Methods The intervention, Tu Salud ¡Si Cuenta! (Your Health Matters!; TSSC), included a newsletter, community health worker discussion, TV and radio segments, which were conducted from 2005 to 2010. We matched an intervention (N = 399) and a control community (N = 400) on demographics and used a cross-sectional assessment in 2010 with randomly sampled adults from both communities. We collected exposure to the campaign, as well as physical activity and sedentary behavior with the International Physical Activity Questionnaire. We conducted bivariate analyses and multivariable logistic regression models to assess the association of TSSC exposure and its components with meeting moderate-to-vigorous intensity physical activity (MVPA) guidelines and exhibiting excessive sedentary behavior, controlling for covariates. Results As compared to the control community, the intervention community has 3 times the odds of meeting MVPA guidelines (Adjusted OR [AOR] = 3.01, 95% CI = 1.85–4.88, p < .05) and 2 times lower odds of excessive sedentary behavior ((AOR = 0.46, 95% CI = 0.30–0.70, p < .05). Exposure in the intervention group to any component was associated with five times the odds of meeting MVPA guidelines (AOR = 5.10, 95% CI 2.88–9.03, p < .001) and 3 times lower odds of excessive sedentary behavior (AOR = 0.32, 95% CI 0.17–0.60, p < .001), compared with those unexposed in the control community. Exposure to newsletters, CHW discussions and TV segments were associated with significantly lower odds of excessive sedentary behavior and higher odds of meeting MVPA guidelines. Exposure to radio segments was only associated with a significantly higher odds of meeting MVPA guidelines (AOR = 4.21, 95% CI = 1.17–15.09). Conclusions This study provides some evidence of the association of community-wide campaigns and its components in Hispanic communities with higher levels of MVPA and lower levels of excessive sedentary behavior. Trial registration number NCT00788879 Date: November 11, 2008.
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Affiliation(s)
- Natalia I Heredia
- The University of Texas Health Science Center at Houston, School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin St, Suite 2576E, Houston, Texas, 77030, USA.
| | - MinJae Lee
- Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Belinda M Reininger
- The University of Texas Health Science Center at Houston, School of Public Health, Brownsville Regional Campus, Houston, Texas, USA
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Rhodes RE, Rebar AL. Conceptualizing and Defining the Intention Construct for Future Physical Activity Research. Exerc Sport Sci Rev 2017; 45:209-216. [DOI: 10.1249/jes.0000000000000127] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Gaudet J, Gallant F, Bélanger M. A Bit of Fit: Minimalist Intervention in Adolescents Based on a Physical Activity Tracker. JMIR Mhealth Uhealth 2017; 5:e92. [PMID: 28684384 PMCID: PMC5519831 DOI: 10.2196/mhealth.7647] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/05/2017] [Accepted: 05/11/2017] [Indexed: 12/04/2022] Open
Abstract
Background Only 5% of Canadian youth meet the recommended 60 minutes of moderate to vigorous physical activity (MVPA) per day, with leisure time being increasingly allocated to technology usage. Direct-to-consumer mHealth devices that promote physical activity, such as wrist-worn physical activity trackers, have features with potential appeal to youth. Objective The primary purpose of this study was to determine whether a minimalist physical activity tracker-based intervention would lead to an increase in physical activity in young adolescents. A secondary aim of this study was to assess change in physical activity across a 7-week intervention, as measured by the tracker. Methods Using a quasi-experimental crossover design, two groups of 23 young adolescents (aged 13-14 years) were randomly assigned to immediate intervention or delayed intervention. The intervention consisted of wearing a Fitbit-Charge-HR physical activity tracker over a 7-week period. Actical accelerometers were used to measure participants’ levels of MVPA before and at the end of intervention periods for each group. Covariates such as age, sex, stage of change for physical activity behavior, and goal commitment were also measured. Results There was an increase in physical activity over the course of the study period, though it was not related to overall physical activity tracker use. An intervention response did, however, occur in a subset of participants. Specifically, exposure to the physical activity tracker was associated with an average daily increase in MVPA by more than 15 minutes (P=.01) among participants who reported being in the action and maintenance stages of behavior change in relation to participation in physical activity. Participants in the precontemplation, contemplation, and preparation stages of behavior change had no change in their level of MVPA (P=.81). Conclusions These results suggest that physical activity trackers may elicit improved physical activity related behavior in young adolescents demonstrating a readiness to be active. Future studies should seek to investigate if integrating physical activity trackers as part of more intensive interventions leads to greater increases in physical activity across different levels of stages of behavior change and if these changes can be sustained over longer periods of time.
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Affiliation(s)
- Jeffrey Gaudet
- Centre de formation médicale du Nouveau-Brunswick, Moncton, NB, Canada
| | - François Gallant
- Centre de formation médicale du Nouveau-Brunswick, Moncton, NB, Canada.,Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, NB, Canada
| | - Mathieu Bélanger
- Centre de formation médicale du Nouveau-Brunswick, Moncton, NB, Canada.,Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, NB, Canada.,Vitalité Health Network, Moncton, NB, Canada
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Scruggs S, Mama SK, Carmack CL, Douglas T, Diamond P, Basen-Engquist K. Randomized Trial of a Lifestyle Physical Activity Intervention for Breast Cancer Survivors: Effects on Transtheoretical Model Variables. Health Promot Pract 2017. [PMID: 28627254 DOI: 10.1177/1524839917709781] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined whether a physical activity intervention affects transtheoretical model (TTM) variables that facilitate exercise adoption in breast cancer survivors. Sixty sedentary breast cancer survivors were randomized to a 6-month lifestyle physical activity intervention or standard care. TTM variables that have been shown to facilitate exercise adoption and progress through the stages of change, including self-efficacy, decisional balance, and processes of change, were measured at baseline, 3 months, and 6 months. Differences in TTM variables between groups were tested using repeated measures analysis of variance. The intervention group had significantly higher self-efficacy ( F = 9.55, p = .003) and perceived significantly fewer cons of exercise ( F = 5.416, p = .025) at 3 and 6 months compared with the standard care group. Self-liberation, counterconditioning, and reinforcement management processes of change increased significantly from baseline to 6 months in the intervention group, and self-efficacy and reinforcement management were significantly associated with improvement in stage of change. The stage-based physical activity intervention increased use of select processes of change, improved self-efficacy, decreased perceptions of the cons of exercise, and helped participants advance in stage of change. These results point to the importance of using a theory-based approach in interventions to increase physical activity in cancer survivors.
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Affiliation(s)
- Stacie Scruggs
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Cindy L Carmack
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tommy Douglas
- 3 The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Pamela Diamond
- 3 The University of Texas Health Science Center at Houston, Houston, TX, USA
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Abbaspour S, Farmanbar R, Njafi F, Ghiasvand AM, Dehghankar L. Decisional balance and self-efficacy of physical activity among the elderly in Rasht in 2013 based on the transtheoretical model. Electron Physician 2017; 9:4447-4453. [PMID: 28713520 PMCID: PMC5498713 DOI: 10.19082/4447] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 03/04/2017] [Indexed: 11/23/2022] Open
Abstract
Background Regular physical activity has been considered as health promotion, and identifying different effective psycho-social variables on physical has proven to be essential. Objective To identify the relationship between decisional balance and self-efficacy in physical activities using the transtheoretical model in the members of a retirement center in Rasht, Guillen. Methods A descriptive cross-sectional study was conducted in 2013 by using convenient sampling on 262 elderly people who are the members of retirement centers in Rasht. Data were collected using Stages of change, Decisional balance, Self-efficacy and Physical Activity Scale for the Elderly (PASE). Data was analyzed using SPSS-16 software, descriptive and analytic statistic (Pearson correlation, Spearman, ANOVA, HSD Tukey, linear and ordinal regression). Results The majority of participants were in maintenance stage. Mean and standard deviation physical activity for the elderly was 119.35±51.50. Stages of change and physical activities were significantly associated with decisional balance and self-efficacy (p<0.0001); however, cons had a significant and reverse association. According to linear and ordinal regression the only predicator variable of physical activity behavior was self-efficacy. Conclusion By increase in pros and self-efficacy on doing physical activity, it can be benefited in designing appropriate intervention programs.
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Affiliation(s)
- Seddigheh Abbaspour
- M.Sc. in Nursing Education, Lecturer, Department of Nursing & Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Rabiollah Farmanbar
- Ph.D. in Health Education, Associate Professor, Department of Health Education and Health Promotion, Health and Environment Research Center, Social Determinants of Health Research Center (SDHRC), Health school, Guilan University of Medical Sciences, Rasht, Iran
| | - Fateme Njafi
- M.Sc. in Nursing Medical and Surgical, Department of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Arezoo Mohamadkhani Ghiasvand
- M.Sc. in Nursing Management, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Dehghankar
- M.Sc. in Nursing Education, Lecturer, Department of Community Health Nursing, Faculty of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
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Everything You Wanted to Know About Motivation (But Weren’t Intrinsically Motivated Enough to Ask). LIFESTYLE MEDICINE 2017. [DOI: 10.1016/b978-0-12-810401-9.00005-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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40
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Abula K, Beckmann J, Chen K, Gröpel P. Validation of the Chinese version of the physical activity stages of change questionnaire. COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1228509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Kahar Abula
- Department of Sport and Health Sciences, Technische Universität München, Georg-Brauchle-Ring 60/62, München 80992, Germany
| | - Jürgen Beckmann
- Department of Sport and Health Sciences, Technische Universität München, Georg-Brauchle-Ring 60/62, München 80992, Germany
| | - Kai Chen
- Department of Physical Education, South West Jiao Tong University, Cheng Du, China
| | - Peter Gröpel
- Department of Sport and Health Sciences, Technische Universität München, Georg-Brauchle-Ring 60/62, München 80992, Germany
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Sigvartsen J, Gabrielsen LE, Abildsnes E, Stea TH, Omfjord CS, Rohde G. Exploring the relationship between physical activity, life goals and health-related quality of life among high school students: a cross-sectional study. BMC Public Health 2016; 15:709. [PMID: 27488255 PMCID: PMC4972944 DOI: 10.1186/s12889-016-3407-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 07/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Two models were developed to increase high school students' participation in physical education (PE): "motion enjoyment" and "sport enjoyment". The first model focuses on increasing knowledge about the health benefits of a physically active lifestyle and thereby promoting a positive attitude towards physical activity, whereas the second model focuses on techniques and practices for enhancing athletic performance. The aims of the present study are to investigate and understand the similarities and differences between students selecting "motion enjoyment" vs. "sport enjoyment" and to examine the extent to which life goals and reported physical activity are associated with health-related quality of life (HRQOL). METHOD A total of 156 high school students (mean age, 16 years [standard deviation = 0.8], 123 girls and 33 boys) were included in this cross-sectional study. HRQOL and life goals were measured using KIDSCREEN-10 and the Adolescent Life Goal Profile Scale, respectively. Physical activity was measured using a self-reporting questionnaire intended to describe the students' leisure-time activity. Independent sample t-tests, chi-square, one-way analyses of variance and multiple regression analysis were applied. RESULTS Self-reported physical activity level and HRQOL were higher among students in the "sport enjoyment" program, while the perceived importance of life goals was the same regardless of the preferred PE model. Multiple regression analyses revealed that the perceived importance of relations-oriented life goals (B = -5.61; 95 % confidence interval CI = -10.53 to -0.70; p = .026), perceived importance of generativity-oriented life goals (B = 4.14.; 95 % CI = 0.85 to 7.422; p = .014), perceived attainability of relations-oriented life goals (B = 7.28; 95 % CI = 2.49 to 12.07; p = .003), age (B = -7.29; 95 % CI = -11.38 to -3.20; p = .001) and gender, with boys as the reference group (B = -12.10; 95 % CI = -19.09 to -5.11; p = .001), were independently associated with increased HRQOL. In exploring the relationships of self-reported physical activity during leisure time, stage of change (B = 3.53; 95 % CI = 1.49 to 5.51; p = .001), gender, with boys as the reference group (B = -8.90; 95 % CI = -15.80 to -2.00; p = .012), and age (B = -6.62; 95 % CI = -10.57 to -2.66; p = .001) were independently associated with increased HRQOL. CONCLUSION Self-reported physical activity habits and life goals were associated with HRQOL to a limited extent. However, the perceived importance of life goals appears to reflect other aspects of individual well-being than HRQOL.
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Affiliation(s)
- Julie Sigvartsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.
| | - Leiv Einar Gabrielsen
- Department for Child and Adolescent Mental Health, Sorlandet Hospital Health Enterprise, Kristiansand, Norway
| | - Eirik Abildsnes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Tonje H Stea
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | | | - Gudrun Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Bernard P, Carayol M, Gourlan M, Boiché J, Romain AJ, Bortolon C, Lareyre O, Ninot G. Moderators of Theory-Based Interventions to Promote Physical Activity in 77 Randomized Controlled Trials. HEALTH EDUCATION & BEHAVIOR 2016; 44:227-235. [DOI: 10.1177/1090198116648667] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A meta-analysis of randomized controlled trials (RCTs) has recently showed that theory-based interventions designed to promote physical activity (PA) significantly increased PA behavior. The objective of the present study was to investigate the moderators of the efficacy of these theory-based interventions. Seventy-seven RCTs evaluating theory-based interventions were systematically identified. Sample, intervention, methodology, and theory implementation characteristics were extracted, coded by three duos of independent investigators, and tested as moderators of interventions effect in a multiple–meta-regression model. Three moderators were negatively associated with the efficacy of theory-based interventions on PA behavior: intervention length (≥14 weeks; β = −.22, p = .004), number of experimental patients (β = −.10, p = .002), and global methodological quality score (β = −.08, p = .04). Our findings suggest that the efficacy of theory-based interventions to promote PA could be overestimated consequently due to methodological weaknesses of RCTs and that interventions shorter than 14 weeks could maximize the increase of PA behavior.
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Affiliation(s)
- Paquito Bernard
- University of Montpellier, Montpellier, France
- Challenge for the Change of Behaviour Group, Montpellier, France
- Université Laval Cancer Research Center, Québec, Canada
- Université Laval, Québec, Canada
- Université Laval Research Center, Québec, Canada
| | - Marion Carayol
- University of Montpellier, Montpellier, France
- Challenge for the Change of Behaviour Group, Montpellier, France
| | - Mathieu Gourlan
- University of Montpellier, Montpellier, France
- Challenge for the Change of Behaviour Group, Montpellier, France
- Institut Regional du Cancer, Montpellier, France
| | - Julie Boiché
- University of Montpellier, Montpellier, France
- Challenge for the Change of Behaviour Group, Montpellier, France
| | - Ahmed Jérôme Romain
- University of Montpellier, Montpellier, France
- Challenge for the Change of Behaviour Group, Montpellier, France
- University Hospital of Lapeyronie, Montpellier, France
| | - Catherine Bortolon
- University of Montpellier, Montpellier, France
- Challenge for the Change of Behaviour Group, Montpellier, France
| | - Olivier Lareyre
- University of Montpellier, Montpellier, France
- Challenge for the Change of Behaviour Group, Montpellier, France
- Institut Regional du Cancer, Montpellier, France
| | - Gregory Ninot
- University of Montpellier, Montpellier, France
- Challenge for the Change of Behaviour Group, Montpellier, France
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Emani S, Thomas R, Shah R, Mehta DS. Application of transtheoretical model to assess the compliance of chronic periodontitis patients to periodontal therapy. Contemp Clin Dent 2016; 7:176-81. [PMID: 27307663 PMCID: PMC4906859 DOI: 10.4103/0976-237x.183068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The present cross-sectional survey study was conducted to assess whether the transtheoretical model for oral hygiene behavior was interrelated in theoretically consistent directions in chronic periodontitis patients and its applicability to assess the compliance of the chronic periodontitis patients to the treatment suggested. MATERIALS AND METHODS A total of 150 chronic periodontitis patients were selected for the proposed study. The selected patients were given four questionnaires that were constructed based on transtheoretical model (TTM), and the patients were divided subsequently into five different groups (precontemplation, contemplation, preparation, action, and maintenance groups) based on their answers to the questionnaires. Then, each patient was given four appointments for their periodontal treatment spaced with a time gap of 10 days. The patients visit for each appointments scheduled to them was documented. The results obtained were assessed using TTM. RESULTS Higher mean pro scores of decisional balance, self-efficacy, and process of change scores was recorded in maintenance group followed by action group, preparation group, contemplation group, and precontemplation group, respectively, whereas higher mean cons score was recorded in precontemplation group followed by contemplation group, preparation group, action group, and maintenance group, respectively. The difference scores of TTM constructs were statistically highly significant between all the five groups. Furthermore, the number of appointment attended in were significantly more than maintenance group followed by action group, preparation group, contemplation group, and precontemplation group. CONCLUSION Within the limitations of this study, it can be concluded that transtheoretical model can be successfully applied to chronic periodontitis patients to assess their compliance to the suggested periodontal treatment.
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Affiliation(s)
- Shilpa Emani
- Clinical Practitioner, Hyderabad, Telangana, India
| | - Raison Thomas
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Rucha Shah
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Dhoom Singh Mehta
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Duan Y, Lippke S, Zhang R, Brehm W, Chung PK. Testing the validity of a stage assessment on health enhancing physical activity in a chinese university student sample. BMC Public Health 2016; 16:260. [PMID: 27112721 PMCID: PMC4845322 DOI: 10.1186/s12889-016-2931-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 03/07/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The study examined the measurement quality of a stage algorithm measuring the Four steps from Inactivity to activity Theory (FIT Model). METHODS In a cross-sectional study, stages were assessed in 1012 Chinese university students in terms of physical activity, social-cognitive variables and health outcomes. Main outcome measures were stages of change, self-reported physical activity, perceived barriers, intrinsic motivation, plans, fitness and health satisfaction. Misclassification, sensitivity, specificity, receiver operating characteristic (ROC) curves, nonlinear trends, and planned comparison were computed. RESULTS Compared to previous studies, sensitivity was at the average level (64 %-71 %), and specificity was comparably higher (76%-89%). When using higher PA intensity criteria (moderate and strenuous intensities), sensitivity was higher, whereas specificity was lower in comparison to the lower PA intensity criteria (also including mild activity). After running contrast and trend analyses, nonlinear trends for all indicative variables across the stages and a match of 77 % of predictions of stage differences were confirmed. CONCLUSION The measurement quality of the stage algorithm was supported in a young adult sample.
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Affiliation(s)
- Yanping Duan
- Department of Physical Education, Hong Kong Baptist University, Hong Kong, China
| | - Sonia Lippke
- Bremen International Graduate School of Social Sciences (BIGSSS), Jacobs University Bremen, Bremen, Germany.
- Department of Psychology & Methods, Jacobs University Bremen, Campus Ring 1, 28759, Bremen, Germany.
| | - Ru Zhang
- Institute of Exercise and Public Health, University of Leipzig, Leipzig, Germany
| | - Walter Brehm
- Institute of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Pak-Kwong Chung
- Department of Physical Education, Hong Kong Baptist University, Hong Kong, China
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Middelkamp J, Van Rooijen M, Steenbergen B. Attendance Behavior of Ex-members in Fitness Clubs: A Retrospective Study Applying the Stages of Change. Percept Mot Skills 2016; 122:350-9. [PMID: 27420326 DOI: 10.1177/0031512516631075] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The transtheoretical model of behavior change (TTM) is often used to understand and predict health-related behavior. The objective of this study is to apply the TTM's stages of change to examine patterns of attendance behavior at fitness clubs. A retrospective study was performed to study the later stages of change, using attendance data of members who cancelled their membership in 2012 in two European fitness chains, including 259,355 ex-members of 267 clubs. A sample of 400 was selected at random for analyses, M age = 32.1 yr. (SD = 10.9; 64% males) and 34.7 yr. (SD = 11.0; 51% males) for BasicFit and HealthCity. Regular attendance behavior was defined by at least four visits per month. In the past, all ex-members had purchased a membership and by that were considered to have entered the preparation stage, but 19.5% had never attended the club in 24 months. Of the ex-members, 10% demonstrated regular attendance behavior for six months, and 2.3% had regular attendance for 24 months. 49% did not attend the club for one full month but started regular attendance again. Significant positive correlations were found in attendance behavior between the 6th and 12th months (r = .61), and the 12th and 24th months (r = .45), suggesting that ex-members who attended for more than six months were more likely to have maintained their attendance behavior. With only 10% of the members demonstrating regular attendance behavior, it is evident that appropriate strategies have to be developed to improve attendance behavior and facilitate exercise behavior in fitness clubs.
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Social Cognitive and Planned Behavior Variables Associated With Stages of Change for Physical Activity in Spinal Cord Injury: A Multivariate Analysis. REHABILITATION RESEARCH, POLICY, AND EDUCATION 2016. [DOI: 10.1891/2168-6653.30.1.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Purpose:To apply the constructs of social cognitive theory (SCT) and the theory of planned behavior (TPB) to understand the stages of change (SOC) for physical activities among individuals with a spinal cord injury (SCI).Method:Ex post facto design using multivariate analysis of variance (MANOVA). The participants were 144 individuals with SCI who completed an online SCT, TPB, and SOC for physical activities survey.Results:Participants in the preintender, intender, and actor groups differed significantly in functional disability, secondary health conditions, exercise self-efficacy, perceived benefits and barriers, intention, and physical health.Conclusion:Findings support the concept of stage-matching exercise and physical activity cognitive behavioral interventions for people with SCI.
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Olsson SJG, Börjesson M, Ekblom-Bak E, Hemmingsson E, Hellénius ML, Kallings LV. Effects of the Swedish physical activity on prescription model on health-related quality of life in overweight older adults: a randomised controlled trial. BMC Public Health 2015; 15:687. [PMID: 26193882 PMCID: PMC4509721 DOI: 10.1186/s12889-015-2036-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 07/07/2015] [Indexed: 12/05/2022] Open
Abstract
Background The effects of physical activity on prescription (PAP) on health-related quality of life (HRQoL) in overweight adults are unclear. We therefore aimed to explore the effects of the Swedish PAP model on HRQoL in overweight older adults. Methods Participants were recruited from a cohort of men and women born between 1937 and 1938, and living in Stockholm County. Inclusion criteria were; insufficiently physically active, i.e. <30 min of at least moderate intensity physical activity (PA) per day; body mass index >25 kg/m2; and waist circumference ≥102 cm (men) or ≥88 cm (women). Altogether, 101 individuals, aged 67 years, were randomly assigned to two parallel groups: intervention group (n = 47) receiving individualised PAP or control group (n = 54). The 36-item Short Form Health Survey (SF-36) was administered before and after the six months intervention. Main outcomes were the SF-36 physical component summary (PCS) and mental component summary (MCS) scores. Intention to treat analysis was utilised. Regression analysis was performed to assess whether changes in PA and body weight affected changes in HRQoL. Results At the six months follow-up, regarding the MCS score, the intervention group had improved significantly more (median: 4.4 [interquartile range (IQR): −2.4 to 23.3]) vs (median: 0.0 [IQR: −4.0 to 4.9]); p < 0.05) and a higher proportion of participants had attained relevant improvements (OR 2.43 (95 % CI 1.00–5.88) p < 0.05) compared to the controls. A within group improvement in the PCS score (median: 3.8 [IQR: −1.9 to 19.5] p < 0.05) was found in the intervention group. Changes in PA and body weight had a small, but significant, mediating effect on the changes in HRQoL. Conclusions PAP had a positive effect on HRQoL, measured by the SF-36 MCS, but no significant between group effect was seen on the PCS in overweight older adults. These effects were, to some extent, mediated by changes in PA and body weight. Our findings support clinical use of the Swedish PAP model. Trial registration ClinicalTrials.gov NCT02320760.
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Affiliation(s)
- Sven J G Olsson
- Department of Sport and Health Sciences, Swedish School of Sport and Health Sciences Stockholm (GIH), Box 5626, 114 86, Stockholm, Sweden.
| | - Mats Börjesson
- Department of Sport and Health Sciences, Swedish School of Sport and Health Sciences Stockholm (GIH), Box 5626, 114 86, Stockholm, Sweden. .,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
| | - Elin Ekblom-Bak
- Department of Sport and Health Sciences, Swedish School of Sport and Health Sciences Stockholm (GIH), Box 5626, 114 86, Stockholm, Sweden.
| | - Erik Hemmingsson
- Department of Medicine, Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
| | - Mai-Lis Hellénius
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
| | - Lena V Kallings
- Department of Sport and Health Sciences, Swedish School of Sport and Health Sciences Stockholm (GIH), Box 5626, 114 86, Stockholm, Sweden.
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Lee JY, Park HA, Min YH. Transtheoretical Model-based Nursing Intervention on Lifestyle Change: A Review Focused on Intervention Delivery Methods. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9:158-67. [PMID: 26160246 DOI: 10.1016/j.anr.2015.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 08/17/2014] [Accepted: 03/13/2015] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The transtheoretical model (TTM) was used to provide tailored nursing for lifestyle management such as diet, physical activity, and smoking cessation. The present study aims to assess the provision of intervention delivery methods, intervention elements, and stage-matched interventions, in order to identify ways in which information technology is used in the TTM-based research. METHODS The relevant literature was selected by two researchers using inclusion criteria after searching for "TTM (transtheoretical or stage of change)" and "nursing" from the databases PubMed and CINAHL. The selected studies were categorized in terms of study characteristics, intervention delivery method, intervention element, and use and level of stage-matched intervention. RESULTS A total of 35 studies were selected including eight studies that used information communication technology (ICT). Nine different intervention delivery methods were used, of which "face-to-face" was the most common at 24 times. Of the 35 studies, 26 provided stage-matched interventions. Seven different intervention elements were used, of which "counseling" was the most common at 27 times. Of all the intervention elements, tailored feedback used ICT the most at seven instances out of nine, and there was a significant difference in the rate of ICT usage among intervention elements. CONCLUSIONS ICT is not yet actively used in the TTM-based nursing interventions. Stage-matched interventions and TTM concepts were shown to be in partial use also in the TTM-based interventions. Therefore, it is necessary to develop a variety of ways to use ICT in tailored nursing interventions and to use TTM frameworks and concepts.
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Affiliation(s)
- Joo Yun Lee
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Hyeoun-Ae Park
- College of Nursing, Seoul National University, Seoul, South Korea; Systems Biomedical Informatics Research Center, Seoul National University, Seoul, South Korea.
| | - Yul Ha Min
- College of Nursing, Gachon University, Incheon, South Korea
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Dishman RK, Jackson AS, Bray MS. Self-regulation of exercise behavior in the TIGER study. Ann Behav Med 2015; 48:80-91. [PMID: 24311018 DOI: 10.1007/s12160-013-9573-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to test experiential and behavioral processes of change as mediators of the prediction of exercise behavior by two self-regulation traits, self-efficacy and self-motivation, while controlling for exercise enjoyment. METHODS Structural equation modeling was applied to questionnaire responses obtained from a diverse sample of participants. Objective measures defined adherence (928 of 1,279 participants attended 80 % or more of sessions) and compliance (867 of 1,145 participants exercised 30 min or more each session at their prescribed heart rate). RESULTS Prediction of attendance by self-efficacy (inversely) and self-motivation was direct and also indirect, mediated through positive relations with the typical use of behavioral change processes. Enjoyment and self-efficacy (inversely) predicted compliance with the exercise prescription. CONCLUSIONS The results support the usefulness of self-regulatory behavioral processes of the transtheoretical model for predicting exercise adherence, but not compliance, extending the supportive evidence for self-regulation beyond self-reports of physical activity used in prior observational studies.
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Affiliation(s)
- Rod K Dishman
- Department of Kinesiology, The University of Georgia, Ramsey Student Center, 330 River Road, Athens, GA, 30602-6554, USA,
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Hirvonen N, Enwald H, Bath PA, Pyky R, Korpelainen R, Huotari ML. Individual factors affecting preferences for feedback message tactics in the contexts of physical activity. JOURNAL OF HEALTH COMMUNICATION 2014; 20:220-229. [PMID: 25491473 DOI: 10.1080/10810730.2014.925015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Tailored feedback on personal physical activity behavior has been used to inform individuals and promote physical activity among different populations. This study aimed to increase the understanding of factors associated with young men's preferences for feedback message tactics in the context of physical activity and exercise. How preferences vary was analyzed in terms of the self-reported physical activity, stage of exercise behavior change, exercise self-efficacy, objectively measured physical health status, and sociodemographic characteristics of young Finnish men. Population-based survey data, including physiological measurements (n = 525), were collected at the Finnish Defence Forces' call-ups in the city of Oulu, Finland, in September 2011. The results indicate that the stage of exercise behavior change, exercise self-efficacy, physical health status, and educational level are associated with a preference for normative and ipsative comparison. Multivariate logistic regression models show that an advanced stage of exercise behavior change and education in the academic track of an upper secondary school are independent predictors of preferring ipsative and normative physical activity feedback among young men. The study provides new insights into how the stage of behavior change influences health information behavior and is in line with studies emphasizing social factors--including education--as being important in shaping health-related behavior. These factors could form the basis for tailoring information when designing health promotion.
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Affiliation(s)
- Noora Hirvonen
- a Information Studies, Faculty of Humanities , University of Oulu , Oulu , Finland
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