Psychometric properties of the Malay version of the self-efficacy for exercise scale

Structural relationship of the social-ecological factors and psychological factors on physical activity

The present study examines the mediating effect of psychological factors in the structural relationships between social and physical environmental factors and the amount of physical activity among undergraduate students at Universiti Sains Malaysia. The sample consisted of 422 students with a mean age of 20.2 years (SD = 1.27). The majority of the students were female (69.7%) and Malay (81.3%). Standardized scales were used to measure the total amount of physical activity and all the study variables. The final SEM had a good fit to the data: CFI = 0.968, TLI = 0.948, SRMR = 0.036, RMSEA (90%CI) = 0.046 (0.025, 0.065), RMSEA p-value = 0.609 with 11 paths relationships. Family support had a significant effect on perceived benefits and perceived barriers. The effect of friend support on physical activity was significantly mediated by perceived benefits, self-efficacy, and psychological needs satisfaction. The effect of the availability of exercise facilities on physical activity was significantly mediated by perceived benefits and psychological needs satisfaction. Furthermore, psychological needs satisfaction mediated the effect of perceived benefits, perceived barriers, and self-efficacy on physical activity. The study findings illustrated that the application of the social-ecological model and psychological factors is important in order to understand and promote positive physical activity behaviour.

Psychometric properties of the Chinese version of the Exercise Self-Efficacy Scale for the Transtheoretical Model: a confirmatory analysis among Chinese children and adolescents

BACKGROUND

Self-efficacy has been recognized as a critical component in people's participation and maintenance of physical activity. This study aims to validate the Chinese version of the Exercise Self-Efficacy Scale (ESE) among Chinese children and adolescents using confirmatory factor analysis (CFA).

METHODS

A cross-sectional study was conducted on two primary and two secondary schools in central China. The ESE scale was translated into Chinese (ESE-C) using the standard forward-backward translation method. Data were analyzed using Mplus 8 for the CFA.

RESULTS

The final model showed a satisfactory level of goodness-of-fit (CFI = 0.918; TLI = 0.905; SRMR = 0.043; RMSEA = 0.066), indicating a good construct validity of the ESE-C for children and adolescents in mainland China. Furthermore, the final ESE-C model achieved composite reliability values of 0.963 and average variance extraction values of 0.597, indicating sufficient convergent and discriminant validity. Besides, the Cronbach's alpha value was 0.964, demonstrating excellent internal consistency of the ESE-C scale.

CONCLUSION

The ESE-C scale is a valid instrument for assessing exercise self-efficacy among children and adolescents in mainland China.

A Theory-Based, Technology-Assisted Intervention in a Hybrid Cardiac Rehabilitation Program for Patients with Coronary Heart Disease: A Feasibility Study

PURPOSE

To assess the feasibility of a technology-assisted intervention in a hybrid cardiac rehabilitation program among patients with coronary heart disease.

METHODS

This study was a two-arm parallel randomized controlled trial. Twenty-eight patients with coronary heart disease were randomly assigned to either the intervention group, receiving a 12-week technology-assisted intervention (n = 14), or the control group (n = 14), receiving usual care. Guided by the Health Belief Model, the intervention group received three center-based, supervised exercise training sessions, a fitness watch that served as a cue to action, six educational videos, and a weekly video call. The Self-efficacy for Exercise, exercise capacity, and Health Promoting Lifestyle Profile II were assessed at baseline and immediately post-intervention (12-weeks).

RESULTS

Among the 28 patients who participated in this study, 85.7% completed the program, with a relatively low attrition rate (14.3%). The number of exercise training sessions accomplished by the participants in the intervention group was 51.27 ± 19.41 out of 60 sessions (85.5%) compared to 36.46 ± 23.05 (60.8%) in the control group. No cardiac adverse events or hospitalizations were reported throughout the study. Participants in the intervention group showed greater improvement in health-promoting behaviors when compared with the control group at 12 weeks. Within-group effects demonstrated improvement in exercise self-efficacy and exercise capacity among participants in the intervention group. A participant satisfaction survey conducted immediately post-intervention revealed that participants were "very satisfied" (23.1%) and "satisfied" (76.9%) with the technology-assisted intervention.

CONCLUSIONS

The findings demonstrated that technology-assisted intervention in a hybrid cardiac rehabilitation program was feasible and suggested to be beneficial in improving exercise self-efficacy, exercise capacity, and health promoting behavior among patients with coronary heart disease. A full-scale study is needed to determine its effectiveness in the long term.

TRIAL AND PROTOCOL REGISTRATION

ClinicalTrials.gov NCT04862351. https://clinicaltrials.gov/ct2/show/NCT04862351.

The Impact of Smartphone Addiction on Chinese University Students' Physical Activity: Exploring the Role of Motivation and Self-Efficacy

Background

Previous studies showed that smartphone addiction (SA) can lead to reduced physical activity (PA), but only a few studies have explored the impact of SA from psychological perspective closely related to PA. This study aimed to examine the extrinsic and partial psychological factors leading to decrease in PA using structural equation modelling analysis.

Methods

We conducted an online survey on 628 males and 1159 female students from 10 universities in Henan Province, China, through a questionnaire survey application “Questionnaire Star”. This study used three models to test the mediating effects of three types of motives (intrinsic motives, body-related motives, and social motives) and self-efficacy, respectively, in the relationship between smartphone addiction and physical activities.

Results

Our result confirmed that smartphone addiction leads to lower physical activities. Secondly, self-efficacy mediates smartphone addiction and physical activities, but the mediating effect of all three types of motivation is not significant. Thirdly, smartphone addiction did not affect intrinsic motivation and body-related motivation, but positively affects social motivation. Finally, as the motivation type changes from internal to external, the mediating effect of self-efficacy becomes stronger.

Conclusion

This study showed that smartphone addiction lead to increase social motivation and decreased self-efficacy, and is a potential barrier to personal participation in physical activities. Our findings provide a new perspective for future design physical activities interventions in China and worldwide especially among university students where smartphone addiction is a problem.

Effects of technology-supported brain breaks videos on exercise self-efficacy among type 2 diabetes mellitus Malaysians

The technology supported Brain Breaks (BB) videos are a series of structured, web-based physical activity (PA) videos designed to promote learning and health. The purpose of this study was to investigate the effect of BB videos on exercise self-efficacy (ESE) among type 2 diabetes mellitus (T2DM) patients using the Malay-versioned exercise self-efficacy scale (ESE-M). The study used a double-blind research design and was randomised into two groups: (1) The Technology Supported BB intervention group, and (2) the control group. 70 T2DM patients with a mean age of 57.6 years (SD = 8.5) were recruited from Hospital Universiti Sains Malaysia. For 4 months, participants in the intervention group were required to undertake PA every day using the BB videos (approximately 10 min). Both groups completed the ESE-M at pre-intervention, the end of the first month, the second month, the third month, and post-intervention. For the data analysis, a mixed factorial analysis of variance was used. The results showed that at the end of the intervention, the two groups’ ESE was significantly different (p < 0.001). From pre- to post-intervention, the intervention group’s ESE-M mean scores improved significantly. Technology-supported BB videos may be an effective strategy for improving ESE in T2DM patients.

Structural equation model of psychological constructs of transtheoretical model, motives for physical activity, and amount of physical activity among people with type 2 diabetes mellitus in Malaysia

BACKGROUND

This study aimed determine the structural relationship between psychological constructs of the transtheoretical model (TTM; processes of change, decisional balance, and exercise self-efficacy), motives for physical activity (PA), and amount of PA among Malaysians with type 2 diabetes mellitus (T2DM).

METHOD

All participants were recruited from the Hospital Universiti Sains Malaysia using a cross-sectional study design with purposive) sampling method. A total of 331 participants were recruited for the present study. Before participation in the study, they were informed that participation in the study was totally voluntary. Those who agreed to participate voluntarily were required to complete the self-administered questionnaire set, which included the processes of change, decisional balance, exercise self-efficacy, physical activity and leisure motivation, and international physical activity questionnaires. Data analysis of structural equation modeling was performed using Mplus 8.

RESULTS

From the 331 participants, most of whom were male (52%) and Malay (89.4%), with a mean age of 62.6 years (standard deviation = 10.29). The final structural equation model fit the data well based on several fit indices [Root Mean Square Error of Approximation (RMSEA) = 0.059, Comparative Fit Index (CFI) = 0.953, Tucker-Lewis Index (TLI) = 0.925, Standardized Root Mean Square Residual (SRMR) = 0.031]. A total of 16 significant path relationships linked between the TTM, motives for PA, and amount of PA.

CONCLUSION

The pros of decisional balance, others' expectations, and psychological condition were constructs that directly affected PA, whereas the other constructs had a significant indirect relationship with the amount of PA. A positive mindset is crucial in deciding a behavioral change toward an active lifestyle in people with T2DM.

Psychometric Properties of the Malay-Language Quality of Life Enjoyment and Satisfaction Scale: A Confirmatory Study on Malaysian Children

The objective of this study was to validate the translated Malay version of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-M) scale among Malaysian primary school children using the confirmatory factor analysis (CFA). The Q-LES-Q-M measures the level of enjoyment and satisfaction experienced with relation to physical health, feelings, homework, and leisure. The participants were 607 Malay students, 240 (39.5%) boys and 367 (60.5%) girls, with an age range from 10 to 11 years old. The original version of the Q-LES-Q was translated into the Malay language by forward to backward translation procedures with consideration for the local culture and suitable vocabulary for primary school students. The participants then completed the Q-LES-Q-M. CFA was performed using Mplus 8 software. Using CFA, the initial model did not result in a good data fit. Further analysis of the CFA suggested some changes to the model to improve the fit indices. Model modification included the deletion of three problematic items and co-varying some error items. This resulted in improved fit indices and 40 items remained in the final model. The final model showed good reliability based on two indicators of composite reliability (CR) and Cronbach’s alpha (CA). The factors with their CR and CA were physical activity (CR = 0.857, CA = 0.854), feelings (CR = 0.808, CA = 0.813), homework (CR = 0.837, CA = 0.837) and leisure (CR = 0.742, CA = 0.737). The final measurement consists of 40 items. The retained items were deemed suitable for Malay primary school children. The revised Q-LES-Q-M with 40 items is suitable for measuring the levels of children’s involvement in determining the enjoyment and satisfaction of learning and physical activity.

The validity and reliability of the Malay version of the social support for exercise and physical environment for physical activity scales

Background

This study aimed to determine the validity of the Malay-translated version scales for assessing the social support and physical environment for exercise activities.

Method

The study was a cross-sectional design in nature, using self-reported questionnaires among the university students in Malaysia. Participants were selected using a convenience sampling approach. Perceptions regarding social support and physical environment were assessed using the Malay-translated version scales. The standard forward-backwards translation was conducted to translate the English version of the scales to the Malay version. Confirmatory factor analysis (CFA) was used to validate the translated version scales; composite reliability (CR) and average variance extracted (AVE) were computed.

Results

A total of 857 students participated in this study (female: 49.1%, male: 50.9%). The mean age of the participants was 20.2 (SD = 1.6). The fit indices of the initial hypothesized measurement models (social support and physical environment) were not satisfactory. Further improvements were made by adding covariances between residuals' items within the same factor for each hypothesized model. The final re-specified measurement models demonstrated adequate factor structure for the social support scale with 24 items (CFI = .932, TLI = .920, SRMR = .054, RMSEA = .061), and the physical environment scale with five items (CFI = .994, TLI = .981, SRMR = .013, RMSEA = .054). The CR was .918 for family support, .919 for friend support, .813 for perceived availability, and .771 for perceived quality. The AVEs were .560 for family support, .547 for friend support, .554 for perceived availability, and .628 for perceived quality. The intra-class correlation (ICC) based on test-retest was .920 for family support, .984 for friend support, .895 for availability of facilities, and .774 for quality of facilities.

Conclusion

The Malay version of the social support scale for exercise and the physical environment scale for physical activity were shown to have adequate psychometric properties for assessing perceived social support and physical environment among the university students in Malaysia.

Perspective

This study presented the psychometric properties of the social support and physical environment scales based on CFA and was the first to translate these scales from the original English version to the Malay version.

Manipulating Self-Avatar Body Dimensions in Virtual Worlds to Complement an Internet-Delivered Intervention to Increase Physical Activity in Overweight Women

Virtual reality has been found to be a useful tool for positively influencing relevant psychological variables in order to increase physical activity (PA), especially in the overweight population. This study investigates the use of avatars and their physical variations to extend the effectiveness of existing interventions to promote PA. The main objective is to analyze the influence of the avatars' body dimensions on the efficacy of an Internet intervention to increase PA levels and improve other relevant variables (motivation toward PA, enjoyment, anxiety, self-efficacy, and PA goals). A total of 42 overweight women received a brief online intervention, and they were randomly assigned to one of three conditions: the "Ideal avatar" (IAC: participants are represented by avatars with ideal body dimensions); the "Real avatar" (RAC: participants are represented by avatars with participants' current body dimensions); and the "Non avatar" (NAC: participants are not represented by avatars). Results showed that the online intervention was effective in increasing PA practice and self-efficacy expectations. However, manipulating the body dimensions of avatars did not improve this intervention, although ideal avatars helped to reduce the anxiety experienced during PA in this population.

Psychometric Properties of the Decisional Balance Scale: A Confirmatory Study on Malaysian University Students

Decisional balance (DB) is the perceived positive aspects (advantages) and negative aspects (disadvantages) that are associated with behavioural change. Behavioural change is dependent on an individual's thoughts after considering the advantages of engaging in exercise. When the benefits exceed the barriers, people are more likely to make changes after cognitively evaluating the functional aspects. The purpose of the present study is to determine the validity and reliability of the DB scale among Malaysian university students using a confirmatory factor analysis (CFA). A cross-sectional study was carried out among students who took part in the co-curricular program. By using the purposive sampling method, students were recruited and given written informed consent forms after acknowledging they understood the purpose of the study. The DB scale, which consists of two factors, namely, advantages and disadvantages, was used as the instrument in the study. The advantages referred to the benefits of participating in exercise, whereas the disadvantages referred to the barriers to exercise. The 10-item, self-administered questionnaires were distributed to participating students. Data were analysed using Mplus 8 for the CFA. A total of 562 students (females = 444, males = 118) with a mean age of 19.81 years (SD = 1.22) participated in the study. Most of the students were engaged in regular physical activity for at least three exercise sessions (mean = 2.62) per week, and the average duration per session was 43 minutes. The hypothesised measurement model of DB did not fit the data well; thus, the measurement model was re-specified. The final measurement model fit the data well (comparative fit index (CFI) = 0.960, Tucker-Lewis index (TLI) = 0.943, standardised root mean square residual (SRMR) = 0.055, root mean square error of approximation (RMSEA) (90% confidence interval (CI)) = 0.061 (0.047, 0.074), RMSEA p-value = 0.096). The composite reliability values of 0.757 for the advantages and 0.792 for the disadvantages were acceptable. The 10-item DB scale with two factors displayed a good model fit for the data with good scale reliability. This could be beneficial for Malaysian undergraduate students in making decisions before engaging in physical activity. The benefits of, and barriers to, exercise could be an important component that affects their decision making.

Factorial validity, measurement and structure invariance of the Malay language decisional balance scale in exercise across gender

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.

Malay Version of Exercise Self-Efficacy: A Confirmatory Analysis among Malaysians with Type 2 Diabetes Mellitus

Exercise self-efficacy (ESE) is one of the psychological constructs in the Transtheoretical Model (TTM). The objective of the present study is to assess the validity and reliability of the Malay version of Exercise self-efficacy scale (ESE-M) among Malaysians with type 2 diabetes mellitus (T2DM). A cross-sectional study design with convenience sampling method using a self-administered questionnaire was carried out. Participants were invited to complete the ESE-M with 18 items. Confirmatory factor analysis (CFA) was conducted and composite reliability (CR) was computed using Mplus 8. A total of 331 Malaysians with T2DM with a mean age of 63 years old (Standard Deviation = 0.57) completed the questionnaire. Most of the participants were male (52%) and Malay (89.4%). Two initial CFA models (single factor and three factors) of ESE-M scale were tested and they did not fit to the data well. Several re-specifications of the models were conducted. The final model for the ESE-M showed improvement on the value of model fit indices for the single factor model (comparative fit index (CFI) = 0.952, Tucker and Lewis index (TLI) = 0.938, standardised root mean square (SRMR) = 0.044, root mean square error of approximation (RMSEA) = 0.054) and three factors model (CFI = 0.891, TLI = 0.863, SRMR = 0.049, RMSEA = 0.081). The CR for the self-efficacy factor was 0.921 (single factor), while CR for internal feelings, competing demands and situational (three factors) were 0.762, 0.818 and 0.864, respectively. The final model of single factor ESE-M showed better fit to the data compared to the three factors ESE-M. This indicated that the single factor ESE-M is more suitable to be adopted for future study among Malaysians with T2DM.