Predicting long-term maintenance of physical activity in older adults.
ABSTRACT Considerable research has established that self-efficacy is a consistent correlate of physical activity. Additional factors, such as exercise-induced affect, social support, and value judgments, have also been identified as having the potential to influence adherence to activity. This study examined the utility of such variables in predicting the long-term exercise behavior of older adults.
In the context of a 6-month randomized controlled trial with an 18-month follow-up, we tested the extent to which adherence during the trial, affective responses to exercise, exercise value, and social support from the exercise group had either a direct or indirect effect through the mediation of exercise self-efficacy on physical activity levels at 6- and 18-month follow-up in a sample (N=174) of older adults (M age, 66 years). Structural equation modeling tested several models of exercise prediction.
The best fitting model indicated significant paths from social support, affect, and exercise frequency to efficacy at the end of the program. Efficacy, in turn, was related to physical activity at 6- and 18-month follow-up. The model accounted for 40% of the variance in 18-month activity levels.
This prospective study provides support for the inclusion of social cognitive variables in models of exercise adherence and highlights the pivotal role of self-efficacy in long-term exercise behavior. Subsequent trials are called for to replicate and extend these findings.
Article: Testing the effectiveness of a self-efficacy based exercise intervention for inactive people with type 2 diabetes mellitus: design of a controlled clinical trial.[show abstract] [hide abstract]
ABSTRACT: Sufficient exercise is important for people with Type 2 Diabetes Mellitus (T2DM), as it can prevent future health problems. Despite, it is estimated that only 30-40% of people with T2DM are sufficiently active. One of the psychosocial constructs that is believed to influence physical activity behaviour, is exercise self-efficacy. The goal of this study is to evaluate a patient-tailored exercise intervention for people with T2DM that takes exercise self-efficacy into account. This study is conducted as a non-randomized controlled clinical trial. Patients are eligible when they are diagnosed with T2DM, exercise less than advised in the ADA guideline of 150 min/week of moderate-intensity aerobic physical activity, have an BMI >25 and are between 18 and 80 years old. Recruitment takes place at a Primary care organization of general practitioners and practice nurses in the south of the Netherlands.Participants are allocated to three groups: An advice intervention -for participants with a high exercise self-efficacy score- in which participants receive a patient-tailored exercise intervention, an intensive intervention -for participants with a low exercise self-efficacy score- in which participants receive a patient-tailored exercise intervention accomplished by a group based intervention, and a control group in which participants receive regular Dutch diabetes care. The primary outcome measure of this study is physical activity. Secondary outcome measures are health status, (symptoms of) depression, exercise self-efficacy, Body Mass Index (BMI), blood pressure and glycemic control. We aimed to design an intervention that can be implemented in Primary care, but also to design an easy accessible program. This study is innovative as it is -to our best knowledge- the first study that takes level of exercise self-efficacy of people with T2DM into account by means of giving extra support to those with the lowest exercise self-efficacy. If the program succeeds in increasing the amount of physical activity it can be implemented in regular primary care. Dutch Trial Register NTR2734.BMC Public Health 05/2012; 12:331. · 2.00 Impact Factor
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ABSTRACT: Healthy People 2020 aims to achieve health equity, eliminate disparities, and improve the health of all groups. Regular physical activity (PA) improves overall health and fitness and has the capability to reduce risk for chronic diseases. Identifying barriers which relate to the Hispanic population is important when designing PA interventions. Therefore, the purpose was to review existing PA interventions targeting Hispanic adults published between 1988 and 2011. This paper was limited to interventions which included more than 35% Hispanic adults (n = 20). Most of the interventions were community based (n = 16), although clinical, family-based, and faith-based settings were also represented. Interventions incorporated theory (n = 16), with social cognitive theory and transtheoretical model being used most frequently. Social support was integral, building on the assumption that it is a strong motivator of PA. Each of the interventions reported success related to PA, social support, and/or BMI. Lessons learned should be incorporated into future interventions.Journal of Environmental and Public Health 01/2012; 2012:156435.
Article: Physical activity for men receiving androgen deprivation therapy for prostate cancer: benefits from a 16-week intervention[show abstract] [hide abstract]
ABSTRACT: Goals of workProstate cancer patients receiving androgen deprivation therapy (ADT) are vulnerable to a number of potentially debilitating side effects, which can significantly impact quality of life. The role of alternate therapies, such as physical activity (PA), in attenuating these side effects is largely understudied for such a large population. Thus, the purpose of this study was to investigate the effects of PA intervention for men receiving ADT on PA behavior, quality of life, and fitness measures. Patients and methodsOne hundred participants were randomized into an intervention (n = 53) or a wait-list control group (n = 47), with 11 dropping out of the intervention group and 23 dropping out of the wait-list control group prior to post-testing. The intervention consisted of both an individually tailored home-based aerobic and light resistant training program and weekly group sessions. PA, quality of life, fitness, and physiological outcomes were assessed pre and post the 16-week intervention. ResultsSignificant increases in PA, supported by changes in girth measures and blood pressure, support the beneficial impact of the intervention. Positive trends were also evident for depression and fatigue. However, due to the high dropout rate, these results must be interpreted with caution. ConclusionsPA effectively attenuates many of the side effects of ADT and should be recommended to prostate survivors as an alternate therapy. Determining the maintenance of this behavior change will be important for understanding how the long-term benefits of increased activity levels may alleviate the late effects of ADT. KeywordsCancer-Prostate-Physical activity-Quality of life-SurvivorshipSupportive Care Cancer 04/2012; 18(5):591-599. · 2.60 Impact Factor