Applying exercise stage of change to a low-income underserved population.
ABSTRACT To validate the transtheoretical model for exercise behavior and the constructs of decisional balance and self-efficacy for exercise in a low-income, poorly educated primary care sample.
Patients attending public primary-care clinics from 4 separate sites in Louisiana were interviewed regarding their health behaviors.
The data provide equivocal support for applying the transtheoretical model for exercise and integrating it with other models of behavior change within this population.
Further studies modifying the decisional balance measures are necessary before definitive statements regarding the applicability of these models to exercise within this specialized population can be made.
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ABSTRACT: Physical activity participation rates in the US have been in steady decline for the last 25 years, so much so that 60% of youth ages 9-13 get no physical activity outside of school (Alliance for a Healthier Generation, 2006). This state of inactivity indicates that promoting participation in physical activity at a young age is of importance. Both the Transtheoretical Model and Social Cognitive Theory have been used to design successful activity promotion interventions (Castro, King, & Brassington, 2001; Lippke, Ziegelmann, & Schwarzer, 2005). The present study was designed to assess the potential effectiveness of an intervention using computerized agents on self-efficacy and stage of change for physical activity in a youth sample. Results support the use of computerized human agents for increasing exercise efficacy and health and fitness knowledge. Further research must be conducted to determine gender and ethnic effects of the pedagogical agents. Moreover, long-term studies should be conducted with more substantial measures of physical activity to determine if the interaction with agents produces change in behavior.
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ABSTRACT: Latinas are more likely to be inactive than non-Hispanic white women. Although 74% of Latinas report no leisure-time activity, few interventions have been designed to promote physical activity among these women. The objective of this study was to assess the effect of the California WISEWOMAN program on low-income Latinas's readiness to change physical activity and on self-reported physical activity behaviors. We screened 1,332 women for cardiovascular disease risk factors and randomly assigned 1,093 women to 2 groups: an enhanced intervention (n = 552) or usual care (n = 541). The enhanced intervention was delivered by community health workers in one-on-one counseling sessions. We examined self-reported readiness to change and physical activity at baseline and 12-month follow-up among participants who completed both assessments (n = 868). Mean age of participants was 52 years (standard deviation, 6 y); most (65%) were Mexican or Mexican American, and most (81%) were not high school graduates. A higher percentage (67%) of the enhanced intervention group was in the action/maintenance stage for vigorous physical activity at follow-up compared with baseline (47%). We found no such change among women in usual care (52%, baseline; 58%, follow-up). A higher percentage of the enhanced intervention group also reported significant increases in moderate (71%, baseline; 84%, follow-up) and vigorous (13% to 33%) physical activity at follow-up than at baseline. Women in usual care reported no changes. A culturally tailored adaptation of the WISEWOMAN program that used community health workers significantly improved both self-reported readiness to engage in physical activity and vigorous physical activity among low-income Latinas.Preventing chronic disease 04/2012; 9:E87. DOI:10.5888/pcd9.110190 · 1.96 Impact Factor
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ABSTRACT: Background/PurposeIdentifying mediators of physical activity change requires measurement instruments that are reliable, valid, and generalizable to multiple populations. Despite continued application of the transtheoretical model (TTM) to the study of physical activity, the structural components of the TTM measurement instruments have been understudied in diverse populations. MethodsA multiethnic sample (N = 700, M age = 47, 63% women, 38% Caucasian) of participants living in Hawaii completed TTM measures. The factor validity and measurement equivalence/invariance (ME/I) of decisional balance, barrier self-efficacy, temptations, and processes of change instruments were explored between men, women, age groups, and ethnicities. Results/ConclusionsMeasurement models of barrier self-efficacy and revised models of temptations and processes of change demonstrated sufficient evidence for ME/I among all subgroups. A revised model of decisional balance demonstrated sufficient evidence for ME/I between genders and among ethnicities, but not among age groups. Future research should examine the stability of these constructs across time.Annals of Behavioral Medicine 06/2008; 35(3):308-318. DOI:10.1007/s12160-008-9035-x · 4.20 Impact Factor