Can we identify who will adhere to long-term physical activity? Signal detection methodology as a potential aid to clinical decision making.
ABSTRACT Signal detection methodology was used to identify the best combination of predictors of long-term exercise adherence in 269 healthy, initially sedentary adults ages 50-65 years. Less educated individuals who were assigned to supervised home-based exercise of either higher or lower intensity and who were less stressed and less fit at baseline than other individuals had the greatest probability of successful adherence by the 2nd year. Overweight individuals assigned to a group-based exercise program were the least likely to be successful 2 years later. Predictors of short-term (1-year) adherence were generally similar to predictors of 2-year adherence. Signal detection analysis may be useful for identifying subgroups of people at risk for underadherence who subsequently might be targeted for intervention.
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ABSTRACT: The health benefits of regular physical activity and exercise have been widely acknowledged. Unfortunately, a decline in physical activity is observed in older adults. Knowledge of the determinants of physical activity (unstructured activity incorporated in daily life) and exercise (structured, planned and repetitive activities) is needed to effectively promote an active lifestyle. Our aim was to systematically review determinants of physical activity and exercise participation among healthy older adults, considering the methodological quality of the included studies. Literature searches were conducted in PubMed/Medline and PsycINFO/OVID for peer reviewed manuscripts published in English from 1990 onwards. We included manuscripts that met the following criteria: 1) population: community dwelling healthy older adults, aged 55 and over; 2) reporting determinants of physical activity or exercise. The outcome measure was qualified as physical activity, exercise, or combination of the two, measured objectively or using self-report. The methodological quality of the selected studies was examined and a best evidence synthesis was applied to assess the association of the determinants with physical activity or exercise. Thirty-four manuscripts reporting on 30 studies met the inclusion criteria, of which two were of high methodological quality. Physical activity was reported in four manuscripts, exercise was reported in sixteen and a combination of the two was reported in fourteen manuscripts. Three manuscripts used objective measures, twenty-two manuscripts used self-report measures and nine manuscripts combined a self-report measure with an objective measure. Due to lack of high quality studies and often only one manuscript reporting on a particular determinant, we concluded "insufficient evidence" for most associations between determinants and physical activity or exercise. Because physical activity was reported in four manuscripts only, the determinants of physical activity particularly need further study. Recommendations for future research include the use of objective measures of physical activity or exercise as well as valid and reliable measures of determinants.International Journal of Behavioral Nutrition and Physical Activity 12/2011; 8:142. DOI:10.1186/1479-5868-8-142 · 3.68 Impact Factor
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ABSTRACT: People may incorrectly perceive that their body weight or Physical Activity (PA) meets health recommendations; this provides an obstacle for change. In this study self-reported BMI and PA were assessed in relation to questions regarding perception of meeting weight and PA recommendations. Signal detection analysis was used to identify population subgroups. Study outcomes showed that 34.4 per cent of the 2535 adult participants underestimated weight health risks; low income, male participants who believed they were sufficiently active underestimated weight health risks the most (52.6%). A total of 23.7 per cent of participants overestimated PA health benefits; older age, low educated participants who did not believe their body weight was a health risk overestimated PA health benefits the most (58.3%). In conclusion, as weight and PA misperceptions are high, efforts are needed to reduce these misperceptions, so that behaviour change initiatives can be more effective.Journal of Health Psychology 03/2011; 16(5):760-9. DOI:10.1177/1359105310390543 · 1.88 Impact Factor
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ABSTRACT: This study assessed the sustained effect of a physical activity (PA) counseling intervention on PA one year after intervention, predictors of sustained PA participation, and three classes of post-intervention PA trajectories (improvers, maintainers, and decliners) in 238 older Veterans. Declines in minutes of PA from 12 to 24 months were observed for both the treatment and control arms of the study. PA at 12 months was the strongest predictor of post-intervention changes in PA. To our surprise, those who took up the intervention and increased PA levels the most, had significant declines in post-intervention PA. Analysis of the three post-intervention PA trajectories demonstrated that the maintenance group actually reflected a group of nonresponders to the intervention who had more comorbidities, lower self-efficacy, and worse physical function than the improvers or decliners. Results suggest that behavioral counseling/support must be ongoing to promote maintenance. Strategies to promote PA appropriately to subgroups of individuals are needed.Journal of aging research 12/2010; 2011:308407. DOI:10.4061/2011/308407