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ABSTRACT: Little is known about how screen-based sedentary behavior at home and in preschool influences children's health and activity patterns. The current study examined the individual and cumulative influence of TV viewing at home and in preschool on children's physical activity (PA) and weight status. Children (n=339) attending 16 preschools in South Carolina were grouped into high and low TV groups based on parent report of children's TV viewing at home and director report of TV use/rules in preschool. T-tests and mixed model ANOVAs examined differences in weight status and PA (min/hr) by high and low TV groups. Results revealed that children who were classified as High TV both at home and in preschool had significantly lower levels of moderate-to-vigorous PA compared with their Low TV counterparts (8.3 (0.3) min/hr vs. 7.6 (0.2) min/hr, p<.05). However, there were no significant differences in weight status or physical activity between the high and low TV groups at home or in preschool when examined individually. These findings demonstrate the importance of total environmental TV exposure on preschooler's PA. Longitudinal and observational research to assess preschoolers' cumulative screen-based sedentary behavior and its relationship with PA and weight status is needed.
Pediatric exercise science 03/2013; · 1.71 Impact Factor
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Sara Wilcox,
Allen Parrott,
Meghan Baruth,
Marilyn Laken,
Margaret Condrasky, Ruth Saunders,
Marsha Dowda,
Rebecca Evans,
Cheryl Addy,
Tatiana Y Warren,
Deborah Kinnard,
Lakisha Zimmerman
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ABSTRACT: BACKGROUND: Faith-based interventions hold promise for promoting health in ethnic minority populations. To date, however, few of these interventions have used a community-based participatory research (CBPR) approach, have targeted both physical activity and healthy eating, and have focused on structural changes in the church. PURPOSE: To report the results of a group randomized CBPR intervention targeting physical activity and healthy eating in African-American churches. DESIGN: Group RCT. Data were collected from 2007 to 2011. Statistical analyses were conducted in 2012. SETTING/PARTICIPANTS: Seventy-four African Methodist Episcopal (AME) churches in South Carolina and 1257 members within them participated in the study. INTERVENTION: Churches were randomized to an immediate (intervention) or delayed (control) 15-month intervention that targeted organizational and environmental changes consistent with the structural ecologic model. A CBPR approach guided intervention development. Intervention churches attended a full-day committee training and a full-day cook training. They also received a stipend and 15 months of mailings and technical assistance calls to support intervention implementation. MAIN OUTCOME MEASURES: Primary outcomes were self-reported moderate- to vigorous-intensity physical activity (MVPA), self-reported fruit and vegetable consumption, and measured blood pressure. Secondary outcomes were self-reported fat- and fiber-related behaviors. Measurements were taken at baseline and 15 months. Intent-to-treat repeated measures ANOVA tested group X time interactions, controlling for church clustering, wave, and size, and participant age, gender, and education. Post hoc ANCOVAs were conducted with measurement completers. RESULTS: There was a significant effect favoring the intervention group in self-reported leisure-time MVPA (d=0.18, p=0.02), but no effect for other outcomes. ANCOVA analyses showed an intervention effect for self-reported leisure-time MVPA (d=0.17, p=0.03) and self-reported fruit and vegetable consumption (d=0.17, p=0.03). Trainings were evaluated very positively (training evaluation item means of 4.2-4.8 on a 5-point scale). CONCLUSIONS: This faith-based structural intervention using a CBPR framework showed small but significant increases in self-reported leisure-time MVPA. This program has potential for broad-based dissemination and reach. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.govNCT00379925.
American journal of preventive medicine 02/2013; 44(2):122-131. · 4.24 Impact Factor
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ABSTRACT: An important influence on youth physical activity (PA) is the provision of instrumental social support (ISS) by parents and other adults. Limited research exists about factors that influence parental provision of ISS for youth PA. Following a theory-based conceptual model, a measure for assessing ISS for PA was developed from elicitation survey results. The purpose of this paper is to describe elicitation methodology and ISS instrument development.
Parents (N = 37) of children (5-14 years) responded to open-ended questions assessing modal beliefs about their provision of ISS for PA regarding a) positive/negative beliefs, b) normative beliefs, c) self-efficacy (SE), and d) ISS for PA. Data were analyzed qualitatively.
ISS behaviors reported by parents include enroll/sign-up youth for structured PA, paying expenses for participation in structured/unstructured PA, and providing transportation for unstructured/structured PA. Child health and fitness (benefits), and time/scheduling conflicts (barriers) were most frequently reported behavioral beliefs. Family members were most frequently identified as specific referents for normative beliefs. Final instrument scales yielded moderately high internal consistency reliability scores.
When developing scales not previously assessed in a population, eliciting modal beliefs about a behavior is an important formative step in instrument development.
Journal of Physical Activity and Health 07/2012; 9(5):706-17.
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ABSTRACT: Children in residential children's homes (RCH) may be at increased risk for physical inactivity due to decreased access to opportunities for activity. Little is known about environmental determinants of physical activity for children in RCH.
Thirty-minute blocks of MVPA and Total METs were measured using the 3-Day Physical Activity Recall (3DPAR). A staff interview, based on the Structural Ecologic Model of Health Behavior, assessed physical activity opportunities, structures, characteristics, policies, and social environment. Wilcoxon 2-sample tests were used to examine differences in environment by location and presence of a recreation director. Mixed model ANOVAs assessed the differences in child level activity by environmental variables.
There were significant correlations between opportunities and characteristics of physical activity, facilities, and equipment with total METS for children. Children in homes with a recreation director and homes in rural locations reported more physical activity. Only rural location had a significant effect on physical activity. Presence of a recreation director was significant in several models.
Rural location may be conducive for increased physical activity in children at RCH. Employing a recreation director or other trained personnel may be an important policy determinant of physical activity for children.
Journal of Physical Activity and Health 07/2011; 8(5):636-44.
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Dawn K Wilson,
M Lee Van Horn,
Heather Kitzman-Ulrich, Ruth Saunders,
Russell Pate,
Hannah G Lawman,
Brent Hutto,
Sarah Griffin,
Nicole Zarrett,
Cheryl L Addy,
Leslie Mansard,
Gary Mixon,
Porschia V Brown
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ABSTRACT: This study reports the results of the "Active by Choice Today" (ACT) trial for increasing moderate-to-vigorous physical activity (MVPA) in low-income and minority adolescents.
The ACT program was a randomized controlled school-based trial testing the efficacy of a motivational plus behavioral skills intervention on increasing MVPA in underserved adolescents. Twenty-four middle schools were matched on school size, percentage minorities, percentage free or reduce lunch, and urban or rural setting before randomization. A total of 1,563 6th grade students (mean age, 11.3 years, 73% African American, 71% free or reduced lunch, 55% female) participated in either a 17-week (over one academic year) intervention or comparison after-school program.
The primary outcome measure was MVPA based on 7-day accelerometry estimates at 2-weeks postintervention and an intermediate outcome was MVPA at midintervention.
At midintervention students in the intervention condition engaged in 4.87 greater minutes of MVPA per day (95% CI: 1.18 to 8.57) than control students. Students in intervention schools engaged in 9.11 min (95% CI: 5.73 to 12.48) more of MVPA per day than those in control schools during the program time periods; indicating a 27 min per week increase in MVPA. No significant effect of the ACT intervention was found outside of school times or for MVPA at 2-weeks postintervention.
Motivational and behavioral skills programs are effective at increasing MVPA in low-income and minority adolescents during program hours, but further research is needed to address home barriers to youth MVPA.
Health Psychology 05/2011; 30(4):463-71. · 3.87 Impact Factor
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ABSTRACT: African Americans are at increased risk for cardiovascular disease and cancer morbidity and mortality. Physical activity and healthy dietary practices can reduce this risk. The church is a promising setting to address health disparities, and community-based participatory research is a preferred approach.
Using a community-based participatory approach and the social ecologic model, the FAN trial aims to increase self-reported moderate-intensity physical activity and fruit and vegetable consumption and reduce blood pressure in African American church members. Secondary aims are to increase objectively measured moderate-intensity physical activity and fiber/whole grain consumption and reduce fat consumption.
FAN is a group randomized trial (GRT) with two levels of clustering: participants (N=1279; n=316 accelerometer subgroup) within church and church within church cluster. In the first wave, seven clusters including 23 churches were randomized to an immediate intervention or delayed intervention. In subsequent waves, 51 churches were randomized to an immediate or delayed intervention.
Church committee members, pastors, and cooks participate in full-day trainings to learn how to implement physical activity and dietary changes in the church. Monthly mailings and technical assistance calls are delivered over the 15-month intervention. Members complete measurements at baseline and 15 months. A detailed process evaluation is included.
FAN focuses on modifying the social, cultural, and policy environment in a faith-based setting. The use of a community-based participatory research approach, engagement of church leaders, inclusion of a detailed process evaluation, and a formal plan for sustainability and dissemination make FAN unique.
Contemporary clinical trials 03/2010; 31(4):323-35. · 1.51 Impact Factor
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ABSTRACT: Mediation analyses in faith-based physical activity (PA) interventions targeting African-American adults are lacking. The purpose of this study was to examine the psychosocial mediators of a faith-based PA intervention with African-American adults. Churches were randomly assigned to receive immediate or delayed (1-year later) training in PA program implementation. A subsample of participants from randomly selected churches took part in telephone surveys at baseline and at 1 year. The primary outcome was percentage of participants meeting PA recommendations. MacKinnon's product of coefficients was used to test for mediation. Participants (n = 418) from 20 churches completed the baseline and 1-year follow-up surveys. There were no statistically significant changes in PA behavior at 1 year. The intervention had a marginally significant effect on increasing the amount of instrumental church support received by church members. However, none of the psychosocial variables tested were found to be significant mediators of the intervention. Mediation analyses provided insight into potential reasons as to why the Health-e-AME intervention did not change PA. The intervention did not successfully change the targeted mediators hypothesized to change PA. Potential reasons for these shortcomings as well as issues to address in future faith-based studies are discussed.
Health Education Research 02/2010; 25(4):645-55. · 1.66 Impact Factor
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ABSTRACT: The purpose of this study was to demonstrate how formative program process evaluation was used to improve dose and fidelity of implementation, as well as reach of the intervention into the target population, in the "Active by Choice Today" (ACT) randomized school-based trial from years 1 to 3 of implementation.
The intervention integrated constructs from Self-Determination Theory and Social Cognitive Theory to enhance intrinsic motivation and behavioral skills for increasing long-term physical activity (PA) behavior in underserved adolescents (low income, minorities). ACT formative process data were examined at the end of each year to provide timely, corrective feedback to keep the intervention "on track".
Between years 1 and 2 and years 2 and 3, three significant changes were made to attempt to increase dose and fidelity rates in the program delivery and participant attendance (reach). These changes included expanding the staff training, reformatting the intervention manual, and developing a tracking system for contacting parents of students who were not attending the after-school programs regularly. Process outcomes suggest that these efforts resulted in notable improvements in attendance, dose, and fidelity of intervention implementation from years 1 to 2 and 2 to 3 of the ACT trial.
Process evaluation methods, particularly implementation monitoring, are useful tools to ensure fidelity in intervention trials and for identifying key best practices for intervention delivery.
International Journal of Behavioral Nutrition and Physical Activity 11/2009; 6:79. · 3.83 Impact Factor
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ABSTRACT: Physical activity (PA) participation offers many benefits especially among ethnic groups that experience health disparities. Partnering with faith-based organizations allows for a more culturally tailored approach to changing health behaviors.
8 Steps to Fitness was a faith-based behavior-change intervention promoting PA among members of African American churches. A quasi-experimental design was used to examine differences between the intervention group (n = 72) and comparison group (n = 74). Health (resting blood pressure, body mass index, waist-hip ratio, fasting blood glucose), psychosocial (PA self-efficacy, social support, enjoyment, self-regulation, depression), and behavioral variables (PA, diet) were assessed at baseline, 3- and 6-months. Repeated measures ANCOVAs tested changes across time between groups.
At 3-months, the intervention group showed significantly more favorable changes in body mass index, waist circumference and social support than the control group. At 6-months, the intervention group showed significantly more favorable changes in hip circumference, waist to hip ratio, systolic blood pressure, and depressive symptoms. There was notable attrition from both the intervention (36%) and the comparison group (58%).
This study was conducted in a real-world setting, and provided insight into how to deliver a culturally-tailored PA intervention program for African Americans with a potential for dissemination.
Journal of physical activity & health 09/2009; 6(5):568-77. · 1.95 Impact Factor
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ABSTRACT: The factorial validity and measurement equivalence/invariance of scales used to measure social-cognitive correlates of physical activity among adolescent girls were examined.
Confirmatory factor analysis was applied to questionnaire responses obtained from a multi-ethnic sample (N = 4885) of middle-school girls from six regions of the United States. A cohort of 1893 girls completed the scales in both sixth and eighth grades, allowing longitudinal analysis.
Theoretically and statistically sound models were developed for each scale, supporting the factorial validity of the scales in all groups. Multi-group and longitudinal invariance was confirmed across race/ethnicity groups, age within grade, BMI categories, and the 2-year period between grades.
The scores from the scales provide valid assessments of social-cognitive variables that are putative mediators or moderators of change in physical activity. The revised scales can be used in observational studies of change or interventions designed to increase physical activity among girls during early adolescence.
Journal of Pediatric Psychology 06/2009; 35(1):72-88. · 2.91 Impact Factor
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ABSTRACT: Recent studies have found a relationship between access to neighborhood physical activity (PA) facilities and physical activity in youth.
The purpose of this study was to assess whether proximity of commercial PA facilities was related to vigorous physical activity (VPA) in 12th grade girls, independent of sport participation and social-cognitive influences, including perceived features of the social and physical environment.
Girls (N = 1,126 girls; 55% black, body mass index = 25.0 +/- 6.4) in 22 high schools completed questionnaires and provided home addresses. Using geographic information systems technology, commercial PA facilities were mapped and counted within 0.75- and 2.0-mile street network buffers around each girl's home. Girls self-reported PA using the 3-day physical activity recall.
Approximately 25% of girls had at least one PA facility within the 0.75-mile buffer, and 65% of girls had at least one PA facility within the 2.0-mile buffer. Models of the direct and indirect relations of commercial PA facilities at 0.75- and 2.0-mile buffers, sport participation, self-efficacy for overcoming barriers and perceived physical and social environment with VPA both had acceptable fit to data (root mean square error of approximation = 0.049 and comparative fit index = 0.91).
The results indicate that proximity to multipurpose commercial PA facilities is a correlate of VPA independent of sport participation and perceived features of the social and physical environment.
Annals of Behavioral Medicine 03/2009; 37(1):77-87. · 4.20 Impact Factor
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ABSTRACT: Theoretically, self-regulatory strategies (e.g., goal setting, self-monitoring) are an important influence of behavior change, but very little research has examined the relationship between self-regulation and physical activity (PA) behavior. Petosa's (1993) 43-item PA self-regulation scale (PASR-43) affords the opportunity for studying this construct in the context of PA; however the PASR-43 has not been tested for structural aspects of validity. Therefore, this study examines the structural validity of the PASR-43 in older adults.
The structural validity of the PASR-43 was tested in a large sample of older adults from North and South Carolina and Ohio (N = 460) using maximum likelihood estimation and confirmatory factor analysis in AMOS 5.0.
The original 6-factor model for the PASR-43 scale did not represent an acceptable fit to the data (chi2 = 4732.25, df = 845, P < .0001, RMSEA = 0.10, NNFI = 0.67, CFI = 0.71). Based on a post hoc specification search, iterative model modifications resulted in a 12-item PA self-regulation scale (PASR-12) that represented an excellent fit to the data (chi2 = 70.75, df = 39, P = .001, RMSEA = 0.04, NNFI = 0.98, CFI = 0.99).
The PASR-12 provides a concise and valid measure of PA self-regulation for use with older adults. Future studies should cross-validate the PASR-12 and examine invariance across time and between age, ethnic, gender, and geographical groups.
Journal of physical activity & health 01/2009; 6 Suppl 1:S105-12. · 1.95 Impact Factor
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ABSTRACT: The purpose of this study was to examine the relationship between food environments and fruit and vegetable (FV) consumption of adolescents (n=246) living in Residential Children's Homes (RCHs) in North and South Carolina, USA. Administrators of 21 RCHs completed the Physical Activity and Dietary Environmental Assessment (PADEA), an instrument assessing FV-related environmental variables of RCHs: (i) policies, (ii) availability, (iii) social environment, (iv) community collaboration and (v) administrative support. Two different approaches using mixed-effects regression models were used to compare FV consumption of adolescents living in RCHs with more conducive food environments compared with adolescents living in RCHs with less conducive environments. Using one approach, PADEA variables were analyzed as categorical data and in the second approach, PADEA variables were analyzed as continuous data. Results indicated greater FV consumption among adolescents residing in RCHs with more conducive food environments compared with less conducive RCHs. Specifically, adolescents living in RCHs with higher levels of administrative support and more FV policies reported greater FV intake compared with adolescents living in RCHs with less support and fewer policies. Food environments are related to adolescents' dietary behaviors and interventions targeting FV consumption should include strategies to increase administrative support and the development of FV-related policies.
Health Education Research 12/2008; 24(3):520-30. · 1.66 Impact Factor
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ABSTRACT: Churches are becoming increasingly popular settings for conducting health promotion programs. Retrospective interviews were conducted with 19 health directors from churches taking part in the evaluation of a large-scale faith-based physical activity initiative. This paper first describes program implementation, church leadership support, and changes in church leadership, and then relates these variables to program outcomes (percentage of participants meeting physical activity recommendations). Finally, barriers and successes to program implementation are reported. The most commonly reported intervention activities implemented by churches were bulletin boards related to healthy eating and physical activity (79%) followed by bulletin inserts (69%), walking programs (58%), chair exercises (48%), praise aerobics (27%), a 10-min exercise CD (26%), and an 8 week behavior change class (26%). Significant increases in physical activity were associated with churches which had ever implemented the behavior change class at the 1-year follow-up. According to health directors, pastors sometimes to often spoke about physical activity and diet from the pulpit but rarely to sometimes took part in program activities. They also reported that pastors spouses' never to rarely spoke about physical activity and diet from the pulpit, and rarely to sometimes took part in program activities. About 68% of the churches had at least one change in pastor over the 3-year study. A majority of these variables, however, were not related to changes in physical activity. Potential reasons for these lack of associations are discussed.
Journal of Community Health 06/2008; 33(5):304-12. · 1.28 Impact Factor
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ABSTRACT: Most people with arthritis are not regularly active. Understanding what factors influence exercise is essential for designing programs to increase participation. The objective of this study was to examine the correlates of exercise in people with arthritis. Using a cross-sectional design, sociodemographic, health-related, and psychosocial variables were collected from community-dwelling individuals with arthritis (N = 141). Associations with exercise level were examined with bivariate statistics (ANOVAs, chi-squares) and logistic-regression analyses. Exercisers were less likely than nonexercisers and insufficiently active people to report that arthritis negatively affected their physical and social functioning, and they reported more positive affect and greater self-efficacy (p < .05). Exercisers also reported less pain than nonexercisers (p < .05). In multiple logistic-regression analyses, self-efficacy and physical limitations remained independent predictors of exercise. The results suggest the need to target exercise self-efficacy when designing exercise interventions. Results also suggest the need to tailor exercise programs to individuals' physical limitations.
Journal of aging and physical activity 04/2008; 16(2):125-43. · 2.09 Impact Factor
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Dawn K Wilson,
Heather Kitzman-Ulrich,
Joel E Williams, Ruth Saunders,
Sarah Griffin,
Russell Pate,
M Lee Van Horn,
Alexandra Evans,
Brent Hutto,
Cheryl L Addy,
Gary Mixon,
Susan B Sisson
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ABSTRACT: Although school-based behavioral interventions for increasing physical activity (PA) in children and adolescents have been conducted, little evidence suggests that these curriculum-based approaches lead to increases in overall activity outside of program days. The overall goal of the "Active by Choice Today" (ACT) trial is to expand the body of knowledge concerning the factors that influence long-term increases in PA in underserved adolescents (low socioeconomic status, minorities) during their middle school years.
An overview of the ACT study design, theoretical framework, process evaluation, and primary hypotheses is presented. The trial involves twenty-four middle schools (1560 6th graders) in South Carolina that are randomly assigned to one of two after-school programs (motivational and life skills intervention, or general health education).
The intervention integrates constructs from Self-Determination and Social Cognitive Theories to enhance intrinsic motivation and behavioral skills for PA. The intervention targets skill development for PA outside of program days and the after-school program social environment (autonomy, choice, participation, belongingness, fun, enjoyment, support) is designed to positively impact cognitive mediators (self-efficacy, perceived competence), and motivational orientation (intrinsic motivation, commitment, positive self-concept). MAIN HYPOTHESES/OUTCOMES: It is hypothesized that the 17-week motivational and life skills intervention will lead to greater increases in moderate-to-vigorous PA (based on 7-day accelerometry estimates) at post-intervention as compared to the general health education program.
Implications of this innovative school-based trial are discussed.
Contemporary Clinical Trials 02/2008; 29(1):21-31. · 1.81 Impact Factor
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ABSTRACT: Health-e-AME was a 3-year intervention designed to promote physical activity at African Methodist Episcopal churches across South Carolina. It is based on a community-participation model designed to disseminate interventions through trained volunteer health directors.
We used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate this intervention through interviews with 50 health directors.
Eighty percent of the churches that had a health director trained during the first year of the intervention and 52% of churches that had a health director trained during the second year adopted at least one component of the intervention. Lack of motivation or commitment from the congregation was the most common barrier to adoption. Intervention activities reached middle-aged women mainly. The intervention was moderately well implemented, and adherence to its principles was adequate. Maintenance analyses showed that individual participants in the intervention's physical activity components continued their participation as long as the church offered them, but churches had difficulties continuing to offer physical activity sessions. The effectiveness analysis showed that the intervention produced promising, but not significant, trends in levels of physical activity.
Our use of the RE-AIM framework to evaluate this intervention serves as a model for a comprehensive evaluation of the health effects of community programs to promote health.
Preventing chronic disease 11/2007; 4(4):A87. · 1.82 Impact Factor
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ABSTRACT: Physical activity (PA) decreases during childhood and adolescence, and PA levels are significantly lower in females than males, particularly during adolescence. Schools are attractive settings in which to implement interventions designed to promote PA in girls and young women, but few studies have tested the sustained effects of such interventions.
Cross-sectional. Data were collected in 2002-2003 and analyzed in 2006-2007.
1594 adolescent girls in 22 high schools.
The intervention, Lifestyle Education for Activity Program (LEAP), was designed to increase physical activity in 9th-grade girls through two channels: changes in instructional practices and changes in the school environment. This study (LEAP 2) examined the extent to which effects of the intervention were maintained when the girls were in the 12th grade.
Number of 30-minute blocks per day of vigorous physical activity.
Girls in the intervention schools that most fully implemented and maintained the intervention were more likely than girls in the other schools to participate in an average of one or more blocks of vigorous physical activity per day (p=0.04, odds ratio=1.49, 95% confidence interval=1.01-2.20).
A comprehensive physical activity intervention that is fully implemented and maintained can increase participation in vigorous physical activity by high school girls.
American Journal of Preventive Medicine 11/2007; 33(4):276-80. · 4.04 Impact Factor
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ABSTRACT: Little is known about the types of physical activity (PA) in which adolescent girls participate. Understanding this, along with examining specific psychosocial correlates of PA, may help guide the development of effective interventions to prevent the decline in PA in female youth.
2791 sixth grade girls participating in the Trial of Activity for Adolescent Girls from six geographical locations completed surveys assessing participation in sports teams and activity classes/lessons in and out of school, self-efficacy for PA, PA enjoyment, physical education (PE) enjoyment, and perceived school climate for girls' PA (data collection: January-May 2003). Correlates of girls' participation in structured PA and sociodemographic differences were explored.
89.5% of girls participated in structured PA: 39% at school and 86% outside of school. Across race/ethnicity, most reported activities were basketball (44%), cheerleading/dance (41%), and swimming (39%). Controlling for socioeconomic status, geographical location, and race/ethnicity, girls with a higher self-efficacy (OR=3.44, CI=1.72-6.92) and higher enjoyment of PE class (OR=1.97, CI=1.25-3.120) were more likely to participate in structured PA. PA enjoyment and perceived school climate for girls' PA were not associated with participation in structured PA.
Interventions that increase self-efficacy and enjoyment of PE could result in greater participation in structured PA and higher overall PA levels among adolescent girls.
Preventive Medicine 06/2007; 44(5):404-9. · 3.22 Impact Factor
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ABSTRACT: Recent public health objectives emphasize the importance of exercise for reducing disability among people with arthritis. Despite the documented benefits of exercise, people with arthritis are less active than those without arthritis. The purpose of this study was to examine the factors that influence exercise participation among insufficiently active individuals with arthritis and to compare these factors with those identified by nonexercisers and regular exercisers with arthritis.
Forty-six individuals with arthritis were recruited from various community-based organizations to participate in seven focus groups segmented by exercise status and education. Trained moderators led each discussion using a standard guide. All focus group discussions were transcribed verbatim and coded.
Pain was the most commonly mentioned barrier to exercise and limited exercise participation for nonexercisers and insufficiently active individuals. Paradoxically, insufficiently active individuals also identified exercise-related reductions in pain as a potential motivation for increasing exercise. Likewise, exercise-related reductions in pain were a motivation to continue exercising for the exerciser groups. Nonexercisers expressed that a reduction in pain was a possible outcome of exercise but were skeptical of its occurrence. Receiving tailored advice from a health care provider was consistently identified as an exercise enabler across the groups.
Findings from this study indicate that potential strategies for increasing exercise participation include incorporating pain management strategies and coping skills into exercise interventions and ensuring that health care providers provide specific exercise advice to their patients with arthritis.
Preventing chronic disease 08/2006; 3(3):A81. · 1.82 Impact Factor
