An Application of the Transtheoretical Model to the Exercise Behavior of Individuals Accessing HIV-related Services

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Clinical research suggests that exercise is beneficial for individuals living with HIV; however, there is little research examining the exercise behavior of individuals living with this disease in a community setting. Furthermore, the trans theoretical model (TTM) of exercise behavior has been widely used to identify the readiness to begin planned exercise behavior in healthy populations, but it has not been widely applied individuals living with HIV who are engaged in HIV-related care services. PURPOSE: To examine 1) the distribution of the stages of change for exercise among individuals accessing HIV-related care services, 2) the differences between the TTM constructs explained by the stage of change, and 3) whether the TTM constructs predict the stages of change better than chance alone. METHODS: Cross-sectional data were collected from 208 individuals accessing HIV-related care services from February - April 2006. Participants completed questionnaires for each TTM construct (processes of change, self-efficacy, and decisional-balance) and a measure of physical activity MET level. RESULTS: Univariate analyses revealed significant differences between stages of change for each of the TTM constructs (p<05). The largest proportion of variance was derived from the behavioral processes (n2 = 0.22) followed by self-efficacy (n2 = 0.15), the experiential processes of change (n2 = 0.14), and decisional-balance (n2 = 0.11). Predictive discriminant analysis revealed that participants in precontemplation were accurately classified 48% of the time, contemplators 25% of the time, preparers 70% of the time, and individuals in maintenance 63% of the time. None of the individuals in action were classified correctly. CONCLUSIONS: This was one of the first studies to examine the TTM for exercise behavior among individuals accessing HIV-related care services. Overall, the results are consistent with other studies in healthy populations, suggesting that stage-matched interventions based on this model can be developed for individuals accessing HIV-related care services.