Applying the Transtheoretical Model to Exercise Behavior and Sleep Quality in Taiwanese College Students

Abstract

Purpose: The purpose of this study was to leverage the explanatory power of the Transtheoretical Model of behavior change (TTM) in an investigation of the exercise habits of Taiwanese college students, as well as in an exploration of the relationship between sleep quality and physical fitness levels. Method: 647 college students (282 women, 365 men, from northern Taiwan volunteered as test subjects. TTM stages were determined using a questionnaire. The quality of their sleep was evaluated using a version of the Pittsburgh Sleep Quality Index (PSQI) tailored to Chinese populations, and their levels of physical fitness were gauged using a battery of field-based health-related fitness tests administered by well-trained instructors. Data were analyzed using one-way ANOVA. Results: The results suggest the following: (1) In terms of the TTM stages of implementing healthy exercise behavior, at the time of the study, only 21.7% of students surveyed were at TTM stages of engaging in regular exercise (11.4% in action, 10.2% in maintenance) Students at more advanced TTM stages of implementing regular exercise performed better in the physical fitness tests than did those who were at earlier TTM stages, and obtained lower global PSQI scores, suggesting superior sleep quality. (2) Significant differences between stages were found for the overall set of TTM and for each physical fitness variable (3) In males, significant correlations were observed between several indicators of fitness (BMI, 1600-m run/walk test, 1-min curl-up test, standing long jump) and certain PSQI sub-scores; in females, such a correlation with indicators of sleep quality was only identified in a single fitness indicator (the 800-m run/ walk test). Conclusion: The results generally support the TTM stage can be used to accurately predict a student's physical fitness level. These findings provide a basis for future studies investigating strategies that are effective in promoting wellness in college students and exercise promotion programs. For example, based on the observation that most Taiwanese college students are engaged in early stages of adopting healthy exercise habits, it is recommended that physical education courses be added to college curricula to encourage students in early stages of change, and to promote physical fitness.