The transtheoretical model and exercise adherence: examining construct associations in later stages of change

Abstract

Abstract Objective Over 40% of Americans are sedentary and of those beginning an exercise program, 50% will drop out within 6 months. The Transtheoretical Model (TTM) is commonly used to describe exercise behavior and develop interventions for the initiation of exercise behavior. Less is known, however, about maintenance of exercise behavior and the construct associations for the action, maintenance, and termination stages of change. Thus, the purpose of this study was to examine which of the TTM constructs (i.e. decisional balance, processes of change, barriers-efficacy, and temptation) best distinguishes between the action, maintenance, and termination stages of change for men and women. Methods Questionnaires measuring each of the TTM constructs were collected from 330 men ( M age=27.14 years) and 380 women ( M age=24.80 years). Data were examined for sex differences and subsequently, two forward logistic regressions were conducted for each sex such that the dependent variables for the regressions were action/maintenance and maintenance/termination. Results Compared to men, women reported significantly less barriers-efficacy ( p =.04), greater pros of exercise ( p =.004), and greater use of behavioral ( p =.001) and experiential ( p p =.02), while barriers efficacy ( p =.001), environmental evaluation ( p =.02), and affect temptation ( p =.03) were associated with maintenance/termination. For the women, environmental reevaluation ( p =.02) and social liberation ( p =.05) were associated with action/maintenance, while barriers-efficacy ( p =.003) was the only construct correlated with maintenance/termination. Conclusions Stage and gender specific considerations are warranted when designing stage-matched exercise interventions for long-term maintenance of exercise behavior.