Higher Exercise Self-efficacy Research Articles

Psychosocial correlates of physical activity in cancer survivors: a systematic review and meta-analysis.

Physical activity (PA) is a non-pharmacological approach to optimize health benefits in cancer survivors and is recommended as part of care. However, most cancer survivors fail to meet PA recommendations. The current systematic review and meta-analysis aimed to identify psychosocial correlates of free-living PA in cancer survivors. Three electronic databases were searched (PubMed, PsycINFO, and SportDiscus). Meta-analyses were conducted for psychosocial correlates tested ≥ 3 times. Sixty-four articles were included. Eighty-eight different free-living PA correlates were identified. Meta-analyses (n = 32 studies) tested 23 PA correlates, of which 16 were significant (p < 0.05). Larger effect sizes (0.30 < ES > 0.45) were found for exercise self-efficacy, perceived behavioral control, intention, lower perceived barriers for exercise, enjoyment, perceived PA benefits, and attitudes. Small-to-moderate effects (0.18 < ES < 0.22) were found for subjective norms, physical functioning, quality of life, depression, and mental health. These findings were generally in line with narrative results. This systematic review highlights important psychosocial correlates of free-living PA that can be targeted in future PA promotion interventions for cancer survivors. Constructs mainly from SCT and TPB were the most studied and appear to be associated with free-living PA in this population. However, we cannot currently assert which frameworks might be more effective. Further studies of better methodological quality, per correlate and theory, exploring longer-term associations and across different types of cancer, are needed. Having higher exercise self-efficacy, perceived behavioral control, intention, enjoyment and perceived PA benefits, more positive attitudes towards PA, and lower perceived barriers for exercise, can help increase PA in cancer survivors.

The effect of exercise training and motivational counselling on physical activity behaviour and psychosocial factors in pregnant women: secondary analyses of the FitMum randomised controlled trial investigating prenatal physical activity

BackgroundA physically active lifestyle is beneficial during pregnancy. However, little is known about physical activity (PA) behaviour and psychosocial factors in women during and after pregnancy. This study examined exercise behavioural regulation, exercise self-efficacy, health-related quality of life, sickness absence and musculoskeletal pain in pregnant women offered either structured supervised exercise training, motivational counselling on PA, or standard prenatal care in the FitMum randomised controlled trial.MethodsTwo hundred and eighteen healthy inactive pregnant women were randomised to structured supervised exercise training (n = 87), motivational counselling on PA (n = 86) or standard prenatal care (n = 45). The women answered the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2), the Pregnancy Exercise Self-Efficacy Scale (P-ESES-DK) and the Short Form 36 Health Survey Questionnaire (SF-36) at baseline (gestational age (GA) of max 15 weeks), GA 28 and 34 weeks, and one year after delivery. Sickness absence and low back and/or pelvic girdle pain were likewise reported in questionnaires at baseline and GA 28 weeks.ResultsParticipants offered structured supervised exercise training or motivational counselling on PA had higher autonomous motivation for exercise during pregnancy compared with participants receiving standard prenatal care (e.g., difference in intrinsic regulation at GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 0.39 [0.16; 0.64], p < 0.001). Participants offered structured supervised exercise training also had higher exercise self-efficacy during pregnancy (e.g., GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 6.97 [2.05; 12.02], p = 0.005). All participants reported high exercise self-efficacy at baseline and medium exercise self-efficacy during pregnancy and one year after delivery. No differences were found between groups in health-related quality of life, sickness absence or low back and/or pelvic girdle pain during pregnancy. No group differences were found one year after delivery.ConclusionStructured supervised exercise training and motivational counselling on PA had important effects on autonomous exercise motivation during pregnancy. Exercise self-efficacy was also increased with structured supervised exercise training compared to standard prenatal care. No group differences in health-related quality of life, sickness absence, or pain were found during and after pregnancy. No effects were found one year post-delivery after intervention cessation.Trial registrationThe study was approved by the Danish National Committee on Health Research Ethics (#H-18011067) and the Danish Data Protection Agency (#P-2019–512). The study adheres to the principles of the Helsinki declaration. Written informed consent was obtained at inclusion.

Exploring differences between gender expressions in exercise self-efficacy and outcome expectations for exercise in individuals with stroke.

Gender expression may be associated with exercise self-efficacy and outcome expectations for exercise in the general population. Exercising for challenge and enjoyment are associated with the instrumental traits typically held by individuals with masculine gender expressions. Conversely, exercising for weight loss to receive validation from others are in line with the expressive traits most commonly held by individuals with feminine gender expressions. Moreover, possessing neither dominant nor expressive traits (undifferentiated gender expressions) have been linked to poorer psychological outcomes. Exercise is important after stroke, but gender differences in psychosocial factors for exercise in this population were unknown. The purpose of this study was to explore whether gender expression differences exist in exercise self-efficacy and outcome expectations for exercise post-stroke. Gender expression (masculine, feminine, androgynous, undifferentiated) was assessed using the Bem Sex-Role Inventory-12 (BSRI-12) in 67 individuals with stroke. Self-efficacy and outcomes expectations for exercise were assessed using the Self-Efficacy for Physical Activity Scale and Short Outcome Expectations for Exercise Scale, respectively. One-way analysis of covariance models were conducted, adjusting for biological sex, age, and time post-stroke. There were differences in exercise self-efficacy across the four gender expression groups (F(3,60) = 4.28, p<0.01), where individuals with masculine gender expressions had higher self-efficacy than those with undifferentiated gender expressions (adjusted mean: 3.56 [SE: 0.17] vs. 2.72 [SE:0.18], p<0.01). There were no differences in outcome expectations for exercise (F(3,57) = 1.08, p = 0.36) between gender expressions. In our pairwise comparisons, we found that individuals with masculine gender expressions had higher exercise self-efficacy than individuals possessing undifferentiated gender expressions. Strategies to enhance exercise self-efficacy after stroke are needed, particularly for individuals with undifferentiated gender expression. There were no associations between gender expression and outcome expectations for exercise after stroke. Clinicians may continue reinforcing the positive expectations towards exercise across all gender expressions.

Abstract 17966: Behavioral Characteristics of High-Risk Postpartum Individuals Predict Response to a Digital Health Intervention to Improve Physical Activity

Background: Hypertensive disorders of pregnancy (HDP) are common among women and increase risk for cardiovascular disease later in life. Postpartum interventions can motivate healthy lifestyle changes but are not universally effective. Patient demographics insufficiently predict intervention response. Our goal is to use cluster analysis to determine how behavioral phenotypes are associated with response to a digital health intervention targeting postpartum women with HDP. Methods: We analyzed 122 participants in the STEP-UP Mom study, a randomized clinical trial comparing wearable step tracker and team-based gamification (intervention) to wearable step tracker alone (control) over 12 weeks. Behavioral characteristics were collected at baseline using validated surveys, to which we applied the k-means method to identify two distinct patient clusters. Linear mixed-effects models were used to estimate mean step count difference between arms from baseline across 12-week follow-up in each cluster. Results: Among the 122 participants, the median age was 33 years and 54% identified as Black. Participant characteristics in each cluster are shown in the Table. Participants in Cluster 1 had higher baseline steps, lower exercise self-efficacy and greater psychosocial distress. There was no significant difference in change in step count in the intervention arm compared to the control arm (-289 steps, 95% CI -1294, 717; p=0.57). Participants in cluster 2 had lower baseline steps, higher exercise self-efficacy, and less psychosocial distress. In cluster 2, participants in the intervention arm walked 1,309 more steps per day on average compared to the control arm (95% CI 475, 2144; p= 0.003). Conclusion: Participants had varied response to a digital health intervention based on behavioral phenotype. This finding may help identify individuals who may benefit from a higher touch or tailored intervention in future studies to increase step count in the postpartum period.

Exercise Self-efficacy Improvements During Cardiac Rehabilitation: IMPACT OF SOCIAL DISPARITIES.

The objective of this study was to determine exercise self-efficacy improvements during cardiac rehabilitation (CR) and identify predictors of exercise self-efficacy change in CR participants. Patients with coronary heart disease at four metropolitan CR sites completed the Exercise Self-efficacy Scale at entry and completion. A general linear model identified independent predictors of change in exercise self-efficacy. The mean age of patients (n = 194) was 65.9 ± 10.5 yr, and 81% were males. The majority (80%) were married or partnered, 76% were White, and 24% were from an ethnic minority background. Patients received CR in-person (n = 91, 47%) or remote-delivered (n = 103, 54%). Exercise self-efficacy mean scores improved significantly from 25.2 ± 5.8 at CR entry to 26.2 ± 6.3 points at completion ( P = .025). The majority of patients (59%) improved their self-efficacy scores, 34% worsened, and 7% had no change. Predictors of reduced exercise self-efficacy change were being from an ethnic minority (B =-2.96), not having a spouse/partner (B =-2.42), attending in-person CR (B =1.75), and having higher exercise self-efficacy at entry (B =-0.37) (adjusted R2 = 0.247). Confidence for self-directed exercise improves in most, but not all, patients during CR. Those at risk for poor improvement (ethnic minorities, single patients) may need extra or tailored support, and screening for exercise self-efficacy at CR entry and completion is recommended. Differences identified from CR delivery mode need exploration using robust methods to account for complex factors.

Who makes it all the way? Participants vs. decliners, and completers vs. drop-outs, in a 6-month exercise trial during cancer treatment. Results from the Phys-Can RCT

PurposeTo compare sociodemographic, health- and exercise-related characteristics of participants vs. decliners, and completers vs. drop-outs, in an exercise intervention trial during cancer treatment.MethodsPatients with newly diagnosed breast, prostate, or colorectal cancer were invited to participate in a 6-month exercise intervention. Background data for all respondents (n = 2051) were collected at baseline by questionnaire and medical records. Additional data were collected using an extended questionnaire, physical activity monitors, and fitness testing for trial participants (n = 577). Moreover, a sub-group of decliners (n = 436) consented to additional data collection by an extended questionnaire . Data were analyzed for between-group differences using independent t-tests and chi2-tests.ResultsTrial participants were younger (59 ± 12yrs vs. 64 ± 11yrs, p < .001), more likely to be women (80% vs. 75%, p = .012), and scheduled for chemotherapy treatment (54% vs. 34%, p < .001), compared to decliners (n = 1391). A greater proportion had university education (60% vs 40%, p < .001), reported higher anxiety and fatigue, higher exercise self-efficacy and outcome expectations, and less kinesiophobia at baseline compared to decliners. A greater proportion of trial participants were classified as ‘not physically active’ at baseline; however, within the group who participated, being “physically active” at baseline was associated with trial completion. Completers (n = 410) also reported less kinesiophobia than drop-outs (n = 167).ConclusionThe recruitment procedures used in comprehensive oncology exercise trials should specifically address barriers for participation among men, patients without university education and older patients. Individualized efforts should be made to enroll patients with low exercise self-efficacy and low outcome expectations of exercise. To retain participants in an ongoing exercise intervention, extra support may be needed for patients with kinesiophobia and those lacking health-enhancing exercise habits at baseline.

Exercise Self-efficacy, Perceived Benefits, and Barriers to Exercise Among Patients Following Acute Myocardial Infarction.

Increasing patient adherence to regular exercise post acute myocardial infarction (AMI) is a major goal after hospitalization. It is therefore essential to identify perceived benefits and barriers to exercise and its association with exercise self-efficacy among patients post AMI. The purpose of this study was to identify the perceived benefits and barriers to exercise and the predictors of exercise self-efficacy among patients after AMI. A cross-sectional study design was used with a convenience sample of 254 patients, recruited from the 3 main hospitals in Jordan. Instruments included the Exercise Benefits and Barriers Scale and the Exercise Self-Efficacy Scale. Mean scores were computed to determine the perceived benefits and barriers responses. Multiple linear regression was conducted to explore the predictors of exercise self-efficacy. Data were collected over 5 months. The greatest perceived benefits were related to personal factors, for example, "I enjoy exercise" (2.45 [0.98]), and physical performance, for example, "My muscle tone is improved with exercise" (2.44 [0.86]) and "Exercise increases my stamina" (2.43 [0.86]). The greatest perceived barriers were related to environmental barriers, for example, "Lack of exercise places" (2.67 [0.82]), and internal factors related to physical exertion itself, for example, "Concerned about getting tired during exercise participation" (2.65 [0.72]). The Exercise Self-Efficacy Scale showed that patients post ST-elevation AMI had higher exercise self-efficacy than those with other treatment modalities (AMI, 44.71 [19.07] vs 36.59 [17.34]; P = .001). Patients treated by primary percutaneous coronary intervention had higher exercise self-efficacy, 49.2 (18.61), than patients treated by thrombolysis and percutaneous coronary intervention, 39.28 (18.3), and patients treated by medications other than thrombolytic therapy, 36.59 (17.4) (F2,251 = 11.612, P = .001). The multiple linear regression model explained approximately 29% of the variance in exercise self-efficacy (F11,242 = 7.914, P < .001). Five variables contributed significantly to the prediction of self-efficacy: type of AMI (standardized β = -0.173, t = -3.311, P = .01), perceived exercise benefits (standardized β = 0.322, t = 4.912, P = .01), perceived exercise barriers (standardized β = -0.291, t = -4.521, P = .01), being Argela smokers (water pipe smoking) (standardized β = -0.132, t = -2.617, P = .029), and cholesterol level (standardized β = -0.158, t = -2.174, P = .003). Primary perceived benefits of exercise reported were in the areas of personal factors and improved physical performance. The main perceived barriers to exercise were in the areas of environmental factors and physical exertion. Identification of benefits and barriers to exercise, type of AMI, and treatment modalities of AMI as predictors of exercise self-efficacy is a significant step for developing appropriate interventions that effectively improve exercise self-efficacy and exercise among post-AMI patients.

Behavioural and psychological pretreatment predictors of short- and long-term weight loss among women with overweight and obesity.

This study aims at identifying behavioural and psychological pretreatment predictors of 12- and 36-month weight loss in women with overweight/obesity enrolled in a behavioural weight management intervention. A sample of 221 women participated in a randomized controlled trial on weight management (n12 month = 184; n36 month = 156). Multiple linear regressions were used to identify pretreatment predictors of successful weight loss, separately for intervention and control groups. Completers-only and baseline observation carried forward analyses were performed. This study is a secondary analysis of data from the 'Promotion of Exercise and Health in Obesity' randomized controlled trial. Fewer weight loss attempts in the last year positively predicted weight loss at 12 months in the intervention group, explaining 6% of the variance. At 36 months, in the intervention group, 20.2% of the variance in weight change was explained by lower eating disinhibition and higher weight-related quality of life in completers-only analyses, while baseline observation carried forward analyses explained only 9.8% of the variance in weight change via higher self-esteem and lower weight loss expectations. In the control group, higher exercise self-efficacy and a more internal weight locus of control predicted weight loss at 36 months, explaining 13.9% of the variance (completers-only analyses). Previous weight loss attempts were identified as the most efficient pretreatment predictor of 12-month weight loss. Eating disinhibition, weight-related quality of life, self-esteem, weight loss expectations, exercise self-efficacy, and weight locus of control seem to be key factors for long-term success. Level I, randomized controlled trial. ClinicalTrials.gov identifier NCT00513084.

Sex differences in osteoporosis self-efficacy among community-residing older adults presenting for DXA.

To understand the extent to which the Osteoporosis Self Efficacy (OSE) Scale is reliable for both men and women. A secondary objective was to evaluate sex differences in OSE. For this cross-sectional study, we analyzed data collected as part of the Patient Activation after DXA Result Notification (PAADRN) pragmatic trial which enrolled 7749 community-residing adults aged 50 and older reporting for bone densitometry. We used univariable methods, item analysis, exploratory and confirmatory factor analyses, and linear regression to evaluate sex differences in OSE responses and measurement. In this sample, the confirmatory factor analysis model for OSE both overall and within groups indicated a poor fit. The sex differences in the measurement model, however, were minor and reflected configural invariance (i.e., constructs were measuring the same things in both men and women), confirming that the OSE was measuring the same constructs in men and women. Men overall had higher exercise self-efficacy and women higher calcium self-efficacy. Overall, education, hip fracture, and self-reported health status predicted exercise self-efficacy whereas prior DXA, self-reported osteoporosis, and history of pharmacotherapy use did not. Predictors of calcium self-efficacy differed by gender. The OSE can be used to measure calcium and exercise self-efficacy in all older adults. However, gender differences in clinical predictors of self-efficacy and the lack of an association of prior DXA with self-efficacy imply that interventions to improve self-efficacy may be insufficient to drive significant improvement in rates of osteoporosis evaluation and treatment. Patient Activation after DXA Result Notification (PAADRN), NCT01507662, https://clinicaltrials.gov/ct2/show/NCT01507662.

Perception Exercise self-efficacy, Body Image and Health-related Quality of Life of Children with Needs Special Education

In this study, it was aimed to examine the body ımage, exercise self-efficacy and health-related quality of life of children with special education needs. Participants of this study were selected from volunteer students in five and eight classes in state school in Mersin during the 2016-2017 academic year. The study group consists of a total of 95 students, 52 of which require special education and 43 of which are healthy. The Health Related Quality of Life Scale (Kid-KINDL) was used to describe the quality of life of healthy and specialist training groups, the Exercise Self-Efficacy Scale (ESS) and the Body Image Scale (BIS) were used to determine exercise levels. According to findings; When the groups’ physical characteristics were compared, a significant difference wasn’t observed in terms of age between them (p&amp;gt; 0.05). However, when compared with healthy group special education group body height, weight and VKI, there was a significant difference at p &amp;lt;.001 level. There was no significant difference between the groups in the friendship subscale of the HRQL-KINDL scale (p&amp;gt; 0.05). However, the total quality of life, physical well-being, emotional well-being, school, self-esteem and family subscales scores of the healthy group were significantly higher than the special education group (p &amp;lt;0.001). Similarly, healthy group ESL and BIS were found to be higher than special education group (p &amp;lt;0.001). As a result of this study, it was seen that the of health group have higher exercise self-efficacy and body image and health-related quality of life than special education group.

The Effects of a Program Combining Exercise and Music on Promoting Exercise Continuance and Psychological Factors in Older People

Physical exercise can have a positive effect on physical and cognitive functions in older people. However, the elderly often face difficulties in maintaining exercise routines. Music is reported to effectively improve the subjective experience of physical exercise’s intensity, execution, and enhanced capacity related to a sense of accomplishment. We aimed to investigate whether adding music to physical exercise promoted exercise continuance compared with physical exercise alone. The participants were 74 community-dwelling older people who independently maintained activities of daily living. They were either assigned to a music group (MG) or non-music group (NMG). Exercise classes were held once a week for 3 months. The number of times participants participated in the exercise classes, and the number of times they performed exercises at home was assessed. In addition, each participant completed a set of questionnaires assessing exercise self-efficacy (SE) and quality of life before and immediately after the 3-month intervention. After the 3-month intervention, the MG had a significantly higher frequency of participation in the exercise classes and a significantly higher exercise SE score compared with the NMG. Our results show that the combination of physical exercise and music was beneficial for exercise continuance and exercise SE compared with physical exercise alone. Keywords: music, exercise, continuance, exercise self-efficacy, independent older people.

Trajectories of Physical Activity Over Two Years in Persons With Rheumatoid Arthritis.

To identify and describe different trajectories of physical activity over 2 years and to identify baseline predictors for each trajectory within a large cohort of people with rheumatoid arthritis (RA). The sample included 2,752 people ages 18-75 years and independent in daily living. Data on sociodemographic, disease-related, and psychosocial variables and physical activity (total weekly hours of vigorously/moderately intense activity and walking) were collected from registers and by questionnaires at baseline, and at 14 and 26 months. K-means cluster analysis was used to identify different physical activity trajectories. Multinomial logistic regression was used to identify predictors of trajectory membership. Three trajectories were identified: 1 stable high (n = 272; with an average of 25 hours of physical activity/week), 1 decreasing (n = 564; changing from 22 to 8 hours), and 1 stable low (n = 1,916; with an average of 3 hours). Predictors of the stable high trajectory versus the other 2 were male sex and already established physical activity at baseline. Predictors of the stable high trajectory versus decreasing trajectory were lower age and less social support for exercise, while predictors of stable high versus the stable low trajectory were less activity limitation and higher exercise self-efficacy. The results indicate that distinct trajectories of physical activity over 2 years in people with RA exist, and that stable, high physical activity is mainly predicted by male sex and already established physical activity at baseline. Additional predictors, amenable to change, include activity limitation, social support, and self-efficacy for exercise, suggesting a wide perspective on maintained physical activity in RA.

Relationship between self-reported and objectively measured physical activity and subjective memory impairment in breast cancer survivors: role of self-efficacy, fatigue and distress.

Many breast cancer survivors report cancer and cancer treatment-associated cognitive change. However, very little is known about the relationship between physical activity and subjective memory impairment (SMI) in this population. The purpose of this study is to examine the relationship between physical activity and SMI and longitudinally test a model examining the role of self-efficacy, fatigue and distress as potential mediators. Post-treatment breast cancer survivors (N = 1477) completed measures of physical activity, self-efficacy, distress (depression, concerns about recurrence, perceived stress, anxiety), fatigue and SMI at baseline and 6-month follow-up. A subsample (n = 362) was randomly selected to wear an accelerometer. It was hypothesized that physical activity indirectly influences SMI via exercise self-efficacy, distress and fatigue. Relationships were examined using panel analysis within a covariance modeling framework. The hypothesized model provided a good fit in the full sample (χ2 = 1462.5, df = 469, p = <0.001; CFI = 0.96; SRMR = 0.04) and the accelerometer subsample (χ2 = 961.8, df = 535, p = <0.001, CFI = 0.94, SRMR = 0.05) indicating increased physical activity is indirectly associated with reduction in SMI across time, via increased exercise self-efficacy and reduced distress and fatigue. Higher levels of physical activity, lower levels of fatigue and distress and higher exercise self-efficacy may play an important role in understanding SMI in breast cancer survivors across time. Future research is warranted to replicate and explore these relationships further. Copyright © 2016 John Wiley & Sons, Ltd.

Home-Based Exercise May Not Decrease the Insulin Resistance in Individuals with Metabolic Syndrome

Background: This study investigated the differences in exercise self-efficacy, compliance, and effectiveness of home-based exercise in individuals with and without metabolic syndrome (MetS). Methods: One hundred and ten individuals at risk for diabetes participated in this study. Subjects were categorized into individuals with MetS and individuals without MetS. Metabolic risk factors and exercise self-efficacy were evaluated for all subjects before and after 3 months of home-based exercise. Univariate analysis of variance was used to compare the effectiveness of a home-based exercise program between individuals with and without MetS. Results: The home-based exercise program improved body mass index and lipid profile in individuals at risk for diabetes, regardless of MetS status at baseline. Individuals without MetS had higher exercise self-efficacy at baseline and performed greater exercise volume compared with individuals with MetS during the intervention. The increased exercise volume in individuals without MetS may contribute to their better control of insulin resistance than individuals with MetS. Furthermore, baseline exercise self-efficacy was correlated with exercise volume executed by subjects at home. Conclusions: We conclude that home-based exercise programs are beneficial for individuals at risk for diabetes. However, more intensive and/or supervised exercise intervention may be needed for those with MetS.

Effectiveness of a Releasing Exercise Program on Anxiety and Self-Efficacy Among Nurses.

The purpose of this study was to evaluate the effectiveness of a releasing exercise program (REP) on anxiety and exercise self-efficacy among nurses. The REP consisted of warm-up and tension-releasing exercises and mood adjustment. Ninety-nine nurses (age = 33.38 ± 7.38 years) experiencing anxiety (average Visual Analog Scale for Anxiety [VASA] score of 5.63 ± 1.44 at baseline) were randomly assigned to an experimental group (n = 50) that received 50-min REP sessions 3 times a week or a control group (n = 49) that did not attend REP sessions. The outcome measures were VASA, the Chinese Version of the Beck Anxiety Inventory, and Exercise Self-Efficacy Scale scores. At Weeks 12 and 24, the experimental group had significantly lower anxiety levels and higher exercise self-efficacy scores than the control group. Therefore, the REP effectively reduces anxiety and enhances self-confidence in exercise capability.

Adherence to physical activity guidelines in older adults, using objectively measured physical activity in a population-based study.

BackgroundPhysical activity (PA) levels in older adults decline with age. The prevalence and correlates of adherence to current UK PA guidelines in older adults has not been studied using objectively measured PA, which can examine precisely whether PA is carried out in bouts of specified length and intensity.MethodsFree living men and women aged 70–93 years from 25 towns in the United Kingdom, participating in parallel on-going population based cohort studies were invited (by post) to wear a GT3x accelerometer over the hip for one week in 2010–12. Adherence to UK PA guidelines was defined as ≥150 minutes/week of moderate or vigorous PA (MVPA) in bouts of ≥10 minutes; the effect of different intensities and durations were examined.Results1593 men and 857 women participated (responses 51% and 29% respectively). 15% men and 10% women achieved ≥150 minutes/week of MVPA (defined as >1040 cpm) in bouts lasting ≥10 minutes. With MVPA defined as >1952 cpm, prevalences were 7% and 3% respectively. Those adhering to guidelines were younger, had fewer chronic health conditions, less depression, less severe mobility limitations, but higher exercise self-efficacy and exercise outcomes expectations. They rated their local environment more highly for social activities and leisure facilities, having somewhere nice to go for a walk and feeling safe after dark, They left the house on more days per week, were more likely to use active transport (cycle or walk) and to walk a dog regularly.ConclusionsFew older adults attain current PA guidelines. Health promotion to extend the duration of moderate-intensity activity episodes to 10 minutes or more could yield important health gains among older adults. However future studies will need to clarify whether attaining guideline amounts of PA in spells lasting 10 minutes or more is critical for reducing chronic disease risks as well as improving cardiometabolic risk factors.

The effects of a transtheoretical model-based exercise stage-matched intervention on exercise behavior in patients with coronary heart disease: A randomized controlled trial

ObjectiveTo determine whether a transtheoretical model-based exercise stage-matched intervention (ESMI) has positive effects on the exercise behavior of sedentary patients with coronary heart disease (CHD). MethodsThe study was a randomized controlled trial with a repeated measures design. Participants (N=196) were randomly allocated to either a conventional (C) group, a patient education (PE) group, or an ESMI group. Exercise behavior was measured by exercise stages of change, exercise self-efficacy, exercise decisional balance, and duration of moderate exercise at baseline, immediate post-intervention, and at 3- and 6-month follow-up. ResultsOur results showed that the ESMI group demonstrated a more positive shift in exercise stages of change (p<0.01), higher exercise self-efficacy (p<0.01), greater exercise benefits (p<0.01), fewer exercise barriers (p<0.01), and longer moderate exercise duration (minutes/week) (p<0.01) after completion of the 8-week intervention compared with the C and PE groups. These significantly positive effects were maintained at 3- and 6-month follow-up. ConclusionThe transtheoretical model-based ESMI had significantly positive effects on the exercise behavior of sedentary CHD patients. Practice implicationsIt is important to provide a structured education program for CHD patients, preferably guided by the transtheoretical model.

Home-Based Exercise May Not Decrease the Insulin Resistance in Individuals With Metabolic Syndrome

This study investigated the differences in exercise self-efficacy, compliance, and effectiveness of home-based exercise in individuals with and without metabolic syndrome (MetS). One hundred and ten individuals at risk for diabetes participated in this study. Subjects were categorized into individuals with MetS and individuals without MetS. Metabolic risk factors and exercise self-efficacy were evaluated for all subjects before and after 3 months of home-based exercise. Univariate analysis of variance was used to compare the effectiveness of a home-based exercise program between individuals with and without MetS. The home-based exercise program improved body mass index and lipid profile in individuals at risk for diabetes, regardless of MetS status at baseline. Individuals without MetS had higher exercise self-efficacy at baseline and performed greater exercise volume compared with individuals with MetS during the intervention. The increased exercise volume in individuals without MetS may contribute to their better control of insulin resistance than individuals with MetS. Furthermore, baseline exercise self-efficacy was correlated with exercise volume executed by subjects at home. We conclude that home-based exercise programs are beneficial for individuals at risk for diabetes. However, more intensive and/or supervised exercise intervention may be needed for those with MetS.

Effects of a 6-Week Walking Program on Taiwanese Women Newly Diagnosed With Early-Stage Breast Cancer

In Western culture, evidence has shown that in women with breast cancer exercise decreases fatigue and improves quality of life. However, only 1 pilot study about the effect of exercise has been examined in the Asian breast cancer population that indicated feasibility. Therefore, it is important to further study the effect of an exercise program for Taiwanese women with breast cancer. The purpose of this study was to test the effects of a walking program on Taiwanese women newly diagnosed with early-stage breast cancer. This was an experimental, longitudinal study with 4-time repeated measures based on Bandura's Self-efficacy Theory, with the aim of implementing interventions to boost exercise self-efficacy and to evaluate research outcomes. SPSS 17.0 with descriptive statistics using frequency, percentage, mean, and SD as well as inferential statistics such as t test, χ test, hierarchical linear model, repeated-measures analysis of variance, and analysis of covariance was used for data analysis. Results of this study indicated that subjects in the exercise group had significantly better quality of life, less fatigue, less sleep disturbances, higher exercise self-efficacy, more exercise behavior, and better exercise capacity compared with those in the usual-care group after the intervention. This program was effective and feasible, but more research studies with experimental, longitudinal design to verify the effects of this exercise program on Taiwanese women with breast cancer will be needed. Nurses, depending on skill and knowledge, can encourage physical activity, refer patients to rehabilitation programs, and prescribe and monitor exercise in breast cancer population.

PSYCHOBIOLOGICAL PREDICTORS OF EXERCISE BEHAVIOUR IN POSTMENOPAUSAL WOMEN

Weight gain and the associated increased risk of obesity-related diseases are associated with the postmenopausal period. However, moderate intensity exercise may be protective for postmenopausal women through attenuation of weight gain. Despite this evidence, many postmenopausal women do not engage in regular exercise. As exercise has a positive effect on body composition and the subsequent health of postmenopausal females, an understanding of why exercise levels decline in this population is needed. In particular, understanding the difference in exercise behaviour characteristics of exercising and non-exercising postmenopausal women may encourage more non-exercising postmenopausal women to obtain the health benefits of exercise. An understanding of the exercise behaviour characteristics of exercising and non-exercising postmenopausal women may also provide information for future health promotion policy directions for this population and allow for the formulation of guidelines for exercise professionals. It appears that the life event of menopause can become a barrier or an opportunity for postmenopausal women to exercise, depending on their exercise behaviour characteristics. Postmenopausal women (N=101) resident in North Queensland volunteered for this study. A self-report questionnaire was utilised to determine the participants’ recent exercise history. Participants completed two exercise behaviour scales. The Selfefficacy for Exercise Scale is a barrier-specific, thirteen-item instrument listing common reasons for preventing participation in exercise. The Health Belief Model(HBM) scale required participants to indicate how much they agreed or disagreed with various statements relating to their individual health beliefs related to exercise and obesity. Anthropometric assessments ascertained body mass index and waist-to-hip ratio.Resting heart rate and blood pressure were also measured. Participants then performed a six minute graded exercise test (GXT) to determine estimated maximum oxygen uptake (V& O2max). A second visit required participants to perform a twenty minute moderate intensity exercise bout on a cycle ergometer while measures of pre, during and post-exercise affect were obtained using the Subjective Exercise Experience Scale (SEES). Following data collection, participants were categorised as exercisers (n=53) or non-exercisers (n=48) based on whether they had performed a minimum of 150 minutes of accumulated moderate intensity exercise in the past 7 days. Univariate and multivariate statistical tests including discriminant function analysis (DFA) were utilised to determine whether significant between-group differences existed for the physiological and psychological variables. The non-exercisers had obtained a lower level of education (U = 971.5, p = .03),were at a lower stage of exercise change (U = 308.0, p = .00), had higher resting diastolic blood pressure (F1,99=7.57, p=0.01), BMI (F1,99=33.63, p=0.00) and WHR (F1,99=5.83, p=0.02) and lower cardiorespiratory fitness (F1,99=21.57, p=0.00) and exercise self-efficacy (F1,99=39.56, p=0.00) compared to the exercisers. Each of these variables may therefore represent barriers to exercise adoption for this sample of non-exercising postmenopausal women. DFA determined that the postmenopausal women with higher exercise self-efficacy,lower BMI and higher cardiorespiratory fitness were more likely to be exercisers. DFA also found that the barrier to exercise items of perceived lack of time,difficulty getting to an exercise location and the weather provided the greatest discrimination between exercisers and non-exercisers. Further analysis of exercise self-efficacy revealed that participants at different stages of change possessed different levels of exercise self-efficacy. Participants with the lowest exercise self-efficacy were in the precontemplation and contemplation stages of change, while participants with the highest exercise self-efficacy were in the action and maintenance stages. DFA results for the HBM scale revealed that the non-exercising postmenopausal women had higher perceptions of susceptibility to developing an obesity-related disease, perceived a greater number of consequences from participating in regular exercise and felt they were less health motivated to control an obesity-related disease compared to the exercising women. Separate mixed design repeated measures ANOVA found that no significant between-group differences occurred for positive well-being (SEESa) and fatigue(SEESc)during twenty minutes of moderate intensity exercise. However,follow-up univariate contrasts (Bonferroni)found that the acute exercise bout did have a beneficial effect for both groups across time, with higher SEESa scores postexercise compared to pre and during exercise. Additionally, SEESc scores for both groups were lower postexercise compared to during the latter stages of exercise. Further research on postmenopausal women residing in Australian metropolitan cities is recommended for determining whether the differences found in this study are unique to postmenopausal women residing in regional North Queensland.