Levels Of Exercise Self-efficacy Research Articles

Correlates of physical activity in ambulatory people with spinal cord injury during the first year after inpatient rehabilitation.

Longitudinal cohort study. Examine the longitudinal association between mobility and level of physical activity (PA) and explore which other factors are also associated with level of PA in ambulatory people with Spinal Cord Injury (SCI) during the first-year post-inpatient rehabilitation. Three SCI-specialized rehabilitation centers and the Dutch community. Forty-seven adults with recent SCI and ambulatory function were included. All had motor incomplete lesions, 49% had tetraplegia, and the mean age was 55 ± 13 years. Duration of accelerometry-based all-day PA and self-reported level of mobility, exertion of walking, pain, fatigue, depressive mood symptoms, fear of falling, exercise self-efficacy, and attitude toward PA were measured just before discharge from inpatient rehabilitation and 6 and 12 months after discharge. All data were longitudinally analyzed using generalized estimating equations analyses. Models were corrected for age, lesion level, and time since injury. Mobility was longitudinally associated with level of PA (beta: 4.5, P < 0.001, R2: 41%). In addition, lower levels of exertion of walking (beta: -5.6, P < 0.001), fear of falling (beta: -34.1, P < 0.001), and higher levels of exercise self-efficacy (beta: 2.3, P = 0.038) were associated with higher levels of PA. Exertion of walking and fear of falling were associated with level of PA independent of mobility. Mobility, exertion of walking, fear of falling, and exercise self-efficacy seem to be correlates of level of PA in ambulatory people with SCI during the first year after inpatient rehabilitation. Targeting these factors using an interdisciplinary approach may enhance levels of PA in this population.

Social cognitive correlates of device-measured and self-reported physical activity in Black and White individuals with multiple sclerosis

BackgroundThere is increasing research interest regarding physical activity behavior among persons with multiple sclerosis (MS), yet there is little known about physical activity and its correlates in Black persons with MS. ObjectiveThis cross-sectional study assessed associations among social cognitive theory (SCT) variables and device-measured and self-reported physical activity in samples of Black and White persons with MS. MethodsParticipants included 67 Black and 141 White persons with MS who wore an ActiGraph accelerometer on a belt around the waist measuring moderate-to-vigorous physical activity (MVPA) for seven days and completed a battery of questionnaires. Questionnaires included demographic and clinical characteristics, leisure-time exercise, exercise self-efficacy, overcoming barriers self-efficacy, function, social support, exercise outcome expectations, and goal setting and planning. ResultsBlack participants with MS engaged in significantly less MVPA, but not sedentary behavior or light physical activity, than the White participants with MS. Black participants further had significantly lower levels of exercise self-efficacy and outcome expectations than the White sample. All SCT correlates were significantly correlated with self-reported physical activity, but only exercise and barriers self-efficacy, perceived function, and exercise goal setting were associated with device-measured MVPA. The difference in physical activity between Black and White participants with MS was accounted for by differences in exercise self-efficacy and outcome expectations. ConclusionsResearchers should consider developing behavioral interventions that target exercise self-efficacy and outcome expectations as SCT variables for increasing physical activity in Black persons with MS.

Exploration of the feasibility to combine patients with chronic obstructive pulmonary disease and chronic heart failure in self-management groups with focus on exercise self-efficacy

Objective To compare the level of exercise self-efficacy, symptoms, functional capacity and health status and investigate the association between these variables in patients with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Additionally, to investigate how diagnosis, symptoms and patient characteristics are associated with exercise self-efficacy in these patient groups. Design Cross-sectional study. Setting Primary care. Subjects Patients (n = 150) with COPD (n = 60), CHF (n = 60) and a double diagnosis (n = 30). Main outcome measures Swedish SCI Exercise Self-Efficacy score, modified Medical Research Council Dyspnea score (mMRC), fatigue score, pain severity score, Hospital Anxiety and Depression Scale, functional capacity measured as six-minute walking distance and health status measured by a Visual Analogue Scale. Results Levels of exercise self-efficacy, health status and symptoms were alike for patients with COPD and patients with CHF. Functional capacity was similar after correction for age. Associations with exercise self-efficacy were found for slight dyspnea (mMRC = 1) (R −4.45; 95% CI −8.41– −0.50), moderate dyspnea (mMRC = 2) (−6.60;−10.68– −2.52), severe dyspnea (mMRC ≥ 3) (−9.94; −15.07– −4.80), fatigue (−0.87;−1.41– −0.32), moderate pain (−3.87;−7.52– −0.21) and severe pain (−5.32;−10.13– −0.52), symptoms of depression (−0.98;−1.42– −0.55) and anxiety (−0.65;−0,10– −0.32), after adjustment for diagnosis, sex and age. Conclusion and implications Patients with COPD or CHF have similar levels of exercise self-efficacy, symptoms, functional capacity and health status. More severe symptoms are associated with lower levels of exercise self-efficacy regardless of diagnosis, sex and age. When forming self-management groups with a focus on exercise self-efficacy, it seems more relevant to consider level of symptoms than the specific diagnosis of COPD or CHF. Key points Exercise training is an important part of self-management in patients with COPD and chronic heart failure (CHF). High exercise self-efficacy is required for optimal exercise training. Patients with COPD and CHF have similar symptoms and similar levels of exercise self-efficacy, functional capacity and health status. Not the diagnosis, but symptoms of dyspnea, fatigue, pain, depression and anxiety are important factors influencing exercise self-efficacy and need to be addressed. When forming self-management groups with a focus on exercise self-efficacy, it seems more relevant to consider the level of symptoms than the specific diagnosis of COPD or CHF.

Factors associated with exercise self-efficacy among people with chronic diseases

AimThe aim of this study is to assess the level of exercise self-efficacy in a population with chronic diseases and identify the factors that could influence exercise self-efficacy. BackgroundPerforming physical exercise is an important part of self-care in chronic diseases. It is highly influenced by individual's self- efficacy. However, little attention has been given to the identification of the factors that could affect the exercise self-efficacy among people with chronic diseases. MethodsThis cross-sectional study was conducted to assess the exercise self-efficacy among people with chronic diseases using the Exercise Self-Efficacy Scale (ESE). Demographic and exercise profiles were also collected. ResultsA total of eighty-five people with chronic diseases from outpatients' clinics participated in this study. The mean age of the participants was 52 ± 13.92 and more than half of them were females (58.8%). The mean score of exercise self-efficacy was 39 ± 21.55. Education level was the main factor that correlated with lower levels of exercise self-efficacy. ConclusionsThis study is first to provide preliminary evidence about levels of exercise self-efficacy and its associated factors among people with chronic diseases in Saudi Arabia. The level of exercise self-efficacy is low in people with chronic diseases and this mainly associated with educational factor. Nurses have an important role to promoting exercise self-efficacy through implementing a comprehensive plan that is patient's centered approach. However, further research is needed to assess perception, detect barriers and conduct intervention that aims to improve exercise Self-efficacy.

청소년의 체중조절관련 건강신념과 운동효능감 및 운동지속의도가 신체활동에 미치는 영향

This study sought to examine whether physical activity level is associated with health belief-related weight control, exercise self-efficacy, and exercise adherence intention in Korean adolescents. As participants in the survey, a total of 652 male and female participants were recruited from junior high schools in Seoul. Statistical analyses were performed using SPSS Statistics program. The perceived benefit of health belief-related weight control was higher than other variables including perceived severity, barrier, and susceptibility in both genders. Female junior high school students were more susceptible to weight control behavior than male participants. In addition, the perceived benefit and barrier of weight control behavior were positively and negatively related to exercise adherence intention, respectively, in both male and female students. However, health belief was not correlated with physical activity level. These results indicate that positive health belief and weight control behavior may contribute to augmenting intrinsic motivation to exercise, but not genuinely increasing exercise participation. In contrast to health belief, the high level of exercise self-efficacy was found to be correlated with increases in exercise adherence intention and physical activity level. Therefore, education and guidance at home and in school are certainly required to establish desirable health belief and enhance exercise self-efficacy, which lead adolescents to maintain their healthy weight through regular physical activity.

Evaluation of factors affecting the levels of physical activity in patients with rheumatoid arthritis: a cross-sectional study.

Relatively little is known about what motivates or prevents patients with rheumatoid arthritis (RA) from adopting physically active lifestyles. This study aimed to evaluate the levels of physical activity and to identify the factors affecting a physically active lifestyle among Korean patients with RA. In this cross-sectional study, data were collected from a rheumatology outpatient clinic of a university-affiliated hospital in South Korea. The levels of physical activity were self-reported using the International Physical Activity Questionnaire. Participants who engaged in more than 600 metabolic equivalent task-minutes/week of physical activity and moderate activity or walking at least three times per week were considered physically active in this study. Structured questionnaires were used to assess perceived barriers and self-efficacy for exercise. Of 345 patients with RA included in this study, about 22% of patients were classified as physically active. Factors associated with a physically active lifestyle were good physical function (odds ratio [OR] = 0.56; 95% confidence interval [CI]: 0.36-0.87) and high levels of exercise self-efficacy (OR = 1.36; 95% CI: 1.20-1.54). Common barriers identified were fatigue, interference with other responsibilities, and a lack of time. Participants showed the lowest self-efficacy for exercise when they had pain and were busy with other activities. The level of physical function and exercise self-efficacy were predictors of physical activity. Individualized physical activity programs tailored to personal abilities and barriers and increasing exercise self-efficacy are needed to facilitate engagement of physical activity in Korean patients with RA. KEY POINTS: • Factors associated with a physically active lifestyle were good physical function and high levels of exercise self-efficacy. • The levels of exercise self-efficacy in Korean patients with RA are low compared to those in other populations. • Frequently encountered barriers in the subjects were being too tired, interference with other responsibilities, and lack of time. • Individualized physical activity programs tailored to personal abilities and barriers and increasing exercise self-efficacy are needed to facilitate engagement of physical activity in Korean patients with RA.

Relationships among walking speed, selected clinical symptoms, and exercise self-efficacy in individuals with knee osteoarthritis

PurposeOsteoarthritis (OA) is characterised by a combination of joint symptoms and signs stemming from defects in the articular cartilage and adjacent tissues, such as bone, synovial joint capsule, muscles, and ligaments. Knee OA is among the most common causes of pain and disability in middle-aged and older people. This study investigated the relationships among selected clinical symptoms (pain, stiffness, physical function), walking speed, and exercise self-efficacy in individuals with knee OA in Ibadan, Nigeria.MethodsThe study involved 100 individuals diagnosed with knee OA. Exercise self-efficacy was assessed with the exercise self-efficacy scale. Pain, stiffness, and physical function were evaluated with the Western Ontario and McMaster (WOMAC) Osteoarthritis Index questionnaire. Walking speed was determined during the 20-meter walk test. Data were analysed with descriptive statistics and Pearson’s correlation test, with significance level set at 0.05.ResultsSignificant correlations were observed between pain intensity and walking speed (ρ = –0.38), stiffness and walking speed (ρ = –0.19), physical function and walking speed (ρ = –0.40), pain intensity and exercise self-efficacy (ρ = –0.43), stiffness and exercise self-efficacy (ρ = –0.46), physical function and exercise self-efficacy (ρ = –0.41). More than 50% of the participants with knee OA had low exercise self-efficacy and moderate walking speed. Individuals with higher levels of pain, stiffness, and functional limitations showed lower levels of exercise self-efficacy and lower walking speed.ConclusionsIndividuals with knee OA presented low exercise self-efficacy, low walking speed, and reduced physical function, probably because of the debilitating effects of the condition.

Effects of Obesity Management Program Provided by Occupational Health Nurse in Worksite.

This study was conducted on 60 male adult technicians in the worksite to examine the impact of the obesity management program on their eating habits, exercise self-efficacy, quality of life, and body components. This was a nonrandomized pretest and posttest intervention study. The obesity management program was applied for 16 weeks on diet education, exercise, and counseling provided by the occupational health nurse in the worksite. The questionnaire for measure included the general characteristics, eating habits, exercise self-efficacy, and quality of life. Body components were measured by using the InBody 720 device. The participants who received the obesity management program showed better eating habits, a higher level of exercise self-efficacy, a higher level of quality of life, lower levels of body weight and body mass index (BMI), a smaller waist and hip circumference, and a higher level of muscle mass as compared with the preapplication.

Managing Obesity by a Specialist Nurse

Background and Aim: This study aimed to investigate the efficacy of nurse-led obesity management program. In the literature, there is a lack of studies conducted within the scope of nursing consultancy given to adult obese individuals. Materials and Methods: The research was planned as a randomized controlled experimental study and was conducted at an endocrine-metabolic clinic of a public hospital. The study was comprised of 64 obeses. The selfefficacy of obese individuals in terms of exercise and eating habits was assessed using the exercise self-efficacy scale, the Self-Efficacy to regulate eating habits scale and the obesity and weight-loss quality-of-life (OWLQOL). Results: It was determined that the nursing consultancy program based on health promotion model had a positive impact on individuals’ eating habits, exercise self-efficacy levels, quality of life, healthy life behaviors and anthropometric measurements. Conclusion: This study emphasizes the significance of the presence of “obesity nurse consultant” and the promotion of nurse consultancy practice in obesity management.

The Effect of School-based Exercise Practices of 9-11 Year Old Girls Students on Obesity and Health-related Quality of Life

This study was planned to determine the effects of school-based exercise practices (SBEP) on obesity and health-related quality of life (HRQL) in 9-11 year old girls. Participants consist of girls students from 9-11 years old in two state schools in Kars. Intervention Group (n: 85) courses of games and physical activities (CGPA) and SBEP (Basketball, Handball, Volleyball, Badminton, Table Tennis) and Control Group (n: 85) were formed as only CGPA. The exercise program; intervention groups was made subject to a training load of 60-70% and repetitions making up 3 days a week for 60 minutes a day, whereas the control group is a compulsory lesson 45 minutes three days a week in the gym or playground. Health-Related Quality of Life Scale (Kid-KINDL) was used in order to define the girl student quality of life before and after SBEP while Exercise Self-Efficacy Scale (ESS) was used for determining their exercise levels. According to the findings; Intervention group was found to be significant at p<.001 level according to the height, weight and body mass index control group of girl students. 4 months after intervention, the proportion of obesity in the intervention group was 25.2% and the rate of overweight was 14.2% while it was observed that the control group had a statistically insignificant decrease in BMI. Intervention group's scores of sub-dimensions of total quality of life, physical well-being, emotional well-being, self-esteem, family as well as exercise self-efficacy levels (ESL) were observed significantly high (p<0.001) compared to control group. A positive relationship (p<0.01; p<0.05) at the level of r=.361; r=.305; r=.219 was found between ESL and the sub-dimensions of physical well-being, emotional well-being and self-esteem of HRQL of intervention group while a significant relationship (p<0.05) at the level of r=.230 was determined between ESL and the sub-dimension of friends of HRQL Scale of control group. Consequently, Female students have a positive effect on ESL and HRQL. Obesity rate decreases as ESL increases and HRQL levels also increase significantly. SBEP participation should be increased at the point of increasing HRQL in children's daily lives and educational settings.

Physical Functioning, Physical Activity, Exercise Self-Efficacy, and Quality of Life Among Individuals With Chronic Heart Failure in Korea: A Cross-Sectional Descriptive Study.

Both the beneficial relationship between exercise and quality of life and the important role played by exercise self-efficacy in maintaining an exercise regimen among individuals with chronic heart failure are well known. However, most nursing interventions for Korean patients with chronic heart failure focus only on providing education related to risk factors and symptoms. Little information is available regarding the influence of physical functions, physical activity, and exercise self-efficacy on quality of life. This study was conducted to examine the impact of physical functioning, physical activity, and exercise self-efficacy on quality of life among individuals with chronic heart failure. This study used a cross-sectional descriptive design. Data were collected from 116 outpatients with chronic heart failure in Korea. Left ventricular ejection fraction and New York Heart Association classifications were chart reviewed. Information pertaining to levels of physical activity, exercise self-efficacy, and quality of life were collected using self-administered questionnaires. Data were analyzed using descriptive statistics, t tests, analyses of variance, correlations, and hierarchical multiple regressions. About 60% of participants were physically inactive, and most showed relatively low exercise self-efficacy. The mean quality-of-life score was 80.09. The significant correlates for quality of life were poverty, functional status, physical inactivity, and exercise self-efficacy. Collectively, these four variables accounted for 50% of the observed total variance in quality of life. Approaches that focus on enhancing exercise self-efficacy may improve patient-centered outcomes in those with chronic heart failure. In light of the low level of exercise self-efficacy reported and the demonstrated ability of this factor to predict quality of life, the development of effective strategies to enhance exercise self-efficacy offers a novel and effective approach to improving the quality of life of patients with chronic heart failure. Nurses should be proactive in advising patients with chronic heart failure to be more physically active and to enhance their self-confidence in diverse ways.

Physiological Responses to Virtual Exergame Feedback for Individuals with Different Levels of Exercise Self-Efficacy

OBJECTIVE: Exercise videogames are increasingly popular as individuals seek to increase their activity. This study assessed the interaction of exercise self-efficacy (ESE) levels and perceived task demands of a virtual game on exercise and physiological reactions. Perceived task demands were manipulated by changing parameters of the participant's avatar in the exergame. METHODOLOGY: An experimental design was used with 89 female undergraduate students (Mean age=18.74+1.05, 18 to 21 years) who were randomly assigned to the high task demand condition (avatar weight remaining constant) or low task demand condition (avatar losing weight). Prior to the biking task, the Exercise Self-Efficacy scale was used to measure ESE. Participants biked on a stationary bike while immersed in a virtual environment with an avatar and were told the avatar would slim if they cycled fast enough. Only half of participants' avatars actually slimmed (high task demand manipulation). During biking, cardiovascular measures were assessed using a Biopac MP150 system with an Impedance Cardiograph and CNAP Monitor 500. One week after completion of the study, participants reported amount of exercise completed in the last week (in 15 minute increments) via the Physical Activity Questionnaire. Moderated regressions and moderated mediation models were used to examine the interaction of ESE levels, experimental condition and cardiovascular reactivity on amount of strenuous physical activity. RESULTS: Individuals with high ESE showed similar results in both task demand conditions with physiological reactivity patterns indicative of threat. Individuals with low ESE with a static avatar completed less exercise than those with low ESE with a slimming avatar. CONCLUSION: Results confirm that individuals with low ESE are particularly vulnerable to exercise demands.

운동행동 변화단계에 따른 노인의 운동 자기효능감과 지각된 건강상태 수준 변화

Abstract The purpose of this study was to verify whether there are any differences in the level of exercise self-efficacy and perceived health status according to the stage of change for exercise behaviors in older adults. The subjects consisted of 231 older adults (91 male, 140 female) by convenience sampling residing in city D. The collected dates were analyzed using one-way ANOVA, Tukey HSD, and simple regression analysis by SPSS WIN 21.0 program. Moreover, all statistical significance level was set at a=.05. The study results were as follows: Analysis of variance showed that exercise self-efficacy showed significant differences according to the stage of change for exercise behaviors, and as a result of the posthoc analysis, it was found that as the stage became higher, their exercise self-efficacy became higher as well. Perceived health status showed significant differences according to the stage of change for exercise behaviors, and as a result of the posthoc analysis, it was found that as the stage became higher, their perceived health status became higher as well. Analysis of variance showed that exercise self-efficacy and perceived health status were significantly associated with the stages of exercise behavior change. This study identified that exercise self-efficacy and perceived health status were significant variables to explain a possible relationship with exercise stages of older adults. This study provides new information to influence the development of the better health promotion and exercise intervention for older adults in the community.

Social support as a predictor of diet and exercise self-efficacy in patients with coronary artery disease

Objectives: This study examined the role of social support and other factors in relation to exercise and diet self-efficacy in Chinese patients with coronary heart disease in Hong Kong.Methods: A cross-sectional study was conducted on a convenience sample identified from two cardiac rehabilitation centers. Eighty-five participants joined the study.Results: Both self-efficacy measures correlated with social support, in particular in the domains of emotional/informational support and positive social interactions. Stronger social support was independently associated with a higher level of exercise and diet self-efficacy. Patients with a higher body mass index had a lower level of exercise self-efficacy, whereas social drinkers had a lower level of diet self-efficacy.Conclusions: Our data supported an association between social support and self-efficacy. It was suggested that social companions would help patients get greater confidence in overcoming barriers to lifestyle modification. Further studies may investigate what type of social support contributes to improving the self-efficacy beliefs of patients.

Consequences of objective self-awareness during exercise.

Although exercise is recommended by healthcare professionals for nearly everyone, adverse reactions can occur following exercising for some overweight individuals. The reported study investigated the cardiovascular consequences of exercise in a stressful environment. In all, 60 females completed two baseline and one biking (i.e. ergometer) periods while cardiovascular and self-report measures were recorded. Findings indicated that those who are more self-aware showed cardiovascular response patterns indicative of threat. Additionally, post-task exercise self-efficacy levels predicted intentions to exercise at a demanding level in the coming week. These findings suggest exercise may exacerbate health issues for some individuals for whom it is recommended.

Examining the moderating effect of depressive symptoms on the relation between exercise and self-efficacy during the initiation of regular exercise.

People with depressive symptoms report lower levels of exercise self-efficacy and are more likely to discontinue regular exercise than others, but it is unclear how depressive symptoms affect the relation between exercise and self-efficacy. We sought to clarify whether depressive symptoms moderate the relations between exercise and same-day self-efficacy, and between self-efficacy and next-day exercise. Participants (n = 116) were physically inactive adults (35% reported clinically significant depressive symptoms) who initiated regular exercise and completed daily assessments for 4 weeks. Mixed linear models were used to test whether (a) self-efficacy differed on days when exercise did and did not occur, (b) self-efficacy predicted next-day exercise, and (c) these relations were moderated by depressive symptoms. First, self-efficacy was lower on days when no exercise occurred, but this difference was larger for people with high depressive symptoms (p < .001). They had lower self-efficacy than people with low depressive symptoms on days when no exercise occurred (p = .03), but self-efficacy did not differ on days when exercise occurred (p = .34). Second, self-efficacy predicted greater odds of next-day exercise, OR = 1.12, 95% [1.04, 1.21], but depressive symptoms did not moderate this relation, OR = 1.00, 95% CI [.99, 1.01]. During exercise initiation, daily self-efficacy is more strongly related to exercise occurrence for people with high depressive symptoms than those with low depressive symptoms, but self-efficacy predicts next-day exercise regardless of depressive symptoms. The findings specify how depressive symptoms affect the relations between exercise and self-efficacy and underscore the importance of targeting self-efficacy in exercise interventions, particularly among people with depressive symptoms. (PsycINFO Database Record

FRI0576-HPR Exercise Participation in People with Antiphospholipid Syndrome: Associations with Exercise Self-Efficacy and Illness Perception

BackgroundPhysical inactivity is a recognised major public health challenge. Antiphospholipid syndrome (APS) is associated with increased risk of cardiovascular morbidity and mortality.1 Physical activity levels of people with chronic illnesses...

Exercise Self-efficacy and Symptoms of Depression After Cardiac Rehabilitation

Cardiac rehabilitation is often recommended after experiencing a cardiac event and has been shown to significantly improve health outcomes among patients. Several psychosocial variables have been linked with cardiac rehabilitation program success, including exercise self-efficacy. However, little is known about temporal patterns in patients' exercise self-efficacy after program completion. This study examined changes in exercise self-efficacy among 133 cardiac rehabilitation patients and whether symptoms of depression impacted the rate of change in exercise self-efficacy. Participants completed questionnaires at the beginning and end of cardiac rehabilitation and at 6-month intervals for 2 years. Growth curve analyses showed that exercise self-efficacy levels were highest at the beginning of cardiac rehabilitation, significantly declined 6 months after cardiac rehabilitation, and leveled off over the next 18 months. Results also showed that baseline depressive symptoms interacted with time: Compared with participants with fewer symptoms, participants high in depressive symptoms began cardiac rehabilitation with lower levels of exercise self-efficacy and evidenced significant declines 6 months after cardiac rehabilitation. At no time were they equal to their counterparts in exercise self-efficacy, and their means were lower 2 years after cardiac rehabilitation than before cardiac rehabilitation. Our findings imply that patients show unrealistic optimism surrounding the ease of initiating and maintaining an exercise program and that integrating efficacy-building activities into cardiac rehabilitation, especially for patients who show signs of distress, is advisable.

Effects of a Behavioral Program on Exercise Adherence and Exercise Self-Efficacy in Community-Dwelling Older Persons

Background. This study determines the effects of a behavioral program on exercise adherence (step counts) and level of exercise self-efficacy (ESE) in community-dwelling older persons. Methods. Sixty-three participants (age = 63.8 ± 4.5 years) were enrolled in this controlled quasi-experimental study. They were divided into 3 groups: (1) EBG performed a 6-week exercise intervention followed by a 5-week behavioral program, (2) EG performed exercise intervention similar to EBG, and (3) control group (CG) did not receive any interventions. Step counts were measured based on the scores recorded by a pedometer while ESE was measured by a self-reported ESE scale. Results. Data analysis showed significant differences due to time effect (F(1,2) = 39.884, P < 0.01, and η = .399); time and group interactions (F(2,60) = 112.683, P < 0.01, and η = .790); and between-group effect (F(2,60) = 12.524, P < 0.01, and η = .295) for step counts. As for ESE, significant differences were also found for time effect (F(2,4) = 66.628, P < 0.05, and η = .526); time and group interactions (F(2,60) = 4.562, P = 0.014, and η = .132); and between-group effect (F(2,60) = 13.632, P < 0.05, and η = .312). EBG presented with significantly higher mean changes for both step counts and ESE compared to other groups (all P < 0.05). Conclusion. This study suggests that the addition of a behavioral program is superior as compared to exercising alone on increasing exercise adherence and level of self-efficacy in older persons.

Testing the effectiveness of a self-efficacy based exercise intervention for inactive people with type 2 diabetes mellitus: design of a controlled clinical trial

BackgroundSufficient exercise is important for people with Type 2 Diabetes Mellitus (T2DM), as it can prevent future health problems. Despite, it is estimated that only 30-40% of people with T2DM are sufficiently active. One of the psychosocial constructs that is believed to influence physical activity behaviour, is exercise self-efficacy. The goal of this study is to evaluate a patient-tailored exercise intervention for people with T2DM that takes exercise self-efficacy into account.Methods/DesignThis study is conducted as a non-randomized controlled clinical trial. Patients are eligible when they are diagnosed with T2DM, exercise less than advised in the ADA guideline of 150 min/week of moderate-intensity aerobic physical activity, have an BMI >25 and are between 18 and 80 years old. Recruitment takes place at a Primary care organization of general practitioners and practice nurses in the south of the Netherlands.Participants are allocated to three groups: An advice intervention -for participants with a high exercise self-efficacy score- in which participants receive a patient-tailored exercise intervention, an intensive intervention -for participants with a low exercise self-efficacy score- in which participants receive a patient-tailored exercise intervention accomplished by a group based intervention, and a control group in which participants receive regular Dutch diabetes care. The primary outcome measure of this study is physical activity. Secondary outcome measures are health status, (symptoms of) depression, exercise self-efficacy, Body Mass Index (BMI), blood pressure and glycemic control.DiscussionWe aimed to design an intervention that can be implemented in Primary care, but also to design an easy accessible program. This study is innovative as it is -to our best knowledge- the first study that takes level of exercise self-efficacy of people with T2DM into account by means of giving extra support to those with the lowest exercise self-efficacy. If the program succeeds in increasing the amount of physical activity it can be implemented in regular primary care.Trial registrationDutch Trial Register NTR2734