Motivational Readiness For Physical Activity Research Articles

Examining the influence of mental health and structural determinants of health on the stage of motivational readiness for health behaviour changes: A path analysis study.

This study explores the influence of mental health and structural determinants of health on motivational readiness for health behaviour change in 1462 Spanish primary healthcare users. Chi-square test and structural equation modelling were performed. Results showed that depression and anxiety were negatively associated with being in the action stages of motivational readiness for a healthy diet and physical activity. This association was statistically significant only for motivational readiness for a healthy diet and depression (). Furthermore, women and workers were more likely to be in the action stages of motivational readiness for a healthy diet while older adults and adults with higher health-related quality of life were more likely to be in the action stages of motivational readiness for physical activity. The present study suggests that structural (being older, being a woman and being employed) and intermediary (suffering from depression and higher health-related quality of life) determinants of health influence motivational readiness for health behaviour changes.

Motivational readiness for physical activity and health literacy: results of a cross-sectional survey of the adult population in Germany

BackgroundHealth literacy, defined as the knowledge, motivation, and competences to use health information to improve health and well-being, is associated with regular physical activity. However, there is limited evidence on whether health literacy is also related to the motivational readiness for physical activity in a general population. The aim of this study was to investigate whether motivational readiness for leisure-time physical activity is associated with health literacy.MethodsAnalyses were based on data of 21,895 adults from the cross-sectional German Health Update and European Health Interview Survey 2014/2015 (GEDA 2014/2015-EHIS). Motivational readiness for leisure-time physical activity was assessed with stages of change for physical activity with a set of validated items. It was then classified, according to an established algorithm, into five stages: precontemplation, contemplation, preparation, action, and maintenance. Health literacy was measured with the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and categorised as low, medium, and high. For bivariate and multinomial logistic regression analyses, the stages were categorised in three phases as: (1) no intention (precontemplation), (2) planning (contemplation or preparation), and (3) in activity (action or maintenance). The models were adjusted for sex, age, education, health consciousness, self-efficacy, and self-perceived general health status.ResultsHigh compared to low health literacy was associated with a 1.65-times (95% CI = 1.39–1.96) greater probability of being in activity than planning. High compared to low health literacy was associated with a reduced risk of having no intention to change physical activity behaviour (relative risk ratio, RRR = 0.84, 95% CI = 0.75–0.95). The associations persisted after adjusting for covariates.ConclusionHigh health literacy was positively associated with more advanced phases of motivational readiness for leisure-time physical activity. Therefore, taking health literacy into account in interventions to promote motivational readiness for leisure-time physical activity could be a useful approach.

Peer mentors delivering a physical activity intervention for cancer survivors: effects among mentors.

To further inform implementation efforts of a telephone-based physical activity (PA) intervention for breast cancer survivors, we assessed the PA, fatigue, mood, and quality of life of the peer mentors/coaches who delivered the program. The coaches were volunteers with the American Cancer Society's Reach to Recovery program. The coaches (n=18) delivered the PA intervention to 76 breast cancer survivors in a randomized controlled trial. Coaches completed assessments of PA (self-report), motivational readiness for PA, and standardized measures of psychosocial variables at the start of coaching and at study exit. At study exit, they also responded to an open-ended question on the benefits that they accrued from the study. We used generalized linear models to analyze the PA data and psychosocial variables. Chi-squared analyses were used for motivational readiness. The written responses to the open-ended question were analyzed to identify themes. Coaches' PA exceeded national recommendations at study entry and exit with no significant changes over time. Sixty-one percent were in the maintenance stage of motivational readiness, and 61% remained in the same stage at study exit. Psychosocial functioning also remained stable over time. Qualitative data revealed that the coaches' gains included helping themselves (with four subthemes) and helping others. Intervention delivery had no unintended negative consequences (PA, motivational readiness, and psychosocial functioning) among coaches. They reported gains that were not reflected in standardized psychosocial assessments. These data support further implementation of peer-delivered PA programs to enhance the reach of interventions.

Compliance to exercise-oncology guidelines in prostate cancer survivors and associations with psychological distress, unmet supportive care needs, and quality of life.

The purpose of this study was to determine prevalence of Australian prostate cancer survivors meeting contemporary exercise-oncology guidelines and identify associations with distress, unmet supportive care needs, and quality of life. A population-based cohort of 463 prostate cancer survivors who were on 10.8months post-curative therapy was assessed for compliance with current exercise guidelines for cancer survivors, motivational readiness for physical activity, psychological distress, unmet supportive care needs, and quality of life. Only 57 men (12.3%) reported sufficient exercise levels (150min of moderate intensity or 75min of strenuous exercise per week and twice weekly resistance exercise), 186 (40.2%) were insufficiently active, and 220 (47.5%) were inactive. Among inactive men, 99 (45.0%) were in the contemplation or preparation stage of motivation readiness. Inactive men had higher global distress (p = 0.01) and Brief Symptom Inventory-Anxiety (p < 0.05) than those who were insufficiently active. Total Supportive Care Needs and International Prostate Cancer Symptom scores were higher in inactive than insufficiently and sufficiently active men (p < 0.05). Lack of physical activity contributed to poorer quality of life. Only a small proportion of Australian prostate cancer survivors met contemporary exercise-oncology recommendations despite increasing recognition of exercise to improve patient outcomes. Strategies are urgently required to increase prostate cancer survivors' participation in aerobic and resistance exercise training.Copyright © 2015 John Wiley & Sons, Ltd.

Developing an Intervention to Address Physical Activity Barriers for African–American Women in the Deep South (USA)

To address high rates of inactivity and related chronic diseases among African-American women. Eleven focus groups on physical activity barriers for African-American women in the deep south (USA) were conducted (n = 56). Feedback guided an intervention development process. The resulting Home-Based Individually Tailored Physical Activity Print intervention was vetted with the target population in a 1-month, single arm, pre-post test demonstration trial (n = 10). Retention was high (90%). Intent-to-treat analyses indicated increases in motivational readiness for physical activity (70% of sample) and physical activity (7-day Physical Activity Recall) from baseline (mean: 89.5 min/week, standard deviation: 61.17) to 1 month (mean: 155 min/week, standard deviation: 100.86). Small improvements in fitness (6-Min Walk Test), weight and psychosocial process measures were also found. Preliminary findings show promise and call for future randomized controlled trials with larger samples to determine efficacy. Such low-cost, high-reach approaches to promoting physical activity have great potential for addressing health disparities and benefiting public health.

Proactive versus reactive recruitment to a physical activity intervention for breast cancer survivors: Does it matter?

There is a gap in the current breast cancer survivorship literature identifying potential sample biases that may result from recruiting participants via different methods. To document whether participant recruitment method influences baseline demographic or psychosocial variables and trial participation among breast cancer survivors recruited for a physical activity intervention trial. Participants were recruited for the trial via either a reactive method (letters mailed through their oncologist's office inviting them to contact the research staff) or a proactive method (referred in person by their oncologist at a clinic appointment). The groups of participants recruited via the two methods were compared based on baseline sociodemographic characteristics, weight, time since diagnosis, stage of disease, treatment, motivational readiness for physical activity, level of physical activity, self-reported physical and mental health, willingness to receive the intervention, and study retention. Participants recruited proactively were closer to the point of diagnosis (mean = 2.5 years, standard deviation (SD) = 1.9 years) than participants recruited reactively via letter mailings (mean = 3.4 years, SD = 2.3 years; p < .05). The two groups were similar with respect to all other baseline characteristics and retention. Recruitment via the two methods was not concurrent. Also, proactive recruitment occurred at a single hospital site. Mailings were made by the oncologists; we are unable to estimate how many letters were mailed. Similarly, we have no information for the patients who were not referred to the study during proactive recruitment. Despite the potential for differences in characteristics and degree of trial participation between trial participants recruited proactively and reactively, in this investigation, the two groups were similar. Information from other trials in other conditions may confirm or modify our conclusion.

Home‐based physical activity intervention for colorectal cancer survivors

The efficacy of a home-based physical activity (PA) intervention for colorectal cancer patients versus contact control was evaluated in a randomized controlled trial. Forty-six patients (mean age = 57.3 years [SD = 9.7], 57% female, mean = 2.99 years post-diagnosis [SD = 1.64]) who had completed treatment for stages 1-3 colorectal cancer were randomized to telephone counseling to support PA (PA group, n = 20) or contact control (control group, n = 26). PA group participants received 3 months of PA counseling (based on the transtheoretical model and the social cognitive theory) delivered via telephone, as well as weekly PA tip sheets. Assessments of PA (Seven-day Physical Activity Recall [7-day PAR] and Community Healthy Activities Model Program for Seniors [CHAMPS]), submaximal aerobic fitness (Treadwalk test), motivational readiness for PA, and psychosocial outcomes were conducted at baseline, 3, 6, and 12 months post-baseline. Objective accelerometer data were collected at the same time points. The PA group reported significant increases in minutes of PA at 3 months (7-day PAR) and caloric expenditure (CHAMPS) compared with the control group, but the group differences were attenuated over time. The PA group showed significant improvements in fitness at 3, 6, and 12 months versus the control group. Improvements in motivational readiness for PA were reported in the PA group only at 3 months. No significant group differences were found for fatigue, self-reported physical functioning, and quality of life at 3, 6, and 12 months. A home-based intervention improved survivors' PA and motivational readiness at 3 months and increased submaximal aerobic fitness at 3, 6, and 12 months.

Motivational readiness for physical activity and quality of life in long-term lung cancer survivors

Little is known about the relationship between motivational readiness for physical activity and quality of life (QOL) in long-term lung cancer survivors. Long-term survivors are considered those who are living 5 years or more following a cancer diagnosis. This project examined the relationship between a self-report measure of motivational readiness for physical activity and QOL in a sample of 272 long-term lung cancer survivors. Participants (54% male, average age 70 years old) completed the mailed survey an average of 6 years after being diagnosed with lung cancer. Survey measures included the stage of change for physical activity and a set of single item QOL and symptom scales. Thirty-seven percent of respondents reported they currently engaged in regular physical activity (a total of 30 min or more per day, at least 5 days per week). Kruskal-Wallis tests revealed that those who reported engaging in regular physical activity reported a better overall QOL, better QOL on all five domains of QOL functioning (mental, physical, social, emotional, and spiritual), and fewer symptoms compared to those with a sedentary lifestyle. Physical activity level may have important QOL and symptom management benefits for long-term lung cancer survivors.

Randomized pilot test of a lifestyle physical activity intervention for breast cancer survivors

Objective This paper will report the results of a pilot test of a 6-month, 21-session intervention to increase breast cancer survivors’ physical activity by teaching them to incorporate short periods of moderate activity into their daily routines (lifestyle intervention). The effect of the intervention on physical performance, quality of life, and physical activity are reported. Methods Sixty breast cancer survivors were randomized to either a lifestyle intervention or a standard care control group. Physical performance, quality of life (Medical outcomes study short form-36 [SF-36]), and physical activity (7-day recall and motivation readiness), were assessed at baseline and 6 months. Results The lifestyle group had significantly better performance in the 6-min walk task than the controls ( p = 0.005) at 6 months. The intervention had positive effects on the bodily pain ( p = 0.020) and general health ( p = 0.006) subscales from the SF-36. The lifestyle group had a greater motivational readiness for physical activity at 6-month than standard care, but no significant differences were seen between the two in terms of number of minutes of moderate or more intense physical activity or number of days on which they did ≥30 min of moderate or more intense activity. Conclusions Despite the small sample size, the lifestyle intervention showed promise for improving physical functioning and quality of life and increasing physical activity, and should be tested in a larger randomized trial. Practice Implications If the lifestyle approach is shown to be effective in a larger trial, it represents a highly feasible intervention that it can be delivered to cancer survivors by health care institutions or community organizations without dedicated exercise facilities and equipment.

Evaluation of Social-Cognitive versus Stage-Matched, Self-Help Physical Activity Interventions at the Workplace

To compare the effectiveness of stage-matched vs. social-cognitive physical activity interventions in a work setting. Both interventions were designed as minimal-contact, self-help programs suitable for large-scale application. Randomized trial. Participants were randomized into one of the two intervention groups at baseline; the follow-up assessment was conducted 1 month later. A large, public university in the southeastern region of the United States. Employees from two academic colleges within the participating institution were eligible to participate: 366 employees completed the baseline assessment; 208 of these completed both assessments (baseline and follow-up) and met the compliance criteria. Printed, self-help exercise booklets (12 to 16 pages in length) either (1) matched to the individual's stage of motivational readiness for exercise adoption at baseline or (2) derived from social-cognitive theory but not matched by stage. Standard questionnaires were administered to assess stage of motivational readiness for physical activity; physical activity participation; and exercise-related processes of change, decisional balance, self-efficacy, outcome expectancy, and goal satisfaction. The two interventions were equally effective in moving participants to higher levels of motivational readiness for regular physical activity. Among participants not already in maintenance at baseline, 34.9% in the stage-matched condition progressed, while 33.9% in the social-cognitive group did so (chi2 = not significant). Analyses of variance showed that the two treatment groups did not differ in terms of physical activity participation, cognitive and behavioral process use, decisional balance, or the other psychological constructs. For both treatment groups, cognitive process use remained high across all stages, while behavioral process use increased at the higher stages. The pros component of decisional balance did not vary across stage, whereas cons decreased significantly between preparation and action. Minimal-contact, one-shot physical activity interventions delivered at work can help people increase their participation in regular physical activity. Stage matching may not necessarily add value to interventions that otherwise make good use of behavior change theory. The findings also reinforce the importance of barrier reduction in long-term adherence. A limiting factor in this study is that employees in the earliest stage of change (precontemplation) were not well-represented in the sample.

Home-Based Physical Activity Intervention for Breast Cancer Patients

The efficacy of a home-based physical activity (PA) intervention for early-stage breast cancer patients was evaluated in a randomized controlled trial. Eighty-six sedentary women (mean age, 53.14 years; standard deviation, 9.70 years) who had completed treatment for stage 0 to II breast cancer were randomly assigned to a PA or contact control group. Participants in the PA group received 12 weeks of PA counseling (based on the Transtheoretical Model) delivered via telephone, as well as weekly exercise tip sheets. Assessments were conducted at baseline, after treatment (12 weeks), and 6 and 9 month after baseline follow-ups. The post-treatment outcomes are reported here. Analyses showed that, after treatment, the PA group reported significantly more total minutes of PA, more minutes of moderate-intensity PA, and higher energy expenditure per week than controls. The PA group also out-performed controls on a field test of fitness. Changes in PA were not reflected in objective activity monitoring. The PA group was more likely than controls to progress in motivational readiness for PA and to meet PA guidelines. No significant group differences were found in body mass index and percent body fat. Post-treatment group comparisons revealed significant improvements in vigor and a reduction in fatigue in the PA group. There was a positive trend in intervention effects on overall mood and body esteem. The intervention successfully increased PA and improved fitness and specific aspects of psychological well-being among early-stage breast cancer patients. The success of a home-based PA intervention has important implications for promoting recovery in this population.

Exploring the feasibility and acceptability of using Internet technology to promote physical activity within a defined community

To explore the feasibility of using the Internet and e-mail to promote physical activity in a defined community. An online survey was conducted through a community-based Internet Service Provider (ISP). ISP clients were recruited via electronic newsletter and direct e-mail. Data were collected on preferred sources of assistance for physical activity advice and stage of motivational readiness for physical activity. Valid surveys were completed by 797 (9% response rate). Participants were: 55% men; 56% aged >45 years; 57% worked full time; mean BMI was 28+/-8. Thirty-six per cent were in the early stages of motivational readiness for physical activity. More than 70% were somewhat to extremely interested in having access to a physical activity website. Promoting physical activity via the Internet and e-mail is feasible and appealing to some people. Expanding the reach, appeal and use of this technology to deliver physical activity programs will be a challenge.

Stages of motivational readiness for physical activity: A comparison of different algorithms of classification

The aim of this study was to compare two approaches to classify individuals into stages of motivational readiness for physical activity and test which one was better explained by attitude and perceived behavioural control, as defined by Ajzen (1991). A survey of 20,430 respondents from a population-based sample. The relevant variables were assessed in a self-administered questionnaire. The cluster approach consisted of combining both intention and behaviour in order to determine clusters of individuals; such clusters correspond to different stages of motivational readiness. The stage of change (SC) approach consisted of grouping the same individuals by using the SC variable of the Transtheoretical Model (TTM). The SC and cluster-solution approaches were replicated across four subsamples of the total number of respondents. Attitude and perceived behavioural control were more strongly associated with stage membership derived from four-cluster solution than with stage membership in the five categories assessed by the SC method. Stage of motivational readiness for physical activity, and possibly for other health-related behaviours, may usefully be characterized when both recent past behaviour and intention in the near future are simultaneously and explicitly taken into consideration.

Perceptions of the Physical Environment, Stage of Change for Physical Activity, and Walking among Australian Adults

Data for this study were from a population survey of 1,200 adults ages 40–60 years, sampled from the Illawarra region of New South Wales. Questionnaire items on perceptions of the environment were factor analyzed into: Aesthetic Environment and Practical Environment. For both factors, those in the Contemplation stage had more negative views of the environment than those in Maintenance. Those who walked for 0–20 min/week held more negative perceptions of their environment than those who walked for 21–120 min/week and those who walked for > 120 min/week. The health promotion implications of these findings are that environments perceived as attractive and as providing convenient access to services and facilities may influence motivational readiness for physical activity and time spent walking.

Physician-based physical activity counseling for middle-aged and older adults: A randomized trial

Sedentary behavior among older adults increases risk for chronic diseases. Physicians in a primary care setting can play an important role in promoting physical activity adoption among their older patients. The Physically Active for Life (PAL) project was a randomized, controlled trial comparing the efficacy of brief physician-delivered physical activity counseling to usual care on self-reported physical activity levels. The physical activity counseling was based on the Transtheoretical Model of Change and social learning theory. Twenty-four community-based primary care medical practices were recruited into the study; 12 were randomized to the Intervention condition and 12 to the Control condition. Physicians in the Intervention practices received training in the delivery of brief physical activity counseling. Subjects in the Intervention practices (n=181) received brief activity counseling matched to their stage of motivational readiness for physical activity, a patient manual, a follow-up appointment with their physician to discuss activity counseling, and newsletter mailings. Subjects in the Control practices (n=174) received standard care. Measures of motivational readiness for physical activity and the Physical Activity Scale for the Elderly (PASE) were administered to subjects in both conditions at baseline, 6 weeks following their initial appointment, and at 8 months. Results showed that at the 6-week follow-up, subjects in the Intervention condition were more likely to be in more advanced stages of motivational readiness for physical activity than subjects in the Control condition. This effect was not maintained at the 8 month follow-up and the intervention did not produce significant changes in PASE scores. Results suggest that more intensive, sustained interventions may be necessary to promote the adoption of physical activity among sedentary, middle-aged, and older adults in primary care medical practices.