Exercise Outcome Expectations Research Articles

Pilot study of social cognitive theory variables as correlates of physical activity among adolescents with pediatric multiple sclerosis

PurposeAdolescents with pediatric onset multiple sclerosis (MS) engage in low rates of physical activity. Behavioral interventions that target physical activity are most successful if grounded in theory. This study explored social cognitive theory (SCT) variables as correlates of physical activity among adolescents with pediatric onset MS. ProceduresParticipants who had a diagnosis of pediatric onset MS, were between the ages of 14 and 18 years, and were fluent and literate in English were eligible. The electronic web-delivered survey included a demographics questionnaire, the Godin Leisure Time Exercise Questionnaire (GLTEQ), and measures of SCT variables. ResultsThe overall sample included 24 adolescents with pediatric onset MS (M:3,F:21) with a mean age of 16.1 years and disease duration of 2.6 years. The sample was predominately Caucasian (n = 14, 58%). Exercise planning (ρ=0.54), exercise outcome expectations (ρ=0.46), self-efficacy for overcoming barriers (ρ = 0.52), and exercise social support (ρ=0.58) were associated with GLTEQ scores. ConclusionsResearchers might develop behavioral interventions that target exercise outcome expectations, exercise planning, self-efficacy for overcoming barriers, and exercise social support for changing physical activity in pediatric onset MS.

Social Cognitive Theory and Physical Activity in Older Adults with Multiple Sclerosis.

The expanding population of older adults with multiple sclerosis (MS) likely experiences many of the same benefits of physical activity (PA) as younger and middle-aged adults with MS. However, participation in PA is exceedingly low in this segment of the MS population. This study examined variables from social cognitive theory (SCT) as correlates of PA in older adults with MS to inform the subsequent development of behavioral interventions. Older adults with MS (≥60 years of age, N = 180) completed an online survey including demographic and clinical characteristics, SCT variables (exercise self-efficacy, exercise goal setting, social support, and outcome expectations), and PA (total PA [TPA] and moderate-to-vigorous PA [MVPA]). Bivariate correlation analyses indicated that all SCT variables were significantly associated with TPA and MVPA (all P ≤ .001). Hierarchical linear regression analyses indicated that disability status was a significant correlate of TPA (β = -0.48, R2 = 0.23) and MVPA (β = -0.44, R2 = 0.19) in step 1; disability and self-efficacy were significant correlates of TPA (disability β = -0.20, self-efficacy β = 0.59, R2 = 0.50) and MVPA (disability β = -0.16, self-efficacy β = 0.60, R2 = 0.47) in step 2; and disability, self-efficacy, and exercise goal setting were significant correlates of TPA (disability β = -0.21, self-efficacy β = 0.50, exercise goal setting β = 0.14, R2 = 0.55) and MVPA (disability β = -0.17, self-efficacy β = 0.51, exercise goal setting β = 0.15, R2 = 0.51) in step 3. These results suggest that behavioral interventions focusing on self-efficacy and exercise goal setting as targets from SCT may be appropriate for increasing PA in older adults with MS.

60세 이상 골다공증 여성노인의 골다공증 지식, 운동기대감과 운동자기효능감과의 관계

Purpose: This study was conducted to identify the relationships between knowledge about osteoporosis, outcome expectations for exercise, and self-efficacy for exercise in older women with osteoporosis. Methods: This was a cross-sectional descriptive study. Participants were 148 women aged 60 years and older who were diagnosed with osteoporosis. Data were collected using self-report questionnaires. Data were analyzed using descriptive statistics, t-test, ANOVA, Mann-Whitney U test, Kruskal-Wallis test, and Pearson"s correlation coefficient. Results: Statistically significant differences in knowledge about osteoporosis were found in age, education level, household income, type of household, chronic disease, medication, alcohol consumption, and perceived health status. Statistically significant differences in outcome expectations for exercise were observed in age, education level, household income, type of household, chronic disease, medication, body mass index, and perceived health status. Statistically significant differences in self-efficacy for exercise were observed in age, household income, chronic disease, and medication. In addition, it was found that knowledge of osteoporosis and self-efficacy for exercise were positively correlated with outcome expectations for exercise. Conclusion: Based on this study, the development of a physical activity program is necessary by considering knowledge about osteoporosis, outcome expectation for exercise, and self-efficacy for exercise.

An Ecological Momentary Assessment Study Investigating Self-efficacy and Outcome Expectancy as Mediators of Affective and Physiological Responses and Exercise Among Endometrial Cancer Survivors.

Previous studies have shown affective and physiological states in response to exercise as predictors of daily exercise, yet little is known about the mechanism underlying such effects. To examine the mediating effects of self-efficacy and outcome expectancy on the relationships between affective and physiological responses to exercise and subsequent exercise levels in endometrial cancer survivors. Ecological momentary assessment (EMA) surveys were delivered up to eight 5- to 7-day periods over 6 months. Participants (n = 100) rated their affective and physiological states before and after each exercise session (predictors) and recorded their self-efficacy and outcome expectancy each morning (mediators). Exercise (outcome) was based on self-reported EMA surveys and accelerometer measures. A 1-1-1 multilevel mediation model was used to disaggregate the within-subject (WS) and between-subject (BS) effects. At the WS level, a more positive affective state after exercise was associated with higher self-efficacy and positive outcome expectation the next day, which in turn was associated with higher subsequent exercise levels (ps < .05). At the BS level, participants who typically had more positive affective and experienced less intense physiological sensation after exercise had higher average self-efficacy, which was associated with higher average exercise levels (ps < .05). In endometrial cancer survivors, affective experience after exercise, daily self-efficacy and positive outcome expectation help explain the day-to-day differences in exercise levels within-person. Findings from this study highlight potentials for behavioral interventions that target affective experience after exercise and daily behavioral cognitions to promote physical activity in cancer survivors' everyday lives.

Do Social Cognitive Theory constructs explain response heterogeneity with a physical activity behavioral intervention in multiple sclerosis?

BackgroundBehavioral interventions based on Social Cognitive Theory (SCT) are efficacious for increasing both objectively-measured and self-reported physical activity in people with multiple sclerosis (MS).PurposeThis study involved a secondary analysis of data focused on SCT constructs as correlates of individual-level changes (i.e., response heterogeneity) following a behavioral intervention.MethodTwenty-two persons with MS who completed a 6-month SCT-based behavioral intervention for increasing physical activity were included in analyses. The intervention consisted of two primary components, namely a dedicated Internet website and one-on-one video chats with a behavioral coach. Outcomes included objectively-measured moderate-vigorous physical activity (MVPA) using Actigraph model GT3X+ accelerometers and self-reported physical activity using the Godin Leisure-Time Exercise Questionnaire (GLTEQ) as well as SCT variables of exercise self-efficacy, barriers self-efficacy, outcome expectations, goal setting and planning and facilitators/impediments.ResultsThere was individual variability in physical activity change following the intervention. For example, 4/22 participants demonstrated a reduction in MVPA, 1/22 participants had no change, 9/22 participants had less than 0.5 standard deviation (SD) increase in MVPA, and 8/22 participants had an increase in MVPA of more than 0.5 SD. Baseline SCT variables, particularly outcome expectations, goal setting, planning, and barriers self-efficacy, correlated with increased physical activity.ConclusionsThis study indicates that SCT variables correlate with the response heterogeneity associated with physical activity behavioral interventions, and this might inform the delivery of interventions consistent with Bandura's stepwise implementation model for optimizing the “fit” of an intervention based on SCT for maximizing treatment efficacy in MS.

Impact of the HealthMatters Train-the-Trainer Program on the Health and Health Behaviors of Staff Supporting Adults With Intellectual and Developmental Disabilities.

The health status and health behaviors among support staff providing daily support for people with intellectual and developmental disabilities (IDD-SS) in community-based organizations (CBOs) have not been systematically studied. This study examined the health impact of IDD-SS workers who participated in a HealthMatters Program: Train-the-Trainer Certified Instructor Workshop followed by implementing a 12-week HealthMatters Program for people with intellectual and developmental disabilities (IDD) that they care for as part of their employment. A total of 48 IDD-SS were enrolled into either an intervention (n = 28) or control group (n = 20). IDD-SS in the intervention group received an 8-hour HealthMatters Program: Train-the-Trainer Workshop immediately prior to teaching a 12-week HealthMatters Program for people with IDD. Assessments were conducted with IDD-SS before and after completing the 12-week HealthMatters Program to evaluate whether IDD-SS experienced any benefit of the training and teaching the program on their own health and health behaviors. Relative to the control group, the IDD-SS in the intervention group showed significant improvements in social/environmental supports for nutrition (F = 4.92, p = .032), exercise outcome expectations (F = 6.58, p = .014), nutrition outcome expectations (F = 8.87, p = .005), fruit and vegetable intake (F = 13.62, p = .001), knowledge of fruit and vegetable intake recommendations (F = 11.25, p = .002), and stages of change for eating fruits and vegetables (F = 6.86, p = .012). Results demonstrated that IDD-SS benefited from the health education programming. Findings support the need to develop programs and organizational policies for health promotion activities for direct care staff.

The Feasibility and Impact of the EMOVE Intervention on Self-efficacy and Outcome Expectations for Exercise in Epilepsy.

The purpose of this pilot study was to evaluate the feasibility of the self-efficacy based Epilepsy-Motivate and Outcome Expectations for Vigorous Exercise (EMOVE) intervention and report on the preliminary efficacy of this intervention aimed at improving exercise behaviors in adults with epilepsy. Methods: A single-group, repeated-measures design was used in 30 outpatients. Data were collected at baseline and 12 weeks after the intervention. Participant outcomes included Self-Efficacy and Outcome Expectations for Exercise in Epilepsy, Beck Depression Inventory-II, Quality of Life in Epilepsy Inventory-31, seizure frequency, average daily steps, and body mass index. Daily number of steps was measured using a wrist-worn activity monitor. Feasibility data were assessed using evidence of treatment fidelity including intervention delivery, receipt, and enactment. Results: Participants were single (63%), white (53%), female (63%), had a mean (SD) age of 46.7 (13) years (range, 26-68 years), had low levels of self-efficacy (mean, 5.10; range, 0-10) and high outcome expectations (mean, 3.90; range, 0-5), took under the recommended 10 000 steps per day (mean, 5107), and had an average of 6 seizures per month. Postintervention testing showed statistical improvement in depressive symptoms (mean [SD], 9.95 [9.47]; P < .05). There were no significant differences found for the other study outcomes. Our study showed the EMOVE intervention was feasible. Study participants had improved depressive symptoms. Future research should focus on increasing the sample size, improving exercise performance through group or individualized exercise sessions, and adding a control group to better evaluate the relationship between the intervention and improved depressive symptoms.

What Do Breast Cancer Survivors Expect From Exercise?

Exercise outcome expectations (OEs) (ie, what one expects to obtain or avoid by exercising) are influential to increase exercise among cancer survivors. The aim of this study was to measure the accessibility (ie, frequency one thinks about exercise resulting in an outcome) and importance (ie, one's value of the outcome) of OEs among breast cancer survivors. Stage IA to IIB breast cancer survivors who were 1 to 5 years posttreatment completed OE questionnaires. Descriptive statistics were used to examine OE accessibility and importance. The sample (n = 73) was 91.8% white, 5.4% African American, 1.4% Asian or Pacific Islander, and 1.4% other. The mean age was 58 (SD, 9.6) years. Outcome expectation importance mean was 6.1 (SD, 0.4), indicating OEs are overall "important." Accessibility mean was 4.8 (SD, 0.6), demonstrating breast cancer survivors think about exercise OEs "sometimes/50% of the time." There was a moderate (rs = 0.48) relationship between OE importance and accessibility, indicating they are related, yet distinct. Outcome expectations are generally important to breast cancer survivors. Thus, OEs may motivate increased exercise among this population. Oncology providers should encourage patients to think about OEs more often to increase exercise. Compared with traditional approaches of informing patients about exercise benefits, this may be a more comprehensive and powerful approach to motivate exercise among breast cancer survivors.

생활체육 참여자의 운동결과기대와 운동결과요인의 관계

생활체육 참여자의 운동결과기대와 운동결과요인의 관계

Exercise beliefs and contributing factors among elderly nursing home residents

Background/Aims: Despite the benefits of exercise for older adults, elderly nursing home residents remain largely inactive. This study examined differences in outcome expectations for exercise, and self-efficacy for exercise between older adults in nursing home care, and older adults in the community. We also assessed the association between these exercise beliefs and participants' physical, psychological and medical conditions. Methods: A total of 22 nursing home residents and 20 community-dwelling older adults completed the Outcome Expectations for Exercise Scale, and the Self-Efficacy for Exercise Scale. Findings: Outcome expectations did not differ between the groups (P=0.78). Self-efficacy for exercise was significantly lower among nursing home residents than in community-dwelling older adults (P=&lt;0.01). Findings indicate that the presence of depressive symptoms were significantly associated with poor exercise beliefs in older adults. Conclusions: Self-efficacy and psychological health could be targets of interventions to increase older adults' exercise participation.

The Mediating Effect of Exercise outcome Expectation in the Structural Relationship Between Exercise Imagery, Exercise outcome Expectation and Intention to Exercise Adherence

The Mediating Effect of Exercise outcome Expectation in the Structural Relationship Between Exercise Imagery, Exercise outcome Expectation and Intention to Exercise Adherence

운동심상과 운동결과기대, 운동지속의도의 구조관계에서 운동결과기대의 매개효과

운동심상과 운동결과기대, 운동지속의도의 구조관계에서 운동결과기대의 매개효과

Effects of gain-versus loss-framed performance feedback on the use of fitness apps: Mediating role of exercise self-efficacy and outcome expectations of exercise

Grounded in prospect theory and self-efficacy theory, this study examines the effect of message framing on users' intentions to adopt fitness applications (“apps”). Through the use of a laboratory experiment employing a specially designed fitness app, we tested the effectiveness of gain-framed performance feedback in the adoption of the fitness app as well as in enhancing exercise self-efficacy and outcome expectations of exercise. Results of this study show the advantage of gain-framed messages over loss-framed messages in increasing user's intentions to use the app. A mediation analysis using a bootstrap method revealed that the effect of the gain-framed messages on users' intentions to use the fitness app was mediated through exercise self-efficacy and outcome expectations of exercise.

Relationship Between Attitudes and Beliefs and Physical Activity in Older Adults With Knee Pain: Secondary Analysis of a Randomized Controlled Trial.

ObjectiveTo investigate how attitudes and beliefs about exercise relate to physical activity behavior in older adults with knee pain attributable to osteoarthritis (OA).MethodsWe conducted secondary data analyses of a randomized controlled trial of exercise interventions (ISRCTN: 93634563). Participants were adults ≥45 years old with knee pain attributable to OA (n = 514). Crude and adjusted cross‐sectional and longitudinal associations between baseline Self‐Efficacy for Exercise (SEE), Positive Outcome Expectations for Exercise (POEE), Negative Outcome Expectations for Exercise scores, and physical activity level, at baseline, 3 months, and 6 months (measured by self‐report using the Physical Activity Scale for the Elderly [PASE]), and important increases in physical activity level (from baseline to 6‐month followup) were investigated using multiple linear and logistic regression.ResultsCross‐sectional associations were found between SEE and PASE scores (β = 4.14 [95% confidence interval (95% CI) 0.26, 8.03]) and POEE and PASE scores (β = 16.71 [95% CI 1.87, 31.55]), adjusted for sociodemographic and clinical covariates. Longitudinal associations were found between baseline SEE and PASE scores at 3 months (β = 4.95 [95% CI 1.02, 8.87]) and 6 months β = 3.71 (0.26, 7.16), and baseline POEE and PASE at 3 months (β = 34.55 [95% CI 20.13, 48.97]) and 6 months (β = 25.74 [95% CI 11.99, 39.49]), adjusted for baseline PASE score and intervention arm. However, no significant associations with important increases in physical activity level were found.ConclusionGreater exercise self‐efficacy and more positive exercise outcome expectations were associated with higher current and future physical activity levels. These may be targets for interventions aimed at increasing physical activity.

Feasibility intervention to increase exercise outcome expectations among breast cancer survivors.

e21584 Background: Exercise is associated with decreased mortality and recurrence risk and improved quality of life for breast cancer survivors (BCS). Roughly 1/3 of BCS exercise enough to experience these benefits. A promising strategy to increase exercise among BCS is to target outcome expectations (OEs), or what one expects to obtain or avoid from a behavior. OE dimensions include 1) importance – value placed on the outcome(s); 2) certainty - perceived probability outcome(s) will occur; and 3) accessibility – the frequency with which outcome(s) are considered. Methods: This RCT tested the feasbility and effects of a self-directed booklet designed to increase OEs and exercise. It was created in collaboration with BCS who successfully use exercise to manage long term side effects. OEs were measured through online surveys and exercise was measure with a Fitbit accelerometer. Data was collected at baseline, 4, 8 and 12 weeks post intervention. Feasibility was defined as the extent to which participants made use of intervention materials and was assessed through 9 researcher related questions. Results: The sample is mean age of 58, 74% white, 26% black, an average 2.5 years post treatment and about 1/3 take an AI or SERM. The booklet “somewhat” (mean = 3.24, SD = 1.8 on 1-5 Likert scale) made use of the booklet, as intended. OEs increased 0.01 points over time in the intervention arm, compared to the control arm ( p = 0.3555); 0.4 points more for black participants compared to white ( p = 0.0003); 0.2 points per every unit of increased exercise self-efficacy ( p &lt; 0.0001), and 0.01 points per month participants were closer to their time of cancer surgery ( p = 0.0037). Intervention arm participants increased their weekly steps by 970, every 4 weeks, compared to participants in the control arm ( p = 0.0283). Conclusions: Overall the intervention was well received by participants, had positive effects on OEs and exercise and can easily be translated into practice with need for minimal resources. Significant differences were noted for black compared to white participants, thus it is necessary to understand racial differences in exercise beliefs when designing future exercise interventions. Clinical trial information: NCT02348710.

Outcome Expectations and Osteoarthritis: Association of Perceived Benefits of Exercise With Self-Efficacy and Depression.

Outcome expectancy is recognized as a determinant of exercise engagement and adherence. However, little is known about which factors influence outcome expectations for exercise among people with knee osteoarthritis (OA). This is the first study to examine the association of outcome expectations for exercise with demographic, physical, and psychosocial outcomes in individuals with knee OA. We performed a cross-sectional analysis of the baseline data from a randomized trial of tai chi versus physical therapy in participants with symptomatic knee OA. Knee pain was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Outcome expectations for exercise, self-efficacy, depression, anxiety, stress, and social support were measured using standard instruments. Logistic regression models were utilized to determine associations with outcome expectations. There were 262 participants, with a mean age of 59.8 years and a mean body mass index of 32.1 kg/m2 ; 69.1% of the participants were female, 51.5% were white, the mean disease duration was 8.6 years, and the mean WOMAC knee pain and function scores were 260.8 and 906.8, respectively. Higher outcome expectations for exercise were associated with greater self-efficacy (odds ratio [OR] 1.25 [95% confidence interval (95% CI) 1.11-1.41]; P = 0.0004), as well as with fewer depressive symptoms (OR 0.84 for each 5-point increase [95% CI 0.73-0.97]; P = 0.01). Outcome expectancy was not significantly associated with sex, race, education, pain, function, radiographic severity, social support, anxiety, or stress. Our results suggest significant associations between outcome expectations for exercise and self-efficacy and depression. Future studies should examine how these relationships longitudinally affect long-term clinical outcomes of exercise-based treatment for knee OA.

Exploration of Exercise Outcome Expectations Among Breast Cancer Survivors.

Exercise is associated with decreased recurrence risk and improved survival and quality of life for breast cancer survivors. However, only an estimated 17% to 37% of survivors adhere to the American Cancer Society exercise guidelines. A critical first step to increase exercise among survivors is to understand how they believe exercise will affect them. The aim of this study is to explore common exercise outcome expectations among 20 female survivors of stage IA to IIB breast cancer who completed adjuvant treatment and an exercise intervention. A mixed-method descriptive study consisting of semistructured telephone interviews assessed exercise outcome expectations and how the experience of cancer and its treatment influenced the expected outcomes of exercise. The qualitative data were analyzed using a summative content analysis procedure; means were calculated for each item of the exercise outcome questionnaire. The qualitative and quantitative data were compared and contrasted. The sample was 70% white and 30% African American, with a mean (SD) age of 62 (8.5) years, and mean (SD) time since treatment completion of 4.2 (1.3) years. Three themes emerged from the interviews: (1) prevalence of common expectations, (2) pervasive impact of fatigue, and (3) a brighter future. Overall, findings revealed that breast cancer survivors have low levels of agreement that exercise may mitigate late and long-term cancer and treatment effects. In general, breast cancer survivors (even those who are motivated to exercise) do not hold strong beliefs that exercise will decrease late and long-term treatment effects. Clinicians can educate survivors about exercise benefits.

Reliability and Validity of the Self-Efficacy for Exercise in Epilepsy and the Outcome Expectations for Exercise in Epilepsy Scales.

The purpose of this study was to test the psychometric properties of the revised Self-Efficacy for Exercise With Epilepsy (SEE-E) and Outcome Expectations for Exercise with Epilepsy (OEE-E) when used with people with epilepsy. The SEE-E and OEE-E were given in face-to-face interviews to 26 persons with epilepsy in an epilepsy clinic. There was some evidence of validity based on Rasch analysis INFIT and OUTFIT statistics. There was some evidence of reliability for the SEE-E and OEE-E based on person and item separation reliability indexes. These measures can be used to identify persons with epilepsy who have low self-efficacy and outcome expectations for exercise and guide design of interventions to strengthen these expectations and thereby improve exercise behavior.

Patients’ perspectives on aerobic exercise early after stroke

Purpose: To describe patient perspectives of aerobic exercise during inpatient stroke rehabilitation, including their self-efficacy and beliefs towards exercise, as well as their perceptions of barriers. Method: A survey was conducted at three Canadian rehabilitation centres to evaluate individuals’ (N = 33) self-efficacy and outcome expectations for exercise. In addition, patient perceptions of other people recovering from stroke, social support, and aerobic exercise as part of rehabilitation were assessed. Results: Thirty-two people completed the survey. Of these, 97% were willing to participate in aerobic exercise 5.9 ± 8.8 days after admission to inpatient rehabilitation. While outcome expectations for exercise were high, participants reported lower self-efficacy for exercise. Patients reported barriers related to the ability to perform exercise (other health problems (i.e., arthritis), not being able to follow instructions and physical impairments) more often than safety concerns (fear of falling). The lack of support from a spouse and family were commonly identified, as was a lack of information on how to perform aerobic exercise. Conclusion: Patients with stroke are willing to participate in aerobic exercise within a week after admission to inpatient rehabilitation. However, they perceive a lack of ability to perform aerobic exercise, social support from family and information as barriers.Implications for rehabilitationAerobic exercise is recognized as part of comprehensive stroke rehabilitation.There is a need to better understand patient perspectives to develop and implement more effective interventions early after stroke.Patients lack confidence in their ability to overcome barriers early after stroke.Patients are concerned with their ability to perform exercise, fall risk, lack of support from a spouse and family, and limited information on aerobic exercise.There is a need to reinforce education with practical experience in structured aerobic exercise programs that show patients and caregivers how to manage disability and complex health needs.

Effects of a Combined Exercise Program Using an iPad for Older Adults.

ObjectivesThe purpose of this study was to examine the function, health status, and efficacy effects of a combined exercise program using an iPad among older women in Korea, a tech-savvy country.MethodsThe study employed a pretest and posttest experimental design with a control group. The experimental group of subjects comprised 16 female older adults and the control group comprised 10 who were aged 65 years or older. The experimental group participated in a supervised group-based exercise program and an individualized home-based exercise program that involved the use of an iPad. The combined group and home-based exercise program consisted of group exercise, which took place in a senior center for 30 minutes weekly, and a home-based iPad exercise program, which the subjects followed at least 3 times a week. The collected data were analyzed using the Statistical Analysis System (SAS ver. 9.3 TS Level 1M0) program, which utilized a chi-square test, a Fisher exact test, a t-test, and a repeated-measures ANOVA.ResultsThe results showed that cognitive status changed significantly over time, and there was an interaction between group and time. Further, self-efficacy for exercise and outcome expectations for exercise changed significantly over time.ConclusionsExercise programs using iPad interventions may be useful for the management of cognitive functioning and the integration of functional physical abilities in older adults.