Physical Activity Intentions Research Articles

Implementation Intentions for Physical Activity Behavior in Older Adult Women: An Examination of Executive Function as a Moderator of Treatment Effects

Implementation intentions are effective for enhancing physical activity, but it is unknown how well these effects extend to older adults and/or are modified by cognitive variables. Our objective is to examine (1) the efficacy of an implementation intentions intervention for physical activity in older adult women and (2) to examine the moderating effects of executive function. Participants (N = 75, M age = 73.72) completed measures of executive function and were randomly assigned to weekly implementation intentions for physical activity (experimental condition), implementation intentions for an unrelated behavior (control condition), or no treatment. Baseline activity was measured by accelerometer and self-report; follow-up activity was measured by weekly self-report. Findings indicated a significant treatment effect for the experimental condition and a treatment by executive function interaction. Specifically, participants with relatively stronger executive function benefited most from the experimental intervention. Implementation intentions are effective for enhancing physical activity among older adult women, and the effects may be especially pronounced for those with relatively stronger executive function.

Movement as Medicine for Type 2 Diabetes: protocol for an open pilot study and external pilot clustered randomised controlled trial to assess acceptability, feasibility and fidelity of a multifaceted behavioural intervention targeting physical activity in primary care.

BackgroundPhysical activity (PA) and nutrition are the cornerstones of diabetes management. Several reviews and meta-analyses report that PA independently produces clinically important improvements in glucose control in people with Type 2 diabetes. However, it remains unclear what the optimal strategies are to increase PA behaviour in people with Type 2 diabetes in routine primary care.MethodsThis study will determine whether an evidence-informed multifaceted behaviour change intervention (Movement as Medicine for Type 2 Diabetes) targeting both consultation behaviour of primary healthcare professionals and PA behaviour in adults with Type 2 diabetes is both acceptable and feasible in the primary care setting. An open pilot study conducted in two primary care practices (phase one) will assess acceptability, feasibility and fidelity. Ongoing feedback from participating primary healthcare professionals and patients will provide opportunities for systematic adaptation and refinement of the intervention and study procedures. A two-arm parallel group clustered pilot randomised controlled trial with patients from participating primary care practices in North East England will assess acceptability, feasibility, and fidelity of the intervention (versus usual clinical care) and trial processes over a 12-month period. Consultation behaviour involving fidelity of intervention delivery, diabetes and PA related knowledge, attitudes/beliefs, intentions and self-efficacy for delivering a behaviour change intervention targeting PA behaviour will be assessed in primary healthcare professionals. We will rehearse the collection of outcome data (with the focus on data yield and quality) for a future definitive trial, through outcome assessment at baseline, one, six and twelve months. An embedded qualitative process evaluation and treatment fidelity assessment will explore issues around intervention implementation and assess whether intervention components can be reliably and faithfully delivered in routine primary care.DiscussionMovement as Medicine for Type 2 Diabetes will address an important gap in the evidence-base, that is, the need for interventions to increase free-living PA behaviour in adults with Type 2 diabetes. The multifaceted intervention incorporates an online accredited training programme for primary healthcare professionals and represents, to the best of our knowledge, the first of its kind in the United Kingdom. This study will establish whether the multifaceted behavioural intervention is acceptable and feasible in routine primary care.Trial registrationMovement as Medicine for Type 2 Diabetes (MaMT2D) was registered with Current Controlled Trials on the 14th January 2012: ISRCTN67997502. The first primary care practice was randomised on the 5th October 2012.

Participation in Regular Leisure-Time Physical Activity Among Individuals with Type 2 Diabetes Not Meeting Canadian Guidelines: the Influence of Intention, Perceived Behavioral Control, and Moral Norm

Most people with type 2 diabetes do not engage in regular leisure-time physical activity. The theory of planned behavior and moral norm construct can enhance our understanding of physical activity intention and behavior among this population. This study aims to identify the determinants of both intention and behavior to participate in regular leisure-time physical activity among individuals with type 2 diabetes who not meet Canada's physical activity guidelines. By using secondary data analysis of a randomized computer-tailored print-based intervention, participants (n = 200) from the province of Quebec (Canada) completed and returned a baseline questionnaire measuring their attitude, perceived behavioral control, and moral norm. One month later, they self-reported their level of leisure-time physical activity. A hierarchical regression equation showed that attitude (beta = 0.10, P < 0.05), perceived behavioral control (beta = 0.37, P < 0.001), and moral norm (beta = 0.45, P < 0.001) were significant determinants of intention, with the final model explaining 63% of the variance. In terms of behavioral prediction, intention (beta = 0.34, P < 0.001) and perceived behavioral control (beta = 0.16, P < 0.05) added 17% to the variance, after controlling the effects of the experimental condition (R (2) = 0.04, P < 0.05) and past participation in leisure-time physical activity (R (2) = 0.22, P < 0.001). The final model explained 43% of the behavioral variance. Finally, the bootstrapping procedure indicated that the influence of moral norm on behavior was mediated by intention and perceived behavioral control. The determinants investigated offered an excellent starting point for designing appropriate counseling messages to promote leisure-time physical activity among individuals with type 2 diabetes.

Key Beliefs Related to Decisions for Physical Activity Engagement Among First-in-Family Students Transitioning to University

The current study investigated key beliefs related to decisions for physical activity (PA) engagement among first-in-family (FIF) students transitioning to university. FIF students (n = 157) completed an online questionnaire assessing standard theory of planned behaviour constructs and belief-based items. One week later, participants completed a follow-up questionnaire assessing self-reported PA during the previous week. Results identified a range of behavioural, normative, and control beliefs that were significantly correlated with both PA intention and behaviour. Various key beliefs were also identified in relation to FIF students' decisions to be regularly physically active, with behavioural beliefs such as "take up too much time", normative beliefs including "friends outside of university", and control beliefs such as "cost", identified. Finally, frequencies of those who strongly or fully accepted these beliefs were analysed, demonstrating that typically, a large number of FIF students did not hold the beliefs, and as such, these are relevant to target in resultant interventions. The current study effectively highlights a number of key beliefs that can be targeted in programs aimed at encouraging FIF students' PA. Further, the study addresses a gap in the literature of targeting FIF students, a cohort at risk for inactivity, and utilises a sound theoretical framework to identify the unique set of beliefs guiding decisions for PA for this at-risk community group.

Why don’t people diagnosed with schizophrenia spectrum disorders (SSDs) get enough exercise?

Our aim was to assess physical activity, attitudes and future intentions among a sample of individuals with schizophrenia spectrum disorders (SSDs). A cross-sectional interview was conducted with a convenience sample of 49 adults with SSDs and in receipt of community mental health services. Interview questions elicited information about exercise behaviour across time, including reasons for expressed preferences. Participants reported variable current physical activities. They were much more likely to report past exercise than current exercise or intentions for future exercise. Participants were more likely to report physical than psychological benefits as incentives for exercise. Social influence and the opportunity for social interaction emerged as reasons for exercising. Barriers to exercise included physical health problems, disinterest and one's psychiatric illness. Community mental health services should routinely integrate targeted interventions that promote exercise. Social support for exercise, strategies to increase self-efficacy and education about the multifaceted benefits of exercise are necessary considerations in the development of such interventions.

Psychological needs satisfaction, motivational regulations and physical activity intention among elementary school students

This study examined the relationship between psychological needs satisfaction, motivational regulations in physical education and physical activity intention among elementary school students. A total of 291 elementary school students in grades 3–6 voluntarily completed the three measures. This study indicated that satisfaction of three basic psychological needs powerfully enhanced self-determined motivation, moderately contributed to introjected regulation and negatively impacted external regulation and amotivation among elementary school students. Having fun, gaining specific benefits and making social connections with their friends all positively influenced elementary school students’ physical activity intentions outside of school.

Bridging the physical activity intention–behaviour gap: contemporary strategies for the clinician

The benefits of regular moderate- to vigorous-intensity physical activity (PA) are numerous, yet most Canadians are inactive. Behavioural researchers have amassed considerable literature on theories-models of PA and many postulate that intention is the proximal antecedent. While intentions are clearly necessary, they are often not sufficient. In this brief overview, I summarize some of the contemporary areas of research aimed at overcoming the intention-behaviour gap in the behavioural science of PA. These are followed by suggestions for how PA practitioners may wish to employ strategies to help their clients translate good intentions into actual behaviour. The topics include the promotion of affect, organization, automaticity, and social responsibility. These areas of research are not meant to be exhaustive in breadth, but they highlight complementary additions to the typical approaches of changing PA through increases in self-efficacy-capability and personal outcome expectations and attitudes.

The role of self‐determination in the relationship between social support and physical activity intentions

AbstractUsing the hierarchical model of intrinsic and extrinsic motivation (HMIEM) and self‐determination theory as theoretical frameworks, the purpose of the present study was to assess the role of motivation‐related variables in the relationship between perceptions of social support and intentions to be physically active. Undergraduate students completed surveys assessing perceptions of social support, psychological needs satisfaction, self‐determination, and future exercise intentions. Model fit with the data was examined and was considered acceptable, indicating that social support was positively related to the satisfaction of psychological needs, which, in turn, was related positively to self‐determination and then to physical activity intentions.

Associations Between Physical Activity Parenting Practices and Adolescent Girls’ Self-Perceptions and Physical Activity Intentions

The current study investigated cross-sectional associations between maternal and paternal logistic and modeling physical activity support and the self-efficacy, self-esteem, and physical activity intentions of 11- to 12-year-old girls. 210 girls reported perceptions of maternal and paternal logistic and modeling support and their self-efficacy, self-esteem and intention to be physically active. Data were analyzed using multivariable regression models. Maternal logistic support was positively associated with participants' self-esteem, physical activity self-efficacy, and intention to be active. Maternal modeling was positively associated with self-efficacy. Paternal modeling was positively associated with self-esteem and self-efficacy but there was no evidence that paternal logistic support was associated with the psychosocial variables. Activity-related parenting practices were associated with psychosocial correlates of physical activity among adolescent girls. Logistic support from mothers, rather than modeling support or paternal support may be a particularly important target when designing interventions aimed at preventing the age-related decline in physical activity among girls.

Automatic and Motivational Predictors of Children’s Physical Activity: Integrating Habit, the Environment, and the Theory of Planned Behavior

Physical activity determinant studies now often include both environmental and sociocognitive factors but few of them acknowledge and explore the mechanisms underlying relevant environmental influences. This study explored environmental correlates of children's self-reported physical activity and potential mediation through the Theory of Planned Behavior (TPB) and habit strength. Six hundred and twenty-one pupils aged 9-11 years were recruited from 4 primary schools in the UK. TPB variables, habit strength and environmental variables were assessed at baseline. Self-reported physical activity was assessed 1 week later. Mediation tests revealed that 43% of the association between convenient facilities and intention was mediated through subjective norms (17%) and habit (26%), while 15% of the association between convenient facilities and physical activity was mediated through habit strength alone. A significant direct effect of convenient facilities and resources in the home environment on physical activity was also found. The school environment was not significantly related to children's physical activity intentions or behavior. The results suggest that the environment influences children's physical activity both directly and indirectly and that habit strength seems to be the most important mediator for this association.

How big is the physical activity intention–behaviour gap? A meta‐analysis using the action control framework

The physical activity (PA) intention-behaviour gap is a topic of considerable contemporary research, given that most of our models used to understand physical activity suggest that intention is the proximal antecedent of behavioural enactment. The purpose of this study was to quantify the intention-PA gap at public health guidelines with a meta-analysis of the action control framework. Systematic review and meta-analysis. Literature searches were conducted in July 2012 among five key search engines. This search yielded a total of 2,865 potentially relevant records; of these, 10 studies fulfilled the full eligibility criteria (N = 3,899). Random-effects meta-analysis procedures with correction for sampling bias were employed in the analysis for estimates of non-intenders who subsequently did not engage in physical activity (21%), non-intenders who subsequently performed physical activity (2%), intenders who were not successful at following through with their PA (36%), and successful intenders (42%). The overall intention-PA gap was 46%. These results emphasize the weakness in early intention models for understanding PA and suggest this would be a problem during intervention. Contemporary research that is validating and exploring additional constructs (e.g., self-regulation, automaticity) that augment intention or improving the measurement of motivation seems warranted. What is already known on this subject? Intention is considered the proximal antecedent of behaviour in many popular models. Intention is also an established correlate of physical activity behaviour, yet discordance is considerable in experimental research. What does this study add? This meta-analysis of studies that have assessed concordance/discordance of physical activity intention and behaviour at public health guidelines shows the intention-behaviour gap at 48% and the discordance is from intenders who do not act. The results demonstrate that discordance is not just from extreme levels of intention or behaviour (e.g., intend to exercise six times but only exercise five), but from levels that are relevant to health promotion.

Stages of change in physical activity behavior in children and adolescents with cerebral palsy

Purpose: To identify facilitators and barriers frequently experienced by families of children with cerebral palsy (CP) and associated with being at the pre-intention, intention and action stages for physical activity. Method: Qualitative study involving in-depth focus group interviews with 33 ambulatory children and adolescents with CP and their parents (n = 33). These interviews were followed by questionnaires to determine stage of behavior change (i.e. pre-intention, intention and action) related to the child’s participation in physical activity. Results: Families who were classified in the intention stage of behavioral change were more likely to identify environmental barriers related to the social environment and the facility or program than parents at the pre-intention stage. Families who were classified into intention and action stages were more likely to identify facilitators related to parental factors than families at the pre-intention stage. Moreover, at the action stage facilitators were related to the facility/program. Conclusions: The identified facilitators and barriers, organized according to three stages of change (pre-intention, intention and action), provide important theoretical insights into how and why children and adolescents with CP and their parents might change their physical activity behavior.Implications for rehabilitationUnderstanding the barriers and facilitators of physical activity for children and adolescents with CP is essential for designing effective interventions to promote participation in this group.Using the three stages of change and the identified barriers and facilitators for participation can result in tailored advice to increase physical activity behavior.

A Case Study on Application of the Theory of Planned Behaviour:Predicting Physical Activity of Adolescents in Hong Kong

Objective: The aim of this case study was to predict the physical activity intention and behaviour of secondary school students in Hong Kong by applying the Ajzen’s Theory of Planned Behaviour (TPB) and past physical activity behaviour. Methods: 486 students (250 male and 236 female), ranging in age from 11 to 18 years, were enrolled in this study. By means of self-administrated questionnaire, demographic data, past physical activity and variables of theory of planned behaviour, such as attitude, subjective norm and perceived behavioural control were measured. Results: About 75% of students did not meet the standard of the physical activity recommended by government. Male had significantly higher behavioural intention than female. The variables of theory of planned behaviour explained 53.1% of physical activity intention with significant factors of subjective norm and perceived behavioural control (PBC), increasing to 56.2% with the addition of past physical activity behaviour. When predicting physical activity behaviour, theory of planned behaviour accounted for 26.6% of the variance. The prediction was further improved by including past physical activity behaviour. Conclusions: Results of this study give evidence that the theory of planned behaviour is a useful framework for prediction of physical activity intention of adolescents in Hong Kong. Among the variables, perceived behavioural control and past behaviour played a significant role in modelling the physical activity intention and behaviour of secondary students.

Underserved Adolescent Girls’ Physical Activity Intentions and Behaviors: Relationships with the Motivational Climate and Perceived Competence in Physical Education

This study investigated underserved adolescent girls’ perceptions of the motivational climate in relationship to their perceptions of competence in urban physical education, self-reported physical activity, and future physical activity intentions. A total of two-hundred-seventy-six underserved (i.e., minority, urban, high poverty) adolescent girls completed questionnaires and a multi-step approach was used to test these relationships. First, a trichotomous model of the perceived motivational climate was tested using confirmatory factor analysis and results suggested a good fit of the data. Structural equation modeling analyses were then used to test both direct and indirect relationships between the perceived motivational climates in physical education, perceived competence in physical education, and physical activity outcomes. Findings revealed that the relationship between the perceived motivational climates and physical activity outcomes were best understood when perceived competence in physical education was accounted for as an intermediary factor.

Messages for men: The efficacy of EPPM-based messages targeting men's physical activity.

The majority of men are insufficiently active. Men's tendencies to participate in risky behaviors and their inactivity likely contribute to their increased risk of morbidity and mortality. Physical activity decreases the risk of developing many chronic diseases and may be an optimal behavior to target in men's health interventions. However, educational resources promoting physical activity for men are lacking. To address this gap, we tested the efficacy of messages based upon the Extended Parallel Process Model (EPPM; Witte, 1992) to increase men's physical activity intentions and behaviors. Men who were not meeting physical activity guidelines (n = 611) were randomly assigned to read high or low efficacy physical activity messages paired with high or no health risk information. Participants read four brief messages on four consecutive days. Intentions were assessed at baseline and the first follow-up (Day 5). Manipulation check measures were assessed at Day 5. Behavior was assessed at baseline and the second follow-up (Day 14). Overall, the messages had small sized effects. A completer analysis revealed that although men's intentions to be active increased over the course of the study regardless of the messages they received, only men who received risk information significantly increased their physical activity. Men who received low efficacy and risk information were less likely to meet the physical activity guidelines at Day 14 than men who only received low efficacy information. From these results, we suggest preliminary recommendations for the development of physical activity messages for men and areas for future EPPM-based research.

Physical Activity Experiences of Individuals Living With a Traumatic Brain Injury: A Qualitative Research Exploration

Traumatic brain injury (TBI) is a significant public health issue due to the incidence, complexity, and cost associated with treatment. The purpose of this study was to determine physical activity (PA) knowledge, attitudes, intentions, and barriers among individuals with a TBI undergoing outpatient rehabilitation. Seventeen participants completed a series of group interviews regarding their PA needs. A qualitative research design was adopted and trustworthiness was established through investigator triangulation of data. A cross-case analysis was completed to identify themes and conceptual patterns. The main themes identified were (a) an inability to differentiate between PA and physical therapy, (b) a limited knowledge of PA health benefits and the relationship to rehabilitation, and (c) an interest in participating in a PA based health promotion program. Future interventions should educate individuals about PA, the associated health benefits, and the role PA plays in the rehabilitation process.

A randomised control trial of experiential learning to promote physical activity

The paucity of training in physical activity (PA) promotion in UK medical schools is a barrier to health professionals' promotion of PA to their patients. Doctors who are more physically active are more likely to counsel patients in this regard. We used a randomised controlled trial (RCT) to examine the effect of an intervention which engaged students in goal-setting, using pedometer step counts, on their PA behaviour and intentions to promote PA in future practice. We invited fourth-year medical students to participate in the study during their four-week placement in primary care. Following baseline pedometer measurement of daily step counts for one week, students were randomly allocated to intervention (individual step count goal-setting) or control groups. Using pedometers, both groups monitored their PA during the following week. Intentions to promote PA were assessed using a questionnaire based on the theory of planned behaviour at baseline, four weeks and nine weeks. Focus groups explored the students' experiences of PA measurement, goalsetting for behaviour change and health promotion teaching. One-hundred and thirty-six students participated (70 intervention; 66 control). The mean change in daily step count was greater ( P =0.001) in the intervention group (1245, 95% CI 762 to 1727) than in the control group (-65, 95% CI -644 to 573). Scores for perceived behavioural control over PA counselling increased in both groups, with a trend for higher scores in the intervention group. Intervention group students described how experience of personal PA behaviour change gave insights into barriers patients may face and improved their confidence in PA counselling. Medical students' personal experience of goal setting in increasing PA appears to lead to a more positive perception of their ability to deliver effective PA promotion in future practice. Inclusion of this learning experience within the undergraduate curriculum may improve doctors' skills in health promotion.

Planning Skills Moderate the Intention–Planning Cognitions–Behaviour Relation: A Longitudinal Study on Physical Activity in Chinese Adolescents

Our objective is to examine the role of planning skills for translating intentions into physical activity via planning cognitions. A study with 534 adolescents was conducted. Over 4 weeks, intention, planning cognitions (prospective anticipation of when, where, and how to perform activities), planning skills (successful past planning experiences), and physical activity were assessed. The results were that skills correlated with intention, planning cognitions, and subsequent physical activity. Planning cognitions were found to mediate the intention–behavior relation, whereas skills moderated the mediating role of planning cognitions: If students reported high skills, they were more likely to translate their intentions into plans and behavior. We conclude that having more skills makes it more likely that adolescents successfully translate their intentions into plans. Promotion of physical activity should improve planning cognitions but also planning skills. Only with planning cognitions and skills might adolescents better be able to act in accordance with their intentions and perform physical activity.

The impact of using visual images of the body within a personalized health risk assessment: An experimental study

To examine the motivational impact of the addition of a visual image to a personalized health risk assessment and the underlying cognitive and emotional mechanisms. An online experimental study in which participants (n = 901; mean age = 27.2 years; 61.5% female) received an assessment and information focusing on the health implications of internal body fat and highlighting the protective benefits of physical activity. Participants were randomized to receive this in either (a) solely text form (control arm) or (b) text plus a visual image of predicted internal body fat (image arm). Participants received information representing one of three levels of health threat, determined by how physically active they were: high, moderate or benign. Main outcome measures were physical activity intentions (assessed pre- and post-intervention), worry, coherence and believability of the information. Intentions to undertake recommended levels of physical activity were significantly higher in the image arm, but only amongst those participants who received a high-threat communication. Believability of the results received was greater in the image arm and mediated the intervention effect on intentions. The addition of a visual image to a risk assessment led to small but significant increases in intentions to undertake recommended levels of physical activity in those at increased health risk. Limitations of the study and implications for future research are discussed. What is already known on this subject? Health risk information that is personalized to the individual may more strongly motivate risk-reducing behaviour change. Little prior research attention has been paid specifically to the motivational impact of personalized visual images and underlying mechanisms. What does this study add? In an experimental design, it is shown that receipt of visual images increases intentions to engage in risk-reducing behaviour, although only when a significant level of threat is presented. The study suggests that images increase the believability of health risk information and this may underlie motivational impact.

Habit as moderator of the intention–physical activity relationship in older adults: a longitudinal study

This longitudinal study examined whether habit strength moderates the intention–physical activity (PA) relationship in older adults, within the framework of the attitude–social influences–efficacy (ASE) model and the theory of planned behaviour (TPB). A total of 1836 older adults (M age = 62.95 years, SD age = 8.17) completed a questionnaire on social cognitive constructs and PA habit strength at baseline, and six months later a measure of PA. Three PA habit groups (i.e. low, medium and high) were composed, based on tertiles of the mean index score. Multi-group structural equation modelling analyses showed that intention significantly determined PA behaviour only in participants with a low or medium habit strength towards PA. This result suggests that PA is not intentional at high levels of habit strength and demonstrates the usefulness of incorporating habit in the ASE and TPB models. Results also showed that about half of the participants with a strong PA habit did not meet the recommended PA level. As strong habits may prevent intentional behavioural change and may hinder the receptiveness and openness for informational PA change strategies, additional intervention strategies, such as awareness raising and the use of implementation intentions, are needed for strongly habitual, but insufficiently active older adults.