Enhancing self-efficacy and exercise readiness in pregnant women

ObjectivesDespite the benefits associated with exercise during pregnancy, many expectant mothers are inactive.DesignThe present study examined whether persuasive messages could influence task and scheduling self-efficacy, exercise intention, action plans, and behavioral commitment among pregnant women.MethodsAfter completing premanipulation task and scheduling self-efficacy and exercise intention measures, participants (n = 125) were randomly assigned to read one of four efficacy-enhancing messages: scheduling, task, combined scheduling/task, or control. Postmanipulation task and scheduling self-efficacy, intentions and action plans and behavioral commitment were then assessed.ResultsRepeated-measures ANOVAs revealed that compared to the control group, inactive participants who read the persuasive messages reported significant increases in scheduling self-efficacy, task self-efficacy, and intention from premanipulation to postmanipulation as well significantly stronger action plans.ConclusionsWritten persuasive messages may promote exercise behavior during pregnancy by increasing scheduling and task self-efficacy, intention, and action plans for exercise.     

Adoption vs. parenting decisions among pregnant adolescents

The choice of adoption is rare among pregnant adolescents. This exploratory study used regression analyses to ascertain which demographic, social, and intervention variables were related to this decision. The adolescents with mothers who favored adoption and/or had few parenting peer models were more likely to choose adoption. Age, knowledge of peers who had chosen adoption, grades in school, level of involvement in a comprehensive adolescent pregnancy program, and participation in individual therapy or Decision-Making Group were not significantly related to the decision. Decision-Making Group is a once-a-week therapy session that focuses on adoption vs. parenting decisions for pregnant adolescents. Eighty-seven percent of the adolescents who participated in these sessions found them helpful. The policy implications for adolescent pregnancy programs are explored.     

Comparison of three antismoking interventions among pregnant women in an urban setting: a randomized trial

This study examined smoking cessation and cigarette reduction of indigent inner city pregnant women (n = 193) who completed one of three interventions: a special video program based on their perceptions of the effects of smoking during pregnancy, the American Lung Association's "Freedom From Smoking For You and Your Baby" program, or the usual physician's advice. Six percent of the women quit smoking, and 43% reduced the number of cigarettes they smoked. There were no significant differences among the three groups for either the number who quit smoking or who reduced the number of cigarettes smoked.     

Self-efficacy and planning strategies can improve physical activity levels in women with a recent history of gestational diabetes mellitus

Introduction: Regular physical activity can reduce the risk of developing diabetes in high risk populations including in women with gestational diabetes mellitus (GDM). This study applied the Health Action Process Approach (HAPA) to determine the motivational and volitional factors important in increasing physical activity among women with previous GDM.

Methods: Women with GDM receiving obstetric care at a teaching hospital in Sri Lanka were invited to participate in a survey 6–36 months post-delivery. At baseline and 8 weeks later, 152 women completed postal and telephone surveys that collected socio-cognitive and physical activity data. The study hypotheses were tested using structural equation modelling.

Results: The modified model fit the data well (CFI = .95, TLI = .94, RMSEA = .057) and explained 11% of the variance in behaviour. Action self-efficacy was the only important predictor of intention to be physically active. Intention as well as maintenance self-efficacy predicted planning, which, in turn, predicted physical activity. Planning mediated the effect of intention and self-efficacy (maintenance and recovery) on physical activity.

Conclusion: This study has identified predictors of physical activity among women with previous GDM that can inform intervention studies. Interventions targeting this population need to include planning strategies and enhance self-efficacy.     

Acute exercise: buffering psychosocial stress responses in women.

We evaluated the experimental hypothesis that an acute bout of aerobic exercise (AE) serves as a buffer to psychosocial stress responses in low to moderate physically fit women. Forty-eight (24 White, 24 Black) 25- to 40-year-old women participated in two counterbalanced experimental conditions: an attention control and a 40-min bout of AE at 70% heart rate (HR) reserve. The attention control and AE treatments were followed by (a) 30 min of quiet rest, (b) exposure to mental and interpersonal threat, and (c) 5 min of recovery. Blood pressure (BP) and HR were monitored at baseline, during the stressors, and throughout recovery. Self-reported distress was assessed before each stressor and upon completion of the recovery period. The results provided clear evidence that exercise dampens BP reactivity to psychosocial stress. Additionally, compared with the attention placebo control, AE reduced both the frequency and intensity of anxiety-related thoughts that occur in anticipation of interpersonal threat and challenge.     

The impact of group psychological interventions on distress in infertile women.

Infertile women express higher levels of distress than fertile women, with distress peaking between the 2nd and 3rd year. The purpose of this study was to determine whether group psychological interventions could prevent this surge. One hundred eighty-four women who had been trying to conceive between 1 and 2 years were randomized into either a cognitive-behavioral group, a support group, or a control group. All experimental participants attended a 10-session group program. Participants completed psychological questionnaires at intake and again at 6 and 12 months. Substantial attrition occurred, particularly in the control group. The cognitive-behavioral and support participants experienced significant psychological improvement at 6 and 12 months compared with the control participants, with the cognitive-behavioral participants experiencing the greatest positive change.     

Setting for exercise and concerns about body appearance of women who exercise.

The present study examined the association between the sex composition of exercise environment and concerns related to body appearance of women who exercise. A questionnaire concerning social physique anxiety, body dissatisfaction, and attitude toward women-only exercise environment was administered to 81 women who used either the women-only area or the co-ed area in a fitness club. A one-way analysis of variance indicated that those who exercised in a women-only area reported more social physique anxiety and dissatisfaction with body size and favored exercising in areas exclusively reserved for women than women who exercised primarily in co-ed areas. The women-only area served as a protective environment for those who were heavier, anxious about their body appearances, and dissatisfied about their body images. These women also preferred to exercise in an exclusively female setting compared to women who used the co-ed area.     

Appearance vs. health motives for exercise and for weight loss

Objective

This study had three primary aims: (1) to investigate differences between restrained and unrestrained eaters in their reasons for exercise and their motives for losing weight; (2) to investigate the association of appearance and health motives for exercise and for losing weight with body image concerns; and (3) to determine whether appearance motives for exercise and for losing weight mediate the link between internalized societal standards of attractiveness and body image concerns.

Design

Cross-sectional survey.

Method

205 women completed measures of dietary restraint, reasons for exercise, motivation for losing weight, internalization of societal standards of attractiveness, and body image concerns.

Results

Unrestrained eaters were more motivated to exercise and to lose weight for health reasons than for appearance reasons, whereas restrained eaters were equally motivated by appearance and health reasons. Appearance-based motives for exercising and for losing weight were positively associated with body image concerns, whereas health-related reasons for exercise were negatively associated with body image concerns. Furthermore, in a multiple mediation analysis, appearance motives for weight loss mediated the relation between internalization of societal standards of attractiveness and body image concerns, but appearance reasons for exercise did not.

Conclusion

These findings indicate that appearance-based motives for exercise and weight loss are associated with negative outcomes. Efforts to promote exercise and weight management should emphasize the health benefits rather than the implications for appearance.     

Cognitive-behavioural interventions in a patient with an anxiety disorder related to diabetes

This study extends the data on the efficacy of cognitive interventions for patients with chronic medical problems and describes the case of a 37-year-old woman with an anxiety disorder related to diabetes. The effects on panic frequency, use of safety behaviour and related beliefs were investigated after the introduction of two main cognitive-behavioral interventions. The results are consistent with predictions from the cognitive model of panic. This case demonstrates the usefulness of directly challenging the 'meaning' of the feared situation in order to produce clinically significant improvements in the management of physical disease.     

Stress reactivity and exercise training in premenopausal and postmenopausal women.

Examined the influence of ovarian function on psychophysiological stress responses and determined if aerobic exercise reduced stress reactivity. Fifty premenopausal and postmenopausal women initially were subjected to a public speaking task and an ice-on-the-forehead procedure, during which time their blood pressure and heart rate were monitored and continuous blood samples were obtained. Subjects also underwent aerobic fitness evaluations with a maximum-exercise treadmill test. Subjects were then randomly assigned to a 12-week exercise program of either aerobic exercise (e.g., walking and jogging at a prescribed exercise intensity) or non-aerobic strength and flexibility training and were then reevaluated. Results indicated that postmenopausal women exhibited lower resting epinephrine levels but greater epinephrine reactivity to the speaking task compared to the premenopausal women. There were no differences between premenopausal and postmenopausal women with respect to cardiovascular or catecholamine responses during the cold challenge. Premenopausal and postmenopausal women also achieved comparable improvements in aerobic fitness. However, results of the mental stress testing were complex and provided only partial support for the role of aerobic exercise in reducing stress responses.     

Association of exercise counselors' sex with exercise session attendance in women enrolled in a cognitive behavioral treatment system

Attendance rates from two groups incorporating a cognitive behavioral treatment system (male counselor group, n=53; female counselor group, n=56) and a control group using standard methods of exercise counseling (n =56) were contrasted with new and returning female exercisers (overall M age=40 yr.). Analysis of variance with follow-up Scheffé tests indicated significantly greater attendance for the treatment groups (54 and 58%) than for the control group (37%) over 6 months. No significant difference between the treatment groups was found. Findings suggest that the sex of exercise counselors does not appear to influence attendance of exercise sessions.     

Psychological well-being and homemaker vs. retiree identity among older women

Social roles have been a central focus in both sociological and developmental theories of adjustment in late life. Research on roles and well-being, however, has focused on earlier adulthood or on comparisons of tenuous roles (such as retiree) with institutional roles (such as employee), especially among men. The few studies comparing older women in the tenuous roles of homemaker and retiree all compare single-role women, and show contradictory results. One possibility is that multiple role identities are linked to greater well-being in older women, as they are among younger women. In this paper the life satisfaction, depression, and self-esteem of older women who consider themselves retired only, homemakers only, or both are compared. The sample includes 864 Black (N=242) and White (N=622) women ages 60 and over from a 1986 national survey. Retired women and homemakers did not differ in well-being; women who called themselves both had higher self-esteem and lower depression than single-role women. In analyses exploring what tenuous role content (daily activities) might explain group differences in well-being, do-it-yourself activities and volunteer activities were significant. Age, education, health, and marital status were also important factors. Recommendations include adopting a multiple role perspective with older women and encouraging their participation in instrumental, informal role activities to maximize well-being.Northwestern University     

Stress, depressive symptoms, and smoking cessation among pregnant women.

Perceived stress and depressive symptoms were examined as correlates and predictors of smoking cessation during pregnancy in a sample of 819 pregnant smokers (454 baseline smokers and 365 baseline quitters). Women who quit early in pregnancy had lower levels of stress and depressive symptoms than baseline smokers. Adjusting for level of addiction and other demographic factors related to stress and depressive symptoms eliminated the significant association between depressive symptoms and smoking cessation. Lower levels of stress and depressive symptoms were not predictive of cessation in later pregnancy. Prenatal healthcare providers should continue to assess level of addiction and provide targeted intensive cessation interventions. Interventions that reduce stress and depression may also be of benefit to women who are continuing smokers in early pregnancy.     

Sleep disturbances in depressed pregnant women and their newborns

Pregnant women (N=253) were recruited during their second trimester of pregnancy (M=22.3 weeks gestation) and assigned to depressed (N=83) and non-depressed groups based on a SCID diagnosis of depression. They were then given self-report measures on sleep disturbance, depression, anxiety and anger, and their urine was assayed for norepinephrine and cortisol. These measures were repeated during their third trimester (M=32.4 weeks). Their newborns were then observed during sleep. During both the second and third trimesters, the depressed women had more sleep disturbances and higher depression, anxiety and anger scores. They also had higher norepinephrine and cortisol levels. The newborns of the depressed mothers also had more sleep disturbances including less time in deep sleep and more time in indeterminate (disorganized) sleep, and they were more active and cried/fussed more.     

MMPI-2 typology of pregnant drug-dependent women in treatment

The present study examined the validity of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) typology for pregnant drug-dependent women. A 3-cluster solution based on 7 MMPI-2 clinical scales emerged as the best model and was replicated across split-half samples and different primary substance-use diagnoses and treatment modalities. The 3 subtypes identified included Type I (n = 40, 24%) with no clinical elevation, Type II (n = 72, 42%) with elevated psychopathic deviate scale, and Type III (n = 58, 34%) with elevations on all 7 scales. Analyses with interview and self-report measures showed good concurrent validity. Type II had higher retention than Type I and Type III across methadone and medication-free treatments, showing some predictive validity. An a priori method for classifying new cases on the basis of the proposed typology was developed and validated. Study findings support MMPI-2's use with pregnant drug-dependent women for assessment and possibly treatment planning.     

Manipulating self-efficacy in the exercise environment in women: influences on affective responses.

Self-efficacy was experimentally manipulated in an exercise context, and its effect on affective responses was examined. College women (N = 46) were randomly assigned to a high- or low-efficacy condition, and efficacy expectations were manipulated by means of bogus feedback and graphs depicting contrived normative data. The manipulation successfully influenced affective responses, with participants in the high-efficacy group reporting more positive and less negative affect than did the low-efficacy group. Efficacy was significantly related to feeling-state responses during and after activity but only in the high-efficacy condition. The results suggest that self-efficacy can be manipulated and that these changes are related to the affective experience associated with exercise. Such findings may have important implications for the roles played by self-efficacy and affect in exercise adherence.     

Predictors of exercise program participation in older women

Abstract

This study examined predictors of exercise program participation in females aged 60 to 89 years of age. Fifty-five exercise program participants and 50 non-exercising subjects were assessed on potential group predictor variables. Univariate analyses indicated that the Exercise compared to the Non-Exercise group had a stronger belief that they did not receive enough exercise in their everyday lives and in the health value of exercise, greater self-efficacy and enjoyment of exercise, and less physical discomfort associated with exercise. The Exercise group perceived exercise programs to be more available and greater family support to participate. Medical advice to exercise and exercise history did not differ significantly between groups. A logistic regression analysis indicated that of the variables assessed, belief that one is not receiving enough exercise in daily life and exercise availability were the most powerful predictors of exercise group membership. The implications of these findings for the promotion of exercise in older women are discussed.