Psychosocial mediators of a lifestyle physical activity intervention in women

ObjectivesA lifestyle physical activity intervention in women based on the transtheoretical model and social–cognitive theory effectively increased physical activity. The aim of the present study was to examine possible mediators (perceived benefits and barriers of physical activity, self-efficacy, processes of change, and social support) of these physical activity changes.MethodsMembers of four units of a women's organization followed a six-month minimal-contact physical activity program. The intervention program included one group meeting, a self-help booklet and five monthly reminder letters. Members of two other units served as control group. Physical activity (accelerometer counts), and psychosocial constructs (self-report questionnaires) were assessed at baseline (pretest) and directly after the intervention (posttest). Women who completed all measurements (n = 101) were included in the mediation analyses.ResultsParticipants in the intervention group reported significantly greater increases in the use of behavioral processes from pretest to posttest than participants in the control group. None of the proposed psychosocial constructs showed a mediating effect on changes in physical activity.ConclusionsThe mechanisms proposed by the transtheoretical model and social–cognitive theory could not explain the positive effect of the intervention on physical activity. Identifying the working components of an intervention remains a challenging and necessary step in the development of effective low-cost and high-reach physical activity interventions.     

Long-term follow-up of physical activity behavior in older adults.

OBJECTIVE: To examine the contribution of social-cognitive factors (self-efficacy and affect) in predicting long-term physical activity in a sample of older adults (N=174). DESIGN: A prospective design assessed physical activity and psychosocial variables at 2 and 5 years following a 6-month randomized, controlled exercise trial. MAIN OUTCOME MEASURES: The primary outcome variable was self-reported physical activity, with previous behavior, self-efficacy, and affect assessed as determinants of physical activity. RESULTS: Covariance modeling analyses indicated that physical activity at Year 2 was the strongest predictor of physical activity at 5-year follow-up. Both self-efficacy and affect at Year 2 were also associated with physical activity at Year 5, as was original treatment condition. Variables accounted for 35% of the variance in Year 5 activity. CONCLUSION: Older adults with higher levels of physical activity, more positive affect, and higher self-efficacy at Year 2 were more likely to continue to be active at Year 5. This study is one of the longest follow-ups of exercise behavior in older adults and has implications for structuring environments to maximize the maintenance of physical activity.     

Accuracy and repeatability of the Yale physical activity survey in assessing physical activity of older adults.

The purpose of this study was to extend the initial evaluation of the Yale Physical Activity Survey to assess physical activity in older adults. The survey yields three indicators of physical activity reflecting activities performed during a typical week of the previous month (Total Time, Total Energy Expenditure) and the past month (Total Activity Summary Index). Questionnaire validity was studied in 56 men and women, ages 56 to 86 years, by comparing the average of 3- or 7 day 24-hr. physical activity records (n=56), predicted maximal oxygen consumption (VO2 max) (n = 23) and the sum of three skinfold measurements. Two-week repeatability was estimated by calculating an intraclass coefficient using an analysis of variance with repeated measures. Spearman rhos were used to study questionnaire validity. Analysis showed the survey was easily administered and scored and exhibited moderate-to-good repeatability. For the first administration the Total Energy Expenditure Index was significantly associated with the physical activity diary (r = .27). On the second administration, correlations were significant for the physical activity diary with the Total Energy Expenditure Index (r = .30), the Total Activity Summary Index (r = .36), and the Total Time Index (r = .27), and for VO2 max and the Total Time Index (r = .49) and Total Activity Summary Index (r = .64). Relative to the criterion measures used in this study, some validity was evident for the second administration in this relatively active and healthy sample of older adults.     

Affective and health-related outcome expectancies for physical activity in older adults

This study tests the effects of affective and health-related outcome expectancies on physical exercise, assuming stronger direct and indirect (via intention) effects from affective outcome expectancy to physical exercise than from health-related outcome expectancy to exercise. Physical exercise and social cognitive variables were assessed at baseline, and 6- and 12-month follow-up in 335 older adults (60–95 years of age). Applying structural equation modelling, there was a direct effect from affective, but not from health-related outcome expectancy on intentions and behaviour. Also, the indirect effect from self-efficacy on physical exercise via affective outcome expectancy was significant, whereas the mediation via health-related outcome expectancy was not. These findings emphasise the relative importance of affective versus health-related outcome expectancies in predicting intentions and physical exercise in older adults and highlight the importance to separate these facets at a conceptual level to enhance both theory development and health promotion.     

Affective and health-related outcome expectancies for physical activity in older adults

This study tests the effects of affective and health-related outcome expectancies on physical exercise, assuming stronger direct and indirect (via intention) effects from affective outcome expectancy to physical exercise than from health-related outcome expectancy to exercise. Physical exercise and social cognitive variables were assessed at baseline, and 6- and 12-month follow-up in 335 older adults (60-95 years of age). Applying structural equation modelling, there was a direct effect from affective, but not from health-related outcome expectancy on intentions and behaviour. Also, the indirect effect from self-efficacy on physical exercise via affective outcome expectancy was significant, whereas the mediation via health-related outcome expectancy was not. These findings emphasise the relative importance of affective versus health-related outcome expectancies in predicting intentions and physical exercise in older adults and highlight the importance to separate these facets at a conceptual level to enhance both theory development and health promotion.     

Predictors of personal investment in physical activity among middle-aged and older adults

The purpose of this study was to determine the relationship between the social psychological components of Personal Investment Theory and exercise behaviors among 47 middle-aged and older men and women participating in an organized exercise program. Specifically, the degree to which personal incentives for exercise, perceptions of sense of self (i.e., physical self-efficacy, fitness locus of control, self-motivation, social identity), and the congruence between program and participants' goals predict present physical activity and estimated future physical activity was examined. Multiple regression analyses indicated that present and future exercise behaviors significantly related to social psychological variables reflecting personal investment.     

Psychosocial mediators of a theory-based resistance training maintenance intervention for prediabetic adults

Objective: Examine psychosocial mediators of the effects of high vs. low-dose resistance training (RT) maintenance interventions among older (ages 50–69), overweight and pre-diabetic adults.

Design: Participants (N = 123) completed a three-month supervised RT initiation phase and were subsequently randomised (time 1) to high or low-dose six-month unsupervised RT maintenance interventions (time 2), followed by a six-month no-contact phase (time 3).

Main Outcome Measures: Online measures of putative mediators and RT behaviour.

Results: RT intervention condition (high vs. low dose) had significant effects on change from time 1 to time 2 in behavioural expectation, self-regulation and perceived satisfaction (f² = .04–.08), but not outcome expectancies, RT strategies or behavioural intentions (f² ≤ .02). Change in each of the putative mediators, except for outcome expectancies (f² ≤ .02), had significant effects on RT behaviour at times 2 (f² = .12–.27) and 3 (f² = .23–.40). In a multiple mediation model, behavioural expectation (f² = .11) and self-regulation (f² = .06) mediated the effects of RT intervention condition on time 2 RT behaviour, whereas perceived satisfaction did not (f² = .01). Self-regulation was a significant mediator of intervention effects on time 3 RT behaviour (f² = .11), but behavioural expectation and perceived satisfaction were not (f² = .04).

Conclusions: Findings suggest that behavioural expectation and self-regulation are appropriate targets for RT maintenance interventions among at-risk older adults.     

Telephone versus mail interventions for maintenance of physical activity in older adults.

Although telephone and mail are often used to promote physical activity adoption, their ability to produce long-term maintenance is unclear. In this study, 140 men and women aged 50-65 years received 1 year of telephone counseling to adopt higher (i.e., more vigorous) versus lower intensity (i.e., moderate) exercise. After 1 year, participants were rerandomized to a 2nd year of contact via (a) telephone and mail or (b) predominantly mail. Participants who were prescribed higher intensity exercise and received predominantly mail had better exercise adherence during the maintenance year than those who received telephone and mail. Both strategies were similarly effective in promoting maintenance in the lower intensity condition. Results suggest that after successful adoption of physical activity with the help of telephone counseling, less intensive interventions are successful for physical activity maintenance in older adults.     

Effect of university physical education courses on intention for physical activity adherence in Korea

Individuals' intentions of adopting physical activity as part of their lifestyle changed after university physical education courses in Korea. Male students (N = 264) taking physical education courses at a university in Korea were tested on the first and last day of a semester using a physical activity adherence questionnaire. The results showed that the intention to continue physical activity increased after taking the courses.     

Investigating the psychosocial determinants of physical activity in older adults: A qualitative approach

Objective: Despite the benefits of physical activity (PA), only one-third of older adults meet the recommended levels. The present study focused on psychosocial determinants of PA following retirement. Social cognitive theory (SCT) was used to better understand pre- and post-retirement adults’ thoughts about PA, the reasons why some individuals are more active than others, and how PA is incorporated into daily life after retirement.

Design: Seven focus groups of older adults (N = 37, M = 64, SD = 5.20; males = 20) representing a range of PA levels and retirement length participated in one of seven focus groups.

Results: Aligned with SCT, self-efficacy beliefs along with perceptions about barriers and benefits of PA were among the major determinants of PA. Findings highlighted the importance of social support, positive outcome expectations and self-regulatory strategies as motivators. The lack of structure in retirement was a hindrance to incorporating PA into daily routine but, when incorporated, PA provided a sense of purpose in the lives of retired individuals.

Conclusion: It is important to understand the meaning of retirement as a life transition and how it affects beliefs about PA to inform SCT-based health promotion interventions targeting individuals in retirement age.     

Yes,we can: physical activity and group identification among healthy adults

Drawing on social identity theory and social cognitive theory, this research was designed to investigate the role played by group identification, self‐efficacy and outcome expectations in physical activity behavior. Healthy adult participants (N = 130) who identified strongly with an exercise referent group reported higher levels of physical activity, and this relationship was mediated by self‐efficacy and outcome expectations. This study adds to the existing literature on the effects of social groups on health and is one of the first to examine the interplay of personal factors and group membership on physical activity.     

Psychosocial mediators of racial differences in nighttime blood pressure dipping among normotensive adults.

Shallow declines in nocturnal compared with diurnal blood pressure (BP dipping) have been associated with cardiovascular disease. In U.S. samples, Blacks demonstrate less BP dipping compared with Whites. In a sample of 60 Black and 60 White normotensive adults we examined stress, social integration (including parental status), social support, and hostility as potential mediators of the association between race and BP dipping. The effect of race on diastolic BP dipping was partially mediated by parental status. The effect of race on heart rate dipping was partially mediated by stressful life events. No psychosocial factors mediated the relation between race and systolic BP dipping. Although psychosocial factors appear to account for some of the observed racial differences in nocturnal blood pressure decline, our data suggest that these differences cannot be attributed entirely to covarying psychosocial effects.     

The impact of physical activity and sex differences on intraindividual variability in inhibitory performance in older adults

It is well-known that processing speed and executive functions decline with advancing age. However, physical activity (PA) has a positive impact on cognitive performances in aging, specifically for inhibition. Less is known concerning intraindividual variability (iiV) in reaction times. This study aims to investigate the influence of PA and sex differences on iiV in inhibitory performance during aging. Healthy adults were divided into active and sedentary groups according to PA level. To analyse iiV in reaction times, individual mean, standard deviation and the ex-Gaussian parameters were considered. An interaction between activity level and sex was revealed, sedentary females being slower and more variable than sedentary men. No sex differences were found in the active groups. These results indicate that the negative impact of sedentariness on cognitive performance in older age is stronger for females. The present findings underline the need to consider sex differences in active aging approaches.     

The effect of implementation intentions on physical activity among obese older adults: A randomised control study

The objective of this study is to quantify situational impacts on coping compared to the impact of personal characteristics. A facet design was used to systematically vary three situational features (ambiguity, social context, and concern at stake) in twenty vignettes of stressful situations that were presented to a sample of 430 healthy persons to elicit coping responses. In addition, relevant personal characteristics (mental health, self-esteem, perceived social support, and dispositional coping styles) were assessed. A series of variance component analyses demonstrated that for eight types of coping behavior, variability within individuals across situations was larger than variability between individuals. Multilevel analyses, accounting for both the person level and the situation level in the data, were employed to identify the situational features and personal characteristics that were responsible for situation-related variance and person-related variance respectively. Results demonstrate that all three situational features proved significant contributors to differentiated situation-specific coping patterns. No single personal factor could be identified as relevant in shaping coping behaviors, although the combined impact of personal factors explained a considerable amount of variance at the personal level. It is concluded that the study of situational features is a promising way to understand in which way situations shape coping behavior, and may be helpful in guiding the development of coping scales tailored to specific situations.     

Associations of cardiorespiratory fitness and moderate-to-vigorous physical activity with latent cognitive abilities in older adults

It has been demonstrated that physical activity has a small but positive effect on cognition in old age, which suggests that it may be possible to alter the trajectory of age-related cognitive decline. However, our understanding of which aspects of physical activity that are important for modifying cognition remains incomplete. Adopting an exploratory approach in a sample of 115 healthy older adults (65–75 years), the present cross-sectional study used structural equation modelling to investigate the dissociable associations of physical activity (moderate-to-vigorous activity, derived from 7-day accelerometry) and cardiorespiratory fitness (VO₂ max, derived from maximal treadmill ergometer test) with multiple latent cognitive abilities (working memory, episodic memory, spatial and verbal reasoning). The results showed a significant positive association between fitness and working memory, when physical activity was statistically controlled for, and a positive association of similar point magnitude between physical activity and episodic memory, when fitness was statistically controlled for, although the latter association did not reach statistical significance. The results add to the foundation for a more careful investigation of the dissociable associations of moderate-to-vigorous physical activity and fitness with cognition in old age, and encourages future research to test the hypothesis that cardiorespiratory fitness benefits working memory via general cerebrovascular effects on grey matter volume, whilst moderate-to-vigorous physical activity benefits episodic memory via effects on neuroplastic processes.     

The relation between risk perceptions and physical activity among older adults: a prospective study

Past studies have found that risk perceptions of suffering from diseases play an important role in the development of intentions to perform physical activity (PA). According to the behaviour motivation hypothesis, perceived risk could be positively and directly related to PA, but this possibility has been ignored and/or underestimated. Accounting for recent methodological developments on the importance of study design and risk perception assessment, the purpose of the present study was to examine the risk-perceptions-PA relationship among older adults. Participants (N=143) aged from 61 to 70 years initially underwent measurement of risk perceptions, baseline PA, socio-demographic and health factors. Six months later, they were asked about their PA participation. Multiple regression analyses revealed that perceived risk of suffering from diseases and conditions without regular PA participation was an independent positive predictor of later PA, over and beyond baseline behaviour, socio-demographic and health variables. This study fills a gap in the existing literature on the PAs of older adults and reveals that risk perceptions are directly linked to their participation. In addition, it extends existing knowledge in health psychology on the behaviour motivation hypothesis, and emphasises the necessity of methodological adjustments when assessing the risk-perception-behaviour relationship.     

The relation between risk perceptions and physical activity among older adults: A prospective study

Past studies have found that risk perceptions of suffering from diseases play an important role in the development of intentions to perform physical activity (PA). According to the behaviour motivation hypothesis, perceived risk could be positively and directly related to PA, but this possibility has been ignored and/or underestimated. Accounting for recent methodological developments on the importance of study design and risk perception assessment, the purpose of the present study was to examine the risk-perceptions–PA relationship among older adults. Participants (N?=?143) aged from 61 to 70 years initially underwent measurement of risk perceptions, baseline PA, socio-demographic and health factors. Six months later, they were asked about their PA participation. Multiple regression analyses revealed that perceived risk of suffering from diseases and conditions without regular PA participation was an independent positive predictor of later PA, over and beyond baseline behaviour, socio-demographic and health variables. This study fills a gap in the existing literature on the PAs of older adults and reveals that risk perceptions are directly linked to their participation. In addition, it extends existing knowledge in health psychology on the behaviour motivation hypothesis, and emphasises the necessity of methodological adjustments when assessing the risk-perception–behaviour relationship.     

Perceived autonomy support,behavioural regulations in physical education and physical activity intention

ObjectivesThe purpose of this study was to examine the relationships between students' perceived autonomy support, behavioural regulations and their intentions to be physically active outside of school.MethodParticipants were 701 secondary school students aged between 13 and 17 years from Singapore. Questionnaires were used to assess perceived autonomy support, behavioural regulation, and intentions to be physically active outside school.ResultsResults supported the hypothesised model in that perceived autonomy support fosters more self-determined forms of behavioural regulations in PE. These forms of behavioural regulations in turn, enhanced more autonomous forms of intentions. The results also yielded an interesting finding that amotivation positively predicted students' intention to be physically active outside school.ConclusionThe findings highlight the importance of perceived autonomy support in fostering more self-determined forms of behavioural regulations in PE and intention to be physically active outside school.     

Supplemental group discussions in memory training for older adults

Memory training was compared in adults aged 60-80. Groups 1 and 2 studied a self-instructional memory training manual; Group 2 also attended supplementary group discussions of typical problems of later life, related coping methods, and the techniques in the self-instructional manuals. Group 3 was a wait-list control group. Memory performance on 2 word lists significantly improved in the supplemental discussion group but not in the group that only studied the self-instructional manual. Enhanced performances were maintained at a 1-month follow-up. Bibliotherapy alone may be inferior to treatment involving a group component, although the mechanisms of such enhancement remain unexplored with respect to memory training. Neither treated group improved their digit span or recall of names and a brief prose passage; teaching older adults the strategies of chunking and use of imagery may not be beneficial.     

Psychosocial mediators of antiretroviral nonadherence in HIV-positive adults with substance use and mental health problems.

This study used data from 1,889 HIV-positive patients on antiretroviral (ARV) medications who participated in the HIV Cost and Services Utilization Study to investigate whether nonadherence to ARV medications among patients with mental health and substance use problems could be explained by difficulty getting and negative attitudes toward ARV medications, poor fit of the regimen with lifestyle, lack of instruction and cues for remembering the regimen from a health care provider, and poor support from others for taking ARV medications. Difficulty getting ARV medications and poor fit with lifestyle were significant mediators of nonadherence for patients with a probable psychiatric disorder. Difficulty getting medication was a mediator for heavy drinkers, and poor fit with lifestyle was a mediator for drug users who drank heavily. Further research is needed to identify and address the barriers to adherence in these populations.