Maria Kosma

A pilot study of a web-based physical activity motivational program for adults with physical disabilities

Purpose. Develop, deliver, and assess the efficacy of a 4-week web-based leisure-time physical activity (LTPA) motivational program based on the Transtheoretical Model and tailored to inactive adults with physical disabilities. Method. This was a pilot-based study incorporating a true experimental design with one treatment and one control group. The intervention program was delivered on the web and was based on the constructs of the Transtheoretical Model. From the 151 individuals who completed the LTPA standardized questionnaire at baseline, 75 people participated in the 1-month post-test assessment. Results. The results of the analysis confirmed the pretest LTPA scores as the study covariate for the post-test assessment (F (1,72) = 16.06, p = 0.001, η2 = 0.18). Based on the one-way ANCOVA, there were no statistically significant differences in LTPA scores between the treatment and control groups at post-test. However, the corresponding effect size and variance explained by the treatment approached a moderate level of significance (d = 0.34 and η2 = 0.04). Conclusions. Although conclusive statements about program effectiveness cannot be secured, several ‘lessons learned’ from this project may be ‘key factors’ for program improvement. Given the pilot nature of the study and the limited resources for program development and monitoring, continued examination of such motivational materials and delivery mechanisms for people with physical disabilities appear warranted.

Self-Efficacy and the Stages and Processes of Change Associated with Adopting and Maintaining Muscular Fitness-Promoting Behaviors

Abstract The majority of physical activity initiatives have been directed toward promoting cardiorespiratory fitness and general health. Far less attention has been devoted to encouraging or understanding muscular fitness-promoting behaviors. The purpose of this study was to determine if constructs from the Transtheoretical Model, a contemporary behavior change framework, could be adapted and applied to the study of muscular fitness-promoting behaviors. Participants were 429 college students who completed measures of stage of change, the behavioral and cognitive processes of change, and self-efficacy. All measures were modified to relate specifically to muscular fitness-promoting behaviors. Two direct discriminant function analyses were performed, revealing that the behavioral processes of change and self-efficacy were the major correlates of the stages of change for muscular fitness-promoting behaviors.

Predictors of Physical Activity Stage of Change Among Adults With Physical Disabilities

Purpose. To use the Transtheoretical Model (TTM) constructs to examine the most important physical activity stage of change predictors for mostly inactive adults with physical disabilities. Methods. A cross-sectional survey completed on the Internet. One hundred fifty-one individuals with physical disabilities (50% response rate) completed the survey questionnaires. Self-report standardized measures were used. Results. A direct discriminant function analysis revealed that the most important stage of change predictors were the behavioral (r2 = .88) and cognitive (r2 = .50) processes of change, followed by self-efficacy (r2 = .33) and decisional balance (r2 = .13). The most accurate stages in prediction were the contemplation (76.3%), preparation (58.3%), and precontemplation (40%) stages, whereas the least accurate stages were the action (0.0%) and maintenance (8.3%) stages. Conclusion. Health promoters and educators may use strategies from the TTM to develop theory-driven physical activity motivational programs for the posited populace. Considering the cross-sectional design, study replication is warranted.

Physical activity beliefs and behaviour of adults with physical disabilities

Purpose. The purpose of this study was to elicit the physical activity (PA) beliefs from adults with physical disabilities; and second, to examine their self-reported PA participation. Method. Participants were 223 adults (M age = 45.4 years, SD = 10.8), with self-reported physical disabilities who completed a web-based survey. Six open-ended questions were used to assess PA beliefs and the PA Scale for Individuals with Physical Disabilities measured self-reported PA. Results. A qualitative analysis showed that the most accessible behavioural advantages are that PA improves emotional functioning and assists with weight management. The most accessible behavioural disadvantages are that PA causes pain or soreness and consumes time. The most accessible normative influences that approve of PA are family, friends, and healthcare professionals. The most accessible control beliefs obstructing PA are disability and associated symptoms, and a lack of access to adequate facilities, equipment, or programs. The most accessible control beliefs that facilitate PA are access to adequate facilities, equipment, or programs, and support or assistance. Finally, the average total PA score was 20.5 metabolic equivalent (METS)-hours/day (SD = 16.8). Conclusions. Adults with physical disabilities possess unique PA beliefs that can be used to design health promotion interventions to increase PA participation.

Comparison of the Validity of Four Fall-Related Psychological Measures in a Community-Based Falls Risk Screening

Abstract We examined the measurement properties of fall-related psychological instruments with a sample of 133 older adults (M age = 74.4 years, SD = 9.4). Measures included the Comprehensive Falls Risk Screening Instrument, Falls-efficacy Scale-International (FES-I), Activities-specific Balance Confidence (ABC), modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE), Consequences of Falling (CoF), Physical Activity Scale for the Elderly (PASE), and 36-Item Short-Form Health Survey (SF-36). The FES-I, ABC, mSAFFE, and CoF were significantly correlated with each other, with SF-36, and with mobility. The ABC and mSAFFE were significantly correlated with PASE. The ABC differentiated between fallers and nonfallers and predicted total falls risk. Findings can assist with the selection of psychological instruments in a falls risk screening context.

Health beliefs and physical activity behavior in adults with multiple sclerosis

BACKGROUND Understanding how health beliefs intersect with physical activity in people with multiple sclerosis (MS) is an important step in developing effective activity promotion programs. OBJECTIVE The purpose of the study was to employ the Health Belief Model (HBM) to assess the health beliefs of adults with MS and examine the relationship between health beliefs and physical activity behavior. METHOD Participants with MS (N = 384) completed a web-based survey assessing the following HBM constructs: perceived susceptibility and seriousness of negative health outcomes, perceived benefits and barriers to physical activity, cues to action, and self-efficacy. Self-reported physical activity was also surveyed. RESULTS Participant perceptions of susceptibility to negative health outcomes were focused more on physical conditioning and functioning rather than on general health conditions. The most important HBM predictors of physical activity were self-efficacy and perceived benefits of exercise. Even when controlling for the significant effects of disability level on physical activity, self-efficacy and perceived benefits remained robust exercise predictors. CONCLUSION Individuals with MS believe they can benefit from physical activity and remain healthy even in the context of their disease. They also acknowledge the fact that their disability levels limit their exercise capabilities. Given that self-efficacy and perceived benefits of activity are important determinants of physical activity, health promotion efforts should be directed at these modifiable factors.

Promoting School Students’ Physical Activity: A Social Ecological Perspective

Guided by a social ecological perspective, the aim of this study was to investigate the predictive strength of individual (barrier self-efficacy), social environmental (support from parents, friends, physical education teachers), and physical environmental variables (equipment accessibility, neighborhood safety) toward physical activity among school students. Participants were 285 students enrolled in a suburban public school. Hierarchical linear regression analysis highlighted the influence of self-efficacy, social support from parents, friends, physical education teachers, and accessible equipment on students’ physical activity. The findings indicated that physical educators and health promoters need to consider multiple factors as they design effective interventions to promote physical activity and prevent physical inactivity among school students. This study also supported the use of a social ecological perspective to investigate students’ physical activity.

Longitudinal changes in psychosocial constructs and physical activity among adults with physical disabilities.

BACKGROUND Given the importance of physical activity (PA) and the low activity levels among adults with physical disabilities, it is important to understand how temporal changes in psychosocial constructs affect PA changes over time. OBJECTIVE/HYPOTHESIS Examine if changes in the transtheoretical model (TTM) constructs affected changes in PA levels over time. METHODS One hundred thirty-two adults with physical disabilities, such as multiple sclerosis and spinal cord injuries, completed a web-based survey once every 4 months, for a total of 3 time points, to assess the TTM constructs and PA. Six latent growth curve analyses were conducted using Mplus(5) to examine if longitudinal changes in the TTM constructs affected temporal changes in PA levels. RESULTS All six hypothesized models fit the sample data well (e.g., χ(2) = NS; RMSEA = <.001-.06). In a descending order of significance, the best predictors of the initial levels of PA were the stages of change, the behavioral processes of change, the cognitive processes of change, self-efficacy, and perceived pros. The meaningful predictors of PA changes over time were the initial levels and the slopes of the cognitive processes of change, perceived pros, and the behavioral processes of change. Although the slopes of the stages of change and perceived cons did not have a statistically significant effect on PA changes, their effects approached a medium size (.33 and .38, respectively). CONCLUSIONS In order to reassure the maintenance of an exercise program, interventionists need to first emphasize cognitive, motivational strategies (cognitive processes of change), such as the importance of PA and positive thoughts about exercise participation as well as exercise benefits (pros) before they implement behavioral strategies (behavioral processes of change), such as social support, goal setting, and self-rewarding.

Recruitment Techniques among Understudied Populations and Their Implications for Physical Activity Promotion.

The inclusion of a representative sample of understudied populations (e.g., women, minorities, older adults, youth, and people with disabilities) in physical activity promotion studies is a public health priority. Given the limited empirical evidence of effective recruitment strategies and limitations in research methodology for both over represented and understudied populations, the purpose of this paper was to overview the effectiveness of different recruitment techniques derived from active and/or passive approaches among mainly under represented populations. Additionally, recommendations for effective recruitment methods are proposed considering such factors as demographic characteristics and target population. Effective recruitment methodology among all people—regardless of age, ethnic background, functional level, or gender—is important for determining the generalizability of study findings.

Intention as a Mediator of Weight Training Behavior among College Students: An Integrative Framework

The purpose of this study was to prospectively examine the mediating role of intention in future weight training behavior (1–8 weeks) using an integrative framework [the theory of planned behavior (TPB) and self-efficacy theory (SET)]. Participants were 251 college students (M age = 21.36; 116 males, 135 females) enrolled in 16 weight training classes. The SET constructs (self-efficacy and incentive) and one TPB construct (intention) were assessed at midterm using standardized self-report questionnaires. Students’ weight training behavior was assessed through their class attendance following the midterm week. The path analysis showed that intention had the largest direct effect on behavior followed by self-efficacy. Both self-efficacy and incentive significantly predicted intention. The overall variance in intention and behavior explained by the model was 17% and 31%, respectively. Health promoters and researchers need to identify strategies to increase self-efficacy and incentive (cross product of outcome expectancy and outcome value) and thus increase intention and behavior.