Nancy C. Gyurcsik

Physical activity in women with arthritis: Examining perceived barriers and self‐regulatory efficacy to cope

OBJECTIVE To examine whether the theory-based social cognitions of perceived barrier frequency, barrier limitation, and self-regulatory efficacy to cope were predictors of planned physical activity among adult women with arthritis. A secondary purpose was to identify and provide a phenomenologic description of the relevant barriers and coping strategies reported by study participants. METHODS Eighty adult women (mean +/- SD age 49.09 +/- 12.89 years) with self-reported doctor-diagnosed arthritis participated in this observational study. Participants completed online survey measures of barriers to physical activity and, for each barrier, reported the frequency of occurrence and the extent of limitation. Measures of coping strategies for each barrier, efficacy to cope, and physical activity were also obtained. RESULTS A multiple hierarchical regression analysis resulted in a model that significantly predicted physical activity (F[9,70] = 6.80, P < 0.01, adjusted R(2) = 0.40). Barrier limitation (standardized beta = -0.56) and efficacy (standardized beta = 0.20) were significant independent predictors. Phenomenologic findings indicated that arthritis-specific personal barriers (e.g., pain and fatigue due to arthritis) and arthritis-specific coping strategies (e.g., activity modification) were more commonly reported than generic barriers and coping strategies. CONCLUSION Self-regulatory efficacy to cope and relevant perceived physical activity barriers, which were primarily arthritis-specific and moderately or more limiting to planned physical activity, were important social cognitive predictors of physical activity, a key nonpharmacologic arthritis treatment, among women with arthritis. Future research direction should examine potential moderators of the relationship between these predictors and physical activity, such as pain acceptance.

Activity and Barriers in Girls(8-16 yr) Based on Grade and Maturity Status

UNLABELLED Minimal research has examined whether the decline in physical activity (PA) among adolescent girls is associated with chronological age (CA) or biological age (BA). PURPOSE To describe the PA levels and perceived barriers to PA of adolescent girls grouped by school grade and maturity status (i.e., early or late maturing) within grades. METHODS Two hundred and twenty-one girls (aged 8-16 yr, grades 4-10) wore an Actical accelerometer for 7 d and then completed a semistructured, open-ended questionnaire on perceived barriers to PA over the 7-d period. Predicted age at peak height velocity and recalled age at menarche were used to assess maturity among the elementary and high school girls, respectively. Maturity and grade group differences in PA were assessed using a MANCOVA and independent sample t-test and barriers to PA using chi-squared statistics. RESULTS Daily minutes spent in moderate to vigorous PA decreased by 40% between grades 4 and 10. Within grade groupings, no differences in PA were found between early and late maturing girls (P > 0.05). Grades 4 to 6 participants cited more interpersonal (i.e., social) barriers. Grades 9 to 10 participants cited more institutional barriers to PA, primarily revolving around the institution of school. No differences were found in types of barriers reported between early and late maturing girls. CONCLUSION Because PA and types of perceived barriers to PA were dependent on grade, future research should work to identify the most salient (i.e., frequent and limiting) barriers to PA by CA in youth. Once reliably was identified, multipronged intervention strategies must be tested for effectiveness to help youth cope with their salient barriers.

Barriers to Moderate Physical Activity in Adult Lesbians

ABSTRACT Adult lesbians are not sufficiently physically active to achieve physical and psychological health benefits. Lesbians are one of the least understood minority groups. Therefore, the purpose of this study was to use an ecological framework to identify factors internal to individuals and present in their social environments that may impede participation in regular physical activity. Twenty-one self-identified lesbians aged 22 to 61 years participated in one of four focus groups. The lesbian participants reported many general barriers (i.e., obstacles to participation regardless of sexual orientation) similar to previous research with other populations of women, not stratified by sexual orientation, such as being too tired and the lack of a physical activity partner. A number of lesbian-specific barriers (i.e., obstacles unique to being a lesbian) were also identified, such as the lack of lesbian-focused physical activity groups and the lack of same-sex family memberships to fitness facilities. In conclusion, for many of the general barriers, some of the proven and effective traditional intervention strategies are likely to be effective in increasing physical activity participation rates in the lesbian population. However, barriers related to sexual orientation are likely deeply entrenched in the socio-cultural system of American society and require a societal rethinking of attitudes towards lesbians, a cultural change that is not as easily amenable to traditional health promotion interventions.

General and Arthritis-Specific Barriers to Moderate Physical Activity in Women With Arthritis

BACKGROUND most women with arthritis are insufficiently active, despite the health benefits derived from participation in moderate physical activity (MPA). Understanding perceived barriers that make it difficult for women with arthritis to be active is needed to inform interventions. Barriers are often assessed through investigator-provided lists, containing mainly general, personal, and situational barriers, common across populations (e.g., lack of time). However, identifying an encompassing range of problematic barriers that challenge womens activity participation is needed. Such barriers may be general and arthritis specific (e.g., pain). Problematic barriers may be best identified through assessment of whether individuals actually experience these barriers (i.e., are present) and, for present barriers, their extent of limitation on activity. Thus, the primary study purpose was to examine whether the presence of general and arthritis-specific barrier categories and the limitation of these overall categories were significant predictors of participation in MPA among women with arthritis (n = 248). METHODS on-line measures of barriers and MPA were completed. FINDINGS a multiple regression model predicting activity was significant (r(2)(adjusted) = .22; p < .01). Both arthritis-specific and general barrier limitation were the strongest predictors of activity. Arthritis-specific personal barriers were reported as being present most often (e.g., pain). CONCLUSION interventions should identify problematic barriers, taking into account the extent to which both general and disease-specific barriers limit activity, and then target their alleviation through the use of coping strategies as a way to improve activity adherence and health among women with arthritis.

Is Level of Pain Acceptance Differentially Related to Social Cognitions and Behavior? The Case of Active Women with Arthritis

Pain from arthritis is a barrier to physical activity (PA), yet some people still manage to be active. This study examined whether women with greater or weaker arthritis pain acceptance were distinguished by social cognitions (self-regulatory efficacy to overcome barriers; outcome expectations of PA) and whether PA differences existed. Women with arthritis (N = 118) completed two surveys. After controlling for pain, a hierarchical discriminant function analysis discriminated pain acceptance groups in terms of the social cognitions. Greater pain acceptance participants were also significantly more active. Findings contribute new insight on the combination of a disease-related factor (pain acceptance) and social cognitions important for adherence.

Pain, anxiety, and negative outcome expectations for activity: do negative psychological profiles differ between the inactive and active?

Adherence to physical activity at ≥150 minutes/week has proven to offer disease management and health‐promoting benefits among adults with arthritis. While highly active people seem undaunted by arthritis pain and are differentiated from the moderately active by adherence‐related psychological factors, knowledge about inactive individuals is lacking. This knowledge may identify what to change in order to help inactive people begin and maintain physical activity. The present study examined the planned, self‐regulated activity of high, moderate, and inactive individuals to determine if differences existed in negative psychological factors.

Predicting planned physical activity of individuals with arthritis: A self-regulatory perspective.

Few individuals with arthritis are sufficiently active. We surveyed a convenience sample of exercisers (N = 134) to examine the utility of social cognitive theory variables, namely, self-regulatory efficacy, negative outcome expectations, and pain acceptance for predicting planned physical activity according to Weinstein’s two prediction suggestions. Logistic regression revealed, after controlling for pain intensity, self-regulatory efficacy, negative outcome expectations, and pain acceptance distinguished groups achieving/not achieving planned physical activity, p < 0.001 (28% variance). A second model adding past physical activity also predicted the groups, p < 0.001 (57% variance). This is one of the first arthritis studies examining planned physical activity relative to Weinstein’s recommendations.

Perceptions of Trained Leaders on Improving the Public Health Impact of Three Arthritis Foundation Programs

The Arthritis Foundation (AF) offers effective community-based programs to help manage arthritis, including aquatic, exercise, and self-help programs. Trained leaders can facilitate the adoption, maintenance, and reach of these programs and thus the impact on public health. This study identifies reasons for becoming AF aquatic, exercise, and/or self-help program leaders, AF program reach, and adoption and maintenance challenges encountered by individuals after being trained. Researchers interviewed by telephone 72 participants who attended an AF leader training workshop. Participants reported various reasons for becoming program leaders (e.g., a wish to help others). AF programs were mainly adopted and maintained in urban communities and in fitness/ health clubs, medical centers, or senior centers. Aquatics programs were the most frequently offered, and all programs had low reach (with a mean number of participants of 14.41, 12.50, and 11.00 for aquatic programs, exercise programs, and self-help programs, respectively. Challenges to adopting and maintaining programs include the time of year (e.g., winter, holidays) and lack of a facility to offer the program.

Self-Regulatory Efficacy Encourages Exercise Persistence Despite Arthritis Flare Symptoms

BACKGROUND The study of exercise adherence during an arthritis flare is recommended by arthritis researchers. Studies to date have been correlational. METHODS Social cognitions of exercising individuals with arthritis who consider exercise adherence under different levels of challenge of an arthritis flare were examined using an experimental design. Exercising individuals with differential self-regulatory efficacy for managing arthritis flare symptoms (SRE-flare) were randomly assigned to conditions where flare symptoms were perceived as either many or few. Individuals in each condition responded about the strength of their anticipated persistence to continue exercise, and their self-regulatory efficacy to use coping strategies to enable exercise. RESULTS Higher SRE-flare individuals expressed significantly (a) greater persistence (Cohens d = 1.17) and (b) more confidence to use their flare coping solutions (Cohens d = 1.44). CONCLUSION Main findings were as hypothesised. When exposed to the condition with more limiting flare symptoms (i.e. greater challenge), high SRE participants were the most confident in dealing with flare symptoms and exercising. Identifying lower SRE-flare individuals less likely to persist with exercise during arthritis flares may improve tailored exercise counselling.

Moving Forward with Physical Activity: Self-Management of Chronic Pain among Women

Community Health, Colorado School of Public Health at the University of Northern Colorado, Greeley, Colorado College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada c Pain Quality Improvement and Research, Royal University Hospital, Saskatoon Health Authority, Saskatoon, Saskatchewan, Canada Department of Archaeology and Anthropology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada