Applying the Transtheoretical Model to Physical Activity Behavior in Individuals With Non-Cystic Fibrosis Bronchiectasis

Abstract

BACKGROUND: The transtheoretical model has been successful in promoting health behavior change in general and clinical populations. However, there is little knowledge about the application of the transtheoretical model to explain physical activity behavior in individuals with non-cystic fibrosis bronchiectasis. The aim was to examine patterns of (1) physical activity and (2) mediators of behavior change (self-efficacy, decisional balance, and processes of change) across stages of change in individuals with non-cystic fibrosis bronchiectasis. METHODS: Fifty-five subjects with non-cystic fibrosis bronchiectasis (mean age ؎ SD ‫؍‬ 63 ؎ 10 y) had physical activity assessed over 7 d using an accelerometer. Each component of the transtheoretical model was assessed using validated questionnaires. Subjects were divided into groups depending on stage of change: Group 1 (pre-contemplation and contemplation; n ‫؍‬ 10), Group 2 (preparation; n ‫؍‬ 20), and Group 3 (action and maintenance; n ‫؍‬ 25). Statistical analyses included one-way analysis of variance and Tukey-Kramer post hoc tests. RESULTS: Physical activity variables were significantly (P < .05) higher in Group 3 (action and maintenance) compared with Group 2 (preparation) and Group 1 (pre-contemplation and contemplation). For self-efficacy, there were no significant differences between groups for mean scores (P ‫؍‬ .14). Decisional balance cons (barriers to being physically active) were significantly lower in Group 3 versus Group 2 (P ‫؍‬ .032). For processes of change, substituting alternatives (substituting inactive options for active options) was significantly higher in Group 3 versus Group 1 (P ‫؍‬ .01), and enlisting social support (seeking out social support to increase and maintain physical activity) was significantly lower in Group 3 versus Group 2 (P ‫؍‬ .038). CONCLUSIONS: The pattern of physical activity across stages of change is consistent with the theoretical predictions of the transtheoretical model. Constructs of the transtheoretical model that appear to be important at different stages of change include decisional balance cons, substituting alternatives, and enlisting social support. This study provides support to explore transtheoretical model-based physical activity interventions in individuals with non-cystic fibrosis bronchiectasis. (ClinicalTrials.gov registration NCT01569009.) Key words: behavioral research; respiratory tract diseases; physical activity; accelerometry. [Respir Care 2016;61(1):68 -77.

Psychosocial Factors Related to Physical Activity in Frail and Prefrail Elderly People.

“…In relation to SE, we found signi cant differences among SE score at the different SoC, observing an incremental trend as we progress in the SoC, which corroborates the data supported by the scienti c literature for healthy elderly (19)(20)(21)(22)(23)25). The same incremental trend was observed but without nding signi cant differences in other study (18).Our data supports a direct signi cant relationship among grouped SoC with SE score, OE, DB score and PBn, suggesting that as the ratings on these variables increase, a progress towards a more active SoC and vice-versa can be observed. Different studies in elderly people have determined SE as one of the predictors of SoC (21,23), practice of PA (19,20,23,25) and the risk of falls (23), however, our results provide novel evidences in frail and pre-frail elderly, suggesting that psychological determinants are important also in vulnerable elders to get enroll in PA or exercise programs.…”

Are Barriers the Same Whether I Want to Start or Maintain Exercise? A Narrative Review on Healthy Older Adults

“…In contrast, it appears that the number of barriers evoked is a good index of level of activity, in that older people who perceived fewer barriers were more likely to engage in moderate or greater intensity activity [ 60 , 61 ]. In a similar vein, another study showed that older adults in the action and maintenance stages have high levels of physical activity and perceive fewer barriers to being active [ 62 ]. Interestingly, these results are not sufficient to determine, for instance, the weight of a barrier on the likelihood of relapse in active people.…”

Reduced Physical Activity With Bronchiectasis

“…7 Although bronchiectasis is a chronic, progressive, and debilitating disease, studies investigating the impact of bronchiectasis on physical activity are scarce. 7,8 A previous study from the United Kingdom showed a high level of sedentary behavior in subjects with bronchiectasis, 7 and they walk a great deal less in day-to-day life compared to Brazilian subjects with bronchiectasis, 6 although the latter subjects had worse pulmonary function and functional capacity. This difference in the amount of daily physical activity among countries has been shown not only in healthy subjects but also in subjects with COPD.…”