Social-cognitive theory predictors of exercise behavior in endometrial cancer survivors.

Abstract

Objective This study evaluated whether social cognitive theory (SCT) variables, as measured by questionnaire and ecological momentary assessment (EMA), predicted exercise in endometrial cancer survivors. Methods One hundred post-treatment endometrial cancer survivors received a 6-month home-based exercise intervention. EMAs were conducted using hand-held computers for 10- to 12-day periods every 2 months. Participants rated morning self-efficacy and positive and negative outcome expectations using the computer, recorded exercise information in real time and at night, and wore accelerometers. At the midpoint of each assessment period participants completed SCT questionnaires. Using linear mixed-effects models, we tested whether morning SCT variables predicted minutes of exercise that day (Question 1) and whether exercise minutes at time point Tj could be predicted by questionnaire measures of SCT variables from time point Tj-1 (Question 2). Results Morning self-efficacy significantly predicted that day’s exercise minutes (p<.0001). Morning positive outcome expectations was also associated with exercise minutes (p=0.0003), but the relationship was attenuated when self-efficacy was included in the model (p=0.4032). Morning negative outcome expectations was not associated with exercise minutes. Of the questionnaire measures of SCT variables, only exercise self-efficacy predicted exercise at the next time point (p=0.003). Conclusions The consistency of the relationship between self-efficacy and exercise minutes over short (same day) and longer (Tj to Tj-1) time periods provides support for a causal relationship. The strength of the relationship between morning self-efficacy and exercise minutes suggest that real-time interventions that target daily variation in self-efficacy may benefit endometrial cancer survivors’ exercise adherence.

Feasibility of a lifestyle intervention for overweight/obese endometrial and breast cancer survivors using an interactive mobile application

“…Although our study only lasted for four-weeks, interventions focused on weight-loss, SE, and PA will lead to success with continued weight-loss and weight maintenance. This concept is echoed by Basen-Engquist et al as they investigated 100 EC survivors and revealed their morning SE significantly (p b0.001) determined that day's exercise minutes [24]. The QOL outcomes were consistent with those found in the survivors of uterine cancer empowered by exercise and healthy diet (SUCCEED) randomized control trial; whereas, QOL did not change with weightloss outcomes [18,23].…”

“…Weight-loss goals were established at the baseline visit and included the loss of approximately 1-2 lb/week. The real-time feedback component provided by the multi-disciplinary team was based on the SCT whereas messaging focused on the patient to improve weight-loss self-efficacy by using verbal or typed persuasion, vicarious learning experiences, mastery, and social support [6,23,24]. Participants received motivational patient-provider feedback notifications in response to their individual input in the LoseIt!…”

Type 2 Diabetes Self-management Among Spanish-Speaking Hispanic Immigrants

“…The commonalities of the self-management of these conditions include behaviors that arise from knowledge, the expectation that desired outcomes will be achieved, and the importance of confidence in one's ability to engage in the behavior given existing social constraints. Social cognitive theory (SCT) has been used as a theoretical framework to guide the study of individual selfmanagement in each of these seemingly different conditions [30][31][32] as well as T2DM self-management among different cultural groups [18,33], but its utilization among recent Hispanic immigrants with limited English proficiency is lacking. Because of the parallels that exist between these conditions and the condition of concern in this work, SCT was used as the theoretical framework to guide the design, analysis, and generalization of findings.…”

Outdoor Adventure Therapy to Increase Physical Activity in Young Adult Cancer Survivors

“…Basen-Engquist et al (2013) measured SCT variables and while they found exercise self-efficacy to be associated with PA, barriers self-efficacy was not significantly associated with PA. In cross-sectional study of 192 breast cancer survivors measuring correlates of PA, barriers self-efficacy was found to have significant and direct associations with perceived PA barriers, enjoyment, social support, and current leisure PA (Rogers, McAuley, Courneya, & Verhulst, 2008).…”

“…In the Pinto et al (2009) intervention breast cancer survivors in the intervention group were given tips based on TTM and SCT, and exercise self-efficacy was found to significantly predict exercise adherence. In a longitudinal study of endometrial cancer survivors, Basen-Engquist et al (2013) found selfefficacy to be a strong predictor of minutes of PA. Having higher morning self-efficacy significantly predicted the participant's total exercise minutes for the day and exercise selfefficacy was the only SCT variable that predicted exercise at the next measurement. Exercise adherence was strongly predicted by TPB variables such as stronger intention, greater selfefficacy, and more positive instrumental attitude (Speed-Andrews et al, 2012).…”