The Long and Winding Road to Physical Activity Maintenance

Abstract

Objectives To build upon state-of-the art theory and empirical data to estimate the strength of multiple mediators of the efficacious Keep Active Minnesota (KAM) physical activity (PA) maintenance intervention. Methods The total, direct, and indirect effects through which KAM helped randomized participants (KAM n=523; UC n=526) maintain moderate or vigorous PA (MVPA) for up to 2 years were estimated using structural equation modeling. Results Multiple mediators explained half (β=.052, P=.13) of the effect of KAM on MVPA (β=.105, P=.004). Self-efficacy was the upstream variable in 2 endogenously mediated effects, and the self-concept mediator emerged as the strongest predictor of MVPA. Conclusions KAM positively impacted self-efficacy, which was associated with PA enjoyment, integration into the self-concept, and PA maintenance. Successful long-term PA maintenance appears to be influenced by multiple small interrelated mediational pathways. Future research evaluating maintenance models should specify recursive relationships among mediators and outcomes.

Mediators of Exercise Maintenance After Cardiac Rehabilitation

“…14,16 In a study using multiple mediation among healthy adults, Lewis et al 32 found that behavioral processes were a mediator of exercise, but self-efficacy and decisional balance were not. Similar results were reported in another study among healthy adults in which behavioral processes and exercise-induced feelings (revitalization) were mediators of exercise at 12M but self-efficacy, decisional balance, cognitive and behavioral processes, social support, and enjoyment were not.…”

“…15 In a study (not included in the review 15 ) that focused on exercise maintenance using a phone-based intervention among healthy 50-70 year old adults, self-efficacy, enjoyment of exercise, and integration into the self-concept were identified as mediators of intervention effects at 6, 12 and 24 months. 16 …”

Applying Natural Language Processing to Understand Motivational Profiles for Maintaining Physical Activity After a Mobile App and Accelerometer-Based Intervention: The mPED Randomized Controlled Trial

“…These technologies allow investigators to incorporate critical components of physical activity maintenance like self-motivation, goal setting, and self-efficacy, to one’s daily life [7,13]. A recent systematic review has shown that smartphone apps and accelerometer-based interventions appear to improve physical activity and sedentary behaviors for at least a short period of time [14].…”

Social comparison processes as contributors to consistent physical activity.

“…Research has begun to focus on the factors that contribute to successful PA adherence and failure to adhere, with PA adherence frequently defined as having met the CDC/ACSM recommendations for PA (CDC/ACSM, 1995;Crain, Martinson, Sherwood, & O'Connor, 2010;. Adherence to PA may be viewed within the context of prevention of relapse to sedentary behavior, thus non-adherence may be conceptualized as lapses in planned PA. One model of behavior relapse, the Dynamic Relapse Model (DRM) describes relapse as a process precipitated by a series of cognitive, affective and behavioral factors (Witkiewitz & Marlatt, 2004).…”

“…Self-efficacy has been identified as the most significant psychosocial predictor of PA maintenance (Crain et al, 2010;Nigg, Borrelli, Maddock, & Dishman, 2008). Low levels of PA self-efficacy are found to be strongly associated with inconsistency in PA in normative (Sallis et al, 1990;Sullum, Clark, & King, 2000) and chronically-ill samples (Bock et al, 1997).…”