Does knowledge of physical activity recommendations increase physical activity among Chinese college students？ Empirical investigations based on the transtheoretical model

Background: Based on the transtheoretical model, the current study investigated whether awareness of physical activity(PA) recommendations had an impact on the stages of PA behavior change and levels of PA among Chinese college students.Methods: In Study 1, with a cross-sectional study design, 9826 students were recruited, and their knowledge of international PA recommendations,PA stage distribution, and self-reported PA level were surveyed. Pearson's χ2 test was used to test whether those participants who were aware and not aware of PA guidelines were equally distributed across the stages of PA behavior, and independent t test was conducted to test the group difference in the actual levels of PA. In Study 2, 279 students who were not aware of the PA recommendations were randomly allocated to either an intervention group or a control group, and only those in the intervention group were presented with international PA guidelines. In both groups,students' PA stages and PA level were examined before the test and then 4 months post-test. Mc Nemar's test for correlated proportions and repeated-measures analysis of variance were conducted to examine the changes in PA stage membership and PA level after the intervention.Results: Study 1 results revealed that only 4.4% of the surveyed students had correct knowledge of PA recommendations. Those who were aware of the recommendations were in later stages of PA behavior(χ~2(4) = 167.19, p < 0.001). They were also significantly more physically active than those who were not aware of the recommendations(t(443.71) = 9.00, p < 0.001, Cohen's d = 0.53). Study 2 results demonstrated that the intervention group participants who were at the precontemplation and contemplation stages at the pre-test each progressed further in the PA stages in the post-test(χ~2(1) = 112.06, p < 0.001; χ~2(1) = 118.76, p = 0.03, respectively), although no significant change in PA level was observed(t(139) < 1, p = 0.89).Conclusion: The results showed that awareness of the PA recommendations was associated with higher stages and levels of PA behavior, and a brief educational exposure to PA recommendations led to improved stages of PA behavior but no change in the levels of PA among Chinese college students. More effective public health campaign strategies are needed to promote the dissemination of the PA recommendations and to raise the awareness of the Chinese student population.

Disease prevention without relapse: Processes of change for HPV vaccination

Background: Human papillomavirus is the most prevalent sexually transmitted infection in the United States and is associated with 70% of cervical cancers as well as over 90% of genital warts. Although the HPV vaccine appears in the US immunization schedule during adolescence, a large percentage of women reach adulthood without being vaccinated. The Transtheoretical Model’s (TTM) Processes of Change (POC) construct provides an assessment of participants’ experiences with HPV vaccination and is a central component of computer-tailored interventions designed to increase compliance with medical recommendations, such as vaccination. This study describes development and validation of a POC measure for increasing HPV vaccination among young adult women. Methods: Cross-sectional measurement development was conducted using an online survey to reach a sample of 340 female college students representing vaccinated and unvaccinated women. Factor analytic structural equation modeling as well as evaluations of the stage by POC were used to evaluate the validity of the POC measure. Results: Confirmatory analyses supported the theoretically expected ten-factor, fully correlated model as the best fit for the data. Expected Stage of Change to POC relationships were also confirmed insofar as each POC was significantly associated with Stage of Change, with the exception of dramatic relief. Follow-up analyses suggested that individuals in the Precontemplation stage used all POC less frequently than individuals in all other stages. Conclusions: The POC measure was found to be internally and externally valid in a sample of college-attending women. The POC measure developed may be used to tailor stage-matched interventions that increase use of experiential and behavioral strategies important for increasing HPV vaccination in this high-risk population.

Stage of readiness for planned activity reveals heart failure patients at higher risk

Few individuals with chronic heart failure (CHF) engage in regular physical activity. PURPOSE: 1) To examine stage of readiness for planned physical activity;2) To compare estimated self-reported daily physical activity and exercise tolerance/capacity by stage of readiness;and 3) To determine the association between stages of readiness for planned physical activity, self-reported daily physical activity and exercise tolerance, in CHF patients. METHODS: One-hundred eleven CHF patients (Age: 53 ± 14 yrs;New YorkHeart Association class II/III) participated. Each participant’s stage of readiness for planned physical activity was assessed. Patients completed a self-reported daily physical activity questionnaire, and performed a six-minute walk test. RESULTS: Average left ventricular ejection fraction (LVEF) was 30.12% ± 10.72%. Twelve patients were in Precontemplation (PC),29 inContemplation (C),30 inPreparation (PR),20 inAction (A), and20 inMaintenance (M). There were no differences in age and LVEF between stages. Those classified in A/M performed more minutes in activities > 3 METs. Average 6MWD was 349 ± 118 meters, with significant differences between stages (PC, C CONCLUSION: The majority of CHF patients are in pre-action stages of readiness for adoption of planned physical activity. Patients in pre-action are engaged in less daily activity and have lower exercise tolerance/capacity than those in A/M. Lower exercise tolerance/capacity suggests these patients are more fragile and at greater risk for complications and early mortality. Greater emphasis should be placed on strategies to move patients toward A/M.

The Benefits and Barriers Related to Regular Participation in Physical Activity by African-American Women: Implications for Intervention Development

A common strategy for improving health behaviors is to emphasize the benefits and reduce the barriers to behavior change. This study investigated potential differences in perceived benefits and barriers related to participation in physical activity (PA) between women in pre-maintenance versus the maintenance phase of PA behavior to determine if perceived benefits were greater and perceived barriers lower in women with more extensive and successful PA participation experience. Data were collected from a community-based sample (N = 113) of middle-aged African-American women. The sample was stratified into two groups according to how long they had been regularly engaging in PA (6 months or longer versus less than 6 months). Chi-square analyses were conducted to investigate possible differences between the two groups of women in regard to perceived benefits and barriers associated with PA. Descriptive data showed that nearly all of the benefits and barriers to PA were perceived as being important for a majority of the participants and chi-square and t-test results indicated few significant between-group differences (p < .05) in regard to these perceptions. Additional analyses indicated there was no significant between-group difference (p < .05) for Body Mass Index. The results suggest the benefits and barriers related to PA behavior are already valued and understood by many African-American women. Further, the results do not support the commonly held belief that effective health behavior improvement programming should emphasize the benefits and reduce the barriers related to the behavior. Practitioners should consider focusing on other evidenced based factors proven to promote PA behavior such as counseling regarding social support (e.g., buddy system) and increasing self-efficacy (e.g., goal setting) to initiate and sustain a physically active lifestyle.

Bicycle Level of Service Evaluation Method for Urban Road Segment

As a sustainable mode of transportation, bicycles significantly improve daily mobility. In order to provide theoretics support for improvement of the bicycling environment, this paper proposed bicycle level of service (BLOS) evaluation method for urban road segment according to cyclists’ perception. First, influence factors of BLOS were identified from aspects of road facility, traffic characteristics, and environmental condition. Second, bicycling videos were recorded and a satisfaction survey was conducted. Four BLOS evaluation models for different separation facilities were established. Last, bicycling behavioral stages of travelers were divided based on the transtheoretical model. A new BLOS classification criterion was proposed according to travelers’ demand of different stages.

Identifying behavioral determinants and stage of readiness for performing knee massage among individuals with knee osteoarthritis:An observational study

Objective Patients who experience knee osteoarthritis or chronic knee pain can alleviate their symptoms by performing self-knee massage.Understanding the readiness and types of determinants needed to facilitate self-knee massage is needed to design effective,theory-informed interventions.The primary objective of this study was to apply the transtheoretical model of behavior change to identify how factors,which include the type of knee condition and pain level,predict an individual’s readiness to adopt self-knee massage.The secondary objective employed the capability,opportunity and motivation-behavior(COM-B)model to identify relevant determinants that are predictive of an individual’s readiness to undertake self-knee massage.Methods An observational study design was used to recruit individuals with knee osteoarthritis(n=270)and chronic knee pain(n=130).Participants completed an online survey that assessed the transtheoretical model of behavior change stages,COM-B determinants(capability,opportunity and motivation),along with self-administered massage behavior.Multivariate analysis of covariance and structural equation modeling were used to test the primary and secondary objective,respectively.Results Participants who had knee osteoarthritis scored higher on the action stage compared to those with chronic pain(P=0.003),and those who experienced greater level of pain scored higher in the contemplation(P<0.001)and action phases(P<0.001)of performing knee massage compared to those with milder pain.The COM-B structural equation model revealed self-administered knee massage to be predicted by capability(β=0.31,P=0.004)and motivation(β=0.29,P<0.001),but not opportunity(β=–0.10,P=0.39).Pain level predicted motivation(β=0.27,P<0.001),but not capability(β=0.09,P=0.07)or opportunity(β=0.01,P=0.83).Tests for mediating effects found that determinants of COM-B(motivation and capability)mediate between pain level and self-administered massage behavior(β=0.10,P=0.002).Conclusion Clinicians and researchers can expect that patients diagnosed with knee osteoarthritis or who have chronic knee pain are ready(action stage)or are considering the behavior(contemplation stage)of self-knee massage.Individuals who report having knee osteoarthritis or chronic knee pain should be coached to develop the skills to perform self-knee massage and helped to develop the motivation to carry out the therapy.

Prevalence and factors associated with stages of behavior change for physical activity in adolescents:a systematic review

Background:To analyze prevalence and factors associated with stages of behavior change for physical activity in adolescents.Data sources:A search was performed in SciELO,PubMed,PsycINFO,SPORTDiscus and LILACS.The search terms were 'behavior change' OR 'stages of change' OR 'stages of readiness' OR 'readiness to change' OR 'transtheoretical model' OR 'process to change' OR 'decisional balance',and 'motor activity' OR 'physical activity' OR 'physical exercise' and 'adolescent' OR 'students'.After the eligibility criteria,18 articles were selected.Results:The highest prevalence of adolescents in the precontemplation,contemplation,and preparation stages was found in the Germany,South Korea,and Iran while there were more adolescents in the action and maintenance in South Korea and Brazil.The evidence of association indicated that females are more likely to be in precontemplation,contemplation and preparation.The evidence was inconclusive for age (in relation to the precontemplation,contemplation,action and maintenance stages),economic status (all stages),shift of study (when stratified by gender) and body composition (all stages).No association was found with parental level of education.Conclusion:The findings can help to guide interventions and further research on the topic of behavior changes for physical activity in adolescents.