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.)
Footnotes
- Correspondence: Judy M Bradley PhD, Wellcome Trust-Wolfson Northern Ireland Clinical Research Facility, U Floor, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AB, Northern Ireland. E-mail: judy.bradley{at}qub.ac.uk.
Drs Wilson and Kirk are co-first authors.
Drs O'Neill and Bradley are co-senior authors.
This work was supported by the Physiotherapy Research Foundation (PRF), the Charitable Trust of the Chartered Society of Physiotherapy (PRF Award (11) A02) and supported by the Northern Ireland Clinical Research Network Respiratory Health interest group. Dr Wilson was supported in part by the Department for Employment and Learning (Northern Ireland) as part of a PhD scholarship. The authors have disclosed no conflicts of interest.
Dr Wilson presented a version of this paper at the British Association of Sport and Exercise Sciences Student Conference, held April 8 and 9, 2014, in Portsmouth, United Kingdom, and at the Physiotherapy UK conference, held October 10 and 11, 2014, in Birmingham, United Kingdom.
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