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STAGE-BASED AND OTHER MODELS OF PHYSICAL ACTIVITY

STAGE-BASED AND OTHER MODELS OF PHYSICAL ACTIVITY. Moving from thinking to doing. Aims. To outline the popular ‘Transtheoretical Model’ approach to physical activity decision-making Cover the ‘natural history’ model of exercise proposed by Sallis and Hovell (1990)

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STAGE-BASED AND OTHER MODELS OF PHYSICAL ACTIVITY

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  1. STAGE-BASED AND OTHER MODELS OF PHYSICAL ACTIVITY Moving from thinking to doing

  2. Aims • To outline the popular ‘Transtheoretical Model’ approach to physical activity decision-making • Cover the ‘natural history’ model of exercise proposed by Sallis and Hovell (1990) • Outline the relapse prevention model • Describe the lifespan interaction model

  3. The Transtheoretical Model of Health Behaviour Change • Core constructs: • Stages of change • Processes of change • Decisional balance (pros and cons) • Self-efficacy

  4. The Transtheoretical Model WHEN HOW Precontemplation Contemplation Preparation Action Maintenance Self-Efficacy Decisional Balance Processes of change

  5. Precontemplation • Physically active? NO • Intention to be active? NO

  6. Contemplation • Physically active? NO • Intention to be active? YES

  7. Preparation • Physically active? Yes, but not at criterion level • Intention to be active? YES

  8. Action • Physically active? YES (less than 6 months) • Intention to be active? YES

  9. Maintenance • Physically active? YES (more than 6 months) • Intention to be active? YES

  10. Prevalence estimates for stages by different levels of physical activity (Marshall & Biddle, 2001)

  11. Prevalence estimates for stages across four countries (Marshall & Biddle, 2001)

  12. Maintenance Preparation Contemplation Precontemplation Stages are thought to be cyclical Action

  13. Processes of change • "the cognitive, affective, and behavioral strategies and techniques people use as they progress through the different stages of change over time" (Marcus et al., 1992)

  14. Processes of change

  15. Processes of change

  16. DECISIONAL BALANCE Pros & cons of exercising • I would be healthier if I exercised (pro) • Other people would respect me more if I exercised(pro) • It is expensive to join a health club(con) • I would probably be sore and uncomfortable if I exercised(con)

  17. Differences in pros and cons across stages (Marshall & Biddle, 2001) Effect Size 2 1.5 1 0.5 Cons Pros 0 Precontemplation Preparation Maintenance Contemplation Action

  18. Self Efficacy The confidence that you can be active in challenging situations Example: I am confident I can be active when I feel I do not have much time

  19. Differences in self-efficacy across stages (Marshall & Biddle, 2001) Effect Size 2.5 2 1.5 1 0.5 0 Precontemplation Preparation Maintenance Contemplation Action

  20. TTM: Critique • the majority of study designs are cross-sectional • there is a need to standardize and improve the reliability of measurement of stages and related constructs • the role of processes of change for physical activity behaviour remains unclear. The presence of higher-order constructs is not apparent in physical activity • stage-by-process interactions are not evident (Marshall & Biddle, 2001)

  21. A NATURAL HISTIORY MODEL OF EXERCISE

  22. MAINTENANCE SEDENTARY ADOPTION RESUMPTION DROP- OUT

  23. Determinants may differ across phases/stage of the model • Key phases/stages applied to exercise: • Starting exercise • Maintaining exercise • Ceasing exercise • Resuming exercise

  24. RELAPSE PREVENTION MODEL

  25. effective coping Adequate or increased self-efficacy Low probability of quitting High risk of ceasing exercise ineffective coping Low self- efficacy Negative attributions High probability of quitting

  26. Lifespan Interaction Model (to be inserted by publisher?)

  27. Chapter 6: Conclusions 1 • the TTM provides an important advance on static linear models of exercise and physical activity determinants by hypothesising both the ‘how’ and ‘when’ of behaviour change • Measures of stages and processes of change are now available and require validation across more diverse samples • TTM research needs to advance beyond description of predictable cross-sectional differences between stages • meta-analytic evidence broadly supports the model, although the classification of processes of change into two higher-order categories is questioned

  28. Chapter 6: Conclusions 2 • a natural history model of exercise is a useful framework for identifying key stages in exercise behaviour • more needs to be known about which determinants are important at each of the phases of the model • relapse prevention may depend more on coping strategies than high-risk situations per se • the hybrid HAPA model allows for the distinction between non-intentional, intentional, and action stages of behaviour

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