Using the stage model for successful physical activity interventions
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Using the stage model for successful physical activity interventions. Chapter 5. Physical Activity Programs. All used the change model (TTM model). The programs are: Imagine Action (Community based program) Jump Start to Health (Workplace based study) Jump Start (Community based study)

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Physical activity programs
Physical Activity Programs interventions

  • All used the change model (TTM model).

  • The programs are:

    • Imagine Action (Community based program)

    • Jump Start to Health (Workplace based study)

    • Jump Start (Community based study)

    • Project Active (Community based study)

    • Project Stride (Community based study)

    • Step into Motion (Community based study)

Imagine action
Imagine Action interventions

  • Participants: Adults enrolled through their workplace or response to advertisement (mass media)

  • Interventions:

    • Letter describing the program.

    • Respondents indicated their level of activity using stage of change inventory

    • Reward for enrolling was “T-shirt.”

    • Staged match Self help & resource manual

    • Weekly fun walks and activity nights

  • Program length was 6 weeks

Self help manual
Self-help Manual interventions

  • Stage 2 of manual was called: What’s in It for You.

    • Stimulus prompts (e.g., take the stairs)

    • Benefits of exercise

    • Common barriers

    • Rewarding oneself (self-determination)

  • Stage 3 of manual was called: Read for Action

    • Goal was 30 minutes of moderate intense activity or 20 minutes of vigorous activity 3-5 days per week (Goal setting).

    • Address barriers to and benefits of PA

    • Goal setting

    • Rewarding oneself

    • Time management (e.g. how to fit your exercise into a busy day)

    • Detailed walking program

Self help resource manual
Self-help & Resource Manual interventions

  • Stage 4 of the manual was called, “Keep it Going.”

    • Preventing lapse and relapse (e.g., trouble shooting situations0

    • Rewarding oneself

    • Goal setting

    • Cross training to prevent boredom (variety)

    • Avoid injury

    • Social support (e.g., find other people who are active)

  • Resource Manual

    • Variety of fee and low cost light to vigorous PA options

    • Organized by mode (e.g., walking, volleyball, aerobics)

Results interventions

  • 30% in stage 2 and 61% in stage 3 at the beginning progressed to stage 4.

  • Additional 30% in stage 2 progressed to Stage 3.

  • Very few lapse or relapse occurred in the adult participants.

    Program demonstrated that low cost, low intensity program can produce important changes in physical activity

Jump to health study
Jump to Health Study interventions

  • Participants: Sedentary employees

  • Study:

    • Recruited through signage at the workplace

    • Participants were randomly assigned to a stage matched self-help program or a non-staged match self-help program.

  • Interventions

    • Printed materials delivered at the beginning and 1 month later

    • Questionnaires about PA habits

    • Employees were given time off to complete the questionnaires

    • Free popcorn and beverages were available for completing the questions.

    • $1 dollar Rhode Island State lottery ticket (Reward)

Study interventions

  • Two groups were formed:

    • Stage matched people were given manuals matched to their current stage.

      • Stage 1: Do I need this? (Focus on benefits)

      • Stage 2: Try it you’ll like it? (Focus on decision balance)

      • Stage 3: I’m on my way. (Focus on goals & barriers)

      • Stage 4: Keep it going (Focus enhance confidence)

      • Stage 5: I won’t stop now (Focus on rewards, variety)

    • Non-staged matched people received American Heart Association manuals.

Results interventions

  • Subject in the staged matched groups became more active than non matched group (37% to 27%)

  • The greats changes where people in stages 1,2, & 3.

Jump start
Jump Start interventions

  • Participants: Anyone

  • Interventions

    • Printed materials that provide individual feedback each time they fill out a questionnaire

  • Questionnaires

    • Contained motivation

    • Cognitive and behavioral strategies

    • Barrier to and benefits of exercise

    • Self-efficacy

    • Exercise prescription

Results interventions

  • People who received the individual stage matched program were more like to achieve the ACSM guideline of 30 minutes of PA every day.

  • People were more likely to maintain there exercise program.

Project active study
Project Active Study interventions

  • Participant: Any group

  • Interventions

    • Walking

    • Free membership at a gym

    • Hour long behavior meeting

    • Goal setting

    • Support person

    • Self- rewards

  • Compared traditional, structured exercise program to that of lifestyle stage matched approach program.

Results interventions

  • Each group was given a 6 month membership to a fitness center.

  • Both groups program gradually increased the participants to exercising for at least 30 minutes for 5 day a week.

  • The study continued over a 2-year period.

  • Both groups showed improvement when compared to the beginning of the program

  • Lifestyle approached worked the best for people in stages 1 and 2.

Step into motion study
Step into Motion Study interventions

  • Participants: Anyone with access to the internet

  • Interventions:

    • Internet

    • No chat rooms, no blogs only restricted to stage matching material on the web

  • Tested a Web-based version in Project STRIDE

  • Study predominately involved women and Caucasians.

  • 44.4% of the participants who received Web based materials achieved public health recommended levels of physical activity and 39.5% achieved the recommended levels in 12 months.

Summary! interventions

  • What are the commonalities of these programs and studies?

    • Staged matched approach promoted PA and exercise level in participants

    • One- treatment-fits-all approach is less effective than matching interventions to the level of the client

    • Stage matched approach delivered in non traditional means is just as effective at traditional, structured exercise programs.