Social-cognitive predictors of physical exercise adherence: three longitudinal studies in rehabilitation.

OBJECTIVE Levels of physical exercise adherence are not predicted well by behavioral intentions. Therefore, action planning and recovery self-efficacy were specified as proximal predictors to bridge the gap between intentions and adherence. The prediction model was examined in 3 studies with participants who were enrolled in cardiac rehabilitation (Study 1, N = 353; Study 2, N = 114) or orthopedic rehabilitation (Study 3, N = 368). MAIN OUTCOME MEASURE Each study included 3 measurement points in time, covering a period between 4 and 12 months. Intentions, planning, self-efficacy, and exercise levels were assessed. RESULTS Structural equation modeling revealed that 1 common model fit all 3 data sets well. Results differed in terms of variance accounted for, but the overall patterns of estimated parameters were similar. CONCLUSIONS Although health risk perception appeared to be a negligible factor, action planning and recovery self-efficacy were effective predictors of physical exercise adherence.

[1]  Urte Scholz,et al.  Predicting Physical Exercise in Cardiac Rehabilitation: The Role of Phase-Specific Self-Efficacy Beliefs , 2005 .

[2]  M. Booth,et al.  Assessment of Physical Activity: An International Perspective , 2000, Research quarterly for exercise and sport.

[3]  Thomas L. Webb,et al.  Implementation intentions and health behaviour , 2005 .

[4]  Neil D Weinstein,et al.  Misleading tests of health behavior theories , 2007, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[5]  M. Conner,et al.  Efficacy of the Theory of Planned Behaviour: a meta-analytic review. , 2001, The British journal of social psychology.

[6]  E. A. Locke.  The Blackwell handbook of principles of organizational behavior , 2000 .

[7]  R. Schwarzer,et al.  Increasing Physical Exercise Levels , 2007, Journal of aging and health.

[8]  M. Conner,et al.  Social cognition models and health behaviour: A structured review , 2000 .

[9]  J. M. Cortina,et al.  What Is Coefficient Alpha? An Examination of Theory and Applications , 1993 .

[10]  Stephen Sutton,et al.  Physical Activity After Cardiac Rehabilitation: Evidence That Different Types of Self-Efficacy Are Important in Maintainers and Relapsers , 2006 .

[11]  R. Schwarzer,et al.  Bridging the intention–behaviour gap: Planning, self-efficacy, and action control in the adoption and maintenance of physical exercise , 2005 .

[12]  D. Rutter.  Social cognition models and changing health behaviours , 2002 .

[13]  James F. Sallis,et al.  Assessment of Physical Activity by Self-Report , 2000 .

[14]  Jerry Suls,et al.  Social psychological foundations of health and illness , 2003 .

[15]  P. Gollwitzer.  Implementation intentions: Strong effects of simple plans. , 1999 .

[16]  R Schwarzer,et al.  Social-cognitive predictors of health behavior: action self-efficacy and coping self-efficacy. , 2000, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[17]  Neil D. Weinstein,et al.  Testing four competing theories of health-protective behavior. , 1993 .

[18]  J. Sallis,et al.  Assessment of Physical Activity by Self-Report: Status, Limitations, and Future Directions , 2000, Research quarterly for exercise and sport.

[19]  G. Alan Marlatt,et al.  Self-efficacy in Changing Societies: Self-efficacy and addictive behavior , 1995 .

[20]  N. Weinstein.  Exploring the Links Between Risk Perceptions and Preventive Health Behavior , 2009 .

[21]  A. Bandura.  Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[22]  C. Abraham,et al.  Planning to lose weight: randomized controlled trial of an implementation intention prompt to enhance weight reduction among overweight and obese women. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[23]  R. Hoyle.  Structural equation modeling: concepts, issues, and applications , 1997 .

[24]  Ralf Schwarzer,et al.  Self-Efficacy : Thought Control Of Action , 1992 .

[25]  A. Bandura.  Social Foundations of Thought and Action , 1986 .

[26]  H. Leventhal,et al.  EFFECTS OF FEAR AND SPECIFICITY OF RECOMMENDATION UPON ATTITUDES AND BEHAVIOR. , 1965, Journal of personality and social psychology.

[27]  Ralf Schwarzer,et al.  Planning and Self-Efficacy in the Adoption and Maintenance of Breast Self-Examination: A Longitudinal Study on Self-Regulatory Cognitions , 2003 .

[28]  I. Ajzen.  The theory of planned behavior , 1991 .

[29]  A. Bandura.  Self-Efficacy: The Exercise of Control , 1997, Journal of Cognitive Psychotherapy.

[30]  M. Conner,et al.  The Theory of Planned Behavior and Exercise: Evidence for the Mediating and Moderating Roles of Planning on Intention-Behavior Relationships , 2005 .

[31]  Derek R. Rutter,et al.  Changing Health Behaviour: Intervention and Research with Social Cognition Models , 2002 .

[32]  M. Conner,et al.  Predicting health behaviour : research and practice with social cognition models , 2005 .

[33]  Jochen P. Ziegelmann,et al.  Initiation and Maintenance of Physical Exercise: Stage-Specific Effects of a Planning Intervention , 2004 .

[34]  R. W. Rogers,et al.  Protection motivation and self-efficacy: A revised theory of fear appeals and attitude change , 1983 .

[35]  N. Weinstein.  Testing four competing theories of health-protective behavior. , 1993, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[36]  Jutta Heckhausen,et al.  Motivation and action , 1991 .

[37]  P. Bentler,et al.  Evaluating model fit. , 1995 .

[38]  D. Gill.  Journal of Sport and Exercise Psychology , 1987 .

[39]  Benjamin Schüz,et al.  Stage-specific effects of an action control intervention on dental flossing. , 2006, Health education research.

[40]  S. Sutton.  Predicting and Explaining Intentions and Behavior: How Well Are We Doing? , 1998 .

[41]  P. Gollwitzer,et al.  Implementation intentions and goal achievement: A meta-analysis of effects and processes , 2006 .

[42]  R. Schwarzer,et al.  Are goal intentions or implementation intentions better predictors of health behavior? A longitudinal study in orthopedic rehabilitation. , 2007 .

[43]  I. Ajzen,et al.  Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research , 1977 .

[44]  S. Lippke,et al.  Planning and strategy use in health behavior change: a life span view , 2007, International journal of behavioral medicine.

[45]  Ralf Schwarzer,et al.  Self-efficacy in the adoption and maintenance of health behaviors: Theoretical approaches and a new model. , 1992 .

[46]  K. J. Munroe,et al.  Task and Scheduling Self-efficacy as Predictors of Exercise Behavior , 2002 .

[47]  A. Luszczynska,et al.  An implementation intentions intervention, the use of a planning strategy, and physical activity after myocardial infarction. , 2006, Social science & medicine.

[48]  P S Freedson,et al.  Comparison of activity levels using the Caltrac accelerometer and five questionnaires. , 1994, Medicine and science in sports and exercise.

[49]  R. Schwarzer,et al.  Adoption and maintenance of physical activity: Planning interventions in young, middle-aged, and older adults , 2006, Psychology & health.

[50]  W. Rodgers,et al.  Task, Coping, and Scheduling Self-Efficacy in Relation to Frequency of Physical Activity1 , 2001 .

[51]  P. Gollwitzer.  Goal Achievement: The Role of Intentions , 1993 .

[52]  A. Bandura,et al.  Self-Efficacy in Changing Societies , 1996, Journal of Cognitive Psychotherapy.

[53]  C. Abraham,et al.  From knowledge to action regulation: Modeling the cognitive prerequisites of sun screen use in australian and uk samples , 2001 .