Which Behaviour Change Techniques Are Most Effective at Increasing Older Adults’ Self-Efficacy and Physical Activity Behaviour? A Systematic Review
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Increasing self-efficacy is an effective mechanism for increasing physical activity, especially for older people.
The aim of this review was to identify behaviour change techniques (BCTs) that increase self-efficacy and physical activity behaviour in non-clinical community-dwelling adults 60 years or over.
A systematic search identified 24 eligible studies reporting change in self-efficacy for physical activity following an intervention. Moderator analyses examined whether the inclusion of specific BCTs (as defined by CALO-RE taxonomy) was associated with changes in self-efficacy and physical activity behaviour.
Overall, interventions increased self-efficacy (d = 0.37) and physical activity (d = 0.14). Self-regulatory techniques such as setting behavioural goals, prompting self-monitoring of behaviour, planning for relapses, providing normative information and providing feedback on performance were associated with lower levels of both self-efficacy and physical activity.
Many commonly used self-regulation intervention techniques that are effective for younger adults may not be effective for older adults.
- US Department of Health and Human Services. Physical activity guidelines for Americans: Be active, healthy and happy. US Department of Health and Human Services, Washington; 2008
- UK Department of Health, start active, stay active. A report on physical activity for health from our four home countries' chief medical officer. UK Department of Health London; 2011
- Warburton D, Charlesworth S, Ivey A, Nettlefold L, Bredin S. A systematic review of the evidence For Canada’s Physical Activity Guidelines for Adults. Int J Behav Nutr Phys Act. 2010; 7: 39. CrossRef
- Paterson D, Warburton D. Physical activity and functional limitations in older adults: A systematic review related to Canada's Physical Activity Guidelines. Int J Behav Nutr Phys Act. 2010; 7: 38. CrossRef
- Kesäniemi A, Riddoch CJ, Reeder B, Blair S, Sørensen T. Advancing the future of physical activity guidelines in Canada: An independent expert panel interpretation of the evidence. Int J Behav Nutr Phys Act. 2010; 7: 41. CrossRef
- NHS information centre for health and social care health survey for England – 2008: Physical activity and fitness. Leeds; 2009
- Hobbs N, Godfrey A, Lara J, et al. Are behavioural interventions effective in increasing physical activity at 12-36 months in adults aged 55 to 70 years? A systematic review and meta-analysis. BMC Med. 2013; 11: 75. CrossRef
- Bandura A. Self-efficacy: The exercise of control. New York, NY: Freeman; 1997.
- Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW. Correlates of physical activity: Why are some people physically active and others not? Lancet. 2012; 380: 258-271. CrossRef
- Koeneman MA, Verheijden MW, Chinapaw MJM, Hopman-Rock M. Determinants of physical activity and exercise in healthy older adults: A systematic review. Int J Behav Nutr Phys Act. 2011; 8: 142. CrossRef
- Rhodes RE, Pfaeffli LA. Mediators of physical activity behaviour change among adult non-clinical populations: A review update. Int J Behav Nutr Phys Act. 2010; 7: 37. CrossRef
- French DP. The role of self-efficacy in changing health-related behaviour: Cause, effect or spurious association? Brit J Health Psychol. 2013; 18: 237-243. CrossRef
- van Stralen MM, Vries HD, Mudde AN, Bolman C, Lechner L. Determinants of initiation and maintenance of physical activity among older adults: A literature review. Health Psychol Rev. 2009; 3: 147-207. CrossRef
- Schwarzer R, Renner B. Social-cognitive predictors of health behavior: Action self-efficacy and coping self-efficacy. Health Psychol. 2000; 19: 487-495. CrossRef
- Williams SL, French DP. What are the most effective intervention techniques for changing physical activity self-efficacy and physical activity behaviour-and are they the same? Health Educ Res. 2011; 26: 308-322. CrossRef
- Olander EK, Fletcher H, Williams S, Atkinson L, Turner A, French DP. What are the most effective techniques in changing obese individuals' physical activity self-efficacy and behaviour: A systematic review and meta-analysis. Int J Behav Nutr Phys Act. 2013; 10: 29. CrossRef
- Michie S, Ashford S, Sniehotta FF, Dombrowski S, Bishop A, French DP. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: The CALO-RE taxonomy. Psychol Health. 2011; 26: 1-20. CrossRef
- Abraham C, Michie S. A taxonomy of behaviour change techniques used in interventions. Health Psychol. 2008; 27: 379-387. CrossRef
- Landis JR, Koch GG. Measurement of observer agreement for categorical data. Biometrics. 1977; 33: 159-174. CrossRef
- Cohen JA. Power primer. Psychol Bull. 1992; 112: 155-159. CrossRef
- Schwarzer R. Statistics software for meta-analysis. Available at: http://userpage.fu-berlin.de/health/meta_e.htm. Accessibility verified May 2, 2013
- Hunter J, Schmidt FL. Methods of meta-analysis: Correcting error and bias in research findings (second edition). Sage: Thousand Oaks, CA; 2004.
- Rosenthal R, DiMatteo MR. Meta-analysis: Recent developments in quantitative methods for literature reviews. Annu Rev Psychol. 2001; 52: 59-82. CrossRef
- Aree-Ue S, Pothiban L, Belza B, Sucamvang K, Panuthai S. Osteoporosis preventive behavior in Thai older adults: Feasibility and acceptability. J Gerontol Nurs. 2006; 32: 23-30.
- Buman MP, Giacobbi PR, Dzierzewski JM, et al. Peer volunteers improve long-term maintenance of physical activity with older adults: A randomized controlled trial. J Phys Act Health. 2001; 8: S257-266.
- Clark DO, Stump TE, Damush TM. Outcomes of an exercise program for older women recruited through primary care. J Aging Health. 2003; 15: 567-585. CrossRef
- Connell CM, Janevic MR. Effects of a Telephone-Based Exercise Intervention for Dementia Caregiving Wives: A Randomized Controlled Trial. J Appl Gerontol. 2009; 28: 171-194. CrossRef
- Greaney ML, Riebe D, Ewing Garber C, et al. Long-term effects of a stage-based intervention for changing exercise intentions and behavior in older adults. Gerontologist. 2008; 48: 358-367. CrossRef
- Clark PG, Rossi JS, Greaney ML, et al. Intervening on exercise and nutrition in older adults: The Rhode Island SENIOR Project. J Aging Health. 2005; 17: 753-778. CrossRef
- Clark PG, Nigg CR, Greene G, Riebe D, Saunders SD. Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR): Translating theory into research. Health Educ Res. 2002; 17: 552-561. CrossRef
- King AC, Pruitt LA, Phillips W, Oka R, Rodenburg A, Haskell WL. Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults. J Gerontol A Biol Sci Med Sci. 2000; 55: 74-83. CrossRef
- Li F, McAuley E, Harmer P, Duncan TE, Chaumeton NR. Tai Chi enhances self-efficacy and exercise behavior in older adults. J Aging Phys Act. 2001; 9: 161-171.
- Li F, Harmer P, McAuley E, Fisher J, Duncan T, Duncan S. Tai chi, self-efficacy, and physical function in the elderly. Prev Sci. 2001; 2: 229-239. CrossRef
- McAuley E, Mailey EL, Mullen SP, et al. Growth trajectories of exercise self-efficacy in older adults: Influence of measures and initial status. Health Psychol. 2011; 30: 75-83. CrossRef
- McAuley E, McAuley E, Mullen S, et al. Self-regulatory processes and exercise adherence in older adults. Am J Prev Med. 2011; 41: 284-290. CrossRef
- McAuley E, Katula J, Mihalko SL, et al. Mode of physical activity and self-efficacy in older adults: A latent growth curve analysis. J Gerontol B Psychol Sci Soc Sci. 1999; 54: 283-292. CrossRef
- McAuley E, Jerome G, Elavsky S, Marquez D, Ramsey S. Predicting long-term maintenance of physical activity in older adults. Prev Med. 2003; 37: 110-118. CrossRef
- McAuley E, Jerome G, Marquez D, Elavsky S, Blissmer B. Exercise self-efficacy in older adults: Social, affective and behavioral influences. Ann Behav Med. 2003; 25: 1-7. CrossRef
- McAuley E, Elavsky S, Jerome G, Konopack J, Marquez D. Physical activity-related well-being in older adults: Social cognitive influences. Psychol Aging. 2005; 20: 295-302. CrossRef
- Michael YL, Carlson NE. Analysis of Individual Social-ecological Mediators and Moderators and Their Ability to Explain Effect of a Randomized Neighborhood Walking Intervention. Int J Behav Nutr Phys Act. 2009; 6: 49. CrossRef
- Fisher KJ, Li F. A community-based walking trial to improve neighborhood quality of life in older adults: A multilevel analysis. Ann Behav Med. 2004; 28: 186-194. CrossRef
- Nahm ES, Barker B, Resnick B, Covington B, Magaziner J, Brennan PF. Effects of a social cognitive theory-based hip fracture prevention web site for older adults. Comput Inf Nurs. 2010; 28: 371-379. CrossRef
- Nahm ES, Resnick B, Covington B. Development of theory-based, online health learning modules for older adults: Lessons learned. Comput Inform Nurs. 2006; 24: 261-268. CrossRef
- Petrella RJ, Koval JJ, Cunningham DA, Paterson DH. Can primary care doctors prescribe exercise to improve fitness? The Step Test Exercise Prescription (STEP) project. Am J Prev Med. 2003; 24: 316-322. CrossRef
- Petrella RJ, Wight D. An office-based instrument for exercise counseling and prescription in primary care. The Step Test Exercise Prescription (STEP). Arch Fam Med. 2000; 9: 339-344. CrossRef
- Pinto BM, Lynn H, Marcus BH, DePue J, Goldstein MG. Physician-based activity counseling: Intervention effects on mediators of motivational readiness for physical activity. Ann Behav Med. 2001; 23: 2-10. CrossRef
- Pinto BM, Goldstein MG, DePue JD, Milan FB. Acceptability and feasibility of physician-based activity counseling. The PAL project. Am J Prev Med. 1998; 15: 95-102. CrossRef
- Pinto BM, Goldstein MG, Marcus BH. Activity counseling by primary care physicians. Prev Med. 1998; 27: 506-513. CrossRef
- Qi BB, Resnick B, Smeltzer SC, Bausell B. Self-efficacy program to prevent osteoporosis among Chinese immigrants: A randomized controlled trial. Nurs Res. 2011; 60: 393-404. CrossRef
- Resnick B, Luisi D, Vogel A. Testing the Senior Exercise Self-efficacy Project (SESEP) for use with urban dwelling minority older adults. Public Health Nurs. 2008; 25: 221-234. CrossRef
- Rose MA. Evaluation of a peer-education program on heart disease prevention with older adults. Public Health Nurs. 1992; 9: 242-247. CrossRef
- Shin KR, Kang Y, Park HJ, Heitkemper M. Effects of exercise program on physical fitness, depression, and self-efficacy of low-income elderly women in South Korea. Public Health Nurs. 2009; 26: 523-531. CrossRef
- Temple B, Janzen BL, Chad K, Bell G, Reeder B, Martin L. The health benefits of a physical activity program for older adults living in congregate housing. Can J Public Health. 2008; 99: 36-40.
- van Stralen MM, de Vries H, Mudde AN, Bolman C, Lechner L. The long-term efficacy of two computer-tailored physical activity interventions for older adults: Main effects and mediators. Health Psychol. 2011; 30: 442-452. CrossRef
- van Stralen MM, de Vries H, Mudde AN, Bolman C, Lechner L. The working mechanisms of an environmentally tailored physical activity intervention for older adults: A randomized controlled trial. Int J Behav Nutr Phys Act. 2009; 6: 83. CrossRef
- van Stralen MM, de Vries H, Bolman C, Mudde AN, Lechner L. Exploring the efficacy and moderators of two computer-tailored physical activity interventions for older adults: A randomized controlled trial. Ann Behav Med. 2010; 39: 139-150. CrossRef
- van Stralen MM, de Vries H, Mudde AN, Bolman C, Lechner L. Efficacy of two tailored interventions promoting physical activity in older adults. Am J Prev Med. 2009; 37: 405-417. CrossRef
- van Stralen MM, Kok G, de Vries H, Mudde AN, Bolman C, Lechner L. The Active plus protocol: Systematic development of two theory- and evidence-based tailored physical activity interventions for the over-fifties. BMC Public Health. 2008; 8: 399. CrossRef
- Anderson KJ, Pullen CH. Physical activity with spiritual strategies intervention: A cluster randomized trial with older African American women. Res Gerontol Nurs. 2013; 6: 11-21. CrossRef
- Dattilo J, Martire L, Gottschall J, Weybright E. A pilot study of an intervention designed to promote walking, balance, and self-efficacy in older adults with fear of falling. Educ Gerontol. 2014; 40: 26-39. CrossRef
- Dye CJ, Williams JE, Kemper KA, McGuire FA, Aybar-Damali B. Impacting mediators of change for physical activity among food stamp recipients. Educ Gerontol. 2012; 38: 788-798. CrossRef
- Irvine AB, Gelatt VA, Seeley JR, Macfarlane P, Gau JM. Web-based intervention to promote physical activity by sedentary older adults: Randomized Controlled Trial. J Med Internet Res. 2013; 15: e19. CrossRef
- Purath J, Keller CS, McPherson S, Ainsworth B. A randomized controlled trial of an office-based physical activity and physical fitness intervention for older adults. Geriatr Nurs. 2013; 34: 204-211. CrossRef
- Dombrowski SU, Sniehotta FF, Avenell A, Johnston M, MacLennan G, Araujo-Soares V. Identifying active ingredients in complex behavioural interventions for obese adults with obesity-related co-morbidities or additional risk factors for co-morbidities: A systematic review. Health Psychol Rev. 2012; 6: 7-32. CrossRef
- Michie S, Abraham C, Whittington C, McAteer J, Gupta S. Effective techniques in healthy eating and physical activity interventions: A meta-regression. Health Psychol. 2009; 28: 690-701. CrossRef
- Peters GJY, de Bruin M, Crutzen R. Everything should be as simple as possible, but no simpler: Towards a protocol for accumulating evidence regarding the active content of health behaviour change interventions. Health Psychol Rev. 2014. doi:10.1080/17437199.2013.848409.
- Carver CS, Scheier MF. Attention and self-regulation: A control theory approach to human behavior. New York: Springer; 1981. CrossRef
- De Luca CR, Leventer RJ. Developmental trajectories of executive functions across the lifespan. In Anderson, Peter; Anderson, Vicki; Jacobs, Rani. Executive functions and the frontal lobes: A lifespan perspective. Washington, DC: Taylor & Francis. 2008:3–21
- Norman DA, Shallice T. Attention to action: Willed and automatic control of behaviour. In: Davidson RJ, Schwartz GE, Shapiro D, eds. Consciousness and Self-Regulation: Advances in Research and Theory. New York: Plenum; 1986: 1-18. CrossRef
- Orbell S, Sheeran P. “Inclined abstainers”: A problem for predicting health-related behaviour. Br J Soc Psychol. 1998; 37: 151-165. CrossRef
- Allan JL, Sniehotta FF, Johnston M. The best laid plans: Planning skills determines the effectiveness of action plans and implementation intentions. Ann Behav Med. 2013; 46: 114-120 doi:10.1007/s12160-013-9483-9.
- Gollwitzer PM. Implementation intentions: Strong effects of simple plans. Am Psychol. 1999; 54: 493-503. CrossRef
- Gollwitzer PM, Sheeran P. Implementation intentions and goal achievement: A meta-analysis of effects and processes. Adv Exp Soc Psychol. 2006; 38: 69-119. CrossRef
- Allan JL, Johnston M, Campbell NC. Missed by an inch or a mile? Predicting size of intention-behaviour gap from measures of executive control. Psychol Health. 2011; 26: 635-650. CrossRef
- Hagger M, Chatzisarantis NLD, Biddle SJH. A meta-analytic review of the theories of reasoned action and planned behavior in physical activity: Predictive validity and the contribution of additional variables. J Sport Exerc Psychol. 2002; 24: 3-32.
- Löckenhoff CE, Carstensen. Socioemotional selectivity theory, aging, and health: The increasingly delicate balance between regulating emotions and making tough choices. J Pers. 2004; 76: 1395-1424. CrossRef
- Kassavou A, Turner A, Hamborg T, French DP. Predicting maintenance of attendance at walking groups: Testing constructs from three leading maintenance theories. Health Psychol. 2014. doi:10.1037/hea0000015.
- Kassavou A, Turner A, French DP. Do interventions to promote walking in groups increase moderate physical activity? A systematic literature review with meta-analysis. Int J Behav Nutr Phys Act. 2013; 10: 18. CrossRef
- Which Behaviour Change Techniques Are Most Effective at Increasing Older Adults’ Self-Efficacy and Physical Activity Behaviour? A Systematic Review
Annals of Behavioral Medicine
Volume 48, Issue 2 , pp 225-234
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Physical activity
- Systematic review
- Older adults
- Behaviour change techniques
- Industry Sectors
- Author Affiliations
- 1. Manchester Centre for Health Psychology, School of Psychological Sciences, University of Manchester, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK
- 2. School of Health Sciences, City University London, London, UK
- 3. Manchester Centre for Health Psychology, Institute of Inflammation and Repair, University of Manchester, Manchester, UK