Advertisement

Journal of Behavioral Medicine

, Volume 30, Issue 1, pp 21–29 | Cite as

Physical Activity Behavior, Motivational Readiness and Self-Efficacy among Ontarians with Cardiovascular Disease and Diabetes

  • Sherry L. Grace
  • Susan Barry-Bianchi
  • Donna E. Stewart
  • Ellen Rukholm
  • Robert P. Nolan
Article

This cross-sectional study examined physical activity and its correlates among 355 diabetes, 144 cardiovascular disease, 75 diabetes and cardiovascular disease, and 390 residents with cardiovascular risk factors. Community residents (N=2566) were screened by telephone, and 964 participants completed a self-report survey. Non-diabetes participants participated in a greater range of physical activities (p<.001), more frequently (p=.013). Diabetes participants had lower physical activity readiness and efficacy (ps<.009). In a regression model (p<.001), region and disease, work, marital and smoking status were significant correlates of physical activity frequency. Interventions which increase motivational readiness and efficacy among diabetics are required to prevent and delay complications, particularly in regions with environmental barriers such as cold weather and homogeneous, low-density land use.

KEY WORDS:

physical activity cardiovascular disease diabetes mellitus self-efficacy motivational readiness. 

Notes

ACKNOWLEDGMENTS

This research was funded by the Heart and Stroke Foundation. S. Grace is supported by the Ontario Ministry of Health and Long-Term Care.

REFERENCES

  1. American Diabetes Association. (2002). Diabetes mellitus and exercise. Diabetes Care 25: s64–s68.Google Scholar
  2. Bondy, S. J., Jaglal, S., and Slaughter, P. M. (1999). Area Variation in Heart Disease Mortality Rates. Institute for Clinical Evaluative Sciences, Toronto, ON.Google Scholar
  3. Booth, M. L., Owen, N., Bauman, A., Clavisi, O., and Leslie, E. (2000). Social-cognitive and perceived environment influences associated with physical activity in older Australians. Prev. Med. 31: 15–22.PubMedCrossRefGoogle Scholar
  4. Brawley, L. R., Rejeski, J. W., and Lutes, L. (2000). A group-mediated cognitive-behavioral intervention for increasing adherence to physical activity in older adults. J. Appl. Biobehav. Res. 5(1): 47–65.Google Scholar
  5. Brown, A., Taylor, R., Noorani, H., Stone, J., and Skidmore, B. (2003). Exercise-Based Cardiac Rehabilitation Programs for Coronary Artery Disease : A Systematic Clinical and Economic Review No. Technology Report no. 34). Ottawa, ON: Canadian Coordinating Office for Health Technology Assessment.Google Scholar
  6. Burns, K. J., Camaione, D. N., Froman, R. D., and Clark, B. A. (1998). Predictors of referral to cardiac rehabilitation and cardiac exercise self-efficacy. Clin. Nurs. Res. 7: 147–163.PubMedGoogle Scholar
  7. Clark, D. O. (1999). Physical activity and its correlates among urban primary care patients aged 55 years or older. J. Gerontol. 54(1): S41–S48.CrossRefGoogle Scholar
  8. Conn, V. S., Burks, K. J., Pomeroy, S. H., Ulbrich, S. L., and Cochran, J. E. (2003). Older women and exercise: Explanatory concepts. Womens Health Issues 13(4): 158– 166.PubMedCrossRefGoogle Scholar
  9. Cowan, R., Logue, E., Milo, L., Britton, P. J., and Smucker, W. (1997). Exercise stage of change and self-efficacy in primary care: Implications for intervention. J. Clin. Psychol. Med. Settings 4(3): 295–311.CrossRefGoogle Scholar
  10. Daly, J., Sindone, A. P., Thompson, D. R., Hancock, K., Chang, E., and Davidson, P. (2002). Barriers to participation in and adherence to cardiac rehabilitation programs: A critical literature review. Prog. Cardiovasc. Nurs. 17(1): 8–17.PubMedGoogle Scholar
  11. Dishman, R. K., and Buckworth, J. (1996). Increasing physical activity: A quantitative synthesis. Med. Sci. Sports Exerc. 28(6): 706–719.PubMedGoogle Scholar
  12. Dubbert, P. M. (2002). Physical activity and exercise: Recent advances and current challenges. J. Consult. Clin. Psychol. 70(3): 526–536.PubMedCrossRefGoogle Scholar
  13. Duncan, G. E., Anton, S. D., Sydeman, S. J., Newton, R. L. Jr., Corsica, J. A., Durning, P. E., et al. (2005). Prescribing exercise at varied levels of intensity and frequency: A randomized trial. Arch. Intern. Med. 165(20): 2362– 2369.PubMedCrossRefGoogle Scholar
  14. Duncan, G. E., Perri, M. G., Theriaque, D. W., Hutson, A. D., Eckel, R. H., Stacpoole, P.W. (2003). Exercise training, without weight loss, increases insulin sensitivity and postheparin plasma lipase activity in previously sedentary adults. Diabetes Care 26(3): 557–62.PubMedGoogle Scholar
  15. Dunn, S. W. (1993). Psychological aspects of diabetes in adults. In Maes, S., Leventhal, H., and Johnston, M. (Eds.), International Review of Health Psychology. Wiley, London, pp. 175–197.Google Scholar
  16. Franco, O. H., de Laet, C., Peeters, A., Jonker, J., Mackenbach, J., and Nusselder, W. (2005). Effects of physical activity on life expectancy with cardiovascular disease. Arch. Intern. Med. 165(20): 2355–2360.PubMedCrossRefGoogle Scholar
  17. Frank, L. D., Andresen, M. A., and Schmid, T. L. (2004). Obesity relationships with community design, physical activity, and time spent in cars. Am. J. Prev. Med. 27(2): 87–96.PubMedCrossRefGoogle Scholar
  18. Grundy, S. M., Pasternak, R., Greenland, P., Smith, S., Jr, and Fuster, V. (1999). Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: A statement for healthcare professionals from the American heart association and the American college of cardiology. Circulation 100(13): 1481–1492.PubMedGoogle Scholar
  19. Hancock, K., Davidson, P. M., Daly, J., Webber, D., and Chang, E. (2005). An exploration of the usefulness of motivational interviewing in facilitating secondary prevention gains in cardiac rehabilitation. J. Cardiopulm. Rehabil. 25(4): 200–206.PubMedCrossRefGoogle Scholar
  20. Henrichs, H., and International Diabetes Federation-Europe and Lions Clubs International Foundations. (2002). Fatalism, denial common among world's diabetics.Google Scholar
  21. Humpel, N., Owen, N., and Leslie, E. (2002). Environmental factors associated with adults’ participation in physical activity: A review. Am. J. Prev. Med. 22(3): 188– 199.PubMedCrossRefGoogle Scholar
  22. Jolliffe, J. A., Rees, K., Taylor, R. S., Thompson, D., Oldridge, N., and Ebrahim, S. (2001). Exercise-based rehabilitation for coronary heart disease. Cochrane Database of Systematic Reviews (Online : Update Software), 1, CD001800.Google Scholar
  23. Kohl, H. W., 3rd. (2001). Physical activity and cardiovascular disease: Evidence for a dose response. Med. Sci. Sports Exerc. 33(6 Suppl): S472–S483.PubMedGoogle Scholar
  24. Lichtenstein, A. H., Appel, L. J., Brands, M., et al. (2006). Diet and lifestyle recommendations revision. A scientific statement form the American Heart Association nutrition committee. Circulation 114: 82–96.PubMedCrossRefGoogle Scholar
  25. Marcus, B. H., Banspach, S. W., Lefebvre, R. C., Rossi, J. S., Carleton, R. A., and Abrams, D. (1992). Using the stages of change model to increase the adoption of physical activity among community participants. Am. J. Health Promot. 6: 424–429.PubMedGoogle Scholar
  26. Marcus, B. H., Bock, B. C., Pinto, B. M., Forsyth, L. H., Roberts, M., and Traficante, R. M. (1998). Efficacy of an individualized, motivationally tailored physical activity intervention. Ann. Behav. Med. 20: 174–180.PubMedCrossRefGoogle Scholar
  27. Marsden, E. (1996). The Role of Exercise in the Well-Being of People with Insulin Dependent Diabetes Mellitus: Perceptions of Patients and Health Professionals. Unpublished Ph.D., University of Glasgow.Google Scholar
  28. Mutrie, N. (1999). Exercise adherence and clinical populations. In Bull, S. (Ed.), Adherence Issues in Sport & Exercise. John Wiley & Sons Ltd., England, pp. 75–109.Google Scholar
  29. Pageot, J. C. (1987). Obstacles to participation in physical activities of the Canadian elderly population. In Berridge, M. E., and Ward, G. R. (Eds.), International Perspectives on Adapted Physical Activity. Human Kinetics, Champaign, IL.Google Scholar
  30. Potthoff, R. F. (1994). Telephone sampling in epidemiologic research: To reap the benefits, avoid the pitfalls. Am. J. Epidemiol. 139(10): 967–978.PubMedGoogle Scholar
  31. Prochaska, J. O., and Velicer, W. F. (1997). The transtheoretical model of health behavior change. Am. J. Health Promot. 12(1): 38–48.PubMedGoogle Scholar
  32. Reed, G. R. (1999). Adherence to exercise and the transtheoretical model of behavior change. In Bull, S. (Ed.), Adherence Issues in Sport & Exercise. John Wiley & Sons Ltd., England, pp. 19–45.Google Scholar
  33. Rodgers, W. M., Hall, C. R., Blanchard, C. M., McAuley, E., and Munroe, K. J. (2002). Task and scheduling self-efficacy as predictors of exercise behavior. Psychol. Health 17(4): 405–416.CrossRefGoogle Scholar
  34. Ruchlin, H. S., and Lachs, M. S. (1999). Prevalence and correlates of exercise among older adults. J. Appl. Gerontol. 18: 341–357.CrossRefGoogle Scholar
  35. Smith, N. L., Savage, P. J., Heckbert, S. R., Barzilay, J. I., Bittner, V. A., Kuller, L. H. et al. (2002). Glucose, blood pressure, and lipid control in older people with and without diabetes mellitus: The cardiovascular health study. J. Am. Geriatr. Soc. 50(3): 416–423.PubMedCrossRefGoogle Scholar
  36. Snoek, F. J. (2002). Breaking the barriers to optimal glycaemic control–what physicians need to know from patients' perspectives. Int. J. Clin. Prac. Suppl. 129: 80–84.Google Scholar
  37. Stephens, T., and Caspersen, C. J. (1994). The demography of physical activity. In Bouchard, C., and Shephard, R. J. (Eds.), Physical Activity, Fitness, and Health: International Proceedings and Consensus Statement. Human Kinetics, Champaign, IL, pp. 204–213.Google Scholar
  38. Swift, C. S., Armstrong, J. E., Beerman, K. A., Campbell, R. K., and Pond-Smith, D. (1995). Attitudes and beliefs about exercise among persons with non-insulin-dependent diabetes. Diabetes Educ. 21(6): 533–540.PubMedGoogle Scholar
  39. Taylor, R. S., Brown, A., Ebrahim, S., Jolliffe, J., Noorani, H., and Rees, K. et al. (2004). Exercise-based rehabilitation for patients with coronary heart disease: Systematic review and meta-analysis of randomized controlled trials. Am. J. Med. 116(10): 682–692.PubMedCrossRefGoogle Scholar
  40. The Criteria Committee of the New York Heart Association (Ed.). (1994). Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels. Little, Brown & Co., Boston.Google Scholar
  41. Trost, S. G., Owen, N., Bauman, A. E., Sallis, J. F., and Brown, W. (2002). Correlates of adults' participation in physical activity: Review and update. Med. Sci. Sports Exerc. 34(12): 1996–2001.PubMedCrossRefGoogle Scholar
  42. Velicer, W., DiClemente, C., Rossi, J., and Prochaska, J. (1990). Relapse situations and self-efficacy: An integrative model. Addictive Behav. 15: 271–283.CrossRefGoogle Scholar
  43. Wilson, P. W., D'Agostino, R. B., Levy, D., Belanger, A. M., Silbershatz, H., and Kannel, W. B. (1998). Prediction of coronary heart disease using risk factor categories. Circulation 97(18): 1837–1847.PubMedGoogle Scholar
  44. Yusuf, S., Hawken, S., Ounpuu, S., Dans, T., Avezum, A., Lanas, F. et al. (2004). Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet 364(9438): 937–952.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Sherry L. Grace
    • 1
    • 2
    • 3
    • 5
  • Susan Barry-Bianchi
    • 2
  • Donna E. Stewart
    • 2
    • 3
  • Ellen Rukholm
    • 4
  • Robert P. Nolan
    • 2
    • 3
  1. 1.York UniversityTorontoCanada
  2. 2.University Health NetworkTorontoCanada
  3. 3.University of TorontoTorontoCanada
  4. 4.Laurentian UniversitySudburyCanada
  5. 5.York UniversityTorontoCanada

Personalised recommendations