A quantitative assessment of the predictive utility of grit in sport.

In high-performance sport, an athlete's ability to overcome setbacks and sustain their pursuit of long-term goals is essential for success. Grit (i.e., passion and perseverance over long-terms) has been linked to success in a variety of domains but is often critiqued for its limited predictive utility when compared to other psychological variables including self-control, conscientiousness, and mental toughness. The purpose of this study was to examine whether grit predicted important athlete outcomes (i.e., various measures of sport performance and athlete well-being) beyond other determinants of success. Data from 214 collegiate student-athletes (111 women, 103 men; Mage = 21.02, SD = 2.26) from Western Canadian universities were analysed. When predicting performance, the addition of the grit subscales (i.e., consistency of interests, perseverance of effort, adaptability to situations) explained an additional 11% of variance (R2 = 0.37, F[7, 203] = 7.16, p < .001) beyond self-control, conscientiousness, and mental toughness in subjective sport performance perceptions; however, grit did not add unique variance when entered into models predicting athlete goal achievement perceptions or highest level of competition. When predicting well-being, addition of the grit subscales added 18% of unique variance (R2 = 0.43, F[7, 203] = 21.43, p < .001) beyond other determinants of success in eudaimonic well-being, and 5% (R2 = 0.17, F[7, 203] = 6.95, p < .001) in satisfaction with sport, but did not add any unique variance to the model predicting mood. The partial support of the predictive utility of grit illustrates the complexity of forecasting success in sport and offers evidence that grit should continue to be studied as a motivational disposition in the domain of sport.

Differences in Resilience Mechanisms and Physical Activity among Women Experiencing Chronic Pain with Higher or Lower Resilience.

BACKGROUND: Chronic pain is a public health issue, with women being disproportionately impacted. Progressing from light physical activity to the recommended moderate to vigorous intensities is effective for chronic pain self-management, yet participation is low among women experiencing chronic pain. Researchers studying resilience approaches to chronic pain contend that women with higher resilience, or functioning well despite adverse life stressors including chronic pain, should have better resilience mechanisms and more physical activity participation. The purpose of this work was to examine whether women experiencing chronic pain, reporting higher versus lower resilience, differed in resilience mechanisms (pain acceptance, self-regulatory efficacy to overcome pain and related barriers to activity, and self-regulatory efficacy to schedule and plan activity) and physical activity (light, moderate-vigorous). METHODS: Adult women experiencing chronic pain (N = 269; Mage = 38.35, SD = 13.13 years) completed an online survey assessing study variables. RESULTS: A multivariate analysis of covariance comparing participants with higher (n = 131) and lower (n = 138) resilience, controlling for age and pain intensity, was significant (p < .001; η2partial = .17). Participants with higher resilience reported significantly higher pain acceptance, self-regulatory efficacy beliefs, and moderate-vigorous physical activity (p's < .01; η2partial = .03 to .14, small to large effects). Light activity did not differ. CONCLUSIONS: Novel findings illustrated that participants with higher resilience exhibited more favorable resilience mechanisms and participation in the recommended moderate-vigorous activity. If intervening among women with lower resilience to improve their resilience mechanisms and moderate-vigorous activity is effective, then intervention adoption and delivery across communities could promote improved pain self-management among women.

Differences in adaptive and maladaptive psychosocial responses to chronic pain among adults with varying physical activity levels.

AIM: Chronic pain is a global public health problem that detrimentally impacts people's health and well-being. Physical activity is beneficial and a recommended self-management strategy for adults living with chronic pain. Yet, many of them struggle to meet the public health recommendation of 150+ minutes/week of moderate-vigorous physical activity. Identifying modifiable factors related to physical activity participation is needed. Adaptive (i.e., self-regulatory efficacy to overcome pain and related barriers [SRE-pain], psychological flexibility) and maladaptive (i.e. pain anxiety) responses were the modifiable factors examined in the present study. The purpose was to investigate whether adults living with chronic pain who were sufficiently active, insufficiently active or inactive significantly differed in their adaptive and maladaptive responses to chronic pain. METHODS: Adults with self-reported chronic pain for 6+ months (N = 318) completed an online survey that measured physical activity, psychological flexibility, SRE-pain and pain anxiety. Sufficiently active (n = 139), insufficiently active (n = 91) and inactive (n = 88) groups were identified. RESULTS: A significant multivariate analysis of covariance (MANCOVA) (p < .001) with univariate follow-up tests illustrated that the sufficiently active individuals reported the highest psychological flexibility and SRE-pain compared to insufficiently active and inactive individuals (p's < .001). Overall, sufficiently active participants responded the most adaptively and least maladaptively to their pain, followed by the insufficiently active. Inactive participants responded the most maladaptively. CONCLUSION: Identifying differences in adaptive and maladaptive responses to pain highlights possible modifiable factors to target in future physical activity intervention research that focuses on improving chronic pain self-management.

A proof-of-concept study on the impact of a chronic pain and physical activity training workshop for exercise professionals.

OBJECTIVES: Physical activity is essential for long-term chronic pain management, yet individuals struggle to participate. Exercise professionals, including fitness instructors, and personal trainers, are preferred delivery agents for education and instruction on chronic pain, physical activity, and strategies to use adherence-promoting behavioral skills. However, exercise professionals receive no relevant training during certification or continuing education opportunities to effectively support their participants living with chronic pain. Based on the ORBIT model for early pre-efficacy phases of development and testing of new behavioral treatments, the present Phase IIa proof-of-concept study was conducted. The purpose was to examine the impacts of a newly developed chronic pain and physical activity training workshop on psychosocial outcomes among exercise professionals. Outcomes included knowledge and attitudes regarding chronic pain, attitudes and beliefs about the relationship between pain and impairment, and self-efficacy to educate and instruct participants with chronic pain. METHODS: Forty-eight exercise professionals (Mage=44.4±11.0 years) participated in a three-hour, in-person workshop that was offered at one of four different locations. Participants completed pre- and post-workshop outcome assessment surveys. RESULTS: Mixed MANOVA results comparing time (pre- versus post-workshop) by workshop location (sites 1 to 4) illustrated a significant within-subjects time effect (p<0.001). All outcomes significantly improved from pre- to post-workshop (p's<0.001), demonstrating large effect sizes (partial eta-squared values ranging from 0.45 to 0.59). CONCLUSIONS: Findings offer early phase preliminary support for the effectiveness of the chronic pain and physical activity training workshop for exercise professionals. Based on ORBIT model recommendations, findings warrant future phased testing via a pilot randomized clinical trial as well as testing for impacts that trained professionals have on activity adherence among their clients living with chronic pain. Eventual workshop adoption by exercise professional certification organizations would ensure widespread and sustainable access to qualified exercise professionals to help individuals engage in physical activity. By increasing the capacity of available exercise professionals to deliver effective support, active individuals could better manage their chronic pain and live well.

Understanding Physiotherapists' Intention to Counsel Clients with Chronic Pain on Exercise: A Focus on Psychosocial Factors.

Purpose: Twenty percent of Canadians experience chronic pain. Exercise is an effective management strategy, yet participation levels are low. Physiotherapists can be key to counselling clients to engage in long-term unsupervised exercise. Yet, investigations that identify psychosocial factors related to physiotherapists' intention to counsel are lacking. The purpose of this study was to examine whether physiotherapists' knowledge of chronic pain, beliefs about pain, and self-efficacy to counsel on exercise predicted their intention to counsel clients with chronic pain on exercise. Method: Practicing physiotherapists (N = 64) completed an online survey that assessed their knowledge of chronic pain, beliefs about pain, self-efficacy, and intention to counsel. A two-step hierarchical multiple regression predicted intention. Step 1 controlled for years of practice, and Step 2 included study variables significantly correlated with intention. Results: Beliefs about pain (r = -0.35, p < 0.01) and self-efficacy (r = 0.69, p < 0.01) were significantly correlated with intention. The overall regression model was significant, F 3,60 = 18.73; p < 0.001. Self-efficacy was the sole significant predictor, t 60 = 5.71, p < 0.0001, sr 2 = 28%. Conclusions: Self-efficacy may facilitate physiotherapists' intention to counsel on exercise for chronic pain. If shown to be a causal factor, interventions that target a change in physiotherapists' self-efficacy should be pursued.

Objectif : une proportion de 20 % des Canadiens souffre de douleurs chroniques. L'exercice est une stratégie de prise en charge efficace, mais les taux de participation sont faibles. Les physiothérapeutes peuvent jouer un rôle déterminant dans les conseils aux clients afin qu'ils suivent un programme d'exercices non supervisés à long terme. Il n'existe pourtant pas d'études pour déterminer les facteurs psychosociaux liés à l'intention de conseiller des physiothérapeutes. La présente étude visait à examiner si les connaissances des physiothérapeutes à l'égard de la douleur chronique, leurs convictions au sujet de la douleur et leur auto-efficacité à donner des conseils sur l'exercice étaient prédictives de leur intention de donner des conseils sur l'exercice à leurs clients ayant des douleurs chroniques. Méthodologie : des physiothérapeutes en exercice (n = 64) ont rempli un sondage en ligne évaluant leurs connaissances sur la douleur chronique, leurs convictions au sujet de la douleur, leur auto-efficacité et leur intention de conseiller. Une analyse de régression hiérarchique multiple en deux étapes a prédit leur intention. L'étape 1 assurait un contrôle par rapport aux années d'exercice et l'étape 2 incluait des variables ayant une corrélation significative avec l'intention. Résultats : les convictions sur la douleur (r = ­0,35, p < 0,01) et l'auto-efficacité (r = 0,69, p < 0,01) avaient une corrélation significative avec l'intention. Le modèle de régression globale était substantiel : F 3,60 = 18,73; p < 0,001. L'auto-efficacité était le seul prédicteur significatif : t 60 = 5,71, p < 0,0001, sr 2 = 28 %. Conclusion : l'auto-efficacité peut faciliter l'intention des physiothérapeutes de donner des conseils sur l'exercice en cas de douleur chronique. S'il est démontré qu'il s'agit d'un facteur causal, il faudrait prévoir des interventions afin de changer l'auto-efficacité des physiothérapeutes.

Facing Multiple Barriers to Exercise: Does Stronger Efficacy Help Individuals with Arthritis?

BACKGROUND: Research about exercise adherence amongst adults with arthritis has been largely correlational, and theoretically based causal studies are needed. We used an experimental design to test the social cognitive theory premise that high self-efficacy helps to overcome challenging barriers to action. METHODS: Exercising individuals (N = 86; female = 78%; M age = 53; BMI = 27) with differential self-regulatory efficacy for managing salient, non-disease barriers were randomly assigned to many or few barrier conditions. Individuals responded about the strength of their anticipated persistence to continue exercise, and their self-regulatory efficacy to use exercise-enabling coping strategies. RESULTS: In the many barriers condition, higher barriers-efficacy individuals expressed (a) greater persistence (Cohen's d = 0.75 [-0.029, 1.79]) and (b) more confidence in their coping solutions (Cohen's d = 0.65 [-0.30, 1.60]) than lower barriers-efficacy counterparts. CONCLUSION: Experimental support was obtained for the theoretical premise that when facing the greatest barrier challenge, individuals highest in self-regulatory efficacy still view exercise as possible. Findings suggest that identifying lower efficacy exercisers with arthritis to tailor their exercise to increase self-regulatory efficacy might also improve their adherence.

Self-Regulatory Efficacy Encourages Exercise Persistence Despite Arthritis Flare Symptoms.

BACKGROUND: The study of exercise adherence during an arthritis flare is recommended by arthritis researchers. Studies to date have been correlational. METHODS: Social cognitions of exercising individuals with arthritis who consider exercise adherence under different levels of challenge of an arthritis flare were examined using an experimental design. Exercising individuals with differential self-regulatory efficacy for managing arthritis flare symptoms (SRE-flare) were randomly assigned to conditions where flare symptoms were perceived as either many or few. Individuals in each condition responded about the strength of their anticipated persistence to continue exercise, and their self-regulatory efficacy to use coping strategies to enable exercise. RESULTS: Higher SRE-flare individuals expressed significantly (a) greater persistence (Cohen's d = 1.17) and (b) more confidence to use their flare coping solutions (Cohen's d = 1.44). CONCLUSION: Main findings were as hypothesised. When exposed to the condition with more limiting flare symptoms (i.e. greater challenge), high SRE participants were the most confident in dealing with flare symptoms and exercising. Identifying lower SRE-flare individuals less likely to persist with exercise during arthritis flares may improve tailored exercise counselling.

Differences in psychosocial responses to pain between sufficiently and insufficiently active adults with arthritis.

OBJECTIVE: Adults with arthritis struggle to meet the physical activity recommendation for disease self-management. Identifying psychosocial factors that differentiate adults who meet (sufficiently active) or do not meet (insufficiently active) the recommendation is needed. This study sought to examine differences in psychosocial responses to arthritis pain among adults who were sufficiently or insufficiently active. DESIGN: This prospective study included adults with medically diagnosed arthritis (N = 136, Mage = 49.75 ± 13.88 years) who completed two online surveys: (1) baseline: pain and psychosocial responses to pain and (2) two weeks later: physical activity. MAIN OUTCOME MEASURES: Psychosocial responses examined in this study were psychological flexibility in response to pain, pain anxiety and maladaptive responses to pain anxiety. RESULTS: A between-groups MANCOVA comparing sufficiently active (n = 87) to insufficiently active (n = 49) participants on psychosocial responses, after controlling for pain intensity, was significant (p = .005). Follow-up ANOVA's revealed that sufficiently active participants reported significantly higher psychological flexibility and used maladaptive responses less often compared to insufficiently active participants (p's < .05). CONCLUSIONS: These findings provide preliminary insight into the psychosocial profile of adults at risk for nonadherence due to their responses to arthritis pain.

Perceived success/failure and attributions associated with self-regulatory efficacy to meet physical activity recommendations for women with arthritis.

The relationship between attributional dimensions women assign to the cause of their perceived success or failure at meeting the recommended physical activity dose and self-regulatory efficacy for future physical activity was examined among women with arthritis. Women (N = 117) aged 18-84 years, with self-reported medically-diagnosed arthritis, completed on-line questions in the fall of 2013 assessing endurance physical activity, perceived outcome for meeting the recommended levels of endurance activity, attributions for one's success or failure in meeting the recommendations, and self-regulatory efficacy to schedule/plan endurance activity over the next month. The main theoretically-driven finding revealed that the interaction of the stability dimension with perceived success/failure was significantly related to self-regulatory efficacy for scheduling and planning future physical activity (ß = 0.35, p = .002). Outcomes attributed to more versus less stable factors accentuated differences in self-regulatory efficacy beliefs following perceived success and failure at being active. It appears that attributional dimensions were associated with self-regulatory efficacy in women with arthritis. This suggests that rather than objectively observed past mastery experience, women's subjective perceptions and explanations of their past experiences were related to efficacy beliefs, especially following a failure experience.

Predicting planned physical activity of individuals with arthritis: A self-regulatory perspective.

Few individuals with arthritis are sufficiently active. We surveyed a convenience sample of exercisers ( N = 134) to examine the utility of social cognitive theory variables, namely, self-regulatory efficacy, negative outcome expectations, and pain acceptance for predicting planned physical activity according to Weinstein's two prediction suggestions. Logistic regression revealed, after controlling for pain intensity, self-regulatory efficacy, negative outcome expectations, and pain acceptance distinguished groups achieving/not achieving planned physical activity, p < 0.001 (28% variance). A second model adding past physical activity also predicted the groups, p < 0.001 (57% variance). This is one of the first arthritis studies examining planned physical activity relative to Weinstein's recommendations.

Prediction of adaptive self-regulatory responses to arthritis pain anxiety in exercising adults: does pain acceptance matter?

BACKGROUND: Exercising for ≥ 150 min/week is a recommended strategy for self-managing arthritis. However, exercise nonadherence is a problem. Arthritis pain anxiety may interfere with regular exercise. According to the fear-avoidance model, individuals may confront their pain anxiety by using adaptive self-regulatory responses (eg, changing exercise type or duration). Furthermore, the anxiety-self-regulatory responses relationship may vary as a function of individuals' pain acceptance levels. OBJECTIVES: To investigate pain acceptance as a moderator of the pain anxiety-adaptive self-regulatory responses relationship. The secondary objective was to examine whether groups of patients who differed in meeting exercise recommendations also differed in pain-related and self-regulatory responses. METHODS: Adults (mean [± SD] age 49.75 ± 13.88 years) with medically diagnosed arthritis completed online measures of arthritis pain-related variables and self-regulatory responses at baseline, and exercise participation two weeks later. Individuals meeting (n=87) and not meeting (n=49) exercise recommendations were identified. RESULTS: Hierarchical multiple regression analysis revealed that pain acceptance moderated the anxiety-adaptive self-regulatory responses relationship. When pain anxiety was lower, greater pain acceptance was associated with less frequent use of adaptive responses. When anxiety was higher, adaptive responses were used regardless of pain acceptance level. MANOVA findings revealed that participants meeting the recommended exercise dose reported significantly lower pain and pain anxiety, and greater pain acceptance (P<0.05) than those not meeting the dose. CONCLUSIONS: Greater pain acceptance may help individuals to focus their efforts to adapt to their pain anxiety only when it is higher, leaving self-regulatory capacity to cope with additional challenges to exercise adherence (eg, busy schedule).

Pain, anxiety, and negative outcome expectations for activity: do negative psychological profiles differ between the inactive and active?

OBJECTIVE: Adherence to physical activity at ≥150 minutes/week has proven to offer disease management and health-promoting benefits among adults with arthritis. While highly active people seem undaunted by arthritis pain and are differentiated from the moderately active by adherence-related psychological factors, knowledge about inactive individuals is lacking. This knowledge may identify what to change in order to help inactive people begin and maintain physical activity. The present study examined the planned, self-regulated activity of high, moderate, and inactive individuals to determine if differences existed in negative psychological factors. METHODS: Adults with a medical diagnosis of arthritis completed online measures of physical activity, perceived pain intensity, pain anxiety, and negative disease-related outcome expectations from being active. High active (n = 94), moderately active (n = 77), and inactive (n = 104) groups were identified. RESULTS: A significant multivariate analysis of covariance revealed group differences (P < 0.001). Followup analyses indicated that inactive participants had the most negative psychological profile. Inactive participants reported that negative disease-related outcomes expectancies were more distressing and likely to occur than either group of active participants and expressed greater pain intensity and pain anxiety than the highly active participants (P < 0.05 for all). CONCLUSION: Identifying differences in negative psychological factors aids in the understanding of differential adherence between activity groups and highlights possible factors to change in future intervention and research.

Examination of self-regulatory efficacy and pain among individuals challenged by arthritis flares.

PURPOSE/OBJECTIVE: Public health guidelines for physical activity (PA) for individuals with arthritis are 150 min/week. Self-regulatory efficacy to plan and schedule activity (SRE-SP) was greater for individuals meeting guidelines in studies when symptoms were usual. Extreme symptoms of a flare presumably challenge or block PA adherence. We found it surprising that the question of whether pain intensity and SRE-SP differ within the same person as a function of symptom severity (i.e., flare vs. no-flare) and PA level has not been addressed. RESEARCH METHOD/DESIGN: Participants (N = 53) reported SRE-SP and SRE to overcome arthritis barriers (SRE-AB) during the following month, average usual and flare-pain intensity, and PA volume in the past 6 months. Mixed-model ANOVAs compared those meeting or not meeting PA guidelines in both flare and no-flare conditions. RESULTS: Main effects for SRE (SP and AB) were significant for within flare/no-flare comparisons (p < .001) and for SRE-SP were significant between PA groups (p < .05). Individuals meeting PA guidelines have the advantage of greater SRE-SP to motivate adherence than those of the less active. All participants' activity was less efficacious during a flare. For pain intensity, a within-subjects flare versus no-flare effect (p < .001) confirmed that flares are perceived as more of an obstacle or challenge for engaging in PA. CONCLUSION/IMPLICATIONS: Regardless of meeting or not meeting PA guidelines, participants reported lower SRE and higher pain intensity during a flare. PA adherence during a flare may require self-regulation of PA to be active, and in particular, to be able to meet recommended guidelines, relative to symptom severity.

Meeting physical activity recommendations: self-regulatory efficacy characterizes differential adherence during arthritis flares.

PURPOSE: Using social-cognitive theory, we examined whether adults who experienced an arthritis flare and met/did not meet the disease-specific public health recommended dose for physical activity differed in their self-regulatory efficacy beliefs, overall pain, and flare-related factors. RESEARCH METHOD/DESIGN: Adults with arthritis (N = 56; M(age) = 49.41 ± 11.56 years) participated in this prospective study. RESULTS: Multivariate analysis of variance comparing groups who met or did not meet the recommended dose (n(met) = 24, ≥ 150 minutes/week vs. n(not met) = 32, < 150 min/week) on efficacy, overall pain, and flare-related factors was significant (p < .01; η(partial)² = .28). People meeting the dose had significantly greater self-regulatory efficacy to overcome arthritis barriers (M(met dose) = 7.33 ± 1.95 vs. M(did not meet dose) = 5.74 ± 2.08, η(partial)² = .14) and to schedule/plan (M(met dose) = 7.27 ± 1.80 vs. M(did not meet dose) = 5.72 ± 1.90, η(partial)² = .15). Overall pain and flare-related factors did not differ (ps > .05). CONCLUSION/IMPLICATION: During flares, individuals with greater self-regulatory efficacy to manage disease barriers and plan their physical activity were more adherent to disease-specific public health activity recommendations. This study was the first to demonstrate differences in social cognitions that characterize adherence to recommended activity among people challenged by arthritis flares. Findings support the theoretical position that self-regulatory efficacy is related to better adherence in the face of challenging disease-related circumstances. The importance of studying individual characteristics of people who succeed in being active despite such obstacles is stressed.

Risk factors for falls in older adults with lower extremity arthritis: a conceptual framework of current knowledge and future directions.

PURPOSE: As the numbers of Canadians aged 65 years and over increases over the next 20 years, the prevalence of chronic conditions, including arthritis, will rise as will the number of falls. Although known fall-risk factors are associated with hip and knee osteoarthritis (OA), minimal research has evaluated fall and fracture risk and/or rates in this population. Thus, the purpose was to summarize research on fall and fracture risk in older adults with hip or knee OA and to develop a conceptual framework of fall-risk screening and assessment. METHOD: The International Classification of Functioning, Disability and Health, clinical practice guidelines for fall-risk screening, and a selected literature review were used. RESULTS: Gaps exist in our knowledge of fall and fracture risk for this population. Muscle performance, balance, and mobility impairments have been identified, but little is known about whether personal and environmental contextual factors impact fall and fracture risk. Physical activity may help to prevent falls, but non-adherence is a problem. CONCLUSION: A need exists to assess fall risk in older adults with hip and knee OA. Promoting regular physical activity by focusing on disease- and activity-specific personal contextual factors may help direct treatment planning.

Objectif : Le nombre de Canadiens de 65 ans et plus augmentera au cours des 20 prochaines années et la prévalence des maladies chroniques, dont l'arthrite, sera en hausse, tout comme le nombre de chutes. Bien que des facteurs de risques de chute connus soient associés à l'arthrose du genou ou de la hanche, une somme minimale de recherches a évalué les risques ou les taux de chutes et de fractures chez ce segment de la population. En conséquence, l'objectif de cette étude était de dresser un résumé des recherches réalisées sur les risques de chute ou de fracture chez les adultes plus âgés aux prises avec de l'arthrose au genou ou à la hanche, et d'élaborer un cadre conceptuel pour le dépistage et l'évaluation des risques de chute. Méthode : La Classification internationale du fonctionnement, du handicap et de la santé (CIF), qui forme les directives cliniques pour le dépistage des risques de chute, et une revue documentaire sélective ont été utilisées. Résultats : Il existe des lacunes dans nos connaissances relatives aux risques de chute et de fracture au sein de ce segment de la population. La dégradation de la performance musculaire, de l'équilibre et de la mobilité a été établie, mais on sait peu de choses en ce qui a trait aux répercussions possibles de facteurs contextuels personnels ou environnementaux sur les risques de chute ou de fracture. L'activité physique peut aider à prévenir les chutes, mais la non-adhésion des patients à un programme d'activité physique pose problème. Conclusion : Une évaluation des risques de chute chez les adultes plus âgés souffrant d'arthrose du genou ou de la hanche est nécessaire. La promotion de l'activité physique régulière, en se concentrant sur les facteurs contextuels personnels propres à la maladie ou à l'activité, pourrait aider directement la planification du traitement.

Is level of pain acceptance differentially related to social cognitions and behavior? The case of active women with arthritis.

Pain from arthritis is a barrier to physical activity (PA), yet some people still manage to be active. This study examined whether women with greater or weaker arthritis pain acceptance were distinguished by social cognitions (self-regulatory efficacy to overcome barriers; outcome expectations of PA) and whether PA differences existed. Women with arthritis (N = 118) completed two surveys. After controlling for pain, a hierarchical discriminant function analysis discriminated pain acceptance groups in terms of the social cognitions. Greater pain acceptance participants were also significantly more active. Findings contribute new insight on the combination of a disease-related factor (pain acceptance) and social cognitions important for adherence.

General and arthritis-specific barriers to moderate physical activity in women with arthritis.

BACKGROUND: most women with arthritis are insufficiently active, despite the health benefits derived from participation in moderate physical activity (MPA). Understanding perceived barriers that make it difficult for women with arthritis to be active is needed to inform interventions. Barriers are often assessed through investigator-provided lists, containing mainly general, personal, and situational barriers, common across populations (e.g., lack of time). However, identifying an encompassing range of problematic barriers that challenge women's activity participation is needed. Such barriers may be general and arthritis specific (e.g., pain). Problematic barriers may be best identified through assessment of whether individuals actually experience these barriers (i.e., are present) and, for present barriers, their extent of limitation on activity. Thus, the primary study purpose was to examine whether the presence of general and arthritis-specific barrier categories and the limitation of these overall categories were significant predictors of participation in MPA among women with arthritis (n = 248). METHODS: on-line measures of barriers and MPA were completed. FINDINGS: a multiple regression model predicting activity was significant (r(2)(adjusted) = .22; p < .01). Both arthritis-specific and general barrier limitation were the strongest predictors of activity. Arthritis-specific personal barriers were reported as being present most often (e.g., pain). CONCLUSION: interventions should identify problematic barriers, taking into account the extent to which both general and disease-specific barriers limit activity, and then target their alleviation through the use of coping strategies as a way to improve activity adherence and health among women with arthritis.

Perceptions of trained leaders on improving the public health impact of three arthritis foundation programs.

The Arthritis Foundation (AF) offers effective community-based programs to help manage arthritis, including aquatic, exercise, and self-help programs. Trained leaders can facilitate the adoption, maintenance, and reach of these programs and thus the impact on public health. This study identifies reasons for becoming AF aquatic, exercise, and/or self-help program leaders, AF program reach, and adoption and maintenance challenges encountered by individuals after being trained. Researchers interviewed by telephone 72 participants who attended an AF leader training workshop. Participants reported various reasons for becoming program leaders (e.g., a wish to help others). AF programs were mainly adopted and maintained in urban communities and in fitness/ health clubs, medical centers, or senior centers. Aquatics programs were the most frequently offered, and all programs had low reach (with a mean number of participants of 14.41, 12.50, and 11.00 for aquatic programs, exercise programs, and self-help programs, respectively. Challenges to adopting and maintaining programs include the time of year (e.g., winter, holidays) and lack of a facility to offer the program.

Physical activity in women with arthritis: examining perceived barriers and self-regulatory efficacy to cope.

OBJECTIVE: To examine whether the theory-based social cognitions of perceived barrier frequency, barrier limitation, and self-regulatory efficacy to cope were predictors of planned physical activity among adult women with arthritis. A secondary purpose was to identify and provide a phenomenologic description of the relevant barriers and coping strategies reported by study participants. METHODS: Eighty adult women (mean +/- SD age 49.09 +/- 12.89 years) with self-reported doctor-diagnosed arthritis participated in this observational study. Participants completed online survey measures of barriers to physical activity and, for each barrier, reported the frequency of occurrence and the extent of limitation. Measures of coping strategies for each barrier, efficacy to cope, and physical activity were also obtained. RESULTS: A multiple hierarchical regression analysis resulted in a model that significantly predicted physical activity (F[9,70] = 6.80, P < 0.01, adjusted R(2) = 0.40). Barrier limitation (standardized beta = -0.56) and efficacy (standardized beta = 0.20) were significant independent predictors. Phenomenologic findings indicated that arthritis-specific personal barriers (e.g., pain and fatigue due to arthritis) and arthritis-specific coping strategies (e.g., activity modification) were more commonly reported than generic barriers and coping strategies. CONCLUSION: Self-regulatory efficacy to cope and relevant perceived physical activity barriers, which were primarily arthritis-specific and moderately or more limiting to planned physical activity, were important social cognitive predictors of physical activity, a key nonpharmacologic arthritis treatment, among women with arthritis. Future research direction should examine potential moderators of the relationship between these predictors and physical activity, such as pain acceptance.