Girls on the move program to increase physical activity participation.

BACKGROUND: Because physical inactivity poses serious health risks, interventions are urgently needed to reverse the increasingly sedentary lifestyles of adolescent girls. OBJECTIVE: The aim of this study was to determine the feasibility of "Girls on the Move," an individually tailored computerized physical activity (PA) program plus nurse counseling intervention, in increasing PA. METHODS: A pretest-posttest control group design was used with 77 racially diverse sedentary girls in Grades 6, 7, and 8 from two middle schools. Each of the instructional grades was randomly assigned to either an intervention or control condition. After completing computerized questionnaires, each girl in the control group received a handout listing the PA recommendations. To encourage PA, each girl in the intervention group received computerized, individually tailored feedback messages based on her responses to the questionnaires, individual counseling from the school's pediatric nurse practitioner (PNP), and telephone calls and mailings from a trained research assistant. At 12 weeks, girls in both groups responded to the questionnaires. RESULTS: No differences in self-reported PA emerged between the intervention and control groups at Weeks 1 (baseline) and 12 (postintervention). Repeated measures ANOVA showed a significant interaction between group and time for social support for PA, F(1, 69) = 5.73, p = .019, indicating that the intervention group had significantly greater social support across time than did the control group. From baseline to postintervention, social support increased for the intervention group but decreased for the control group. DISCUSSION: Reasons for the lack of significant differences between the groups on the PA measures were cited. Important information that could inform subsequent studies that test interventions to increase youth PA was acquired from conducting this study. Future efforts to increase PA participation might include this approach for enhancing social support for PA.

Exercise self-efficacy, exercise benefits and barriers, and commitment to a plan for exercise among Korean women with osteoporosis and osteoarthritis.

This study compared perceived exercise self-efficacy, exercise benefits, exercise barriers, and commitment to a plan for exercise between Korean women with a diagnosis of either osteoporosis or osteoarthritis. The influence of exercise self-efficacy, exercise benefits and barriers on commitment to a plan for exercise was also assessed in each group. Participants in the study were 154 Korean women over 40 years of age who were recruited from hospitals, health centers or a nursing home. The two groups differed on commitment to a plan for exercise with commitment greater among women with osteoporosis. Exercise self-efficacy was the most influential variable on commitment to a plan for exercise accounting for 27% of the variance in commitment among osteoporosis patients and 53% of the variance among osteoarthritis patients. This study generated information relevant to tailoring exercise interventions to the differing needs and perceptions of Korean women with osteoporosis and osteoarthritis.

Test of the health promotion model as a causal model of commitment to a plan for exercise among Korean adults with chronic disease.

The purpose of this study was to test seven constructs (prior experience of exercise, perceived health status, exercise benefits, exercise barriers, exercise self-efficacy, social support for exercise, and options for exercise) from the health promotion model (HPM) as a causal model of commitment to a plan for exercise in a sample of 400 Korean adults with chronic disease. Using structural equation modeling (SEM), we found that all fit indices indicated a good fit. The final model accounted for 54% of the variance in commitment to a plan for exercise. Prior experience with exercise and exercise benefits were the factors most highly related. Health professionals can assess prior experience and emphasize personally relevant benefits of exercise in designing intervention programs to help Korean adults with chronic disease become more physically active.

Physical activity, self-efficacy, and perceived exertion among adolescents.

The relationship of self-efficacy, a sense of confidence in personal physical activity (PA) skills, to perceived exertion during activity was explored among 168 African American and European American boys and girls between 9 and 17 years of age. Participants walked/ran on a treadmill at a speed equivalent to 60% of their peak VO2 for 20 minutes and provided ratings of exertion every 4 minutes. Pre-activity self-efficacy predicted perceived exertion for boys only. Girls were lower than boys in pre-activity self-efficacy and subsequently reported greater perceived exertion. For both genders, lower perceived exertion during PA resulted in higher post-activity self-efficacy. Uncomfortable perceptions of exertion during initial efforts to increase PA are likely to discourage future activity. Interventions that can lower perceptions of exertion may enhance self-efficacy and promote a sense of competence in PA skills.

Exercise self-efficacy, enjoyment, and feeling states among adolescents.

Knowledge of cognitions and feelings related to physical activity (PA) can assist in counseling adolescents to prevent the decrease in PA that occurs during this developmental period. This study, which involves a 2 (gender) 2 (race) 3 (developmental stage) design, examines relationships among PA self-efficacy (SE), enjoyment, and feeling states (FS) during PA and compares responses among 168 African American and European American boys and girls during early, middle, and late adolescence. More positive FS during a standardized PA episode on a treadmill predicts higher postactivity SE and greater enjoyment of the task. FS worsens as the session progresses, particularly for adolescents who in early puberty, report feeling significantly worse than those in both middle and late puberty at 16 minutes and 20 minutes. Findings suggest that nurses should assist adolescents to reduce negative feelings during activity to augment PA enjoyment, as well as SE following PA.

Physical activity self-definition among adolescents.

Since research involving adults indicates that physical activity (PA) self-definition influences PA participation, understanding PA self-definition and related factors, such as PA frequency and enjoyment, in youth is essential for designing interventions to reverse the decline in PA that occurs from childhood through adolescence. The objective of this study was to explore correlates of PA self-definition and assess differences in PA self-definition among African American and European American boys and girls in early, middle, and late puberty. A 3 (developmental stage) x 2 (gender) design was used. African American and European American boys and girls, ages 9 to 17, participated. A total of 168 adolescents completed demographic data, developmental stage, and current and future PA self-definition questionnaires. Peak VO2 was obtained as a measure of physical fitness. Current PA self-definition was positively correlated with peak VO2 (p < .01) and future PA self-definition (p <.01). Males had higher current (p = .032) and future (p = .021) PA self-definition than females. The finding that boys have stronger current and future PA self-definitions than girls highlights the challenge for health professionals to enact immediate and effective measures to alter girls' perceptions of themselves in terms of PA participation. Since current PA self-definition is also significantly correlated with future PA participation, strategies to assist girls in developing a strong PA self-definition may contribute to increased PA in their adult years.

Using methodological triangulation for cultural verification of commitment to a plan for exercise scale among Korean adults with chronic diseases.

The purpose of this study was twofold: to use methodological triangulation to increase the cultural appropriateness of the Planning for Exercise Scale (Pender, 1996), which measures commitment to a plan of action, and to psychometrically evaluate the revised scale in a selected population of 230 Korean adults experiencing chronic diseases. First, through a qualitative approach, the cultural properties of the concept were identified in order to revise Pender's Planning for Exercise Scale. The revised scale consisted of 20 items: 13 items emerged from the qualitative procedure and seven items were retained from the original scale. Through a quantitative approach, the revised scale was analyzed psychometrically. Results showed the scale had sufficient reliability and validity to warrant its use by researchers or practitioners evaluating the level of commitment to a plan for exercise among Korean adults. The revised instrument is appropriate for use in future intervention studies designed to improve the performance of exercise among Koreans who are chronically ill.

Barriers to physical activity perceived by adolescent girls.

Girls in the United States are at high risk for inactivity and resultant overweight or obesity. Perceived barriers to physical activity are critical factors for health care professionals to consider when intervening with this population to increase physical activity. This descriptive study identified barriers to physical activity reported by girls in middle school. Participants were recruited from two middle schools in the Midwest. Using a Likert-type scale, a total of 77 ethnically diverse girls, ages 11 to 14, responded to 23 items representing barriers to physical activity participation. Mean scores and percentages were computed for each barrier statement. The top barriers to physical activity that emerged for the girls in this investigation were "I am self-conscious about my looks when I exercise" and "I am not motivated to be active." Strategies that health professionals can use to counsel girls of this age in overcoming barriers to physical activity are presented. This health-related information can enhance anticipatory guidance to girls.

Does counseling by clinicians improve physical activity? A summary of the evidence for the U.S. Preventive Services Task Force.

PURPOSE: To determine whether counseling adults in primary care settings improves and maintains physical activity levels. DATA SOURCES: The Cochrane Database of Systematic Reviews and Registry of Controlled Trials and the MEDLINE, HealthStar, and Best Evidence databases were searched for papers published from 1994 to March 2002. STUDY SELECTION: Controlled trials, case-control studies, and observational studies that examined counseling interventions aimed at increasing physical activity in general primary care populations were reviewed. The researchers included trials in which 1) a patient's primary care clinician performed some of the counseling intervention; 2) behavioral outcomes (physical activity) were reported; and 3) the study was of "good" or "fair" quality, according to criteria developed by the U.S. Preventive Services Task Force. DATA EXTRACTION: Data were abstracted on design and execution, quality, providers, patients, setting, counseling intervention, and self-reported physical activity at follow-up. DATA SYNTHESIS: Eight trials involving 9054 adults met the inclusion criteria. Among six controlled trials with a usual care control group, the effects of counseling on physical activity were mixed. Because most studies had at least one methodologic limitation, it was difficult to rigorously assess the efficacy of the interventions. More research is needed to clarify the effect, benefits, and potential harms of counseling patients in primary care settings to increase physical activity. CONCLUSION: Evidence is inconclusive that counseling adults in the primary care setting to increase physical activity is effective.

Self-efficacy and perceived exertion of girls during exercise.

BACKGROUND: An important national goal in Healthy People 2010 is to reduce the high prevalence of sedentary lifestyles and resultant overweight and obesity among girls. OBJECTIVES: The purpose of the present study was threefold: (a) to determine if pre-exercise self-efficacy predicted girls' perceptions of exertion during exercise, (b) to determine if these perceptions, in turn, influenced postexercise self-efficacy, and (c) to assess if exercise self-efficacy increased following completion of an exercise task. METHODS: A sample of 103 girls, 8 to 17 years of age, pedaled 20 minutes on a cycle ergometer at 60% of their predetermined peak VO2 in a climatic chamber (90 degrees F, 50% relative humidity). Ratings of perceived exertion were obtained every 4 minutes. Exercise self-efficacy was assessed before and after the exercise session. RESULTS: Controlling for peak VO2 and percent body fat, pre-exercise efficacy exerted an independent effect on perception of exertion during exercise with girls high on pre-exercise self-efficacy reporting lower perceived exertion during exercise, than girls low on self-efficacy. Both pre-exercise efficacy and perceived exertion explained postexercise efficacy. Exercise self-efficacy increased significantly from pre- to postexercise. CONCLUSIONS: Pre-exercise efficacy is an important factor influencing girls' perceptions of exertion during exercise and their postexercise efficacy. Increased exercise self-efficacy of girls following successful completion of an exercise challenge suggests possible strategies to increase physical activity.