Assessing stage of change for physical activity: how congruent are parallel methods?

The single-question self-classification Stages of Change scales (SAS) for two modes of physical activity were compared with parallel staging methods. In Study 1, the participants (N = 50) completed SAS in a questionnaire and were then personally interviewed on their physical activity. In four fifths of the cases, SAS indicated the same stage as the interviewer's judgment. In Study 2, a representative survey sample (N = 600) completed both SAS and, in another questionnaire, a three-question algorithm staging instrument (TSQ) constructed for the same target behaviors. About 50% of all participants were placed in the same stage with both instruments. The compatibility rate rose to 80% when the number of stages was reduced from the original eight to five. However, TSQ also accumulated a higher share of cases in the stages with regular action. In both studies, the most obvious sources for incompatible staging were the regularity and time frame of the targeted behavior. Thus, neither SAS nor TSQ is on its own a sufficiently accurate instrument for use in personalized stage-based interventions. TSQ shows no obvious advantages over SAS. In counseling, SAS seems useful in combination with a personal interview.

Stages of change in two modes of health-enhancing physical activity: methodological aspects and promotional implications.

Measurement scales for stages of change were developed and the stages were assessed in two specific modes of Health-Enhancing Physical Activity (HEPA) in a cross-sectional survey (N = 1516); representative samples were selected from three age groups, i.e. from three phases of adult life. Outdoor Aerobic Exercise (OAE) was used as an example of fitness activity; Everyday Commuting Activity (ECA) was selected to represent lifestyle physical activity. Scales used by the Prochaska team were modified for this study, and the stages of Precontemplation and Preparation were each divided into two new stages. Consistency of the stage measurement was moderate for OAE and good for ECA. As regards content validity, consistent associations were found between stage scores and contextual variables for both behaviors. The results show that, at a given time, a person can be in different stages in different modes of HEPA. Therefore, the behavior of interest must be specified before accurate information on the stages of change in a population can be obtained. The results also indicate the importance of contextual factors in HEPA promotion.

The versatile nature of physical activity--on the psychological, behavioural and contextual characteristics of health-related physical activity.

This paper presents a comprehensive characterisation of physical activity based on psychological, behavioural and contextual aspects. Based on the characterisation it suggests a promotional classification of physical activity into five categories. The categories are: 1, Occupational activity; 2, Lifestyle activity; 3, Recreation activity; 4, Fitness activity; and 5, Sport activity. Examples are given of activities in each category and of the related emotional aspects, outcome expectations, degree of personal choice and health benefits. The importance of the emotional component and the relevance of the outcome expectations are discussed and contextual considerations are presented on the basis of the promotional classification. The implications of the classification for the practice of health-enhancing physical activity promotion are discussed.

What is counseling all about--basics in the counseling of health-related physical activity.

Counseling is presented as a professional approach in health care to promote physical activity in personal contacts. General principles of counseling are introduced with emphasis on client-centeredness, cooperative role relations, unconstrained interaction, and goal-oriented proceeding. The contacts with the clients or the patients are divided into three categories with different preconditions for the extent to which counseling methods can be applied and demands placed on the practitioner's counseling skills: 1, On the spot information and advice within a single contact; 2, Preplanned way of proceeding within a few repeated contacts touching the same topic; 3, Planned period of proper counseling sessions. Implications for counseling in physical activity are given.

How to develop a group curriculum: developing an exercise programme for overweight adults.

This paper reports on work to develop introductory exercise courses for sedentary, moderately overweight adults. The aim is to offer a safe and motivating programme of physical exercise and, through experiential learning, to encourage and facilitate increased physical activity. The core of the programme is a course of 10-20 weekly exercise classes. The classes include a variety of physical exercises adapted to the special needs of overweight adults (BMI 28-34 kg/m2) and a number of health-related fitness tests. We outline the underlying principles of the exercise courses, their structure and contents, the guidelines of instruction, and the use of formative evaluation. In addition, we report on the implementation of five weight-reduction courses and six exercise courses involving a total of 209 participants. A fairly high level of programme acceptability (in terms of attendance rates and personal commitment) and programme feasibility (in terms of acceptability, changes in personal orientation towards health and weight reduction, and satisfaction among participants) was achieved.

Client views on periodic health examinations: opinions and personal experience.

Clients' views on periodic health examinations (PHEs) were examined in a questionnaire study in Tampere, Finland. A sample of 240 clients aged 45 years looked back at their recent experiences of PHE screening and counselling sessions with a public health nurse. According to the clients' accounts, the discussions and counselling had dealt with living habits and, to a lesser extent, diseases, symptoms and the prevention of illness. The vast majority of the respondents appreciated the friendly and considerate manner in which the nurse dealt with the situation. About half of them felt that the discussion was personally important to them. Virtually all respondents saw the PHE programme as beneficial for everyone. Opinions were more divided on the benefits of the health examination sessions compared with medical help from a physician or with laboratory tests. The dimensions of client opinions were extracted by means of factor analysis. One of the factors emerging in the analysis demanded access to health examinations from the vantage point of individual rights or entitlement. In women, a factor emphasizing self-care was also discerned. The interpretation of the factors was based on the social tradition of community-based health services in Finland by means of the concept of social representation.