Psychometric evaluation of the exercise self-efficacy scale among Korean adults with chronic diseases.

The purpose of this study was to assess the psychometric properties, appropriateness, and demographic response patterns of an exercise self-efficacy scale for Korean adults with chronic diseases. After assessment of face validity by an expert Korean panel, 249 Korean adults with chronic diseases, ages 18-79 years, were recruited from hospitals or health centers in five Korean cities and surrounding rural areas to complete the questionnaire. In a factor analysis the original 18-item exercise self-efficacy scale converged to one factor without rotation and to three subfactors with rotation: situational/interpersonal factor, competing demands factor, and internal feelings factor. Descriptive analysis showed that Korean adults with chronic diseases perceived they had relatively low exercise self-efficacy, with the situational/interpersonal factor as the lowest factor. Exercise self-efficacy was significantly correlated with gender, education, regular exercise, and frequency of exercise. The exercise self-efficacy scale was shown to be a useful measure of exercise beliefs of Korean adults with chronic diseases.

Physical activity research in nursing.

PURPOSE: To present exemplars of physical activity research in nursing, illustrate the importance of physical activity research across the lifespan, and recommend directions for theory development and research. METHODS: Studies of physical activity and exercise currently being conducted by nurse investigators were reported and critiqued by attendees of the Midwest Nursing Research Society 2000 Preconference session entitled "Promoting Physical Activity Among Diverse Groups Across the Health Continuum." Physical activity and exercise literature during the past decade was reviewed. Databases searched included Medline, CINAHL, Wilson, and ERIC. FINDINGS: Investigators have emphasized the need to evaluate the effects of theory-based physical activity interventions designed to alter key correlates of physical activity identified through descriptive research. CONCLUSIONS: Regular physical activity is necessary for health promotion and disease prevention for all populations. Continued research in this important area of health behavior is critical to identify the most effective interventions to increase physical activity among diverse populations.

Motivation for physical activity among children and adolescents.

Assisting children and adolescents in adopting physically active lifestyles is an integral part of the health education and health promotion services provide by nurses in school, family, community, and primary care settings. In order to effectively engage in physical activity counseling, the determinants of physical activity must be understood and integrated into effective interventions for youths. This review of research literature includes a critique of intervention studies aimed at helping children and adolescents adopt active lifestyles that will be sustained throughout life. Social cognitive theory provided the theoretical basis for most of the studies reviewed but specification of how theory concepts were operationalized in the interventions was often unclear. Suggestions for increasing the rigor of theoretically based intervention studies aimed at promoting physical activity are proposed. Models and variables are identified that need further testing to determine their relevance to the promotion of physical activity during childhood and adolescence.

Changes in physical activity beliefs and behaviors of boys and girls across the transition to junior high school.

PURPOSE: This longitudinal study investigated gender-specific changes in physical activity beliefs and behaviors across the elementary to junior high school transition. METHODS: Physical activity beliefs and behaviors were measured in a cohort of 132 racially diverse youth during the year prior to and following the transition. Questionnaires assessed variables hypothetically linked to activity. Physical activity was monitored with the Child/Adolescent Activity Log. RESULTS: Gender differences in physical activity beliefs emerged. Across the transition, boys reported decreased efficacy, social support, and expectations (norms) to be physically active. Although girls also reported decreased social support for physical activity, they further reported exposure to fewer active role models and were less likely to perceive that the benefits of regular activity out-weighed the barriers following the transition. Gender differences in activity levels were apparent, with girls being less active than boys. Despite changes in physical activity beliefs across the school transition, no significant changes in actual level of activity occurred over this period. Although beliefs were significantly related to behaviors in the domain of physical activity, pretransition activity level was the best predictor of posttransition activity level. CONCLUSIONS: These data indicate that physical activity beliefs of adolescents change over the school transition. These changes are significantly, but not highly, related to level of physical activity. Future research should explore the influences of activity-related affect and social and physical contexts on physical activity across adolescence.

Development of the child/adolescent activity log: a comprehensive and feasible measure of leisure-time physical activity.

The purpose of this study was to test the utility of a new instrument, the Child/Adolescent Activity Log (CAAL), designed to measure children's physical activities in a school setting efficiently, yet comprehensively. At baseline, 459 participants (mean age 12 + 1.4, 59% White, 34% African American, 7% other) were recruited to participate in a 2-year study focusing on patterns and predictions of physical activity at critical school transition points. The CAAL was administered daily for a 1-week period on 6 occasions to this cohort. From the CAAL, information about the pattern of specific activities chosen, average daily duration of activity, and average daily expenditure per kg body weight was obtained. The validity of the log was supported by its (1) correlation with Caltrac readings, (2) relation in the predicted direction with a single-item measure of typical level of physical activity and fitness indices, and (3) expected changes in exercise patterns over time and by gender. If future studies corroborate the psychometric properties and ease of administration of the CAAL, its utility in community-based studies is promising.

Educating APNs for implementing the guidelines for adolescents in Bright futures: guidelines of health supervision of infants, children, and adolescents.

As the scope of what constitutes health and the range of determinants of health-promoting and compromising behaviors among adolescents are expanded, APNs must be well prepared to be powerful influences in the lives of all adolescents. The guidelines offered by Bright Futures challenge nurse educators to prepare APNs who possess the core competencies to knowledgeably address the health issues and concerns of all adolescents in multiple settings. The American Academy of Nursing Expert Panel's recommendations contained herein, if implemented, will further enhance the capabilities of graduate programs to prepare APNs to provide developmentally and culturally relevant disease prevention and health promotion care to adolescents and their families.

Gender and developmental differences in exercise beliefs among youth and prediction of their exercise behavior.

This study examined gender and developmental differences in exercise-related beliefs and exercise behaviors of 286 racially diverse youth and explored factors predictive of exercise. Compared to males, females reported less prior and current exercise, lower self-esteem, poorer health status, and lower exercise self-schema. Adolescents, in contrast to pre-adolescents, reported less social support for exercise and fewer exercise role models. In a path model, gender, the benefits/barriers differential, and access to exercise facilities and programs directly predicted exercise. Effects of grade, perceived health status, exercise self-efficacy, social support for exercise, and social norms for exercise on exercise behavior, were mediated through the benefits/barriers differential. Effect of race on exercise was mediated by access to exercise facilities and programs. Continued exploration of gender and developmental differences in variables influencing physical activity can yield valuable information for tailoring exercise promotion interventions to the unique needs of youth.

Predicting health-promoting lifestyles in the workplace.

A multivariate model proposed as explanatory and predictive of health-promoting lifestyles was evaluated in a sample of 589 employees enrolled in six employer-sponsored health-promotion programs. Perceived personal competence, definition of health, perceived health status, and perceived control of health accounted for 31% of the variance in health-promoting lifestyle patterns. Employees who reported more health-promoting lifestyles perceived themselves as competent in handling life situations, defined health as high-level wellness rather than merely the absence of illness, evaluated their health positively, and perceived their health as affected by significant others but not by chance or luck. Those who were female, older, and in the maintenance phase of the company fitness program also had healthier lifestyle patterns. These variables and the perception of health as internally controlled were predictive of health-promoting lifestyles three months later.

A Spanish language version of the Health-Promoting Lifestyle Profile.

The development and initial psychometric evaluation of a Spanish language version of the Health-Promoting Lifestyle Profile (HPLP) is described. The 48-item instrument was translated into Spanish and found to be culturally relevant and reliable in a pilot study. The Spanish version was then administered to a diverse but predominantly Mexican-American group of 485 Hispanics residing in metropolitan and surrounding rural areas. In a principal components factor analysis, all but one item loaded significantly on six factors similar to those isolated previously during psychometric assessment of the English language version. Those six dimensions comprise the HPLP subscales of self-actualization, health responsibility, exercise, nutrition, interpersonal support, and stress management. The six factors explained 45.9% of the variance in the measure. Second-order factor analysis yielded a single factor, interpreted as health-promoting lifestyle. The alpha reliability coefficient for the total scale was .93 and 2-week test-retest reliability was .86; alpha coefficients for the subscales ranged from .70 to .87.

Expressing health through lifestyle patterns.

Few concepts have received more attention from health professionals and the public during the last decade than health. This is largely due to the emergence of disease prevention and health promotion as global priorities. Unfortunately, the nature of health as a positive life process is poorly understood. Theoretical formulations of health often lack specificity and existing measures almost without exception reflect a narrow clinical perspective of health as the absence of disease. The purpose of this paper is to propose a system for classifying expressions of health of persons in their entirety and to suggest related indicators of high-level health.