Effect of Certified Personal Trainer Services on Stage of Exercise Behavior and Exercise Mediators in Female College Students

Objective: The authors examined the effect of certified personal trainer services on exercise behavior by using the transtheoretical model of behavioral change. Participants: Female college students (n = 449) completed surveys during the first week (T1) and last week (T2) of the fall semester. Methods: Students receiving personal trainer services during the fall semester (experimental group, n = 31) were cross-matched with students who had not received services (control group, n = 31). Results: The control group demonstrated a statistically significant regression in stage of exercise change scores; the experimental group did not. The authors found the 2 groups to have a statistically significant difference in the pattern of exercise behavior change over the course of the semester, with more active maintainers and progressors in the experimental group. Conclusions: Cognitive and behavioral processes of change, decisional balance, and scheduling self-efficacy significantly decreased in the control group, whereas cognitive processes of change, decisional balance, and scheduling self-efficacy remained statistically unchanged in the experimental group.     

Predictors of exercise relapse in a college population

Exercise improves physical and mental health. Nevertheless, most 20-year-olds do not exercise, and approximately 50% of the participants in exercise programs drop out in the first 3 to 6 months. In view of the health benefits of exercise, college health educators and clinicians need to be able to identify factors that predict exercise relapse in a student population. The authors administered questionnaires measuring Prochaska's 10 processes of change for exercise, self-efficacy, and decisional balance to 52 physically active undergraduate students. They assessed baseline exercise levels in October and reassessed them about 8 weeks later. At baseline, relapsers had significantly lower self-efficacy scores than those who maintained their exercise levels. The relapsers also had higher perceived negative views of exercise. These findings provide support for applying the transtheoretical model of behavioral change to a college population.     

Old and New Environmental Issues for College and University Health Services

Abstract

Exercise improves physical and mental health. Nevertheless, most 20-year-olds do not exercise, and approximately 50% of the participants in exercise programs drop out in the first 3 to 6 months. In view of the health benefits of exercise, college health educators and clinicians need to be able to identify factors that predict exercise relapse in a student population. The authors administered questionnaires measuring Prochaska's 10 processes of change for exercise, self-efficacy, and decisional balance to 52 physically active undergraduate students. They assessed baseline exercise levels in October and reassessed them about 8 weeks later. At baseline, relapsers had significantly lower self-efficacy scores than those who maintained their exercise levels. The relapsers also had higher perceived negative views of exercise. These findings provide support for applying the transtheoretical model of behavioral change to a college population.     

Exercise behavior in older adults: a test of the transtheoretical model

The transtheoretical model (TTM) was developed as a guide for understanding behavior change. Little attention has been given, however, to the appropriateness of the TTM for explaining the adoption of exercise behavior in older adults. The purposes of this study were to determine the reliability of the TTM instruments and validate TTM predictions in 86 community-dwelling older adults (mean age 75.1 +/- 7.0 years, 87% women) who were participants in a 16-week walking program. TTM construct scales--self-efficacy, decisional balance (pros and cons), and processes of change (behavioral and cognitive)--were generally reliable (all>.78). Behavioral processes of change increased from baseline to follow-up, but pros, cons, and cognitive processes did not change among participants who became regular exercisers. Stage of change did not predict exercise adoption, but baseline self-efficacy predicted walking behavior. These results lend partial support to the TTM in predicting exercise behavior.     

Predicting habitual physical activity using coping strategies in older fallers engaged in falls-prevention exercise

One third of adults over 65 yr old fall each year. Wide-ranging consequences include fracture, reduced activity, and death. Research synthesis suggests that falls-prevention programs can be effective in reducing falls by about 20%. Strength and balance training is the most efficacious component, and the assumed method of effect is an improvement in these performance domains. There is some evidence for this, but the authors have previously proposed an alternative method, activity restriction, leading to a reduction in subsequent falls through a reduction in exposure. The aim of this study was to examine physical activity in older fallers, applying a theory of adaptation, to ascertain predictors of habitual physical activity. Referrals to hospital- and community-based exercise programs were assessed for (a) habitual walking steps and (b) coping strategies, falls self-efficacy, social support, and balance mobility. There was no average group change in physical activity. There was high interindividual variability. Two coping strategies, loss-based selection and optimization, best explained the change in physical activity between baseline and follow-up. Notwithstanding some limitations, this work suggests further use of adaptation theory in falls research. A potential application is the creation of a profiling tool to enable clinicians to better match treatment to patient.     

The Freshman 15—A Closer Look

Abstract

Objectives and Participants: Changes in body weight, composition, and size were examined in college freshmen at the beginning (initial, n = 240) and end of fall semester 2007 (n = 214) and the end of spring semester 2008 (n = 205). Methods: Height, weight, body composition, and waist and hip measurements were assessed. Results: Mean weight, body mass index (BMI), absolute and percent body fat all increased significantly over fall semester and the academic year. About 31% of freshmen lost ≥5 lbs. Mean academic year weight gain was 2.6 lbs (entire group) and 6.0 lbs (weight gainers); body fat increased by 4.4 lbs in the weight gainers. A significant correlation (r = .509) was found between weight change and waist circumference change, but not between weight change and waist to hip ratio change. Conclusions: Freshmen weight gain is associated with increases in body fat and waist circumference, which may be troublesome should the trend continue throughout college.     

Characteristics of optimum falls prevention exercise programmes for community-dwelling older adults using the FITT principle

This review aims to identify the optimal exercise intervention characteristics for falls prevention among community-dwelling adults aged 60 years and over. Articles for inclusion were sourced by searching the Academic Search Premier, AMED, Biomedical Reference Collection: Expanded, CINAHL Plus, MEDLINE and SPORTDiscus databases with the key words ‘falls’, ‘prevention’, ‘exercise’ and ‘community’ and via reference lists of relevant articles. Only articles of level 1 or level 2 evidence (Howick et al. 2011) were included. Other inclusion criteria included recording falls incidence as an outcome measure, examining a community-dwelling population aged 60 years or over and implementing exercise as a single intervention in at least one group. Exercise programme characteristics from 31 articles were examined according to their frequency, intensity, time and type and their effects on falls incidence were reviewed. Exercising for a minimum of 1 h/week for at least 40 h over the course of an intervention is required to successfully reduce falls incidence. The optimal exercise frequency is three times per week, but the optimal duration per bout remains unclear. Specific balance training of sufficiently challenging intensity is a vital programme component, and strength training is most effective when combined with balance training. Flexibility and endurance training may also be included as part of a comprehensive programme. A combination of group and individual home exercise may be most effective for preventing falls and promoting exercise adherence.     

Older adults' exercise behavior: roles of selected constructs of social-cognitive theory

Exercise is consistently related to physical and psychological health benefits in older adults. Bandura's social-cognitive theory (SCT) is one theoretical perspective on understanding and predicting exercise behavior. Thus, the authors examined whether three SCT variables-self-efficacy, self-regulation, and outcome-expectancy value-predicted older adults' (N = 98) exercise behavior. Bivariate analyses revealed that regular exercise was associated with being male, White, and married; having higher income, education, and self-efficacy; using self-regulation skills; and having favorable outcome-expectancy values (p < .05). In a simultaneous multivariate model, however, self-regulation (p = .0097) was the only variable independently associated with regular exercise. Thus, exercise interventions targeting older adults should include components aimed at increasing the use of self-regulation strategies.     

Web-assisted instruction for changing social cognitive variables related to physical activity

The authors examined the efficacy of Web-assisted instruction for promoting the use of social cognitive theory (SCT) strategies related to physical activity. They recruited college students attending health courses. The authors created 3 groups (Web-assisted, comparison, and control) based on the course structure. The Web-assisted group received information on exercise and fitness and a Web-based program (treatment, n = 127); 7 sections received the same exercise and fitness information as the treatment condition, but no Web-based program (comparison, n = 118); and 6 sections received information in unrelated areas (control, n = 178). The Web-based program consisted of 9 Web assignments (1 per week) that targeted key SCT variables. Satisfaction with the Web-based program was high. Use of self-regulation strategies was significantly higher at posttest in the treatment group than it was in the other groups. Knowledge concerning the skills taught by the Web assignments was significantly greater in the treatment group than it was in the comparison group. The results of this study demonstrate that a Web-based instructional program has a positive impact on knowledge and skills related to SCT strategies for changing physical activity behavior.     

Social-cognitive determinants of physical activity attendance in older adults

The present study evaluated whether, and to what extent, the constructs implicated in the theory of planned behavior could predict behavioral intention to exercise and exercise-class attendance of older adults (age 65-90 years) already enrolled in a physical activity program. The study also evaluated whether including self-efficacy judgments might improve the predictive capacity of the model. Participants (N = 1,095) were randomly sampled Italian volunteers from exercise classes for older adults. First, they completed questionnaires assessing the above-mentioned constructs. Then, class attendance was recorded during the following 3 months. Results indicated a substantial correspondence between the model and the data. Perceived behavioral control and self-efficacy were the strongest predictors of behavioral intention, whereas attitudes and subjective norms only partially contributed to its prediction. The inclusion of self-efficacy improved the predictive capacity of the overall model. Finally, results showed a weak relation between behavioral intention and attendance rate in physical activity sessions.     

Behavioral regulations and dispositional flow in exercise among American college students relative to stages of change and gender

Objective: The purpose of this study was to examine behavioral regulations and dispositional flow in exercise among university students in terms of gender and stage of change. Participants: Data were collected from American college students (N = 257; M_age ± SD = 23.02 ± 4.05) in Spring 2013. Methods: Behavioral regulations and dispositional flow in exercise were assessed, along with stage of change. Results: Exercisers in the maintenance stage of change displayed significantly more self-determined motivation to exercise and a greater tendency to experience flow than those in preparation and action stages. Significant correlations were observed among behavioral regulations and flow state. Nonsignificant differences were observed for gender on behavioral regulations and dispositional flow in exercise. Conclusions: The results suggest that promotion of self-determined motivation and dispositional flow in exercisers may improve the quality of their experiences, as well as to foster their exercise behavior.     

The evaluation of a mind/body intervention to reduce psychological distress and perceived stress in college students

The authors examined the effect of a 6-week mind/body intervention on college students' psychological distress, anxiety, and perception of stress. One hundred twenty-eight students were randomly assigned to an experimental group (n = 63) or a waitlist control group (n = 65). The experimental group received 6 90-minute group-training sessions in the relaxation response and cognitive behavioral skills. The Symptom Checklist-90-Revised, Spielberger State-Trait Anxiety Inventory, and the Perceived Stress Scale were used to assess the students' psychological state before and after the intervention. Ninety students (70% of the initial sample) completed the postassessment measure. Significantly greater reductions in psychological distress, state anxiety, and perceived stress were found in the experimental group. This brief mind/body training may be useful as a preventive intervention for college students, according to the authors, who called for further research to determine whether the observed treatment effect can be sustained over a longer period of time.     

Factors associated with exercise participation in adults with arthritis

Most people with arthritis are not regularly active. Understanding what factors influence exercise is essential for designing programs to increase participation. The objective of this study was to examine the correlates of exercise in people with arthritis. Using a cross-sectional design, sociodemographic, health-related, and psychosocial variables were collected from community-dwelling individuals with arthritis (N = 141). Associations with exercise level were examined with bivariate statistics (ANOVAs, chi-squares) and logistic-regression analyses. Exercisers were less likely than nonexercisers and insufficiently active people to report that arthritis negatively affected their physical and social functioning, and they reported more positive affect and greater self-efficacy (p < .05). Exercisers also reported less pain than nonexercisers (p < .05). In multiple logistic-regression analyses, self-efficacy and physical limitations remained independent predictors of exercise. The results suggest the need to target exercise self-efficacy when designing exercise interventions. Results also suggest the need to tailor exercise programs to individuals' physical limitations.     

Sex-dependent associations between daily physical activity and leg exercise blood pressure responses

The authors examined interindividual and sex-specific variation in systolic (SBP) and diastolic (DBP) blood pressure responses to graded leg-extension exercise in healthy older (60-78 yr) women (n = 21) and men (n = 19). Maximal oxygen uptake (VO2max), body composition, physical activity (accelerometry), and vascular function were measured to identify predictors of exercise BP. Neither VO2max nor activity counts were associated with the rise in SBP or DBP during exercise in men. The strongest predictors of these responses in men were age (SBP: r2 = .19, p = .05) and peak exercise leg vasodilation (DBP: r2 = -.21, p < .05). In women, the modest relationship observed between VO2max and exercise BP was abolished after adjusting for central adiposity and activity counts (best predictors, cumulative r2 = .53, p < .05, for both SBP and DBP). These results suggest that determinants of variation in submaximal exercise BP responses among older adults are sex specific, with daily physical activity influencing these responses in women but not men.     

The impact of high-calorie-expenditure exercise on quality of life in older adults with coronary heart disease

The acceptability of a high-calorie-expenditure (HCE) exercise program in older coronary heart disease patients participating in a behavioral weight-control program was evaluated. Seventy-four overweight patients (median age 63 yr) were randomly assigned to a 5-mo intervention of HCE exercise (3,000-3,500 kcal/wk daily walking) or standard cardiac-rehabilitation (CR) exercise (700-800 kcal/wk). Both groups received counseling to achieve a dietary caloric deficit of 3,500 kcal/ wk. Assessments at baseline and 5 mo included self-reported measures of quality of life and psychosocial variables. The HCE group experienced significantly greater weight loss (8.2 ± 4 vs. 3.7 ± 5 kg, p < .001). Changes from baseline to 5 mo on scores of physical, emotional, and social functioning were greater for the HCE than CR group (p < .05). HCE exercise also resulted in greater positive change in exercise enjoyment (p = .05), which was mediated by weight change. Even high-risk older adults can be successful in an HCE exercise program and experience no adverse physical or emotional changes.     

The effect of self-care information on health-related attitudes and beliefs of college students

We conducted a study to determine whether an intervention using self-care information would change college students' attitudes and beliefs concerning personal responsibility and involvement in their own health care. Individuals entering a student health service were randomly assigned to a treatment or control group. Members of the treatment group (n = 187) received the intervention and completed the survey instrument. Members of the control group (n = 204) completed the survey instrument only. The intervention consisted of one page of general information about the benefits to individuals of taking responsibility for their own health and a booklet containing excerpts from a consumer-oriented health care book. The survey instrument was composed of a measure of attitudes toward information and behavioral involvement in health care and a measure of beliefs regarding control over one's health. Results indicated that the intervention was able to change the treatment group's attitudes regarding active participation in health care. The treatment group's responses also reflected less belief that health was outside of the individual's control. The study showed that a positive change in health-related attitudes and beliefs can result from a relatively uncomplicated informational intervention.     

The effects of physical therapists' guidance on improvement in a strength-training program for the frail elderly

Elderly participants experiencing difficulty in chair rising and with a maximum knee-extensor torque below 87.5 N . m were randomized to different versions of a strength-training program for the knee-extensors: to a high-guidance group (HG; two group sessions supervised by a physical therapist and one unsupervised home session per week, n = 17), a medium-guidance group (MG; one supervised group session and two unsupervised home sessions per week, n = 16), or a control group (C; no exercise, n = 16). Maximal isometric knee strength increased more in HG than in C (p = .03) and with increasing guidance (p = .03). The effect was mainly the result of participants with low initial strength. Walking speed increased more for HG than for C (p = .02) and than for MG (p = .06). No statistically significant improvements were seen on other functional tests. In summary, the study shows a trend toward better results with more supervision, but more and larger studies are needed to confirm this.     

The effect of 6 months training on leg power, balance, and functional mobility of independently living adults over 70 years old

Where strength training has been used in conjunction with functional-task training in older people, not only have there been improvements in leg strength but also improved function has been measured (e.g., Skelton & McLaughlin, 1996). Many studies use participants from care homes rather than community dwellers. We investigated changes in leg power, balance, and functional mobility in community-dwelling sedentary men and women over 70 years of age (n = 6 for training group [TR]; n = 10 for control group [CN]). Progressive training took place over 24 weeks using seated and nonseated exercise. For TR, leg power increased 40%, from 108 +/- 40 to 141 +/- 53 W (p < .01); dynamic balance increased 48%, from 22.3 +/- 7.9 to 33.1 +/- 6.1 cm (p < .01; functional reach); and functional mobility increased 12%, from 7.46 +/- 1.32 to 6.54 +/- 1.41 s (p < .05; timed walk). CN showed no significant change. In conclusion, a community-based exercise program led to large improvements in leg-extensor power, dynamic balance, and functional mobility.     

Using the wellness inventory to assess health and well-being in college students at the end of the semester

Abstract

Objective: The authors examined the end of semester outcomes (December, 2017) on the Wellness Inventory and demographics among college students taking a Physical Education (PED 101) course at a university in the southeast United States. Participants: College students were assessed at the end of the semester for health and well-being outcomes according to the Wellness Inventory. Results: Results showed that there were few gender or age differences for the dimensions of well-being. However, there were significant differences for most of the dimensions of health and well-being between frequent exercisers and infrequent exercisers. There were also significant differences between students who reported being in excellent health versus students who reported being in fair or poor health. Conclusions: Consistent exercise throughout the week may play a role in overall health and well-being. The results from this study warrant further investigation into the relationship between the exercise frequency and the dimensions of health and well-being.     

Pilot Testing a Cognitive-Behavioral Protocol on Psychosocial Predictors of Exercise,Nutrition, Weight,and Body Satisfaction Changes in a College-Level Health-Related Fitness Course

Abstract

Objective: Small-scale pilot testing of supplementing a required college health-related fitness course with a cognitive-behavioral exercise-support protocol (The Coach Approach). Participants: Three classes were randomly assigned to Usual processes (n = 32), Coach Approach–supplemented: Mid-size Groups (n = 32), and Coach Approach–supplemented: Small Groups (n = 34) conditions. Methods: Repeated-measures analyses of variance (ANOVAs) assessed overall and between-class changes in the behavioral/physiological factors of exercise, fruit/vegetable intake, and body mass index (BMI); and the psychosocial factors of self-regulation, exercise self-efficacy, mood, and body satisfaction. Dependent t tests evaluated within-class changes. Multiple regression analyses tested prediction of exercise by changes in self-regulation, self-efficacy, and mood. Results: Significant improvements in self-regulation and fruit/vegetable intake were found in all classes. The Coach Approach–supplemented classes demonstrated significant increases in exercise. Significant improvements in BMI, self-efficacy, and body satisfaction were found in only The Coach Approach–supplemented: Small Groups class. Psychosocial changes predicted increased exercise. Self-regulation was the strongest contributor. Conclusions: Overall, results were positive and warrant more comprehensive testing.