Sources of self-efficacy for physical activity

"Oh no, they caught it!": Vicarious experience of COVID-19, protection motivation and protective behaviors

Utilizing the components of the protection motivation theory, this study investigated the role of close others' diagnosis of COVID-19 (as a vicarious experience) in individuals' adherence to protective behavior against COVID-19. Path analysis of online survey data from 3695 participants showed that the presence of a diagnosed close other was positively related to perceived vulnerability, while being negatively related to perceived response efficacy and self-efficacy. In addition, perceived severity and efficacy appraisals were positively associated with protective behavioral tendencies. Although efficacy appraisal mediated the relationship between vicarious experience and protective behavior, threat appraisal did not mediate this relationship. In sum, the results suggest that efficacy appraisal derived from vicarious experiences can be more consequential for protective behaviors than threat appraisal. Implications of these results on future large-scale health crises are discussed along with limitations and future directions.

A community-based modified sport program for rural community-dwelling older adults: A pilot study

INTRODUCTION

With Australia's ageing population, especially in rural regions, promoting physical activity among older adults is crucial.

OBJECTIVE

To identify factors influencing participation of older adults (60 years or over) from a rural community in a modified sport program and assess satisfaction with a pilot modified sport program informed by these findings.

DESIGN

Insights and ideas from two focus groups exploring community perspectives on a modified sport program informed the development of a six-week pilot modified sport program delivered with the local fitness centre. Post-program surveys assessed participant satisfaction, willingness to continue, and likelihood of recommending the program to others.

FINDINGS

Nine participants attended the focus groups, highlighting increased social connection, health management, and healthy ageing as key motivators. Joint and health concerns, cost, and time constraints emerged as main barriers. Preferences for the program included weekly sessions, alternating sports, indoor venues, and supporting modifications, but maintaining traditional rules. Thirteen participants participated in the pilot modified sport program. There was strong program attendance (86%). All participants (13/13) rated their satisfaction as very satisfied. They were highly likely to recommend the program to others (8.5/10) and were interested in continuing modified sport after the pilot (7.7/10).

DISCUSSION

This study demonstrates for the first time that modified sport is of interest to older people in the rural setting, and that delivering such a program is feasible in a small community. Rural communities implementing modified sport should consider the availability of suitable facilities and equipment, access to an engaging facilitator and participant cost.

CONCLUSION

Through a strong connection between the health service and community fitness centre, a modified sport program was developed and implemented, well-attended and enjoyed by participants in a rural community.

The Relationship between Physical Activity and Life Satisfaction among University Students in China: The Mediating Role of Self-Efficacy and Resilience

(1) Background: Universities play a crucial role in nurturing healthy habits, and physical activity has emerged as a valuable tool for enhancing the life satisfaction, self-efficacy, and resilience of college students. Therefore, the purpose of this study was to investigate the mediating role of physical activity in the relationship between life satisfaction and self-efficacy as well as resilience among Chinese university students. (2) Method: This study used the Physical Activity Rating Scale (PARS-3), the Self-Efficacy Scale (CGES), the Mental Toughness Scale (CD-RISC), and the Life Satisfaction Scale (CSLSS) to administer questionnaires to 353 university students from two universities in Chengdu, Sichuan Province. Using a random simple sampling method, the data were processed and analyzed using SPSS 22.0 and Excel software. (3) Results: (1) Physical activity exhibited a significant positive correlation with self-efficacy, resilience, and life satisfaction; self-efficacy was significantly and positively related to resilience and life satisfaction; and resilience was significantly and positively related to life satisfaction. (2) Physical activity had a positive predictive effect on life satisfaction (β = 0.2771; 95% confidence interval (CI): 0.1905, 0.3637, 55.51%). (3) Self-efficacy (β = 0.0368; 95% confidence interval (CI): 0.0087, 0.0692, 7.37%) and resilience (β = 0.137; 95% confidence interval (CI): 0.0919, 0.1894, 27.44%) mediated the relationship between physical activity and life satisfaction. Also, the chain-mediating effect of self-efficacy and resilience between physical activity and life satisfaction reached significant levels (β = 0.0483; 95% confidence interval (CI): 0.0279, 0.0745, 9.68%). (4) Conclusion: Active participation in physical activity not only enhanced the life satisfaction of college students but also indirectly impacted their life satisfaction by improving their self-efficacy and resilience. Consequently, this led to an overall improvement in the life satisfaction of college students.

An Australian exploratory study of individual physical functioning and wellbeing of rural clients with chronic diseases whose structured exercise groups were cancelled due to social distancing requirements of the COVID-19 pandemic

BACKGROUND

The primary aim of this study was to describe if there was a change in physical functioning of rural clients with chronic diseases who were unable to attend their structured exercise groups during the COVID-19 pandemic. The secondary aim was to describe their physical activity during lockdown and their wellbeing upon return to their structured exercise groups.

METHOD

Physical functioning measures collected in January to March 2020 (prior to suspension of structured exercise groups due to the lockdown) were repeated in July 2020 (when face-to-face activity resumed) and compared. A survey collected information about the client's level of physical activity during lockdown and wellbeing measures at the end of the lockdown.

RESULTS

Forty-seven clients consented to provide physical functioning tests and 52 completed the survey. Only the modified 2-min step-up test displayed a statistically (but not clinically) significant change (n =29, 51.7vs 54.1 rep, P =0.01). Physical activity undertaken during lockdown was less in 48% (n =24), the same in 44% (n =22) and increased in 8% (n =4) of clients. Despite the lockdown, clients had high global satisfaction, high subjective wellbeing and normal resilience.

CONCLUSIONS

Clinically significant changes in physical functioning when clients were unable to attend structured exercise groups for three months during the COVID-19 pandemic were not observed in this exploratory study. Further research is required to confirm the impact of isolation on physical functioning in those participating in group exercise to improve their chronic disease management.

Development and feasibility of a theory-guided and evidence-based physical activity intervention in pregnant women with high risk for gestational diabetes mellitus: a pilot clinical trial

BACKGROUND

Physical activity has been utilized as an effective strategy to prevent gestational diabetes mellitus (GDM). However, most pregnant women with high risk for GDM did not achieve the recommended physical activity level. Furthermore, relevant physical activity protocols have varied without theory-guided and evidence-based tailored to pregnant women with high risk for GDM. This study aimed to develop and pilot test a theory-guided and evidence-based physical activity intervention protocol for pregnant women with high risk for GDM.

METHODS

The study design was guided by the Medical Research Council Framework for Developing and Evaluating Complex Intervention (the MRC framework). The preliminary protocol for physical activity intervention was developed based on self-efficacy theory, research evidence identified from systematic reviews and clinic trials, stakeholder engagement, context, and economic considerations. The preliminary intervention protocol was validated through a content validity study by an expert panel of 10 experts. A single-blinded randomized controlled trial (RCT) was designed to test the feasibility and acceptability of the intervention.

RESULTS

The validity of the preliminary intervention protocol was excellent as consensus was achieved. The final 13 sessions of self-efficacy enhancing physical activity intervention protocol were developed, including knowledge education, exercise clinic visits and video, and group discussions with face-to-face and online blended sessions. In the feasibility study, 34 pregnant women with high risk for GDM were randomized for the intervention (n = 17) or the control group (n = 17). The recruitment and retention rates were 82.9% and 58.9%, respectively. Women in the intervention group had a lower incidence of GDM (26.7% vs. 36.5%) than the control group (P >0.05). All participants were satisfied with the intervention and agreed that the intervention was helpful.

CONCLUSIONS

The developed self-efficacy-enhancing physical activity intervention is a feasible and acceptable intervention for enhancing physical activity among pregnant women with high risk for GDM and is ready to be tested in a more extensive RCT study.

TRIAL REGISTRATION

The study was registered on 4 February 2022 (ChiCTR2200056355) by the Chinese Clini Trial Registry (CHiCTR).

Enhancing physical activity and reducing symptoms of patients with osteoarthritis of the knee: a randomized controlled trial of the PrevOP-Psychological Adherence Program

BACKGROUND

This primary analysis evaluated the "PREVenting the impairment of primary Osteoarthritis by high-impact long-term Physical exercise regimen-Psychological Adherence Program" (PrevOP-PAP), designed to support patients with osteoarthritis of the knee (OAK) to engage in regular moderate-to-vigorous physical activity (MVPA) to reduce OAK symptoms (WOMAC scores). Theory-based on the health action process approach (HAPA), the intervention targeted volitional precursors of MVPA change: action and coping planning, maintenance and recovery self-efficacy, action control, and social network formation. We hypothesized that compared to an active control condition, increases in MVPA at the end of the 12-month intervention would translate into lower WOMAC scores at 24 months in the intervention condition.

METHODS

Participants with radiographically verified moderate OAK (N = 241; 62.66% female; M(SD) = 65.60(7.61) years) were randomly assigned to the intervention (51%) or the active control condition. WOMAC scores (24 months) were the primary -, accelerometer-assessed MVPA (12 months) the key secondary outcomes. The PrevOP-PAP was a 12-month intervention with computer-assisted face-to-face and phone-based sessions designed to increase HAPA-proposed volitional precursors of MVPA change (up to 24 months; secondary outcomes). Intent-to-treat analyses included multiple regression and manifest path models.

RESULTS

MVPA (12 months) did not mediate effects of the PrevOP-PAP on WOMAC scores (24 months). Compared to the active control condition, WOMAC scores (24 months) were lower in the intervention condition, but this effect did not remain stable in sensitivity analyses (b(SE) = -8.41(4.66), 95%-CI [-17.53; 0.71]). However, exploratory analyses revealed significantly stronger reductions in WOMAC-pain (24 months) in the intervention condition (b(SE) = -2.99(1.18), 95%-CI [-5.36; -0.63]). Groups did not differ in MVPA at 12 months (b(SE) = -3.78(3.42), 95%-CI [-10.80; 2.58]). Of the proposed precursors of MVPA change, action planning was higher in the intervention than in the control condition (24 months; b(SE) = 0.64(0.26), 95%-CI [0.14; 1.15]).

CONCLUSIONS

Compared to an active control condition, the PrevOP-PAP did not produce reliable effects on WOMAC scores and none on preceding MVPA. Of the HAPA-proposed volitional precursors, only action planning was sustainably increased. Future interventions should use m-health applications to digitally support long-term changes in proposed volitional precursors of MVPA change.

TRIAL REGISTRATION

German Clinical Trials Register; https://drks.de/search/de/trial/DRKS00009677 ; also available at http://apps.who.int/trialsearch/ ; registration number: DRKS00009677; date of registration: 26/01/2016.

Deliberate ignorance-a barrier for information interventions targeting reduced meat consumption?

OBJECTIVE

Despite abundant information about negative consequences of consuming meat, consumption in many Western countries is many times higher than recommended. One possible explanation for this discrepancy is that people consciously decide to ignore such information-a phenomenon called deliberate ignorance. We investigated this potential barrier for information interventions aiming to reduce meat consumption.

METHODS

In three studies, a total of 1133 participants had the opportunity to see 18 information chunks on negative consequences of meat consumption or to ignore part of the information. Deliberate ignorance was measured as the number of ignored information chunks. We assessed potential predictors and outcomes of deliberate ignorance. Interventions to reduce deliberate ignorance (i.e., self-affirmation, contemplation, and self-efficacy) were experimentally tested.

RESULTS

The more information participants ignored, the less they changed their intention to reduce their meat consumption (r = -.124). This effect was partially explained by cognitive dissonance induced by the presented information. While neither self-affirmation nor contemplation exercises reduced deliberate ignorance, self-efficacy exercises did.

CONCLUSION

Deliberate ignorance is a potential barrier for information interventions aiming to reduce meat consumption and needs to be considered in future interventions and research. Self-efficacy exercises are a promising approach to reduce deliberate ignorance and should be further explored.

"Feeling Good" After Exercise During a Weight Loss Program: Subjective Well-Being in Support of a Hedonic Paradigm

A large portion of the U.S. population desires to lose weight, but only a small portion maintains a desirable body weight. We examined weight loss success and the psychological benefits of exercise among men and women who were obese and initially sedentary (N = 33). These participants completed anthropometric assessments and psychological inventories before and after graded exercise tests (GXTs) at the beginning and end of their enrollment in a 6-month behavioral weight loss program (BWLP). Participants significantly decreased their body weight, body mass index (BMI), and % body fat; they also increased their aerobic capacity and exercise time. They reported long-term increases in their stage of change, self-efficacy, exercise enjoyment and processes of change. They also reported immediate changes toward more positive affect, as measured with pre-to post-GXTs on both the Profile of Mood States (POMS) and State Anxiety Subscale (A-State) at the beginning and again at end of the BWLP. Mood benefits were reported on the POMS subscales of Tension, Depression, Anger, Vigor, and Confusion. At the end of the BWLP, Fatigue and Confusion continued to improve after a 20-min post-GXT recovery period. Finally, reductions in Depression and Fatigue after the first GXT were correlated with program success, as indicated by decreases in BMI, percent body fat, and body weight. Initial scores on trait enjoyment were associated with decreased BMI and body weight. Psychological benefits of exercise may help individuals who are obese and sedentary change their behavior and exercise perceptions from something they "should do" to something they "want to do." Feeling good during weight loss efforts is an important pathway to change and should be an explicit component goal of BWLPs.

Understanding the Experiences of People Living with Stroke Engaging in a Community-Based Physical-Activity Programme

Research has evidenced that regular exercise can provide physical and physiological benefits for people living with stroke. Our study aims to explore the experiences of people living with stroke when participating in a community physical activity programme. This programme was created to offer targeted physical activity and education interventions following the discharge of patients from the healthcare pathway. This qualitative study involved semi-structured interviews with 16 participants living with stroke who were recruited from individuals who had engaged with the activity programme. A reflexive thematic analysis was conducted on the data, and four overarching themes were developed: (i) Feelings of appreciation, (ii) Interactions with other patients, (iii) Positive contributions of trained instructors, and iv) Personal progress. Generally, participants reported very positive perceptions of the exercise programme, and were very grateful for the opportunity that the exercise classes provided. We hope that these findings will offer practical suggestions for healthcare providers who might develop similar activity programmes for clinical populations.

The Relationship between Exercise Self-Efficacy, Intention, and Structural Barriers for Physical Activity after a Cancer Diagnosis

Simple Summary

Despite numerous benefits of physical activity for cancer patients, the majority is insufficiently active. Previous research has shown that structural barriers negatively affect patients’ physical activity behavior. Identifying underlying mechanisms could help to develop effective strategies that alleviate those barriers and increase physical activity levels. In the current survey study, we investigated whether cancer patients’ self-efficacy, i.e., their confidence in their ability, and their intention to exercise mediated the relationship between structural barriers and physical activity. The results revealed a negative relation between structural barriers and patients’ self-efficacy. Lower self-efficacy, in turn, decreased patients’ intention and their likelihood to engage in physical activity. This mediating effect especially applied to those individuals who were sufficiently active before the diagnosis. Thus, the findings suggest that interventions directly addressing the perception of structural barriers or patients’ self-efficacy in dealing with these barriers might be effective in improving the physical activity levels of cancer patients.

Abstract

Previous research has shown that structural barriers negatively influence the physical activity (PA) behavior of cancer patients, but underlying mechanisms are unclear. The aim of the current study was to explore the potential mediating role of social-cognitive factors, namely PA self-efficacy and PA intention in this context. A total of 856 cancer patients completed a questionnaire on sociodemographic and medical characteristics, pre- and post-diagnosis PA, PA self-efficacy, PA intention, and PA impediment by structural barriers. A serial mediation model was used to test whether the association between structural barriers and post-diagnosis PA was mediated by PA self-efficacy and/or PA intention, in the overall sample and in subsamples defined by individuals’ pre-diagnosis PA. The results confirmed that structural barriers were not directly (95%CI [−0.45; 0.10]) but indirectly associated with post-diagnosis PA. Higher impediment by structural barriers decreased the likelihood of sufficient post-diagnosis PA via lower PA self-efficacy (95%CI [−0.25; −0.06]) and via the serial pathway of lower PA self-efficacy and lower PA intention (95%CI [−0.19; −0.05]). Investigating differences in these mediations by pre-diagnosis PA yielded significance only among previously active cancer patients. Both structural barriers and PA self-efficacy might hence be relevant target points for interventions aiming to improve PA behavior, especially among pre-diagnosis active cancer patients.

High-intensity interval training in people with mild multiple sclerosis: a mixed-methods feasibility study

Background/Aims

High-intensity interval training has received increased attention as a mode of exercise, including as a therapy in clinical populations. This study investigated the acceptability of a high-intensity interval training intervention in people with mild multiple sclerosis.

Methods

Participants attended two sessions a week for the 6-week intervention. Each session consisted of 6–10 sets of 60-second high-intensity intervals interspersed with 120 seconds of recovery. The acceptability, intervention adherence and safety of the high-intensity interval training protocol and estimates of treatment effects (fitness, physical activity levels, fatigue and quality of life) were used to determine intervention feasibility. Qualitative interviews were used to explore the acceptability of the intervention.

Results

A total of 11 people with mild multiple sclerosis consented to participate in a 6-week high-intensity interval intervention. One participant dropped out of the intervention. The participants expressed apprehension before the intervention but attendance at the exercise sessions was high (87%). Participants experienced some symptom exacerbation following sessions, although none were serious. Improvements were seen in fitness, physical activity, fatigue and health-related quality of life.

Conclusions

The study findings suggest that high-intensity interval training is acceptable, safe and may offer disease-related benefits for the participants. Participants did experience some symptom exacerbation and further studies are needed to determine the long-term appeal of high-intensity interval training for people with mild multiple sclerosis.

The impact of physical fitness on resilience to modern life stress and the mediating role of general self-efficacy

Substantial evidence shows that physical activity and fitness play a protective role in the development of stress related disorders. However, the beneficial effects of fitness for resilience to modern life stress are not fully understood. Potentially protective effects may be attributed to enhanced resilience via underlying psychosocial mechanisms such as self-efficacy expectations. This study investigated whether physical activity and fitness contribute to prospectively measured resilience and examined the mediating effect of general self-efficacy. 431 initially healthy adults participated in fitness assessments as part of a longitudinal-prospective study, designed to identify mechanisms of resilience. Self-efficacy and habitual activity were assessed in parallel to cardiorespiratory and muscular fitness, which were determined by a submaximal step-test, hand strength and standing long jump test. Resilience was indexed by stressor reactivity: mental health problems in relation to reported life events and daily hassles, monitored quarterly for nine months. Hierarchical linear regression models and bootstrapped mediation analyses were applied. We could show that muscular and self-perceived fitness were positively associated with stress resilience. Extending this finding, the muscular fitness-resilience relationship was partly mediated by self-efficacy expectations. In this context, self-efficacy expectations may act as one underlying psychological mechanism, with complementary benefits for the promotion of mental health. While physical activity and cardiorespiratory fitness did not predict resilience prospectively, we found muscular and self-perceived fitness to be significant prognostic parameters for stress resilience. Although there is still more need to identify specific fitness parameters in light of stress resilience, our study underscores the general relevance of fitness for stress-related disorders prevention.

Proposing a Core Outcome Set for Physical Activity and Exercise Interventions in People With Rare Neurological Conditions

Rare neurological conditions (RNCs) encompass a variety of diseases that differ in progression and symptoms but typically include muscle weakness, sensory and balance impairment and difficulty with coordinating voluntary movement. This can limit overall physical activity, so interventions to address this are recommended. The aim of this study was to agree a core outcome measurement set for physical activity interventions in people living with RNCs. We followed established guidelines to develop core outcome sets. Broad ranging discussions in a series of stakeholder workshops led to the consensus that (1) physical well-being; (2) psychological well-being and (3) participation in day-to-day activities should be evaluated in interventions. Recommendations were further informed by a scoping review of physical activity interventions for people living with RNCs. Nearly 200 outcome measures were identified from the review with a specific focus on activities or functions (e.g, on lower limb function, ability to perform daily tasks) but limited consideration of participation based outcomes (e.g., social interaction, work and leisure). Follow on searches identified two instruments that matched the priority areas: the Oxford Participation and Activities Questionnaire and the Sources of Self-Efficacy for Physical Activity. We propose these scales as measures to assess outcomes that are particularly relevant to assess when evaluating physical activity interventions mong people with RNCs. Validation work across rare neurological conditions is now required to inform application of this core outcome set in future clinical trials to facilitate syntheses of results and meta-analyses.

Written Advice Given by African American Smokers to Their Peers: Qualitative Study of Motivational Messages

BACKGROUND

Although African Americans have the lowest rates of smoking onset and progression to daily smoking, they are less likely to achieve long-term cessation. Interventions tailored to promote use of cessation resources in African American individuals who smoke are needed. In our past work, we demonstrated the effectiveness of a technology-assisted peer-written message intervention for increasing smoking cessation in non-Hispanic White smokers. In this formative study, we have adapted this intervention to be specific for African American smokers.

OBJECTIVE

We aimed to report on the qualitative analysis of messages written by African American current and former smokers for their peers in response to hypothetical scenarios of smokers facing cessation challenges.

METHODS

We recruited African American adult current and former smokers (n=41) via ResearchMatch between April 2017 and November 2017. We asked participants to write motivational messages for their peers in response to smoking-related hypothetical scenarios. We also collected data on sociodemographic factors and smoking characteristics. Thematic analysis was conducted to identify cessation strategies suggested by the study participants.

RESULTS

Among the study participants, 60% (25/41) were female. Additionally, more than half (23/41, 56%) were thinking about quitting, 29% (12/41) had set a quit date, and 27% (11/41) had used electronic cigarettes in the past 30 days. Themes derived from the qualitative analysis of peer-written messages were (1) behavioral strategies, (2) seeking help, (3) improvements in quality of life, (4) attitudes and expectations, and (5) mindfulness/religious or spiritual practices. Under the behavioral strategies theme, distraction strategies were the most frequently suggested strategies (referenced 84 times in the 318 messages), followed by use of evidence-based treatments/cessation strategies. Within the seeking help theme, subthemes included seeking help or support from family/friends or close social networks (referenced 56 times) and health care professionals (referenced 22 times). The most frequent subthemes that emerged from improvements in the quality of life theme included improving one's health (referenced 22 times) and quality of life (referenced 21 times). Subthemes that emerged from the attitude and expectations theme included practicing positive self-talk (referenced 27 times), autonomy/independence from the smoking habit (referenced six times), and financial cost of smoking (referenced five times). The two subthemes that emerged from the mindfulness/religious or spiritual practices theme were use of self-awareness techniques (referenced 36 times) and religious or spiritual practices to cope (referenced 13 times).

CONCLUSIONS

Our approach to adapt a prior peer-message intervention to African American smokers yielded a set of evidence-based messages that may be suitable for smokers at all phases of motivation to quit (ready to quit or not ready to quit). In future research, we plan to assess the impact of texting these messages to African American smokers in a smoking cessation trial.

Applying Social Cognition Models to Explain Walking Duration in Older Adults: The Role of Intrinsic Motivation

This study examined the applicability of the health action process approach (HAPA) to walking duration in older adults and the added value of extending the HAPA by intrinsic motivation. Self-reports from older adults (N = 309; Mage = 78.7, 70-95 years) regarding activity-related intrinsic motivation and HAPA variables were collected at the baseline of a fall prevention intervention study. Walking duration at ≥3 metabolic equivalents of task was measured for 7 days via body-worn accelerometers. Two structural equation models with walking duration as a manifest outcome were specified. In both models, the model fit was acceptable, but intention and planning were not associated with walking duration. Intrinsic motivation was significantly related to most HAPA variables and walking duration. Variance explained for walking duration was R2 = .14 in the HAPA and R2 = .17 in the extended model. For explaining older adults' walking duration, intrinsic motivation, but not HAPA-based intention and planning, seemed to be important.

Coping self-efficacy influences health information avoidance

Avoiding information about one's health can have long-term implications for health and well-being. Two studies examined the relationship between health information avoidance and coping self-efficacy, or a sense that one can effectively cope. In Study 1, coping self-efficacy, but not general self-efficacy, was associated with information avoidance. In Study 2, participants who reflected on their positive coping strategies were less likely to avoid learning their risk for disease as compared to those who did not reflect on their coping strategies. These findings suggest that coping self-efficacy is a good target for future interventions aimed at reducing health information avoidance.

Understanding Health Risk Comprehension: The Role of Math Anxiety, Subjective Numeracy, and Objective Numeracy

Background. Numeracy skills are important for medical decision making as lower numeracy is associated with misinterpreting statistical health risks. Math anxiety, characterized by negative emotions about numerical tasks, and lower subjective numeracy (i.e., self-assessments of numerical competence) are also associated with poor risk comprehension. Objective. To explore independent and mediated associations of math anxiety, numerical ability, and subjective numeracy with risk comprehension and to ascertain whether their associations are specific to the health domain. Methods. Objective numeracy was measured with a 14-item test. Math anxiety and subjective numeracy were assessed with self-report scales. Risk comprehension was measured with a 12-item test. In experiment 1, risk comprehension items were limited to scenarios in the health domain. In experiment 2, participants were randomly assigned to receive numerically equivalent risk comprehension items in either a health or nonhealth domain. Results. Linear regression analyses revealed that individuals with higher objective numeracy were more likely to respond correctly to the risk comprehension items, as were individuals with higher subjective numeracy. Higher math anxiety was associated with a lower likelihood of correct responding when controlling for objective numeracy but not when controlling for subjective numeracy. Mediation analyses indicated that math anxiety may undermine risk comprehension in 3 ways, including through 1) objective numeracy, 2) subjective numeracy, and 3) objective and subjective numeracy in serial, with subjective numeracy mediating the association between objective numeracy and risk comprehension. Findings did not differ by domain. Conclusions. Math anxiety, objective numeracy, and subjective numeracy are associated with risk comprehension through unique pathways. Education initiatives for improving health risk comprehension may be most effective if jointly aimed at tackling numerical ability as well as negative emotions and self-evaluations related to numeracy.

“How to use it more?” Self-efficacy and its sources in the use of social media for knowledge sharing

Purpose

The purpose of this paper is to investigate sources of self-efficacy for researchers and the sources’ impact on the researchers’ use of social media for knowledge sharing. It is a continuation of a larger study (Alshahrani and Rasmussen Pennington, 2018).

Design/methodology/approach

The authors distributed an online questionnaire to researchers at the University of Strathclyde (n=144) and analysed the responses using descriptive statistics.

Findings

Participants relied on personal mastery experience, vicarious experience, verbal persuasion and emotional arousal for social media use. These elements of self-efficacy mostly led them to use it effectively, with a few exceptions.

Research limitations/implications

The convenience sample utilised for this study, which included academic staff, researchers and PhD students at one university, is small and may not be entirely representative of the larger population.

Practical implications

This study contributes to the existing literature on social media and knowledge sharing. It can help researchers understand how they can develop their self-efficacy and its sources in order to enhance their online professional presence. Additionally, academic institutions can use these results to inform how they can best encourage and support their researchers in improving their professional social media use.

Originality/value

Researchers do rely on their self-efficacy and its sources to use social media for knowledge sharing. These results can help researchers and their institutions eliminate barriers and improve online engagement with colleagues, students, the public and other relevant research stakeholders.

The association of self-efficacy and hospitalization rates in people with type-2 diabetes: A prospective cohort study

AIMS

Self-efficacy is presumed important in chronic disease management; we assessed the association between self-efficacy and risk of hospitalization in adults with type-2 diabetes.

METHODS

A prospective cohort was assembled between December 2011 to December 2013. Participants completed an extensive survey, including a previously validated 6-item assessment of chronic disease management self-efficacy. The association between self-efficacy (low, medium, high) and all-cause hospitalization within 1 year of the survey was assessed using multivariable logistic regression, after adjustment for sociodemographic characteristics, physical, behavioral and psychosocial factors.

RESULTS

Among the cohort (n = 1915), the average age was 64.5 (SD 10.7) years, 45.3% were women and 199 (10.4%), 459 (24.0%) and 1257 (65.6%) participants reported low, medium and high self-efficacy, respectively. Participants with low self-efficacy were younger, had more comorbidities, and followed less healthy behaviors compared to those with high self-efficacy. In unadjusted analyses, low self-efficacy was associated with increased risk of hospitalization (23.6% vs 9.6%; odds ratio (OR) 2.90: 95% confidence interval (95%CI 1.99, 4.23)) compared to those with high self-efficacy, while no significant association was observed for medium self-efficacy level (OR 1.28: 95%CI 0.91, 1.79). After adjustment, there was no difference in hospitalization risk for participants with low (OR 0.99; 95%CI 0.59, 1.67) or medium (OR 0.67; 95%CI 0.44, 1.01) self-efficacy compared to high self-efficacy.

CONCLUSIONS

Our results suggest that self-efficacy is not independently associated with lower all-cause hospitalization in this population. Focus on additional heath aspects are likely required to improve overall health outcomes in people with type-2 diabetes.

“Why not use it more?” Sources of self-efficacy in researchers’ use of social media for knowledge sharing

Purpose

The purpose of this paper is to investigate the sources of self-efficacy that researchers rely on when using social media for knowledge sharing and to explore how these sources impact their use.

Design/methodology/approach

The study employed 30 semi-structured interviews with researchers at a major Scottish university. The authors analysed the interview transcriptions using directed content analysis.

Findings

The researchers relied on the four sources of self-efficacy proposed by Bandura (1977) when using social media for knowledge sharing. These sources lead researchers to use social media effectively and frequently for sharing knowledge, although some may discourage its use.

Research limitations/implications

It extends the self-efficacy integrative theoretical framework of Bandura (1977) by presenting the relative amount of the influence of these sources for researchers to share their ideas, experiences, questions and research outputs on social media. While the participants included academic staff, postdoctoral researchers, and PhD students, the majority were PhD students.

Practical implications

The findings can help universities understand how to promote productive use of social media. For example, academic staff who have high personal mastery experience could mentor those who do not.

Originality/value

This is the first known study to investigate the sources of self-efficacy that impact researchers’ use of social media for knowledge sharing.

Facilitating physical activity and reducing symptoms in patients with knee osteoarthritis: study protocol of a randomized controlled trial to test a theory-based PrevOP-psychological adherence program (PrevOP-PAP)

Background

The present randomized controlled trial, which is crossed with the “PREVenting the impairment of primary Osteoarthritis by high impact long-term Physical exercise regimen” Main Medical Trial (PrevOP-MMT), aims to evaluate a psychological adherence program (PrevOP-PAP), and is designed to support persons with knee osteoarthritis (OAK) in the uptake and maintenance of regular physical activity to reduce OAK symptoms. The PrevOP-PAP is based on the Health Action Process Approach (HAPA), a social-cognitive theory predicting health behavior change in individuals, extended here by social network characteristics and social exchange processes. It is expected that participants with OAK receiving the PrevOP-PAP will maintain higher levels of regular physical activity throughout a 24-month period and consequently report lower levels of OAK symptoms than participants of an active control condition.

Methods

A total of N = 240 participants with medically verified moderate OAK will be randomly assigned to an intervention condition (PrevOP-PAP-I; 50%) or an active control condition (PrevOP-PAP-CTRL). The PrevOP-PAP-I includes a motivational intervention, repeated self-regulation interventions, and a network creation intervention delivered over 12 months. Modes of intervention delivery include a paper-pencil motivation leaflet with a quiz, a computer-assisted face-to-face intervention, four computer assisted phone-based interventions, and activity calendars. The PrevOP-PAP-CTRL includes the motivational intervention only. Primary outcome will be OAK symptoms. Secondary outcomes include objectively and subjectively measured physical activity and indicators of quality of life. Other outcomes are HAPA-derived self-regulatory indicators as well as proposed social network and social exchange mechanisms of health behavior change. Assessments take place at baseline, 6 months, 12 months, 18 months, and 24 months following baseline.

Discussion

Based on the extended HAPA, this study seeks to reveal the self-regulatory and social mechanisms of the uptake and maintenance of physical activity and their relation to disease symptoms in persons with OAK. The design and evaluation of this program are intended to become a yardstick for future development and implementation of digitalized psychological adherence programs in this population.

Trial registration

German Clinical Trials Register; also available at http://apps.who.int/trialsearch/; registration number: DRKS00009677; date of registration: 26 January 2016.

Perceived somatic and affective barriers for self-efficacy and physical activity

According to Bandura's social-cognitive theory, perceptions of somatic and affective barriers are sources of self-efficacy. This longitudinal study compares general indicators of health barriers with measures of perceived somatic and affective barriers to predict self-efficacy and accelerometer-assessed physical activity in a subsample of n = 153 (selected at random from N = 310) community-dwelling German older adults. Perceived somatic and affective barriers longitudinally predicted physical activity mediated by self-efficacy, whereas general health barriers did not. Perceived health barriers to physical activity might be more important than more objective health barriers for older adults' physical activity levels.

Phone-based Intervention under Nurse Guidance after Stroke (PINGS): study protocol for a randomized controlled trial

BACKGROUND

Hypertension is the premier modifiable risk factor for recurrent stroke. In sub-Saharan Africa (SSA) where the stroke burden is escalating, little is known about the role of behavioral interventions in enhancing blood pressure (BP) control after stroke. Our objective is to test whether an m-Health technology-enabled, nurse-led, multilevel integrated approach is effective in improving BP control among Ghanaian stroke patients within 1 month of symptom onset compared with standard of care.

METHODS

This two-arm cluster randomized controlled feasibility pilot trial will involve 60 recent-stroke survivors. Using a computer-generated sequence, patients will be randomly allocated into four clusters of 15 patients each per physician: two clusters in the intervention arm and two in the control arm. Patients in the intervention arm will receive a simple pillbox, a Blue-toothed UA-767Plus BT BP device and smartphone for monitoring and reporting BP measurements and medication intake under nurse guidance for 3 months. Tailored motivational text messages will be delivered based upon levels of adherence to the medication intake. Both groups will be followed up for 6 months to compare BP control at months 3, 6 and 9 as primary outcome measure. Physicians assessing BP control will be blinded to arms into which patients are allocated. Secondary outcome measures will include medication adherence scores and Competence and Autonomous Self-regulation Scale scores. A qualitative study is planned after follow-up to explore the lived experiences of participants in the intervention arm.

DISCUSSION

A feasible and preliminarily effective intervention would lead to a larger more definitive efficacy/effectiveness randomized controlled trial powered to look at clinical events, with the potential to reduce stroke-related morbidity and mortality in a low- to middle-income country.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02568137 , registered on 13 July 2015.

Self-Efficacy, Planning, or a Combination of Both? A Longitudinal Experimental Study Comparing Effects of Three Interventions on Adolescents' Body Fat

Background

The superiority of an intervention combining two sets of theory-based behavior change techniques targeting planning and self-efficacy over an intervention targeting planning only or self-efficacy only has rarely been investigated.

Purpose

We compared the influence of self-efficacy, planning, and self-efficacy+planning interventions with an education-based control condition on adolescents’ body fat, assuming mediating effects of respective social cognitive variables and moderate-to-vigorous physical activity (MVPA). The moderating role of the built environment was examined.

Methods

Participants (N = 1217, aged 14–18 years) were randomly assigned to four conditions: planning (n = 270), self-efficacy (n = 311), self-efficacy+planning (n = 351), and control (n = 285). The measurement was conducted at baseline (T1), two-month follow-up (T2), and fourteen-month follow-up (T3). Interventions/control group procedures were delivered at T1 and T2. Percent of body fat tissue (measured at T1 and T3) was the main outcome. Social cognitive mediators (self-efficacy and planning) were assessed at T1 and T2. The behavioral mediator (MVPA) and the presence of built MVPA facilities (the moderator) were evaluated at T1 and T3.

Results

Similar small increases of body fat were found across the three intervention groups, but the increment of body fat was significantly larger in the control group. On average, differences between control and intervention groups translated to approximately 1% of body fat. Effects of the interventions on body fat were mediated by relevant social cognitive variables and MVPA. A lower increase of body fat was found among intervention group participants who had access to newly-built MVPA facilities.

Conclusions

We found no superiority of an intervention targeting two social cognitive variables over the intervention targeting one cognition only.

Self-Efficacy and Planning as Predictors of Physical Activity in the Context of Workplace Health Promotion

BACKGROUND

Fostering self-efficacy and planning in individuals can support the uptake and maintenance of regular physical activity. This study examined self-efficacy and planning as mechanisms of an online-delivered workplace health promotion intervention to enhance employees' physical activity. A special focus lay on reciprocal interrelations among self-efficacy and planning over time, as previous work predominantly accounted for only one predictive direction at a time.

METHODS

Data from N = 1,063 employees of a pharmaceutical company who reported an intention to increase their physical activity levels were assessed at three measurement points up to 12 weeks following the intervention. Cross-lagged panel analyses were performed to examine effects of self-efficacy and planning on physical activity as well as reciprocal interrelations between self-efficacy and planning.

RESULTS

Findings indicated an increase in self-efficacy, planning, and physical activity following the intervention. Planning was consistently linked to subsequent physical activity, whereas self-efficacy was not associated. Also, reciprocal interrelations among self-efficacy and planning were found across both measurement lags.

CONCLUSIONS

Planning was confirmed as a predictor of physical activity, whereas self-efficacy was not. However, cross-lagged interrelations indicated reciprocal reactivation among self-efficacy and planning over time, suggesting beneficial effects of including strategies that foster both volitional constructs in interventions.

Revisiting self-regulatory techniques to promote physical activity in older adults: null-findings from a randomised controlled trial

OBJECTIVE

A randomised controlled trial (RCT) was conducted to evaluate a three-hour face-to-face physical activity (PA) intervention in community-dwelling older German adults with four groups: The intervention group (IG) received behaviour change techniques (BCTs) based on the health action process approach plus a views-on-ageing component to increase PA. The second intervention group 'planning' (IGpl) contained the same BCTs, only substituted the views-on-ageing component against an additional planning task. An active control group received the same BCTs, however, targeting volunteering instead of PA. A passive control group (PCG) received no intervention.

DESIGN

The RCT comprised 5 time-points over 14 months in N = 310 participants aged 64+.

MAIN OUTCOME MEASURES

Self-reported as well as accelerometer-assessed PA.

RESULTS

Neither PA measure increased in the IG as compared to the other groups at any point in time. Bayes analyses supported these null-effects.

CONCLUSION

A possible explanation for this null-finding in line with a recent meta-analysis is that some self-regulatory BCTs may be ineffective or even negatively associated with PA in interventions for older adults as they are assumed to be less acceptable for older adults. This interpretation was supported by observed reluctance to participate in self-regulatory BCTs in the current study.

A self-efficacy questionnaire regarding leisure time physical activity: Psychometric properties among Iranian male adolescents

BACKGROUND

Attention to different aspects of self-efficacy leads to actual evaluation of self-efficacy about physical activity. This study was carried out in order to design and determine psychometric characteristics of a questionnaire for evaluation of self-efficacy about leisure time physical activity (SELPA) among Iranian adolescent boys, with an emphasis on regulatory self-efficacy.

MATERIALS AND METHODS

This descriptive-analytic study was conducted in 734 male adolescents aged 15-19 years in Isfahan. After item generation and item selection based on review of literature and other questionnaires, content validity index (CVI) and content validity ratio (CVR) were determined and items were modified employing the opinions of expert panel (N = 10). Comprehensibility of the questionnaire was determined by members of target group (N = 35). Exploratory factors analysis (EFA) was operated on sample 1 (N 1 = 325) and confirmatory factors analysis (CFA) on sample 2 (N 2 = 347). Reliability of SELPA was estimated via internal consistency method.

RESULTS

According to EFA, barrier self-efficacy and scheduling self-efficacy are the two main aspects of SELPA with the total variance of 65%. The suggested model was confirmed by CFA and all fitness indices of the corrected model were good. Cronbach's alpha was totally estimated as 0.89 and for barrier and scheduling self-efficacy, it was 0.86 and 0.81, respectively.

CONCLUSIONS

The results provide some evidence for acceptable validity and reliability of SELPA in Iranian adolescent boys. However, further investigations, especially for evaluation of predictive power of the questionnaire, are necessary.

The Impact of the Project K Youth Development Program on Self-Efficacy: A Randomized Controlled Trial

A key issue for youth development programs is whether the learning they provide is transferred to participants' daily lives. It is also important that they are effective for the diverse range of participants they attract. This study used a randomized controlled trial design to measure the impact of Project K, a New Zealand-based youth development program, on academic and social self-efficacy. Project K combines a 3-week wilderness adventure, a 10 day community service component, and 1 year of mentoring to promote positive growth in 14-15 year olds with low self-efficacy. At baseline, the evaluation included 600 Project K (46 % female) and 577 Control participants (48 % female) and revealed that Project K was effective in improving both social and academic self-efficacy from pre- to post-program with effects being sustained 1 year later. Parents' perceptions of changes in the participants' interpersonal skills supported these findings. Differential program effects were found across participant subgroups, particularly 1 year after program completion. The implications of these differences are discussed.

Psychometric Properties of a Short Measure for Psychosocial Factors and Associations With Phase of Physical Activity Change Among Finnish Working-Aged Men

Insufficient physical activity (PA) and poor physical fitness are risks for several noncommunicable diseases among working-aged men. PA programs have been launched to increase activity levels in the population but working-aged men have been underrepresented in these programs. The aim of the present cross-sectional study was to evaluate validity of a short scale for psychosocial factors among Finnish working-aged men who participated in a PA campaign. The study examined also the associations between psychosocial factors and phase of PA change across fitness groups. Physical fitness was assessed with a body fitness index constructed on the basis of a handgrip test, the Polar OwnIndex Test, and body composition analysis (InBody 720). The men were classified into low ( n = 162), moderate ( n = 358), and high ( n = 320) body fitness index groups. Psychosocial factors and self-reported phase of PA change were assessed with a questionnaire. Psychometric properties of the scale were assessed with confirmatory factor analysis and differences between phases of PA change were examined with one-way analysis of variance. The evaluated scale included factors for self-efficacy, goal setting, skills, and social support. Good physical fitness was related to better perceived self-efficacy and ability to manage one's PA environment. Goal setting was critical for PA change at all fitness levels. Better understanding of the interactions between psychosocial factors and PA change could help in targeting PA programs to low-fit men. Further study should examine the validity of the improved psychosocial measure.

Self-efficacy versus perceived enjoyment as predictors of physical activity behaviour

OBJECTIVE

Self-efficacy and physical activity (PA) enjoyment are related to PA behaviour, but it is unclear which is more important and how they interrelate. The purpose of this study was to examine how these two constructs interrelate to influence PA behaviour.

DESIGN

Participants were low-active adults (n = 448) participating in a RCT examining the effect of a PA promotion intervention. Participants completed physical activity, enjoyment and self-efficacy measures at baseline, six and 12 months.

RESULTS

Self-efficacy and enjoyment at both baseline and six months predicted PA at 12 months. However, enjoyment was a stronger predictor than self-efficacy, in that self-efficacy no longer predicted PA behaviour when included alongside enjoyment. In follow-up mediation analyses, enjoyment at six months did not mediate the effect of baseline self-efficacy on 12-month PA; however, six-month self-efficacy mediated the effect of baseline enjoyment on 12-month PA.

CONCLUSION

Our results indicate that interventions should perhaps initially focus on increasing enjoyment of physical activity. Greater PA enjoyment appears to influence individuals' self-reported ability to engage in regular PA (i.e. higher self-efficacy ratings). Additional research is needed to better understand the interrelationships between self-efficacy and enjoyment and how these constructs affect PA.

Planning and self-efficacy interventions encouraging replacing energy-dense foods intake with fruit and vegetable: A longitudinal experimental study

OBJECTIVE

This longitudinal experimental study compared effects of self-efficacy, planning and education-based conditions, encouraging adolescents to eat fruit and vegetable in place of energy-dense foods.

DESIGN

Data were collected among 506 adolescents (13-18 years old) who were randomly assigned to control (n = 181), planning (n = 153) or self-efficacy (n = 172) conditions. Measurements were taken at baseline (T1), at a 2-month follow-up (T2), and at a 14-month follow-up (T3). Interventions/control group procedures were delivered at T1 and T2.

OUTCOME MEASURES

Self-reports of fruit and vegetable intake (FVI) and energy-dense foods intake were collected at three times. Cognitive mediators (self-efficacy and planning) were assessed at T1 and T2. Body weight and height were objectively measured at T1 and T3.

RESULTS AND CONCLUSIONS

Similar significant increases of FVI were found for planning and self-efficacy interventions (T3). The planning intervention did not influence energy-dense food intake (T3), but the self-efficacy intervention tended to result in stabilising intake (compared to an increase found in the control group). There were no effects on body weight. Similar patterns were found for the total sample and for a subsample of adolescents with overweight/obesity. The effects of interventions on FVI were mediated by respective cognitions.

Antecedents and mediators of physical activity in endometrial cancer survivors: Increasing physical activity through steps to health

OBJECTIVE

Research has shown that physical activity (PA) has a positive effect on cancer survivors, including improving quality of life, improving physical fitness, and decreasing risk for cancer recurrence in some cancer types. Theory-based intervention approaches have identified self-efficacy as a potential mediator of PA intervention. This study examines the temporal relationships at 4 time points (T1-T4) between several social-cognitive theory constructs and PA among a group of endometrial cancer survivors receiving PA intervention.

METHOD

A sample of 98 sedentary women who were at least 6 months posttreatment for endometrial cancer were given interventions to increase their PA. We tested whether modeling, physiological somatic sensations, and social support at previous time points predicted self-efficacy at later time points, which in turn would predict PA at later time points.

RESULTS

Results indicated that, as physiological somatic sensations at T2 decreased, self-efficacy at T3 increased, which led to an increase in PA at T4. This suggests that self-efficacy is a significant mediator between physiological somatic sensations and PA. Exploratory follow-up models suggest that model fit can be improved with the addition of contemporaneous effects between self-efficacy and PA at T3 and T4, changing the timing of the mediational relationships.

CONCLUSION

Physiological somatic sensations appear to be an important construct to target to increase PA in this population. Self-efficacy appeared to mediate the relationship between physiological somatic sensations and PA, but the timing of this relationship requires further study. (PsycINFO Database Record