Associations of Constructs of Transtheoretical Model With Physical Activity Behavior Among Individuals With Essential Hypertension

[Association between transtheoretical model and physical activity in patients with hypertension]

OBJECTIVE

To identify the association between the transtheoretical model (TTM) and physical activity (PA) carried out in free time in patients with arterial hypertension in the central region of Mexico.

DESIGN

Comparative cross-sectional study. SITE: The study was carried out in the Family Medicine Unit No.1 (UFM1) of the Mexican Social Security Institute in Aguascalientes, Mexico.

PARTICIPANTS

Four hundred thirty-five adults aged 40 to 70 with arterial hypertension who attended the outpatient clinic at UFM1 were included.

INTERVENTIONS

The Global Physical Activity Questionnaire and the Stages of Change algorithm from the TTM were applied.

MAIN MEASUREMENTS

A descriptive, bivariate analysis and ordinal logistic regression were performed to evaluate the association between TTM stages and PA.

RESULTS

As patients progress through the stages of change, their weekly PA increased. Individuals in the action, maintenance and consolidation stages were significantly more likely to perform higher levels of exercise: 20 times more likely in the action stage with an ordinal odds ratio (OR) of 20.07 (CI95%: 10,52-38,25), 24 times more in the maintenance stage with OR 24 (CI95%: 12,79-47,63) and 40 times more in the consolidation stage with OR 40,35 (IC95%: 19,25-84,59).

CONCLUSIONS

The strong association between the stages of change and PA reveals the importance of applying the TTM to achieve success in programs to promote healthy habits by designing strategies that suit each subject.

Blood pressure management protocol based on transtheoretical model effectiveness on self- care: A systematic review

Background

Hypertension is a prevalent medical condition associated with cardiovascular and kidney diseases, leading to premature death and disability. Despite medication use, hypertension continues to rise due to unhealthy lifestyles. Self-care strategies play crucial roles in effectively treating hypertension. We aimed to evaluate the effectiveness of interventions based on the transtheoretical model (TTM) in improving self-care, self-efficacy, and health-related quality of life (HRQOL) in hypertensive adults.

Methods

A comprehensive search was performed in multiple databases using appropriate search strategies. Two independent reviewers screened articles, and assessed their adherence to the inclusion and exclusion criteria. The risk of bias in randomized controlled trials was assessed by the Cochrane Collaboration tool and quasi-experimental studies using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Quasi-Experimental Studies.

Results

The review included 24 studies with a total of 6553 participants. Most interventions aimed to encourage a healthier lifestyle and improve diet and physical activity. The message was delivered through various methods such as slide/tape messages, individual education/counseling sessions, telephone-delivered interventions, and multimedia training software based on the TTM. Control groups received physician visits or attended lifestyle lectures but did not receive specific behavior change programs like the intervention groups.

Conclusion

Our results indicated that the TTM and stage of change model can be an appropriate framework for delivering educational messages to patients.