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Nina Sperber, Katherine S. Hall, Kelli Allen, Brenda M. DeVellis, Megan Lewis and Leigh F. Callahan

Background:

Physical and psychological symptoms limit physical activity for people with arthritis. This study examined if self-efficacy mediated a relationship between symptom and physical activity (PA) frequency change.

Methods:

This was a secondary analysis of older adults with arthritis and joint pain in a trial of a lifestyle PA program (n = 339). Measures were depressive symptoms, pain, fatigue, arthritis self-efficacy, PA self-efficacy, and PA frequency. A panel model was used to analyze relationships at baseline and changes at 20 weeks.

Results:

The mean age was 68.8 years. At baseline, depression and fatigue were associated with arthritis self-efficacy (β = –.34 and –.24) and, in turn, PA self-efficacy (β = .63); PA self-efficacy was associated with PA (β = .15). Pain and depression changes were associated with arthritis self-efficacy change (β = –.20 and –.21) and, in turn, PA self-efficacy (β = .32) change; PA self-efficacy change was associated with PA change (β = .36).

Conclusion:

Change in symptom severity affected change in PA frequency. These relationships appeared to operate through self-efficacy. Over time, pain appeared to have a stronger relationship than fatigue with self-efficacy and PA. These findings support strategies to help people with arthritis strengthen their confidence for symptom coping and PA participation.

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Nina R. Sperber, Kelli D. Allen, Brenda M. DeVellis, Robert F. DeVellis, Megan A. Lewis and Leigh F. Callahan

Objective:

The authors explored whether demographic and psychosocial variables predicted differences in physical activity for participants with arthritis in a trial of Active Living Every Day (ALED).

Method:

Participants (N = 280) from 17 community sites were randomized into ALED or usual care. The authors assessed participant demographic characteristics, self-efficacy, outcome expectations, pain, fatigue, and depressive symptoms at baseline and physical activity frequency at 20-wk follow-up. They conducted linear regression with interaction terms (Baseline Characteristic × Randomization Group).

Results:

Being female (p ≤ .05), less depressed (p ≤ .05), or younger (p ≤ .10) was associated with more frequent posttest physical activity for ALED participants than for those with usual care. Higher education was associated with more physical activity for both ALED and usual-care groups.

Discussion:

ALED was particularly effective for female, younger, and less depressed participants. Further research should determine whether modifications could produce better outcomes in other subgroups.