Search Results

You are looking at 1 - 10 of 21 items for

  • Author: Sara Wilcox x
  • Refine by Access: All Content x
Clear All Modify Search
Restricted access

Behavioral Interventions and Physical Activity in Older Adults: Gains and Gaps

Sara Wilcox

There is strong evidence that older adults greatly benefit from regular physical activity. Yet, older age is consistently associated with lower levels of aerobic physical activity and strength training and higher levels of sedentary behavior, underscoring the need to better understand physical activity behavior in this population. Reviews of interventions to increase physical activity have overall yielded promising results. Interventions based on behavior theory appear to be more effective than non-theory-based interventions, yet strategies from these theories are underutilized in both research and practice. This paper discusses the importance of behavioral interventions, cites findings from the Active for Life initiative to illustrate several key concepts, and provides recommendations to address significant gaps in the literature, including the use of theory, mediation analyses, physical activity maintenance, diversity of participants, and dissemination and translational research.

Restricted access

Predictors of Physical Activity 6 Months Postintervention in the Active for Life Initiative

Meghan Baruth and Sara Wilcox

Background:

Understanding who is most and least likely to remain active after the completion of physical activity (PA) interventions can assist in developing more targeted and effective programs to enhance prolonged behavior change. The purpose of this study was to examine predictors of meeting PA recommendations 6 months postintervention in participants enrolled in Active for Life.

Methods:

Participants from 2 behavioral PA programs [158 Active Choices (AC); 1025 Active Living Every Day (ALED)] completed surveys 6 months after completion of the active intervention. Analyses examined predictors of meeting PA recommendations at follow-up.

Results:

The following were significant predictors: In ALED: self-report health status, satisfaction with body function, and self-efficacy at baseline; PA status at posttest; changes in self-efficacy, perceived stress, and satisfaction with body function and appearance from baseline to posttest. In AC: PA status at posttest.

Conclusions:

The ultimate goal of health promotion programs is to teach the behavioral skills necessary to sustain behavior change once an active intervention is complete. The findings from this study suggest that predicting PA behavior after cessation of PA interventions may not be straightforward, and predictor variables may operate differently in different intervention approaches.

Restricted access

The Effects of Life Events and Interpersonal Loss on Exercise Adherence in Older Adults

Sara Wilcox and Abby C. King

Associations of life events and interpersonal loss with participation in home-and group-based exercise were studied in 97 older adults (64% women, 70.2 ± 4.1 years). Life events were assessed with a modified Social Readjustment Rating Scale at baseline and 6 and 12 months. Exercise logs and class-attendance records documented exercise participation. Participants experienced 3.62 ± 3.56 unique life events over the course of the study, and 28 participants reported an interpersonal loss (5 men, 23 women). Number of life events was negatively associated with home-based exercise participation (p < .05); among women, this association approached significance (p = .06) for class-based exercise. Women who experienced an interpersonal loss had lower class-based participation than those who did not (p = .02), but home-based participation rates were unaffected. Life events, particularly interpersonal loss, appear to have a negative impact on exercise in women, and this effect appears greater for class-based than for home-based exercise.

Restricted access

Predictors of Weight Loss for African-American Women in the Faith, Activity, and Nutrition (FAN) Study

Rebecca Kyryliuk, Meghan Baruth, and Sara Wilcox

Background:

Understanding predictors of weight loss can assist in developing targeted evidence-based programs to reduce obesity in faith-based settings. The purpose of this study was to examine predictors of weight loss for a sample of African-American women taking part in in a church-based study.

Methods:

Participants (N = 350) completed physical assessments and comprehensive surveys at baseline and 15 months later. Analyses examined baseline variables and change in variables from baseline to posttest, as predictors of ≥ 5% weight loss at posttest. Demographic, health-related, and behavioral variables were examined.

Results:

Lower baseline stress predicted greater likelihood of weight loss. Increased leisure-time physical activity (LTPA) from baseline to posttest was predictive of greater weight loss. The odds of ≥ 5% weight loss was 38% lower for every 1-point increase in baseline stress (OR = 0.62, CI = 0.39, 0.98, P = .04) and 6% greater for every 1-hour increase in posttest LTPA (OR = 1.06, CI = 1.0, 1.12, P = .049).

Conclusions:

Increased LTPA appears to be an independent predictor of modest but meaningful reductions in weight among African-American women. African-American women reporting higher levels of stress at baseline may require more intense strategies emphasizing increased LTPA to lose weight.

Restricted access

Psychometric Properties of the Self-Efficacy for Exercise Questionnaire in a Diverse Sample of Men and Women

Sara Wilcox, Patricia A. Sharpe, Brent Hutto, and Michelle L. Granner

Background:

Self-efficacy is a consistent correlate of physical activity, but most self-efficacy measures have not been validated in diverse populations. This study examined the construct, criterion-related, and convergent validity and internal consistency of the Self-Efficacy for Exercise Questionnaire.

Methods:

African American and Caucasian adults (N = 1919) from two adjacent counties in South Carolina were identified through a list-assisted random digit-dialed telephone survey. Psychometric properties of the measure were assessed by gender, race, age, education, and body weight subgroups.

Results:

Across all subgroups, a single-factor solution explained 93 to 98% of the common variance in an exploratory factor analysis, and all 14 items had factor loadings exceeding 0.40. Higher exercise self-efficacy was significantly associated with greater physical activity, younger age, male gender, higher education, and lower body weight, as predicted. Internal consistency was high for all subgroups (α = 0.90 to 0.94).

Conclusion:

The Self-Efficacy for Exercise Questionnaire appears to be a valid and reliable measure for use with diverse populations.

Restricted access

Sumter County on the Move! Evaluation of a Walking Group Intervention to Promote Physical Activity Within Existing Social Networks

Melinda Forthofer, Sara Wilcox, Deborah Kinnard, Brent Hutto, and Patricia A. Sharpe

Background: Social network–driven approaches have promise for promoting physical activity in community settings. Yet, there have been few direct investigations of such interventions. This study tested the effectiveness of a social network–driven, group-based walking intervention in a medically underserved community. Methods: This study used a quasi-experimental pretest–posttest design with 3 measurement time points to examine the effectiveness of Sumter County on the Move! in communities in Sumter County, SC. A total of 293 individuals participated in 59 walking groups formed from existing social networks. Participants were 86% females, 67% black, and 31% white, with a mean age of 49.5 years. Measures included perceptions of the walking groups; psychosocial factors such as self-regulation, self-efficacy, and social support; and both self-reported and objectively measured physical activity. Results: The intervention produced significant increases in goal setting and social support for physical activity from multiple sources, and these intervention effects were sustained through the final measurement point 6 months after completion of the intervention. Nonetheless, few of the desired changes in physical activity were observed. Conclusion: Our mixed results underscore the importance of future research to better understand the dose and duration of intervention implementation required to effect and sustain behavior change.

Restricted access

Measuring Physical Activity Self-Regulation Strategies in Older Adults

Michelle Renee Umstattd, Rob Motl, Sara Wilcox, Ruth Saunders, and Melissa Watford

Background:

Theoretically, self-regulatory strategies (eg, goal setting, self-monitoring) are an important influence of behavior change, but very little research has examined the relationship between self-regulation and physical activity (PA) behavior. Petosa’s (1993) 43-item PA self-regulation scale (PASR-43) affords the opportunity for studying this construct in the context of PA; however the PASR-43 has not been tested for structural aspects of validity. Therefore, this study examines the structural validity of the PASR-43 in older adults.

Methods:

The structural validity of the PASR-43 was tested in a large sample of older adults from North and South Carolina and Ohio (N = 460) using maximum likelihood estimation and confirmatory factor analysis in AMOS 5.0.

Results:

The original 6-factor model for the PASR-43 scale did not represent an acceptable fit to the data (x2 = 4732.25, df = 845, P < .0001, RMSEA = 0.10, NNFI = 0.67, CFI = 0.71). Based on a post hoc specification search, iterative model modifications resulted in a 12-item PA self-regulation scale (PASR-12) that represented an excellent fit to the data (x2 = 70.75, df = 39, P = .001, RMSEA = 0.04, NNFI = 0.98, CFI = 0.99).

Conclusions:

The PASR-12 provides a concise and valid measure of PA self-regulation for use with older adults. Future studies should cross-validate the PASR-12 and examine invariance across time and between age, ethnic, gender, and geographical groups.

Full access

Effects of Home-Based Walking on Quality of Life and Fatigue Outcomes in Early Stage Breast Cancer Survivors: A 12-Week Pilot Study

Meghan Baruth, Sara Wilcox, Cheryl Der Ananian, and Sue Heiney

Background:

Adjuvant treatment for breast cancer may result in long-lasting, adverse emotional and physical side effects, and reduce quality of life (QOL). This pilot study examined the effects of a home-based walking program on QOL and fatigue in early stage breast cancer survivors and whether changes in walking behavior were associated with changes in outcomes.

Methods:

Participants (n = 32) were randomized to a 12-week home-based walking intervention plus brief telephone counseling (n = 20) or a wait-list control group (n = 12). Self-reported fatigue, QOL, and walking were assessed at baseline and 12-weeks. Results are presented as effect sizes.

Results:

Participants in the intervention had improvements in a majority of fatigue and QOL outcomes, whereas the control group had no change or worsened in many; effect sizes were generally in the small to medium range. Changes in fatigue/QOL outcomes were associated with changes in walking behavior, with effects generally in the small to medium range.

Conclusion:

Home-based physical activity (walking) programs may be an appropriate avenue for alleviating the adverse side effects that often accompany adjuvant treatment for breast cancer. These programs have potential for widespread dissemination, which may have considerable impact on the quality of life of women recently completing breast cancer treatment.

Full access

Characteristics of Walking Group Leaders as Compared with Walking Group Members in a Community-Based Study

Sara Wilcox, Melinda Forthofer, Patricia A. Sharpe, and Brent Hutto

Background:

Walking interventions delivered by lay leaders have been shown to be effective. Knowing the characteristics of individuals who volunteer to be group leaders in walking programs could facilitate more efficient and effective recruitment and training.

Methods:

Walking group leaders were recruited into a community-based program and formed walking groups from existing social networks. Leaders and members completed a survey, participated in physical measurements, and wore an accelerometer. Regression models (adjusting for group clustering and covariates) tested psychosocial and behavioral differences between leaders and members.

Results:

The sample included 296 adults (86% women, 66% African American). Leaders (n = 60) were similar to members (n = 236) with respect to most sociodemographic and health characteristics, but were significantly older and more likely to report arthritis and high cholesterol (P-values < .05). Although leaders and members were similar in sedentary behavior and physical activity, leaders reported higher levels of exercise self-regulation, self-efficacy, and social support (P-values < .01). Leaders also reported greater use of outdoor trails (P = .005) and other outdoor recreation areas (P = .003) for physical activity than members.

Conclusion:

Although walking group leaders were no more active than members, leaders did display psychosocial characteristics and behaviors consistent with a greater readiness for change.

Restricted access

Factors Associated with Exercise Participation in Adults with Arthritis

Cheryl Der Ananian, Sara Wilcox, Ken Watkins, Ruth P. Saunders, and Alexandra E. Evans

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.