A 20-week behavioral study was conducted involving adult males (N = 66) in programs of cardiovascular and muscular endurance training. The relationship between exercise adherence and selected psychological and biological variables was examined as was the ability of these variables to discriminate between exercise adherers and dropouts. Results indicated that percent body fat, self-motivation, and body weight discriminated (p < .05) between eventual adherers and dropouts. When combined within a psychobiologic prediction model, these variables accurately classified actual adherers and dropouts in approximately 80% of all cases and accounted for nearly 50% of the variance in adherence behavior. In addition, participants symptomatic with regard to coronary heart disease adhered for a shorter period of time (p < .01) than did those who were asymptomatic. Results did not support theoretical expectations related to the roles of attitude toward physical activity, self-perceptions of physical ability, or locus of health control in the adherence process. These data suggest that the assessment of self-motivation and body composition may substantially enhance the initial diagnosis of the dropout-prone exercise participant and may ultimately assist in adherence facilitation.
Rod K. Dishman and Larry R. Gettman
Marina L. McCready and Bonita C. Long
The purpose of this investigation was to examine the relationship between exercise adherence and the combined effects of locus of control and attitudes toward physical activity. The primary instruments used were the Internal, Powerful Others, and Chance Scales (Levenson, 1974); the Exercise Objectives Locus of Control Scales (developed by the first author); and the Revised Children's Attitudes Toward Physical Activity Inventory (Schutz, Smell, & Wood, 1981a). The subjects were 61 females, ages 15-57 (M = 28), voluntarily participating in 8- to 12-week aerobic fitness programs. Findings indicated only a weak relationship between adherence and the combination of locus of control and attitudes. Results of stepwise regression analysis revealed that two attitude measures were the best predictors of exercise adherence. In general, those subjects who at the outset of the programs had a less positive attitude toward participating in physical activity for continuing social relations and a more positive attitude toward participating in order to reduce stress and tension tended to have a higher percent attendance.
Eva-Carin Lindgren and Bengt Fridlund
The purpose of this study was to develop a theoretical understanding of what could influence exercise adherence in physically non-active young women. Interviews with twelve physically nonactive young women were strategically selected and analyzed by grounded theory. The results were that several factors could influence exercise adherence in physically non-active young women, and that these factors can be regarded as a number of interrelated dimensions. The influence was coming either from the exercise or from the environment connected to the exercise. The participants wanted to feel enjoyment and to learn something during the exercise (recreation/learning influence). They also wanted to feel belongingness during the exercise (social influence). An influence that promotes health or builds skills (investment influence) could be a trigger to start exercising among the participants, but not to maintain exercise adherence. Influence coming from the environment (enabling influence) was both important and stimulating for physically non-active young women in establishing regular exercise. It is important to present the model developed in this study to communities, sports federations and other authorities working with health promotion activities so that they can explore innovative ways to promote exercise adherence among physically non-active young women. Good examples could be to offer non-competitive sports as well as to develop well-designed exercise programs for physically non-active young women.
Nathalie André and Rod K. Dishman
Exercise adherence involves a number of sociocognitive factors that influence the adoption and maintenance of regular physical activity. Among traitlike factors, self-motivation is believed to be a unique predictor of persistence during behavior change. The aim of this study was to validate the factor structure of a French version of the Self-Motivation Inventory (SMI) and to provide initial convergent and discriminant evidence for its construct validity as a correlate of exercise adherence.
Four hundred seventy-one elderly were recruited and administered the SMI-10. Structural equation modeling tested the relation of SMI-10 scores with exercise adherence in a correlated network that included decisional balance and perceived quality of life.
Acceptable evidence was found to support the factor validity and measurement equivalence of the French version of the SMI-10. Moreover, self-motivation was related to exercise adherence independently of decisional balance and perceived quality of life, providing initial evidence for construct validity.
Rebecca A. Seguin, Christina D. Economos, Ruth Palombo, Raymond Hyatt, Julia Kuder and Miriam E. Nelson
Despite the recognized health benefits, few older women participate in strength-training exercises.
The purpose of this study was to examine factors related to older women’s adherence to strength training after participation in the Strong Women Program, a nationally disseminated community program. Adherence was defined as ≥4 months of twice-weekly strength training. Surveys were sent to 970 program participants from 23 states and to participants’ corresponding program leaders. Five-hundred fifty-seven participants responded (57%).
Of respondents who completed surveys (527), 79% (415) adhered to strength training; adherers reported a mean of 14.1 ± 9.1 months of strength training. Logistic-regression analysis revealed that exercise adherence was positively associated with age (p = .001), higher lifetime physical activity levels (p = .045), better perceived health (p = .003), leader’s sports participation (p = .028), and leader’s prior experience leading programs (p = .006).
These data lend insight to factors that may be related to exercise adherence among midlife and older women.
David M. Williams, Shira Dunsiger, Jessica A. Emerson, Chad J. Gwaltney, Peter M. Monti and Robert Miranda Jr.
Affective response to exercise may mediate the effects of self-paced exercise on exercise adherence. Fiftynine low-active (exercise <60 min/week), overweight (body mass index: 25.0–39.9) adults (ages 18–65) were randomly assigned to self-paced (but not to exceed 76% maximum heart rate) or prescribed moderate intensity exercise (64–76% maximum heart rate) in the context of otherwise identical 6-month print-based exercise promotion programs. Frequency and duration of exercise sessions and affective responses (good/bad) to exercise were assessed via ecological momentary assessment throughout the 6-month program. A regression-based mediation model was used to estimate (a) effects of experimental condition on affective response to exercise (path a = 0.20, SE = 0.28, f 2 = 0.02); (b) effects of affective response on duration/latency of the next exercise session (path b = 0.47, SE = 0.25, f 2 = 0.04); and (c) indirect effects of experimental condition on exercise outcomes via affective response (path ab = 0.11, SE = 0.06, f 2 = 0.10). Results provide modest preliminary support for a mediational pathway linking self-paced exercise, affective response, and exercise adherence.
Kerry R. McGannon and Michael K. Mauws
Despite a great deal of research encompassing personal, interpersonal, and socio-environmental realms, the widespread prevalence of sedentary lifestyles would indicate that there is still much to be learned about individuals' inability to adhere to exercise programs. Building on Bourdieu’s assertion that three modes of knowledge are required for a satisfactory understanding of the social world, in this paper we argue that current understandings are limited by their reliance on subjectivist and/or objectivist modes of understanding. We suggest that what is necessary is a third, praxeological mode of understanding if we are to satisfactorily address the exercise adherence problem. Toward this end, we describe how ethnomethodological and poststructuralist perspectives can be usefully combined to explore the adherence problem from a praxeological perspective.
Ikuyo Imayama, Catherine M. Alfano, Caitlin E. Mason, Chiachi Wang, Liren Xiao, Catherine Duggan, Kristin L. Campbell, Karen E. Foster-Schubert, Ching-Yun Wang and Anne McTiernan
Regular exercise increases exercise self-efficacy and health-related quality of life (HRQOL); however, the mechanisms are unknown. We examined the associations of exercise adherence and physiological improvements with changes in exercise self-efficacy and HRQOL.
Middle-aged adults (N = 202) were randomized to 12 months aerobic exercise (360 minutes/week) or control. Weight, waist circumference, percent body fat, cardiopulmonary fitness, HRQOL (SF-36), and exercise self-efficacy were assessed at baseline and 12 months. Adherence was measured in minutes/day from activity logs.
Exercise adherence was associated with reduced bodily pain, improved general health and vitality, and reduced role-emotional scores (P trend ≤ 0.05). Increased fitness was associated with improved physical functioning, bodily pain and general health scores (P trend ≤ 0.04). Reduced weight and percent body fat were associated with improved physical functioning, general health, and bodily pain scores (P trend < 0.05). Decreased waist circumference was associated with improved bodily pain and general health but with reduced role-emotional scores (Ptrend ≤ 0.05). High exercise adherence, increased cardiopulmonary fitness and reduced weight, waist circumference and percent body fat were associated with increased exercise self-efficacy (P trend < 0.02).
Monitoring adherence and tailoring exercise programs to induce changes in cardiopulmonary fitness and body composition may lead to greater improvements in HRQOL and self-efficacy that could promote exercise maintenance.
Minyoung Lee, Min Joo Kim, Dongwon Suh, Jungjin Kim, Eunkyoung Jo and BumChul Yoon
Little is known about the effectiveness of self-determination theory (SDT), a representative motivational theory, on exercise domain in older adults. This feasibility study used quantitative and qualitative approaches to evaluate the effectiveness of a 13-month group exercise program applying SDT-based motivational strategies on exercise adherence, physical fitness, and quality of life, and to explore factors affecting exercise adherence in South Korean older adults (N = 18). Exercise attendance rate was high (82.52%). There were significant differences in aerobic endurance (p < .001), lower body strength (p < .05), dynamic balance (p < .001), and perceived social functioning (p < .05) at 13 months compared with baseline. Factors affecting exercise adherence were related to the SDT-based motivational strategies. These results support the importance of health professionals applying SDT-based motivational strategies to exercise programs to help facilitate motivation for participation and to promote physical fitness and quality of life in older adults.
Seung-Youn Hong, Susan Hughes and Thomas Prohaska
Many different constructs are used currently in the literature to assess exercise adherence. This study examined whether the same or different variables predict exercise attendance and exercise completion among sedentary older adults.
Thirty-seven randomized control trials were selected from articles published between 1980 and 2000 that tested exercise interventions for sedentary older adults. Block-entry, weighted, hierarchical meta-regression analyses were conducted.
Different factors predicted attendance and completion. Group-based (P < .05) and resistance exercise (P < .1) predicted higher attendance rates than individual-based and aerobic exercise. In contrast, facility-based exercise was associated with higher completion rates than home-based exercise (P < .1).
Results show that completing a program is not synonymous with good attendance. Program designers need to consider different strategies to boost both of these rates that need to be maximized to best benefit program participants.