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Jessica M. Lipschitz, Miryam Yusufov, Andrea Paiva, Colleen A. Redding, Joseph S. Rossi, Sara Johnson, Bryan Blissmer, N. Simay Gokbayrak, Wayne F. Velicer, and James O. Prochaska

This study examined longitudinal differences in use of transtheoretical model (TTM) behavior change constructs in maintainers (who reached and maintained exercise guidelines), relapsers (who reached guidelines, then regressed), and nonchangers (who did not reach guidelines). Data from two population-based TTM-tailored randomized trial intervention groups targeting exercise behavior (N = 1050) were pooled, and analyses assessed differences in TTM constructs between the three groups at baseline, 12 months, and 24 months. Findings indicated that relapsers tended to use TTM variables similarly to maintainers with the exception of self-efficacy, consciousness raising, and most behavioral processes of change, at 24 months. Nonchangers, however, used all TTM variables less than maintainers at nearly every time point. Findings suggest that relapsers remain more active than nonchangers in terms of use of change processes. Poor response to interventions (nonchangers) may be predicted by low baseline engagement in change processes. Although relapsers reverted to physical inactivity, their overall greater use of TTM constructs suggests that their efforts to change remain better than those of the stable nonchanger group. Future research can focus on treatment engagement strategies to help the stable nonchangers initiate change and to help relapsers to maintain treatment gains.

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Aoife Lane, Niamh Murphy, Adrian Bauman, and Tien Chey


To promote maintenance of sufficient physical activity (PA), better understanding of factors associated with behavioral relapse is needed.


To identify PA relapsers and predictors of this state in a large community sample of women who participated in 2 mass 10-km events in Ireland.


Relapsers to ‘low active’ were identified at 3-month follow-up, and factors associated with relapse investigated.


11% of the sample decreased their participation by at least 60 minutes of moderate-intensity PA per week and regressed to ‘insufficiently active.’ Adjusted analysis indicated relapse was associated with walking the event (OR = 1.40; 95% CI = 1.05−1.85) and not achieving tertiary education (OR = 1.49; 95% CI = 1.18−1.88). Normal-range BMI, training continuously, urban residence, and increases in self efficacy and positive perceptions of the physical environment were related to lower incidence of relapse.


Education, living in an urban area, BMI, walking the event, training, and self efficacy are all associated with relapse and while mass events are a useful motivator for PA, strategies are required following events to maintain participation levels and generate a lasting public health impact.

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Parminder K. Flora, Shaelyn M. Strachan, Lawrence R. Brawley, and Kevin S. Spink

Research on exercise identity (EXID) indicates that it is related to negative affect when exercisers are inconsistent or relapse. Although identity theory suggests that causal attributions about this inconsistency elicit negative self-conscious emotions of shame and guilt, no EXID studies have examined this for exercise relapse. Weiner’s attribution-based theory of interpersonal motivation (2010) offers a means of testing the attribution-emotion link. Using both frameworks, we examined whether EXID and attributional properties predicted negative emotions for exercise relapse. Participants (n = 224) read an exercise relapse vignette, and then completed EXID, attributions, and emotion measures. Hierarchical multiple regression models using EXID and the attributional property of controllability significantly predicted each of shame and guilt, R 2 adjusted = .09, ps ≤ .001. Results support identity theory suggestions and Weiner’s specific attribution-emotion hypothesis. This first demonstration of an interlinking of EXID, controllability, and negative self-conscious emotions offers more predictive utility using complementary theories than either theory alone.

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Yoojin Suh, Madeline Weikert, Deirdre Dlugonski, Brian Sandroff, and Robert W. Motl


Persons with multiple sclerosis (MS) are often physically inactive and sedentary. This observation has prompted the search for modifiable variables derived from established theories that act as correlates of physical activity. Such variables would presumably represent targets for interventions designed to promote change in physical activity behavior among persons with MS. The current study examined social cognitive variables as correlates of physical activity in persons with MS.


Persons (N = 218) with relapsing-remitting MS completed a questionnaire battery that assessed physical activity behavior; self-efficacy for physical activity; physical, social, and self-evaluative outcome expectations for exercise, functional limitations as an impediment for physical activity, and exercise goal-setting. The battery was delivered and returned through the US postal service. Data were analyzed using covariance modeling in Mplus 3.0.


Self-efficacy had indirect effects on physical activity via impediments (path coefficient = .10, P < .005), self-evaluative outcome expectations (path coefficient = .07, P < .025), and goal-setting (path coefficient = .09, P < .01). The model explained 40% of variance in self-reported physical activity.


This cross-sectional study suggests that self-efficacy is indirectly associated with physical activity by way of goals, self-evaluative outcome expectations, and impediments in persons with relapsing-remitting MS.

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Rafer S. Lutz, Marc R. Lochbaum, Beth Lanning, Lucinda G. Stinson, and Ronda Brewer

Blue-collar workers (N = 203) from a large food-processing plant in the south-western U.S. completed measures of perceived stress and leisure-time exercise at an initial test session in addition to a 2-month follow-up session. Mean age of the sample participants equaled 43.61 (SD = 9.79), and 69.5% of the sample were male, 71.4% were Caucasian, and 74.9% were married/cohabitating. Structural equation modeling was employed to examine the cross-lagged relationships between perceived stress and leisure-time exercise at these time points, controlling for gender, marital status, age, and yearly household income. Results indicated that a model with a path from perceptions of Time 1 stress to Time 2 exercise frequency was most parsimonious and provided acceptable model ft, suggesting that perceptions of stress are related to reductions in exercise participation in this population. However, there was little support for a relationship between Time 1 exercise participation and Time 2 perceived stress.

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Urte Scholz, Falko F. Sniehotta, and Ralf Schwarzer

During the process of health behavior change, individuals pass different phases characterized by different demands and challenges that have to be mastered. To overcome these demands successfully, phase-specific self-efficacy beliefs are important. The present study distinguishes between task self-efficacy, maintenance self-efficacy, and recovery self-efficacy. These phase-specific beliefs were studied in a sample of 484 cardiac patients during rehabilitation treatment and at follow-up 2 and 4 months after discharge to predict physical exercise at 4 and 12 months follow-up. The three phase-specific self-efficacies showed sufficient discriminant validity and allowed for differential predictions of intentions and behavior. Persons in the maintenance phase benefited more from maintenance self-efficacy in terms of physical exercise than persons not in the maintenance phase. Those who had to resume their physical exercise after a health related break profited more from recovery self-efficacy in terms of physical exercise than persons who were continuously active. Implications for possible interventions are discussed.

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Matthew J Smith and Oliver R. Runswick

) the recovery process to (f) relapsing. Rigor Numerous steps were taken to enhance the rigor of the study. For example, the second author acted as a critical friend to the first author at all stages of the research process, for example, in the data, by encouraging reflection upon interpretations of the findings

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Jenny H. Conviser, Amanda Schlitzer Tierney, and Riley Nickols

: MDTT communication, evidence-based practices, weight and medical monitoring protocols, guidelines for navigating levels of treatment, optimizing the benefits of treatment, and strategies for relapse prevention. Multidisciplinary Treatment Team Model A multidisciplinary treatment team (MDTT) of

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Afshin Moghadasi, Gholamali Ghasemi, Ebrahim Sadeghi-Demneh, and Masoud Etemadifar

were divided into 2 groups: control group (n = 15) and training group (n = 19) (Figure  1 ). Inclusion criteria included the following: (1) diagnosis of relapsing–remitting MS according to the McDonald’s criteria, 16 (2) an Expanded Disability Status Scale score less than 4, (3) being female and

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Peter R. Giacobbi Jr., Frederick Dietrich, Rebecca Larson, and Lesley J. White

The purpose of this study was to evaluate perceptions of quality of life after a 4-month progressive resistance training program for individuals with multiple sclerosis (MS). A second purpose was to examine participants’ views about factors that facilitated or impeded exercise behavior. Qualitative interviews were conducted with eight females (Mage = 49.86, SD = 6.94) with relapsing remitting MS. Audio-tape recorded interviews were transcribed verbatim and coded. Walking performance improved (M = 13.08%, SD = 7.11). All participants perceived improvements in muscular strength and endurance while six indicated improvements in walking endurance and performance in tasks of daily living. Social benefits of participation were discussed by seven participants including interactions in the exercise environment. We concluded that supervised resistance training may promote improvements in QOL for women with relapsing remitting MS.