The role of control beliefs in predicting physical activity among Active Living Every Day participants with arthritis Public Deposited

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  • March 22, 2019
Creator
  • Sperber, Nina R.
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
Abstract
  • Physical activity promotion constitutes an important public health approach to managing arthritis, the leading cause of disability in the US. Many people with arthritis have good outcomes with lifestyle physical activity. However, we do not know why some fare better than others. Perceived control over exercise ability and outcomes have predicted physical activity in other studies, but less is known about how these beliefs relate to physical activity within the context of arthritis. I explored the role of these factors in predicting physical activity among participants with arthritis in Active Living Every Day (ALED) , a theory-informed lifestyle physical activity program originally designed for people without arthritis. I analyzed baseline and post-test data of the intervention group from an evaluation of ALED for people with arthritis. Candidate predictors were depressive symptoms, physical symptoms, and control beliefs (helplessness, arthritis and exercise self-efficacy, and exercise outcome expectations). Hierarchical linear regression was used to examine baseline predictors of post-intervention physical activity and function. A second analytic approach used multiple mediation to test relationships posited in Social Cognitive Theory. I examined whether physical and depressive symptoms affected physical activity via exercise and arthritis symptom self-efficacy and whether outcome expectations mediated between these types of self-efficacy and physical activity. The final analyses replicated these mediation analyses but with only post-test measures of efficacy and outcome expectations. The final sample consisted of 143 intervention participants. Their mean age was 68 years, and the majority were female (86%) and white (75%). Slightly more than half (55%) had above a high school education. Control beliefs emerged as influential beyond arthritis symptoms in both the hierarchical regression and mediation analyses. Post-test outcome expectations also significantly mediated the relationship between baseline self-efficacy and post-test physical activity. Higher education predicted more physical activity. Depressive symptoms did not predict physical activity. Because control beliefs at both the beginning and end of the intervention were important predictors of physical activity outcomes, even more attention needs to be given to them in interventions directed at people with arthritis. Lifestyle physical activity interventions for people with arthritis might be more effective with greater attention given to cognitive behavioral techniques for both exercise and symptom management. Additionally, program material that meets needs of those with less formal education could yield better outcomes for more participants.
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  • In Copyright
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  • "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Health Behavior and Health Education of the School of Public Health."
Advisor
  • DeVellis, Brenda M.
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  • Chapel Hill, NC
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  • Open access
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