Abstract
Multiple chronic diseases are caused or complicated by a sedentary lifestyle. Thus, an important and challenging application of psychology in clinical settings is changing the behavior of sedentary primary care patients. This study focused on exercise stage of change and self-efficacy in a sample of adult family practice patients recruited while waiting for their scheduled physician appointment. Regarding exercise stage of change, 15% of respondents were in the Precontemplation stage, 26% in the Contemplation stage, 50% in the Preparation stage, 7% in the Action stage, and 13% in the Maintenance stage. Mean self-efficacy scores for exercise were significantly higher among respondents in the Action and Maintenance stages of change. These cross-sectional data are consistent with the hypothesis that movement through the exercise stages of change could be encouraged by clinical interventions that increase exercise self-efficacy. The identification of multiple personal opportunities for increasing exercise self-efficacy may be clinically useful in this context. Recommendations for psychologists in primary care settings in their work with physicians are offered.
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REFERENCES
Bandura, A. (1977a). Self-efficacy: Toward a unifying theory of behavioral change. Psychology Review, 84, 191–215.
Bandura, A. (1977b). Social learning theory. Englewood Cliffs, NJ: Prentice-Hall.
Bandura, A., Adams, N. E., Hardy, A. B., & Howells, G. N. (1980). Tests of the generality of self-efficacy theory. Cognitive Therapy and Research, 4, 39–66.
Bandura, A. (1984). Recyclying misconceptions of perceived self-efficacy. Cognitive Therapy Research, 8, 231–255.
Bandura, A. (1986). Social foundations of thought and action. A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.
Blair, S. N. (1991). Living with exercise. Dallas, TX: American Health.
Brownell, K. D. (1990). Dieting readiness. Weight Control Digest, 1, 1–9.
Carmody, T. P., Senner, J. W., Manilow, M. R., & Matarazzo, J. D. (1980). Physical exercise rehabilitation: Long-term drop-out rate in cardiac patients. Journal of Behavioral Medicine, 3, 163–168.
Craighead, L. W., & Blum, M. D. (1989) Supervised exercise in behavioral treatment for moderate obesity. Behavior Therapy, 20, 49–59.
Derogatis, L., & Melisaratos, N. (1983). The Brief Symptom Inventory: An introductory report. Psychological Medicine, 13, 595–605.
Dubbert, P. M. (1992). Exercise in behavioral medicine. Journal of Consulting and Clinical Psychology, 60, 613–618.
Dubbert, P. A., Martin, J. E., Cushman, W. C., Meydrech, E. F., & Carroll, R. G. (1994). Endurance exercise in mild hypertension: effects on blood pressure and associated metabolic and quality of life variables. Journal of Human Hypertension, 8, 265–272.
Fagard, R. H. (1995). Prescription and results of physical activity. Journal of Cardiovascular Pharmacology, 25, (Suppl. 1), S20–S27.
Foreyt, J. P. (1987). Issues in the assessment and treatment of obesity. Journal of Consulting and Clinical Psychology, 55, 677–684.
Gilchrist, V., Miller, R. S., Gillanders, W. R., et al. (1993). Does family practice at residency teaching sites reflect community practice? Journal of Family Practice, 37(6), 555–563.
Harris, S. S., Caspersen, C. J., DeFriese, G. H., & Estes, H. (1989). Physical activity counseling for healthy adults as a primary preventive intervention in the clinical setting. JAMA 261(24), 3590–3589.
Kristal, A. R., Shattuck, A. L., Henry, H. J., & Fowler, A. S. (1990). Rapid assessment of dietary intake of fat, fiber, and saturated fat: Validity of an instrument suitable for community intervention research and nutrition surveillance. American Journal of Health Promotion, 4(4), 288–295.
Logue, E., Zeiger, T., Smucker, W., & Milo, L. (1996). Family physician gender, health behavior, and obesity realted counseling procedures (manuscript submitted for publication).
Marcus, B. H., Banspach, S. W., Lefebre, R. C., Rossi, J. S., Carleton, R. A., & Abrams, D. B. (1992). Using the stages of change model to increase the adoption of physical activity among community participants. American Journal of Health Promotion, 6(6), 424–429.
Marcus, B. H., Selby, V. C., Niaura, R. S., & Rossi, J. S. (1992). Self-efficacy and the stages of exercise behavior change. Research Quarterly for Exercise and Sport, 63(1), 60–66.
Marcus, B. H., Rossi, J. S., Selby, V. C., Niaura, R. S., & Abrams, D. B. (1992). The stages and processes of exercise adoption and maintenance in a worksite sample. Health Psychology, 11,(6), 386–395.
McAuley, E. (1992). The role of efficacy cognitions in the prediction of exercise behavior in middle-aged adults. Journal of Behavioral Medicine, 15, 65–88.
Paffenbarger, R. S., Kampert, J. B., Lee, I.-M., Hype, R. T., Leung, R. W., & Wing, A. L. (1994). Changes in physical activity and other lifeway patterns influencing longevity. Medicine and Science in Sports and Exercise, 857–865.
Patrick, K., Sallis, J. S., Long, B., Calfas, K. J., Wooten, W., Heath, G., & Pratt, M. (1994). A new tool for encouraging activity: Project PACE. The Physician and Sportsmedicine, 22(11), 45–52.
Pate, R. R., Pratt, M., Blair, S. N., Haslell, W. L., Macera, C. A., Bouchard, C., et al. (1994). Physical activity and public health, A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Journal of the American Medical Association, 273(5), 402–407.
Powell, K. E., Thompson, P. D., Caspersen, C. J., & Kendrick, J. S. (1987). Physical activity and the incidence of coronary heart disease. Annual Review of Public Health, 8, 253–287.
Prochaska, J. O. (1991). Assessing how people change. Cancer, 67(3), 805–807.
Prochaska, J. O. (1993). Working in harmony with how people change naturally. Rhode Island Medicine, 76, 491–493.
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change in smoking: Towards an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390–395.
Prochaska, J. O., & DiClemente, C. C. (1985). Common processes of self-change in smoking, weight control, and psychological distress. In S. Shiffman & T. Wills (Eds.), Coping and substance use (pp. 345–363). New York: Academic.
Prochaska, J. O., & DiClemente, C. C. (1992). Stages of change in the modification of problem behaviors. In M. Hersen, R. M. Eisler, & P. M. Miller (Eds.), Progress in behavior modification. Syacamore, Il: Sycamore.
Prochaska, J. O., DiClemente, C. C. & Norcross, J. C. (1992). In search of how people change. American Psychologist, 47(9), 1102–1114.
Prochaska, J. O., Velicer, W. F., Rossi, J. S., Goldstein, M. G., Marcus, B. H., Rakowski, Fiore, C., Harlow, L. L., Redding, C. A., Rosenbloom, D., & Rossi, S. R. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology, 13(1), 39–46.
Public Health Service (1991). Objectives 1.2, 2.3, 15.10 and 17.12. Healthy People 2000: National health promotion and disease prevention objectives. Washington, DC: U. S. Government Printing Office.
Rodgers, W. M., & Brawley, L. R. (1993). Using both self-efficacy theory and the theory of planned behavior to discriminate adherers and dropouts from structured programs. Journal of Applied Sport Psychology, 5, 195–206.
Rossi, S. R. (1993). Application of the Transtheoretical Model to dietary fat reduction in a naturalistic environment. Kingston: University of Rhode Island. (Published on Microfilm DAI, reference for dietary fat stage of change related measures.)
Rossi, J. S. (1995). Why do people fail to maintain weight loss? In D. B. Allison & F. X. Pi-Sunyer (Eds.), Obesity treatment: Establishing goals, improving outcomes, and reassessing the research agenda. New York: Plenum.
Rossi, S. R., Rossi, J. S., Rossi-DelPrete, L. M., Prochaska, J. O., Banspach, S. W., & Carleton, R. A. (1994). A process of change model for weight control for participants in community-based weight loss programs. International Journal of the Addictions, 29(2), 161–177.
Ryckman, R. M., Robbins, M. A., Thornton, B., & Contrell, P. (1982). Development and validation of a physical self-efficacy scale. Journal of Personality and Social Psychology, 42, 891–900.
Sallis, J. F., Pinski, R. B., Grossman, R. M., Patterson, T. L., et al. (1988). The development of self-efficacy scales for health-related diet and exercise behaviors. Health Education Research, 3,(3), 283–292.
Spangler, J. G., & Konen, J. C. (1993). Predicting exercise and smoking behaviors in diabetic and hypertensive patients. Archives of Family Medicine, 2, 149–155.
Special Medical Reports (1996). NIH develops consensus statement on the role of physical activity for cardiovascular health. American Family Physician 54(2), 763–767.
Strecher, V. J., DeVillis, B. M., Becker, M. H., & Rosenstock, I. M. (1986). The role of self-efficacy in achieving health behavior change. Health Education Quarterly, 13(1), 73–92.
Thompson, W. G. (1994). Exercise and health: Fact or hype? Southern Medical Journal, 87(5), 567–574.
U.S. Preventive Services Task Force (1989). In Exercise counseling: Guide to clinical preventive services (pp. 297–304). Baltimore, MD: Williams & Wilkins.
U.S. Public Health Service (1990). Healthy People 2000: National health promotion and disease prevention objectives. Washington, DC: U.S. Public Health Service, U.S. Deptartment of Health and Human Services publication 91-50212.
Will, P. M., Demko, T. M. & George, D. L. (1996) Prescribing exercise for health: A simple framework for primary care. American Family Physician, 53(2), 579–585.
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Cowan, R., Logue, E., Milo, L. et al. Exercise Stage of Change and Self-Efficacy in Primary Care: Implications for Intervention. Journal of Clinical Psychology in Medical Settings 4, 295–311 (1997). https://doi.org/10.1023/A:1026237432292
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DOI: https://doi.org/10.1023/A:1026237432292