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Biomedical subjects

K S Courneya

Publications and source records attributed to K S Courneya.

17 recordsLinked to original sources
PubMed1998

Transtheoretical Model: examining adolescent exercise behavior.

PURPOSE: The entire Transtheoretical Model, consisting of stages of change, processes of change, self-efficacy, and decisional balance, was tested for its applicability to understanding exercise behavior in an adolescent population. METHODS: Students (n = 819) from five community high schools (Grades 9-12) completed self-administered questionnaires, all of which were adapted from previous literature. Stage of exercise behavior change served as the dependent variable. RESULTS: Distribution of the sample across the stages was: precontemplation, n = 17 (2.1%); contemplation, n = 34 (4.2%); preparation, n = 235 (28.7%); action, n = 129 (15.7%); and maintenance, n = 404 (49.3%). Univariate analyses of variance (p < 0.0038) followed up with Tukey's post-hoc analyses revealed that all of the constructs differed significantly across stages. Profile analysis indicated that pros and cons intersected in the action stage using t scores; however, when analyzing raw scores, this intersection was found to be in the precontemplation stage. DISCUSSION: Preliminary evidence was found for the applicability of the Transtheoretical Model to adolescents. The low rate of adolescents in the precontemplation and contemplation stages was not deemed a major limitation, owing to the purpose of the investigation.

Adolescent↗
PubMed1998

The lifetime total physical activity questionnaire: development and reliability.

OBJECTIVE: To develop and test the intra-rater reliability of an interview-administered questionnaire that assesses lifetime patterns of total physical activity including occupational, household, and exercise/sports activities. METHODS: The questionnaire was developed and pretested using cognitive interviewing techniques on a sample of women with and without previous breast cancer diagnoses. A pilot study was conducted with 115 women who were interviewed twice, 6 to 8 wk apart by interviewers trained in cognitive interviewing methods. Respondents used recall calendars to record their education, occupations, life events, and physical activity patterns before the interviews. Interviewers helped respondents recall their lifetime exposures, including their occupational, household, and exercise/sports activities, using these calendars and memory-probing strategies. Activity levels were estimated as the average number of hours of activity per week over different time periods. Means and correlation coefficients were estimated and compared for the two time periods. RESULTS: The questionnaire was found to be highly reliable. The test-retest correlations for hours per week spent in total lifetime physical activity was 0.74, for lifetime occupational activity was 0.87, for household activity was 0.77, and for exercise/sports activities was 0.72. CONCLUSIONS: This is the first questionnaire to measure lifetime physical activity by collecting data on each type of physical activity separately over lifetime and by measuring frequency, intensity, and duration of each activity. It is also the first physical activity questionnaire to be developed, refined, and administered using cognitive-based methods employed in survey research. Respondents were able to reliably recall their lifetime physical activity patterns. This instrument can be used for any disease outcome for which physical activity may be a risk factor.

Breast Neoplasms↗
PubMed1997

Maintaining attendance at a fitness center: an application of the decision balance sheet.

The effect of a decision balance sheet intervention on attendance at a university fitness facility was examined. Facility members were randomly assigned to control, placebo, and experimental conditions. The control condition received no intervention, whereas the placebo and experimental conditions were called by telephone and asked to complete either an irrelevant (smoking) or relevant (exercising at the fitness facility) decision balance sheet. Attendance was monitored surreptitiously for 4 weeks baseline and 8 weeks post intervention. Statistical analyses indicated that the control and placebo conditions showed a significant decrease in attendance from baseline to intervention, whereas those in the experimental condition maintained attendance levels. Discussion focused on broadening the application of the decision balance sheet, determining its theoretical boundaries, and the necessity and appropriateness of decision alternatives for the decision balance sheet in the exercise domain.

Adolescent↗
PubMed1997

Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors.

The purpose of this study was to identify the main exercise patterns of colorectal cancer survivors across the cancer experience and determine their relationship with current quality of life (QOL). Participants were 130 colorectal cancer survivors who were diagnosed within the previous 4 years and had received adjuvant treatment. Each participant completed a mailed, self-administered questionnaire that assessed exercise behavior at three time points (prediagnosis, active treatment, posttreatment), current QOL (physical, functional, emotional, social), and overall satisfaction with life (SWL). Colorectal cancer survivors exhibited four main exercise patterns across the cancer experience which were labeled maintainers (active at all three time points), temporary relapsers (active prediagnosis, inactive during treatment, active posttreatment), permanent relapsers (active prediagnosis, inactive during treatment, inactive posttreatment), and nonexercisers (inactive at all three time points). Statistical analyses showed that: (a) functional QOL was the least possessed but most important QOL dimension underlying overall SWL, (b) exercise levels decreased from prediagnosis to active treatment and then increased from active treatment to posttreatment but not back to prediagnosis levels, and (c) permanent relapsers reported the lowest QOL of the four main exercise patterns. It was concluded that cancer treatment has a negative impact on exercise levels and that those previously active individuals who fail to reinitiate exercise after cancer treatment experience the lowest QOL 1 to 4 years later. Findings are discussed in reference to previous research along with suggestions for future research, practical implications, and limitations of the study.

Activities of Daily Living↗
PubMed1997

A simple reinforcement strategy for increasing attendance at a fitness facility.

The purpose of the present study was to examine the effect of a previously untested reinforcement strategy (i.e., 1 month's free membership) on attendance at a fitness facility. Participants were paying members of a fitness facility randomly assigned to control (n = 100), placebo (n = 100), and reinforcement (n = 100) conditions. The control condition received no intervention; the placebo condition received a letter by mail; and the reinforcement condition received the same letter by mail, except that it included an additional paragraph instructing them that they could earn 1 month's free membership if they attended the fitness facility at least 12 times in the next month. Attendance was monitored for 1 month baseline and postintervention by using the facility's computer system. Analysis of variance, t tests, and chi-square analysis all revealed that the reinforcement condition had the best attendance record during the intervention period. These preliminary results shed some light on increasing attendance at a fitness facility. Discussion highlighted the practical implications of the findings and offered directions for future research.

Adult↗
PubMed1996

Exercise as rehabilitation for cancer patients.

OBJECTIVE: To review the literature on the association of exercise and rehabilitation among cancer patients in order to stimulate research in this field. DATA SOURCES: Computerized literature search of databases (Medline, Psychlit, Sportdiscus, Cinahl) and manual search of journals done to identify all empirical studies on exercise and rehabilitation of cancer patients ever conducted and published in any language on this topic. STUDY SELECTION: Eleven studies found, of these, two were unpublished conference proceedings and could not be obtained, two were doctoral dissertations and seven were published research studies. Of the nine studies reviewed, four were randomized controlled trials, three were quasi-experimental studies, and two were retrospective studies (case-control and cohort in design). All of the studies examined breast cancer patients only. DATA EXTRACTION: Qualitative review conducted since the studies had heterogeneous study designs including the type and form of exercise intervention or measurement, the data collection methods, and the outcome variables. DATA SYNTHESIS: Overall, exercise resulted in an improvement of the physiologic parameters observed, including increases in functional capacity and lean tissue, decreases in percent body fat, nausea and fatigue. Improvements in psychologic indicators of well-being and quality of life also found. CONCLUSIONS: Exercise appears to improve breast cancer patients physiologic and psychologic well being; however, the research studies reviewed here have numerous methodologic limitations and these results must be considered as preliminary evidence only. To improve knowledge of how exercise may help the rehabilitation of all types of cancer patients, future research studies are needed that use a wider sample of cancer patients, a well-designed randomized controlled design, an exercise intervention that more closely reflects true life circumstances, that is of long duration, that measures numerous physiologic and psychologic changes, and that examines exercise recruitment and adherence problems that may occur.

Activities of Daily Living↗
PubMed1996

Effect of a stimulus control intervention on attendance at a university fitness center.

The purpose of the present study was to determine the isolated effects of stimulus control on attendance at a fitness facility. Participants were members of a university fitness club randomly assigned to control (n = 50), placebo (n = 50), and stimulus control (n = 100) conditions. The control condition received no intervention, the placebo condition received a letter by mail, and the stimulus control condition received the same letter by mail plus a complimentary "EXERCISE" key chain, which was to act as the stimulus control. Attendance was monitored surreptitiously for 5 weeks baseline and 8 weeks postintervention by using the facility's computer system. A manipulation check found that 48 of the 100 participants used the key chain. Therefore, analyses were conducted separately for "intention to treat" and "actual treatment" conditions. Repeated measures multivariate analyses of variance revealed no main or interaction effects involving experimental condition in either the "intention to treat" or "actual treatment" analyses. Discussion focused on explanations for why the stimulus control intervention was not successful, and directions for future research were provided.

Adult↗
PubMed1995

Cognitive mediators of the social influence-exercise adherence relationship: a test of the theory of planned behavior.

The purpose of this study was to examine cognitive constructs from the theory of planned behavior (i.e., attitude, perceived behavioral control, and intention) as potential mediators of the relationship between selected social influence constructs (i.e., subjective norm, social support, and cohesion) and adherence to structured exercise classes. Sixty-two participants completed self-administered questionnaires during the fourth week (social influence constructs) and eighth week (cognitive constructs) of a 12-week exercise program. Exercise adherence was monitored during weeks 9 through 12 using perceived intensity and attendance. Pearson correlations indicated that social support correlated with perceived behavioral control, whereas cohesion correlated with attitude. Path analysis supported two distinct paths from social influence to exercise adherence: (a) social support-->perceived behavioral control-->intention-->exercise adherence, and (b) cohesion-->attitude-->intention-->exercise adherence. Discussion focuses on the theoretical importance of these findings, conceptual and measurement issues regarding subjective norm, and suggestions for future research.

Adult↗
PubMed1995

Understanding readiness for regular physical activity in older individuals: an application of the theory of planned behavior.

This study examined whether stage of readiness for regular physical activity (i.e., discrete phases from inactive to active) was related to beliefs concerning perceived social pressure, attitude, perceived control, and intention. Data were collected from 288 older people through the mail. Frequency data indicated that over 50% of the sample had been engaging in regular physical activity for longer than 6 months. Analysis of variance (ANOVA) results showed that all selected variables shared significant variance with stage of readiness, and discrimination among the stages by the selected variables was successful. Path analysis indicated that intention, attitude, and perceived control had direct relationships with stage of readiness. Discussion focused on the utility of these variables for understanding individual differences in stage of readiness for regular physical activity.

Activities of Daily Living↗
PubMed1994

Enhancing exercise adherence in middle-aged males and females.

BACKGROUND: Perceptions of personal efficacy have been consistently identified as being determinants of exercise adherence in asymptomatic, rehabilitative, younger, and older populations. The present study incorporated a randomized control design in an effort to examine the effects of an efficacy-based intervention in enhancing exercise adherence in a large sample (N = 114) of formerly sedentary middle-aged males and females. METHODS: Subjects randomly assigned to an exercise plus intervention group or an exercise plus attentional control group participated in a 5-month long walking program led by trained personnel. Exercise behavior (frequency, miles walked, duration) were assessed on a continuous basis and self-efficacy was measured at 1, 2, and 4 months. RESULTS: Repeated measures multivariate analyses revealed a significant treatment effect with subjects in the intervention group exercising more frequently, for longer duration, and walking greater distances over the course of the program. Path analysis indicated that the effect of the treatment on adherence was direct rather than through self-efficacy as hypothesized. Self-efficacy was, however, a significant predictor of exercise behavior in the early and middle stages of the exercise program but not during the last month. CONCLUSIONS: An intervention program designed to maximize information pertaining to participants' capabilities appears to have had a reasonable effect on reducing attrition in middle-aged males and females and self-efficacy was a significant predictor of exercise frequency over time. Further research efforts are required to tease out those cognitive factors that might underlie any effects of interventions in exercise adherence.

Attitude to Health↗
PubMed1994

Factors affecting the intention-physical activity relationship: intention versus expectation and scale correspondence.

The present study examined two issues believed to be relevant for the application of the theory of planned behavior to the physical activity domain: (a) the conceptual distinction between intention and expectation and (b) the effect of failing to obtain scale correspondence (Courneya & McAuley, 1993). Subjects for the study were 170 undergraduate students who completed an initial questionnaire assessing the constructs of interest and follow-up self-reports of physical activity at 2 and 4 weeks. Results indicated that: (a) expectation shared 9% more variance with frequency of physical activity than did intention, and (b) scale correspondence significantly improved the correlation between intention and physical activity. Discussion focused on conceptual and methodological issues concerning the theory of planned behavior as applied to physical activity.

Adult↗
PubMed1994

Are there different determinants of the frequency, intensity, and duration of physical activity?

The authors of this study explored whether different determinants exist for each of the three components of physical activity (frequency, intensity, and duration). The theoretical model they used was a modified version of the theory of planned behavior. Undergraduate volunteers (N = 170) completed an initial questionnaire and provided self-reports 2 and 4 weeks later of their physical activity during the interval. Hierarchical regression analyses indicated that both intention and self-efficacy explained unique variance in frequency and intensity, but only intention explained unique variance in duration. Further hierarchical regression analyses showed that self-efficacy contributed unique variance to all three components of intention, whereas attitude was implicated only in intended frequency and duration, and affect only in intended intensity. Possible explanations for the emergence of different determinants of the three components are discussed, and directions for future research are suggested.

Adolescent↗
PubMed1993

Can short-range intentions predict physical activity participation.

This study examined the issue of proximity of intention in the physical activity domain by employing both short-range (2 and 3 days) and longer range (4 weeks) intentions in the prediction of participation in physical activity. Subjects were 42 undergraduate students who completed intention and physical activity assessments every class (Monday, Wednesday, and Friday) for six weeks and also a single assessment four weeks apart. Analysis indicated that short-range intention is a better predictor of physical activity than is the longer range intention; however, even the short-range intention-physical activity correlations were only of modest magnitude. Interpretation of the results focused on the potential nonvolitional nature of physical activity and the possible role of perceived behavioral control and behavioral expectation.

Adult↗
PubMed1991

Effects of acute and long-term exercise on self-efficacy responses in sedentary, middle-aged males and females.

We examined the effects of acute and long-term exercise on perceptions of personal efficacy in sedentary, middle-aged males and females. Both males and females demonstrated significant increases in efficacy following acute exercise. Females, who had demonstrated initially lower self-perceptions than males, made dramatic increases in efficacy during the exercise program, equaling or surpassing those of males. Exploratory analyses revealed significant relationships between self-efficacy and subsequent physiological responses to exercise.

Attitude to Health↗
PubMedDate not supplied

Utility of the theory of planned behavior for understanding exercise during breast cancer treatment.

Preliminary evidence indicates that physical exercise may be an effective strategy for helping cancer patients cope with the negative side-effects of their treatment. The purpose of the present study was to examine the utility of the theory of planned behavior in understanding cancer patients' motivation to exercise during treatment. A total of 164 women who had been diagnosed with breast cancer within the previous 2 years participated in the study. A retrospective design was used wherein these women were asked to recall their beliefs and exercise behavior during cancer treatment using a self-administered, mailed questionnaire. Results showed that: (1) the salient beliefs of breast cancer patients concerning exercise were different from those of the healthy population; (2) intention and perceived behavioral control were significant determinants of exercise during cancer treatment; and, (3) attitude and subjective norm were significant determinants of intention. It was concluded that the theory of planned behavior may be a viable framework on which to base interventions designed to promote exercise during cancer treatment. The results of this study are preliminary, however, and more sophisticated research designs to examine this question are warranted.

Adaptation, Psychological↗
PubMedDate not supplied

Determinants of exercise during colorectal cancer treatment: an application of the theory of planned behavior.

PURPOSE/OBJECTIVES: To examine determinants of exercise during colorectal cancer treatment using the theory of planned behavior. DESIGN: A retrospective survey. SETTING: Cancer Registry of Alberta, Canada. SAMPLE: Randomly selected survivors of colorectal cancer (N = 110) diagnosed between 1992 and 1995 who had undergone adjuvant therapy. Participants' ages ranged from 26 to 77 years (mean = 61 years; SD = 11), 63% were male, and 85% were disease stage II or III. METHODS: Initial open-ended elicitation questionnaire to determine salient beliefs, a mailed main questionnaire, a postcard reminder one week later, and a second questionnaire three weeks later. Exercise was assessed by the Godin Leisure Time Exercise Questionnaire. MAIN RESEARCH VARIABLES: Exercise during cancer treatment, intention, perceived behavioral control, attitude, subjective norm, and salient beliefs. FINDINGS: Exercise during cancer treatment was determined by intention and perceived behavioral control. Intention was determined solely by attitude. Salient beliefs about exercise were different for patients with cancer as compared to a healthy population. CONCLUSIONS: The theory of planned behavior may be a viable framework on which to base interventions to promote exercise in patients with colorectal cancer. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses need to have an understanding of motivational factors related to exercise during cancer treatment to be able to assist patients with cancer to initiate and maintain exercise.

Adult↗