Age-specific trends in health-related quality of life among US adults: findings from National Health and Nutrition Examination Survey, 2001–2016

Quality of Life Research - Health-related quality of life (HRQoL) is an important indicator of population health, yet no age-specific trend analyses in HRQoL have been conducted with a nationally...     

Evaluation of a healthy-lifestyle approach to weight management

BACKGROUND: Obesity and overweight have reached near-epidemic proportions in the United States. There is a need to further investigate intervention strategies designed to help individuals manage their weight by improving diet and exercise behaviors. We designed a multidisciplinary weight management program that included healthy eating, regular exercise, and behavioral changes based on the Transtheoretical Model. The program focused on a healthy lifestyle rather than weight loss. METHODS: Overweight and obese adults (n = 144; BMI = 32.5 +/- 3.8) participated in a 6-month clinic-based weight management program. The first 3 months of the program were intense (twice weekly for 2 h) followed by 3 months of reduced clinical contact. Assessments completed at baseline, 3 months, and 6 months included weight, body composition, BMI, total cholesterol, HDL-C, LDL-C, and 24-h diet recalls. VO(2max) was assessed at baseline and at 3 months. RESULTS: Subjects experienced significant decreases in weight, percentage body fat, BMI, total cholesterol, LDL-C, total caloric intake, and the percentage of energy intake from dietary fat as well as a significant increase in VO(2max) (P < 0.05) at 3 months. Changes were maintained at 6 months, with weight, total cholesterol, and LDL-C demonstrating further improvement. CONCLUSIONS: A clinic-based weight management program that focuses on lifestyle is successful at promoting changes in exercise and dietary behaviors. These changes appear to promote good health, as evidenced by moderate weight loss, increased cardiorespiratory fitness, and improved lipid profiles.     

Exercise Intensity and Self-Efficacy Effects on Anxiety Reduction in Healthy, Older Adults

The purpose of the present study was to examine the effects of varying exercise intensities and changes in self-efficacy on anxiety reduction in a sample of healthy, older adults. Eighty older adults from a randomized controlled exercise trial participated in this study and completed measures of self-efficacy and the State Anxiety Inventory (SAI) prior to and following light-, moderate-, and high-intensity exercise. Latent growth curve modeling analyses revealed that although anxiety was reduced following the light-intensity condition, no significant changes in anxiety occurred following the moderate-intensity condition, and anxiety increased following the high-intensity condition. In addition, changes in self-efficacy were related to anxiety responses only in the moderate-intensity condition. An analysis of SAI items indicated that although the light-intensity condition resulted in decreased arousal and anxiousness, the high-intensity condition resulted in increased arousal and decreased anxiousness. These results are discussed in terms of social cognitive theory and the appropriateness of the SAI for use in exercise settings.     

Testing the requirements of stages of physical activity among adults: The comparative effectiveness of stage-matched, mismatched, standard care, and control interventions

We tested the comparative efficacy of 4 interventions to increase the physical activity behavior of college personnel randomly assigned to one condition (N = 196, 74% female, M age = 43.4 years) for 16 weeks. Stage-matched and mismatched interventions were developed based on the stages of change from the Transtheoretical Model and were contrasted with standard care (action-oriented) and control interventions to test the requirements of a true stage behavior. Repeated measures of multi-variate analyses of covariance indicated that the stage-matched and standard care interventions resulted in greater levels of both total and lifestyle physical activity compared with the mismatched and control interventions. The results supported the requirements of a stage behavior as defined by Weinstein, Rothman, and Sutton (1) and the superiority of the stage-matched intervention versus the mismatched intervention. However, the standard care intervention performed as well as the matched intervention, suggesting the need for further investigation. The results are discussed with respect to the high proportion of individuals in the action-oriented stages and previous research findings in the smoking literature.     

Women Bound to Be Active: A Pilot Study to Explore the Feasibility of an Intervention to Increase Physical Activity and Self-Worth in Women

ABSTRACT

Increasing physical activity (PA) has become a national health objective due to its associated health benefits, but low participation rates. Therefore, the purpose of this study was to determine the feasibility of an 8-month (September 2006–April 2007) PA book club (Women Bound to Be Active-WBA) in increasing PA and self-worth (SW) among women. Fifty-six adult women participated in an 8-month intervention consisting of weekly meetings designed to improve PA knowledge, awareness, confidence, and SW. Results indicated a significant increase in PA and SW. The WBA program represents a creative theory-based approach to empowering women to be more active.     

Baseline transtheoretical and dietary behavioral predictors of dietary fat moderation over 12 and 24 months

Longitudinal predictors of dietary behavior change are important and in need of study. This secondary data analysis combined primary data across three randomized trials to examine transtheoretical model (TTM) and specific dietary predictors of successful dietary change at 12 and 24 months separately in treatment and control groups (N = 4178). The treatment group received three TTM-tailored print interventions over 12 months between 1995 and 2000. Chi-square and MANOVA analyses were used to examine baseline predictors of dietary outcome at 12 and 24 months. Last, a multivariable logistic regression was conducted with all baseline variables included. Across all analyses in both treatment and control groups, the most robust predictors of successful change were for TTM-tailored treatment group, preparation stage of change, and increased use of dietary behavior variables such as moderating fat intake, substitution of lower fat foods, and increasing intake of healthful foods. These results provide strong evidence for treatment, stage and behavioral dietary severity effects predicting dietary behavior change over time, and for targeting these variables with the strongest relationships to outcome in interventions, such as TTM-tailored dietary interventions.     

Social relations, physical activity, and well-being in older adults

BACKGROUND: A randomized controlled trial was conducted to examine: (a) the effect of two physical activity modes on changes in subjective well-being (SWB) over the course of a 12-month period in older, formerly sedentary adults (N = 174, M age = 65.5 years) and (b) the role played by physical activity participation and social support in changes in SWB over time. METHOD: Participants were randomized into either an aerobic activity group or a stretching and toning group. Structural equation modeling was employed to conduct multiple sample latent growth curve analyses of individual growth in measures of SWB (happiness, satisfaction with life, and loneliness) over time. RESULTS: A curvilinear growth pattern was revealed with well-being significantly improving over the course of the intervention followed by significant declines at the 6-month follow-up. Subsequent structural analyses were conducted showing that frequency of exercise participation was a significant predictor of improvement in satisfaction with life, whereas social relations were related to increases in satisfaction with life and reductions in loneliness. Improvements in social relations and exercise frequency also helped to buffer the declines in satisfaction with life at follow-up. CONCLUSIONS: It appears that social relations integral to the exercise environment are significant determinants of subjective well-being in older adults. Findings are discussed in terms of how physical activity environments might be structured to maximize improvements in more global well-being constructs such as satisfaction with life.     

Mode of physical activity and self-efficacy in older adults: a latent growth curve analysis.

A randomized controlled trial examined the effect of two physical activity modes on changes in self-efficacy over the course of a 12-month period in older, formerly sedentary adults (N = 174, M age = 65.5 years). Participants were randomized into either an aerobic activity group or a stretching and toning group. Structural equation modeling was employed to conduct multiple sample latent growth curve analyses of individual growth in exercise and physical self-efficacy over time. Results revealed a curvilinear growth pattern for both types of efficacy with increases occurring over the first 6 months followed by declines at the 6-month follow-up. There was a significant treatment by mean level growth interaction for exercise efficacy with both groups increasing over time, but the aerobic group evidenced a twofold increase in growth over the stretching group. Structural analyses indicated that frequency of exercise participation was a significant predictor of overall growth in efficacy, and improvements in fitness were only related to exercise efficacy growth in the stretching group. Findings are discussed in terms of social cognitive theory and further application of latent growth curve modeling to studies of physical activity effects in older adults.     

Long-term maintenance of exercise and healthy eating behaviors in overweight adults

BACKGROUND: Most people experience weight regain following the termination of a weight management program. The failure to maintain changes in diet and exercise patterns is a major factor. This study presents 24-month outcomes of a healthy-lifestyle weight management program designed to promote long-term changes in diet and exercise behaviors. METHODS: Overweight and obese adults (n = 144; BMI = 32.5 +/- 3.8) completed a 6-month clinic-based weight management program and were followed for an additional 18 months. Assessments completed at baseline, 6, 12, and 24 months included weight, body composition, dietary recalls, self-reported physical activity, and mediator variables based on Transtheoretical Model of Health Behavior Change. RESULTS: At 24 months, subjects maintained decreases in weight, % body fat, caloric intake, % kcal saturated fat, and increases in weekly exercise minutes (P < 0.05). Individuals who maintained regular exercise at 24 months had higher confidence scores and higher use of experiential and behavioral processes. Individuals who maintained a healthy diet at 24 months had lower temptation scores and higher use of experiential and behavioral processes. CONCLUSIONS: A healthy-lifestyle weight management program is successful at promoting long-term changes in exercise and dietary behaviors. Individuals who actively engage in the maintenance process are more likely to succeed.