跨理论模型中自我效能、变化阶段对变化过程和身体活动关系的中介效应

通过方便抽样法选取浙江省5所高校704名大学生为研究参与者,采用横向调查设计和结构公式建模方法,检验跨理论模型各结构之间及其与身体活动之间的关系。研究结果表明,自我效能和变化阶段在变化过程与身体活动之间扮演着完全中介角色。该结果与自我效能理论和计划行为理论的预测结果相一致。变化过程可经由3条路径对身体活动产生显著的间接影响,第1条路径为变化过程→自我效能→身体活动,这条路径的中介强度最大,约占总效应的一半;第2条路径为变化过程→自我效能→变化阶段→身体活动,此路径的中介强度为28.3%;第3条路径为变化过程→变化阶段→身体活动,该路径的中介强度为19.7%。这一结果提示跨理论模型各结构之间的关系是相互关联的,共同组成了跨理论的整体模式,基于跨理论模型的干预研究不仅要考虑到模型内部各结构之间的关系,也要将整个模式作为干预的目标,只有这样才可能对跨理论模型干预措施的有效性做出正确判断。     

Physical Activity Indicators,Metabolic Biomarkers,and Comorbidity in Type 2 Diabetes

ABSTRACT

Purpose: This study aimed (1) to compare physical activity (PA) indicators, metabolic biomarkers, and comorbidity, (2) to investigate the relationship between PA indicators and metabolic biomarkers, comorbidity and (3) to identify barriers to PA in patients with type 2 diabetes (T2DM) who are using oral hypoglycaemic agent (OHA) or combined OHA and insulin (OHAiN). Methods: Sixty-one patients were classified as patients using only OHA or combined OHAiN. Metabolic biomarkers (waist-to-hip ratio, body mass index (BMI), lipid profile, glycosylated haemoglobin (HbA1c), fasting blood glucose, comorbidity and PA indicators (self-reported PA, number of steps (NOS), 6-minute walking distance (6MWD)) were assessed. PA perceptions and reasons for inactivity were questioned. Results: The comorbidity (p = .013), low-density lipoprotein-cholesterol (p = .026), total cholesterol (p = .008) and HbA1c (p = .020) were higher and PA level was lower (p = .007) in the OHAiN group. NOS was positively correlated with high-density lipoprotein-cholesterol (p = .037) and negatively correlated with BMI (p = .007). 6MWD was negatively correlated with BMI (p = .014) and comorbidity (p = .004) in the OHA group. BMI was a significant predictor of NOS (adjusted R² = 0.242) and comorbidity for 6MWD (adjusted R² = 0.250) in the OHA group. The majority of the patients (OHA = 34.3%, OHAiN = 42.3%) reported “lack of time” as the most common barrier to PA. Conclusions: This study showed that patients on OHAiN have lower PA levels, poorer metabolic profiles, and higher comorbidity rates than OHA users. PA indicators were related with some metabolic biomarkers and comorbidity in only OHA users. The most common reason for inactivity was “the lack of time” in both groups.     

Factors Associated With Transitional Shifts in College Students' Physical Activity Behavior

The Transtheoretical Model (Prochaska & Marcus, 1994) has been widely used as a framework for understanding exercise behavior change. The purpose of this study was to clarify equivocal research findings reported for model predictions when examining stage movement over time rather than static stages and to provide some evidence of the construct validity of transitional stages. Participants were female (n = 285) and male (n = 243) undergraduates (M age = 19.9 years, SD = 2.7) who completed previously validated questionnaires twice, separated by 9 weeks, that assessed stage of change, exercise behavior, processes of change, pros and cons of exercise, and exercise self-efficacy. Participants were classified into one of five transitional shift groups based on their responses at baseline and follow up: (a) stable sedentary, (b) stable active, (c) activity adopters, (d) activity relapsers, and (e) perpetual preparers. Results of a 5 (group) x 2 (time) repeated measures (RM) analysis of variance (ANOVA) examining exercise behavior revealed a significant interaction (p < .001) and supported transitional stage classification, with activity adopters and stable actives increasing exercise over time and relapsers decreasing activity. Separate 5 (group) x 2 (time) RM ANOVAs examining model constructs revealed no significant interaction for cognitive processes of change; however, activity adopters and stable actives reported significant (p < .01) increases in the use of behavioral processes over time, while only the activity relapsers and perpetual preparers reported decreases. Activity relapsers also reported significant (p < .05) decreases in the pros of exercise. No significant interactions were found for the cons of exercise behavior. Unlike findings reported in cross-sectional studies, increases in self-efficacy did not accompany increases in exercise stage. The findings strongly support examination of stage movement classifications rather than static stages, as these transitions provide greater insight into the mechanisms of exercise behavior change.     

大学生身体活动阶段变化与健康状况关系的研究

基于锻炼心理学领域中的"从无活动到保持活动的4步骤模型"(Four Steps from In-activity to Activity;FIT模型),以3 807名大学生为研究对象,探讨了大学生身体活动阶段变化与健康状况变量(身体体质、主观良好感、健康满意度和不适感)之间的关系。研究结果表明,处于活动阶段的个体,其健康状况水平均好于处于不活动阶段的个体;在3个活动阶段上,处于保持期(即长期保持规律性身体活动)的个体,其健康状况水平均好于处于探索期和波动期的个体;人口统计学变量和健康状况变量共同解释了17.6%的阶段方差变异(F=108.48,P<0.05)。验证了FIT模型中大学生身体活动阶段变化与健康状况之间的相关关系,为今后运用FIT模型诊断大学生身体活动变化阶段及其相应健康状况提供了实证依据。     

Reliability and Validity of a New Physical Activity Self-Report Measure for Younger Children

The purpose of this study was to assess the test–retest reliability and validity of a new Youth Physical Activity Self-Report measure. Heart rate and direct observation were employed as criterion measures with a sample of 79 children (aged 7–9 years). Spearman's rho (ρ) correlation between self reported activity intensity and heart rate was .87 for weekday and .795 for weekend; the correlation between self-reported activity duration and duration as measured by heart rate were .837 and .684 for weekday and weekend, respectively. These correlations fell when recalled inactivity was excluded from analysis. A correlation of ρ = .557 was found between self-reported activity intensity and direct observation. Results establish support for the self-report measure as an effective tool for measuring the previous day physical activity of younger children.     

The transtheoretical model in the context of physical activity in a school-based sample of German adolescents

Abstract

Physical activity in adolescents is an important public health issue. Regular participation in physical activity is associated with various health benefits. However, problems with motivational adherence to physical activity have been documented. The transtheoretical model is a model of behaviour change. This model, which consists of stages of change, self-efficacy, decisional balance, and processes of change, has not been extensively investigated in youth. In addition, the health-enhancing physical activity concept has rarely been applied in this context.

A cross-sectional design was used. A random sample of seven junior high schools from Bremen (Germany) resulted in a sample of 588 adolescents (50.5% males, mean age=15.0 years, s=0.67). Respondents completed a self-administered questionnaire assessing stages of change, self-efficacy, decisional balance, and processes of change. Univariate analyses of variance were used to identify which constructs differed significantly across the stages of change. Discriminant analysis was used to determine which variables best discriminate the stages.

Distribution of the sample across the stages was: precontemplation, n=175 (29.8%); contemplation, n=135 (22.0%); preparation, n=63 (10.7%); action, n=20 (3.4%); and maintenance, n=195 (33.2%). Significant effects of stages of change were found for self-efficacy, pros, and seven of the ten processes of change. In general, scores of these constructs increased across the stages. Cons did not differ significantly across the stages.

The results provide support for some of the assumptions of the transtheoretical model in a German sample of adolescents. Some of our findings raise questions about the usefulness of five discrete stages. From a public health viewpoint, tailored interventions based on motivational readiness to change would be fruitful, but further research is warranted.     

The Validity of the Tritrac-R3D Activity Monitor for the Assessment of Physical Activity in Children

Abstract

The purpose of this study was to evaluate the validity of the Tritrac-R3D Activity Monitor, a new instrument designed to improve assessments of physical activity. Comparisons were made with a heart rate monitor and with a Caltrac Activity Monitor. Thirty-five children (ages 9–11 years) were monitored on 3 different school days with all 3 instruments. The Tritrac was moderately correlated with the heart rate monitor (r =.58) and highly correlated with the Caltrac monitor (r =.88). By taking advantage of the minute-by-minute timing capability of the Tritrac and the heart rate monitors, it was discovered, that the correlations between these instruments were highest during free play situations (lunch/recess, recess, after school) and were lower when activity was more limited (class time) or structured (physical education). The ability of the Tritrac to assess activity on a minute-by-minute basis may greatly enhance its overall utility.     

Pedometer-Determined Physical Activity and Its Comparison With the International Physical Activity Questionnaire in a Sample of Belgian Adults

Pedometer-determined physical activity (PA) levels in Belgian adults were provided and compared to PA scores reported in the International Physical Activity Questionnaire (IPAQ). The representative sample (N = 1,239) of the Belgian population took on average 9,655 (4,526) steps/day. According to pedometer indices 58.4% were insufficiently active. Steps/day differed significantly between gender (F = 5.0, p = .026), age groups (F = 3.3, p = .01), employment status (F = 6.2, p = .013), and days of monitoring (F = 7.4, p = .007). Steps/day were negatively correlated to the time spent sitting and positively to PA at work, in transport, and in leisure time (p < .001). Steps data can discriminate between PA levels reported in the IPAQ. Belgian population pedometer-determined PA levels are higher than those reported in samples of the United States; however, there is a wide distribution of ambulatory behavior.     

运动疗法对超重和肥胖的早发2型糖尿病患者胰岛素抵抗的影响

探讨运动疗法对超重和肥胖的早发2型糖尿病患者体重、胰岛素抵抗、β细胞功能的影响。收集40岁以下2型糖尿病117例,按就诊顺序随机分为A、B两组,在饮食治疗及胰岛素治疗的前提下,A组患者采用快走的运动方案;B组患者只参加一般日常工作和家务劳动。在12 w后再次测定患者血压、体重、空腹血糖、空腹胰岛素、血脂谱,以及胰岛素抵抗指数、β细胞功能指数计数,并记录用药情况,与12 w之前的结果进行对比。发现A组患者体重下降率、血压下降率、胰岛素用量都明显低于B组(P<0.05),停药率明显高于B组(P<0.05);A组治疗后胰岛素抵抗指数改善好于B组(P<0.05)。运动疗法可降低超重和肥胖早发2型糖尿病患者的体重,有助于代谢综合征的改善,可以减少胰岛素的使用量,有助于胰岛素抵抗和β细胞功能的改善。     

Validity of the New Lifestyles NL-1000 Accelerometer for Measuring Time Spent in Moderate-to-Vigorous Physical Activity in School Settings

Current interest in promoting physical activity in the school environment necessitates an inexpensive, accurate method of measuring physical activity in such settings. Additionally, it is recognized that physical activity must be of at least moderate intensity in order to yield substantial health benefits. The purpose of the study, therefore, was to determine the validity of the New Lifestyles NL-1000 (New Lifestyles, Inc., Lee's Summit, Missouri, USA) accelerometer for measuring moderate-to-vigorous physical activity in school settings, using the Actigraph GT1M (ActiGraph, Pensacola, Florida, USA) as the criterion. Data were collected during a cross-country run (n = 12), physical education (n = 18), and classroom-based physical activities (n = 42). Significant and meaningful intraclass correlations between methods were found, and NL-1000 estimates of moderate-to-vigorous physical activity were not meaningfully different from GT1M-estimated moderate-to-vigorous physical activity. The NL-1000 therefore shows promising validity evidence as an inexpensive, convenient method of measuring moderate-to-vigorous physical activity in school settings.     

Physical Activity Levels and Prompts in Young Children at Recess: A Two-Year Study of a Bi-Ethnic Sample

Abstract

We investigated physical activity and encouragement for activity in a bi-ethnic cohort during recess. Activity and associated interactions of 287 children were recorded at preschool and again 2.2 years later. Children expended nearly twice as much energy at preschool recess than at elementary recess. Activity levels declined as recess time elapsed. At preschool, European-American children engaged in more moderate to vigorous activity than Mexican-Americans. As participants moved to elementary school, teachers' prompts to be active decreased and prompts from peers increased. Boys and girls received similar amounts of activity prompts at preschool, but prompts to boys increased over time. The findings suggest that school environments could be altered to promote healthful physical activity among young children.     

体力活动的社会生态模型研究进展

在促进体力活动的研究中,传统理论过于强调个体心理因素的作用,而相对忽视了宏观环境因素所起的作用. 社会生态模型作为一个全面的、跨学科的分析框架,为体力活动研究提供了新的思路,即综合考虑个体及环境的各层次影响因素：个体内层次、人际层次、组织层次、社区层次和政策层次.本文对该模型在体力活动领域的应用演进以及各个层次的研究进展进行梳理,以期为未来应用该模型的相关干预研究提供理论借鉴.     

中国国民体力活动水平的区域特征研究

改革开放30余年来,中国经济取得了举世瞩目的成就,城乡居民收入有了大幅提高,随着东部沿海地区经济的发展,中西部经济发展水平也在上扬。同时,不同地区、城乡之间的居民收入差距也在不断扩大,收入差距的扩大在一定程度上造成了思想意识的差异,这种差异带来了国民生活方式和体力活动模式的改变。利用2010年第3次国民体质监测工作中,在全国31个省(自治区、直辖市)开展的成年人群体力活动的调查资料,进行成年人群体力活动水平的现状分析,结果显示:1)我国居民各单项体力活动水平具有明显的区域差异,东部地区交通类、工作类体力活动水平完全静坐类人群和闲暇时间体育锻炼活跃度2(重度)的人数比例高于中、西部地区,西部地区家务类体力活动水平活跃度2(重度)的人数比例高于东、中部地区;2)北方地区交通类、工作类、家务类、闲暇时间体育锻炼活跃度1(中度)的人数比例高于南方地区;3)我国居民总体体力活动水平与社会经济发展水平的区域趋势相似,具有明显的区域差异,东部地区完全静坐类、体力活动活跃类人数比例高于西部,沿海区域高于内陆区域。     

我国老年人身体活动及其影响因素的历时变化——基于CHARLS2011年和2018年数据的分析

基于中国健康与养老追踪调查(CHARLS)2011年和2018年的数据,利用logistic回归、平均偏效应模型以及交互模型,分析我国老年人身体活动及影响因素的历时变化。结果表明:我国老年人身体活动达标率从2011年的16.91%提升至2018年的48.65%,且同时呈现出同增长性与差异增大性;年龄、婚姻特征的影响程度增加,户籍、地域特征的影响程度减小;老年群体身体活动情况存在着明显的年龄、性别、教育以及户籍的分化。并以此提出建议:一要重视老年人身体活动不足的问题,提供有利于促进老年人身体活动的支持性环境,二要针对不同老年人群体,制定差异化的身体活动促进策略,三要根据区域地域差异化特征,进一步重视和引导城区中东部老年人的身体活动。     

浙江省中学生参加课外体育活动状况的调查研究

对浙江省杭、宁、温、嘉等地区十所重点和非重点中学的2 052名初一至高三6个年级的中学生进行课外体育活动的问卷调查,并针对所调查结果,提出了相应的建议:积极、科学地引导学生参加课外体育活动;鼓励更多的社会力量兴建体育场馆和设施;号召家庭、学校和社会给予男女生同等的关注和机会。     

社会学因素对厦门市成年人体力活动量的影响研究

为了探究社会学因素对厦门市成年人体力活动量的影响,本研究通过分析部分社会学因素与厦门市居民(20岁以上)体力活动量之间的关系.以问卷调查的方式对厦门市成年人进行调查,采用回归分析影响成年人体力活动量因素.研究发现,吸烟和体力活动总量有相关性(95％CI=154.456-670.823,p＜0.01);一周参加锻炼的频率...     

浙江省青少年不同体育活动状况对心理健康因子影响的调查研究

应用《身心症状自评量表(SCL-90)》及自编《参与体育活动状况调查表》,在浙江省10个地区随机抽取2 000名青少年进行问卷调查,并对他们参与体育活动状况与心理健康10因子的情况加以分析,结果表明:浙江省青少年SCL-90因子分均略高于国内常模;青少年参加体育活动的意愿、参与次数、参加活动项目及形式对SCL-90量表中的因子有不同程度影响。     

Measuring Physical Activity in Preschoolers: Reliability and Validity of the System for Observing Fitness Instruction Time for Preschoolers (SOFIT-P)

The purpose of this study is describe the initial feasibility, reliability, and validity of an instrument to measure physical activity in preschoolers using direct observation. The System for Observing Fitness Instruction Time for Preschoolers was developed and tested among 3- to 6-year-old children over fall 2008 for feasibility and reliability (Phase I, n = 67) and in fall 2009 for concurrent validity (Phase II, n = 27). Phase I showed that preschoolers spent >75% of their active time at preschool in light physical activity. The mean inter-observer agreements scores were ≥.75 for physical activity level and type. Correlation coefficients, measuring construct validity between the lesson context and physical activity types with and with the activity levels, were moderately strong. Phase II showed moderately strong correlations ranging from .50 to .54 between the System for Observing Fitness Instruction Time for Preschoolers and Actigraph accelerometers for physical activity levels. The System for Observing Fitness Instruction Time for Preschoolers shows promising initial results as a new method for measuring physical activity among preschoolers.     

身体活动水平对大学生全人健康的影响研究

为了考察性别、年级、身体活动水平与大学生全人健康各维度之间的差异性,采用问卷调查法,对1713名大学生进行问卷调查,回收有效问卷1570份,有效率为92%。使用独立样本t检验对男、女大学生进行差异分析,对不同年级的低、中、高运动强度和频率进行方差分析。结果表明:大学生的全人健康水平处于中等水平(M=2.55,SD=0.43),其中女大学生整体健康水平高于男大学生,女大学生在职业、智力、情感、精神、身体健康维度均高于男大学生,两者在财务、社会、环境健康维度无显著性差异。二年级大学生全人健康水平最高,四年级最低。身体健康和社会健康是全人健康模型中得分最高的维度。在中、高等强度身体活动水平上全人健康得分最高,低运动频率的大学生全人健康水平最高,高运动频率的大学生全人健康水平最低。由此可知,引入国外全人健康测量工具,用来评估我国大学生群体,其结果具有较高的信效度。相关变量的检定与研究假设相符,为今后进一步开展全人健康相关研究奠定了基础。