An application of the transtheoretical model to the exercise behavior of individuals accessing HIV-related services
Basta, Tania Barman
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The purpose of the study was to examine: 1) the distribution of the stages of change for exercise among individuals accessing HIV-related services, 2) the differences between TTM constructs (decisional-balance, processes of change, and self-efficacy) explained by the stages of change among individuals accessing HIV-related services, and 3) whether the TTM constructs accurately predict the stages of change for exercise better than chance alone. Cross-sectional survey data were collected from 208 individuals accessing HIV care related services from February - April, 2006 in Atlanta, GA. Participants completed and returned questionnaires for each TTM construct (decisional-balance, self-efficacy, behavioral and experiential processes of change) along with a measure of physical activity MET level. Participants had been living with an HIV diagnosis for an average of 11.75 (SD = 6.59) years. The majority of the sample self-identified as male (87.0%), African-American or Black (84.6%), single (69.2%), and homosexual (54.8%). The ages of the participants ranged was from 22 to 63 years with an average age of 42.6 years (SD = 7.1). Univariate analyses revealed significant differences between the TTM constructs and the stages of change for exercise (p < .05). The largest proportion of variance was derived from the behavioral processes of change (n2= .22), followed by self-efficacy (n2= .15), the experiential processes of change (n2= .14), and decisional-balance (n2= .11). There were no significant differences between stages of change for physical activity level (METs). Predictive discriminant analysis revealed that participants in precontemplation were accurately classified 48% of the time, contemplators 25% of the time, preparers 70% of the time, and individuals in maintenance were accurately classified 63% of the time. None of the individuals in action were classified correctly. The overall stage of change classification accuracy was 48%. This was one of the first studies to examine the TTM for exercise behavior among individuals accessing HIV-care related services. Overall, the results are consistent with other studies in healthy populations; therefore, stage-matched exercise interventions based on this model can be developed for individuals accessing HIV-related care services.