To inform future walking interventions, we sought to identify exercise mediators that are associated with readiness to exercise in persons with either asymptomatic peripheral arterial disease (PAD) or disease risk factors. We enrolled participants excluded from a larger behavioral intervention trial for persons with diabetes mellitus and PAD. Participants completed surveys assessing exercise mediators and stage of readiness to exercise (precontemplation, contemplation, or action). Data were analyzed using nonparametric tests. Participants in the stage of action substituted physical activity as an alternative, rewarded themselves, and committed themselves more than other participants (P < .01). Action participants perceived more benefits to exercise than precontemplation participants (P < .05). Contemplation and action participants had higher outcome expectations for exercise, and action participants received more enjoyment from physical activity than precontemplation participants (P < .05 and P = .05, respectively). Identifying these mediators is important for future exercise interventions and treatments.
Garg PK, Tian L., Criqui MH, et al. Physical activity during daily life and mortality in patients with peripheral arterial disease. Circulation. 2006;114(3):242-248.
2.
Collins TC, Johnson SL, Souchek J.Unsupervised walking therapy and atherosclerotic risk-factor management for patients with peripheral arterial disease: a pilot trial. Ann Behav Med. 2007; 33(3):318-324.
3.
McDermott MM , Tiukinhoy S., Greenland P., et al. A pilot exercise intervention to improve lower extremity functioning in peripheral arterial disease unaccompanied by intermittent claudication . J Cardiopulm Rehabil. 2004;24(3):187-196.
4.
Hirsch AT, Criqui MH, Treat-Jacobson D., et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA. 2001;286(11):1317-1324.
5.
Collins TC, Petersen JN, Suarez-Almazor M., Ashton CMThe prevalence of peripheral arterial disease in a racially diverse population . Arch Intern Med. 2003;163(12):1469-1474.
6.
Painter JE, Borba CPC, Hynes M., Mays D., Glanz K.The use of theory in health behavior research from 2000 to 2005: a systematic review. Ann Behav Med.2008;35(3):358-362.
7.
Stutts WCPhysical activity determinants in adults: perceived benefits, barriers, and self efficacy. AAOHN J. 2002;50(11):499-507.
8.
Marcus BH, Selby VC, Niaura RS, Rossi JSSelf efficacy and the stages of exercise behavior change. Res Q Exerc Sport. 1992; 63(1):60-66.
9.
Resnick B., Zimmerman SI, Orwig D., Furstenberg AL, Magaziner J.Outcome expectations for exercise scale: utility and psychometrics . J Gerontol B Psychol Sci Soc Sci. 2000 ;55(6): S352-S356.
10.
Marcus BH, Rakowski W., Rossi JSAssessing motivational readiness and decision making for exercise . Health Psychol. 1992;11(4):257-261.
11.
Marcus BH, Forsyth LHMotivating People to Be Physically Active. Champaign, IL : Human Kinetics; 2003.
12.
Sarkin JA, Johnson SS, Prochaska JO, Prochaska JMApplying the transtheoretical model to regular moderate exercise in an overweight population: validation of a stages of change measure. Prev Med. 2001;33(5):462-469.
13.
Reed GR, Velicer WF, Prochaska JO, Rossi JS, Marcus BHWhat makes a good staging algorithm: examples from regular exercise . Am J Health Promot. 1997;12(1):57-66.
14.
Calfas KJ, Long BJ, Sallis JF, Wooten WJ, Pratt M., Patrick K.A controlled trial of physician counseling to promote the adoption of physical activity. Prev Med. 1996;25(3):225-233.
15.
Marcus BH, Rossi JS, Selby VC, Niaura RS, Abrams DBThe stages and processes of exercise adoption and maintenance in a worksite sample. Health Psychol. 1992;11(6):386-395.
16.
Sallis JF, Grossman RM, Pinski RB, Patterson TL, Nader PRThe development of scales to measure social support for diet and exercise behaviors. Prev Med. 1987;16(6):825-836.
17.
Kendzierski D., DeCarlo KJPhysical activity enjoyment scale: two validation studies. J Sport Exerc Psychol. 1991; 13(1):50-64.
18.
Schutzer KA , Graves BSBarriers and motivations to exercise in older adults. Prev Med. 2004;39(5):1056-1061.
19.
Mutrie N., Carney C., Blamey A., Crawford F., Aitchison T., Whitelaw A.‘‘Walk in to Work Out’’: a randomised controlled trial of a self help intervention to promote active commuting. J Epidemiol Community Health. 2002;56(6):407-412.
20.
Williams DM , Matthews CE, Rutt C., Napolitano MA, Marcus BHInterventions to increase walking behavior . Med Sci Sports Exerc. 2008;40(7):S567-S573.
21.
Engel L., Lindner H.Impact of using a pedometer on time spent walking in older adults with type 2 diabetes. Diabetes Educ. 2006;32(1):98-107.
22.
Hultquist CN , Albright C., Thompson DLComparison of walking recommendations in previously inactive women. Med Sci Sports Exerc. 2005 ;37(4):676-683.
23.
Rovniak LS, Anderson ES, Winett RA, Stephens RSSocial cognitive determinants of physical activity in young adults: a prospective structural equation analysis. Ann Behav Med . 2002; 24(2):149-156.
24.
Calfas KJ, Sallis JF, Oldenburg B., Ffrench M.Mediators of change in physical activity following an intervention in primary care: PACE. Prev Med. 1997;26(3):297-304.
25.
Rejeski JW, Tian L., Liao Y., McDermott MMSocial cognitive constructs and the promotion of physical activity in patients with peripheral artery disease. J Cardiopulm Rehabil Prev . 2008;28(1): 65-72.
26.
Bandura A.Social Foundations of Thought and Action: A Social Cognitive Theory . Englewood Cliffs, NJ: Prentice-Hall ; 1986.
27.
Prochaska JO , Velicer WFThe transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38-48.
28.
Prochaska JA , Velicer WF, Rossi JS, et al. Stages of change and decisional balance for 12 problem behaviors. Health Psychol . 1994;13(1):39-46.
