BACKGROUND: The transtheoretical model has been successful in promoting health
behavior change in general and clinical populations. However, there is little
knowledge about the application of the transtheoretical model to explain physical
activity behavior in individuals with non-cystic fibrosis bronchiectasis. The aim
was to examine patterns of (1) physical activity and (2) mediators of behavior
change (self-efficacy, decisional balance, and processes of change) across stages
of change in individuals with non-cystic fibrosis bronchiectasis.
METHODS: Fifty-five subjects with non-cystic fibrosis bronchiectasis (mean age ±
SD = 63 ± 10 y) had physical activity assessed over 7 d using an accelerometer.
Each component of the transtheoretical model was assessed using validated
questionnaires. Subjects were divided into groups depending on stage of change:
Group 1 (pre-contemplation and contemplation; n = 10), Group 2 (preparation; n =
20), and Group 3 (action and maintenance; n = 25). Statistical analyses included
one-way analysis of variance and Tukey-Kramer post hoc tests.
RESULTS: Physical activity variables were significantly (P < .05) higher in Group
3 (action and maintenance) compared with Group 2 (preparation) and Group 1
(pre-contemplation and contemplation). For self-efficacy, there were no
significant differences between groups for mean scores (P = .14). Decisional
balance cons (barriers to being physically active) were significantly lower in
Group 3 versus Group 2 (P = .032). For processes of change, substituting
alternatives (substituting inactive options for active options) was significantly
higher in Group 3 versus Group 1 (P = .01), and enlisting social support (seeking
out social support to increase and maintain physical activity) was significantly
lower in Group 3 versus Group 2 (P = .038).
CONCLUSIONS: The pattern of physical activity across stages of change is
consistent with the theoretical predictions of the transtheoretical model.
Constructs of the transtheoretical model that appear to be important at different
stages of change include decisional balance cons, substituting alternatives, and
enlisting social support. This study provides support to explore transtheoretical
model-based physical activity interventions in individuals with non-cystic