Research article - (2017)16, 163 - 171
The Effects of a Self-Efficacy Intervention on Exercise Behavior of Fitness Club Members in 52 Weeks and Long-Term Relationships of Transtheoretical Model Constructs
Jan Middelkamp1,, Maaike van Rooijen2, Peter Wolfhagen3, Bert Steenbergen4,5
1Radboud University, Behavioural Science Institute, Nijmegen The Netherlands
2Verwey-Jonker Institute, Utrecht, The Netherlands
3ActivityWorkx, Zevenaar, The Netherlands
4Radboud University, Behavioural Science Institute, Nijmegen, The Netherlands
5the Australian Catholic University in Melbourne, Australia

Jan Middelkamp
✉ Montessorilaan 3, Postbox 9104, 6500 HE, Nijmegen, The Netherlands
Email: jan@hddgroup.com
Received: 14-12-2016 -- Accepted: 13-03-2017
Published (online): 01-06-2017

ABSTRACT

The transtheoretical model of behavior change (TTM) is often used to understand changes in health-related behavior, like exercise. Exercise behavior in fitness clubs is an understudied topic, but preliminary studies showed low frequencies and large numbers of drop-out. An initial 12-week self-efficacy intervention reported significant effects on exercise behavior. The objective of this follow up study is testing effects on exercise behavior over 52 weeks and the long-term relationships of all TTM constructs. In total 122 participants (Mage 42.02 yr.; SD 12.29; 67% females) were recruited and randomly assigned to group 1 (control), group 2 (self-set activities) and group 3 (self-set goals coaching). All participants were monitored 52-weeks. Measurements at baseline, 4, 8, 12, 26 and 52 weeks, using validated scales for stages of change, self-efficacy, decisional balance and processes of change. Exercise behavior and drop-outs were registered. An ANOVA revealed that group 3 significantly (p < 0.05) differed in exercise sessions from group 1 and 2 during the 12 weeks. A chi-square test indicated significant differences for continuing exercising after the intervention: 7 of group 1; 6 of group 2; 19 of group 3. In total 5 demonstrated regular exercise behavior at 26 weeks, and 3 at 52 weeks. Self-efficacy, decisional balance, and processes of change showed limited long-term changes over the later stages of change. At all measurements, participants reported more pros than cons and used more behavioral than cognitive processes. Exercise behavior of members in fitness clubs demonstrated dramatic developments in 52 weeks. The frequencies of sessions were so low that health effects will be minimal. The integrative character of the TTM appears to be weak; the data indicated limited relationships. More research is needed to understand exercise behavior and define optimal strategies to increase exercise attendance and decrease drop-outs in the long term.

Key words: Health, programs, maintenance, attendance, adherence, drop-out

Key Points
  • Approximately 151 million individuals exercise in 187.000 fitness clubs worldwide, mainly for health benefits.
  • The transtheoretical model of behavior change is often used to understand changes in health-related behavior, like exercise, but was never applied to this understudied population.
  • An initial 12-week self-efficacy intervention reported significant effects on (increased) exercise behavior.
  • The effects of this intervention were diminished at 26 and 52 weeks, with respectively only five and three participants maintaining regular exercise behavior in fitness clubs.
  • The integrative character of the TTM in this population appears to be weak; the data indicated limited relationships.








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