title: The roles of self-efficacy and motivation in the prediction of short- and long-term adherence to exercise among patients with coronary heart disease.
abstract: OBJECTIVE
  Poor adherence to regular exercise is a documented challenge among people with heart disease. Identifying key determinants of exercise adherence and distinguishing between the processes driving short- and long-term adherence to regular exercise is a valuable endeavor. The purpose of the present study was to test a model of exercise behavior change, which incorporates motivational orientations and self-efficacy for exercise behavior, in the prediction of short- and long-term exercise adherence.
  
  
  METHODS
  Male and female patients (N = 801) hospitalized for coronary heart disease were recruited from 3 tertiary care cardiac centers and followed for a period of 1 year after hospital discharge. A prospective, longitudinal design was used to examine the roles of motivation and self-efficacy (measured at recruitment and at 2 and 6 months after discharge) in the prediction of exercise behavior at 6 and 12 months. Baseline measures of exercise and clinical and demographic covariates were included in the analyses.
  
  
  RESULTS
  Structural equation modeling showed that both autonomous motivation and self-efficacy were important determinants of short-term (6-month) exercise behavior regulation, but that only autonomous motivation remained a significant predictor of long-term (12-month) exercise behavior. Self-efficacy partially mediated the relationship between motivation for exercise and 6-month exercise behavior.
  
  
  CONCLUSIONS
  This research confirmed the roles of autonomous motivation and self-efficacy in the health behavior change process and emphasized the key function of autonomous motivation in exercise maintenance. Theoretical and cardiac rehabilitation program applications of this research are discussed.
authors.affiliation: School of Psychology.
authors.forename: Monika E
authors.initials: ME
authors.lastname: Slovinec D'Angelo
authors.affiliation: School of Psychology.
authors.forename: Luc G
authors.initials: LG
authors.lastname: Pelletier
authors.affiliation: Division of Prevention and Rehabilitation, University of Ottawa Heart Institute.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Reid
authors.affiliation: School of Psychology.
authors.forename: Veronika
authors.initials: V
authors.lastname: Huta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000523:psychology / Q000534:rehabilitation*; D015444:Exercise / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D020377:Self Efficacy; D013997:Time Factors