title: Applying the Transtheoretical Model to Physical Activity Behavior in Individuals With Non-Cystic Fibrosis Bronchiectasis.
abstract: 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 fibrosis bronchiectasis. (ClinicalTrials.gov registration NCT01569009.).
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland. UKCRC Centre of Excellence for Public Health, Belfast, Northern Ireland.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Wilson
authors.affiliation: School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland.
authors.forename: Alison
authors.initials: A
authors.lastname: Kirk
authors.affiliation: Centre for Health and Rehabilitation Technologies, Institute for Nursing and Health Research, Ulster University, Derry, Northern Ireland.
authors.forename: Kate
authors.initials: K
authors.lastname: Hayes
authors.affiliation: Centre for Health and Rehabilitation Technologies, Institute for Nursing and Health Research, Ulster University, Derry, Northern Ireland.
authors.forename: Ian
authors.initials: I
authors.lastname: Bradbury
authors.affiliation: UKCRC Centre of Excellence for Public Health, Belfast, Northern Ireland. Centre for Health and Rehabilitation Technologies, Institute for Nursing and Health Research, Ulster University, Derry, Northern Ireland.
authors.forename: Suzanne
authors.initials: S
authors.lastname: McDonough
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland. UKCRC Centre of Excellence for Public Health, Belfast, Northern Ireland.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Tully
authors.affiliation: Centre for Health and Rehabilitation Technologies, Institute for Nursing and Health Research, Ulster University, Derry, Northern Ireland.
authors.forename: Brenda
authors.initials: B
authors.lastname: O'Neill
authors.affiliation: Wellcome Trust-Wolfson Northern Ireland Clinical Research Facility, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland. judy.bradley@qub.ac.uk.
authors.forename: Judy M
authors.initials: JM
authors.lastname: Bradley
mesh_terms: D061725:Accelerometry; D000368:Aged; D001987:Bronchiectasis / Q000523:psychology*; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009043:Motor Activity; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: accelerometry; behavioral research; physical activity; respiratory tract diseases