title: Changes in enjoyment, self-efficacy, and motivation during a randomized trial to promote habitual physical activity adoption in bariatric surgery patients.
abstract: BACKGROUND
  The Bari-Active trial found that a physical activity (PA) intervention (PAI), versus standard presurgical care control (SC), produced significant increases in daily bout-related moderate-to-vigorous PA (MVPA, in≥10-min bouts) preoperatively. The present study examined whether PAI also produces superior improvements in psychological and/or motivational processes that may be important for PA adoption.
  
  
  OBJECTIVE
  Compare PAI and SC on baseline to postintervention changes in PA-related enjoyment, self-efficacy, and motivations, and examine whether greater bout-related MVPA changes are associated with greater improvements in these variables.
  
  
  METHODS
  University hospital, United States.
  
  
  METHODS
  Participants (87% female; body mass index = 45.0±6.5 kg/m(2)) were randomly assigned to 6 weeks of PAI (n = 40) or SC (n = 35). PAI received weekly counseling sessions to increase daily walking exercise. At baseline and postintervention, both groups completed 7-day objective PA monitoring and questionnaires to evaluate changes in bout-related MVPA and PA enjoyment, self-efficacy, and motivation.
  
  
  RESULTS
  Retention was 84% at postintervention. Intent-to-treat analyses showed that PAI on average reported more favorable changes than SC in PA enjoyment, self-efficacy, amotivation (i.e., lack of PA motivation), and identified and intrinsic regulations (i.e., more autonomous PA motivations; P<.01). In PAI completers (n = 33), changes in bout-related MVPA and psychological/motivational variables were unrelated.
  
  
  CONCLUSIONS
  PAI produced greater improvements in PA-related enjoyment, self-efficacy, and motivations than SC. The lack of association between objectively measured PA changes and psychological/motivational processes highlights the need for future research to identify which processes are most important for PA adoption and maintenance in bariatric surgery patients, and to determine whether the method used to measure PA affects the pattern of association.
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital Weight Control and Diabetes Research Center, Providence, Rhode Island. Electronic address: dbond@lifespan.org.
authors.forename: Dale S
authors.initials: DS
authors.lastname: Bond
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital Weight Control and Diabetes Research Center, Providence, Rhode Island.
authors.forename: J
authors.initials: J
authors.lastname: Graham Thomas
authors.affiliation: Department of Surgery, Alpert Medical School of Brown University, The Miriam Hospital, Providence, Rhode Island.
authors.forename: Sivamainthan
authors.initials: S
authors.lastname: Vithiananthan
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital Weight Control and Diabetes Research Center, Providence, Rhode Island.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Webster
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital Weight Control and Diabetes Research Center, Providence, Rhode Island.
authors.forename: Jessica
authors.initials: J
authors.lastname: Unick
authors.affiliation: Department of Surgery, Alpert Medical School of Brown University, The Miriam Hospital, Providence, Rhode Island.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Ryder
authors.affiliation: Department of Surgery, Roger Williams Hospital, Providence, Rhode Island.
authors.forename: Dieter
authors.initials: D
authors.lastname: Pohl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000523:psychology; D003376:Counseling; D005081:Exercise Therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009767:Obesity, Morbid / Q000523:psychology / Q000628:therapy*; D010549:Personal Satisfaction; D020377:Self Efficacy; D016138:Walking / Q000523:psychology; D055815:Young Adult
keywords: Bariatric surgery; Enjoyment; Intervention; Motivation; Physical activity; Self-efficacy