Transtheoretical Model for Exercise: Measure Redevelopment and Assessing the Role of Barriers in a Diverse Population

• Published in: American journal of health promotion Vol. 38; no. 2; pp. 186 - 196
• Main Authors: Monahan, Katie, Paiva, Andrea, Blissmer, Bryan, Sacco, Allegra, Robbins, Mark
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.02.2024; American Journal of Health Promotion
• Subjects: Adult; Adults; African Americans; Barriers; Black people; Confirmatory factor analysis; Cross-Sectional Studies; Discomfort; Exercise; Exercise - psychology; Health Behavior; Health promotion; Hispanic people; Humans; Measurement; Self Efficacy; Surveys and Questionnaires; Transtheoretical Model; United States; United States; United States > US; racial minority groups; exercise; Transtheoretical Model; measurement issues; health promotion
• ISSN: 0890-1171; 2168-6602; 2168-6602
• DOI: 10.1177/08901171231213692

Purpose To redevelop and improve Transtheoretical Model (TTM) exercise measures for Black and Hispanic/Latinx adults. The redeveloped scales will address barriers to exercise potentially relevant to populations of color in the United States (US). Design Cross-sectional, split-half measure development. Setting Online survey in the US. Subjects 450 Black and/or Hispanic/Latinx adults. Measures Demographics, exercise engagement (IPAQ-SF), stage of change (SOC), decisional balance (DCBL), self-efficacy (SE), and barriers to exercise. Analysis Split-half exploratory (EFA) and confirmatory factor analyses (CFA) were executed to establish measurement structure and fit, followed by multivariate analyses to assess constructs by SOC. Results EFA/CFA for DCBL revealed three factors (α = .85, .70, .75) which represented Pros of exercise, Cons of exercise related to time and safety, and Cons of exercise related to physical or emotional discomfort. Model fit was adequate (CFI = .89). For SE, two factors (α = .85, .77) resulted with good model fit (CFI = .91). These factors reflected self-efficacy to exercise when confronted with generally challenging situations, and self-efficacy to exercise when specifically experiencing affective difficulties, such as depression or anxiety. Lastly, a novel Barriers measure resulted in three factors (α = .82, .77, .76), representing barriers encountered due to family responsibilities, work obligations, and health challenges, with good model fit (CFI = .95). Shifts in the core TTM constructs by SOC largely mapped onto the theoretical trends expected under the TTM. Conclusion This study produced systematically developed TTM exercise measures for Black and Hispanic/Latinx adults in the US that address and incorporate important barriers to exercise. This research represents an important step forward in broadening the inclusion of diverse populations to TTM measure development processes and may lead to a better understanding of relevant factors impeding exercise engagement in the US.