Psychosocial Mediators of Physical Activity and Fitness Changes in the Activity Counseling Trial
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ORIGINAL ARTICLE
Psychosocial Mediators of Physical Activity and Fitness Changes in the Activity Counseling Trial Meghan Baruth, Ph.D. & Sara Wilcox, Ph.D. & Andrea L. Dunn, Ph.D. & Abby C. King, Ph.D. & Bess H. Marcus, Ph.D. & W. Jack Rejeski, Ph.D. & James F. Sallis, Ph.D. & Steven N. Blair, PED
Published online: 30 April 2010 # The Society of Behavioral Medicine 2010
Abstract Background Improved understanding of the mediators of physical activity (PA) interventions could lead to improvements in theory and programs. Purpose To examine the 24-month mediating effects of psychosocial variables on PA and cardiorespiratory fitness M. Baruth (*) : S. Wilcox : S. N. Blair Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA e-mail: [email protected] A. L. Dunn Klein-Buendel, Inc., Golden, CO, USA A. C. King Department of Health Research and Policy and the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA B. H. Marcus Behavioral and Social Sciences Section, Brown University Program in Public Health, Providence, RI, USA W. J. Rejeski Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA J. F. Sallis Department of Psychology, San Diego State University, San Diego, CA, USA S. N. Blair Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
(CRF) outcomes in 878 initially sedentary adults aged 3575 participating in the Activity Counseling Trial. Methods Participants were assigned to one of three intervention arms: physician advice, assistance, or counseling. MacKinnon’s product of coefficients was used to test for longitudinal and contemporaneous mediation. Results Changes in behavioral processes of change from baseline to 24 months significantly mediated the relationship between the active intervention arms and improvements in PA and CRF from baseline to 24 months in both men and women. None of the other psychosocial variables tested met criteria for mediation. Conclusions Results indicate that behavioral interventions should incorporate methods to encourage participants to use these behavioral strategies as they attempt to become more active. Keywords Behavior change . Exercise . RCT . Intervention . Physician counseling
Introduction Progress has been made in developing more effective approaches to promoting physical activity (PA) [1]; however, much less is known regarding how behavioral interventions work [2]. As a result, there has been a call for research on mediating mechanisms [2]. A mediator is an intervening variable that provides a possible explanation for the causal relationship between an intervention and an outcome [3]. More specifically, mediators begin to open up the “black box” of behavior change and provide explanations for why or how interventions produce improvements in behavior, or fail to do so [4]. Behavioral interventions are typically designed to change mediators
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