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Long-Term Effects of a Stage-Based Intervention for Changing Exercise Intentions and Behavior in Older Adults

Correspondence: Address correspondence to Mary L. Greaney, PhD, Public Health Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115. E-mail: mgreaney{at}hsph.harvard.edu

Purpose: We examined the efficacy of an intervention tailored to the individual's stage of change for exercise adoption on exercise stage of change, physical activity, and physical function in community-dwelling older adults. Design and Methods: We randomized participants to a print and telephone intervention or a contact comparison group. Through the use of longitudinal analyses we examined the intervention's effectiveness in promoting stage progression, altering decisional balance and the processes of change, increasing self-efficacy and physical activity, and improving physical function among older adults who completed the 24-month study (N = 966). We conducted similar analyses that excluded individuals who were in maintenance at baseline and 24 months. Results:  At the end of the study, there were no differences in stage progression, self-efficacy, decisional balance, the processes of change, physical activity, or physical function by intervention assignment. When the analyses excluded those participants (n = 358) who were in the maintenance stage for exercise throughout the intervention, we found that, compared with the comparison group, a greater proportion of individuals who received the exercise intervention progressed in stage by 24 months. Conversely, more individuals in the comparison group remained stable or regressed in stage compared with the intervention group. Implications: Results indicate that a tailored intervention is effective in increasing motivational readiness for exercise in individuals who were in stages of change other than maintenance.

Key Words: Behavior change • Exercise • Health promotion • Intervention • Transtheoretical model