Determinants of readiness to adopt regular physical activity among Thai patients at risk for cardiovascular disease: A transtheoretical model

The Transtheoretical Model (TTM) was employed as a conceptual framework to explore the determinants of readiness for adopting regular physical activity and to evaluate the validity of the TTM constructs among Thai patients at risk for cardiovascular disease (CVD). This non-experimental correlational study used a convenience sample of 436 Thai adults diagnosed with hypertension, diabetes, hyperlipidemia, or both diabetes and hyperlipidemia, who came for follow-up treatment at hypertension, cardiac, and endocrine out-patient clinics at four public hospitals in Bangkok, Thailand. Data were collected using a demographic characteristics-questionnaire, physical activity characteristics questionnaire, and the questionnaires from the TTM constructs including (a) stages of readiness for adopting regular physical activity; (b) ten processes of change; (c) self-efficacy; and (d) decisional balance (pros and cons). Data were analyzed by using descriptive statistics, paired- t test, analysis of variances, multivariate analyses of variance, and discriminant analysis.; The subjects were predominantly female, with a mean age of 54.3. Most individuals were married and had a primary school education. The common diseases related to the risk of cardiovascular disease were hypertension, diabetes, and both hypertension and hyperlipidemia. The distribution of stages of change was 12% in precontemplation, 22% in contemplation, 35% in preparation, 12% in action, and 19% in maintenance. Most subjects participated in leisure-time activities, and the weekly moderate-intensity physical activity (MPA) was 65.3 minutes. There were significant moderate relationships between stages of changes and weekly MPA (η = .75) as well as behavioral processes (η = .61). Across five stages of change, there were weak associations (η = .04–.46) among age, education level, experiential processes, self-efficacy, pros, and cons.; Mean age and educational level for the precontemplation stage were lower than means for age and educational level in each of the other stages. For weekly MPA, there was a significant increase in mean MPA from contemplation stage to maintenance stage. The mean scores for experiential processes, behavioral processes, and self-efficacy variables significantly increased from precontemplation to action. In terms of decisional balance, the mean pros score for individuals in the preparation stage was less than the mean pros score for those in the maintenance stage. The mean score for cons in the action stage was lower than mean scores in the precontemplation, contemplation, and preparation stages. Additionally, the discriminant analysis showed that the set of variables including processes of change, self-efficacy, decisional balance, age, and educational level were able to classify stages of change correctly for 62.0% of participants.; These findings support the applicability of TTM to physical activity in a Thai population at risk for CVD. Therefore, TTM may provide a basis for further testing TTM-based interventions among that population. Moreover, knowing the determinants of regular physical activity can provide guidance to develop health promotion programs that match physical activity interventions with stages of change.