Older women and exercise: Explanatory concepts

Background. Older women remain predominantly sedentary despite potential health benefits and reduced risks of cardiovascular disease associated with regular exercise. Primary care interventions to increase exercise need to focus on constructs amenable to intervention that predict exercise behavior. Purpose. The study tested an explanatory model of older women's exercise behavior using concepts from social cognitive theory, the transtheoretical model, and the theory of planned behavior (self-efficacy, outcome expectancy, perceived exercise barriers, processes of change, perceived health, and age). Methods. Data were collected by interviews with 203 older community-dwelling women physically capable of some exercise. Ordinary least squares regression results were used to determine the direct and indirect effects in a path model. Findings. All concepts and 13 hypothesized paths were retained in the trimmed model. The constructs accounted for 46% of the variance in exercise behavior. Outcome expectancy had the largest total effect. Processes of change had the largest direct effect on exercise behavior. Exercise self-efficacy and perceived exercise barriers accounted for similar amounts of variance in exercise behavior, whereas age and health had only modest effects. Conclusion. Important constructs for future exercise model testing and intervention research should include outcome expectancy, processes of change, exercise self-efficacy, and perceived barriers to exercise. Primary care interventions designed to increase older women's exercise should focus on these same constructs.