Proxy Efficacy: Implications for Self-Efficacy and Exercise Intentions in Cardiac Rehabilitation.

Objective: To examine relations among proxy efficacy, exercise self-efficacy, and exercise in cardiac rehabilitation. Participants and Study Design: Twenty-nine cardiac rehabilitation outpatients (24 men and 5 women) enrolled in a 12-week hospital-based program. Measures of proxy efficacy and exercise self-efficacy, obtained in Week 3, were used to predict program attendance and exercise self-efficacy at Week 10. Late program (i.e.. Week 10) exercise self-efficacy and proxy efficacy were also used to predict postprogram exercise intentions. Results: Early program proxy efficacy and attendance predicted late program exercise self-efficacy (adjusted K2 = .71, p     

Use of an efficacy-enhancing message to influence the self-regulatory efficacy of cardiac rehabilitation participants: A field experiment.

Objective: To examine whether a message designed to target sources of self-efficacy information could increase self-regulatory efficacy for independent exercise among cardiac rehabilitation (CR) participants. Study Design: Randomized controlled field experiment. Method: Fifty-four participants completed premanipulation measures of self-regulatory efficacy and exercise intentions, then were randomly assigned to read either an efficacy-enhancing or control message. Participants completed postmanipulation measures of self-regulatory efficacy, intentions, agreement with action plans, and behavioral commitment. Results: A 2 × 2 repeated-measures multivariate analysis of variance revealed a significant Message × Time interaction (p     

Enhancing student academic and health functioning: A self-regulatory perspective.

Discusses a program of research on students' self-regulation of their academic and health functioning from initial operational definitions to training and intervention studies. This body of evidence has shown that students' use of self-regulatory processes, such as learning strategies, goal setting, self-monitoring, and self-efficacy beliefs, predict academic and health success and self-motivation. From a social cognitive perspective, students' development of self-regulation begins initially with social modeling and imitation and shifts to self-directed sources of control. Deficiencies in self-regulation are linked to student's health and academic problems. Implications for school psychologists are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy beliefs in geriatric rehabilitation

Motivation is an important variable in older adults' ability to recover from any disabling event. The theory of self-efficacy states that efficacy beliefs affect behavior, motivational level, thought patterns, and emotional reactions in response to any situation. This study explored the impact of efficacy beliefs on older adults in a rehabilitation program and tested interventions to strengthen efficacy beliefs related to participation in rehabilitation and functional performance. An experimental pretest-posttest design was used. Participants were randomly assigned to: the usual care control group or the treatment group. The study was completed on an inpatient geriatric rehabilitation unit. The sample consisted of 77 participants, 55 women and 22 men with a mean age of 78 +/- 7.2. Individuals in the treatment group received three efficacy enhancing interventions: role modeling, verbal persuasion, and physiological feedback. Baseline data were collected within 48 hours of admission and included four investigator-developed efficacy measures: Functional Inventory Measure, Participation Index, Numeric Rating Scale for pain, amount of analgesic used for pain, and Health Status. With the exception of Health Status, these measures were again completed within 48 hours of discharge. Admission performance was the only statistically significant predictor of efficacy beliefs. All efficacy beliefs increased over time and were significantly correlated with performance behaviors and length of stay. The treatment group had stronger efficacy beliefs regarding participation, higher participation at discharge, and less pain than the control group. Efficacy beliefs, both self-efficacy and outcome expectations, are related to participation, functional performance, and length of stay. Interventions to strengthen these beliefs improved participation in rehabilitation and decreased pain. Consideration of motivation can facilitate rehabilitation and help older adults obtain and maintain their highest functional level.     

Growth trajectories of exercise self-efficacy in older adults: Influence of measures and initial status.

Objective: This study examined differential trajectories of exercise-related self-efficacy beliefs across a 12-month randomized controlled exercise trial. Method: Previously inactive older adults (N = 144; M age = 66.5) were randomly assigned to one of two exercise conditions (walking, flexibility-toning-balance) and completed measures of barriers self-efficacy (BARSE), exercise self-efficacy (EXSE), and self-efficacy for walking (SEW) across a 12-month period. Changes in efficacy were examined according to efficacy type and interindividual differences. Latent growth curve modeling was employed to (a) examine average levels and change in each type of efficacy for the collapsed sample and by intervention condition and (b) explore subpopulations (i.e., latent classes) within the sample that differ in their baseline efficacy and trajectory. Results: Analyses revealed two negative trends in BARSE and EXSE at predicted transition points, in addition to a positive linear trend in SEW. Two subgroups with unique baseline efficacy and trajectory profiles were also identified. Conclusion: These results shed new light on the relationship between exercise and self-efficacy in older adults. They also highlight the need for strategies for increasing and maintaining efficacy within interventions, namely targeting participants who start with a disadvantage (lower efficacy) and integrating efficacy-boosting strategies for all participants prior to program end. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Common and specific process factors in cardiac rehabilitation: Independent and interactive effects of the working alliance and self-efficacy.

Objective: Therapeutic processes in cardiac rehabilitation programs are virtually unexamined. Models were tested by which changes in the working alliance between patient and staff (agreement on goals/tasks; emotional bond) may affect outcomes in conjunction with changes in patient self-efficacy to change their diets and increase exercise. Design: Cardiac patients (n = 79) participated in a 12-week program, and completed assessments at early, mid, and late treatment. Main Outcome Measures: Changes in cardiac depression, physical health, perceived exertion during exercise, rate/pressure product at submaximal exercise tolerance, weight loss, return to work, total fat intake. Results: Early-treatment changes in agreement on goals/tasks were related to changes in psychosocial factors and perceived exertion during exercise independent of effects of changes in self-efficacy. Early-treatment changes in goals/tasks and self-efficacy interacted to predict changes in cardiorespiratory fitness, weight loss, and return to work such that patients high on both goals/tasks and self-efficacy showed the most gains. Conclusion: Sound therapeutic relationships between patients and staff may play an important role in facilitating the achievement of a wide-range of salutary outcomes during cardiac rehabilitation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sources of self-efficacy: An investigation of elementary school students in France.

The purpose of this study was to assess the influence of Bandura's (1997) theorized sources of self-efficacy on the academic and self-regulatory efficacy beliefs of 3rd-grade elementary school students (N = 395) in France, to examine whether classroom context might explain a significant portion of the variation in self-efficacy, and to assess whether these sources differ as a function of sex. Hierarchical linear modeling revealed that mastery experience, social persuasions, and mean classroom-level self-efficacy predicted mathematics self-efficacy. Mastery experience, social persuasions, physiological state, and mean classroom-level self-efficacy predicted French self-efficacy. All 4 sources predicted self-efficacy for self-regulated learning in both subjects, with the exception of vicarious experience in French. Classroom-level variables did not predict self-efficacy for self-regulated learning in either subject. Boys outperformed girls in mathematics and reported higher mathematics self-efficacy, self-regulatory efficacy, mastery experience, social persuasions, and lower physiological arousal. In French, girls outperformed boys but reported lower self-efficacy. Findings support and refine the theoretical tenets of Bandura's social cognitive theory. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Impact of pulmonary rehabilitation on self-efficacy, quality of life, and exercise tolerance.

Objective: The objective of the present study was to investigate changes in psychological, physiological, and behavioral-performance variables as a function of pulmonary exercise rehabilitation. Study Design and Participants: Forty patients diagnosed with chronic obstructive pulmonary disease (COPD) were recruited for participation in a 12-week outpatient pulmonary rehabilitation program. Measures: Measures included 6-min walking distance (exercise tolerance), 6-min walking distance self-efficacy, overall quality of life, dyspnea, fatigue, and emotional function. Results: Results revealed significant improvements over the course of the program in each of these measures, regardless of disease severity. In addition, improvements in exercise tolerance were significantly associated with increases in self-efficacy, which, in turn, were significantly related to improved quality of life. Conclusions: The results support the tenets of social-cognitive theory and suggest that participation in an outpatient pulmonary rehabilitation program can provide both physiological and psychological benefits for individuals with COPD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-regulatory processes defend against the threat of death: Effects of self-control depletion and trait self-control on thoughts and fears of dying.

Nine studies (N = 979) demonstrated that managing the threat of death requires self-regulation. Both trait and state self-control ability moderated the degree to which people experienced death-related thought and anxiety. Participants high (vs. low) in self-control generated fewer death-related thoughts after being primed with death, reported less death anxiety, were less likely to perceive death-related themes in ambiguous scenes, and reacted with less worldview defense when mortality was made salient. Further, coping with thoughts of death led to self-regulatory fatigue. After writing about death versus a control topic, participants performed worse on several measures of self-regulation that were irrelevant to death. These results suggest that self-regulation is a key intrapsychic mechanism for alleviating troublesome thoughts and feelings about mortality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal-fetal disease information as a source of exercise motivation during pregnancy.

Objective: A Protection Motivation Theory (PMT) framework was used to examine whether information about the role of exercise in preventing maternal-fetal disease served as a meaningful source of exercise motivation. Design: Pregnant women (n = 208) were randomly assigned into one of three conditions: PMT, attention control, and noncontact control. Women in the PMT group read a brochure about the benefits of exercise during pregnancy incorporating the major components of PMT; perceived vulnerability (PV), perceived severity (PS), response efficacy (RE), and self-efficacy (SE). Participants in the attention-control condition read a brochure about diet. Following treatment, all participants completed measures of their beliefs toward maternal-fetal disease and exercise, goal intention (GI), and implementation intention (IMI). One week later, a measure of self-reported exercise behavior was collected. Main Outcome Measures: Main outcome measures were PMT variables (PV, PS, RE, and SE), GI, IMI, and follow-up physical activity. Results: Participants assigned to the PMT-present group reported significantly higher PS, RE, SE, GI, and increased exercise behavior. PS, RE, and SE predicted GI, GI predicted IMI, and IMI predicted exercise behavior. Conclusion: Information grounded in PMT is effective in influencing pregnant women’s beliefs and intentions as well as changing their initial behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experimental evaluation of rehabilitation in chronic obstructive pulmonary disease: Short-term effects on exercise endurance and health status.

Assigned 119 adults (mean age 62.6 yrs) with chronic obstructive pulmonary disease to an 8-wk comprehensive rehabilitation program (CRP) or to an 8-wk education control program (ECP). The CRP included education, physical and respiratory therapy instruction, psychosocial support, and supervised exercise training. The ECP included biweekly classroom instruction and discussions on respiratory therapy, medical aspects of lung disease, clinical pharmacology, and diet, but no exercise training. Ss received physiological and psychosocial evaluation before and after intervention. Six months after enrollment, Ss in the CRP showed significant increases in exercise endurance, whereas Ss in the ECP showed nonsignificant increases. Ss in the CRP also showed related improvements in self-efficacy for walking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivational “spill-over” during weight control: Increased self-determination and exercise intrinsic motivation predict eating self-regulation.

Objective: Successful weight management relies on at least two health behaviors, eating and exercise. However, little is known about their interaction on a motivational and behavioral level. Based on the Hierarchical Model of Motivation the authors examined whether exercise-specific motivation can transfer to eating regulation during a lifestyle weight control program. The authors further investigated whether general, treatment-related, and exercise motivation underlie the relation between increased exercise and improved eating regulation. Design: Overweight/obese women participated in a 1-year randomized controlled trial (N = 239). The intervention focused on promoting physical activity and internal motivation for exercise and weight loss, following Self-Determination Theory. The control group received general health education. Main Outcome Measures: General and exercise specific self-determination, eating self-regulation variables, and physical activity behavior. Results: General self-determination and more autonomous exercise motivation predicted eating self-regulation over 12 months. Additionally, general and exercise self-determination fully mediated the relation between physical activity and eating self-regulation. Conclusion: Increased general self-determination and exercise motivation seem to facilitate improvements in eating self-regulation during weight control in women. These motivational mechanisms also underlie the relationship between improvements in exercise behavior and eating regulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of self-efficacy in rehabilitation outcome among chronic low back pain patients.

Examined the role of self-efficacy beliefs in the rehabilitation of 45 low back pain patients participating in a 3-wk rehabilitation program. Increments in self-efficacy beliefs during the rehabilitation program were not associated with improved patient functioning at discharge from the program. However, in support of the theorized role of self-efficacy in behavior change, these increments in self-efficacy significantly predicted better patient functioning and less reported pain at the 6-mo follow-up assessment. Implications of these findings for the rehabilitation of low back pain patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Applying social cognitive theory to interest in research among counseling psychology doctoral students: A path analysis.

In this study, the R. W. Lent, S. D. Brown, and G. Hackett (see record 1994-47157-001) social cognitive model of interest development was applied to the prediction of interest in research. Participants included 184 counseling psychology doctoral students. Results of a path analysis indicated that 5 variables were significant predictors of interest in research: research outcome expectations, research self-efficacy beliefs, investigative interests, artistic interests, and age. In addition, several factors indirectly affected interest in research through effects on research self-efficacy—the research training environment, Holland Investigative interests, and year in program. Research training environment, Holland Investigative interests, and research self-efficacy beliefs also had an impact on interest in research indirectly through their effects on research outcome expectations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Negative self-efficacy and goal effects revisited.

The authors address the verification of the functional properties of self-efficacy beliefs and document how self-efficacy beliefs operate in concert with goal systems within a sociocognitive theory of self-regulation in contrast to the focus of control theory on discrepancy reduction. Social cognitive theory posits proactive discrepancy production by adoption of goal challenges working in concert with reactive discrepancy reduction in realizing them. Converging evidence from diverse methodological and analytic strategies verifies that perceived self-efficacy and personal goals enhance motivation and performance attainments. The large body of evidence, as evaluated by 9 meta-analyses for the effect sizes of self-efficacy beliefs and by the vast body of research on goal setting, contradicts findings (J. B. Vancouver, C. M. Thompson, & A. A. Williams, 2001, J. B. Vancouver, C. M. Thompson. E. C. Tischner, & D. J. Putka, 2002) that belief in one's capabilities and personal goals is self-debilitating. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy and safety of exercise programs in cardiac rehabilitation

Physical activity performed by patients with coronary heart disease is a two-edged sword. A number of biological changes produced by regular exercise may reduce the risk of future cardiac events, while the increase in cardiac work produced by this same exercise can predispose the patient to sudden cardiac death. Data from observational studies as well as randomized clinical trials demonstrate a lower cardiac mortality rate for men participating in exercise rehabilitation programs vs nonparticipants. Overall, exercise program participants appear to experience a reduction of approximately 25% in cardiac and all-cause mortality, but no single study has provided definitive results. During medically supervised exercise, the risk of cardiac death based on reports of programs in the United States is approximately one event in every 60,000 participant-hours of exercise. At this rate, a typical rehabilitation program that has 95 patients exercising 3 h.wk-1 could expect a sudden cardiac death during an exercise session once every 4 yr. No data have been published on the morbidity or mortality benefits or risks of home-based exercise or for women participants. Also, the contribution of continuous electrocardiographic monitoring to the safety of exercise training of cardiac patients is yet to be defined.     

Older adults with chronic disease: Benefits of group-mediated counseling in the promotion of physically active lifestyles.

In this 12-month trial standard exercise training was compared with a group-mediated cognitive behavioral (GMCB) intervention with respect to effects on long-term adherence and change in physical function of older adults who were either at risk for or had cardiovascular disease. Participants (147 older men and women) were randomized to the 2 treatments. Outcomes included self-reported physical activity, fitness, and self-efficacy. The GMCB treatment produced greater improvements on all outcomes than did standard exercise therapy. Regardless of treatment assignment, men had more favorable change on the study outcomes than did women. Analysis of a self-regulatory process measure in the GMCB group revealed that change in barriers efficacy was related to change in physical activity and fitness. Results suggest that teaching older adults to integrate physical activity into their lives via GMCB leads to better long-term outcomes than standardized exercise therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective evaluation of the effects of stress on exercise adherence in community-residing women.

The effects of stress on exercise behavior in community-residing women exercising on their own were assessed. Participants (N?=?82) completed a background questionnaire and kept exercise diaries and Weekly Stress Inventories (P. J. Brantley, G. N. Jones, E. Boudreax, & S. L. Catz, 1997) for 8 consecutive weeks. During weeks with a high frequency of stressful events, participants exercised for less time and reported lower self-efficacy for meeting upcoming exercise goals. During weeks of high perceived stress, participants exercised significantly fewer days, omitted more planned exercise sessions, were less satisfied with their exercise, and had lower self-efficacy for meeting exercise goals. Findings suggest that perceptions of stressful events and cognitive reactions to missed exercise may play a significant role in mediating exercise behavior and support the view of exercise relapse as an ongoing process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Process and Outcome in Cardiac Rehabilitation: An Examination of Cross-Lagged Effects.

Cardiac rehabilitation patients improve cardiorespiratory fitness and quality of life, yet therapeutic processes that produce these changes remain unknown. A cross-lagged panel design was used to determine whether early-treatment enhancement of self-efficacy regarding abilities to change diet and exercise habits and the quality of the patient-staff working alliance predicted late-treatment changes in a wide range of outcomes, but not vice versa. Eighty cardiac patients participating in a 12-week program completed measures at early, mid- and late treatment. Early-treatment changes in exercise self-efficacy predicted late-treatment changes in activity level, depression, and working alliance, but not vice versa. Diet self-efficacy changes correlated with concurrent changes in fat intake and body weight. Early-treatment changes in cardiorespiratory fitness and activity level predicted late-treatment changes in working alliance, but not vice versa. Findings suggest that increased exercise self-efficacy represents an important therapeutic mechanism by which rehabilitation gains are realized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does barrier efficacy mediate the gender-exercise adherence relationship during phase II cardiac rehabilitation?

Objective: To determine whether barrier efficacy (i.e., confidence in one's ability to perform an elemental task under challenging conditions) mediated the gender-exercise adherence relationship in Phase 11 cardiac rehabilitation. Study Design and Participants: A questionnaire concerning 9 exercise barriers was administered to 98 Phase 11 cardiac rehabilitation patients (50 male and 48 female). Results: Men had significantly higher exercise adherence rates, F(l, 96) = 7.22, p = .01, effect size = .53, and barrier efficacy, F(l, 95) = 17.50, p