Date of Award
Fall 2014
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Nursing
First Advisor
Topp, Robert
Second Advisor
Haglund, Kristin
Third Advisor
Berg, Jill Winters
Abstract
In the United States, 35.5% of adult women are classified as obese, defined as a body mass index (BMI) of > 30 kg/m2. The health risks associated with obesity can be mitigated through losing even 5-10% of initial body weight. Evidence shows that reductions in caloric intake alone without increases in caloric expenditure leads to a decline in resting metabolic rate, thereby impeding attainment or maintenance of weight loss. The purpose of this cross-sectional, mixed-methods study was to explore the antecedents of regular exercise among women with obesity who did and did not achieve weight loss over six months. The antecedents studied (behavioral beliefs, normative beliefs, control beliefs, attitudes, subjective norms, perceived behavioral control, and behavioral intentions) were based on the Theory of Planned Behavior (TPB) (Azjen, 2006). Forty-two women were recruited from a clinic in the Midwest. Twenty-six women did not achieve at least a 5% weight loss over six months, while 16 women did. Quantitatively, the antecedents were measured using the Physical Activity Survey for Adults at Risk for Diabetes (Blue, 2004). Additionally, a subgroup of women participated in one of two focus groups, based on their achievement of weight loss, to explore antecedents of their intention to exercise. No statistically significant findings were noted to discriminate TPB antecedents between the two groups when bivariate comparisons were conducted. However, four themes emerged from analysis of the focus group data using the qualitative descriptive approach: exercise is good for me, but I don¡&hibar;t like it; friends make it happen; more time does not equal more exercise; and control is key. Overall, the focus group data yielded differences in how the two groups discussed the antecedents of attitude and perceived behavioral control. Similarly, multiple regression analysis noted that attitude and perceived behavioral control were the only independent predictors of intention to exercise (F(2,39) = 33.426, p < .0005) and explained 63.2% of the variance of intention to exercise. Results from the study indicate that targeted interventions to increase women¡&hibar;s perception of behavioral control and attitudes toward exercise may facilitate their intention to exercise, and thereby their actual exercise behavior.