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Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Testing the validity of a stage assessment on health enhancing physical activity in a chinese university student sample

Authors: Yanping Duan, Sonia Lippke, Ru Zhang, Walter Brehm, Pak-Kwong Chung

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

The study examined the measurement quality of a stage algorithm measuring the Four steps from Inactivity to activity Theory (FIT Model).

Methods

In a cross-sectional study, stages were assessed in 1012 Chinese university students in terms of physical activity, social-cognitive variables and health outcomes. Main outcome measures were stages of change, self-reported physical activity, perceived barriers, intrinsic motivation, plans, fitness and health satisfaction. Misclassification, sensitivity, specificity, receiver operating characteristic (ROC) curves, nonlinear trends, and planned comparison were computed.

Results

Compared to previous studies, sensitivity was at the average level (64 %-71 %), and specificity was comparably higher (76%-89%). When using higher PA intensity criteria (moderate and strenuous intensities), sensitivity was higher, whereas specificity was lower in comparison to the lower PA intensity criteria (also including mild activity). After running contrast and trend analyses, nonlinear trends for all indicative variables across the stages and a match of 77 % of predictions of stage differences were confirmed.

Conclusion

The measurement quality of the stage algorithm was supported in a young adult sample.
Literature
1.
go back to reference WHO. Global recommendations on physical activity for health. ISBN: 9789241599979;2010. WHO. Global recommendations on physical activity for health. ISBN: 9789241599979;2010.
2.
go back to reference Duan YP, Brehm W, Wagner P, Chung PK, Graf S, Zhang R, Si GY. Transition to adulthood: relationships among psychosocial correlates, stages of change for physical activity and health outcomes in a cross-cultural sample. J Phys Activity Health. 2015; doi: http://dx.doi.org/10.1123/jpah.2014-0389. Duan YP, Brehm W, Wagner P, Chung PK, Graf S, Zhang R, Si GY. Transition to adulthood: relationships among psychosocial correlates, stages of change for physical activity and health outcomes in a cross-cultural sample. J Phys Activity Health. 2015; doi: http://​dx.​doi.​org/​10.​1123/​jpah.​2014-0389.​
3.
go back to reference Sinclair KM, Hamlin MJ, Gd S. Physical activity levels of first-year New Zealand university students: a pilot study. Youth Studies Australia. 2005;24(1):38–42. Sinclair KM, Hamlin MJ, Gd S. Physical activity levels of first-year New Zealand university students: a pilot study. Youth Studies Australia. 2005;24(1):38–42.
4.
go back to reference Hoyos I, Irazusta A, Gravina L, Gil SM, Gil J, Irazusta J. Reduced cardiovascular risk is associated with aerobic fitness in university students. Europ J Sport Sci. 2011;11(2):87–94.CrossRef Hoyos I, Irazusta A, Gravina L, Gil SM, Gil J, Irazusta J. Reduced cardiovascular risk is associated with aerobic fitness in university students. Europ J Sport Sci. 2011;11(2):87–94.CrossRef
5.
go back to reference Biddle SJH, Fuchs R. Exercise psychology: a view from Europe. Psychol Sport Exerc. 2009;10:410–9.CrossRef Biddle SJH, Fuchs R. Exercise psychology: a view from Europe. Psychol Sport Exerc. 2009;10:410–9.CrossRef
6.
go back to reference Prochaska JO, Marcus BH. The transtheoretical model: applications to exercise. In: Dishman RK, editor. Advances in exercise adherence. Champaign, IL, England: Human Kinetics Publishers; 1994. p. 161–80. Prochaska JO, Marcus BH. The transtheoretical model: applications to exercise. In: Dishman RK, editor. Advances in exercise adherence. Champaign, IL, England: Human Kinetics Publishers; 1994. p. 161–80.
7.
go back to reference Schwarzer R. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Appl Psychol Int Rev. 2008;57:1–29. Schwarzer R. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Appl Psychol Int Rev. 2008;57:1–29.
8.
go back to reference Duan YP, Brehm W, Strobl H, Tittlbach S, Huang ZJ, Si GY. Steps to and correlates of health-enhancing physical activity in adulthood: an intercultural study between German and Chinese individuals. J Exerc Sci & Fitness. 2013;11:63–77.CrossRef Duan YP, Brehm W, Strobl H, Tittlbach S, Huang ZJ, Si GY. Steps to and correlates of health-enhancing physical activity in adulthood: an intercultural study between German and Chinese individuals. J Exerc Sci & Fitness. 2013;11:63–77.CrossRef
9.
go back to reference Spencer L, Adams TB, Malone S, et al. Applying the transtheoretical model to exercise: a systematic and comprehensive review of the literature. Health Promotion Practice. 2006;7:429–43.CrossRef Spencer L, Adams TB, Malone S, et al. Applying the transtheoretical model to exercise: a systematic and comprehensive review of the literature. Health Promotion Practice. 2006;7:429–43.CrossRef
10.
go back to reference Lippke S, Ziegelmann JP. Understanding and modeling health behavior. The multi-stage model of health behavior change. J Health Psychol. 2006;11:37–50.CrossRefPubMed Lippke S, Ziegelmann JP. Understanding and modeling health behavior. The multi-stage model of health behavior change. J Health Psychol. 2006;11:37–50.CrossRefPubMed
11.
go back to reference Brehm W, Wagner P, Sygusch R, et al. Health promotion by means of health sport. Scand J Med Sci Sports. 2005;15:13–20.CrossRefPubMed Brehm W, Wagner P, Sygusch R, et al. Health promotion by means of health sport. Scand J Med Sci Sports. 2005;15:13–20.CrossRefPubMed
12.
go back to reference Brehm W, Duan YP, Mair T, Strobl H, Tittlbach S. Körperlich-sportliche Aktivität als Gesundheitsverhalten: Das FIT-Stufen Modell. Bayreuther Beiträge zur Sportwissenschaft, Heft 12. Bayreuth: Universität Bayreuth. Germany; 2010. Brehm W, Duan YP, Mair T, Strobl H, Tittlbach S. Körperlich-sportliche Aktivität als Gesundheitsverhalten: Das FIT-Stufen Modell. Bayreuther Beiträge zur Sportwissenschaft, Heft 12. Bayreuth: Universität Bayreuth. Germany; 2010.
13.
go back to reference Duan YP, Huang Z, Si G, et al. Physical activity as health behavior: the FIT-Stage Model. Bayreuth Contributions to Sport Science. No. 13. Bayreuth, Germany: University Bayreuth; 2010 [in Chinese]. Duan YP, Huang Z, Si G, et al. Physical activity as health behavior: the FIT-Stage Model. Bayreuth Contributions to Sport Science. No. 13. Bayreuth, Germany: University Bayreuth; 2010 [in Chinese].
14.
go back to reference Sutton SR. (2000). Interpreting cross-sectional data on stages of change. Psychol Health. 2000;15:163–71.CrossRef Sutton SR. (2000). Interpreting cross-sectional data on stages of change. Psychol Health. 2000;15:163–71.CrossRef
15.
go back to reference Duan YP, Lippke S, Wagner P, Brehm W. Testing Two Stage Assessments in a Chinese College Student Sample: Correspondences and Discontinuity Patterns Across Stages. Psychol Sport Exerc. 2011;12:306–13.CrossRef Duan YP, Lippke S, Wagner P, Brehm W. Testing Two Stage Assessments in a Chinese College Student Sample: Correspondences and Discontinuity Patterns Across Stages. Psychol Sport Exerc. 2011;12:306–13.CrossRef
16.
go back to reference Schumann A, Estabrooks PA, Nigg CR, Hill J. Validation of the stages of change with mild, moderate, and strenuous physical activity behavior, intentions, and self-efficacy. Int J Sport Med. 2003;5:363–5. Schumann A, Estabrooks PA, Nigg CR, Hill J. Validation of the stages of change with mild, moderate, and strenuous physical activity behavior, intentions, and self-efficacy. Int J Sport Med. 2003;5:363–5.
17.
go back to reference Tittlbach S, Sygusch R, Brehm W, Woll A, Lampert T, Abele A, Bös, K. Association between physical activity and health in German adolescents. Europ J Sport Sci. 2011;11:283–91. Tittlbach S, Sygusch R, Brehm W, Woll A, Lampert T, Abele A, Bös, K. Association between physical activity and health in German adolescents. Europ J Sport Sci. 2011;11:283–91.
18.
go back to reference Heneghan C, Badenoch D. Evidence-based medicine toolkit. 2nd ed. Malden, MA: Blackwell Publishing; 2006.CrossRef Heneghan C, Badenoch D. Evidence-based medicine toolkit. 2nd ed. Malden, MA: Blackwell Publishing; 2006.CrossRef
19.
go back to reference Lippke S, Fleig L, Pomp S, Schwarzer R. Validity of a stage algorithm for physical activity in participants recruited from orthopedic and cardiac rehabilitation clinics. Rehabil Psychol. 2010;55:398–408.CrossRefPubMed Lippke S, Fleig L, Pomp S, Schwarzer R. Validity of a stage algorithm for physical activity in participants recruited from orthopedic and cardiac rehabilitation clinics. Rehabil Psychol. 2010;55:398–408.CrossRefPubMed
20.
go back to reference Nigg CR. There is more to stages of exercise than just exercise. Am College Sport Med. 2005;33:32–5. Nigg CR. There is more to stages of exercise than just exercise. Am College Sport Med. 2005;33:32–5.
21.
go back to reference Lippke S, Ziegelmann JP, Schwarzer R, Velicer WF. Validity of stage assessment in the adoption and maintenance of physical activity and fruit and vegetable consumption. Health Psychol. 2009;28:183–93.CrossRefPubMedPubMedCentral Lippke S, Ziegelmann JP, Schwarzer R, Velicer WF. Validity of stage assessment in the adoption and maintenance of physical activity and fruit and vegetable consumption. Health Psychol. 2009;28:183–93.CrossRefPubMedPubMedCentral
22.
go back to reference Weinstein ND, Rothman AJ, Sutton SR. Stage theories of health behavior: Conceptual and methodological issues. Health Psych. 1998;17:290–9.CrossRef Weinstein ND, Rothman AJ, Sutton SR. Stage theories of health behavior: Conceptual and methodological issues. Health Psych. 1998;17:290–9.CrossRef
23.
go back to reference Dohnke B, Nowossadeck E, Müller-Fahrnow W. Motivation and participation in a phase III cardiac rehabilitation programme: an application of the Health Action Process Approach. Res Sport Med: Int J. 2010;18:219–35.CrossRef Dohnke B, Nowossadeck E, Müller-Fahrnow W. Motivation and participation in a phase III cardiac rehabilitation programme: an application of the Health Action Process Approach. Res Sport Med: Int J. 2010;18:219–35.CrossRef
24.
go back to reference Lippke S, Plotnikoff RC. The Protection Motivation Theory within the stages of the Transtheoretical Model – Stage-specific interplay of variables and prediction of stage transitions. Brit J Health Psych. 2009;14(2):211–29.CrossRef Lippke S, Plotnikoff RC. The Protection Motivation Theory within the stages of the Transtheoretical Model – Stage-specific interplay of variables and prediction of stage transitions. Brit J Health Psych. 2009;14(2):211–29.CrossRef
25.
go back to reference Armitage CJ, Arden MA. Exploring discontinuity patterns in the Transtheoretical Model: An application of the theory of planned behaviour. Brit J Health Psych. 2002;7:89–103.CrossRef Armitage CJ, Arden MA. Exploring discontinuity patterns in the Transtheoretical Model: An application of the theory of planned behaviour. Brit J Health Psych. 2002;7:89–103.CrossRef
26.
go back to reference Duan YP, Zhang R, Wei XN, Brehm W. Assessing stage validity of stage model for physical activity behavior: a study on FIT model. Chinese J of Sports Med. 2014;33(6):573–80 [in Chinese]. Duan YP, Zhang R, Wei XN, Brehm W. Assessing stage validity of stage model for physical activity behavior: a study on FIT model. Chinese J of Sports Med. 2014;33(6):573–80 [in Chinese].
27.
go back to reference Ainsworth BE, Haskell WL, Whitt MC, et al. (2000). Compendium of physical activities: An update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(9 Suppl):457–64.CrossRef Ainsworth BE, Haskell WL, Whitt MC, et al. (2000). Compendium of physical activities: An update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(9 Suppl):457–64.CrossRef
28.
go back to reference Brehm W, Sygusch R. Qualitäten von Gesundheitssport unter den Voraussetzungeneines bewegungsarmen Lebensstils: Methodenband. Bayreuther Beiträge zur Sportwissenschaft. Heft 7. Bayreuth: Universität Bayreuth. Germany; 2008. Brehm W, Sygusch R. Qualitäten von Gesundheitssport unter den Voraussetzungeneines bewegungsarmen Lebensstils: Methodenband. Bayreuther Beiträge zur Sportwissenschaft. Heft 7. Bayreuth: Universität Bayreuth. Germany; 2008.
29.
go back to reference Duan YP, Wei XN, Brehm W, Strobl H, Huang ZJ, Si GY, Tittlbach S. A theory construction of adults’ physical activity process of change and its measurement. China Sport Sci. 2011;31:37–42 [in Chinese]. Duan YP, Wei XN, Brehm W, Strobl H, Huang ZJ, Si GY, Tittlbach S. A theory construction of adults’ physical activity process of change and its measurement. China Sport Sci. 2011;31:37–42 [in Chinese].
30.
go back to reference Seelig H, Fuchs R. Messung der sport- und bewegungsbezogenen Selbstkonkordanz. Z Sportpsychol. 2006;13:121–39.CrossRef Seelig H, Fuchs R. Messung der sport- und bewegungsbezogenen Selbstkonkordanz. Z Sportpsychol. 2006;13:121–39.CrossRef
31.
go back to reference Lippke S, Ziegelmann JP, Schwarzer R. Stage-specific adoption and maintenance of physical activity: testing a three-stage model. Psychol Sport Exerc. 2005;6:585–603.CrossRef Lippke S, Ziegelmann JP, Schwarzer R. Stage-specific adoption and maintenance of physical activity: testing a three-stage model. Psychol Sport Exerc. 2005;6:585–603.CrossRef
32.
go back to reference Bös K, Abel T, Woll A, Niemann S, Tittlbach S, Schott N. Der Fragebogen zur Erfassung des motorischen Funktionsstatus (FFB-Mot). Diagnostica. 2002;48(2):101–11.CrossRef Bös K, Abel T, Woll A, Niemann S, Tittlbach S, Schott N. Der Fragebogen zur Erfassung des motorischen Funktionsstatus (FFB-Mot). Diagnostica. 2002;48(2):101–11.CrossRef
33.
go back to reference Fahrenberg J, Myrtek M, Schumacher J, Brähler E. Fragebogen zur Lebenszufriedenheit (FLZ). Handanweisung. Göttingen, Germany: Hogrefe; 2000. Fahrenberg J, Myrtek M, Schumacher J, Brähler E. Fragebogen zur Lebenszufriedenheit (FLZ). Handanweisung. Göttingen, Germany: Hogrefe; 2000.
35.
go back to reference Ruscio J. A probability-based measure of effect size: Robustness to base rates and other factors. Psychol Meth. 2008;13:19–30.CrossRef Ruscio J. A probability-based measure of effect size: Robustness to base rates and other factors. Psychol Meth. 2008;13:19–30.CrossRef
37.
go back to reference Šimundić AM. Measures of diagnostic accuracy: basic definitions. Med Biol Sci. 2008;22:61–5. Šimundić AM. Measures of diagnostic accuracy: basic definitions. Med Biol Sci. 2008;22:61–5.
38.
go back to reference Plotnikoff RC, Lippke S, Reinbold-Matthews M, Courneya KS, Karunamuni N, Sigal RJ, Birkett N. Assessing the validity of a stage measure on physical activity in a population-based sample of individuals with type 1 or type 2 diabetes. Meas Phys Educ Exerc Sci. 2007;11:73–91. Plotnikoff RC, Lippke S, Reinbold-Matthews M, Courneya KS, Karunamuni N, Sigal RJ, Birkett N. Assessing the validity of a stage measure on physical activity in a population-based sample of individuals with type 1 or type 2 diabetes. Meas Phys Educ Exerc Sci. 2007;11:73–91.
39.
go back to reference Cardinal BJ, Lee JY, Kim YH, Lee H, Li KK, Si Q. Behavioral, Demographic, Psychosocial, and Sociocultural Concomitants of Stage of Change for Physical Activity Behavior in a Mixed-Culture Sample. Am J Health Promo. 2009;23(4):274–8.CrossRef Cardinal BJ, Lee JY, Kim YH, Lee H, Li KK, Si Q. Behavioral, Demographic, Psychosocial, and Sociocultural Concomitants of Stage of Change for Physical Activity Behavior in a Mixed-Culture Sample. Am J Health Promo. 2009;23(4):274–8.CrossRef
40.
go back to reference Martínez-Lemos RI, Puig-Ribera AM, García-García O. Perceived barriers to physical activity and related factors in Spanish university students. Open J Prev Med. 2014;4:164–74.CrossRef Martínez-Lemos RI, Puig-Ribera AM, García-García O. Perceived barriers to physical activity and related factors in Spanish university students. Open J Prev Med. 2014;4:164–74.CrossRef
41.
go back to reference Al-Otaibi HH. Measuring stages of change, perceived barriers and self efficacy for physical activity in Saudi Arabia. Asian Pac J Cancer P. 2013;14:1009–16.CrossRef Al-Otaibi HH. Measuring stages of change, perceived barriers and self efficacy for physical activity in Saudi Arabia. Asian Pac J Cancer P. 2013;14:1009–16.CrossRef
42.
go back to reference Buckworth J, Lee RE, Regan G, et al. Decomposing intrinsic and extrinsic motivation for exercise: application to stages of motivational readiness. Psychol Sport Exerc. 2007;8:441–61.CrossRef Buckworth J, Lee RE, Regan G, et al. Decomposing intrinsic and extrinsic motivation for exercise: application to stages of motivational readiness. Psychol Sport Exerc. 2007;8:441–61.CrossRef
43.
go back to reference Wagner P. Aussteigen oder dabeibleiben? Determinanten der Aufrechterhaltung sportlicher Aktivität in gesundheitsorientierten Sportprogrammen. Wiss. Buchges: Darmstadt; 2000. Wagner P. Aussteigen oder dabeibleiben? Determinanten der Aufrechterhaltung sportlicher Aktivität in gesundheitsorientierten Sportprogrammen. Wiss. Buchges: Darmstadt; 2000.
Metadata
Title
Testing the validity of a stage assessment on health enhancing physical activity in a chinese university student sample
Authors
Yanping Duan
Sonia Lippke
Ru Zhang
Walter Brehm
Pak-Kwong Chung
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-2931-2

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