Taylor M J, Arriscado D, Vlaev I, Taylor D, Gately P, Darzi A
Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK.
Int J Obes (Lond). 2016 Jan;40(1):34-8. doi: 10.1038/ijo.2015.210. Epub 2015 Oct 7.
BACKGROUND/OBJECTIVES: According to the COM-B ('Capability', 'Opportunity', 'Motivation' and 'Behaviour') model of behaviour, three factors are essential for behaviour to occur: capability, opportunity and motivation. Obese children are less likely to feel capable of exercising. The implementation of a new methodological approach to investigate the relationship between perceived exercise capability (PEC) and childhood obesity was conducted, which involved creating a new instrument, and demonstrating how it can be used to measure obesity intervention outcomes.
SUBJECTS/METHODS: A questionnaire aiming to measure perceived exercise capability, opportunity and motivation was systematically constructed using the COM-B model and administered to 71 obese children (aged 9-17 years (12.24±0.2.01), body mass index (BMI) standard deviation scores (SDS) 2.80±0.660) at a weight-management camp in northern England. Scale validity and reliability was assessed. Relationships between PEC, as measured by the questionnaire, and BMI SDS were investigated for the children at the weight-management camp, and for 45 Spanish schoolchildren (aged 9-13 years, (10.52±1.23), BMI SDS 0.80±0.99). A pilot study, demonstrating how the questionnaire can be used to measure the effectiveness of an intervention aiming to bring about improved PEC for weight-management camp attendees, was conducted. No participants withdrew from these studies.
The questionnaire domain (exercise capability, opportunity and motivation) composite scales were found to have adequate internal consistency (a=0.712-0.796) and construct validity (χ(2)/degrees of freedom=1.55, root mean square error of approximation=0.072, comparative fit index=0.92). Linear regression revealed that low PEC was associated with higher baseline BMI SDS for both UK (b=-0.289, P=0.010) and Spanish (b=-0.446, P=0.047) participants. Pilot study findings provide preliminary evidence for PEC improvements through intervention being achievable, and measurable using the questionnaire.
Evidence is presented for reliability and validity of the questionnaire, and for feasibility of its use in the context of a childhood obesity intervention. Future research could investigate the link between PEC and childhood obesity further.
背景/目的：根据行为的COM-B（“能力”“机会”“动机”和“行为”）模型，行为发生的三个要素是：能力、机会和动机。肥胖儿童感觉自己不太可能有能力进行锻炼。本研究采用一种新的方法来探究感知运动能力（PEC）与儿童肥胖之间的关系，包括创建一种新工具，并展示如何用它来衡量肥胖干预的效果。
对象/方法：使用COM-B模型系统构建了一份旨在测量感知运动能力、机会和动机的问卷，并在英格兰北部的一个体重管理营中对71名肥胖儿童（年龄9至17岁（12.24±2.01），体重指数（BMI）标准差分数（SDS）为2.80±0.660）进行了问卷调查。评估了量表的效度和信度。对体重管理营中的儿童以及45名西班牙学童（年龄9至13岁，（10.52±1.23），BMI SDS为0.80±0.99）调查了问卷所测量的PEC与BMI SDS之间的关系。开展了一项试点研究，展示该问卷如何用于测量旨在提高体重管理营参与者PEC的干预措施的有效性。这些研究中没有参与者退出。
问卷领域（运动能力、机会和动机）的综合量表具有足够的内部一致性（α=0.712 - 0.796）和结构效度（χ(2)/自由度=1.55，近似均方根误差=0.072，比较拟合指数=0.92）。线性回归显示，对于英国（b=-0.289，P=0.010）和西班牙（b=-0.446，P=0.047）参与者，低PEC与更高的基线BMI SDS相关。试点研究结果为通过干预实现PEC改善并可使用该问卷进行测量提供了初步证据。
本研究提供了问卷信效度的证据以及其在儿童肥胖干预背景下使用的可行性。未来的研究可以进一步探究PEC与儿童肥胖之间的联系。
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