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自主决定理论和计划行为理论的综合理论是否能解释老年人接受动机咨询干预后积极生活参与的变化?

Do the integrated theories of self-determination and planned behavior explain the change in active life engagement following a motivational counseling intervention among older people?

机构信息

Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.

Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece.

出版信息

Soc Sci Med. 2023 Dec;339:116409. doi: 10.1016/j.socscimed.2023.116409. Epub 2023 Nov 14.

Abstract

BACKGROUND

An integrated model based on self-determination and planned behavior theories has been used to explain physical activity and other health-related behaviors mainly among younger populations, not older adults. The present study aimed to conduct a secondary analysis to explore whether changes in theory-based constructs explain a change in activity level (including 17 activities in essential life areas) among 75- and 80-year-old individuals.

METHODS

Data came from the Promoting well-being through active aging (AGNES) study, a two-arm single-blinded randomized control trial, where participants in the intervention group (n = 101) received year-long individualized counseling between 2017-19 in Jyväskylä, Finland. Activity frequency was assessed using the University of Jyväskylä Active Aging Scale (UJACAS) activity sub-score, perceived autonomy support with the Health Climate Questionnaire, autonomous motivation with a sub-scale from the Self-Regulation Questionnaire, and attitude with three items. Subjective norm, perceived behavioral control, and intention were each assessed with one item. Change in variables between baseline and the 12-month follow-up was specified via latent factors. Various structural equation models were tested to assess whether the basic or modified model, including additional paths from baseline variables to change factors, provided a better data fit.

RESULTS

In the modified integrated model, baseline attitude and change in attitude directly explained the change in activity frequency. Moreover, statistically significant indirect paths were observed from baseline autonomous motivation through baseline attitude, and from activity frequency through change in attitude to change in activity frequency.

CONCLUSIONS

The theoretical integrated model did not account for the change in active life engagement. The modified integrated model revealed significant change paths, highlighting autonomous motivation and attitudes as influential change constructs. For future intervention design, the modified integrated model appears useful in identifying behavior change pathways for older adults.

摘要

背景

基于自我决定和计划行为理论的综合模型主要用于解释年轻人的体力活动和其他与健康相关的行为,而不是老年人。本研究旨在进行二次分析,以探讨理论基础构念的变化是否可以解释 75 至 80 岁个体的活动水平变化(包括基本生活领域的 17 项活动)。

方法

数据来自于通过积极老龄化促进健康(AGNES)研究,这是一项双臂、单盲、随机对照试验,干预组(n=101)的参与者在 2017-19 年期间在芬兰于韦斯屈莱接受了为期一年的个性化咨询。使用于韦斯屈莱大学积极老龄化量表(UJACAS)活动子量表评估活动频率,使用健康气候问卷评估自主支持感,使用自我调节问卷的子量表评估自主动机,使用三个项目评估态度。主观规范、感知行为控制和意图各用一个项目评估。通过潜在因素指定基线和 12 个月随访之间变量的变化。测试了各种结构方程模型,以评估基本或修改后的模型(包括从基线变量到变化因素的附加路径)是否提供更好的数据拟合度。

结果

在修改后的综合模型中,基线态度和态度变化直接解释了活动频率的变化。此外,还观察到从基线自主动机通过基线态度,以及从活动频率通过态度变化到活动频率变化的具有统计学意义的间接路径。

结论

理论综合模型无法解释积极生活参与的变化。修改后的综合模型揭示了显著的变化路径,强调了自主动机和态度是影响变化的构念。对于未来的干预设计,修改后的综合模型在确定老年人的行为变化途径方面似乎很有用。

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