Psychological factor and its structure influencing the change of exercise behavior of Chinese adult community residents: a TTM-based study

Taking TTM as the research background, and focusing on the model's important theoretical value and the shortcoming of previous study, the present study assumed that the Transtheoretical Model (TTM) has characteristic of localization and reasonable structure for Chinese adult community residents. TTM could predict the exercise behavior of adult community residents and there were main psychological factors for influencing the transition between the behavioral stages of physical exercise. In study 1, 163 (66 men, 97 women, age = 37.44 ± 7.96 yrs.) adult community residents participated in the study for testing the applicability of TTM. Results suggested the need for revising Scale of Changing Stage of Exercise Behavior for the adult community residents. In study 2, semi-structured interviews were applied to 29 (mean age = 40.72 yrs.) adult community residents and the Initial Scale of Changing Stage of Exercise Behavior for Chinese Adult Community Residents was developed, in accordance with the principle of psychometrics and the theory of TTM. Then, the scale was validated by applying to 182 (78 men, 104 women, age = 39.99 ± 12.19 yrs.) adult community residents, and the standardized Scale of Changing Stage of Exercise Behavior for Chinese Adult Community Residents was formed. Subsequently, the standardized scale was re-validated by applying to 292 (120 men, 172 women, age = 37.90 ± 5.07 yrs.) adult community residents, and structures of each factor of TTM were established. Exercise behavior could be effectively divided into five Changing Stages, i.e. Pre-contemplation, Contemplation, Preparation, Action, and Maintenance. The Processes of Change was constructed with five lower factors: Effect Experience, Consciousness Raising, Conception Changing, Self-regulation, and Active Management. Decisional Balance was constructed with independent factors of Exercise Profits and Exercise Costs. Self-efficacy was constructed with three lower factors: Objective Environmental Factors, Subjective Personal Factors, and Influence of Important Others. In study 3, Structural Equation Modeling was adopted to discuss the structural relationship among various factors of TTM and the predictive effect to exercise behavior. Self-efficacy and Changing Stages partly mediated the relationship between the Processes of Change and exercise behavior; The Changing Stages partly mediated the relationship between the Processes of Change and exercise behavior; while Changing Stages fully mediated the relationship between Exercise Profits and exercise behavior. All factors of TTM accumulatively explained 36.09% of the variance of exercise behavior. Main psychological factors influencing the changing of stages were explored by using MANOVA and Multiple Regression: (1) Prominent stage characteristic exists in Processes of Change, Decisional Balance and Self-efficacy; (2) During the transition from Pre-contemplation to Contemplation, Self-regulation, Exercise Profit, and Consciousness Raising are the main influencing factors; during the transition from Contemplation to Preparation, Exercise Profit is the main influencing factor; during the transition from Preparation to Action, Self-regulation and Active Management are the main influencing factors; from Action to Maintenance, Exercise Cost and Self-efficacy are the main influencing factors. It was concluded that TTM has the characteristic of localization and reasonable structure for Chinese adult community residents, and can be used as an effective theoretical base of predicting and intervening their exercise behavior.