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The role of self-efficacy in the initiation and maintenance of physical activity
[Thesis]. Manchester, UK: The University of Manchester; 2017.
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Abstract
Background: Self-efficacy is an important determinant of physical activity. Yet it remains unclear which behaviour change techniques (BCTs) are most effective at changing self-efficacy for physical activity. This PhD thesis aimed to explore issues surrounding which individual BCTs and clusters of BCTs that are most effective in initiating and maintaining changes in self-efficacy and physical activity behaviour across different adult populations through a systematic review with meta-analysis. This thesis consists of three linked papers which examined: 1) the individual and clusters of BCTs that are most effective in initiating and maintaining changes in self-efficacy and physical activity behaviour across all adult populations, 2) the individual BCTs which are effective in initiating self-efficacy and physical activity in two clinical samples (hypertension or heart disease, and pain or arthritis), and 3) the extent of theory use in interventions and examination of BCT use across theories. Methods: One hundred and eighty randomised trials which reported changes in self-efficacy were included into the review. Intervention content was reliably coded using the BCT Taxonomy v1 by two independent coders. From the 180 randomised trials, 204 comparisons were identified for the meta-analyses and moderator analyses. Meta-regressions examined whether the presence and absence of individual BCTs and intervention characteristics were associated with effect size changes for self-efficacy and physical activity. Chi-square analyses were conducted in Journal Article Three to examine for differences in BCT use across theories. Results: In Journal Article One, lack of meaningful clustering of BCTs was found. Interventions had small but significant effects on self-efficacy for the initiation of physical activity (d=0.26; 95%CI: [0.21, 0.31]) and physical activity (d= 0.21; 95%CI: [0.17, 0.26]) across all adult populations. Small effects were also found for the maintenance of physical activity self-efficacy behaviour, and these were non-statistically significant. In Journal Article Two, the interventions had small to medium sized significant effects on the initiation of physical activity self-efficacy and behaviour in hypertension or heart disease, and pain or arthritis samples. Few BCTs were found to moderate intervention effects on self-efficacy or physical activity in either clinical sample. In Journal Article Three, theory was not used extensively in interventions. Differences in the use of BCTs were found across theories, some of which mapped onto the constructs of the adopted theoretical frameworks. Conclusions: It seems that there are no specific sets of BCTs that are effective for changing self-efficacy and physical activity across all adult populations. In addition to BCTs, there needs to be further research into how communication styles and delivery characteristics can influence intervention effectiveness. It is also important to understand how BCTs and theory can be used optimally together, as there appears to be discrepancy between what theories proposes to be effective and what empirical evidence generated by this review suggests may be effective.
Keyword(s)
Behaviour change; Meta-analysis; Physical activity; Self-efficacy; Systematic review