Exercise: Stages of Change (Continuous Measure)

Please use the following definition of exercise when answering these questions:

Regular Exercise is any planned physical activity (e.g., brisk walking, aerobics, jogging, bicycling, swimming, rowing, etc.) performed to increase physical fitness.  Such activity should be performed 3 to 5 times per week for 20-60 minutes per session.  Exercise does not have to be painful to be effective but should be done at a level that increases your breathing rate and causes you to break a sweat.

Please enter the number in the right hand column that indicates how strongly you agree or disagree with the following statements.

1 = Strongly Disagree
2 = Disagree
3 = Undecided
4 = Agree
5 = Strongly Agree

1.As far as I’m concerned, I don’t need to exercise regularly. 
2.I have been exercising regularly for a long time and I plan to continue. 
3.I don’t exercise and right now I don’t care. 
4.I am finally exercising regularly. 
5.I have been successful at exercising regularly and I plan to continue. 
6.I am satisfied with being a sedentary person. 
7.I have been thinking that I might want to start exercising regularly. 
8.I have started exercising regularly within the last 6 months. 
9.I could exercise regularly, but I don’t plan to. 
10.Recently, I have started to exercise regularly. 
11.I don’t have the time or energy to exercise regularly right now. 
12.I have started to exercise regularly, and I plan to continue. 
13.I have been thinking about whether I will be able to exercise regularly. 
14.I have set up a day and a time to start exercising regularly within the next few weeks. 
15.I have managed to keep exercising regularly through the last 6 months. 
16.I have been thinking that I may want to begin exercising regularly. 
17.I have lined up with a friend to start exercising regularly within the next few weeks. 
18.I have completed 6 months of regular exercise. 
19.I know that regular exercise is worthwhile, but I don’t have time for it in the near future. 
20.I have been calling friends to find someone to start exercising with in the next few weeks. 
21.I think regular exercise is good, but I can’t figure it into my schedule right now. 
22.I really think I should work on getting started with a regular exercise program in the next 6 months. 
23.I am preparing to start a regular exercise group in the next few weeks. 
24.I am aware of the importance of regular exercise but I can’t do it right now. 

Scoring

Items
Precontemplation (non-believers in exercise)1, 3, 6, 9
Precontemplation (believers in exercise) 11, 19, 21, 24
Contemplation 7, 13, 16, 22
Preparation 14, 17, 20, 23
Action 4, 8, 10, 12
Maintenance 2, 5, 15, 18

Factor Loadings

 ItemPCACFA
Precontemplation Non-Believer:1.804.650
3.752.744
6.822.898
9.784.757
Precontemplation Believer:11.825.749
19.861.810
21.901.858
24.873.871
Contemplation:7.821.779
13.834.759
16.911.912
22.911.922
Preparation:14.699.693
17.908.831
20.901.830
23.712.686
Action Items4.748.817
8.867.680
10.833.536
12.732.882
Maintenance:2.923.884
5.900.888
15.939.947
18.928.931

References

Marcus, B.H., Selby, V.C., Niaura, R.S., & Rossi, J.S. (1992). Self-efficacy and the stages of exercise behavior change. Research Quarterly for Exercise and Sport, 63, 60-66.

Reed, G.R. (1994).  Measuring stage of change for exercise behavior change, URICA-E2.  Unpublished Dissertation.

Dissertation Abstract

This project set out to continue the development and refinement of the URICA-E2, an instrument to measure stage of change for regular exercise based on the Transtheoretical Model of Behavior Change.

In Study One, the URICA-E2 which is a proportionate measure of stage of change, was analyzed using Principal Component Analysis and refined into a 24-item instrument capturing not five, but six stages of change: Precontemplation-Non Believer (PCN), Precontemplation-Believer (PCB), Contemplation (C), Preparation (P), Action (A), and Maintenance (M). The standardized scale scores from the URICA-E2 were clustered and seven profiles were found. They duplicated the six stages and added a seventh which was tentatively named Ambivalent (ABV).

In Study Two, a series of models were tested using Confirmatory Factor Analysis in order to better understand the relationship between the stage constructs. Nine models were tested:  two types of simplex, four types of circumplex, and three types of punctuated equilibrium. A circumplex model, where the strongest relationships were found among the stages which are adjacent, alternate, and opposite, was found to nearly mimic the exercise data.  This supports the very common experience of people frequently relapsing and frequently restarting regular exercise.

Study Three sought confirmation of the URICA-E2 by validating it against three short form staging algorithms, the Decisional Balance instrument, the Confidence instrument, and a measure of hours of exercise. The Single Question Algorithm was found to outperform the other algorithms. The profiles of the URICA-E2 demonstrated the classic crossover of pros with cons around the Preparation stage. Confidence was seen to rise across the profiles.

In conclusion, it was found that the URICA-E2 is a multipurpose tool, well worth the effort required to use it. What other instrument could give you six stages of change, seven profiles, and show a circumplex to be the best way to describe the relationship between the stages? For the times that demand a shorter staging instrument, the Single Question Algorithm has proved to be an instrument of choice. It has the advantage of simplicity, ease of administration, and it performs as well as if not better than its five question counterpart.