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Participation in PEAC vs. intramural sport on exercise self-efficacy, attitude toward exercise, and physical fitness

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Participation in PEAC vs. Intramural Sport on Exercise Self-Efficacy, Attitude Toward Exercise,
and Physical Fitness
Participation in PEAC vs. Intramural Sport on Exercise Self-Efficacy, Attitude Toward Exercise,
and Physical Fitness
A thesis submitted in partial fulfillment
of the requirements of the degree of
Master of Science in Kinesiology
By
Charles Andrew Matthews
University of Arkansas
Bachelor of Science in Business Administration, 1995
May 2010
University of Arkansas
UMI Number: 1484703
All rights reserved
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UMI 1484703
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ABSTRACT
The purpose of this study was to examine the effect of participation in PEAC courses at
the University of Arkansas vs. participation in intramural sports on fitness measures, attitudes
toward exercise, and exercise self-efficacy. Sixty students (26 females, 34 males) participated in
this study. Students were in either one of three groups PEAC, intramural, or control. Baseline
measures were taken for all three groups, and the PEAC and intramural groups participated in
repeat testing at the end of either the PEAC course or the intramural season. ANOVA repeated
measure tests were used to compare across groups for differences in baseline measures.
Significance was set at the p < .05 level. Intramural students were found to have significantly
lower body fat compared to the control group (p = .025). Intramural students were also found
to have significantly greater estimated aerobic capacity compared to the control group (p =
.025). Paired t-tests were used to asses changes due to participation in either a PEAC course or
intramural sport. No significant improvements were found.
This thesis approved for
recommendation to the
Graduate Council
Thesis Director:
Inza Fort, £d. D.
Thesis Committee:
Paul Calleja, Ph. D.
Ro Di Brezzo,
Wo.
Acknowledgments
This project was more difficult than originally imagined. The lack of a deadline
combined with a full-time job stretched this project's completion date well beyond what it
should have been. It has definitely given me a greater respect for fellow graduate students who
have completed a thesis. When I discover that someone has completed a master's degree I will
ask about their thesis. If they did not complete one, I will automatically think less of their effort.
©
I want to thank my wife Cheryl, and son Ben for their understanding and help during the
process. Especially for transporting me and my testing equipment to the intramural fields on a
couple of rainy nights
I would also like to thank Barbara Batson, my Director at the Career Development
Center at the University of Arkansas. Without her umm... "encouragement" I would never have
completed a master's degree.
v
Dedication
This thesis is dedicated to Ben Matthews. When faced with the choice of doing a
difficult task that you have never been faced with previously, step up to that challenge! It will
force you to grow. With the proper amount of effort you can do anything you set your mind to
do.
Ben, I love you.
VI
Table of Contents
Title Page
i
Abstract
ii
Thesis Approval
iii
Thesis Duplication Release
iv
Acknowledgements
v
Dedication
vi
Table of Contents
vii
Chapter 1: Introduction
1
Statement of the Problem
3
Hypotheses
4
Definitions
4
Assumptions
6
Delimitations
6
Limitations
6
Significance of the Study
6
Chapter 2: Review of the literature
8
Benefits of physical activity
8
Physical activity among college students
19
Barriers to Exercise
19
Self-efficacy toward exercise
21
College as a time of change for students
22
Attitudes toward Exercise
25
Stages of Change
26
vii
College Intramural Sports
28
College PEAC course
29
Summary of Literature Review
30
Chapter 3: Methods
32
Participants
32
Measures
32
Procedures
36
Data Analysis
36
Chapter 4: Results and Discussion
37
Results
37
Discussion
44
Chapter 5: Summary, Conclusions, and Recommendations
49
Summary
49
Conclusions
50
Recommendations
51
References
52
Appendix A
58
Appendix B
59
Appendix C
60
Appendix D
63
Appendix E
64
Appendix F
65
Appendix G
68
viii
Chapter One
Introduction
Health Crisis in America
The current health of the nation and in particular the college aged student can be
examined by looking at some alarming statistics found on the Centers for Disease Control's
(CDC) website. Nearly 62.6 percent of people aged 18-24 are not meeting the recommended
amount of physical activity (CDC, 2007). Pollack et al., (1998)in writing a position stand for The
American College of Sports Medicine (ACMS) recommend 3 - 5 sessions a week ranging from
20-60 minutes at a moderate intensity. CDC information also shows a rise in diabetes,
cholesterol, and overweight/obesity for this same age group. The number that stands out far
and above all others is the percent of Americans that are overweight or obese. The Centers for
Disease Control (2007) reported that 61.5 percent of the population aged 2 0 - 4 4 was
overweight or obese. In the Milken Institute report "An Unhealthy America: The Economic
Burden of Chronic Disease", DeVol and Bedroussian (2007) highlight the cost of chronic disease
to the American economy and predict dramatic increases for the near future. The current
economic impact including lost productivity and direct cost is estimated to be 1.3 trillion dollars
each year. One of the implications of the DeVol and Bedroussian findings is that our nation
should renew its commitment to achieving a healthy body weight. The CDC also describes
chronic diseases as being among the most preventable of all our health problems (CDC 2009).
Benefits of Exercise
The Milken Report looks at 10 chronic diseases: breast cancer, colon cancer, lung
cancer, asthma, diabetes, mental disorders, heart disease, hypertension, and stroke. All but
asthma, lung cancer, and mental disorders are associated with physical inactivity and
1
overweight/obesity risk factors (DeVol and Bedroussian, 2007). ACSM's "Guidelines for
Exercise Testing and Prescription" concurs with DeVol and Bedroussian stating that a large body
of studies has documented the health and fitness benefits associated with exercise. ACSM also
includes reduction of osteoporotic fractures, gall bladder disease, depression, and anxiety as
benefits of physical fitness and exercise training (ACSM 2007).
Barriers to Exercise
There are a great number of barriers to beginning an exercise program or becoming
physically active. Of the many barriers found in the research lack of time, lack of a partner,
perception that exercise is boring, lack of facilities, competent instruction, exercise is hard,
embarrassment, lack of interest, school work, job responsibilities, lack of family support, and
exercise self-efficacy are mentioned most often as being key barriers to starting or maintaining
exercise (Tappe, Duda, & Ehrnwald, 1989; Grubbs & Carter, 2002; Ah, Ebert, Park, & Kang, 2004;
McAulley, 1992).
This list lends itself to being divided into two categories. Those that are extrinsic: lack of
time, lack of a partner, lack of facilities, competent instruction, school work, job responsibilities,
and lack of family support. Intrinsic factors include the perceptions that exercise is hard,
exercise is boring, embarrassment, lack of interest, and self-efficacy. Nahas, Goldfine, and
Codings (2003) look at determinates of physical activity in adolescents and young adults. They
believe that the number one barrier listed for not exercising, lack of time, is a convenient
excuse. They cite Edginton, Jordan, DeGraaf & Edginton (1995) that Americans spend on
average four hours each day watching television. Nahas, Goldfine, and Collins (2003) reviewed
the theoretical background of behavioral change and report that self-efficacy is closely tied to
success in performing certain behaviors including exercise.
2
Attitudes Toward Exercise
Mack & Shaddox (2004) portend that a positive attitude toward exercise is a key
determinant of participation in exercise and the intensity exerted during exercise. Leslie et al.
(1999) in their study of insufficiently active college students note that college students are going
through a time in which they are open to cognitive change including attitudes toward exercise.
Mack & Shaddox (2004), using an instrument developed by McPhearson & Yuhasz (1968),
measured the changes in college students participating in a college wellness course. Students
showed significant improvement in attitudes toward exercise and physical activity following
completion of the course.
Trends at the University of Arkansas in Intramural Sports and PEAC Courses.
Participation in intramural sports has increased dramatically in the recent years.
Funding is provided through a student activities fee paid by each student at the University of
Arkansas. Conversely, enrollment numbers for Physical Education and Activity Courses (PEAC)
have seen just the opposite trend. Student interest for enrolling in PEAC courses has not
dwindled; it is the funding for these courses that has decreased. These courses are funded
through the educational budget for the department of Health, Kinesiology, Recreation and
Dance in the College of Education and Health Professions.
Statement of the Problem
The purpose of this study was to examine attitudes toward exercise, exercise selfefficacy and certain physical fitness measures of University of Arkansas students, and the effect
that participation in either an intramural sport or enrollment in a PEAC course would have in
changing these measures.
3
Hypotheses
1.
Students participating in PEAC courses are not significantly different from the U of A
general population in fitness levels.
2. Students participating in intramurals are more fit than students from the general
student population and the students participating in PEAC courses.
3. The general population of students and students participating in PEAC courses will
score significantly lower on self-efficacy toward exercise and attitudes toward
exercise compared to students participating in intramural sports pre-test.
4.
Students participating in PEAC courses will show significant improvement on the
measured fitness components.
5.
Participation in a PEAC course will significantly improve exercise self-efficacy scores.
6.
Participation in a PEAC course will significantly improve attitude toward exercise
scores.
7.
Participation in intramurals will not significantly improve exercise self-efficacy
scores.
8.
Participation in intramurals will not significantly improve attitude toward exercise
scores.
9. Students participating in an intramural
"season" will show
no significant
improvement in the measured fitness components.
Definitions
1. Aerobic Capacity - the ability of the blood, heart, and lungs to transport oxygen to
working muscles and the ability of those muscles to utilize the oxygen (Heyward,
2006, p. 55). The best measure of aerobic capacity is V02 Max.
4
2. Bio Electrical Impedance - a measure of body composition that measures the time it
takes a small amount of electrical current to pass between two points in the body.
The elapsed time is affected by the amount of body fat. Body fat impedes the flow of
the electrical current. The longer the elapsed time the higher the percentage of body
fat (McArdle, Katch, & Katch, 2007, p. 797).
3. Body Composition - the expression of body-make up as fat and fat-free masses.
Often cited as percentage of body fat.
4. Flexibility - the ability to move a joint through its complete range of motion. This
includes not only the ability to move the ligaments and fasciae, but also involves the
antagonistic muscles (Hamilton, 2002, p. 413).
5. Intramural Season - length of time of season varies by sport at the University of
Arkansas. It includes the time from first practice to last game of the season.
6. MET-is a measure of exercise work. It is a ratio of a working metabolic rate to a
resting metabolic rate. A met of 1 would be considered at quiet rest.
7. PEAC Course - credit bearing course at the University of Arkansas that teaches or
reinforces a basic sport training or fitness concept. Length of courses are eight
weeks.
8. Physical Fitness - includes measures of estimated aerobic capacity, body
composition, flexibility and strength. Each category has a reference set of norms.
9. Self efficacy - a person's belief that s/he can succeed in a specific situation (Bandura,
1977.)
10.
Strength - maximal force that can be generated by a muscle group.
5
11.
V02 Max - measure of peak oxygen consumption during maximal aerobic
exercise which is often expressed in milliliters of oxygen per kilogram of body weight
per minute (Heyward, 2006 p. 55).
Assumptions
1. All participants will answer questionnaires honestly and to the best of their abilities.
2. All participants will give their best effort when performing tests of physical fitness.
Delimitations
This study's generalizability is delimited to students similar to those at the University of
Arkansas, and only on similar attitudes, exercise self-efficacy, and fitness measures.
Limitations
Participants may have engaged in exercise outside of the PEAC course or Intramural
sport program.
Significance of Study
There is an ongoing health crisis in the United States today. This discussion has reached
the highest level in our country with health care and insurance coverage as the primary
domestic agenda for the Obama administration. This topic has been the subject of year long
hearings in both the Senate and House of Representatives culminating in a bipartisan summit on
health care. However, the primary focus of these debates has been health insurance coverage.
While the primary focus should be on the prevention of disease and illness that can be achieved
through physical activity. The Milken Report looks at 10 chronic diseases: breast cancer, colon
cancer, lung cancer, asthma, diabetes, mental disorders, heart disease, hypertension, and
stroke. All but asthma, lung cancer, and mental disorders are associated with physical inactivity
and overweight/obesity risk factors (DeVol and Bedroussian, 2007). It has been found that
college is a time of change for students and that the activity level students had during the
6
college years correlates with the level of activity later in life. It has been show that participation
in physical activity/ wellness classes can positively affect the attitudes and self-efficacy of
students toward exercise. College may well be the last window of opportunity to affect the
behavior patterns of individuals relating to physical activity.
Funding for Intramural Sports and PEAC courses at the University of Arkansas occur
through different means. Intramural sports are funded through student fees, while funding for
PEAC courses are funded by the College of Education and Health Profession's educational
budget. The funding for intramural sports has increased significantly in the last two decades,
while the funding for PEAC courses has significantly decreased. This study examines the
effectiveness of these two programs in reaching University of Arkansas students and affecting1
their attitudes, exercise self-efficacy, and level of fitness.
7
Chapter Two
Literature Review
Our nation is in the midst of a health crisis that is affecting all ages of our society.
Reports from the CDC show an increase in the numbers of individuals suffering from diabetes,
high cholesterol, cardiovascular disease and an alarmingly high percentage of our population
being classified as either overweight/obese (CDC, 2007). The Milken Institute report "An
Unhealthy America: The Economic Burden of Chronic Disease" (DeVol and Bedroussian, 2007)
highlights the economic impact this health crisis is having on our country. The current economic
impact including lost productivity and direct cost is estimated to be 1.3 trillion dollars each year.
While this is very concerning information, the bright spot is that there has been a tremendous
amount of research on the positive effects that exercise can have on avoiding many of the
chronic diseases that are driving this health pandemic. The effects of exercise are broad and far
ranging. Exercise affects the body physiologically, psychologically, and the ability to perform
day-to-day activities.
Benefits of Physical Activity
Cardiovascular Disease
In a review of the Women's Health Initiative, Bassauk and Manson (2003) evaluated the
cardiovascular effects that brisk walking 2.5 hours or one 30 minute session for 5 days per week
had on cardiovascular disease. The findings showed a 30 - 40 percent reduction in myocardial
infarction compared to sedentary women. Hakim, Curb, Petrovitch, Rodriguez, Yano, Ross, G.W.
et al (1999) also looked at the role of walking in reducing coronary artery disease in elderly men.
Nearly 2,700 men aged 71 to 93 participated in The Honolulu Heart Program evaluation of
walking in relation to coronary heart disease. Between 1991 and 1993, men who had no
coronary heart disease were evaluated on distance walked per week. During the four year
8
follow-up period, 109 men experienced a coronary event. Results of the study indicated men
who walked less than .25 miles per day had a 2-fold increase in the risk of coronary heart
disease compared to men who walked more than 1.5 miles per day. Men who walked between
.25 miles and 1.5 miles per day were also at significantly higher risk of coronary artery disease.
While most people think of the elderly as suffering from coronary heart disease, Becque,
Katch, Rocchini, Marks, & Morehead (1988) believe that the factors that predispose individuals
to heart disease are developed during adolescence. In their 1988 study examining Coronary Risk
Incidence of Obese Adolescents, 36 participants were selected who met the criteria of being in
the 75th or greater percentile of body weight and triceps skinfold test. Participants, after a 12
hour fast, were examined at the University of Michigan Hospital for the following: body
composition, V02 max, blood pressure, and blood lipid levels. These tests yielded information
on seven modifiable risk factors for coronary artery disease: total cholesterol, triglyceride level,
high-density lipoprotein cholesterol level, systolic blood pressure, diastolic blood pressure,
obesity, and physical work capacity. Of the 36 members of the trial, 97 % had three or more risk
factors. Participants were assigned to a control group, a diet and behavior group, or an exercise
plus diet and behavior. The control group was asked to not change current behaviors. The diet
group met with a nutritionist and a behavior therapist once a week for 20 weeks. A diet was set
to induce a 1 to 2 pound loss per week. The exercise plus diet and behavior group were given
the same instructions as the diet and behavior group plus exercised three times a week for 50
minutes. Each exercise session included warm-up/cool-down, flexibility, aerobic and strength
training. Aerobic training was initially set at 15 minutes per session and increased over a
number of weeks to a maximum of 40 minutes per session. Results of the intervention showed
a significant difference in the total risk reduction from the diet and behavior group (14.8 % risk
reduction) to the exercise plus diet and behavior group (41.1 % risk reduction). Becque et al.
9
(1988) believe that the data shows the strong relationship that exercise plays in reducing the
multiple risk profile change to obese adolescents.
Hypertension
Hypertension is a key risk factor for cardiovascular disease (CVD). The role that exercise
can play in reducing this risk factor can, in turn, also reduce the risk of CVD. Hagberg, Park, and
Brown (2000) reviewed the role of exercise in the treatment of CVD. Exercise training can lower
blood pressure (BP) in many individuals inflicted with hypertension approximately 11 mm hg
systolic and 8 mm hg diastolic. Low to moderate exercise intensity seems to produce the best
results for reducing BP. Women and the middle aged tend to have the best results. A single
bout of exercise will lower BP for the following 24 hours. Ongoing training will produce even
greater reductions in systolic pressure.
Stroke
Agnarsson, Thorgeirsson, Sigvaldason, & Sigfusson (1999) studied 4,484 men aged 45 to
80 following an initial physical fitness screening and health questionnaire for 11 years. Results
showed that leisure time activity maintained after 40 years of age reduced the risk of stroke.
Further, a review of Lee and Paffenbarger's (1998) study of Harvard alumni also concludes that
physical activity is associated with a reduction in the risk for stroke. Lee and Paffenbarger
followed up with nearly 11,000 members of the original study from the Harvard Alumni Health
Survey. The participants in the survey were chosen from the original survey population who had
not indicated cancer or heart disease on the original health questionnaire, and who submitted a
follow-up survey in 1988. Results indicated that participants who completed between 1000 and
3000 kcal/week of exercise had a decreased risk of stroke.
10
Obesity
Pi-Sunyer (2002) highlighted the obesity epidemic and consequences in Obesity
Research. With results of the National Health and Nutrition Examination Surveys (NHANES),
Sunyer illustrated the dramatic rise in obesity in the United States. He describes a slow increase
in obesity from the first NHANES survey to the second, but highlights a dramatic increase from
the second survey (14.5%) in 1976 to the third survey (22.5%) in 1988. Pi-Sunyer also explored
the pathophysiology of obesity. Between 30 to 40 percent of obesity can be attributed to
genetics, but the vast amount of obesity is caused by environmental factors. A sedentary life
style is a primary contributor of environmentally caused obesity. The following disorders are
associated with obesity: insulin resistance, hyperinsulinemia, type 2 diabetes, hypertension,
dyslipidemia, coronary heart disease, gallbladder disease, cancer, and all-cause mortality.
ACSM's (2009) "Appropriate Physical Activity Intervention Strategies for Weight Loss and
Prevention of Weight Regain for Adults" highlights the role of physical activity in maintaining,
losing, and preventing regain of weight. This is a follow-up from their 2001 position statement.
Current findings suggest that exercise expenditure of less than 150 minutes per week at
moderate intensity is not sufficient to prevent weight gain. Evidence supports physical activity
output between 150 and 250 minutes per week will prevent weight gain, and perhaps a
moderate weight loss. However, greater than 250 minutes per week is needed to see a
significant weight loss, and greater than 250 minutes per week is needed to prevent regain of
weight. The addition of a moderate dietary restriction of 500 - 700 kcal per day is associated
with improved weight loss. The dose-response relationship of exercise to weight loss is direct.
Ball, Owen, Salmon, Bauman, & Gore (2001) looked at a randomly selected group of
1,302 men and women aged 18 - 72 comparing self-reported physical activity to anthropometric
data. BMI and skinfold testing were completed for all participants. Participants whose BMI
11
would categorize them as underweight (BMI <20) or Obese (BMI >30) were excluded from the
study, as the focus of this particular study was to compare physical activity levels of the normal
(BMI between 20 and 25) to overweight (BMI between 25 and 30) categories. Participants
completed a detailed Leisure Time Physical Activity (LTPA) questionnaire that assessed specific
activities, frequencies, duration and intensity over the previous two weeks. This information
was used to categorize individuals into sedentary, low, moderate, or high categories of LTPA. A
separate assessment of work/home activity was recorded and used to classify participants as
either active or inactive for work/home activity. Median skinfold scores were assessed for men
and women separately. Participants whose scores fell below the median were listed in the
lower body fat category. Those with scores higher than the median were listed in the upper
body fat category. Education was self-reported as sub-secondary, secondary, or tertiary. Results
indicated that age and education levels were significantly associated with BMI category for both
men and women. After controlling for age and education, LTPA was associated with being in the
normal category for women. Increased activity was correlated with a higher probability of being
in the normal BMI category. LPTA scores for men were only associated in the high activity
category, and those in the high activity category were 1.8 times more likely than men in the
sedentary category to be in the normal BMI category. There was a correlation for women in the
moderate and high LPTA categories for being in the lower body fat category. In conclusion,
higher LTPA scores were associated with lower BMI and body fat for women and to a smaller
degree for men and BMI. The authors acknowledge that other studies have found contradictory
results for men.
In 2004, Blair and Church reviewed the arguments for fitness vs. fatness. The primary
discussion involves the divergent results in what is of primary importance to health, fitness or
fatness? Two articles of concern in this discussion are the "Relation of Physical Fitness vs. Body
12
Mass Index with Coronary Artery Disease and Cardiovascular Events in Women" (Wessel, Arant,
Olson, Johnson, Reis, Sharaf, & Shaw, 2004), and the "Relationship of Physical Activity vs. Body
Mass Index with Type 2 Diabetes in Women" (Weinstein, 2004). The Wessel study showed that
fitness was the primary indicator of reduced cardiovascular disease, and the Weinstien study
showed that fatness or BMI was the primary indicator of reduced incidence of Type 2 Diabetes.
However, Blair and Church (2004) contend that physical activity is of primary concern in both
instances because it affects both fitness and fatness. Increased levels of physical activity and
intensity will increase the level of aerobic capacity measured as V02 Max and studies have
shown that physical activity is a key component to weight loss which affects BMI.
Type 2 Diabetes
Type 2 Diabetes is a disease that deals with insulin resistance and insulin deficiency.
Complications of the disease are broad ranging and include cardiovascular disease, retinopathy,
neuropathy, and nephropathy (ASCM, 2000). ACSM's (2000) position statement, Exercise and
Type 2 Diabetes, concludes that exercise offers both acute and chronic benefits for those
suffering with Type 2 Diabetes.
ASCM (2000) details the acute benefits of exercise: after mild to moderate intensity
exercise, blood glucose levels decrease (Hubinger, Franzen, & Gries, 1987; Koivisto & Defronzo,
1984). It is believed that there is an attenuation of glucose production and an increase in
muscle glucose use. This effect continues briefly post exercise (Minuk, Vranic, Marliss, Hanna,
Albisser, & Zinman, 1981). Individuals in early stages of Type 2 Diabetes exhibit a reduction of
glucose uptake into skeletal muscle by as much as 40% compared to non-diabetic individuals
(Defronzo, Simonson, & Ferrannini, 1982). Burstein, Epstein, Shapiro, Cahruzi, & Kamieli (1990)
contend that the increased sensitivity to insulin uptake lasts for 12 to 24 hours post exercise.
13
The ACSM (2000) position statement also acknowledges that chronic exercise benefits
individuals with Type 2 Diabetes by helping to control hypertension, metabolic control, lipids
and lipoproteins, and weight loss/maintenance. The acute effects of glucose control diminish by
72 hours, so it is recommended that exercise occur on a frequent basis.
Cancer
In their 2002 article, Physical Activity and Cancer Prevention, Friedenreich & Orenstein
review the literature on physical activity's role in cancer prevention and provide an overview of
the hypothesized biological mechanisms that may be involved. The World Cancer Research
Fund & American Institute for Cancer Research (1997) categories were used to classify the
effects of physical activity on preventing certain cancers: convincing, probable, possible, or
insufficient. Research indicated that increased physical activity has shown a convincing
decrease in risk for breast and colon cancers, a probable decrease in risk for prostate cancer, a
possible decrease in risk for lung and endometrial cancers, and an insufficient relationship to all
other cancers. Friedenreich & Orenstein (2002) list as possible biological mechanisms in the
prevention of cancer the effect of exercise in lowering the amount of biologically available sex
hormones. The reductions in these hormones could lead to a decreased risk for breast,
endometrium, ovaries, prostate and testes cancer. High levels of insulin-like growth factors (IGF)
have been associated with breast, prostate and lung cancers. Physical activity has been shown
to increase IFG binding proteins which decreases the amount of IFG available at potential cancer
sites. They also believe that physical activity's effect on weight control is very important. Colon,
kidney, esophagus, endometrium, thyroid, and postmenopausal breast cancer have been
associated with increased occurrences at greater body weights (IARC Working Group, 2002).
Some studies have shown physical activity to be a better way to reduce intra-abdominal fat than
diet alone (McTiernan, Ulrich, Slate, & Potter, 1998). It has also been reported that intra-
14
abdominal fat may be more metabolically active and associated with a greater risk for disease
(Matsuzawa, Shimomura, Nakamura, Keno, Kotani, &Tokunaga, 1995).
Aging
As a nation, we are aging. In 1995,12.8 percent of the U.S. population was age 65 or
older. By 2030 the number will rise to 20 percent. A key concern for the aging population is the
ability to maintain the activities of daily living (ADL). The ability to cook, rise from a chair, dress
oneself, walk, get out of bed, and go shopping are all ADL's. Many of these items are related to
balance, fatigue, muscular strength, and bone health. Physical activity can play a key role in
maintaining the fitness to continue with ADL's. As we age, it is primarily from disuse that we
lose the ability to function and it is never too late to start or to gain back some of what has been
lost.
Feskanich, Willett, & Colditz (2002) analyzed the effect of walking and leisure time
activity on the risk for hip fracture. Their study was part of the Nurse's Health Study that began
in 1976 with 121,700 nurses aged 30 to 55. At the time of the initial questionnaire, participants
provided a medical history and information on risk factors related to CVD and cancer. Follow-up
surveys occurred every two years. In 1986, post-menopausal women who answered specific
activity questions and had not had a previous hip fracture were included in the sub-analysis. A
total of 61,700 women, aged 44 to 77, participated in this study. During the 12-year follow-up
period, 415 cases of low impact fracture were identified. Examples of low impact fracture
would be from a slip on ice or a fall from the height of a chair. Participants answered questions
on exercise modality, frequency, duration, and intensity to determine physical activity. Based
upon responses participants were assigned a MET hours per week. MET is a measure of physical
activity expenditure. Participants in this study were fairly sedentary with a 7 MET/hrs week
median score. Results of this study indicated that activity and BMI were inversely related with
15
hip fracture. Women who walked 4 or more hours a week had a significantly reduced relative
risk of hip fracture compared to those who walked less than 1 hour a week. Physical activity and
bone health are discussed at length in the ACSM's (2004) position stand. Weight bearing
exercises of high intensity help children and adolescents to build bone mass density (BMD). The
goal during adulthood is to maintain bone mass density to reduce the risk of fractures.
Relatively high intensity weight bearing exercise has shown to help maintain BMD, but has also
shown that after discontinuation of exercise BMD declines. ACSM (2004) recommends
maintaining regular weight bearing exercise throughout adulthood as a way to optimize bone
health.
Postural stability can be defined as having little risk of losing balance while standing or
falling during a movement. Numerous studies.highlight the association of aging with a decline in
postural stability (Era & Heikkinen, 1985; Hasselkus, & Shambes, 1975, & Woolacott &
Shumway-Cook, 1990), but Lord, Ward, Williams, & Strudwick (1995) demonstrated that a long
term exercise program can improve postural stability.
Hunter, McCarthy, & Bamman (2004) review the effects of resistance training in older
adults. The etiology of age related strength loss is not fully understood, but the consequences
of the muscle loss has been well documented. The loss of muscle know as sarcopenia has a
negative effect on strength, power, and muscular endurance which in turn increases difficulty
with weight bearing exercises, increases risk of falls leading to fractures, and leads to increased
fatigue which makes exercise more difficult. This series of actions leads to decreased physical
activity and increases disability further adding to loss of muscle. This cycle is illustrated from a
figure taken from their 2004 article (Figurel).
16
Sarcopenla
4 Strength
i Power
''
^
T Difficulty
with weightbearing tasks
T Risk of tails
and fractures
I Muscular
endurance
T Fatigability
and exercise
difficulty
ir
J Physical activity
T Disability
Fig. 1. A model of the functional consequences of age-related
sarcopenla and the positive feedback loop by which the erad result
of reduced physical activity further exacerbates progression of the
disorder. I indicates decrease: t indicates Increase.
The authors go on to highlight the peak age for muscle mass is in the third decade of life and
slowly declines in the fourth and fifth decade and more rapidly in the following decades.
However, their findings show that only 30 percent of this decline is age related and that a
number of factors influence the remaining decrease in sarcopenia. Declining phyical activity
plays a dominant role in the loss of muscle leading to a positive feedback in the model of
functional cosequenses of age-related sarcopenia. Breaking the cycle of physical inactivity will
lead to positive outcomes in the form of increased strength, endurance and ability to perform
ADLs.
Psychological
In a meta-analysis review North, McCullagh, & Tran (1990) reviewed the literature
looking at several questions. Outcomes compared across studies were converted to an effect
size (ES) to allow for comparison across studies. On the question, "Does exercise affect
depression level?", eighty studies were included in the review to answer this question and the
17
authors found that exercise provided an anti-depressive effect. Exercise was also subdivided
into single exercise sessions, exercise programs, and follow-up measurements. Single exercise
sessions looked at the effect of acute exercise, exercise programs looked at multi-session
exercise programs, and follow-up measurements looked at effects after a program had halted.
The authors found that in each case exercise had a significant anti-depressive effect concluding
that benefits can occur from the very beginning and have a long term effect. Another question
the authors looked at was, "What subject populations decrease depression with exercise?"
Review showed that significant anti-depressive effects occurred across all age ranges, but that
the older the subject the greater the decrease in depression. Exercise was equally effective for
both genders. Exercise provided an anti-depressive effect across all health status categories
reviewed. Subjects in medical rehabilitation programs showed a greater change than subjects
listed as apparently healthy or subjects in psychotherapy treatment. All modes of exercise were
found to be anti-depressive and the longer the program the greater the benefit. Exercise was
found to be as effective as psychotherapy, and more effective than relaxation. Exercise when
combined with psychotherapy was even more effective. In 1987 Roth and Holms studied the
effects of aerobic exercise compared to relaxation on treating depression. Students in a general
psychology course at the University of Kansas were given a life experiences survey. Students
who reported having a high number of stressful experiences and were not currently
participating in regular aerobic exercise or relaxation were invited to participate in the study.
Participants were assigned to either aerobic, relaxation, or control groups. Subjects participated
in physical and psychological screening prior to the beginning of the study, at five weeks, at the
end of the 11 week study, and 2 months following completion of the study. The aerobic group
participated in walking and running that elicited a 75 percent predicted heart rate max 3 days
each week for eleven weeks. The relaxation group was trained in muscle relaxation techniques,
18
and visual imagery and participated in relaxation periods 3 days a week for 11 weeks. The
control group was only seen when collecting data. Members of the exercise group had
improvements in aerobic fitness. Members of the exercise group showed a larger decrease in
depression at 5 weeks than either the relaxation or control group, but the difference in
effectiveness lessened by the conclusion of the study. This study indicated that aerobic exercise
was more beneficial in decreasing depression and that results could be achieved in a relatively
short time period.
Physical activity/ health status among college students
Volicer, Quattrocchi, Candelieri, & Nicolosi (2003) chose a random sample of 297 college
students from the National College Health Association's annual National College Health
Assessment. Their findings revealed that the mean BMI was 23.7, with 28.5 percent overweight
and 8.6% obese. Students aged 21 or greater were more likely to be overweight or obese (40.1%
vs. 27%, p< .018). They also found that male students were more likely to be overweight or
obese (42.0% vs. 29.5%, p< .015). Wallace, Buckworth, Kirby, & Sherman (2000) also note in
their study physical activity decreases with age and that only 42% of male and 30% of female
college age students report participating in vigorous physical activity on a regular basis, and the
steepest declines in physical activity are among adolescents (age 15 - 1 8 ) and young adults (20 25). Leslie et al. (1999) describes the college student in a time of transition from a more active
youth to a less active or sedentary adulthood. In their study of Australian college students they
find 47% of females and 32% of males are insufficiently active.
Barriers to Exercise
A number of studies have examined the reasons that keep individuals from exercising.
These factors can range from attitudinal to lack of facilities. Tappe, Duda, & Ehrnwald (1989)
looked at perceived barriers to exercise among high school students. Two hundred thirty six
19
students anonymously completed a questionnaire that measured perceived barriers and current
physical activity. Students were asked to rate nine items as barriers to exercise using a ninepoint Likert scale. The nine items were: 1) wanting to do other things with one's time 2) lack of
interest 3) unsuitable weather 4) having no place to exercise and the lack of needed equipment
5) job responsibilities 6) school or school work 7) a boyfriend or girlfriend that kept one from
being physically active 8) use of alcohol or other drugs and 9) feeling sick or having an injury.
Physical activity was measured using a modified Heyward's (2006) assessment of physical
activity. The most commonly cited barrier was wanting to do something else with one's time.
Also receiving notable consideration as barriers were unsuitable weather, lack of interest, school
work, job responsibilities, and lack of equipment or facilities. Males were more likely to claim
girlfriends and drug and alcohol use as barriers while females were more likely to state that bad
weather, lack of desire or interest, or school work were barriers. Because of the number of
barriers that deal with time and responsibilities the authors feel that school health and physical
educational programs need to be given greater priority within the total curriculum.
Grubbs & Carter (2002) studied the perceived benefits and barriers to exercise behavior
in college undergraduates. Subjects were 147 students enrolled in either the biology or
philosophy department with an average age of 19.9. Subjects were asked to complete a fourpart questionnaire. Subjects completed sections on demographics, current exercise habits,
exercise barriers/benefits scale (EBBS), and were given the opportunity to write in brief
comments about exercise beliefs. The EBBS was a 4-point Likert scale ranging from strongly
agree to strongly disagree. Fourteen of the 43 questions on the questionnaire dealt with
perceived barriers. The top five barriers to exercise as listed by subjects were 1) Exercise tires
me, 2) Exercise is hard work, 3) I am fatigued by exercise, 4) Exercise takes too much of my time,
and 5) My family members do not encourage me to exercise. Results indicated that individuals
20
who exercised regularly perceived more benefits and fewer barriers to exercise and conversely
those who perceived more barriers were less likely to exercise regularly. Subjects who
participated in intramurals had higher rates of exercise participation than those not
participating in intramurals. Physical performance and appearance were listed as top benefits,
while lack of time and exertion were the top barriers.
Self-efficacy
One's ability to believe that he/she can accomplish a task is a primary influencer of
behavior. Bandura (1977) examines this process in "Self-efficacy: Toward a Unifying Theory of
Behavioral Change". Outcome expectations are the belief that a certain behavior will produce a
given result. Efficacy expectations are the beliefs that one can perform that particular behavior.
These expectations are different in that a person can believe that a behavior will lead to an
outcome, but not necessarily believe that they possess the ability to perform that particular
behavior. Personal mastery will affect the initiation and persistence of a behavior. Individuals
avoid situations in which they feel they do not have the appropriate skills, but readily get
involved in activities they judge themselves as capable. The stronger the perceived self-efficacy,
the greater the individual effort is expended. Bandura further elucidates that expectations
alone will not produce desired performance if the individual is lacking in the necessary skills, and
that some people can assuredly accomplish certain behaviors but lack the motivation. However,
with the appropriate skills and motivation self-efficacy can play a key role in a person's choice of
activities.
While Bandura's (1977) work was not specifically looking at health or exercise behavior
a number of studies have given us insight to the application of self-efficacy to exercise and
health behavior. When looking at the relationship of perceived benefits and barriers to exercise
behavior, Grubbs and Carter (2002) found that before one will invest time and resources into an
21
activity they must believe that there is a great chance of a successful outcome. When looking at
personal, social, and environmental influences of exercise behavior, Leslie et al. (1999) found
that higher levels of self-efficacy were related to higher levels of physical activity. Wallace,
Buckworth, Kirby, and Sherman (2000) reviewed the predictors of exercise behavior change
among college students and found that exercise self-efficacy, physical activity history, nonexercise estimation of aerobic capacity, family support, and friend support were significant
factors in changing behavior. However, exercise self-efficacy was the most significant of the
predictors for change. Self-efficacy is a significant predictor of all health behaviors examined by
Ah, Ebert, Ngamvirtoj, Park and Knag (2004) except for smoking, and that since self-efficacy is
amenable to change it should be a primary focus of promotions or programs to college students.
College as a Time of Change
Attitudes have been argued to both become stable and to change over time. Krosnick &
Alwin (1989) dissect the relationship to age and attitudinal change. Giving a brief history of the
two competing theories, the impressionable years hypothesis and the increasing persistence
hypothesis, Krosnick and Alwin laid the ground work for their study. The impressionable years
hypothesis contends that socializing factors that people experience in their youth and young
adulthood form lenses through which they interpret situations and make decisions, and that
attitudes stabilize and change little throughout latter adulthood. A classic example of this would
be Newcomb's (1943) Personality and Social Change study involving social and political attitudes
of female students before, during, and after attendance at Bennington College. This group of
young women had been reared in socioeconomically advantaged and conservative families, and
attended a very liberal college in Bennington. The participants of the study completed a series
of political measures surveys throughout the collegiate experience. The students' mean political
rating moved from conservative to liberal over time. The longer a student attended Bennington
22
the more liberal she became. Newcomb, Koening, Hacks, & Warwick (1967) followed up
interviewing many of the participants of the original study. Their findings were that a liberal
attitude remained. In the last follow-up with the Bennington women attitudes had remained
stable from the 1967 study (Alwin, Cohen, & Newcomb, 1984). Krosnick and Alwin (1989) also
reviewed Sears (1981) Life Stage Effects on Attitudinal Change study as an example of the
increasing persistence hypothesis. Sears' study reviewed political attitude stability over the life
span by looking at racial prejudice. In 1972 Sears surveyed participants aged 21 - 61+ using a 10
question instrument. Respondents were divided into the following age groups: 21 - 28, 29 - 44,
45 - 60, 61+. The survey was administered again in 1976. Results supported the increasing
persistence hypothesis in that test re-test correlation increased across the age groups, and that
the elderly 61+ were particularly susceptible to change. Krosnick and Alwin (1989) felt that
these studies had significant methodological problems in that their test re-test analysis was not
a pure measure of attitudes but also included a certain amount of random error measurement.
In their study Krosnick and Alwin proposed to alleviate the random error measurement by
sampling from a nationally representative group aged 18 to 83, by measuring a range of social
and political attitudes, and assessed data in a way that allowed them to separate attitude from
random error that did not require assumptions about the unidimensionality of attitudinal
characteristics. This study was broken into two distinct categories between election attitudinal
changes, and within election attitudinal changes. For the between election study, participants
were surveyed three times in a four year span, during the 1956 presidential election, during the
1958 mid-term election and again during the 1960 presidential election. This was repeated
during the 1972 presidential election, 1974 mid-term election, and finally in the 1976
presidential election. All participants were asked the same 50 questions. Respondents were
grouped by age: 18 - 25, 26 - 33, 34 - 41,42 - 49, 50 - 57, 58 - 65, and 68 - 83. The within
23
election survey was administered three times during the 1980 presidential election in January or
February, June, and September or October. Participants all completed an 18 question survey,
and were divided into the same age groups as the between survey respondents. Results were
similar for the between election and within election studies. Attitude stability for the youngest
group is significantly smaller than the mean of the 26 - 33 grouping, meaning that young adults
are more open to changing attitudes. There is a significant difference in the 26 - 33 group
compared to the 34 - 83 group in the between elections study but in no other groupings. There
is no correlation between age and stability for the 34-83 groupings which disconfirms the
increasing persistence hypothesis. There is no significant decrease in attitude stability for the 68
- 83 grouping which refutes Sears' (1981) suggestion that attitude stability decreases in the
oldest population. Krosnick and Alwin's study strongly supports the Impressionable Years
hypothesis. Also of note is that attitudes were shown to change in a relatively short period of
time (8 months) during the within election study for the young adults.
Pascarella & Terenzini (2005) took a second look at how college affects students in a
review of their earlier 1990 study of How College Affects Students. In what many in student
affairs consider the bible on college students, Pascarela & Terenzini write an entire chapter on
attitudes and values. They find that significant change occurs in attitudes and values during the
college years in a great many areas including sociopolitical, civic and community involvement,
racial-ethnic, gender-role, homosexuality, educational and occupational, religious, interest in
the arts. While health belief and exercise are not specifically addressed, we see that the college
years are a time of great change for students. Pascarella and Terenzini acknowledge that it is
impossible to separate out the effects of college from maturation on attitudes, but these
changes that occur during college persist in to later adult years.
24
Costa & McCrae (1994) in reviewing stability and change in personalities found that
personalities are generally set by age 30. One construct they look at is Openness. Within the
Openness construct of personality are the attributes of action, ideas, and values. This seems to
fit in well with the impressionable years hypothesis in that young adults are open to attitudinal
changes, but at a certain point in the late twenties to early thirties both personality and
openness to change is greatly reduced. Leslie et al. (1999) in their study of insufficiently active
college students note college students are going through a time in which they are open to
cognitive change including attitudes toward exercise.
Attitudes toward Exercise
Attitudes toward exercise can affect one's participation in physical activity. McPherson
and Yuhasz (1968) developed the "Attitudes Toward Exercise and Physical Activity" scale to
evaluate changes in attitude of post myocardial infarction males following an exercise program.
This scale is composed of 50 questions that state commonly held opinions, beliefs, attitudes,
and fallacies about exercise. The scale is a split-half instrument in which half are stated
positively and half are stated negatively. Each statement was randomly assigned order within
the instrument. The instrument was tested for reliability using an odd-even split-half
assessment and a test-retest assessment with a two-to-seven day interval. Reliability ranged
from .81 to .95. Validity was tested by measuring mean scores for each item. A significant
difference was found (p > .01) between a group of presumed favorable to exercise and a group
presumed unfavorable to exercise. Mack & Shaddox (2004), using this instrument developed by
McPherson and Yuhasz (1968), measured the changes in college students participating in a
college wellness course. Students showed significant improvement in attitudes toward exercise
and physical activity following completion of the course. Mack and Shaddox (2004) portend that
25
a positive attitude toward exercise is a key determinant of participation in exercise and the
intensity exerted during exercise.
Nahas (1992) looked at how knowledge and attitudes can be influenced by participation
in a fitness education program. In his study, he reviews the past behavioral research which
points to knowledge in a specific subject matter's ability to change specific attitudes. The
purpose of his study was to examine factors that positively influence physical activity among
low-fit college students. Participants of his study were 913 female college students from a
major university in Brazil. Of the 913 students, 120 of the students were in the low-fit category
and were randomly selected to participate in the full study. One-third were randomly assigned
to a lecture and discussion group (A), a hand-out only group (B), and a control group. All groups
participated in a physical activity attitudinal survey and a health-related fitness knowledge test.
Group A & B received information and instruction for six weeks. The control group did not
receive additional information regarding health and fitness. Ten days following the end of the
treatment period, all participants completed the attitudinal and fitness surveys again. Results
indicated that group A and group B both scored significantly higher than the control group on
the fitness knowledge retest, but only group A scored significantly higher on the attitudinal test
suggesting that the lecture-discussion was more effective in changing attitudes compared to
informational handouts.
Stages of Change
Prochaska & DeClimente (1983) created a model to describe the process through which
people adapt or maintain behavioral change. This model accounts for different levels of
individual interest or commitment to the change process. Their model for stages of change
includes Precontemplation (no intention), Contemplation (intention), Action (new action), and
Maintenance (sustained action) of the behavior. In their original study Prochaska & DeClimente
26
(1983) were focused on smoking cessation. Marcus, Selby, Niaura, & Rossi (1992) were
interested in creating a scale to use with the Stage of Change model to measure exercise
behavior. In addition to the use of a stages model participants completed a self-efficacy scale
for exercise. The goals of the study were to create a stages of change scale to measure exercise
behavior and to test the ability of a self-efficacy scale to differentiate individuals into stage of
change readiness. Subjects were recruited from a state wide health promotion project within
the state of Rhode Island. Participants completed a stages of change model based upon the
Prochaska & DeClimente (1983) study but modified to describe exercise behavior. Subjects
were asked to select from a Likert-type scale for each of the stages: 1 indicated strongly disagree
and 5 indicated strongly agree. Participants were categorized into the stage with which they
most strongly identified. Participants also completed a five-item self-efficacy questionnaire
relating to one's ability to persist with exercise in various situations. An 11 point scale was used
to measure confidence: 1 = not confident at all and 11 = extremely confident. Results revealed
8% precontemplation, 21.1% contemplation, 36.9% action, and 34% maintenance. The selfefficacy instrument had a r= .82 internal consistency. Their finding also showed that those
choosing precontemplation also scored lowest on self-efficacy, and that those choosing
maintenance also scored highest. There were a large number of selections in the action and
maintenance categories that the authors felt it would be good to add an additional category and
a time component to the categories. They based this upon the follow up work of Prochaska &
DiClemente (1985) who suggested a preparation stage between contemplation and action. The
instruments were updated for the second part of the study. The rating scale for exercise selfefficacy was changed to a 7-point scale (Figure 2).
27
Figure 2
Revised Exercise Behavior Scale
Stage
Pre contemplation
Item
I currently do not exercise and I do not intend
to exercise in the next 6 months.
I currently do not exercise, but I am thinking
about starting in the next 6 months.
I currently exercise, but not regularly.
I currently exercise regularly, but have only
begun doing so in the last 6 months.
I have been exercising regularly for more than
6 months.
I used to exercise regularly in the past, but I
am not doing so currently.
Contemplation
Preparation
Action
Maintenance
Relapse
Findings revealed similar results to the first study, but gave additional details to the
breakdown of respondents in the preparation and action stage. Both studies showed significant
relationships of stages of change to measures of self-efficacy. A test of reliability was conducted
in a test retest format from a subset of study two participants. Reliability for the self-efficacy
instrument was at r= .90 and the stages of change model at r= .78.
College Intramural Sports
Intramural is derived from two Latin words intra meaning within and murus meaning
wall. Combining the two into one gives the definition of the word to mean within these walls.
Intramural sports/recreation is competition among college students at a college or university.
Intramural sports/recreation can be divided into four categories: competitive programming,
self-service programming, sports clubs, and special interest programming. Competitive
programming is the most commonly thought of aspect of intramurals. It is the organized
leagues that offer competition leading to individual or league championships. Sports may be
conducted as a tournament or as league that features a regular season and a playoff. Seasons
differ in length from sport to sport. Self-service programming is as the name implies directed by
28
individual participation in informal activities within the recreation facility. Sports clubs are
formed by people with a common interest in promoting a sport activity, learning new or
improving skills associated with that sport, competing both on and off campus. Special interest
groups revolve around the special needs of a particular group. This could include family
activities, faculty and staff groups, or disabled participants (Mueller & Reznik, 1979).
Physical Education Courses in Post Secondary Education
The history of physical education in post secondary education is long and extensive. As
early as 1883 F.A. Walker, President of the Massachusetts Institute of Technology, supported
the introduction of physical education in the college setting. He was also instrumental in leading
the cause of physical education on college campuses by recommending the creation of
departments of physical education (Park 1992). Sparling (2003) outlines the progress of physical
education in post secondary institutions at the beginning of his article College Physical
Education, An Unrecognized Agent of Change in Combating Inactivity-related Diseases.
Following F.A. Walker's asserting the need of physical education on college campuses, physical
education became part of the general education curriculum on most college campuses in the
United States (Hensley, 2000). Sparling (2003) reported that during the 1970's ideological and
funding changes negatively impacted the number of schools that required a physical education
component for graduation. The number of colleges and universities requiring a physical
education component fell from 90 percent in the 1960's to 65 percent in the 1990's.
Despite the declining number of schools requiring physical education as a graduation
component, evidence continues to mount that physical activity and participation in a college
physical education class has positive lifelong health benefits. Sparling and Snow (2002) reported
that participation in physical activity during the senior year lasts beyond graduation. In their
29
survey they found that 85 percent of regular exercisers during college reported similar or
increased activity patterns six years later. Also, 81 percent of non-exercisers reported similar or
decreased activity patterns at the six year mark. Not only are lifelong benefits derived from
participation in physical education, but also the acute benefits of exercise can provide stress
relief, decrease levels of anxiety, alter blood lipid profiles and regulate insulin sensitivity and
blood glucose (ACSM 2000; Hagberg, Park, and Brown 2000; Hubinger, Franzen, and Gries, 1987;
Koivisto and Defronzo, 1984; North, McCullagh and Tran 1990)
Sparling and Snow (2002) also exposit that college may also be the last window of
opportunity to change behavioral patterns for the following reasons: college is a time of
transition and students are open to changing behavior patterns; extensive facilities are
available, as well as numerous opportunities to participate in club sports; and credit and noncredit courses can provide basic instruction for new skills. "Physical education should be a
requirement because all college students need to know how to be physically active—
intellectually and experientially—and why physical activity is important to their overall wellbeing. Moreover, they need to achieve an appropriate level of health and science literacy. For
example, every student should understand the principles of energy balance and know how to
implement healthful changes in their eating and exercise behaviors. They should be equipped
with the knowledge and analytical skills to navigate through the maze of diet and fitness
programs in the marketplace and on the internet" (Sparling, 2003).
Summary of Literature Review
The benefits of physical activity have been highlighted in study after study. Benefits
found in physical activity included reducing the risk of cardiovascular disease, decreasing blood
lipid levels, decreasing body fat, increasing V02 max, decreasing weight, decreasing risk of
30
stroke, reducing incidence of Type 2 Diabetes, preventing certain cancers, helping maintain
activities of daily living, decreasing anxiety and depression. The cost of these behavioral based
preventable illnesses is a huge burden on our society, and needs to be reduced.
It was also found that college is a time of change for students and that the activity level
students had during the college years correlates with the level of activity later in life. It has been
shown that participation in physical activity/ wellness classes can positively affect the attitudes
and self-efficacy of students toward exercise. College may well be the last window of
opportunity to affect the behavior patterns of individuals relating to physical activity.
31
Chapter 3
Methods
The purpose of this study was take a base line measure of exercise self-efficacy,
attitudes toward exercise, and fitness measures of students prior to participation in either a
PEAC course or intramural sports and then to examine the differential effects participation in
either a PEAC course or intramural sports has upon exercise self-efficacy, attitudes toward
exercise, and fitness measures.
Participants
Participants in this study were comprised of 60 students enrolled at the University of
Arkansas. Nineteen of the subjects participated in intramural sports during the fall semester of
2009, 21 subjects participated in a PEAC course during the first eight weeks of the fall semester
of 2009 (students participated in either the fitness walking or weight training course), and 20
subjects were enrolled in a general sociology course who ware not participating in intramural
sports or enrolled in a PEAC course during the fall semester of 2009. Written informed consent
was obtained from all participants. The University of Arkansas Institutional Review Board
approved the methods and procedures used in this research project. See Appendix A for IRB
approval 09-07-002 and Appendix B for a copy of the Informed Consent form.
Measures
Attitudes Toward Exercise. Participants completed the Attitude Toward Exercise and
Physical Activity questionnaire developed by McPherson, Paivio, Yuhasz, Rechnitzer, Pickard and
Lefcoe (1968) (Appendix C). This instrument was originally created to assess attitude changes in
post cardiac infarction patients participating in an exercise program. The instrument was later
adapted by Mack and Shaddox (2004) to measure attitude changes in college students
participating in a college wellness program.
32
Stages of Change. Participants rated their current level of activity using the Stages of
Change scale created by Marcus, Selby, Niaura, & Rossi (1992) (Appendix D).
Self Efficacy. Participants completed the SCI Self-Efficacy scale developed by Kroll, Kehn,
Groah, and Neri (2007) (Appendix E).
Fitness Assessment. A person's level of fitness can greatly affect their ability to perform
activities of daily living but can also affect their morbidity and mortality as well. The following
tests were used to assess each student's fitness level and compare to the norms for healthy
adults.
1.
Flexibility: The traditional Sit-and-Reach Test was used as the American College of Sports
Medicine (ACSM) cites it as an easy to administer and interpret test that provides a very
good measure of flexibility (ACSM, 2007).
2.
Estimated Aerobic Capacity: The University of Houston non-exercise assessment was
used to evaluate students' maximal oxygen uptake. Extensive research has shown that
non-exercise assessments provide a quick, safe, and reliable measure of aerobic
capacity (George, Stone, and Lee, 1997; Jackson, Blair, Nahar, Wier, Ross, and Stuteville,
1990; Radim, Jackson, LaMonte, Morrow, Blair, Wareham, et al., 2005; Williford,
Scharff-Olson, Wang, Belessing, Smith, and Duey, 1996).
3. Strength: Grip strength using a hand dynamometer and leg strength using a back/leg
dynamometer was collected to give an indication of upper and lower body strength.
4.
Body Composition: Bioelectric Impedance is a measure of body composition that
measures the time it takes a small amount of electrical current to pass between two
points in the body. The elapsed time is affected by the amount of body fat. Body fat
impedes the flow of the electrical current. The longer the elapsed time the higher the
percentage of body fat (McArdle, Katch, & Katch, 2007 p. 797). Body composition is a
33
key component of a fitness assessment because the amount of body fat plays a role in
many of the functions of the human body. Too much body fat increases the likelihood
of coronary artery disease, hypertension, and certain types of cancer. Too little body fat
also has health consequences relating to normal functioning of the nervous and
reproductive systems as well as interfering with the maturation process during
adolescence. (Heyward, 2006 p. 171)
Fitness Norms
The following tables of fitness norms will provide a reference to scores received from
participants (Heyward 2006).
Table 1
Sit and Reach
Age YR
Men
Excellent
>=
Very Good
Good
Fair
Needs
improvement
<=
Women
Excellent
>=
Very Good
Good
Fair
Needs
Improvement
<=
15-19
20-29
30-39
40-49
50-59
60-69
39
40
38
35
35
33
34-38
29-33
24-28
23
34-39
30-33
25-29
24
33-37
28-32
23-27
22
29-34
24-28
18-23
17
28-34
24-27
16-23
15
25-32
20-24
15-19
14
43
41
41
38
39
35
38-42
34-37
29-33
28
37-40
33-36
28-32
27
36-40
32-35
27-31
26
34-37
30-33
25-29
24
33-38
30-32
25-29
24
31-34
27-30
23-26
22
34
Table 2
Aerobic Capacity
Age (yr)
Women
20-29
30-39
40-49
50-59
60-69
Men
20-29
30-39
40-49
50-59
60-69
Poor
<=
35
33
31
24
25
Fair
Good
Excellent
36-39
34-36
32-34
25-28
26-28
40-43
37-40
35-38
29-30
29-31
44-49
41-45
39-44
31-34
32-35
Superior
>=
50
46
45
35
36
41
40
37
34
30
42-45
41-43
38-41
35-37
31-34
46-50
44-47
42-45
38-42
35-38
51-55
48-53
46-52
43-49
39-45
56
54
53
50
46
Table 3
Strength
Classification
Men
Excellent
>
Good
Average
Below Average
Poor
<
Women
Excellent
>
Good
Average
Below Average
Poor
<
Left Grip (kg)
Right Grip (kg)
Leg Strength (kg)
68
56-67
43-55
39-42
39
70
62-69
48-61
41-47
41
241
214-240
160-213
137-159
137
37
34-36
22-33
18-21
18
41
38-40
25-37
22-24
22
136
114-135
66-113
49-65
49
35
Table 4
Body Composition
Age (yr)
Male
18-34
35-55
55+
NR<
Low
Mid
Upper
Obesity >
8
10
10
8
10
10
13
18
16
22
25
23
22
25
23
Female
18-34
35-55
55+
20
25
25
20
25
25
28
32
30
35
38
35
35
38
35
Procedures
Data was collected at the beginning and end of the PEAC course and the beginning and
end of the intramural season. Students in the sociology course participated in data collection
once as a control measure at the beginning of the study. Data for student profile, readiness for
exercise, exercise self-efficacy, and attitude toward exercise was collected via printed survey.
Collection of physical fitness components was collected by the researcher following protocols as
detailed in Appendix F.
Data Analysis
Paired t-tests were used to track pre-post differences in relation to attitude toward
exercise, exercise self-efficacy toward exercise, and performance on the physical fitness
measures of estimated aerobic capacity, body composition, flexibility, and strength. ANOVA
statistical tests were used to analyze the differences in initial testing among the three student
groups (PEAC, intramural, control). Tukey's Honestly Significant Differences (HSD) post-hoc test
was used to analyze significant differences.
36
Chapter 4
Results and Discussion
The purpose of this study was to examine compare the fitness, attitudes toward
exercise, and exercise self-efficacy of students participating in intramural sports, for-credit
physical education activity classes, and a control group at the University of Arkansas and to
determine differential effect of participation in PEAC or Intramurals on changes in these
measures. Post test collection of student participating in both the intramural and physical
education classes were gathered to determine the effectiveness in changing fitness, attitudes,
and exercise self-efficacy. The variables examined included physical measures of height, weight,
body fat percentage, flexibility, grip strength, leg strength, and estimated aerobic capacity.
Psychological measures included SCI Exercise Self-Efficacy by Krol, Kehn, Groah, and Neri, (2007)
and McPherson's (1968) Attitude Toward Exercise questionnaire.
Results
Hypotheses 1 & 2
It was hypothesized that students participating in PEAC courses would not be significantly
different from the U of A general population in fitness levels. It was also hypothesized that
students participating in intramurals would have significantly better fitness sores than students
from the general student population and the students participating in PEAC courses. A one-way
ANOVA test was used to compare fitness measures across group type (Intramurals, PEAC, and
Control). Comparisons across groups revealed a significant difference in the categories of body
fat and estimated aerobic capacity (Table 5). Further analysis using Tukey's HSD reviled that
only significant differences were found between the control participants and intramural
participants. Participants in the intramural group had significantly lower body fat, and
37
significantly greater estimated aerobic capacity compared to the control group. No other
significant differences were found (Table 6).
Table 5
Analysis of Variance by Group Tvoe on Fitness Measures
PEAC
(N = 21)
Intramurals
(N = 19)
F-value
Significance
<N = 20)
Control
Weight
X
SD
156.98
24.39
160.40
49.34
164.37
29.80
0.21
0.812
Body Fat Percentage
X
SD
18.22
10.27
23.16
7.74
15.86
6.77
3.82
0.028*
Sit and Reach
X
SD
29.40
11.19
32.93
9.42
26.87
10.40
1.68
0.196
Grip Strengh Right
X
SD
41.23
12.27
40.03
13.61
41.98
10.05
0.13
0.878
Grip Strengh Left
X
SD
39.36
11.79
38.03
13.89
38.10
9.74
0.08
0.923
Leg Strengh
X
SD
246.67
107.86
249.00
114.15
307.74
121.28
1.85
0.167
Aerobic Capcity
X
SD
44.60
9.36
41.86
6.92
48.46
6.08
3.66
0.032*
*p <.05
38
Table 6
Tukey HSD Comparison by Group and Fitness Measure
Mean Difference
Significance
Body Fat Percentage
PEAC
Control
Intramurais
-4.94
2.36
0.156
0.654
Control
PEAC
Intramurais
4.94
7.30
0.156
0.025 *
Intramurais
PEAC
Control
-2.36
-7.30
0.654
0.025 *
PEAC
Control
Intramurais
2.74
-3.86
0.409
0.256
Control
PEAC
Intramurais
-2.74
-6.60
0.490
0.025 *
Intramurais
PEAC
Control
3.86
6.60
0.256
0.025 *
Aerobic Capcity
* p < .05
Hypothesis 3
It was hypothesized that the general population of students and students participating
in PEAC courses would score significantly lower on exercise self-efficacy toward exercise and
attitudes toward exercise compared to students participating in intramural sports pre-test. A
one-way ANOVA test was used to compare Exercise Self-Efficacy Scale scores and Attitude
Toward Exercise and Physical Activity scores across groups. No significant differences were
found (Table 7).
39
Table 7
Analysis of Variance by Group Type on Self-efficacy and Attitudes Toward Exercise
PEAC
Control
(N = 20)
Intramurals
(N = 19)
F-value
Significance
Serf-efficacy
X
SD
34.52
4.29
33.00
4.54
36.05
3.22
2.74
0.073
Attitudes Toward Exercise
X
SD
193.10
14.97
193.55
12.48
189.53
19.42
0.38
0.687
"p <.05
Hypothesis 4
It was hypothesized that students participating in PEAC courses would show significant
improvement on the measured fitness components. Paired T-test analysis was used to analyze
changes in fitness sores preformed before and after participation in the PEAC course. No
significant improvements were found (Table 8).
Table 8
Paired t-Test for Pre-test and Post-test Fitness Measures for PEAC Students
Pre-test
Post-test
t-value
Significance
Weight
156.98
160.16
-3.73
0.001*
Body Fat Percentage
18.22
19.93
-3.29
0.004*
Sit and Reach
29.40
30.64
-1.51
0.146
Grip Strength Right
41.23
42.04
-0.64
0528
Grip Strength Left
39.36
38.80
0.74
0468
Leg Strength
246.67
253.33
-1.17
0.256
Aerobic Capacity
* p < .05
44.60
44.08
0.88
0.392
40
Hypothesis 5
It was hypothesized that participation in a PEAC course would significantly improve
exercise self-efficacy scores. Paired T-test analysis was used to compare pre and post test scores
of PEAC students on the SCI Test. No significant improvements were found (Table 9).
Table 9
Paired t-Test for Pre-test and Post-test Psychometric Measures for PEAC Students
Self-efficacy
Attitude Toward Exercise
Pre-test
Post-test
t-value
Significance
34.52
34.71
-0.30
0.771
133.10
193.00
0£5
0.958
* p <.05
Hypothesis 6
It was hypothesized that participation in a PEAC course would significantly improve
attitude toward exercise scores. Paired T-test analysis was used to compare pre and post test
scores of PEAC students on the ATEPA Test. No significant improvements were found (Table 9).
Hypothesis 7
It was hypothesized that participation in intramurals would not significantly improve
exercise self-efficacy scores. Paired T-test analysis was used to compare pre and post test scores
of PEAC students on the SCI Test. No significant improvements were found (Table 10).
41
Table 10
Paired t-Test for Pre-test and Post-test Psychometric Measures
for Intramural Students
Pre-test
Post-test
t-value
Significance
36.05
35.74
0.33
0.746
18953
190.37
-0.38
0.711
Self-efficacy
Attitude Toward Exercise
* p < .05
Hypothesis 8
It was hypothesized that participation in intramurals would not significantly improve
attitude toward exercise scores. Paired T-test analysis was used to compare pre and post test
scores of PEAC students on the ATEPA Test. No significant improvements were found (Table 10).
Hypothesis 9
It was hypothesized that students participating in an intramural "season" would show
no significant improvement in the measured fitness components. Paired T-test analysis was
used to compare pre and post test scores of PEAC students on the SCI Test. No significant
improvements were found (Table 11).
42
Table 11
Paired t-Test for Pre-test and Post-test Fitness Measures
for Intramural Students
Pre-test
Post-test
t-value
Significance
Weight
154.37
163.74
1.03
0.316
Body Fat Percentage
15.86
15.92
-0.14
0.891
Sit and Reach
26.87
28.92
-1.78
0.092
Grip Strength Right
41.98
41.97
0.01
0.992
Grip Strength Left
38.10
39.21
-0.93
0.364
Leg Strength
308.74
300.26
0.71
0484
Aerobic Capacity
p <.05
48.46
48.93
-1.42
0.172
A comparison of student's initial fitness score norms by group and by gender found in
Table 12. Fitness Norms can be found in Tables 1-4.
Table 12
Fitness Norms by Group by Gender
Body Fat
Sit and Reach
Grip Right
Grip Left
Leg
Aerobic
Capacity
Control
F Low
M Upper
Good
Good
Poor
Poor
Poor
Poor
Avg
Avg
Fair
Good
Intramural
F Low
poor
Avg
Good
M Mid
Very Good
poor
Needs
Improvement Poor
Poor
Avg
Exc
F Mid
M Low
Fair
Fair
Poor
Poor
Avg
Below Avg
Fair
Excellent
PEAC
Poor
Poor
43
Discussion
Hypotheses 1 & 2
These two hypotheses looked at fitness and activity among three different groups of
student at the University of Arkansas. Student fitness and exercise participation in the United
States has decreased over the last four decades (Hardin, Andrew, and Bemiller, 2009).
Accompanying this decrease in the decrease in fitness activity has been a steady rise in the
number of students working during the academic year (Stern and Nakata, 1991). This
combination of less exercise and more work has lead to a less fit student population. Hardin,
Andrew, and Bemiller (2009) indicated that one of the primary reasons for participating in
physical education courses is the health benefit associated with exercise. The study indicated
that the students participating in physical education courses would be similar to the general
student population, but less fit compared to student who were actively engaged in intramural
sports. In the continuum of fitness the results have shown that the general student population
is less fit, students participating in PEAC classes more fit, and the student engaged in intramural
activities most fit. However there is not a significant difference in fitness when comparing the
general population and the PEAC students or when comparing the PEAC participants and the
intramural students. However, when looking at the general population and the intramural
participants there was a significant difference in body fat and estimated aerobic capacity
between the two groups. Between 30 to 40 percent of obesity can be attributed to genetics,
but the vast amount of obesity is caused by environmental factors (Pi-Sunyer, 2002). A
sedentary life style is a primary contributor of environmentally caused obesity. The following
disorders are associated with obesity: insulin resistance, hyperinsulinemia, type 2 diabetes,
hypertension, dyslipidemia, coronary heart disease, gallbladder disease, cancer, and all-cause
44
mortality. A larger percentage body fat and a lower estimated aerobic capacity are tied to
decreased physical activity.
Hypothesis 3
Based upon the belief that there would be significant difference in the fitness of the
three groups, there was anticipation that there would also be significant differences in the
attitudes toward exercise and self-efficacy of exercise. Marcus, Selby, Niaura, and Rossi (1992)
elucidated that self-efficacy played a role in participation in exercise. If you believed you could,
you would try. But if you had no belief that you would succeed, you would be less inclined to
try. Since there was no significant difference in the fitness outcomes between the intramural
and PEAC student, finding no significant differences in exercise self-efficacy and attitudes
toward exercise was consistent with expectations. And while there was not a significant
difference in either attitudes or exercise self-efficacy between Intramural and the control group
of students, the differences in outcomes on exercise self-efficacy approached significance at a
.058 level.
Hypothesis 4
Hypothesis 4 related to expected changes to be seen during the PEAC course. The
fitness measures looked at in this study included flexibility, strength and aerobic capacity.
Students participating in walking and weight training programs should be expected to stretch
post workout and see benefits of increased flexibility. Students participating in both the fitness
walking and the weight training courses were given instruction in designing exercise programs
including the design of a stretching program to follow either the walking or the weight lifting.
Students received lecture during the first few classes of their respective courses to cover the
basic knowledge of walking or weight lifting. Following the instruction students participated in
the activity for the remainder of the course. Follow-up conversations with instructor highlighted
45
the fact that this was his first time to teach PEAC courses at the University of Arkansas and he
was left to his own to design the courses materials and the structure of the classes. He has
indicated that he has changed several aspects of the courses based upon his initial experience
with the courses. Students participating in a walking program should expect to see an increase
in aerobic capacity and not see weight gains. However, the time allotted for walking in this
program was not sufficient to produce either an increase in aerobic capacity or prevent weight
gain. ACSM (2009) guidelines recommend at least 150 minutes per week to prevent weight gain
and between 250-300 minutes per week to see weight lose. There was a component of aerobic
exercise in the weight training course but not monitored. Students participating in the weight
training course should have seen improvements in strength but many were working from in
accurate exercise programs. For example, in the courses the participants were enrolled in there
was very little fitness evaluation upfront and students exercise programs were likely insufficient
to produce changes. Supervision of the students' progress was lacking and monitoring of the
cool down stretching was inconsistent. The instructor has since improved these aspects of the
courses, and now approves the exercise program submitted by the student during the beginning
of the course. The lack of controls in the course seemed to play a role in not seeing significant
changes in fitness scores. Another factor to consider is the length of the courses may not be
sufficiently long enough to produce significant changes in fitness measures, but could be the
starting point of a lifelong habit. Potentially the lack of expected improvements could be
indicated to be an instructor issue, but in the larger scale this instructor was part of a program
and if the instructor was left to create and implement his courses on his own it is potentially a
systemic problem that will occur each time a new instructor is introduced to this program. As
instructors for the PEAC program are primarily graduate assistants, the turnover of instructors is
fairly regular.
46
Hypothesis 5
Hypothesis 5 looked at expected changes in exercise self-efficacy for students
participating in PEAC courses. Initial exercise self-efficacy scores were very high across the
board for students participating in the PEAC course. The average score fell between sometimes
true and always true on the scale of overcoming barriers to exercise. With such a high starting
score, it was very unlikely to increase significantly. Perhaps the high initial value related to
enthusiasm related to starting a new program. It was encouraging to see that at the end of the
course that the student's exercise self-efficacy had increased slightly.
Hypothesis 6
Hypothesis 6 looked at expected changes in attitudes toward exercise for students
participating in PEAC courses. Findings in this study stand in contrast to the findings of Mack
and Shaddox (2004) in which they found significant improvements in short term changes in
attitude toward exercise in students participating in a PEAC course. Perhaps the sheer number
of students participating in their study (1,625 compared to the 21 in this study) provides the
difference. Nahas (1992) also found that participation in a PEAC course that had lecture type
information relating to fitness combined with physical activity improved attitude. Perhaps there
was more focus on the information provided in those courses compared to the limited
information provided in the PEAC courses in this study.
Hypotheses 7, 8, & Hypothesis 9
These hypotheses related to the lack of expected changes in students scores on fitness,
exercise self-efficacy, and attitude toward exercise. Significant improvements on fitness,
exercise self-efficacy or attitude toward exercise scores for these students who were actively
participating in physical activity were not expected. The assumption was that intramural
47
students were already very active and fit and would not see significant changes in activity of
fitness based upon participation in intramural sports. The study reflected those expectations.
48
Chapter 5
Summary, Conclusions, and Recommendations
Summary
The purpose of this study was to examine the fitness, exercise self-efficacy, and
attitudes toward exercise of three student groups at the University of Arkansas. The three
groups of students were students participating in a for-credit physical education course (PEAC),
students participating in an intramural sport, and a control group of students participating in
neither a PEAC course nor an intramural sport. Follow-up testing was completed on the student
participating in the PEAC course and intramural sports to determine the effect of participation
on fitness, exercise self-efficacy, and attitudes toward exercise.
Participants in the study included 26 female and 34 male students ranging in age from
18 to 27 years of age. Fitness measures included estimated aerobic capacity, body composition,
flexibility, and strength. Participants also completed the Attitude Toward Exercise and Physical
Activity questionnaire developed by McPherson, Paivio, Yuhasz, Rechnitzer, Pickard and Lefcoe
(1968), and the SCI Self-Efficacy scale developed by Kroll, Kehn, Groah, & Neri, (2007). It was
hypothesized that PEAC and Control groups would be similar in fitness, attitude and exercise
self-efficacy and that students participating in intramurals would score higher in fitness,
attitude, and exercise self-efficacy compared to the other groups. It was also hypothesized that
participation in PEAC would significantly increase fitness, attitude, and exercise self-efficacy
score, but participation in Intramurals would not produce significant increases.
ANOVA statistical tests were used to analyze the differences in initial testing among the
three student groups (PEAC, intramural, control). Paired t-tests were used to track pre-post
differences in relation to attitude toward exercise, self-efficacy toward exercise, and
performance on the physical fitness measures of estimated aerobic capacity, body composition,
49
flexibility, and strength. Significant differences were found only when comparing intramural
students' body fat and estimated aerobic capacity to the control group. Intramural students had
significantly lower body fat and significantly higher estimated aerobic capacities. No significant
increases were found in pre - post tests for PEAC students or students participating in
intramurals.
Conclusions
Based on the findings and limitations of this study, the following conclusions were
made:
1.
PEAC students were not significantly different in fitness, attitude and exercise selfefficacy from the general population of student at the University of Arkansas.
2. Students participating in intramural sports were significantly more fit than the
general population of students at the University of Arkansas when using percent
body fat or estimated aerobic capacity as the measures of fitness.
3. As currently offered, the PEAC courses Fitness Walking and Weight Training at the
University of Arkansas did not significantly improve fitness measures, attitudes
toward exercise, or exercise self-efficacy.
4.
Participation in the intramural sports basketball and flag football at the University of
Arkansas did not significantly improve fitness measures, attitudes toward exercise,
or exercise self-efficacy.
This study raised questions to be addressed in the future. Would fitness measures have
been significantly different if more sensitive equipment had been employed? This specifically
refers to measures of strength and estimated aerobic capacity. Would a random selection of
general population student have provided a better sampling of the University of Arkansas
student body than selecting students from one sociology course? Does the limited offering in
50
both number and type of PEAC courses at the University of Arkansas discourage unfit students
from participating?
Recommendations
Recommendations have been taken from observations made during this study as well as
from results and conclusions.
1.
Measure aerobic capacity using an exercise protocol.
2.
Measure strength using an isokinetic device similar to a biodex.
3.
Increase the numbers of participants in the study.
4.
Randomly select students from the entire student population.
5.
Implementation of tighter controls and training of graduate students for the instruction
of the PEAC courses.
51
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57
Appendix A
UNIVERSITY^ARKANSAS
120 Ozark Hall • Fayetteville, Arkansas 72701 • (479) 575-2208 • (479) 575-3846 (FAX)
Email: irb@uark.edu
Research Support and Sponsored Programs
Institutional Review Board
TO:
Andy Matthews
Inza Fort
FROM:
Ro Windwalker
IRB Coordinator
RE:
New Protocol Approval
IRB Protocol #:
09-07-002
Protocol Title:
Participation in PEAC vs. Intramural Sport on Exercise SelfEfficacy, Attitude Toward Exercise, and Physical Fitness
Review Type:
•
Approved Project Period:
Start Date: 07/24/2009 Expiration Date: 07/23/2010
EXEMPT
E3 EXPEDITED
•
FULL IRB
Your protocol has been approved by the IRB. Protocols are approved for a maximum period of
one year. If you wish to continue the project past the approved project period (see above), you
must submit a request, using the form Continuing Review for IRB Approved Projects, prior to the
expiration date. This form is available from the IRB Coordinator or on the Compliance website
(http://www.uark.edu/admin/rsspinfo/compliance/index.html). As a courtesy, you will be sent a
reminder two months in advance of that date. However, failure to receive a reminder does not
negate your obligation to make the request in sufficient time for review and approval. Federal
regulations prohibit retroactive approval of continuation. Failure to receive approval to continue
the project prior to the expiration date will result in Termination of the protocol approval. The IRB
Coordinator can give you guidance on submission times.
If you wish to make any modifications in the approved protocol, you must seek approval prior to
implementing those changes. All modifications should be requested in writing (email is
acceptable) and must provide sufficient detail to assess the impact of the change.
If you have questions or need any assistance from the IRB, please contact me at 120 Ozark Hall,
5-2208, or irb@uark.edu.
58
Appendix B
Informed Consent
Title: Comparison of Participants of PEAC courses and Intramural Sports and the Change associated in participation
Researcher(s):
Administrator(s):
Andy Matthews, Graduate Student
Inza Fort, Faculty Advisor
University of Arkansas
College of Education and Health Professions
Health Science, Kinesiology, Recreation and Dance
HPER 308M
Fayetteville, AR 72701-1201
(479) 575-2910
Rosemary Ruff, Director
Research & Sponsored Programs
Research Compliance
University of Arkansas
120 Ozark Hall
Fayetteville, AR 72701-1201
479-575-3845
rruff@uark.edu
Description: The purpose of this study is to evaluate the effect of participation in intramural sports vs. enrollment in a
credit bearing PEAC course at the University of Arkansas on key physiological and psychological measures.
Participants will complete a survey regarding readiness for exercise, self-efficacy of exercise, and attitude toward
exercise. Participants will also be evaluated on key fitness measures including flexibility using the standard sit and
reach protocol, aerobic capacity using the University of Houston non-exercise assessment, strength via a hand and leg
dynamometer, and body composition using a bioelectric impedance. Participants enrolled in a credit bearing PEAC
course or competing in an intramural sport will complete the survey and fitness at the beginning and end of their
course/sport. Participants enrolled in a general education course will complete the survey and fitness assessment
only once to be used as a base line comparison for those involved in PEAC or Intramurals.
Risks and Benefits: Participation in this study will gain knowledge of their own fitness and attitudes toward fitness
while contributing to a broader knowledge of the fitness and attitudes toward fitness of University of Arkansas
students. Knowledge will also be acquired regarding effectiveness of PEAC and intramurals in changing attitudes and
fitness levels. This information could be used in making future policy decisions at the University of Arkansas.
Voluntary Participation: Participation in this study is completely voluntary. There is no remuneration offered.
Confidentiality: All individual information will be kept confidential. Only aggregate information will be reported.
Right to Withdraw: You are free to refuse to participate in the research and to withdraw from this study at anytime.
Your decision to withdraw will bring no negative consequences — no penalty to you.
Informed Consent: I,
, have read the
(Please Print)
description, including the purpose of the study, the procedures to be used, the potential risks and side effects, the
confidentiality, as well as the option to withdraw from the study at any time. Each of these items has been explained
to me by the investigator. The investigator has answered all of my questions regarding the study, and I believe I
understand what is involved. My signature below indicates that I freely agree to participate in this experimental study
and that I have received a copy of this agreement from the investigator.
Signature
Date
59
Appendix C
Attitude Toward Exercise and Physical Activity
In order to assess your attitudes toward exercise and physical activity, we would like you
to express your true feelings, beliefs, and actions with respect to the following statements. There
are no right or wrong answers, it is strictly a matter of personal beliefs and attitudes toward
exercise. Therefore, please express how you feel, not how you think you should feel.
You have been provided with a separate answer sheet for recording your reaction to each
statement. Read each statement carefully, then go to the answer sheet, and place an "X" in the
parentheses which are under the word or words which best express your feeling about the
statement.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
Physical exercise is beneficial to the human body.
Exercise helps to work off emotional tensions and anxieties.
Adults get all the physical activity they need in their daily work.
Exercise is of little value in maintaining desirable body weight.
Regular physical activity makes one feel better.
Physical education should be a required subject for elementary and secondary school
children.
Exercise does more harm than good.
Those who are physically able should take part in a daily period of physical activity.
An individual has all the strength and stamina he needs without participating in an
exercise program.
Exercise does little to improve a person's sense of well-being.
Heavy physical exercise makes an individual muscle bound.
When recovering from a cold it is best if one does not engage in physical activity.
Participation in physical activity aids mental relaxation.
Exercise is important in aiding a person to gain and maintain all-around good health.
The heart cannot be strengthened by exercise.
A person's leisure time should be spent in rest and relaxation.
Individual sports such as tennis are more satisfying to play than team games.
I think exercise is good for me.
You should seek help from a qualified physical educator before you undertake strenuous
exercise.
Regular exercise decreases one's desire to smoke.
A person in good physical condition is more able to endure nervous stress.
Exercising with a group leads to improved social relationships.
Exercise becomes less necessary as one advances in age.
A woman can improve her poise and posture by regular participation in physical activity.
Regular physical activity has a beneficial effect on an individual's ability to carry out
his/her job responsibilities.
60
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
Exercise gets rid of harmful feelings and emotions such as anger and hostility.
Those who are physically healthy do not need to engage in physical exercises.
Anyone over 25 years of age should avoid exercise because he/she might strain his/her
heart.
Regular participation in physical activity makes one look better.
It is better to have never exercised at all than to have exercised and stopped
completely.
It is annoying that we have to waste our time exercising.
A period of exercise gives a feeling of well-being.
Exercise is of no real value in improving one's health.
Those who are physically able should engage in a weekly session of physical activity.
Muscles, when not used, turn to fat.
Exercise is valuable in building up an adequate reserve of strength and stamina for
everyday living.
Regular exercise does not relieve constipation.
If I exercised I would rather do it by myself.
Girls should not exercise strenuously because they will become muscular.
Physical exercise is less important today than it was in my parent's time.
Exercise increases one's appetite.
When one reaches full physical growth exercise is no longer necessary.
Physical activity in some form is an excellent remedy for the tense, irritable and anxious
person.
Regular physical activity makes a person more alert.
Regular physical activity has little effect on one's personality.
A person in good physical condition is less likely to have colds.
Regular physical activity will help me live longer.
Working up a good sweat helps to get rid of body poisons.
When a person improves his/her physical condition, he/she improves his/her work
productivity.
Physical activity can help in preventing major medical diseases.
61
Answer Sheet
Attitude Toward Exercise and Physical Activity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
62
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Strongly Agree
Agree
Neutral
Disagree
Student ID:
Strongly Disagree
Name:
Appendix D
Current Level of Activity
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.
Check one choice:
D I have been exercising for MORE than 6 months
D I have been exercising for LESS than 6 months
Q I exercise but not regularly
I—11 INTEND to begin exercising in the next 6 months
•
I DO NOT intend to begin exercising in the next 6 months
63
Appendix E
SCI EXERCISE SELF-EFFICACY
Please indicate how confident you are with regard to carrying out regular physical
activities and exercise. (Please check only one box for each question).
1. that I can overcome barriers and
challenges with regard to physical
activity and exercise if I try hard enough
2. that I can find means and ways to be physically
active and exercise
3. that I can accomplish my physical
activity and exercise goals that I set
4. that when I am confronted with a barrier to
physical activity or exercise I can find several
solutions to overcome this barrier
5. that I can be physically active or
exercise even when I am tired
6. that I can be physically active or
exercise even when I am feeling
depressed
7. that I can be physically active or
exercise even without the support of my family
or friends
8. that I can be physically active or
exercise without the help of a therapist or
trainer
9. that I can motivate myself to start being
physically active or exercising again after I've
stopped for a while
10.that I can be physically active or
exercise even if I had no access to a gym,
exercise, training, or rehabilitation facility
64
Always True
Sometimes True
Rarely True
Not at All True
1 am confident:
Appendix F
Fitness Test Collection Protocols
Collection of data will occur in the following order:
Height
Weight
Body composition from bio electric impedance
Non-exercise aerobic capacity
Sit and Reach
Hand grip strength
Leg Strength
Protocols
Height will be measured in inches to the nearest half inch
Weight will be measured in pounds to the nearest pound.
Body composition will be measured using a hand held bioelectric impedance device
Non-exercise aerobic capacity will be determined by using the University of Houston Exercise
protocol as follows:
Participants will determine their Physical Activity Rating (PAR)
Give yourself the appropriate PAR score (0-7) based on the following scale:
I. Does not participate regularly in programmed recreation, sport, or physical activity.
0 points: Avoids walking or exercise (for example, always uses elevators, drives
whenever possible instead of walking).
1 point: Walks for pleasure, routinely uses stairs, occasionally exercises sufficiently to
cause heavy breathing or perspiration.
II. Participates regularly in recreation or work requiring modest physical activity (such as golf,
horseback riding, calisthenics, gymnastics, table tennis, bowling, weight lifting, or yard work).
2 points: 10-60 minutes per week
3 points: Over 1 hour per week
65
III. Participates regularly in heavy physical exercise (such as running or jogging, swimming,
cycling, rowing, skipping rope, running in place) or engages in vigorous aerobic type activity
(such as tennis, basketball, or handball).
4 points: Runs less than 1 mile per week or spends less than 30 minutes per week in
comparable physical activity.
5 points: Runs 1-5 miles per week or spends 30-60 minutes per week in comparable
physical activity.
6 points: Runs 5-10 miles per week or spends 1-3 hours per week in comparable
physical activity.
7 points: Runs more than 10 miles per week or spends more than 3 hours per week in
comparable physical activity.
V02max will be estimated based upon physical activity rating, age, percent body fat.
Choose the appropriate formula and fill in the appropriate values
PAR = Physical Activity Rating
A = Age (in years)
% fat = Percent body fat (multiplied by 100; e.g., 25% 013100 = 0.25 03100 = 25)
G = Gender (0 for women, 1 for men)
V02max = 50.513 + 1.589(PAR) - 0.289(A) - 0.522(% fat) + 5.863(G)
V02max = 50.513 + (1.589 •
(PAR)) - (0.289 •
(age)) - (0.522 •
(% fat)) + (5.863 •
(gender)) =
ml/kg/min
V02max:
ml/kg/min
Standard Sit and Reach Test
Using a standard sit and reach box w/ a zero point of 26 cm.
Participants will sit on floor with knees extended and soles of feet against the edge of the box.
Inner edges of soles should be 6 in. apart.
With knees fully extended, arms evenly stretched, hands parallel with palms down participant
will slowly reach forward as far as possible along the top of the box. Participant will hold at
farthest point for about 2 seconds.
Two attempts will be made recording the maximum score to the nearest .5 com
Hand Grip Test
Adjust hand grip size to a position that is comfortable for the participant.
Participant will stand erect, holding the dynamometer with shoulder adducted and neutrally
rotated, elbow flexed to 90 degrees.
66
Participant will squeeze as hard as possible for a brief maximal contraction.
Test both hands. Two attempts per hand. Record best score for each hand.
Leg Strength Test
Using a back/leg dynamometer, the participant stands on the platform with trunk erect and
knees flexed to 130 to 140 degrees.
Participant holds hand bar using a pronated grip and positions it across the thighs by adjusting
the chain. Without using the back, participant slowly exerts as much force as possible while
extending the knees. Administer two attempts recording the largest score.
67
Appendix G
Raw Data
Student Profile
ID
Age
Level
Gender
Group
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
19
22
20
20
19
20
23
20
21
21
23
27
22
22
21
19
22
21
23
20
19
17
18
18
21
18
19
18
20
18
18
19
18
19
So
Sr
Jr
Jr
So
Jr
Sr
Jr
Jr
Sr
Sr
Sr
Sr
Sr
Sr
So
Sr
Sr
Sr
Jr
So
Fr
Fr
Fr
So
Fr
So
Fr
Jr
Fr
Fr
So
Fr
So
F
PEAC
F
PEAC
M
PEAC
F
PEAC
F
PEAC
M
PEAC
F
PEAC
F
PEAC
M
PEAC
F
PEAC
M
PEAC
M
PEAC
M
PEAC
M
PEAC
M
PEAC
M
PEAC
F
PEAC
F
PEAC
M
PEAC
M
PEAC
M
PEAC
F
Control
M
Control
F
Control
M
Control
M
Control
F
Control
M
Control
F
Control
M
Control
M
Control
M
Control
F
Control
F
Control
Gender
Group
19
18
19
19
18
23
22
21
18
18
21
26
18
18
20
21
18
18
20
23
21
18
20
20
18
20
So
So
F
Control
F
Control
F
Control
F
Control
M
Control
M
Control
F
Control
F
Intramurals
M
Intramurals
M
Intramurals
M
Intramurals
F
Intramurals
M
Intramurals
M
Intramurals
F
Intramurals
M
Intramurals
M
Intramurals
M
Intramurals
M
Intramurals
M
Intramurals
M
Intramurals
M
Intramurals
LL.
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
Intramurals
F
Intramurals
M
Intramurals
F
Intramurals
Pre-test Scores
Sit
and
Reach
Grip
Right
Grip
Left
Leg
Est.
Aerobic
Capacity
ID
SCI
ATEPA
Height
Weight
Body
Fat
1
37
176
65
152
27.1
40
33.1
32.4
140
38.82
2
37
215
62
186
36.3
39
36.6
32.8
220
28.38
3
38
199
74
169
7.4
26
51.9
50.6
360
56.27
4
37
203
56.5
131
SCI
ATEPA
Height
Weight
38.5
Sit
and
31.4
Grip
Right
28.4
Grip
Left
180
ID
16.3
Body
Fat
47.35
Est.
Aerobic
69
Leg
Reach
5 33
6 37
7 30
8 30
9 37
10 35
11 23
12 35
13 32
14 40
15 40
16 33
17 28
18 37
19 31
20 38
21 37
22 33
23 36
24 38
25 38
26 29
27 35
28 33
29 30
30 32
31 37
32 36
33 22
34 32
35 25
36 30
37 28
38 36
39 35
40 39
41 36
42 37
ID
SCI
202
210
168
204
169
197
170
201
193
213
197
184
192
183
177
189
213
193
211
202
215
188
202
195
196
183
184
186
192
199
205
171
193
183
206
166
201
204
ATEPA
Capacity
66
70
129
190
136
155
141
134
121
170
150
175
171
107
180
169
156
72.5
181.5
12.5
42
36
17
33
32
34
33
33
4
34
71.5
17.7
16.5
52.1
23.7
30.6
27.7
43
29
4
33
28
47
27
30
20
36
17.3
26.5
63
68
193
125
156
112
162
288
152
236
121
248
198
160
120
118
125
138
130
120
196
132
171
148
Height
Veight
61
68.5
62
64.25
71
66
67
69.5
68
67.5
65
65.5
68.5
64
64.4
63
69.5
70
68
70
55.5
69
69
70.5
59
60.5
64
65
63
65
72.5
68.5
28
7.4
30
41
42
9
16
20.9
21.5
30.6
27.5
120
39.89
4
9.3
4.1
18
43.6
42
280
49.23
56.3
44.3
250
50.07
56.9
55.1
370
55.82
50.3
53.7 340
46.98
59.4
54.6 480
52.12
33
33.2 220
55.15
21.2
29.4
80
37.61
30
25.9
160
32.01
45.9
42.9
290
48.80
45.8
43
300
53.61
51.3 400
51.18
15.1
29.8
32.2
14.8
4
30.8
29.9
17
13.6
18.8
9.6
38.2
26.9
28.5
25
32.8
25.6
14.6
27.9
23.9
19.2
21.3
9.2
32.9
24.4
Body
Fat
70
38
33.7 220
33.58
54.3
58.2
340
45.89
21.4
20.4
120
31.49
23.9
21.7
130
29.51
50.1
45.5
180
52.80
58.1
32
180
38.00
53.4 380
48.84
26.8
25.5
70
41.85
48.8
48.1
320
56.42
64.8
60.5 420
34.41
27.1
24.8 240
40.51
67.7
66.3
370
41.06
25.1
21.9
180
38.04
51.2
59.1
340
35.64
44.2
43.2
230
46.25
35.5
52.8
46.7 400
49.80
32
46
37
40
37
37
31
31
35
34
Sit
and
32.8
29.1
100
34.66
27
26.2
180
36.43
39.6
31.4
160
37.40
33.1
28.3
190
32.34
28.3
27.8
180
42.08
24.9
21.9
140
42.94
45.1
45.7
280
49.59
42.8
38.7 460
54.46
29.7
30
160
36.52
32
Grip
Right
25.2
Grip
Left
210
39.65
Est.
Aerobic
Leg
Reach
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
30
30
37
37
37
40
39
33
38
38
33
32
37
33
39
39
36
40
170
165
184
184
166
210
209
189
159
182
172
191
193
179
235
211
204
194
71
71.75
74
65.5
73.5
71
68
78.8
72
74
71
76
75.5
78.5
62
67
72.5
66
145
179
170
144
236
165
138
166
146
154
168
185
172
234
118
162
158
135
8.6
Capacity
15.5
8.6
26
30
38
30
28
36
20
27
10
10.5
13.5
43.2
47.1
10.9
53.4
48
45.9
45.7
27.7
22
29
19
52.6
35.9
22.7
47.5
25.8
20.6
24.2
33.5
40.4
34.8
14.1
18
43.8
38.5
20.2
40.5
32
28.4
10.8
16.5
26.4
19
7.2
15.8
8.8
8
10
47.3
48.2
56
50.3
37.7
33.5
29.7
30.7
41.1
41.3
59.9
55.9
26.8
25.1
52.1
44.8
42.5
34.8
35.5
35.1
410
320
260
160
340
560
120
480
336
260
320
310
390
370
140
340
420
120
48.27
51.89
49.64
37.16
46.02
56.95
47.61
53.66
54.94
52.62
53.06
53.57
54.62
41.48
42.42
41.63
53.35
42.13
Post-test Scores
ID SCI ATE PA Weight
1 34
180
160
221
2 37
186
3 37
193
178
4 36
208
134
208
5 37
129
6 37
208
198
7 33
169
139
8 28
199
152
9 36
178
138
10 35
201
140
11 29
180
123
184
12 35
172
ID
SCI
ATEPA
Weight
Body
and
Fat
Reach
Grip
Right
Grip
Left
30.5
41.5
33.4
30.3
40.5
40.5
34.9
32.5
9.7
28
57.4
52.8
19.6
39.5
28.1
36.2
25.4
32
37.6
33.2
19.2
40.5
52.6
55.6
29.8
20.1
19.4
21
20.6
7.4
40
9
16
73.8
44
25.5
21.5
32.7
28.3
4
43
43
42.2
11.3
42
Sit
and
Reach
53.4
39.4
28.3
Body
Fat
71
Grip
Right
Grip
Left
Leg
180
220
380
140
200
380
130
120
160
120
240
310
Leg
Aerobic
Capacity
37.05
30.96
53.48
40.86
34.94
46.93
31.49
34.73
51.21
37.49
50.82
45.85
Est.
Aerobic
Capacity
13
14
15
16
17
18
19
20
21
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
36
32
39
34
32
36
31
38
37
40
40
27
35
37
29
40
38
31
35
30
31
38
39
32
39
39
39
40
199
197
209
176
185
183
171
197
207
201
165
178
186
173
189
193
204
184
171
180
178
188
193
177
233
206
207
211
161
180
173
113
184
172
156
186
190
145
156
180
57.6
52.8
18.7
28
31
46.4
50.7
17.2
36.5
61.5
60.5
4.7
26
34.4
31.1
31.7
30.5
21.7
22.6
32.1
30.4
27.1
18
15
36
4
48.8
47.1
39.5
40.9
38.3
19.2
18.5
53.2
50.1
22.9
39.5
27.2
28.1
11.3
27.5
51.9
51.7
10.7
12.1
25.5
59.1
58.7
169.2
15.5
25.9
34.8
142
230
164
27.1
27.5
30.1
47.4
42.5
64.6
52.4
137.4
15.1
23.3
11.6
164
148
152
8.3
9.9
26
37
37
25
38
24
50.2
44.6
26.5
38.6
35.1
12.1
36.6
32.3
163.6
10.1
43.9
46.1
54.1
51.8
47.4
44.5
52.1
48.3
26.8
22.3
41.7
37.2
24
7.9
184.4
10.9
167
239
9.5
23.9
115.8
21.6
159
157
24.8
9
17
22
30
24
48
32
14.5
18.5
49.1
44.2
132.5
21
43
30.1
28.7
72
390
340
490
230
80
200
280
300
430
300
400
380
240
160
350
560
150
380
310
260
240
350
360
315
140
230
460
120
52.38
48.20
50.86
56.38
33.96
32.45
49.87
53.89
51.99
38.85
46.86
51.21
50.16
36.80
46.59
56.58
47.97
53.92
55.54
55.98
54.86
53.57
54.88
45.05
44.58
41.32
51.55
43.31
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