Evaluating the components of the Exercise Plus Program: rationale, theory and implementation.

Recovery following a hip fracture is facilitated by participation in regular exercise. Despite the benefits of exercise, it is difficult to get older adults to initiate and adhere to regular exercise programs. The Attribution Theory of Achievement Motivation suggests that an individual's future involvement in an activity is based on assessments of prior experience with the activity. Conversely, the Theory of Self-efficacy states that self-efficacy expectations and outcome expectations are not only influenced by behavior, but also by verbal encouragement, physiological sensations and exposure to role models or self-modeling. These expectations then determine the individual's willingness to initiate and engage in a given activity. Using a 2x2 factorial design, the primary aim of this study is to compare these two theories. The effectiveness of the Exercise Plus Program will be compared to the individual components of the program (Exercise Training and Plus components) on both self-efficacy and outcome expectations, exercise behavior, activity, and specific physical and psychological outcomes. A total of 240 older women post hip fracture will be recruited from five different acute care facilities. This study will add to current knowledge by examining the impact of a combined exercise training/social learning intervention approach versus either alone.