Using constructs of the transtheoretical model to predict classes of change in regular physical activity: a multi-ethnic longitudinal cohort study.

Explaining variation in meeting recommended levels of physical activity across time is important for the design of effective public health interventions. To model longitudinal change in constructs of the Transtheoretical Model and test their hypothesized relations with change in meeting the Healthy People 2010 guidelines for regular participation in moderate or vigorous physical activity, a cohort (N = 497) from a random, multi-ethnic sample of 700 adults living in Hawaii was assessed at 6-month intervals three or more times for 2 years. Latent class growth modeling was used to classify people according to their initial levels and trajectories of change in the transtheoretical variables and separately according to whether they met the physical activity guideline each time. Relations of the variables and their change with classes of meeting the guideline were then tested using multinomial logistic regression. Despite declines or no change in mean scores for all transtheoretical variables except self-efficacy, participants who maintained or attained the physical activity guideline were more likely to retain higher scores across the 2 years of observation. The usefulness of transtheoretical constructs for predicting maintenance of, or increases in, public health levels of physical activity was generally supported. These longitudinal results support earlier cross-sectional findings which indicate that, contrary to theory, people appear to use both experiential and behavioral processes while they attempt to increase or maintain their physical activity.