Regular exercise in 30- to 60-year-old men: combining the stages-of-change model and the theory of planned behavior to identify determinants for targeting heart health interventions.

The theory of planned behavior and the stages-of-change model were used to gain a clearer understanding of the factors associated with regular exercise in order to plan more effective programs in heart disease prevention. The study was conducted using a self-administered postal questionnaire sent to a sample of 2,269 men 30 to 60 years of age. Nearly a quarter (23.3%) of respondents were physically inactive, of whom 10.5% were in the precontemplation and 12.8% in the contemplation stages; 42.1% exercised less than twice a week, of whom 22.4% were in the preparation I and 19.7% in the preparation II stages. Only 34.6% were in the action stage, exercising regularly for at least 20 minutes twice a week or more with the intention of continuing to do so. Logistic regression indicated that the variables derived from the theory of planned behavior, namely attitude, subjective norm and perceived behavioral control, were differently associated with the stages of behavior. Perceived behavioral control was strongly significant in all stages. Attitude was related with stages in which individuals have intention of exercising (contemplation and preparation II). In contrast, subjective norm seemed to be associated with stages in which individuals have no intention of doing so (precontemplation and preparation I). By identifying the specific needs of sub-groups, the results can help define programs most likely to accelerate men to the stage of regular exercise, part of an effective strategy for heart health promotion in this high-risk population.