Relationships between proxy reliance and exercise self-management perceptions among novice cardiac rehabilitation participants


Background: Regular physical activity (PA) aids recovery after a cardiac incident. Despite cardiac rehabilitation (CR) success, many participants fail to adhere to exercise six months after CR. Proxy agency (cf. social-cognitive theory; Bandura, 1997) identifies one potential adherence liability: participants' reliance on CR staff. Strong reliance on CR staff (proxies) has been inversely related to self-regualtory efficacy (SRE) for managing home exercise (Bray, Brawley, Millen, 2006). Purposes: (1) Compare novice CR participants high and low in proxy reliance with respect to (a) SRE for exercise, (b) perceived PA difficulty, (c) persistence, and (d) SRE for self-managed (SM) exercise. (2) Examine relationships between reliance and SRE; between SRE and persistence; between SRE for SM-exercise, task difficulty and satisfaction. Design and Methods: As part of the first year of a larger, prospective study, novices (Mage= 65), from two municipal health region CR sites were examined. Participants were examined over 12 weeks. Baseline and post-CR measures were obtained including perceptions about self-selected SM-exercise post-CR. Results: MANCOVA revealed significant main effects of high versus low proxy reliance for post-CR SRE and persistence after controlling for baseline SRE (p < .05). Positive relationships were observed for SM-exercise SRE and satisfaction. Inverse relationships were observed between SM-exercise SRE and difficulty; satisfaction and difficulty. Baseline SRE predicted: (1) post-CR persistence and (2) post-CR SM-exercise bouts. All correlations and regression p's < .05. Conclusions: Findings about the relation between reliance and exercise difficulty agree with Bandura's suggestions. New relationships were observed for individuals' self-selected SM-exercise post-CR.

Acknowledgments: SSHRC Canada Research Chair Training Funds