Self-efficacy and outcome expectations related to reducing sedentary behaviour and increasing physical activity in older adults with a mobility limitation


Background: Few older adults with a mobility limitation achieve sufficient physical activity (PA) due to pain and physical dysfunction. In this population, reducing sedentary behaviour (SB) may be a more realistic starting point to modify activity behaviours compared to increasing PA. However, it is unknown how receptive this population is to this novel health intervention. We used social cognitive theory to examine receptivity of older adults with a mobility limitation to reducing SB relative to increasing PA. Specifically, we compared participants' self-efficacy and outcome expectations related to both behaviours. Methods: Pre-operative (n=39) and one-year post-operative (n=37) total knee replacement patients completed self-efficacy (task and self-regulatory efficacy) and outcome expectation questionnaires related to reducing SB and increasing PA. Paired samples t-tests and Wilcoxon Signed Rank Tests (for non-normal distributions) were used for statistical analyses. Results: Independent samples t-tests (with Bonferroni corrections) showed no significant differences between pre- and post-op groups. Therefore, groups were collapsed for analyses. Patients reported greater task self-efficacy for reducing SB (Median=80.89, IQR= 34.71) compared to increasing PA (Median=71.43, IQR=40.00) (Z=-2.441, p=0.015). There was no difference between patients' self-regulatory efficacy for reducing SB (M=4.95, SD=1.95) compared to increasing PA (M=4.63, SD=2.01); t(75)=1.802, p=0.076. Increasing PA was more strongly expected to lead to positive outcomes (M=4.07, SD=0.54) than reducing SB (M=3.89, SD=0.72; t(74)=-2.89, p=0.005). Conclusion: Although patients were more confident to reduce SB than increase PA and were equally confident to manage both behaviors, educating this population about positive outcomes associated with reducing SB may enhance receptivity to SB interventions.