Examining theoretical predictors of leisure-time physical activity maintenance post-cardiac rehabilitation


Background: Adults who participate in cardiac rehabilitation have difficulty maintaining leisure-time physical activity (LTPA) post-program. More research is needed to (1) understand the relative importance of theoretical predictors of maintenance and (2) combine theories in an effort to create an integrated theory of maintenance. The purpose of this study was to investigate the direct and indirect relationships between constructs from self-determination theory, Rothman's theory of maintenance, self-efficacy theory, and LTPA maintenance in a cardiac rehabilitation population. Methods: Adults who completed a 4-month cardiac rehabilitation program (N=76) responded to questionnaires at four, six, and 12 months. Three binary logistic regression models and six a priori models were tested to examine direct and indirect relationships between the theoretical constructs and LTPA maintenance. Results: Participants with higher self-determined motivation (OR=3.00, p=.02), general satisfaction (OR=1.80, p=.04), and scheduling self-efficacy (OR=1.05, p=.03), at six months were more likely to maintain LTPA at 12 months. General satisfaction (at six months) mediated the relationship between self-determined motivation (at four months) and LTPA maintenance (at 12 months). Self-determined motivation (at six months) also mediated the relationship between general satisfaction (at four months) and LTPA maintenance (at 12 months). Conclusion: This research answered the call from Kwasnicka and colleagues (2016) to test for relationships between constructs from various maintenance theories. There appears to a bi-directional relationship between self-determined motivation and general satisfaction, however, this finding needs to be further explored. Cardiac rehabilitation programs may want to target participants' self-determined motivation to increase satisfaction and the likelihood of LTPA maintenance.