Rationale and Objective:

Both cardiovascular disease (CVD) and diabetes mellitus (DM) require changes in health behaviour, particularly physical activity (PA), for prevention of recurrence and complications respectively. This study examined PA behaviour and its correlates, including motivational readiness and self-efficacy, among 355 DM, 144 CVD, 75DM and CVD, and 390 residents with cardiovascular (CV) risk factors recruited through multiple means including random digit dialing, from rural (32.3%), northern (13.9%), and urban regions with increased CV prevalence and hospitalizations.

Methods & Measures:

This constitutes a cross-sectional study from a larger randomized controlled trial (Community Outreach Heart Health Risk Reduction Trial; COHRT). Ontarians at elevated risk for CVD (ie 2 or more risk factors) were invited to participate. Participants completed a self-report survey, and clinical data were provided by healthcare providers. PA frequency, intensity and duration were evaluated through items from the 1996 National Population Health Survey. Motivational readiness was assessed with two items, both scored on a 5-point scale ranging from "No, I am not at all ready" to "Yes, regularly for more than 6 months." Corresponding items were created to assess PA efficacy in the domains of moderate-to-vigorous intensity activity and lifestyle activity most days of the week.

Results:

Results revealed that non-DM participants participated in a greater number of PA activities (P < .001) more frequently (P = .013) than DM participants. Most participants were in the maintenance stage of readiness regarding planned lifestyle activity most days of the week; however they were more frequently in earlier stages with regard to vigorous PA. Motivational readiness for moderate to vigorous PA was significantly lower in DM participants than CVD participants (P = .007) and those with neither condition (P = .009). An examination of PA correlates by disease status revealed lower PA readiness and efficacy among those with DM when compared to non-DM participants (Ps < .009). In a logistic regression analysis controlling for demographic and clinical characteristics ([chi](12) = 51.98, P > .001), disease status (DM OR = .65) and region (northern OR = .55) were significant correlates of PA frequency.

Conclusion:

Physical inactivity is prevalent and threatens primary and secondary prevention of CVD. Yet factors influencing PA behaviour in medical populations (particularly those with DM) have been neglected in the literature. These results suggest that northern residents and those with DM are at increased risk of physical inactivity. Further efforts to increase motivational readiness and efficacy among people with DM are required to ensure the prevention and delay of complications including CVD, particularly interventions which can 'reach' people living in northern regions.

Section Description

For more information, contact Marilyn Thomas (204) 488-5854