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Biomedical subjects

Chris M Blanchard

Publications and source records attributed to Chris M Blanchard.

At least 19 recordsLinked to original sources
PubMed2006

Predicting physical activity and outcome expectations in cancer survivors: an application of Self-Determination Theory.

The purpose of this study was to examine the contributions of autonomous and controlled motives drawn from Self-Determination Theory (SDT; Intrinsic Motivation and Self-determination in Human Behavior. Plenum Press: New York, 1985; Handbook of Self-determination Research. University of Rochester Press: New York, 2002) towards predicting physical activity behaviours and outcome expectations in adult cancer survivors. Participants were cancer-survivors (N=220) and a non-cancer comparison cohort (N=220) who completed an adapted version of the Treatment Self-Regulation Questionnaire modified for physical activity behaviour (TSRQ-PA), an assessment of the number of minutes engaged in moderate-to-vigorous physical activity (MVPA) weekly, and the anticipated outcomes expected from regular physical activity (OE). Simultaneous multiple regression analyses indicated that autonomous motives was the dominant predictor of OEs across both cancer and non-cancer cohorts (R(2adj)=0.29-0.43), while MVPA was predicted by autonomous (beta's ranged from 0.21 to 0.34) and controlled (beta's ranged from -0.04 to -0.23) motives after controlling for demographic considerations. Cancer status (cancer versus no cancer) did not moderate the motivation-physical activity relationship. Collectively, these findings suggest that the distinction between autonomous and controlled motives is useful and compliments a growing body of evidence supporting SDT as a framework for understanding motivational processes in physical activity contexts with cancer survivors.

Adult↗
PubMed2006

Determinants of physical activity after hospitalization for coronary artery disease: the Tracking Exercise After Cardiac Hospitalization (TEACH) Study.

BACKGROUND: Little is known about physical activity levels in patients with coronary artery disease (CAD) who are not engaged in cardiac rehabilitation. We explored the trajectory of physical activity after hospitalization for CAD, and examined the effects of demographic, medical, and activity-related factors on the trajectory. DESIGN: A prospective cohort study. METHODS: A total of 782 patients were recruited during CAD-related hospitalization. Leisure-time activity energy expenditure (AEE) was measured 2, 6 and 12 months later. Sex, age, education, reason for hospitalization, congestive heart failure (CHF), diabetes, and physical activity before hospitalization were assessed at recruitment. Participation in cardiac rehabilitation was measured at follow-up. RESULTS: AEE was 1948+/-1450, 1676+/-1290, and 1637+/-1486 kcal/week at 2, 6 and 12 months, respectively. There was a negative effect of time from 2 months post-hospitalization on physical activity (P<0.001). Interactions were found between age and time (P=0.012) and education and time (P=0.001). Main effects were noted for sex (men more active than women; P<0.001), CHF (those without CHF more active; P<0.01), diabetes (those without diabetes more active; P<0.05), and previous level of physical activity (those active before hospitalization more active after; P<0.001). Coronary artery bypass graft patients were more active than percutaneous coronary intervention (PCI) patients (P=0.033). CONCLUSIONS: Physical activity levels declined from 2 months after hospitalization. Specific subgroups (e.g. less educated, younger) were at greater risk of decline and other subgroups (e.g. women, and PCI, CHF, and diabetic patients) demonstrated lower physical activity. These groups need tailored interventions.

Adult↗
PubMed2006

Exercise use as complementary therapy among breast and prostate cancer survivors receiving active treatment: examination of exercise intention.

BACKGROUND: Exercise is associated with an improved quality of life among cancer survivors. Previous research has highlighted the utility of the theory of planned behavior in understanding cancer survivors' intention to exercise. The purpose of this study was to extend the research on the theory of planned behavior in relation to exercise intention in breast cancer survivors and to provide preliminary evidence supporting its application with prostate cancer survivors during treatment. METHODS: Participants consisted of 126 breast and 82 prostate cancer survivors receiving active treatment. Participants completed self-administered, mail-in questionnaires that assessed demographic and medical variables, past exercise, and the theory of planned behavior. RESULTS: For breast cancer survivors, the results revealed that attitudes, subjective norm, and perceived behavioral control explained 66% of the variance in exercise intention with the instrumental component of attitude, subjective norm, and perceived behavioral control making significant unique contributions to intention. For prostate cancer survivors, attitudes, subjective norm, and perceived behavioral control explained 57% of the variance in exercise intention, with subjective norm and perceived behavioral control making significant unique contributions to intention. CONCLUSIONS: The results provide further support that the theory of planned behavior is a useful framework for understanding determinants of exercise intention in breast cancer survivors undergoing active treatment and preliminary support for prostate cancer survivors undergoing active treatment. When designing exercise interventions, differences in breast and prostate cancer survivors' exercise intention merit consideration.

Aged↗
PubMed2006

A multicomponent model of the theory of planned behaviour.

The purpose of this study was to investigate the measurement and predictive structure of multiple components of attitude (affective and instrumental), subjective norm (injunctive and descriptive) and an alternative measure of perceived behavioural control (PBC; skills/ability, opportunity, and resources) in the exercise domain. An additional purpose of the study was to compare the validity of the alternative PBC measure to a standard PBC measure for predicting exercise intention and behaviour. Participants were 220 undergraduates who completed measures of the theory of planned behaviour (TPB) and a 2-week follow-up of exercise behaviour. Results supported the discriminant validity in the measurement domains of all TPB components. Predictive validity of exercise behaviour for these components, however, was only evident for attitude and PBC components. Our alternative PBC measure was found commensurate with the standard PBC measure. Finally, intention significantly (p < .05) predicted exercise behaviour (R2 = .42), while affective attitude, and perceived opportunity significantly (p < .05) predicted intention (R2 = .47).

Adult↗
PubMed2006

Conceptual categories or operational constructs? Evaluating higher order theory of planned behavior structures in the exercise domain.

The theory of planned behavior (TPB) is a popular framework for understanding the informational and motivational influences of exercise behavior One tenet of this model that has not been examined is the belief that direct measures of TPB component constructs are organized through higher order constructs. The authors'purpose of this article was to test this higher order conceptualization in comparison with a multidimensional TPB model using structural equation modeling. Participants (N=268) completed direct measures of the TPB and a 2-week follow-up of exercise behavior The results generally supported multidimensional TPB constructs over higher order structures. Direct measures of attitude (i.e., affective and instrumental) and subjective norm (i.e., injunctive and descriptive) had better psychometric properties when considered multidimensionally. Perceived behavioral control (i.e., self-efficacy, controllability), however, had estimation problems for both the multidimensional and the higher order model. Aggregation of TPB components is not warranted, and the perceived behavioral control components may possess a structure more complex than simple multidimensionality or a superordinate higher order construct.

Attitude↗
PubMed2005

Meeting the public's cancer information needs: characteristics of callers to the National Cancer Information Center of the American Cancer Society.

BACKGROUND: In this study, we describe the characteristics of the callers of the American Cancer Society's National Cancer Information Center (NCIC), why they called, how they learned about NCIC, and their satisfaction. METHODS: A random sample of callers (N = 19,487) completed a telephone survey. RESULTS: The majority were female, White, 45 to 74 years old, had incomes greater than 35,001 dollars, and were college educated. They learned about the NCIC through TV advertisements and requested information about specific cancers, local programs, or making donations. CONCLUSIONS: These findings validate the usefulness of the NCIC and are helpful in identifying and targeting persons who do not routinely use this service.

Adolescent↗
PubMed2004

Further validation of the multidimensional fatigue symptom inventory-short form.

A growing body of evidence is documenting the multidimensional nature of cancer-related fatigue. Although several multidimensional measures of fatigue have been developed, further validation of these scales is needed. To this end, the current study sought to evaluate the factorial and construct validity of the 30-item Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). A heterogeneous sample of 304 cancer patients (mean age 55 years) completed the MFSI-SF, along with several other measures of psychosocial functioning including the MOS-SF-36 and Fatigue Symptom Inventory, following the fourth cycle of chemotherapy treatment. The results of a confirmatory factor analysis indicated the 5-factor model provided a good fit to the data as evidenced by commonly used goodness of fit indices (CFI 0.90 and IFI 0.90). Additional evidence for the validity of the MFSI-SF was provided via correlations with other relevant instruments (range -0.21 to 0.82). In sum, the current study provides support for the MFSI-SF as a valuable tool for the multidimensional assessment of cancer-related fatigue.

Adult↗
PubMed2004

Comparing short form and RAND physical and mental health summary scores: results from total hip arthroplasty and high-risk primary-care patients.

OBJECTIVES: Summary physical health scores for the Short Form (SF) measures are computing using positive weights for physical items and negative weights for mental health items. Mental health summary scores use positive weights for mental items and negative weights for physical. The RAND Health Status Inventory (HSI) measures do not use negative weights. Do these different approaches to scoring matter? The objective was to compare summary scores using both the SF and RAND-HSI. METHODS: SF-36 and the Health Utilities Index Mark 3 (HUI3) were administered to a cohort of patients waiting for elective total hip arthroplasty (THA). SF-12 and HUI3 were administered to a cohort of high-risk primary-care patients. Summary scores were generated and compared. Single-attribute utility scores for emotion in HUI3 were also computed. Canadian and US norms for SF, RAND-HSI, and HUI3 were used to interpret results. RESULTS: For THA patients, mean physical health scores were 28 and 36 for SF and RAND-HSI. Mean mental health scores were 55 and 42. For the primary-care patients, the scores were 34 and 36 for physical and 46 and 40 for mental health. CONCLUSIONS: SF and RAND-HSI provided somewhat similar summary scores in the THA study. However, SF and RAND-HSI mental health scores differed in the primary-care patient cohort and results from HUI3 corroborate the mental health deficits identified by the RAND-HSI. It may be wise for investigators to use both SF and RAND-HSI scoring systems.

Arthroplasty, Replacement, Hip↗
PubMed2003

Research interests in the field of behavioral, psychosocial, and policy cancer research.

The growth of research in behavioral, psychosocial, and policy aspects of cancer is quite evident through examination of the literature. Although it is necessary to recognize the importance of past achievements in these areas, it is equally essential to identify the current interests and future areas that will form a new research agenda. The present study is the first attempt to shed light on these issues by surveying a group of behavioral, psychosocial and policy researchers from 1997 (n=714) and 2002 (n=1102). Questions were posed that dealt with current and future research interests. Results indicate a stable core of research interests in the field, as well as changing trends in interest that may affect the direction of future research. Prevention and detection, psychosocial issues, and quality of life were clearly the most recognized research interests. Emerging areas of research interest seem to be special populations and health care delivery. Examination of these findings may help with research planning, funding allocation, management, beginning researcher education, and practice.

Behavioral Medicine↗
PubMed2003

Is absolute amount or change in exercise more associated with quality of life in adult cancer survivors?

BACKGROUND: The present study examined the association between quality of life (QOL) in adult cancer survivors and the (a) absolute current amount of exercise and (b) change in exercise since cancer diagnosis. METHODS: Three hundred fifty-two (mean age = 59.6) adult cancer survivors recruited from outpatient clinics in four states (Iowa, Wisconsin, Minnesota, and Georgia) and a minority support groups completed a survey including demographic, medical, exercise behavior, and QOL questions. RESULTS: Hierarchical multiple regression analyses controlling for important demographic and medical variables showed that adult cancer survivors who currently exercised three times per week had significantly higher QOL than those who did not (beta = 0.13, P < 0.05). Furthermore, compared to adult cancer survivors who exercised less since their cancer diagnosis, those who maintained (beta = 0.28, P < 0.08) or increased (beta = 0.24, P < 0.01) the amount of exercise they performed since their cancer diagnosis had significantly higher QOL. Finally, examination of the DeltaR(2)(adjusted) between the two exercise models showed that the absolute current amount of exercise explained an additional 1% (DeltaR(2)(adjusted) = 0.01 P < 0.05) of the variance in QOL whereas the change in exercise explained an additional 7% (DeltaR(2)(adjusted) = 0.07, P < 0.01). CONCLUSION: Change in exercise since cancer diagnosis may be a more important correlate of QOL in adult cancer survivors than the absolute current amount of exercise.

Adult↗
PubMed2003

A comparison of physical activity of posttreatment breast cancer survivors and noncancer controls.

The authors obtained data from 335 breast cancer survivors and 6,880 noncancer controls. They proposed (1) to determine whether, after treatment, the survivors were meeting the Center for Disease Control and Prevention/American College of Sports Medicine recommendations for physical activity and were similar to the controls in physical activity and (2) to compare the modes of activity of the 2 groups in frequency, min/session, and sessions/wk. Adjusted logistic regression analyses revealed that the breast cancer survivors engaged in as much moderate, vigorous, and combined physical activity as the noncancer controls did. However, chi-square analyses showed that survivors engaged in more yard work than the controls did, whereas independent-sample t tests showed that the frequency and the total min/wk of stretching were significantly higher in breast cancer survivors compared with noncancer controls. Findings from the study suggest that breast cancer survivors engage in as much physical activity as controls do, but that the groups differ in specific activities.

Adult↗
PubMed2002

Self-efficacy and mood in cardiac rehabilitation: should gender be considered?

The authors proposed to (a) determine the influence of phase II cardiac rehabilitation (CR) on task and barrier efficacy and mood in men and women, (b) determine the influence of task and barrier efficacy on postphase II CR exercise adherence, and (c) examine the bidirectional relationship between self-efficacy and mood. Fifty-seven men and 24 women completed task and barrier efficacy scales and the anxiety, depression, and vigor subscales 3 to 5 weeks before phase II CR, immediately before and after phase II CR, and 6 to 10 weeks after phase II CR. They found that the women had significantly larger increases in task and barrier efficacy from pre- to postphase II CR than the men did, whereas both men and women had a significant decline at follow-up. Men and women had a similar decrease in anxiety and an increase in vigor during phase II CR. However, vigor significantly declined at follow-up. All changes in mood were significantly related to changes in task and barrier efficacy.

Affect↗
PubMed2002

Determinants of exercise intention and behavior in survivors of breast and prostate cancer: an application of the theory of planned behavior.

The purpose of this study was to evaluate the theory of planned behavior as a framework for understanding exercise intention and behavior in survivors of breast and prostate cancer. Participants were 83 survivors of breast and 46 survivors of prostate cancer who were diagnosed within the previous 4 years and had completed treatment. Each participant completed a mailed self-administered questionnaire that assessed exercise during the previous week, demographic and medical variables, and the theory of planned behavior. For survivors of breast cancer, regression analyses indicated that attitude, subjective norm, and perceived behavioral control explained 45% of the variance in exercise intention with attitude, subjective norm, and perceived behavioral control each uniquely contributing to intention. Furthermore, exercise intention explained 30% of the variance in exercise behavior; however, perceived behavioral control added no unique variance. For survivors of prostate cancer, attitudes, subjective norm, and perceived behavioral control explained 36% of the variance in exercise intention, but only perceived behavioral control made a significant unique contribution. Furthermore, intention explained 36% of the variance in exercise behavior; however, perceived behavioral control added no unique variance. Results suggest that nurses may use the theory of planned behavior as a model for understanding the determinants of exercise intentions and behavior in survivors of breast and prostate cancer.

Attitude to Health↗
PubMedDate not supplied

Is the theory of planned behavior a useful framework for understanding exercise adherence during phase II cardiac rehabilitation?

PURPOSE: This study evaluated the theory of planned behavior (TPB) as a framework for understanding exercise adherence during phase II cardiac rehabilitation (CR). METHODS: A total of 215 patients completed a baseline questionnaire that included the TPB constructs and past exercise. Exercise adherence was measured via program attendance during phase II CR. RESULTS: Hierarchic regression analyses indicated that attitude, subjective norm, and perceived behavioral control (PBC) explained 30% of the variance in exercise intention, with attitude, subjective norm, and PBC each making significant unique contributions to intention. Furthermore, exercise intention explained 12% of the variance in exercise adherence. Finally, the behavioral, normative, and control beliefs provided novel information concerning why patients in phase II CR hold certain attitudes, subjective norms, PBC, and exercise intentions. CONCLUSION: Results of the present study provide evidence that the TPB is a useful framework for understanding exercise intentions and adherence during phase II CR.

Aged↗
PubMedDate not supplied

Correlates of physical activity change in patients not attending cardiac rehabilitation.

OBJECTIVE: Limited research has identified theoretical correlates of physical activity (PA) change in patients not receiving cardiac rehabilitation. The purpose of the present study was to determine whether changes in self-efficacy, PA intention, perceived severity and susceptibility, and PA benefits/barriers were associated with changes in PA over a 12-month period in these patients. METHODS: Patients (N = 555) not attending cardiac rehabilitation completed a psychosocial questionnaire in hospital and 6 and 12 months after hospitalization for a cardiac event. RESULTS: Hierarchical regression analyses showed that the increase in PA from baseline to 6 months was significantly related to an increase in self-efficacy and PA intentions and a decrease in the impact of health-related barriers. Furthermore, the decrease in PA from 6 to 12 months was significantly related to a decrease in health-related benefits and PA intentions and an increase in time and health-related barriers. Finally, the increase in PA from baseline to 12 months was significantly related to an increase in health-related benefits and intentions and a decrease in health-related barriers. CONCLUSIONS: Changes in PA levels over a 12-month period were associated with changes in various theoretical variables. Interestingly, the associations among these variables with PA varied as a function of time after hospitalization.

Coronary Artery Disease↗
PubMedDate not supplied

Is stress management training a useful addition to physician advice and nicotine replacement therapy during smoking cessation in women? Results of a randomized trial.

PURPOSE: To determine whether a stress management (SM) program could improve cessation rates when added to usual care (UC) among women attempting to quit smoking. DESIGN: Randomized controlled trial conducted during a 12-month period. SETTING: Smoking cessation clinics located within two tertiary care centers in Ottawa, Ontario. SUBJECTS: A total of 332 women smokers 19 years or older who smoked 10 or more cigarettes per day were recruited via advertisements. INTERVENTION. Either UC (physician advice and nicotine replacement therapy) or UC plus an eight-session group SM training program (coping skills development relevant to smoking-specific and generic stressors). MEASURES: Point prevalence abstinence 2 and 12 months after study intake. A secondary outcome of interest was change in perceived stress during the intervention period. RESULTS: On an intent-to-treat basis, the addition of SM to UC had no incremental effect on 2- or 12-month abstinence rates. Abstinence rates at 2 months were 26.2% vs. 31.7% in the UC and SM groups, respectively (p = .59). At 12 months, the rates were 18.5% vs. 20.7% (p = .86). When quit rates were compared including only participants who demonstrated adequate adherence to the intervention protocol, there was a significant difference between the UC and SM groups at 2 months (34.9% vs. 48.7%; adjusted odds ratio, 1.88; 95% confidence interval, 1.04-3.42; p = .04) but not at 12 months (23.0% vs. 28.2%; adjusted odds ratio, 1.24; 95% confidence interval, .64-2.41; p = .53). There was a significant reduction in perceived stress from preintervention to postintervention; however, this decrease was not moderated by group assignment. CONCLUSION: The addition of SM in our setting neither increased abstinence rates nor reduced perceived stress over and above UC in women motivated to quit smoking. Poor attendance at the SM intervention undermined its effectiveness.

Adult↗