Stages of change for leisure time physical activity in Brazilian adults: longitudinal study

Tessaro, Valéria Cristina Zamataro; Silva, Ana Maria Rigo; Loch, Mathias Roberto

doi:10.1590/1413-81232021268.18022020

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ARTICLE • Ciênc. saúde coletiva 26 (08) • Aug 2021 • https://doi.org/10.1590/1413-81232021268.18022020 copy

Stages of change for leisure time physical activity in Brazilian adults: longitudinal study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The objective of this study was to analyze the maintenance of and movement between stages of change for leisure time physical activity (LTPA) after four years and the association with sociodemographic characteristics. A cross-sectional population-based study was conducted with 1,180 individuals aged 40 years or over in 2011. In 2015, 885 participants were reinterviewed. The dependent variables were the maintenance of and movement between stages of change for LTPA behavior. The data was analyzed using adjusted Poisson regression. We found that around 40% of the study participants were still at the same stage they were at in the first assessment, while 31.6% had relapsed and 27% had advanced at least one stage. The stages that showed the highest frequencies were remained in precontemplation and maintenance. The risk of remaining at the precontemplation stage was higher among men (RR=1.59; 95%CI:1.21-2.11), respondents aged ≥60 years (RR=1.35; 95%CI:1.03-1.78), those with a lower level of education (RR=1.24; 95%CI:1.04-2.33), and those from economic classes C and D/E (RR=1.71; 95%CI:1.17-2.49 and RR=1.88; 95%CI:1.12-3.18, respectively). The frequency of individuals who remained at the maintenance stage was significantly lower in economic classes D/E than in classes A/B (RR=0.35; 95%CI:0.14-0.87).

Keywords:
Physical activity; Lifestyle; Longitudinal study; Health behavior

Stages	Characteristics
Precontemplation	Individuals who do not intend to change their behavior in the next six months
Contemplation	Individuals who intend to change their behavior in the next six months
Preparation	Individuals who intend to change their behavior in the foreseeable future (generally the next 30 days)
Action	Individuals who have adopted a change in behavior for less than six months
Maintenance	Individuals who have sustained a change in behavior for more than six months

Total	Participants 2011		Participants 2015		Losses		p-value*
Total	n=1180	%	n=885	%	n=295	%
Sex
Male	641	54.3	495	77.2	146	22.8
Female	539	45.7	390	72.4	149	27.6	0.032
Age group (years)
40-49	476	40.3	349	73.3	127	26.7
50-59	366	31.0	297	81.1	69	18.9	0.003
≥ 60	338	28.7	239	70.7	99	29.3
Marital status
With a partner	863	73.1	608	70.5	255	29.5
Without a partner	317	26.9	277	87.4	40	12.6	<0.001
Level of education (years)
0-8	860	72.9	648	75.3	212	24.7
9-11	190	16.1	145	76.3	45	23.7	0.479
≥ 12	130	11.0	92	70.8	38	29.2
Economic class (ABEP)
A/B	449	38.1	313	69.7	136	30.3
C	614	52.0	472	76.9	142	23.1	0.001
D/E	117	9.9	100	85.5	17	14.5

2015	PC	C	P	A	M	Total
2011	PC	C	P	A	M	Total
PC	172 (57.0%)	35 (11.6%)	54 (17.9%)	4 (1.32%)	37 (12.3%)	302 (34.1%)
C	41 (34.2%)	22 (18.3%)	32 (26.7%)	3 (2.5%)	22 (18.3%)	120 (13.6%)
P	60 (31.1%)	37 (19.2%)	52 (27.0%)	16 (8.3%)	28 (14.5%)	193 (21.8%)
A	8 (21.1%)	8 (21.1%)	13 (34.2%)	1 (2.63%)	8 (21.1%)	38 (4.3%)
M	44 (19.0%)	22 (9.5%)	37 (16.0%)	10 (4.31%)	119 (51.3%)	232 (26.2%)
Total	325 (36.8%)	124 (14.0%)	188 (21.2%)	34 (3.8%)	214 (24.2%)	885 (100.0%)

	Remained in M		Remained in A		Remained in P		Remained in C		Remained in PC
Variables	n (%)	RR(1)(2) (IC95%)	n (%)	RR(1)(2) (IC95%)	n (%)	RR(1)(2) (IC95%)	n (%)	RR(1)(2) (IC95%)	n (%)	RR(1)(2) (IC95%)
Sex
Male	67 (13.5%)	1.0	-	1.0	37 (7.5%)	1.0	14 (2.8%)	1.0	80 (16.2%)	1.0
Female	52 (13.3%)	0.93 (0.66-1.31)	1 (0.3%)	-	15 (3.8%)	0.46 (0.25-1.04)	8 (2.1%)	0.75 (0.30-1.87)	92 (23.6%)	1.59 (1.21-2.11)**
Age group (years)
44-59	66 (12.4%)	1.0	1 (0.2%)	1.0	38 (7.1%)	1.0	13 (2.4%)	1.0	86 (16.1%)	1.0
≥ 60	53 (15.1%)	1.09 (0.86-2.10)	-	-	14 (4.0%)	0.62 (0.34-1.12)	9 (2.6%)	1.06 (0.44-2.59)	86 (24.4%)	1.35 (1.03-1.78)**
Marital status
With a partner	90 (13.7%)	1.0	1 (0.2%)	1.0	40 (6.1%)	1.0	16 (2.4%)	1.0	127 (19.4%)	1.0
Without a partner	29 (12.6%)	1.02 (0.68-1.52)	-	-	12 (5.2%)	0.92 (0.47-1.79)	6 (2.6%)	0.91 (0.31-2.68)	45 (19.7%)	0.99 (0.71-1.37)
Level of education (years)
0-8	72 (11.1%)	0.62 (0.38-1.03)	-	-	34 (5.2%)	1.03 (0.68-8.01)	14 (2.2%)	0.44 (0.14-1.36)	146 (22.5%)	1.24 (1.04-2.33)**
9-11	27 (18.6%)	0.94 (0.56-1.58)	-	-	15 (10.3%)	1.06 (0.99-11.38)	4 (2.8%)	0.63 (0.15-2.65)	15 (10.3%)	0.77 (0.37-1.60)
≥ 12	20 (21.7%)	1.0	1 (1.1%)	1.0	3 (3.3%)	1.0	4 (4.3%)	1.0	11 (12.0%)	1.0
Economic class (ABEP)
A/B	61 (18.3%)	1.0	1 (0.3%)	1.0	25 (7.5%)	1.0	9 (2.7%)	1.0	41 (12.2%)	1.0
C	53 (11.4%)	0.71 (0.48-1.04)	-	-	24 (5.1%)	0.67 (0.36-1.24)	10 (2.1%)	1.03 (0.45-2.36)	109 (23.3%)	1.71 (1.17-2.49)*
D/E	5 (6.1%)	0.35 (0.14-0.87)**	-	-	3 (3.6%)	0.50 (0.14-1.83)	3 (3.6%)	1.08 (0.37-8.54)	22 (26.5%)	1.88 (1.12-3.18)*
Total	119 (13.4%)		1 (0.1%)		52 (5.9%)		22 (2.5%)		172 (19.4%)

	Positive ⁽¹⁾		Negative⁽²⁾
Variables	n (%)	RR (95% CI)⁽³⁾⁽⁴⁾	n (%)	RR (95% CI)⁽³⁾⁽⁴⁾
Sex
Male	132(26.7%)	1.0	165(33.3%)	1.0
Female	107(27.4%)	1.00(0.80-1.25)	115(29.5%)	0.90(0.73-1.10)
Age group (years)
44-59	158(29.6%)	1.0	171(32.1%)	1.0
≥ 60	81(23.0%)	0.74(0.58-1.14)	109(31.0%)	0.98(0.79-1.20)
Marital status
With a partner	178(27.1%)	1.0	204(31.1%)	1.0
Without a partner	61(26.6%)	1.02(0.78-1.32)	76(33.2%)	1.03(0.82-1.29)
Level of education (years)
0-8	187(28.9%)	1.06(0.98-2.32)	195(30.1%)	0.81(0.58-1.13)
9-11	32(22.1%)	1.03(0.62-1.68)	52(35.9%)	1.00(0.70-1.42)
≥ 12	20(21.7%)	1.0	33(35.9%)	1.0
Economic class (ABEP)
A/B	91(27.2%)	1.0	107(31.9%)	1.0
C	126(27.0%)	0.91(0.59-1.40)	145(31.0%)	1.05(0.83-1.33)
D/E	22(26.5%)	0.89(0.69-1.14)	28(33.7%)	1.07(0.78-1.69)
Total	239(27.0%)		280(31.6%)

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[1] Collaborations

VCZ Tessaro worked in the conception and design, analysis and interpretation of data, article writing, critical review of intellectual content. AMR Silva and MR Loch worked on the conception and design, analysis and interpretation of data, review of the article’s writing, critical review of the intellectual content and approval of the final version.