Longitudinal patterns of stages of change for exercise and lifestyle intervention outcomes

Purpose: To examine the transition patterns of stages of change (SoC) for regular exercise over time among individuals participating in a lifestyle intervention project and to investigate the association between longitudinal patterns of SoC and lifestyle intervention outcomes.

Methods: We analyzed data from the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) Program, a lifestyle intervention program to prevent diabetes among American Indian and Alaska Natives (AI/ANs). A total of 1,344 participants completed the project questionnaires at baseline, post-curriculum, and one year. Latent class analysis (LCA) was conducted to identify the longitudinal patterns of SoC for regular exercise reported at the three time points. An improved 3-step approach was used to investigate the associations between latent class membership and behavioral changes after the intervention.

Results: Three latent classes were identified: Pre-action, Transition, and Maintenance classes. The participants in the Transition class moved from pre-action stage at baseline to action or maintenance stage post-intervention. Compared to the other two classes, those in the Transition class had the greatest improvements in physical activity and weight outcomes at both time points post-baseline. Furthermore, at year 1 assessment, the Transition and Maintenance classes had less attenuation than the Pre-action class in the improvements they had achieved initially in all the outcome variables.

Conclusions: LCA methods are useful in identifying longitudinal patterns of readiness to change exercise behavior. Three latent classes were found in this study. The Transition class, where stage progression occurred, had the highest magnitude in positive behavioral changes.