Investigating Exercise Behavior Predictors In Women With Cardiovascular Risk Factors: An Integrated Behavioral Model Approach

Investigating Exercise Behavior Predictors in Women with Cardiovascular Risk Factors: An Integrated Behavioral Model ApproachDonya Nemati, PhD, MSc; Navin Kaushal, PhD, AHA; Tarah J. Ballinger, MD PURPOSE. Cardiovascular disease (CVD) continues to be the leading cause of death among women in the United States. Moderate-to-vigorous level of physical activity (MVPA) is one of the most effective preventive measures to improve heart health, yet the proportion of women with suboptimal MVPA remains high. This observational study aimed to investigate factors influencing MVPA levels in women with CVD risk factors using the Integrated Behavior Model (IBM). METHODS: Women presenting for cancer prevention services at the Indiana University Simon Cancer Center completed two surveys four weeks apart with the first survey consisting of validated IBM measures, MVPA, and the second survey assessed their MVPA. RESULTS: A total of 113 women (age; Mean = 51.0, SD = 11.73, 92% Caucasian) who self-reported CVD risk factors such as hypertension, high cholesterol, and diabetes completed the study. Of those, 54.86% had multiple (≥2) CVD risk factors and 40.7% had a BMI ≥ 30.0. Participants reported engaging in 110 mins (SD = 124.73) of MVPA/week at baseline. The direct effect of the tested IBM revealed that change in MVPA was predicted by intention (β = .20, p < .018) and habit (b = .30, p = .005). Intention was predicted by subjective norms (β = .34, p < .001), and exercise self-efficacy (β = .33, p = .009). Habit was predicted by consistency (β = .18, p = .019). Change in MVPA was predicted by personal barriers (β = -.25, p = .001) and environmental barriers (β = -.16, p = .036). Autonomous motivation predicted self-efficacy (β = .69, p < .001) and MVPA through habit and intention (β = .26, p = .020). CONCLUSION. Approximately, 30% of women met the recommended PA levels (≥ 150 min/week). While autonomous motivation was associated with key determinants and an increase in MVPA, personal and environmental barriers showed negative effects on MVPA. These findings highlight the complexity of factors influencing PA among women with CVD risk factors and suggest targeted interventions focusing on increasing motivation, behavioral intentions, habit formation, and overcoming barriers that could enhance MVPA engagement in this population.