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Positive Exercise Experience Facilitates Behavior Change via Self-Efficacy


Linda Parschau, Lena Fleig, Lisa Marie Warner, Sarah Pomp, Milena Barz, Nina Knoll, Ralf Schwarzer and Sonia Lippke
Health Educ Behav published online 10 April 2014
DOI: 10.1177/1090198114529132

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research-article2014
HEBXXX10.1177/1090198114529132Health Education & BehaviorParschau et al.

Article
Health Education & Behavior

Positive Exercise Experience 1­–9


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Self-Efficacy DOI: 10.1177/1090198114529132


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Linda Parschau, PhD1, Lena Fleig, PhD1, Lisa Marie Warner, PhD1,2,
Sarah Pomp, PhD1, Milena Barz, Dipl-Psych1, Nina Knoll, PhD1,
Ralf Schwarzer, PhD3,1, and Sonia Lippke, PhD4

Abstract
Purpose. Motivational processes can be set in motion when positive consequences of physical exercise are experienced.
However, relationships between positive exercise experience and determinants of the motivational and the volitional phases
of exercise change have attracted only sparse attention in research. Method. This research examines direct and indirect
associations between positive experience and motivational as well as volitional self-efficacy, intention, action planning, and
exercise in two distinct longitudinal samples. The first one originates from an online observational study in the general
population with three measurement points in time (N = 350) and the second one from a clinical intervention study in a
rehabilitation context with four measurement points (N = 275). Results. Structural equation modeling revealed the following:
Positive experience is directly related with motivational self-efficacy as well as intentions in both samples. In the online sample
only, positive experience is associated with volitional self-efficacy. In each sample, experience is indirectly associated with
action planning via motivational self-efficacy and intentions. Moreover, action planning, in turn, predicts changes in physical
exercise levels. Conclusions. Findings suggest a more prominent role of positive experience in the motivational than in the
volitional phase of physical exercise change. Thus, this research contributes to the understanding of how positive experience
is involved in the behavior change process.

Keywords
exercise, intention, motivation, phase-specific self-efficacy, volition

Despite the physical and mental health benefits of physical Furthermore, the experience of well-being (feeling better
activity (Saxena, Van Ommeren, Tang, & Armstrong, 2005; afterward), social aspects (e.g., meeting people during
Warburton, Nicol, & Bredin, 2006), many adults remain exercise) and positive impact on one’s own appearance sup-
physically inactive. According to the World Health port engagement in physical activity (Sherwood & Jeffery,
Organization (2011), 44.5% of the population in the indus- 2000; Taylor et al., 1999).
trialized countries does not meet the recommendations of So far, the differential role of positive experience with exer-
being physically active for at least 30 minutes on 5 or more cise for motivational and volitional processes has attracted
days a week. only sparse attention in research. However, a deeper under-
Lack of time, motivation, and energy as well as negative standing of how positive experience is related to physical
experience with physical activity (e.g., sweating, pain)
seem to be main reasons for inactivity (Toscos, Consolvo,
1
& McDonald, 2011). However, a recent longitudinal twin Freie Universität Berlin, Berlin, Germany
2
study (Aaltonen et al., 2012) concludes that perceived German Centre of Gerontology, Berlin, Germany
3
Institute for Positive Psychology and Education, Australian Catholic
­barriers are not as important for the initiation and mainte- University, Sydney, Australia
nance of regular physical activity as expected because no 4
Jacobs University Bremen, Bremen, Germany
difference in perceived barriers between active and inactive
Corresponding Author:
co-twins was identified. Instead, experiencing positive con- Linda Parschau, Department of Health Psychology, Freie Universität
sequences such as pride as well as beneficial health effects Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany.
were found to be more conducive for regular activity. Email: linda.parschau@fu-berlin.de

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2 Health Education & Behavior 

exercise as well as to intentions to perform health behaviors is sustain an initiated behavior. His assumptions were con-
required to develop effective interventions. firmed by a study on rehabilitation patients’ positive experi-
In the course of health behavior change, different cogni- ence with exercise (Fleig, Lippke, Pomp, & Schwarzer,
tive processes have been found important. Most theories dis- 2011). In this study, the authors found that recently experi-
tinguish at least two phases—a motivational and a volitional enced positive consequences enhanced satisfaction with
phase (Heckhausen, 1991). The motivational phase refers to exercise and action planning, which in turn fostered exercise
the formation of a behavioral intention and is, therefore, also maintenance. Their findings point to a mediating effect of
known as the goal-setting phase. Once the intention to satisfaction and action planning between patients’ positive
change one’s behavior has been developed, the volitional or experience with exercise and their subsequent levels of exer-
goal-pursuit phase begins. cise. However, the authors did not test whether positive
The Health Action Process Approach (HAPA; Schwarzer, experience also had an impact on patients’ levels of exercise
Lippke, & Luszczynska, 2011) suggests phase-specific self- via an increase in intentions and self-efficacy. Yet self-effi-
efficacy beliefs. Motivational self-efficacy (e.g., “I am cer- cacy beliefs are suggested to be fostered because of positive
tain that I can do X”) is crucial to develop an intention in the experience as well, implying a mediating effect of self-effi-
motivational phase. Volitional self-efficacy (e.g., “I am cacy between positive experience and physical exercise
capable of coping with barriers and recovering from set- (Sherwood & Jeffery, 2000). This assumption was confirmed
backs”), however, should be instrumental in pursuing goals in recent studies investigating a sample of university stu-
once they have been set (Schwarzer et al., 2011). It can com- dents (Parschau et al., 2013) and a sample of older adults
prise coping (or maintenance) and recovery self-efficacy, with chronic illnesses (Warner, Schüz, Knittle, Ziegelmann,
and individuals already intending to change their behavior & Wurm, 2011).
should mainly benefit from such kinds of volitional self- To sum up, there is some initial empirical evidence that
efficacy. Furthermore, action planning is a facilitating factor exercise experience may be a catalyst for several social–cog-
in the volitional phase. It is a prospective self-regulatory nitive mechanisms. However, the question of how positive
strategy, and individuals who generate plans are more likely experience exerts its influence on physical exercise remains.
to translate their intentions into behavior (Koring et al.,
2012; Sniehotta, Scholz, & Schwarzer, 2005). However, the
belief in being able to change one’s behavior as well as Aims
action planning is not sufficient. Earlier experience of con- This research aims to investigate the role of exercise experi-
sequences that came along with this particular health behav- ence as a starting point in the behavior change processes.
ior (e.g., feeling better afterward) is also meaningful in the Positive experience with consequences of physical exercise
behavior change process but the concept is not explicitly is assumed to stimulate motivational self-efficacy, behav-
included within the HAPA, which examines outcome expec- ioral intentions, and volitional self-efficacy. Action planning
tancies. The latter are prospective, whereas outcome experi- should be affected by experience indirectly via an increase in
ences relate to the same phenomenon, however in a motivational self-efficacy, intentions, and volitional self-
retrospective way. efficacy. Action planning would, in turn, predict changes in
The experience of behavioral consequences has to be dis- physical exercise. To evaluate the validity of this theoretical
tinguished from the concept of mastery experience as defined model, we will test it in two distinct samples: the first origi-
by Bandura (1998). Mastery experience is seen as success nating from a longitudinal online observation study in the
with the performance of the behavior itself and not as a pre- general population, the second from a clinical intervention
viously experienced positive outcome of this behavior. study in a rehabilitation context.
Fuchs, Goehner, and Seelig (2011) describe outcome experi-
ence as individual experience and appraisals after the adop-
tion of a novel behavior. The authors propose that past Study 1
experience of positive consequences of physical exercise
(e.g., “jogging made me feel better”) affects motivational
Method
processes such as the formation of intentions. Based on this Participants and Procedure. Participants were recruited
assumption, a theory-based intervention program for inpa- through a scientific TV show which is broadcasted weekly in
tients of an orthopedic rehabilitation clinic was developed Germany. Data collection started with the program about
with prompting focus on past success as a behavior change New Year’s resolutions in January 2012. The website of this
technique. More precisely, patients were asked to acknowl- TV show contained a link to the online study. At Time 1
edge past positive consequences of physical exercise in a (T1), 729 participants provided informed consent, filled in
group discussion session to set the motivational phase in the online questionnaire, and provided their e-mail addresses
motion (Fuchs et al., 2011). for follow-up assessments. The second measurement point in
Furthermore, Rothman (2000) argues that being satisfied time (T2) was implemented 2 weeks later by inviting partici-
with experienced consequences of a behavior is important to pants via e-mail to respond to the follow-up questionnaire.

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Parschau et al. 3

Table 1.  Intercorrelations, Factor Loadings, Means, Standard Deviations, and Ranges for Positive Experience, Motivational Self-Efficacy,
Volitional Self-Efficacy, Behavioral Intention, Action Planning and Exercise for Study 1.

1 2 3 4 5 6 M (SD) Range
1. Positive experience T1 .62-.72 2.91 (0.55) 1-4
2. Motivational self-efficacy T1 .28*** .81-.84 3.12 (0.72) 1-4
3. Volitional self-efficacy T2 .34*** .54*** .59-.84 3.10 (0.65) 1-4
4. Intention T1 .31*** .48*** .45*** .42-.86 3.45 (0.59) 1-4
5. Action planning T2 .27*** .38*** .40*** .47*** .51-.91 2.84 (0.84) 1-4
6. Exercise T1a .14* .36*** .27*** .31*** .29*** 102.66 (109.51) 0-487
7. Exercise T3a .18** .38*** .31*** .39*** .32*** .73*** 120.80 (120.48) 0-458

Note. All scores are related to the manifest scales. The ranges of indicator factor loadings on latent constructs are presented in the diagonal and in
boldface. Intercorrelations are presented below the diagonal. N = 350. T1 = Time 1; T2 = Time 2; T3 = Time 3.
a
Minutes per week.
*p < .05. **p < .01. ***p < .001.

The T2 questionnaire was completed by 555 participants. Likert-type scale, ranging from 1 = completely disagree to 4
Another e-mail invitation for the second follow-up question- = completely agree and the time frame referred to “the next
naire (T3) took place 5 weeks after T1. All three online ques- weeks.”
tionnaires were completed by 350 participants. Behavioral intention to perform physical exercise was
The sample consisted of 63.7% women. Participants were assessed at T1 with the item stem “I strongly intend to . . .”
on average 41 years of age (SD = 12.8, range 16-90 years) which was followed by four items such as “. . . be physically
and had a mean body mass index of 24.7 kg/m2 (SD = 4.5, active several days a week” (Cronbach’s α = .77).
range 16.8-49.5 kg/m2). The majority of the participants Action planning was assessed at T2 by three items
were living with a partner (67.4%) and graduated from high (Cronbach’s α = .81). The item stem “I have planned in detail
school (81.4%). . . .” was followed by items such as “. . . how often I will be
physically active.”
Measures.  The online-based questionnaires contained demo- Motivational self-efficacy consisted of two single-item
graphic and psychometric scales. All items given below were indicators assessed at T1 (r = .68) such as “I am certain that
translated from German. I can be physically active even if it is difficult for me.”
Self-reported strenuous physical exercise was measured Volitional self-efficacy was measured at T2 with four items
twice by using two items of the Godin Leisure-Time Exercise such as “I am certain that I can be physically active on a regular
Questionnaire (Godin & Shephard, 1985; Plotnikoff et al., basis even if I have to overcome myself” (Cronbach’s α = .83).
2007). At T1 and T3, participants were asked to indicate the Intercorrelations, factor loadings, means, standard devia-
average number of sessions per week and the average dura- tions, and ranges of all constructs are displayed in Table 1.
tion of a session regarding strenuous physical exercise such
as intensive swimming, jogging, and cycling. Frequency and Data Analysis.  SPSS 20 was used for reliability, descriptive
average duration per session were multiplied to form a mea- and attrition analyses. Structural equation modeling was per-
sure of weighted duration of strenuous exercise throughout a formed with AMOS 20. By default, missing values were
normal week. Exercise scores 3 standard deviations larger treated using full information maximum likelihood. Good-
than the mean were truncated. ness-of-fit indices to evaluate model fit were the Tucker–
Positive exercise experience was measured at T1 by nine Lewis Index (TLI), comparative fit index (CFI), and root
items of the revised Exercise Experience Scale (Fleig et al., mean square error of approximation (RMSEA). A satisfac-
2011). The items were responded to on 4-point Likert-type tory model fit is indicated by TLI and CFI greater than .90
scales, ranging from 1 = completely disagree to 4 = com- and RMSEA lower than .08 (Kline, 2005).
pletely agree. The item stem “When I was physically active, The structural equation model included positive exercise
I experienced that . . .” was followed by positive conse- experience as a distal predictor. Direct paths of positive
quences such as “. . . I felt physically better afterward” experience on motivational self-efficacy, intention, voli-
(Cronbach’s α = .76). To minimize the number of single indi- tional self-efficacy, and subsequent physical exercise were
cators for the latent variable and thereby reducing error vari- added. Physical exercise at T1 was included as a covariate.
ances simultaneously, three parcels of three items each were Furthermore, baseline exercise and positive experience were
used as indicators for exercise experience (Little, allowed to correlate. Latent constructs were created for posi-
Cunningham, Shahar, & Widaman, 2002). tive experience, motivational self-efficacy, behavioral inten-
The following scales were adapted from Schwarzer et al. tion, volitional self-efficacy, and action planning whereas
(2011). The response format for each scale was a 4-point exercise was specified as a manifest outcome.

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4 Health Education & Behavior 

Figure 1.  Path diagram of Study 1 (N = 350).


Note. T1 = Time 1 (baseline); T2 = Time 2 (2 weeks after T1); T3 = Time 3 (5 weeks after T1). Nonsignificant paths are not displayed.
**p < .001.

Results Positive experience and motivational self-efficacy


accounted for 49% of the variance in volitional self-efficacy.
Attrition Analysis.  Attrition analyses revealed no differences
The amount of explained variance in physical exercise was
with regard to demographic characteristics (sex, age, partner
54%. Within the 5 weeks between T1 and T3, exercise levels
status, and education) and baseline assessments of positive
remained relatively stable.
experience, motivational self-efficacy, and intention between
participants who provided complete longitudinal data (48.1%
of the initial sample) and those who did not take part in the Discussion
follow-up assessment. However, the longitudinal sample
was significantly more active at baseline (Mresponders = 104.21 In an online-recruited sample, we investigated in which
minutes, SDresponders = 115.52, Mnonresponders = 84.56 minutes, way positive experience is associated with determinants of
SDnonresponders = 114.29, t(727) = −2.31, p < .05). This differ- the motivational and volitional phases of physical exer-
ence was accounted for by including baseline physical exer- cise. Structural equation modeling provided evidence for
cise as a covariate into the structural equation model. the relationship between experience and motivational self-
efficacy on one hand as well as behavioral intentions on
Evaluation of the Sequential Mediator Model. The hypothe- the other. Positive experience was also directly related to
sized model had an adequate fit with χ2(126) = 325.79, p < volitional self-efficacy, even though not as strongly as to
.001, χ2/df = 2.59, TLI = .90, CFI = .93 and RMSEA = .07 motivational self-efficacy. Additionally, positive experi-
(90% confidence interval = [.06, .08]). Figure 1 displays its ence was not directly associated with changes in strenuous
standardized parameter estimates. exercise.
Positive experience emerged as a predictor of motiva- However, by interpreting the results, a selection bias
tional self-efficacy and behavioral intention. Positive experi- might have to be taken into account. It cannot be ruled out
ence accounted for 16% of the variance in motivational that the volunteer sample might have had an enhanced inter-
self-efficacy. The amount of the explained variance in inten- est in the topic of physical exercise compared with the gen-
tion was 41%. eral population. Therefore, it might be that the rather high
The direct path from experience to physical exercise T3 means in positive experiences, intention, and behavior are
was not significant (β = .07, p > .10). Therefore, the path was associated with an enhanced interest in the study’s topic.
omitted in Figure 1. Furthermore, the investigated sample is likely to be biased

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Parschau et al. 5

toward higher educated individuals and should therefore not exhausting, light sweating) and strenuous physical exercise
be generalized to individuals with a less educational (fast heart rate, sweating) on average per week. For the
background. analyses, a composite score (number of sessions per week
Although data of three measurement points in time were multiplied by minutes per session) was formed for moder-
available, the relationship between positive experience, ate and strenuous activities. Both scores (r = .29) were then
motivational self-efficacy, and intention, respectively, was aggregated to the total number of exercise per week. Scores
examined only cross-sectionally at T1. An investigation of larger than three standard deviations above the sample’s
four measurement points would allow testing the assumed mean were truncated.
temporal order and the preceding role of exercise experience Based on a measure by Lippke, Fleig, Pomp, and
in more detail. Therefore, we also analyzed data of a second Schwarzer (2010), behavioral intentions to perform exer-
study with four measurement points in time. cise were assessed at T2 with the item stem “I intend to do
the following activities . . .” which was followed for exam-
ple by “. . . fitness activities (e.g., using an exercise bike).”
Study 2 Participants could indicate the frequency and duration they
intended by choosing one of the following answering
Method
options: 1 = not at all, 2 = less than one time per week for
Participants and Procedure.  Data of a second study were ana- about 40 [20] minutes, 3 = at least once per week for 40
lyzed to substantiate the previous findings in the context of [20] minutes, 4 = at least three times per week for 40 [20]
tertiary prevention over four measurement points in time. minutes, and 5 = at least five times per week for 40 [20]
Participants were recruited in three German rehabilitation minutes or more. Because of different medical recommen-
clinics between 2009 and 2011 (one inpatient cardiac, one dations, response options regarding the duration varied for
inpatient orthopedic, and one outpatient orthopedic). The orthopedic (20 minutes) and cardiac (40 minutes) rehabili-
regular program within these clinics provided medical, phys- tation patients. To account for this difference, the type of
iotherapeutic, and psychological treatment. The first mea- patient was entered as a covariate into the structural equa-
surement point in time (T1) took place at the beginning of tion models. Even though the internal consistency for this
rehabilitation. After having provided informed consent, 461 scale was low (Cronbach’s α = .44), a factor analysis sug-
patients completed a computer-based questionnaire. At the gested one component for all three items (factor loadings
end of the rehabilitation program (T2), patients were asked between .56 and .80).
to respond to a second computer-based questionnaire. Six The response format for all following items was a 6-point
weeks after discharge, a third assessment was completed via Likert-type scale, ranging from 1 = completely disagree to 6
computer-assisted telephone interviews (CATI; T3). Six = completely agree.
months after discharge, the fourth assessment (T4) was again Positive exercise experience was measured at T1 by five
carried out via CATI. items of the revised Exercise Experience Scale (Fleig et al.,
The longitudinal rehabilitation sample included partici- 2011). The item stem “When I was physically active, I expe-
pants who took part at least at the T1 and T4 measurements rienced that . . .” was followed by positive consequences
(n = 275). Of this sample, 69% were individuals in orthope- such as “. . . it had a positive impact on my health” (Cronbach’s
dic rehabilitation and 31% were individuals in cardiac reha- α = .75).
bilitation. The sample consisted of more women (56%) than Action planning was assessed at T3 by four items
men. The mean age was 50 years (SD = 9.3, range 19-76 (Cronbach’s α = .87). The item stem “Regarding the next
years) and the mean body mass index was 28.2 kg/m2 (SD = four weeks, I have already planned . . .” was followed for
5.8, range 16.7-49.2 kg/m2). Most of the rehabilitation example by the item “. . . which physical activities I will
patients indicated to have a partner (75.3%) and 44.7% of the perform.”
participants graduated from high school. Phase-specific self-efficacy was assessed at T2 (Lippke
et al., 2010). Motivational self-efficacy was measured with
Measures.  The assessments contained demographic as well the stem “I am certain that I can be physically active on a
as several psychometric scales. Social-cognitive variables regular basis even if . . .” followed by two items such as “. . .
were partly related to the rehabilitation context and, there- it is difficult” (r = .83). Volitional self-efficacy consisted of
fore, differed from the ones in Study 1. All items given below two indicators such as “I am capable of exercising on a regu-
were translated from German. lar basis even if it takes some time until it becomes a routine”
Self-reported moderate and strenuous physical exercise (r = .67). The time frame of the two self-efficacy scales
was measured by using four items of the modified version referred to “the next weeks after the rehabilitation.”
of the Godin Leisure-Time Exercise Questionnaire (Godin Intercorrelations, factor loadings, means, standard devia-
& Shephard, 1985; Plotnikoff et al., 2007). At T1 and T4, tions, and ranges for each manifest scale are displayed in
participants were asked to indicate how many times and Table 2. All analyses were performed in the same manner as
how long per session they performed moderate (hardly in Study 1.

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6 Health Education & Behavior 

Table 2.  Intercorrelations, Factor Loadings, Means, Standard Deviations, and Ranges for Positive Experience, Motivational Self-Efficacy,
Volitional Self-Efficacy, Behavioral Intention, Action Planning, and Exercise for Study 2.

1 2 3 4 5 6 M (SD) Range
1. Positive experience T1 .41-.81 3.96 (1.11) 1-6
2. Motivational self-efficacy T2 .21** .90-.92 4.80 (1.24) 1-6
3. Volitional self-efficacy T2 .04 .53*** .68-.99 4.15 (1.41) 1-6
4. Intention T2 .31*** .16* .09 .32-.57 2.88 (0.72) 1-5
5. Action planning T3 .12 .27*** .24*** .24*** .74-.88 4.46 (1.45) 1-6
6. Exercise T1a .16* .20** .10 .20** .14* 75.25 (99.26) 0-354
7. Exercise T4a .15* .22** .04 .30*** .20** .29*** 149.82 (121.87) 0-464

Note. All scores are related to the manifest scales. The ranges of indicator factor loadings on latent constructs are presented in the diagonal and in
boldface. Intercorrelations are presented below the diagonal. N = 275. T1 = Time 1; T2 = Time 2; T3 = Time 3; T4 = Time 4.
a
Minutes per week.
*p < .05.**p < .01. ***p < .001.

Results Positive experience at the beginning of the rehabilitation pro-


gram was associated with motivational self-efficacy as well
Attrition Analysis. At baseline, 461 rehabilitation patients as with behavioral intentions at the end of the rehabilitation.
agreed to participate in the study. The first follow-up ques- However, positive experience at the beginning of the rehabili-
tionnaire (T2) was completed by 377 participants (81.8%) at tation was neither related to volitional self-efficacy 6 weeks
the end of rehabilitation. At T3, 346 of them responded to the after discharge nor related to physical exercise 6 months after
second follow-up questionnaire (CATI, 75.1% of the initial discharge.
sample) and at T4, 275 responded to the third follow-up Although the setting and sample characteristics differed
questionnaire (CATI, 59.7% of the initial sample). between both studies, all paths of the hypothesized model—
Attrition analyses revealed no baseline differences in apart from the path between exercise experience and voli-
terms of sex, type of patients, partner status, education, exer- tional self-efficacy—were replicated in Study 2.
cise, and positive experience between participants who
stayed in the longitudinal sample and those who did not take
part in the follow-up assessments. The longitudinal sample General Discussion
was, however, older (Mresponders = 50.2, SDresponders = 9.3, As an individual’s current exercise may partly be driven by
Mnonresponders = 47.8, SDnonresponders = 11.6, t(314.6) = −2.24, past experiences with exercise consequences, we investigated
p < .05; effect size d = .17). Therefore, age was included as a the function of positive exercise experience in two distinct
covariate into the structural equation model. samples. Changes in the level of physical exercise were not
directly predicted by positive experience neither in the online-
Evaluation of the Sequential Mediator Model. The fit of the recruited sample of the general population nor in the sample
hypothesized model was satisfactory with χ2(161) = 278.60, of rehabilitation patients. Positive exercise experience did,
p < .001, χ2/df = 1.73, TLI = .90, CFI = .93, and RMSEA = however, relate to motivational self-efficacy and behavioral
.05 (90% confidence interval = [.04, .06]). Figure 2 displays intentions, which in turn predicted later exercise. Additionally,
the standardized parameter estimates. positive experience was associated with volitional self-effi-
Levels of motivational self-efficacy and behavioral inten- cacy in Study 1. Nevertheless, results of both studies indicate
tions were predicted by levels of positive experience. Positive a more consistent link between positive exercise experience
experience accounted for 6% of the variance in motivational and motivational factors, less so with volitional factors. This
self-efficacy. The amount of explained variance in intentions finding is in accordance with the assumptions by Fuchs et al.
was 28%. (2011) suggesting that the experience of positive conse-
Neither volitional self-efficacy (β = −.06, p > .10) nor quences affects motivational determinants of exercise.
exercise at T4 (β = .12, p = .10) were significantly predicted Furthermore, both studies found intentions as well as voli-
by positive experience. The amount of explained variance in tional self-efficacy to be related to subsequent action planning
exercise was 13%. which, in turn, was associated with exercise later on. These
No significant effects of type of patient (orthopedic vs. findings partly confirm previous evidence for the HAPA
cardiac) and age were found on exercise levels. (Chiu, Lynch, Chan, & Berven, 2011; Sniehotta et al., 2005).

Discussion Strengths and Limitations


In Study 2, the sample consisted of rehabilitation patients, A strength of this article lies in the replication of findings
and data were assessed at four measurement points in time. because the hypothesized model was tested in two samples

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Parschau et al. 7

Figure 2.  Path diagram of Study 2 (N = 275).


Note. T1 = Time 1 (baseline); T2 = Time 2 (end of rehabilitation); T3 = Time 3 (6 weeks after T2); T4 = Time 4 (6 months after T2). Nonsignificant paths
are not displayed.
*p < .05. **p < .001.

and distinct contexts. Although both studies showed a con- cognitions such as action planning, coping planning, and
siderable dropout rate, the samples had an acceptable size action control might be investigated in more detail by dif-
with 350 and 275 study participants, respectively. However, ferentiating between the initiation and maintenance of
the differences between responders and nonresponders were physical exercise. Moreover, examining whether long-term
accounted for in our analyses. Although the samples were or short-term exercise experience has different effects on
surveyed on three and four measurement points in time in subsequent exercise might be of further interest. The the-
Study 1 and Study 2, respectively, causality cannot be proven matic content of the experience (e.g., health, emotion, or
by these research designs. appearance related) might also offer implications for exer-
cise interventions.
These two studies bear several practical implications for
Implications for Future Research the promotion of exercise self-efficacy, exercise intentions,
Previous studies found motivational self-efficacy to be a and exercise behavior in the general population and in reha-
strong predictor of behavioral intentions (Parschau et al., bilitation patients. To raise individuals’ awareness of positive
2012; Scholz, Sniehotta, & Schwarzer, 2005). However, evi- exercise experience, a recall of positive effects of previous
dence on how motivational self-efficacy can be fostered is exercise could be prompted in interviews or recorded in dia-
rare. On the basis of the literature (Fleig et al., 2011; Fuchs ries (Fleig et al., 2011; Pomp, Fleig, Schwarzer, & Lippke,
et al., 2011; Parschau et al., 2013; Rothman, 2000) and the 2012). Providing individuals with feedback on their positive
results of the present study, the construct of exercise experi- exercise outcomes has been found effective in previous stud-
ence is a promising candidate to be integrated and further ies (Ashford, Edmunds, & French, 2010) and could be
investigated in health behavior change models. another straightforward strategy to be implemented, for
As both studies investigated a selection of motivational example, in the rehabilitation context.
and volitional components taken from established models
only (e.g., HAPA), the function and location of exercise
Conclusion
experience in health behavior change models is not yet suf-
ficiently clarified. In future studies, direct and indirect According to the present results, positive exercise experience
associations between positive experience and volitional seems to be relevant in the motivational phase of changes in

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8 Health Education & Behavior 

exercise behavior. Together with future research on positive and self-efficacy on physical activity. Health Education &
experience in the context of other health behaviors, this con- Behavior, 39, 152-158. doi:10.1177/1090198111417621
struct is a promising candidate to be integrated into the moti- Lippke, S., Fleig, L., Pomp, S., & Schwarzer, R. (2010). Validity
vational phase of health behavior process models. of a stage algorithm for physical activity in participants
recruited from orthopedic and cardiac rehabilitation clin-
ics. Rehabilitation Psychology, 55, 398-408. doi:10.1037/a00
Acknowledgments 21563
We thank the rehabilitation clinics and their rehabilitants for par- Little, T. D., Cunningham, W. A., Shahar, G., & Widaman,
ticipating in this study. We especially appreciate the support of Mrs. K. F. (2002). To parcel or not to parcel: Exploring the question,
Pimmer, Dr. Kiwus, Dr. Glatz, Dr. Milse, and Dr. Johnigk. weighing the merits. Structural Equation Modeling, 9,
151-173. doi:10.1207/S15328007SEM0902_1
Declaration of Conflicting Interests Parschau, L., Fleig, L., Koring, M., Lange, D., Knoll, N., Schwarzer,
R., & Lippke, S. (2013). Positive experience, self-efficacy, and
The authors declared no potential conflicts of interests with respect action control predict physical activity changes: A moderated
to the research, authorship, and/or publication of this article. mediation analysis. British Journal of Health Psychology, 18,
395-406. doi:10.1111/j.2044-8287.2012.02099.x
Funding Parschau, L., Richert, J., Koring, M., Ernsting, A., Lippke, S., &
Schwarzer, R. (2012). Changes in social-cognitive variables
The authors declared the following financial support for the research,
are associated with stage transitions in physical activity. Health
authorship, and/or publication of this article: Study 2 was supported
Education Research, 27, 129-140. doi:10.1093/her/cyr085
by the Deutsche Rentenversicherung Bund (DRV; German Pension
Plotnikoff, R. C., Lippke, S., Reinbold-Matthews, M., Courneya,
Insurance) within the project FABA (Project ID 8011-106-31/31.91).
K. S., Karunamuni, N., Sigal, R. J., & Birkett, N. (2007).
Assessing the validity of a stage measure on physical activity
References in a population-based sample of individuals with type 1 or type
Aaltonen, S., Leskinen, T., Morris, T., Alen, M., Kaprio, J., 2 diabetes. Measurement in Physical Education and Exercise
Liukkonen, J., & Kujala, U. (2012). Motives for and barriers Science, 11, 73-91. doi:10.1080/10913670701294062
to physical activity in twin pairs discordant for leisure time Pomp, S., Fleig, L., Schwarzer, R., & Lippke, S. (2012). Depressive
physical activity for 30 years. International Journal of Sports symptoms interfere with post-rehabilitation exercise: Outcome
Medicine, 33, 157-163. doi:10.1055/s-0031-1287848 expectancies and experience as mediators. Psychology, Health,
Ashford, S., Edmunds, J., & French, D. P. (2010). What is the & Medicine, 17, 698-708. doi:10.1080/13548506.2012.661864
best way to change self-efficacy to promote lifestyle and rec- Rothman, A. J. (2000). Toward a theory-based analysis of behav-
reational physical activity? A systematic review with meta- ioral maintenance. Health Psychology, 19(1 Suppl.), 64-69.
analysis. British Journal of Health Psychology, 15, 265-288. doi:10.1037/0278-6133.19.Suppl1.64
doi:10.1348/135910709X461752 Saxena, S., Van Ommeren, M., Tang, K. C., & Armstrong, T. P.
Bandura, A. (1998). Health promotion from the perspective of (2005). Mental health benefits of physical activity. Journal
social cognitive theory. Psychology & Health, 13, 623-649. of Mental Health, 14, 445-451. doi:10.1080/09638230500
doi:10.1080/08870449808407422 270776
Chiu, C. Y., Lynch, R. T., Chan, F., & Berven, N. L. (2011). The Scholz, U., Sniehotta, F. F., & Schwarzer, R. (2005). Predicting
Health Action Process Approach as a motivational model for physical exercise in cardiac rehabilitation: The role of phase-
physical activity self-management for people with multiple specific self-efficacy beliefs. Journal of Sport & Exercise
sclerosis: A path analysis. Rehabilitation Psychology, 56, Psychology, 27, 135-151.
171-181. doi:10.1037/a0024583 Schwarzer, R., Lippke, S., & Luszczynska, A. (2011). Mechanisms
Fleig, L., Lippke, S., Pomp, S., & Schwarzer, R. (2011). Exercise of health behavior change in persons with chronic illness or
maintenance after rehabilitation: How experience can make disability: The Health Action Process Approach (HAPA).
a difference. Psychology of Sport and Exercise, 12, 293-299. Rehabilitation Psychology, 56, 161-170. doi:10.1037/a00
doi:10.1016/j.psychsport.2011.01.003 24509
Fuchs, R., Goehner, W., & Seelig, H. (2011). Long-term effects Sherwood, N. E., & Jeffery, R. W. (2000). The behavioral deter-
of a psychological group intervention on physical exercise and minants of exercise: Implications for physical activity inter-
health: The MoVo concept. Journal of Physical Activity and ventions. Annual Review of Nutrition, 20, 21-44. doi:10.1146/
Health, 8, 794-803. annurev.nutr.20.1.21
Godin, G., & Shephard, R. J. (1985). A simple method to assess Sniehotta, F. F., Scholz, U., & Schwarzer, R. (2005). Bridging the inten-
exercise behavior in the community. Canadian Journal of tion-behaviour gap: Planning, self-efficacy, and action control in
Applied Sport Sciences, 10, 141-146. the adoption and maintenance of physical exercise. Psychology &
Heckhausen, H. (1991). Motivation and action. Berlin, Germany: Health, 20, 143-160. doi:10.1080/08870440512331317670
Springer. Taylor, W. C., Yancey, A. K., Leslie, J., Murray, N. G., Cummings,
Kline, R. B. (2005). Principles and practice of structural equation S. S., Sharkey, S. A., . . .McCarthy, W. J. (1999). Physical activ-
modeling. New York, NY: Guilford Press. ity among African American and Latino middle school girls:
Koring, M., Richert, J., Lippke, S., Parschau, L., Reuter, T., Consistent beliefs, expectations, and experiences across two sites.
& Schwarzer, R. (2012). Synergistic effects of planning Women & Health, 30(2), 67-82. doi:10.1300/J013v30n02_05

Downloaded from heb.sagepub.com at University of Waikato Library on May 25, 2014


Parschau et al. 9

Toscos, T., Consolvo, S., & McDonald, D. W. (2011). Barriers Warner, L. M., Schüz, B., Knittle, K., Ziegelmann, J. P., & Wurm, S.
to physical activity: A study of self-revelation in an online (2011). Sources of perceived self-efficacy as predictors of physi-
community. Journal of Medical Systems, 35, 1225-1242. cal activity in older adults. Applied Psychology: Health and
doi:10.1007/s10916-011-9721-2 Well-Being, 3, 172-192. doi:10.1111/j.1758-0854.2011.01050.x
Warburton, D. E., Nicol, C. W., & Bredin, S. S. (2006). Health World Health Organization. (2011). Global status report on non-
benefits of physical activity: The evidence. Canadian Medi­ communicable diseases 2010. Description of the global bur-
cal Association Journal, 174, 801-809. doi:10.1503/cmaj. den of NCDs, their risk factors and determinants. Geneva,
051351 Switzerland: Author.

Downloaded from heb.sagepub.com at University of Waikato Library on May 25, 2014

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