Journal of Behavioral Medicine

, Volume 38, Issue 6, pp 886–898 | Cite as

Impact of a brief intervention on self-regulation, self-efficacy and physical activity in older adults with type 2 diabetes

  • Erin A. Olson
  • Edward McAuley


Despite evidence of the benefits of physical activity, most individuals with type 2 diabetes do not meet physical activity recommendations. The purpose of this study was to test the efficacy of a brief intervention targeting self-efficacy and self-regulation to increase physical activity in older adults with type 2 diabetes. Older adults (Mage = 61.8 ± 6.4) with type 2 diabetes or metabolic syndrome were randomized into a titrated physical activity intervention (n = 58) or an online health education course (n = 58). The intervention included walking exercise and theory-based group workshops. Self-efficacy, self-regulation and physical activity were assessed at baseline, post-intervention, and a follow-up. Results indicated a group by time effect for self-regulation [F(2,88) = 14.021, p < .001, η 2 = .24] and self-efficacy [F(12,77) = 2.322, p < .05, η 2 = .266] with increases in the intervention group. The intervention resulted in short-term increases in physical activity (d = .76, p < .01), which were partially maintained at the 6-month follow-up (d = .35, p < .01). The intervention increased short-term physical activity but was not successful at maintaining increases in physical activity. Similar intervention effects were observed in self-efficacy and self-regulation. Future research warrants adjusting intervention strategies to increase long-term change.


Diabetes Physical activity Older adults Self-regulation Self-efficacy 



Research was funded by: National Institute on Aging: F31 AG042232, R01 AG0200118, 5T32AG023480-10; and by the Shahid Khan and Ann Carlson Khan Endowed Professorship. Funding sources had no involvement in research design; data collection, analysis or interpretation; manuscript writing; or decision to submit for publication. Authors have no financial disclosures.

Compliance with Ethical Standards

Conflict of interest

Erin A. Olson and Edward McAuley declare no conflict of interest.

Human and animal rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants for being included in the study.


  1. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. New Jersey: Prentice Hall.Google Scholar
  2. Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman.Google Scholar
  3. Bandura, A. (2005). The primacy of self-regulation in health promotion. Applied Psychology, 54(2), 245–254.CrossRefGoogle Scholar
  4. Brawley, L. R., Rejeski, W. J., & King, A. C. (2003). Promoting physical activity for older adults: The challenges for changing behavior. American Journal of Preventive Medicine, 25(3Sii), 172–183.CrossRefPubMedGoogle Scholar
  5. Centers for Disease Control and Prevention. (2011). National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Retrieved from
  6. Centers for Disease Control and Prevention. (2013). Press Release: One in five adults meets overall physical activity guidelines. Retrieved from
  7. Copeland, J. L. (2009). Accelerometer assessment of physical activity in active, healthy older adults. Journal of Aging and Physical Activity, 17, 17–30.PubMedGoogle Scholar
  8. de Jager, C. A., Budge, M. M., & Clarke, R. (2003). Utility of TICS-M for the assessment of cognitive function in older adults. International Journal of Geriatric Psychiatry, 18, 318–324.CrossRefPubMedGoogle Scholar
  9. Diabetes Prevention Program Research Group. (2002). Reduction of the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6), 393–403.PubMedCentralCrossRefGoogle Scholar
  10. Dishman, R. K. (1982). Compliance/adherence in health-related exercise. Health Psychology, 1, 237–267.CrossRefGoogle Scholar
  11. Dishman, R. K., Motl, R. W., Sallis, J. F., Dunn, A. L., Birnbaum, A. S., Welk, G. J., et al. (2005). Self-management strategies mediate self-efficacy and physical activity. American Journal of Preventive Medicine, 29(1), 10–18.PubMedCentralCrossRefPubMedGoogle Scholar
  12. Duncan, G. E., Perri, M. G., Theriaque, D. W., Hutson, A. D., Eckel, R. H., & Stacpoole, P. W. (2003). Exercise training, without weight loss, increases insulin sensitivity and postherparin plasma lipase activity in previously sedentary adults. Diabetes Care, 26, 557–562. doi: 10.2337/diacare.26.3.557 CrossRefPubMedGoogle Scholar
  13. Freedson, P. S., Melanson, E., & Sirand, J. (1998). Calibration of the computer science and applications, inc. accelerometer. Medicine and Science in Sports and Exercise, 30, 777–781.CrossRefPubMedGoogle Scholar
  14. Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., et al. (2005). Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation, 112, 2735–2752.CrossRefPubMedGoogle Scholar
  15. Jeon, C. Y., Looken, R. P., Hu, F. B., & van Dam, R. M. (2007). Physical activity of moderate intensity and risk of type 2 diabetes: A systematic review. Diabetes Care, 30, 744–752.CrossRefPubMedGoogle Scholar
  16. Lally, P., Van Jaarsveld, C. H. M., Potts, H. W. W., & Wardle, J. (2010). How are habits formed: Modeling habit formation in the real world. European Journal of Social Psychology, 40, 998–1009.CrossRefGoogle Scholar
  17. Lerman, I. (2005). Adherence to treatment: The key for avoiding long-term complications of diabetes. Archives of Medical Research, 36, 300–306.CrossRefPubMedGoogle Scholar
  18. Luciano, E., Carneiro, E. M., Carvalho, C. R., Carvalheira, J. B., Peres, S. B., Reis, M. A., et al. (2002). Endurance training improves responsiveness to insulin and modulates insulin signaling transduction through the phosphatidylinositol 3-kinase/Akt-1 pathway. European Journal of Endocrinology, 147, 149–157. doi: 10.1530/eje.0.1470149 CrossRefPubMedGoogle Scholar
  19. Maes, S., & Karoly, P. (2005). Self-regulation assessment and intervention in physical health and illness: A review. Applied Psychology, 54(2), 267–299.CrossRefGoogle Scholar
  20. Mailey, E. L., Gothe, N. P., Wójcicki, T. R., Szabo, A. N., Olson, E. A., Mullen, S. P., et al. (2014). Influence of allowable interruption period on estimates of accelerometer wear time and sedentary time in older adults. Journal of Aging and Physical Activity, 22(2), 255–260. doi: 10.1123/japa.2013-0021 PubMedCentralCrossRefPubMedGoogle Scholar
  21. Masse, L., Fummeler, B., Anderson, C., Mathews, C., Trost, S., Catellier, D., et al. (2005). Accelerometer data reduction: A comparison of four reduction algorithms on select outcome variables. Medicine and Science in Sports and Exercise, 37(11), S544–S554.CrossRefPubMedGoogle Scholar
  22. Matos, A., Ropelle, E. R., Pauli, J. R., Frederico, M. J. S., de Pinho, R. A., Velloso, L. A., & De Souza, C. T. (2010). Acute exercise reverses TRB3 expression in the skeletal muscle and ameliorates whole body insulin sensitivity in diabetic mice. Acta Physiologica, 198, 61–69. doi: 10.1111/j.1748-1716.2009.02031.x CrossRefPubMedGoogle Scholar
  23. McAuley, E. (1992). The role of efficacy cognitions in the prediction of exercise behavior in middle-aged adults. Journal of Behavorial Medicine, 15(1), 65–88.CrossRefGoogle Scholar
  24. McAuley, E., & Blissmer, B. (2000). Self-efficacy determinants and consequences of physical activity. Exercise and Sport Science Reviews, 28(2), 85–88.Google Scholar
  25. McAuley, E., Blissmer, B., Katula, J., Duncan, T. E., & Mihalko, S. L. (2000). Physical activity, self-esteem, and self-efficacy relationships in older adults: A randomized controlled trial. Annals of Behavioral Medicine, 22, 131–139.CrossRefPubMedGoogle Scholar
  26. McAuley, E., Hall, K. S., Motl, R. W., White, S. M., Wójcicki, T. R., Hu, L., & Doerksen, S. E. (2009). Trajectory of declines in physical activity in community-dwelling older women: Social cognitive influences. Journals of Gerontology, Series B: Psychological Sciences, 64B(5), 543–550. doi: 10.1093/geronb/gbp049 CrossRefGoogle Scholar
  27. McAuley, E., Jerome, G. J., Marquez, D. X., Elavsky, S., & Blissmer, B. (2003). Exercise self-efficacy in older adults: Social, affective and behavioral influences. Annals of Behavioral Medicine, 25, 1–7. doi: 10.1207/S15324796ABM2501_01 CrossRefPubMedGoogle Scholar
  28. McAuley, E., Lox, C., & Duncan, T. E. (1993). Long-term maintenance of exercise, self-efficacy, and physiologic change in older adults. Journals of Gerontology, Series B: Psychological Sciences, 48(4), 218–224.Google Scholar
  29. McAuley, E., Mailey, E. L., Mullen, S. P., Szabo, A. N., Wójckicki, T. R., White, S. M., et al. (2011). Growth trajectories of exercise self-efficacy in older adults: Influence of measures and initial status. Health Psychology, 30(1), 75–83. doi: 10.1037/a0021567 PubMedCentralCrossRefPubMedGoogle Scholar
  30. McAuley, E., & Mihalko, S. L. (1998). Measuring exercise-related self-efficacy. In J. L. Duda (Ed.), Advances in sport and exercise psychology measurement. Fitness Information Technology: West Virginia.Google Scholar
  31. McBean, A. M., Gilbertson, D. T., Li, S., & Collins, A. J. (2004). Differences in diabetes prevalence, incidence, and mortality among the elderly of four racial/ethnic groups: White, Blacks, Hispanics, and Asians. Diabetes Care, 27, 2317–2324.CrossRefPubMedGoogle Scholar
  32. Moore, S. M., Charvat, J. M., Gordon, N. H., Pashkow, F., Ribisl, P., Roberts, B. L., & Rocco, M. (2006). Effects of a CHANGE intervention to increase exercise maintenance following cardiac events. Annals of Behavioral Medicine, 31, 53–62. doi: 10.1207/s15324796abm3101_9 CrossRefPubMedGoogle Scholar
  33. Morrato, E. H., Hill, J. O., Wyatt, H. R., Ghushchyan, V., & Sullivan, P. W. (2007). Physical activity in the U.S. adults with diabetes and at risk for developing diabetes, 2003. Diabetes Care, 30(2), 203–209.CrossRefPubMedGoogle Scholar
  34. Nwasuruba, C. K., Khan, M., & Egede, L. E. (2007). Racial/ethnic differences in multiples self-care behaviors in adults with diabetes. Journal of General Internal Medicine, 22, 115–120.PubMedCentralCrossRefPubMedGoogle Scholar
  35. Rejeski, W. J., Marsh, A. P., Chmelo, E., Prescott, A. J., Dobrosielski, M., Walkup, M. P., et al. (2009). The lifestyle interventions and independence for elders pilot (LIFE-P): 2-year follow-up. Journals of Gerontology, Series A: Biological Sciences, 64A(4), 462–467.CrossRefGoogle Scholar
  36. Resnick, H., Harris, M., Brock, D., & Harris, T. (2000). American Diabetes Association diabetes diagnostic criteria, advancing age and cardiovascular disease risk profiles. Diabetes Care, 23, 176–180.CrossRefPubMedGoogle Scholar
  37. Rogers, L. Q., Hopkins-Price, P., Vicari, S., Markwell, S., Pamenter, R., Courneya, K. S., et al. (2009a). Physical activity and health outcomes three months after completing a physical activity behavior change intervention: Persistent and delayed effects. Cancer Epidemiology, Biomarkers and Prevention, 18, 1410–1418.CrossRefPubMedGoogle Scholar
  38. Rogers, L. Q., Hopkins-Price, P., Vicari, S., Pamenter, R., Courneya, K. S., Markwell, S., et al. (2009b). A randomized trial to increase physical activity in breast cancer survivors. Medicine and Science in Sports and Exercise, 41(4), 935–936. doi: 10.1249/MSS.0b013e31818e0e1b CrossRefPubMedGoogle Scholar
  39. Sigal, R. J., Kenny, G. P., Wasserman, D. H., Castaneda-Sceppa, C., & White, R. D. (2006). Physical activity/exercise and type 2 diabetes: A consensus statement from the American Diabetes Association. Diabetes Care, 29(6), 1433–1438.CrossRefPubMedGoogle Scholar
  40. The LIFE Study Investigators. (2006). Effects of a physical activity intervention on measures of physical performance: Results of the lifestyle interventions and independence for elders pilot (LIFE-P) study. Journals of Gerontology, Series A: Biological Sciences, 61A(11), 1157–1165.CrossRefGoogle Scholar
  41. Touati, S., Meziri, F., Devaux, S., Berthelot, A., Touyz, R., & Laurent, P. (2011). Exercise reverses metabolic syndrome in high-fat diet-induced obese rats. Medicine and Science in Sports and Exercise, 43(3), 398–407. doi: 10.1249/MSS.0b013e3181eeb12d CrossRefPubMedGoogle Scholar
  42. Umstattd, M. R., Motl, R. W., Wilcox, S., Saunders, R., & Watford, M. (2009). Measuring physical activity self-regulation strategies in older adults. Journal of Physical Activity and Health, 6, S105–S112.PubMedGoogle Scholar
  43. Wing, R. R., Goldstein, M. G., Acton, K. J., Birch, L. L., Jakicic, J. M., Sallis, J. F., et al. (2001). Behavioral science research in diabetes: Lifestyle changes related to obesity, eating behavior, and physical activity. Diabetes Care, 24, 117–123.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Kinesiology and Community HealthUniversity of Illinois at Urbana-ChampaignUrbanaUSA
  2. 2.The Institute for Aging Research at Hebrew SeniorLifeHarvard Medical SchoolBostonUSA

Personalised recommendations