Elsevier

Nursing Outlook

Volume 58, Issue 1, January 2010, Pages 52-58
Nursing Outlook

Article
A situation-specific theory of Midlife Women's Attitudes Toward Physical Activity (MAPA)

https://doi.org/10.1016/j.outlook.2009.07.001Get rights and content

This paper presents a situation specific theory—the Midlife Women's Attitudes Toward Physical Activity (MAPA) theory—that explains how women's attitudes toward physical activity influence their participation in physical activity. Using the integrative approach of Im, the theory was developed based on the Attitude, Social Influence, and Self Efficacy Model; a review of the related literature; and a study of women's attitudes toward physical activity. As a situation-specific theory, the MAPA theory can be linked easily to nursing practice and research projects related to physical activity in midlife women, especially interventions aimed at increasing midlife women's participation in physical activity.

Section snippets

Definitions Used in Theory Development

In this theoretical development work, we refer to physical activity as bodily movements produced by the contraction of skeletal muscles that result in energy expenditure, and we define exercise as a subset of physical activity that is planned, structured, repetitive, and has the improvement or maintenance of physical fitness as an intermediate or a final objective.13 We also refer to attitudes toward physical activity as what a woman thinks and expresses about a physically active lifestyle for

Multiple Sources for Theory Development

As the integrative approach directs, the MAPA theory was developed by exploring the phenomenon in multiple sources: a midrange theory, an integrative literature review, and the findings of a research project. First, a midrange theory—the Attitude, Social Influence, and Self Efficacy (ASE) Model by De Vries et al10 was used as a source for the development of the MAPA theory. From the ASE Model, three psychosocial determinants of physical activity behavior—attitude, social influence, and

The Mapa Theory

The proposed MAPA theory (Fig 1) is composed of 8 major concepts: (a) women's attitudes toward physical activity, (b) women's participation in physical activity, (c) background characteristics, (d) health and menopausal status, (e) physical activity self-efficacy, (f) social influence, (g) perceived barriers, and (h) the contexts of women's daily lives. The major concepts and their associations are described below.

Women's Attitudes Toward Physical Activity

The findings from several studies have suggested certain ethnic-specific attitudes toward physical activity and their associations to physical activity levels.3, 14, 16 Post-menopausal African-American women did not participate in physical activity because of a lack of time as a result of work and family responsibilities.16 Although whites valued individual outcomes and spoke of personal factors promoting or preventing exercise, Mexican Americans viewed physical activity as prescriptive,

Women's Participation in Physical Activity

Women's rate of participating in physical activity is commonly low, and they tend to be less likely to be physically active than men.3, 17 Data from the Behavioral Risk Factor Surveillance System (BRFSS) for Texas showed that only 19.5% of the women in the survey engaged in more than 20 minutes of vigorous physical activity 3 or more days per week in the previous month.17 In addition, most midlife and older adults lead sedentary lifestyles.3 A number of studies have also reported ethnic

Background Characteristics

Because age, educational level, socioeconomic status, employment status, marital status, the number of children, and acculturation are background characteristics known to influence women's physical activity,1, 3, 4, 5, 13 these variables are another major concept in the MAPA theory. However, the findings on the directions of the relationships between the background factors and women's physical activity were inconsistent, which may be a result of differences in the measurement of physical

Health and Menopausal Status

Perceived health status has been reported to influence women's participation in physical activity; adults with poor self-perceived health status performed no or few physical activities during their leisure-time.5, 20 As women reach midlife, the incidence of chronic conditions increases significantly, and symptoms of various chronic conditions (eg, fatigue, weakness, sleep disturbances) may make it more challenging to engage in health-promoting behaviors, physical activity, and exercise. One of

Physical Activity Self-Efficacy

Physical activity self-efficacy (how confident an individual is in their ability to be active) is the most frequently identified factor associated with physical activity.1 Studies report that self-efficacy is associated with adherence to and regularity of physical activity, and it is a significant predictor of women's participation in physical activity.1, 24, 25

The MAPA Study also supported the association of physical activity self-efficacy with midlife women's participation in physical

Social Influence

Social influence, one of the main environmental determinants of physical activity, consists of the opinion of family, friends, colleagues, and health professionals, but also the general opinion of society.10, 15, 16 The influence of family and friends has been repeatedly reported to have a positive influence on physical activity in healthy people.16 However, health professionals' influence was positively correlated with weight reduction, but not physical activity.15

Although the quantitative

Perceived Barriers

The perceived barriers to physical activity were a significant factor that influenced physical activity.6, 16, 26 Lack of time, feeling tired, feeling that they were active enough at their jobs, and lack of motivation influenced women's participation in physical activity.26 Studies have indicated that inadequate time was a major barrier to physical activity.16, 26

The quantitative findings of the MAPA Study indicated significant relationships between perceived barriers and midlife women's

Contexts of Daily Lives

Studies have indicated ethnic differences in the contexts of participation in physical activity.15, 16, 26, 27,31 For example, Taiwanese women are expected to meet all of the emotional and physical demands of their husbands and children,26 which frequently makes it hard for them to find time for physical activity. Other gender roles in individual cultures have also been reported to affect physical activity.26 For instance, women with fewer domestic tasks were more likely to engage in

Conclusion

The MAPA theory presented in this paper describes how midlife women's attitudes influence their physical activity and integrates multiple factors that are known to influence their participation in physical activity within the sociocultural contexts of their daily lives. As a situation-specific theory, the MAPA theory is anticipated to be used easily in nursing practice and research projects related to physical activity in midlife women, especially physical activity interventions. However, the

Eun-Ok Im, PhD, MPH, RN, CNS, FAAN, is Professor, and La Quinta Motor Inns Inc. Centennial Professor in Nursing at School of Nursing, The University of Texas at Austin, Austin, TX.

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    Eun-Ok Im, PhD, MPH, RN, CNS, FAAN, is Professor, and La Quinta Motor Inns Inc. Centennial Professor in Nursing at School of Nursing, The University of Texas at Austin, Austin, TX.

    Alexa K. Stuifbergen, PhD, RN, FAAN, is Professor, and Dolores Sands Chair in Nursing Research at School of Nursing, The University of Texas at Austin, Austin, TX.

    Lorraine Walker, PhD, MPH, FN, FAAN, is Professor, and Luci B. Johnson Centennial Professor at School of Nursing, The University of Texas at Austin, Austin, TX.

    Theory development was conducted as a part of a study supported by Grant No. R01NR010568 from the National Institute of Nursing Research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.

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