The Role of Self-efficacy, Social Support, and Neighborhood Environment in Exercise Behavior of Middle-aged Women

Abstract

During the past decade, there has been an almost 50% decrease in the exercise participation prevalence among Korean middle-aged women. Studies to date have stablished corroboration, regarding the correlates of exercise behavior from intrapersonal and interpersonal perspectives, in which self-efficacy and social support was identified as key influential factors. However, there have been few researches that have examined the potential environment and policy correlates of exercise behavior in Korea. The purpose of this cross-sectional study was to investigate the prevalence and the correlates of exercise behavior of middle-aged women from intrapersonal, interpersonal, and environmental levels. In this study, data on exercise behavior, self-efficacy, social support, neighborhood environment, and policy was collected through structured questionnaires completed by 253 participants (out of a total of 292 middle-aged women recruited via convenience sampling). Data analysis was conducted by using descriptive statistics, independent t-tests, cross tabulations, and logistic regression techniques using SPSS 19.0 for Windows. Prevalence of participation in exercise behavior based on stages of change was 51% (preparation 23.7%, action 8.7%, and maintenance 18.6%), and that of non-participation in exercise was 49% (precontemplation 2.4% and contemplation 46.6%). Exercise behavior was significantly associated with general characteristics such as age group (χ²=11.46, p=.003), menstruation status (χ²=9.11, p=.011), total physical activity (t=-5.58, p<.001), daily average sitting minutes (t=2.08, p=.038), physical activity level (χ²=28.33, p<.001), and exercise partner (χ²=24.35, p<.001). Exercise behavior was also in a significant correlation with self-efficacy (t=-5.34, p<.001), social support from family members‟ participation (t=-3.52, p=.001) and social support from non-family members‟ participation (t=-4.62, p<.001), neighborhood infrastructures in walking distance (t=-2.43, p=.016), and social interaction while walking (t=- 2.63, p=.009). Logistic regression revealed that such correlates as exercise partner (odds ratio [OR], 2.77; 95 % confidence interval [CI], 1.26-6.05), self-efficacy (OR, 1.62; 95 % CI, 1.38- 3.46), and neighborhood infrastructures in walking distance (OR, 0.53; 95 % CI, 1.01- 2.59) increased the likelihood of the participation in exercise behavior among middle-aged women. The findings of this study supports the need for the implementation of interventions, which reflects the multi-level correlates to promote changes in the exercise behavior among middleaged women, thus helping them achieve the desired level of health outcomes. Further research is recommended to compile sufficient evidence regarding the correlates of exercise behavior from environment and policy levels.

본 연구는 지역사회 중년여성의 운동행위와 관련요인을 자기 효능감, 사회적지지, 거주지역환경의 차원에서 파악하기 위한 서술적 조사연구이다. 2013년 10월-11월 서울 및 경기지역에 거주하는 253명의 중년여성을 대상으로 편의 표집하여 구조화된 설문지를 이용하여 자료 수집을 하였다. 자료 분석은 SPSS 19.0을 이용하여 기술통계, 독립 t검정, 교차분석, 로지스틱 회귀분석기법을 사용하였다. 연구결과는 다음과 같다. 중년여성의 운동행위 변화단계상의 분포는 운동행위 비실천군 49%(계획 전 단계 2.4%, 계획단계 46.6%,), 실천군 51%(준비단계 23.7%, 행동단계 8.7%, 유지단계 18.6%)인 것으로 나타났다. 중년여성의 운동행위 실천 유무에 따른 일반적 특성을 비교하였을 때 인구사회학적 특성에서는 연령군(χ²=11.46, p=.003), 건강관련 특성에서는 월경상태(χ²=9.11, p=.011), 운동행위관련 특성에서는 총 신체 활동량(t=-5.58, p<.001), 앉아서 보내는 시간(t=2.08, p=.038), 신체 활동군(χ²=28.33, p<.001), 운동파트너 유무(χ²=24.35, p<.001)에 유의한 차이가 있었다. 중년여성의 운동행위 실천 유무에 따라 자기 효능감(t=-5.34, p<.001)에 유의한 차이가 있었으며, 사회적 지지는 가족참여지지(t=-3.52, p=.001), 가족 외 지인 참여 지지(t=-4.62, p<.001)에 각각 유의한 차이가 있었다. 거주 지역 환경 특성 중 다양한 제반시설까지의 도보거리(t=-2.43, p=.016) 및 산책 시 이웃과의 상호작용(t=-2.63, p=.009)에 유의한 차이가 있었다. 운동행위에 따른 주관적 거주 지역 정책 인식에 대한 차이는 없었다. 중년여성의 운동행위 실천에 영향을 미치는 요인을 파악하기 위하여 로지스틱 회귀 분석을 실시한 결과, 운동파트너(OR=2.77, 95%CI: 1.26-6.05), 자기 효능감(OR=2.19, 95%CI: 1.38-3.46), 그리고 가까운 도보거리에 거주지역내 다양한 제반시설이 갖추어진 환경(OR=1.62, 95%CI: 1.01-2.59)이 주요 영향요인으로 나타났다. 이상의 연구 결과를 통해 중년여성의 운동행위 실천에 영향을 주는 요인들을 반영한 운동행위 증진프로그램을 실시할 것을 제언한다.