Temporal Discounting and its Effect on exercise behavior in elders Foundations at asu Im never going to do research It starts with a passion to LEARN and possibly CHANGE something that you feel could be better ID: 784234
Download The PPT/PDF document "Linda M. Tate, PhD, APrN" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Linda M. Tate, PhD, APrN
Temporal Discounting and its Effect on exercise behavior in elders
Slide2Foundations at
asu
Slide3I’m never going to do research
It starts with a passion to LEARN and possibly CHANGE something that you feel could be better
EXPLORE
COMMUNICATE
SHAREDISCUSSMAKE A FUNDAMENTAL DIFFERENCE (DO THE GREATEST GOOD FOR THE GREATEST NUMBER OF PEOPLE)
Slide4Background
In the USA, 2020 the over 65 group will grow by 18%80% of person >65 have at least one chronic illness
As this number rises so will the rates of chronic illness
Exercise is one of the most important health behaviors to prevent chronic disease and disability in elders
Elders need to increase exercise participation and healthcare providers must understand how to successfully engage them
Slide5Significance
Multiple studies have looked at exercise in elders
The Theory of Planned Behavior(TPB) has been used as a guide for multiple research inquiries and is a good predictor but does not take into account time
Measuring Delay(Temporal) Discounting along with the model will give us a temporal (time) concept and may add to the predictability of the TPB
Slide6Knowledge gap
Gaps in the literature exist regarding exercise in elders and temporal discountingOnly two studies were found that addressed temporal discounting in eldersNo published studies that included temporal discounting and the TPB
Slide7Conceptual framework
Use the TBP as a conceptual guide to measure attitudes, subjective norm, perceived control, and intentionMeasure temporal discounting along side the model to investigate possible effects on exercise behavior and the prediction of exercise
Slide8TPB with discounting
A
TTITUDE
S
UBJECTIVE
NORM
B
EHAVIORAL
C
ONTROL
B
EHAVIORAL
I
NTENTION
T
EMPORAL
D
ISCOUNTIN
g
E
XERCISE
B
EHAVIOR
Slide9Specific aims
Determine if additional variable, discounting rate, affects the predictability of the TPB among elders.Determine if discounting rates vary between exercising and non-exercising elders.
Slide10Methods
Cross sectional design with 137 community dwelling elders (60 years of age or older) Little to no cognitive impairment based on the Six-item Memory Screener (Score of 4 or greater)Must be able to exercise based on the (EASY) tool
Recruited from 11 churches in rural Arkansas
Church leaders were contacted and permission was obtained to attend older adult bible studies
Initial meeting, informational handouts were given and the study was explainedSecond meeting, potential participants were screened and those eligible completed the remaining questionnairesThe number of Non-exercisers was obtained much quicker, then asking about exercise became part of the screening
68 Exercisers and 69 Non-exercisers
Slide11Instruments
Six-item Memory ScreenerExercise and Screening for You (EASY) toolDemographic formYale Physical Activity Survey (YPAS)Fitness attitude scale
Expectations of others scale
Perceived behavioral control scale
Intention to exercise scaleKirby Delay-discounting Monetary Choice Questionnaire (MCQ)
Slide12Analysis
Specific Aim # 1Determine if discounting rates affect the predictability of the TPB among eldersPath analysis
Specific Aim # 2
Determine if discounting rates vary between exercising and non-exercising elders
t-test (Mann-Whitney), Correlation (Chi square), ANCOVA
Slide13Demographics
Variable
All
Exercisers
Non-exercisers
P value*
Age Years, Mean (SD)
65.26 (4.51)
64.96 (4.22)
65.56 (4.79)
0.431
Gender, n (%)
0.327
Female
83 (60.6%)
44 (64.7%)
39 (56.5%)
Male54 (39.4%)24 (35.3%) 30 (43.5%)
Race, n (%) 0.122 Caucasian73 (54.0 %)
43 (63.2%)31 (44.9%) African American42 (30.7%)16 (23.5%)26 (37.7%)
Hispanic/Asian22 (15.3%)9(13.3%)12 (17.4%) Marital Status, n (%)
0.794 Married102 (74.5%)52 (76.5%)50 (72.5%) Divorced21 (15.3%)
9 (13.2%)12 (17.4%) Widowed/Never Married14 (10.2%)7 (10.3%)7 (10.1%)
Educational Level, n (%) 0.004 1-11 grade15 (10.9%)14 (20.6%)1 (1.5%)
High school graduate56 (40.9%)26 (38.2%)30 (43.5%) 1-3 yrs. college or Tech24 (17.5%)
11 (16.2%)13 (18.8%) College graduate42 (30.7%)17 (25.0%)25 (36.2%)
Household Income, n (%) 0.032 $0.00- $14,99911 (8.0%) 9 (13.2%)
2 (2.9%) $15,000-$24,99937 (27.0%)20 (29.4%)17 (24.6%) $25,000-$34,99915 (10.9%)
4 (5.9%)11 (15.9%) $35,000-$49,99919 (13.9%)12 (17.7%)7 (10.2%)
$50,000-$74,99933 (24.1%)
16 (23.5%)17 (24.6%) $75,000 >22 (16.1%)7 (10.3%)15 (21.8%)
VAI, Mean (SD)20.07 (15.93)33.97 (9.18)6.38 (6.41) <0.001Temporal Discounting, Mean (SD)0.0358 (0.708)0.0127 (0.016)
0.0586 (0.093)<0.001
Slide14Path Models
Model 1
Model 2
A
TTITUDE
(
?
?
)
S
UBJECTIVE
NORM
(
?
?
)
B
EHAVIORAL
C
ONTROL
(
?
?
)
B
EHAVIORAL
I
NTENTION
(
?
?
)
T
EMPORAL
(
?
?
)
D
ISCOUNTIN
g
E
XERCISE
B
EHAVIOR
(
?
?
)
?
?
?
?
?
?
?
?
?
?
Slide15Findings
Dependent
Independent
Adj. R2
Standardized coefficients
t
P
MODEL 1
0.473
Behavioral Intention
Attitude (log)
0.443
6.16
<.001
Behavioral Intention
Subjective Norm
0.147
2.30
0.023
Behavioral Intention
Behavioral Control
0.32
4.56
<.001
MODEL 2
0.275Exercise BehaviorBehavioral Intention
0.5046.30<.001Exercise BehaviorTemporal Discounting
-0.066-0.820.413
Slide16Path coefficients
Slide17findings
Correlations with Temporal Discounting
Exercise
(VAI)
Age
Race
Gender
Marital
Education
Level
Annual Income
Discounting
Rate
r =-0.273
r =0.195
X
2
= 3.802
X
2
= 4.605
X2 = 7.436X2 = 12.209X2 = 19.074p Value 0.0010.0220.118
0.1830.1350.1720.215
Slide18REsults
T-test was used to compare discounting rates between exercisers and non-exerciserst = 4.028, p = 0.000, 95% CI = (0.023, 0.069)Mann-Whitney was used to compare discounting rates between exercisers and non-exercisers
W = 1679, p = 0.004
ANCOVA was used to control for covariates
Mean discounting rates was 3.32 times higher for non-exercisers (95% CI 1.90, 5.93, p < 0.001)
Slide19Limitations
Scales for measurementPurposive samplingGeneralizability
Slide20Implications
Reinforcement of TPB for exercise predictionFocus on overlap of temporal discounting and behavioral intention for future studiesNon-exercising adults that discount at higher rates may require different strategies or rewards for participating in exercise behavior
Future research on discovering rewards that work
Other methods
Slide21REferences
Agency for Healthcare Research and Quality (2009). Factsheets: Aging.
U.S. Department of Health & Human Services.
http://www.ahrq.gov/research/findings/factsheets/aging/index.html
Callahan C., Unverzagt F., Hui, L., Perkins,A. & Hendrie H. (2002). Six-item screener to identify cognitive impairment among potential subjects for clinical research.
Medical Care
. 40(9), 771-81.
Chapman, G.B.
, &
Elstein, A.S.
(1995). Valuing the future: temporal discounting of health and money.
Medical Decision Making, 15(4),
373-386.
de Wit, H., Flory, J., Acheson A., McCloskey, M. & Manuck, S. (2007). IQ and nonplanning impulsivity are independently associated with delay discounting in middle-aged adults.
Personality and Individual Differences
, 42, 111–121.
Glanz, K., Rimer, B.K., & Lewis, F.M. (2002). Health behavior and health education: theory, research, and practice
. San Francisco: Jossey-Bass. Government Printing Office. Retrieved from: http://www.census.gov/2010census/data. Kerner, M.S. & A.H. Grossman. (2001). Scale construction for measuring attitude, beliefs, perception of control, and intention to exercise. Journal of Sports Medicine and Physical Fitness, 41(1), 124-131. Kirby, K.N. (2009). One-year temporal stability of delay-discount rates. Psychonomic Bulletin & Review, 16(3), 457-462. Madden, G.J., & Bickel, W.K. (2010). Impulsivity: the behavioral and neurological science of discounting. Washington, DC: American Psychological Association. National Institute on Aging. (2015).
NIHSeniorHealth. Health Benefits. Retrieved from: http://nihseniohealth.gov/exerciseforolderadults/healthbenefits/01.html.Tate, L. M., Tsai, P. F., Rettiganti, M., Landes, R. D., Lefler, L. L. Bryant, K. (2017). Examining exercise in older adults using the Theory of Planned Behavior and Temporal Discounting. Research in Gerontological Nursing. 10 (6). 252-259.Tate, L. M., Tsai, P., Landes, R. D., Rettiganti, M., & Lefler, L. L. (2015). Temporal discounting rates and their relation to exercise behavior in older adults. Physiology & Behavior, 152(Part A), 295-299. doi:10.1016/j.physbeh.2015.10.003 United States Census Bureau. (2010). 2010 Date release schedules. Washington, DC:
Slide22