Academic journal article Journal of Nursing Measurement

Preliminary Reliability and Validity of an Exercise Benefits and Barriers for Stroke Prevention Scale in an African American Sample

Academic journal article Journal of Nursing Measurement

Preliminary Reliability and Validity of an Exercise Benefits and Barriers for Stroke Prevention Scale in an African American Sample

Article excerpt

Background and Purpose: African Americans are at heightened risk of first stroke, and regular exercise can reduce stroke risk. Benefits and barriers to exercise subscales from 2 instruments were combined to create the Exercise Benefits and Barriers for Stroke Prevention (EBBSP) scale. Methods: Reliability and validity of the EBBSP scale were examined in a nonrandom sample of 66 African Americans who were primarily female, average age 43.3 ± 9.4 years, and high school graduates. Results: Both subscales had adequate internal consistency reliability. Factor analysis revealed two factors for each subscale. More benefits and fewer perceived barriers were significantly related to current exercise and future intentions to exercise. Conclusions: The EBBSP scale may be useful in research focused on understanding, predicting, and promoting exercise for stroke prevention in adults.

Keywords: exercise; benefits; barriers; stroke; prevention; African American

African Americans have nearly twice the risk of first stroke and higher stroke-related morbidity and mortality than Whites (Go et al., 2014). Physical inactivity is a modifiable lifestyle risk factor for stroke that can be improved with regular exercise. People who are moderately to highly active on most days can reduce their risk of stroke by up to 30% (Sacco et al., 2006). African Americans also have a disproportionate number of risk factors for stroke, including hypertension, diabetes, and obesity (Howard et al., 2011; Kleindorfer et al., 2010), and physical activity is an inexpensive and validated lifestyle intervention to control these risk factors. However, achieving recommended levels of physical activity is challenging, and a greater percentage of African Americans than Whites do not exercise regularly (Schiller, Lucas, & Peregoy, 2012). People's health beliefs can influence their decisions to engage in preventative health behaviors. Understanding stroke-related health beliefs for exercise, such as perceived benefits and barriers, may be helpful in developing educational tools and interventions aimed at increasing exercise to reduce stroke. However, valid and reliable measures of stroke-related health beliefs about exercise relevant to African Americans are needed. This article reports the psychometric properties of the Exercise Benefits and Barriers for Stroke Prevention scale in a sample of young to middle-aged African Americans.

BACKGROUND AND CONCEPTUAL FRAMEWORK

Perceived benefits and perceived barriers are original concepts of the health belief model, which attempts to explain and predict preventative health behaviors by focusing on the attitudes and beliefs of individuals (Rosenstock, 1974). Perceived benefits and barriers of any health behavior form the likelihood that individuals will engage in a health-related activity, such as regular exercise. The belief that engaging in regular exercise will be effective in reducing an individual's risk for stroke is considered a perceived benefit. Perceived barriers refer to an individual's belief of the challenges and negative effects of regular exercise, which may deter him or her from participating. The model proposes that individuals who perceive positive outcomes (i.e., benefit) and few obstacles (i.e., barriers) associated with exercise are more likely to participate or have intentions to do so.

Few stroke prevention studies have examined relationships between perceived benefits and barriers to exercise and actual exercise or exercise intentions. Sullivan et al. (Sullivan, White, Young, Chang, Roos, & Scott, 2008; Sullivan, White, Young, & Scott, 2009) found that greater benefits and fewer barriers to exercise were associated with higher future intentions to exercise in older adults. In the first author's (DA) pilot study of 34 young adult African Americans, greater benefits and fewer barriers to exercise were associated with higher exercise participation (Aycock, 2011). However, the Cerebrovascular Attitudes and Beliefs Scale-Revised (Sullivan, White, Young, & Scott, 2010), which was used to measure perceived benefits and barriers in these three studies had some internal consistency reliabilities ,. …

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