FINAL Journal 2010

8/9/2019 FINAL Journal 2010

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April 2010 Volume 45 – Number 1

Arkansas Association For Health,

Physical Education, Recreation andDance



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April 2010 – Arkansas Journal – Volume 45 – Number 1

CCOONN T TEENN T TSS

News and Information Award Qualifications . . . . . . . 3

Message from the President. . . . . . . 4

ArkAHPERD Board of Directors. . . . . . 5

Calendar . . . . . . . . . 5

2009 ArkAHPERD Award Winners. . . . . . 6

2009 ArkAHPERD Coordinator and Scholarship Winners . . 8

2009 ArkAHPERD SuperStars Competition . . . . 9

ArticlesFrom College to Career: Charting a Course

Paul Finnicum and Mitch Mathis . . . . 10Integrated Activities - Math and Physical Education . . . . . 17 Andy Mooneyhan

Enhancing Exercise Behaviors: Application of Self-Efficacy Concept

Shawn Mitchell and Lori W. Turner . . . . . . 19

Aerobic Strength Training as a Weight Control Solution Andy Mooneyhan and Allen Mooneyhan . . . . . . 25

Enhancing the Practice of Osteoprotective Behaviors: . . . 30

Application of the Health Belief ModelMeg Sheppard, Lori Turner and Sharon Hunt

On the Cover: The 2009 Teacher of the Year Award Winners



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HONOR

Candidate must meet the following qualifications:

A. Be at least 30 years of age and have earned a

Master’s degree or its equivalent.B. Have served the profession for at least five years

prior to the nomination.C. Be a current member of ArkAHPERD. Former

members who have retired from professional work may be exempt.

D. Be of high moral character and personal integrity who by their leadership and industry have madeoutstanding and noteworthy contributions to theadvancement of our profession in the state of Arkansas. To indicate leadership or meritorious contributions,

the nominator shall present evidence of the nominee’ssuccessful experiences in any two of the following categories of service:

1. Service to the association.2. Advancement of the profession through

leadership of outstanding programs.3. Advancement of the profession through

presentation, writings, or research.

Any ArkAHPERD member may submit nominationsby sending six (6) copies of the candidate’s qualificationsto Janet Forbess, [email protected].

HIGHER EDUCATOR OF THE YEAR


A. Have served the profession for at least threeyears prior to the nomination.

B. Be a member of ArkAHPERD C. Be of high moral character and personal

integrity who by their leadership and industry have made outstanding and noteworthy contributions to the advancement of teaching ,research, or service in the state of Arkansas.

D. Be employed by an institution of highereducation in the state of Arkansas.

Any ArkAHPERD member may submit nominationsby sending a copy of the candidate’s qualifications toPatrick Wempe, [email protected]

TEACHER OF THE YEAR

Teacher awards are presented in the areas of elementary physical education, middle school physical education,

secondary physical education, dance, and health.


A. Have served the profession for at least threeyears prior to the nomination.

B. Be a member of AAHPERD & ArkAHPERD.C. Be of high moral character and personal integrity

who by their leadership and industry have madeoutstanding and noteworthy contributions to theadvancement of teaching in the state of Arkansas.

D. Be employed by a public school system in thestate of Arkansas.

E. Have a full time teaching contract, and have a

minimum of 60% of their total teaching responsibility in the nominated area.F. Have a minimum of five years teaching

experience in the nominated area.G. Conduct a quality program.

They must submit three letters of recommendation and agree to make completeNASPE application if selected.

Any ArkAHPERD member may submit nominations by contacting Angie Smith-Nix, [email protected].

STUDENT

Scholarships

ArkAHPERD awards four scholarships annually forstudents majoring in HPERD. They include the NewmanMcGee, Past President’s, Jeff Farris Jr., and John Hosinskischolarships. Students must possess a minimum 2.5 GPA.[See your academic advisor for special details.]

Research Award

Research awards of $100, $50, and $25 are awarded toundergraduate and graduate students who are members of ArkAHPERD. Students must submit an abstract and a

complete paper Bennie Prince, [email protected] by October 1, 2005. Papers selected for the research awardsmust be presented by the student in an oral or posterformat at the November convention.

ArkAHPERD Web Site: http://www.arkahperd.org/



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Hope this letter finds all of you happy and most of all healthy!Preparations are beginning for the ArkAHPERD Convention to be held onNovember 4rd and 5th at the Holiday Inn Airport, Little Rock. We hope this will bethe largest convention ever! Please SAVE THE DATE!

In mentioning dates, I would like to share with you the trainings from the ADE,Office of Coordinated School Health that might be of interest to you.

On May 10th the Office of Coordinated School Health will host a

NASPE Pipeline Workshop. This workshop will be limited to 50

participants. The workshop is Assessment Strategies: K-12 Physical

Education. Information is posted on ADE, Office of Coordinated School

Health website. This will provide Physical Education teachers with 7 hours

of professional development.

On June 17th the Office of Coordinated School Health will host a PE Symposium for teachers

and coaches. There will be two tracks, one for elementary and one for high school. This will be at

Bauxite High School and teachers will receive 6 hours of professional development. The cost of the

symposium will be $20 to cover the cost of food and snacks. A registration form and a draft agenda

is on our website. We are limited to 100 participants. Sessions will be hosted by Anthony Lucas of

D1 Sports, Dr. Blair Dean of Arkansas State University and Dr. Timothy Baghurst of Henderson

State University

Also there are 57 schools receiving the CWIP (Child Wellness Intervention Project) Grants. They will

be doing SPARK and FITNESSGRAM trainings July 12-17th.

If you would like more information, please go to the website at www.arkansascsh.org and print off aregistration form for the workshops mentioned and more information.

As my presidency comes to an end, I am continuing to work diligently on the membership drive for ourorganization. I ask that every one of you remain active in recruiting new members, who are in our profession. We have to remain committed to this goal!

In addition we need to remain steadfast in our advocacy of requiring physical activity/education in our schools,colleges and universities.

Please continue your efforts on the membership drive and if you have any questions or comments, do nothesitate to contact me ( [email protected] ).

With regards,Lynn Glover-Stanley,PRESIDENT ArkAHPERD

Message from the President

http://www.arkansascsh.org/



mailto:[email protected]







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ArkAHPERD Board of Directors

Glover-Stanley, Lynn President [email protected], Mitch President-elect [email protected]

Forbess, Janet Program Coordinator [email protected], Andy Executive Director [email protected], Traci JRFH Coordinator [email protected] Beaton, Lindsay HRH Coordinator [email protected], Mitch Journal/Newsletter Editor [email protected], Allen WEB Master [email protected]

Division Vice Presidents / VP-elects

Wilf, Martha Athletics & Sports [email protected] Hilson, Valarie Health-elect [email protected], Pam Recreation [email protected], Jessica Recreation-elect [email protected], Bennie General [email protected]

Stilwell, Laura Dance [email protected] Beaton, Lindsay Dance-elect [email protected], Jennifer Physical Education [email protected]

Section Chairs / Chair-elects

Turley, Ken Exercise Science [email protected], Dennis Athletic Training [email protected], John Athletic Training-elect [email protected], Nathan Elementary Phys Ed [email protected] Gaines, Cathryn Elementary Phys Ed-elect [email protected], Susan Higher Education-elect [email protected], Lance Research [email protected]

Baghurst, Tim Research-elect [email protected], Jessica Secondary Phys Ed [email protected], Paul Secondary Phys Ed-elect [email protected]

Standing Committee Chairs

Andy Mooneyhan Constitution [email protected], Lynn Constitution [email protected], Carrie District Organization [email protected], Shellie Scholarships [email protected]

Wempe, Patrick Higher Educator of the Year [email protected], Janet Honor Award [email protected], Angela Necrology [email protected]

Smith-Nix, Angela Teacher Awards [email protected]

ArkAHPERD 2010 State Convention will be November 4-5

Holiday Inn Airport Convention Center

3201 Bankhead Dr.

Little Rock, AR 72206

Phone: 501-490-1000



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ArkAHPERDHonor AwardDr. Blair Dean

Arkansas State University

ArkAHPERDHigher Educator of the Year

Dr. Jack KernUniversity of Arkansas

Fayetteville

ArkAHPERDSecondary Teacher of the Year

Jody KoonsSouthwest Junior High School

Springdale



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ArkAHPERDMiddle School

Teacher of the YearBill Spence

Hellstern Middle SchoolSpringdale

ArkAHPERDElementary School Teacher of the Year

Josh HicklinElmdale Elementary School

Springdale

ArkAHPERDHealth Educator of the Year

Penny Pabst J.O. Kelly Middle School

Springdale



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ArkAHPERDOutstanding JRFH Coordinator

Laura Phillips

Westwood Primary SchoolGreenwood

$15,442

ArkAHPERDOutstanding HFH Coordinator

Cindra Roberson Arkansas Tech University

Russellville$6,275

ArkAHPERDStudent Scholarship Winners Jeff Farris, Jr. - Julie Rhyne

University of Arkansas -FayettevilleNewman McGee - Jonathan

Sutherland Arkansas Tech University



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First PlaceEdris Whitaker

Chris Thompson Arkansas State University

Second PlaceZach Butler

Keelan NewsomBrett Ivey

Michael Wimberley


Third Place

Tracey Higgins Josh Cagle Javon Hartley




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A Peer Reviewed Article

From College to Career: Charting a CoursePaul Finnicum and Mitch Mathis, ArkansasState University

It may be an obscure reference, but some of youprobably remember the Twisted Sister video “I Wanna Rock” because of the part in the video when the strict teacher gets up close and personal with a student for doodling Twisted Sister pictureson his book and sneers, “What do y ou want to do with your life?” The student respondsemphatically, “I wanna rock!”

It would be nice if everyone knew with certainty what they wanted to do with the rest of their lifeby the time they were ready for college, but inreality, that is not the case. Many people come tocollege with a vague idea about a career. Up to 80percent of entering college students indicate that

they are not certain of their choice of major, evenif they have initially "decided" on one. (RichardStockton College of New Jersey 1997) The endresult is that 50 to 70 percent of undergraduatestudents will change their majors at least onceduring their college careers (Gordon 1994) while20 percent change twice and 10 percent changethree or more times (The Daily Collegian Online2005). Additionally, studies show that most people will change careers about four or five times overthe course of their lives. (Hansen 2010)

It’s impractical to think that this article or any other singular piece of advice will eliminate this

uncertainty, but students could certainly benefitfrom career orientation courses or consulting withtheir counselors and parents as they make thedecision whether to pursue higher education or vocational training. In addition, participating injob-shadowing programs can offer students a morerealistic idea of what careers actually involve.

However, even if they have taken advantage of those opportunities, it seems apparent that somedoubt remains for most people as they pursue acollege degree. Hopefully this article will preparethem a little bit better and remove some of thedoubt.

Start Early at CollegeLet's face it, choosing a college major is a sourceof concern that affects students' personal,academic, and social lives. Making a decision asimportant as choosing a major is one that shouldnot be rushed, but should be made with thebenefit of accurate information and sound advice.Parker Palmer (2000) has suggested that ”Before

you tell your life what you intend to do with it,listen for what it intends to do with you.”

A possible strategy for discovering this would beto begin with a self-assessment of your interests.

Answer the following questions about yourself. Who are you? What types of things excite you? What types of jobs or careers appeal to you? Whatare you good at? What do you like to do? Wheredo you want to be in ten years? What have youdone in your life that is most meaningful to you? When have you felt the most natural, at ease, andconfident? What would you do every day if youcould? What are your strengths? What are your weaknesses? What kind of skills do you have? What were your best subjects in high school? Whatkinds of extracurricular activities did youparticipate in while in high school? What kinds of things did you learn from part-time or summer

jobs?

It would also be beneficial to consider what you value in a job/career. Is it important for you tohave a job that focuses on helping society andhaving a positive impact on others? Are you thekind of person who enjoys group affiliation or would you rather work alone? Are you looking forstability, security, status, money?

These questions are simple, yet complex, butimportant to your decision making process. If youare still not sure, and even if you feel strongly about a direction to take, it is a good idea tocomplete a more specific self-test. College careercenters have a variety of self-tests that can helpanswer some of these questions and many resources are available online. While the results of a self-test or answers to the questions in theprevious paragraph may provide some guidance,ultimately it may be the wisest choice to select amajor in college because you love the subjectmatter, and let the career questions answerthemselves.

However, it is a sound strategy to access the careerservice center early in your college years, even if you have selected a career path These centersoffer a wide array of services, such as, career

inventories, job placement, resume writing, andetiquette dinners. In addition, while investigating your options do not forget to include a number of other valuable resources like your college's coursecatalog, your professors--especially your academicadviser--your classmates, alumni, family andfriends, the internet and books such as:How to Choose a College Major , by Andrews (VGMCareer Horizons).

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Major Decisions: A Guide to College Majors , Blumenthal and Despres (Wintergreen/OrchardHouse).

Nobody said it was easy to select a major. Thereare many resources that can help you with yourcareer exploration, but at some point in time you

will need to make a final reality check and honestly evaluate your options. Whatever you decide, if you have used available resources wisely, you haveinformed yourself enough to make a learneddecision about a career/major.

While Pursuing Your Degree

Although many people believe it takes four yearsto complete undergraduate degree requirements,the U.S. Department of Education's NationalCenter for Education Statistics (NCES) trackedthe progress of first-time students seeking abachelor’s degree or its equivalent and attending afour-year institution full time in the 2000-2001

school year. It found that only 36 percent of students graduate from college within four yearsand only 57.5 percent of undergraduates whobegan that year had attained a degree or certificatesix years later. (College Board 2010)

However many years it takes students to obtain adegree, they will take about 40-50 classes along the way. Most of those will be classes in majorrequirements along with a number of generaleducation courses, and if you are lucky, a few elective courses. Some of these courses you willsimply survive, but in some you will thrive.Regardless of your interest in any specific courses

you would be wise to always keep your eyes on theprize--your own personal development. Takeadvantage of what the course has to offer in the way of developing your skills. College isn't vocational training, it is about getting a well-rounded education that will enable you to competein a global environment. So, even though algebraor English or history or some other subjects may seem boring and inconsequential, each course hasa value added component that is designed tobenefit you in the long run.

Beyond the suggestion to work hard in yourcourses, it is also a good idea to take advantage of

activities outside the classroom. If you need to work part-time, consider a place of employmentrelated to your degree. For instance, if you arepursuing a degree in physical education, a YMCAor a college intramural program will provide youthe opportunity to work with people involved inphysical activity. If you are pursuing a degree inhealth, working or volunteering with a non-profitorganization will be providing valuable experience.

In addition to those activities, consider joining amajor's club or a professional organizationassociated with your major. Both will provide you with opportunities to explore career possibilitiesthrough workshops, conferences and literaturethey produce. Many of the professionalorganizations will offer certifications that may beimportant to your career choice.

The Job Hunt As you prepare to look for a job, there are a few things you need to do. If you have been working with your career services center you should already have a solid resume. You need both a paper copy and an electronic copy of your resume, including alist of references with correct contact information.Since about half of all Americans live within 50miles of their birthplace (Daily Breeze 2007) itstands to reason that many people will be looking within that radius. With that in mind a number of resources can be accessed depending upon your

major.

For starters, newspapers like the ArkansasDemocrat Gazette or your local paper will havejob postings. In addition, organizations like the Arkansas Activities Association, the American Alliance for Health, Physical Education,Recreation and Dance and state coaching associations will have job listings on their websites. The Arkansas Department of Health and the Arkansas Department of Education also serve asjob specific sites that will post opportunities formajors in health and physical education.

Beyond that, message boards will sometimesprovide leads on possible openings and certainly personal contacts with professionals in yourdiscipline are valuable links. Do not forget to talk to your college advisor and other teachers withinyour major as well as utilizing the campus careerservices center.

If you are conducting a nationwide search then it'sprobably best to do most of those online using professional organizations like the NationalStrength and Conditioning Association and North American Society for Sport Management or youcan apply directly through a business's homepageor an online job posting board. Also, employment

websites like Monsterjobs.com andCareerbuilder.com have a large selection of jobs.from multiple sources

As you search for jobs you will also run into a variety of application processes. Someorganizations still use paper, mail, and fax, whilemany others are going paperless. Most sitesrequire an electronic resume/application and may also require that an account be set up with them






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with the addition of an online profile. Some willsimply request that the applicant e-mail a resumeand cover letter. Even though the applicationmethod has changed, many of the rules remain thesame, and whichever process is being used, themost important thing for any job applicant is tofollow the rules to the letter.

That means following the directions diligently andbeing meticulous when checking your work.Provide any optional information that may berequested as well to ensure you are providing everything they need to make a decision. If youcannot make an online system work, contact thehuman resources office. While you may feel likethis will make you look technologically challenged,if you want the job and you have the skills, this justmay speak to your initiative and persistence, whichare other sellable qualities.

Don't forget to follow up with an e-mail or a

phone call just to make sure all your applicationmaterials have been received. This will be anindication of other valuable qualities you possessand bring life to your application materials,because actions indeed speak louder than words.

Finally, a word of caution. Just as many employersare turning to social networks like LinkedIn, Twitter and Facebook for recruiting, they are alsousing those sites to screen candidates. ACareerBuilder.com survey (2009) revealed that45% of prospective employers use socialnetworks-- Facebook more than LinkedIn--and areusing that personal information to reject 35% of the applications they receive.

The potential employers are rejecting theapplications for a variety of reasons, such as:

Provocative or inappropriate photos orinformation

Drinking or drug use

Disparaging comments about previousemployer, colleague or client racistremarks

Falsifying qualifications This blurring of lines between your work andsocial life may seem unfair, but it is a reality. Whileit is appropriate to use a social network to share

aspects of your private life, and you may disagree with an employer's assessment of what isinappropriate, the safest strategy is to deleteeverything, vigorously edit and censor the site orhide your profile from public view.

The Cover LetterGone in 60 seconds. Yes that's the title of a moviebut it's also been revealed that cover letters areread in less than 60 seconds (Dehne 2010). That'sall the time it takes for most hiring managers or

employers to decide if you're worth interviewing. You might think, well okay, as long as I wind up inthe stack of potential candidates that's all thatmatters. That is true to a point, but wouldn't yourather be on top of the stack? So, for yourconsideration, following are some things toconsider as you create your cover letter.

Whether it's a term paper, cover letter or resume,people are always concerned about length. In thecase of the cover letter you ought to be able to say everything there is to say in one page. For themost part you would not go beyond one pageunless you were including information that for onereason or another isn't included in your resume.However, as you will see in the section onresumes, it is wise to tailor the resume to theposition so you can include all necessary information.

Make sure you personalize the letter. In today's

world, it would be highly unusual, for you to notbe able to find the name of the person handling the application process. However, if for somereason you cannot obtain the name of theaddressee, you can consider using To Whom itMay Concern or Dear Sir or Madam.

Since it is highly unlikely that you won't be able toobtain the necessary name, perhaps a more realisticdilemma is being uncertain of the addressee'sgender. Once again, given our current level of technology this information should be a phone callaway, but in the event you can't obtain it, consideraddressing the person by the first initial of theirfirst name, as in, Dear K. Maxfield.

Once you have the salutation out of the way it'stime to highlight your strengths and identify whatmakes you different from all other applicants and why they should consider you for this position. Acover letter is designed to present your goals,credentials and availability to a potential employerin a concise and engaging fashion. This is yourchance to get your proverbial foot in the door anda well-crafted letter is a crucial first step inobtaining employment. Your resume can providedetails, but your cover letter must persuade thereader to consider you among all other applicants.

So, state your intentions and identify yourqualifications right from the get-go. While wehave been taught not to brag, the cover letter andresume is the time to follow the adage attributed tothe great Cardinal pitcher Dizzy Dean, "It ain'tbraggin' if you can do it." However, a word of caution here, given our ability to perform factchecks and background checks, makes sure youdon't embellish your credentials. As Joe Friday on

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http://msn.careerbuilder.com/jobs/keyword/recruiter



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Dragnet used to say, "All we want are the factsma'am."

A clean, error-free presentation, combined withstrong phrasing and solid facts, will encourage thereader to review the attached resume and call youin for an interview. Cover letters should be clear

and to the point. Include the specific job title, twoto three reasons why your experience makes you agood fit and a brief outline of your careerhighlights. Include some relevant skills andaccomplishments from your most recent jobs or inyour most recent classes if they are appropriate tothe job you are applying for, such as:

Developed online course

Created major's club website

Organized fund raiser for Haiti relief thatnetted $5700

Created new database for fitness centerto assist with client management

Beyond that it is standard practice to state thereason for your interest in the company. Do yourhomework and point out company specifics suchas a department or a new project. Be proactive with your closure and make sure you provide yourhome, work, email and/or cell phone numbers andtell them you will follow up by phone or email toprovide any additional information required.

Resume "Dos"Resume templates are easy to obtain and easy touse. Be careful though. It could result insomething akin to two women showing up at aparty with the same dress. It will get attention, butin the wrong way. That doesn't mean going overboard in the other direction with fonts andcolors, but it does mean that you would do well by getting professional help or by using the oftmentioned career services center.

What you will discover is there is no "one-size-fits-all" format for resumes. It depends on what youhave done and what you are trying to do. Sincethis article is mainly focusing on fresh out of college applicants, a skills/functional resume isbest if you have little work experience. However,formats can be combined in whatever fashion thatallows you to be draw attention to youraccomplishments.

In essence you need to let your content reveal thejob you want. A content-driven résumé shouldhighlight assets and experiences you will bring tothe work environment. Keep in mind that yourresume should be marketing piece that outlinesyour skills more than providing a stagnantemployment and academic history. Any professional will tell you to begin at thebeginning with your resume, which means to start

with the basics, like your contact information. It'salso a good idea to include your contactinformation on all pages of your resume. Beyondthat it is necessary to tailor your resume to eachorganization, so while you can begin with atemplate, be ready to modify and update yourresume as needed. Management skills may beneeded for one organization, fund raising might beimportant to another. Along similar lines, takenotice of the language employers use to describethe job and include that language in your résumé. Whatever the case, don't create 150 copies of acookie cutter resume. Instead, individualize yourresume to the job for the best chance at landing aninterview.

As you agonize over formatting issues, it mighthelp you to know that the percentage of onlineapplications viewed by an actual human being ranges from 5 percent to 25 percent (Willis 2009).So, whether it is scanned by a computer or a

human, like the cover letter, the resume is scannedquickly. Since the objective of your resume is toland an interview, and since a lot of companies usesoftware programs to screen candidates, it is agood idea to use the same phrases or keywordsfound in the job description when writing aresume and cover letter to improve the chances of getting over that first obstacle.

And speaking of objectives, It is generally a goodidea to include an objective on your resume. Thedesign of the objective is to make it clear to apotential employer the job for which you areapplying. While it is not required, it may prove

effective as a tool for letting the reader know rightfrom the beginning what you are interested in andmore specifically, which positions match yourinterests.

Since many resumes are submitted online orfiltered through a software program it would alsobe wise to create more than one resume format-- a Word document that can be attached to an emailand a text version that will hold its formatregardless of the platform. Also, if you aresubmitting paper copies, make sure you use a goodprinter.

Additionally, regarding your electronic resume it

would be wise not to use fancy embellishmentslike bullets, borders and italics, because they oftentranslate into messy documents once they arefiltered through an online system. It is moreimportant that the person on the other end is ableto read it as compared to being "pretty". So, keepa copy of a clean, simple résumé for the onlinesystems, and a fancier version with good paper anda watermark for those who desire a paper copy.



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There's an old carpentry adage, measure twice andcut once, that applies to proofreading your resume. While software that performs spell checks andgrammar checks are a good first defense, not only do you need to proof your resume twice afterperforming those checks, but you also need tohave someone else review your work. Select askilled reader to review your resume before yousubmit it, preferably someone with some writing skills.

Résumé Don'tsNow that you have some ideas for what to includeon your resume, let's take a look at some items toleave off your resume beginning with items likeyour picture, height, weight, age, politicalaffiliation, sexual preference, race or religion.None of these belong in the applicant review process.

While you may be attractive, and your "Glamour

shot" has you looking even better, unless theapplication process requires a picture--think modeling--then leave it off. Looks are notsupposed to be part of the review process, and it isillegal for any employer to discriminate againstapplicants for any of the other characteristics. Inthe litigious world we live in someone could file adiscrimination lawsuit if they are not hired, soapplicant reviewers will simply discard the resumeto avoid any potential problems. Don't let yoursbe tossed in that pile.

Speaking of attractive, there may be those whothink a resume is made more attractive by changing fonts or using wildly colored paper.Back in the day, special paper was a recommendedaddition to the resume process, but that does nottranslate to using Razorback red in today's world. Also, multiple fonts and symbols become a readerdistraction rather than an attraction.

Remember that your resume and cover letter arebeing reviewed quickly, so don't add extraneousinformation like your hobbies, unless they havesomething to do with the job for which you areapplying. If you want to show how your passionfor physical fitness would be an asset to a positionby describing a devotion to marathoning, that'sone thing. But telling employers that you love to

paint on an application for a physical educationposition is another. It's probably best to save thatinformation for the interview when you're asked what you like to do outside of work.

Along those same lines, although the employermay be screening you via social networks, youdon't need to give them a look at your personal life via the resume by sharing family websites or blog spots. You also don't want them to make the

wrong assumption about your social life as a resultof your old college email address-- [email protected].

Even though it is one of the Ten Commandments,it has been estimated that up to 40% of all résuméscontain some type of false information (Tomassi

2006). Human resource departments are being much more methodical in the applicant review process, so if you don't have a degree, don't say you do. If you don't have experience in the field,include experience you have had that relate to thejob like volunteer activities. Also, people havebeen hired after they have been fired, so justbecause you've been fired is no reason to lie. Anything you tell an employer can be confirmed,so just tell the truth the whole truth and nothing but the truth.

Even if you have been fired don't allow negativity on your résumé. You can follow a don't ask don't

tell philosophy about sensitive items until you areasked, perhaps during the interview process. Atthat time it would be diplomatic for you to takethe high road and address a firing as philosophicaldifferences rather than stating your boss was anincompetent idiot. The best practice is to keepyour résumé all positive all the time.

Finally, sometimes traditions die hard, but in somecases they need to go. Old school resumesfrequently contained statements like, "Referencesavailable upon request" or "Available forinterview." Make your resume lean and mean.Don't include unnecessary information.

The Interview Part One: What to Wear, WhatNot to WearIt happens all the time--a candidate looks good onpaper--but once the interview begins it becomesapparent that appearances can be deceiving. As weknow from the Bible we are not supposed tojudge, but you will definitely be judged by yourfuture employer. At first glance you will be judgedby how you look. From then on what you say andhow you say it will be scrutinized. Here are a few things for every interviewee to consider as they prepare to interview.

First, being on time really means being there early.

That means planning for every possible barrier tobeing on time, such as traffic, weather, flat tires,and so on. If you get there early you can handlebathroom requirements, get a drink a water, getyour paperwork in order and visit with thereceptionist to ease your nerves.

Next, what not to wear is not just a TV show.Every organization has a culture of its own andclothing is part of the culture. Make sure you havea clear understanding of the necessary attire for the

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http://msn.careerbuilder.com/jobs/keyword/art



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job for which you are applying and dressaccordingly. If you have any doubt about what to wear, dress on the conservative side and wear abusiness suit. It is better to overdress rather thanunderdress.

Some of the following should go without saying

but perhaps they need to be said because they areseen so often in the interview process. For the women, your fingernails should be neat and clean,not too long, nor adorned with any wild polish.Go easy on the makeup and the perfume too. Youare not going out to a nightclub. Your jewelry shouldn't be noisy or loud, and it would be a goodidea to leave any piercings beyond one per ear inthe jewelry box. A handful of rings may draw inappropriate attention as well. As for clothing,the interview is not the time or place for shortskirts, open-toed shoes, or stiletto heels. Finally,purses/handbags should be conservative. Leaveyour I Love Lucy purse at home.

For the men, clean, trimmed fingernails are theorder of the day. If you wear a lot of rings theinterview is the time to leave a couple at home.Consider leaving your worn looking runner's watch at home too. While facial hair is acceptable,it needs to be neat and trimmed. Out-of-date suits with lapels that are too wide or too narrow willdraw the wrong kind of attention and skip theleather jacket unless your auditioning for a band.Don't forget to polish or brush your shoes andiron your clothes. Lastly, if you are bringing abriefcase with you, make sure it hasn't seen betterdays.

Beyond that, if you come early as previously stated,you will have time to go to the bathroom and takecare of last minute adjustments so your appearanceisn't a concern. Then you can begin the interview process confidently.

The Interview Part Two: It's Not Just What You Say, It's How You Say It Just be yourself. How many times have we allheard that one. It's good advice, but we play many roles on any given day, and on the day of yourinterview, your role requires that you put your very best foot forward. The interviewees who willimpress the most are the ones who are animated

and entertaining as they provide information. If you say you are excited about the chance to work for a company but don't show any enthusiasm, youare sending a mixed message. There are a numberof other nonverbal messages to be aware of as youtry to sell yourself to an organization.

It's customary in America to greet someone with ahandshake, but few people are taught how toshake hands, and let's face it, with what we know

about disease transmission, many people alaHowie Mandel, are reluctant to participate in thecustom. Unless you are applying for a health-related position, the interview is probably not agood time to announce your germ phobia.

Anyway, handshakes should always be firm, not

feats of strength. And even though you may benervous, your hand should be dry and warm, notcold and clammy. If you get there early asrecommended, washing your hands in warm water will prepare you for the first round of handshakesand also prevent you from spreading any germs.

As you shake hands and converse with peoplethroughout the day, make sure you consistently make eye contact. That doesn't mean you shouldstare. Try looking at the interviewer's hands asthey finish a question and then return your gaze tothe eyes as you respond. Lastly, on the subject of hands, keep things that you may fidget with out of

your hands, like pens, papers or your hair.Don't forget to consider your posture too. Youdon't have to assume a stiff ramrod posture, but asyou try to relax, realize that sometimes the relaxedposition sometimes turns into a slouch and thatcan send the wrong message, as can the two handsclasped behind your head, the arms crossed overthe chest, your hands covering your mouth and onand on. And oh yeah, don't forget to smile.

Certainly your interview preparation shouldn't stop with your wardrobe or your nonverbalcommunication. Since almost every organization will have some sort of web presence, check them

out online prior to the interview. Hopefully, youare actually reviewing what you know about thembecause you already checked them out as youprepared your cover letter and resume. At the very least you should know something about theorganization's mission, and the products andservices it provides.

Next you need to be prepared for questions about why you left your last job, your strengths and weaknesses, and the good old tell me aboutyourself. Many people worry unnecessarily aboutquestions like, "If you could be a tree, what kind of tree would you be and why?" Those questions

don't happen very often if at all. What you need tobe prepared for is to sell yourself by being able totell what you can do to help the organizationaccomplish their goals.

That's where the time spent at the career servicescenter would pay off because they frequently offermock interviews. If you don't take advantage of that, the next best thing would be to find sometypical questions online and write out your answersin preparation for the live interview. Better yet



16

would be to have a friend or family member ask you the questions and critique your answers as wellas your nonverbal responses.

Post-interview Many job searches are highly competitive, and toparaphrase a sports analogy, it's important to go

until you hear the whistle--in this case the whistleis analogous to the traditional sound at thebeginning and end of the workday.

Often applicants will give special attention toresearching the company and practicing answers tointerview questions in advance. As a result, they make a great first impression and impresspersonnel managers. But all too often they underestimate the value of following up after theirinterviews. If your application and interview impressed them, then you could seal the deal witha few post-interview moves.

It's always a good idea to summarize the interview

process immediately afterwards so you can use thatinformation in your follow-up correspondence. An email immediately after the interview to all of the members of the search committee is a nicetouch. At that point you might also answerunanswered questions from the interview process.Follow that with a handwritten note that includes athank you along with some of your observationsabout the process and the organization This willserve as an example of your professionalism andyour level of interest and demonstrate your ability to follow through. Not many job seekers do this,and it will make you stand out just that muchmore.

ConclusionIn Robert Frost's The Road Not Taken (1915) he wrote: Two roads diverged in a wood, and I--I took the one less traveled by, And that has made all the difference. You may remember from an English literatureclass that this has been interpreted by some as adeclaration of individualism. And whileindividualism has been a frequent refrain frommany parents and teachers, the job seeking processis probably not a good time to apply that principle. A better strategy is to take the paved road so you

have a better chance of arriving safely at yourchosen destination--the beginning of your career.

ReferencesBauer, C. (12-12-2005) Indecision forces many students to change majors. The Daily CollegianOnline. Copyright © 2010 Collegian Inc.

http://www.collegian.psu.edu

Dehne, S. (2-26-2009. 2:03 pm). Stay on Contacts'Radar Screens: 4 Vital Post-Interview Moves.CareerBuilder.com http://www.careerbuilder.com

Dehne, S. Story Filed (1-21-2010 - 3:33 PM) Q&A: Your Cover Letter Questions Answered.CareerBuilder.com http://careerbuilder.com

Frost, R (1916). The Road Not Taken. MountainInterval. New York, H. Holt and company.

Gordon, V. (1994). Issues in advising the undecidedcollege student. National Resource Center for TheFreshman Year Experience. Columbia, SC

Hansen, R. (2-21-2010). Choosing a College Major:How to Chart Your Ideal Pathhttp://www.quintcareers.com/

Palmer, P. (2000). Let Your Life Speak: Listening forthe Voice of Vocation. San Francisco: Jossey-Bass.

Richard Stockton College of New Jersey Center for Academic Advising (6/17/1997).http://loki.stockton.edu/~advising/undcided.html.

The College Board.http://www.collegeboard.com/parents/pay/scholarships-aid/36990.html © 2010 The College Board

The Daily Breeze. (3-6-2007). About half of all Americans live within 50 miles of their birthplace.http://www.encyclopedia.com/

Tomassi, K. ( 05.23.2006 3:00 PM ET). MostCommon Resume Lies.http://www.forbes.com/2006/05/20/resume-lies-

work_cx_kdt_06work_0523lies.html

Willis, G. (5-6-2009. 03:34 PM ET). Consumer TipsEmpowering YOU to be a savvy consumer.http://tips.blogs.cnn.com/2009/05/06/networking-online. CNN © 2010 Cable News Network. TurnerBroadcasting System, Inc. All Rights Reserved

www.careerbuilder.com. (8-19-2009). Forty-fivePercent of Employers Use Social Networking Sites toResearch Job Candidates, CareerBuilder Survey Finds

http://www.careerbuilder.com/



http://www.quintcareers.com/






17


Integrated Activities - Math and PhysicalEducation Andy Mooneyhan, Arkansas State University

A primary objective of a contemporary physical

education program should be to improve a child’smovement skills. Games/movement activities arean often used medium to achieve this objective. Today there has been an increased emphasis onusing games/movement activities to not only improve a child’s movement skills but also toenhance that child’s academic learning.

One academic area that has an obvious connection with physical education is mathematics. Many physical education games/movement activitiesrequire students (a) to do a selected movement anumber of times or (b) to keep a running score.Examples include having children (a) count “1-2-

3-4” while doing selected exercises, (b) sequentially count the number of jumping jacks completed, or(c) record the score following a bean bag targetgame.

Below are four movement activities that have thepotential to meet a specific physical educationobjective, while improving the students’ mathcognition.

Add ’em Up This activity, as the name implies, involves

addition. The objective is for the children to learnaddition while improving selected loco-motorskills. A stack of numbered cards are placed in the

center of the play area. Children, in groups of 4-6,are placed around the perimeter. A targetednumber, such as “25”, is given to the groups by the teacher. On command the first child in eachgroup runs to the center of the play area, picks upa numbered card, and returns to the group. Thenext child in line repeats the activity. Whenhe/she returns, the group adds the two numberedcards together. The activity continues until thetarget number of “25” is reached or surpassed.

The activity can be modified by:Requiring each group to reach an exact number. If a group surpasses the target number, a child must

return a card and select a smaller numbered cardChanging the loco-motor skills used, having children skip, gallop, jump, etc.Using colored cards (red, blue, green, yellow),requiring each group to (a) select only red cards or(b) use all 4 colors to reach their target number.

Count ’em Down This activity involves subtraction. Six hoops

are placed in an open area with students, in groupsof 4-6, placed around the perimeter. Twelve to

fifteen cards, numbered from 1-5, are placed ineach hoop with more lower (1-3) than upper (4-5)numbered cards. Each group is given a targetnumber, such as “25”. On command the firstchild in each group runs to their hoop, picks upone numbered card and upon return the groupsubtracts that number from “25”. The activity continues until the group reaches “0”. Aneffective means to facilitate learning is to place“25” objects, such as bean bags, on the floorbefore each group. When a child returns with anumbered card, that number of bean bags is takenaway. For example, if the first child returns with a“6” card, six bean bags are removed from the“25”, leaving 19 bean bags. This allows thechildren to visualize each remainder.

Multiply ’em This activity involves multiplication for upper

elementary children and is organized like eitheractivity above, except each card contains amultiplication problems, such as “2 x 2 =”, ratherthan numbers. The first child in each group runsto pick up a card. Upon return, the group solvesthe problem and writes the answer on a piece of paper. The activity continues until each child hasretrieved a card. This activity can be modified by having each group:

Collect and correctly answer as many problem cards as possible in a specifiedtime limit

Perform a certain exercise (jumping jacks,

sit ups, etc) as determined by the answerto each problem

Answer complex problems, such as “2 x 3 x 4 =”and “(2 + 2) x 2 =

Divide ‘em and Conquer This activity involves division. The activity

requires a series of stations around the perimeterof the play area, each with a hoop containing cards with division problems on them. Each station hasa specific series of problems. Station one may have “2” series problems (18 ÷ 2, 16 ÷ 2, etc); whereas station two may have “3” series problems(18 ÷ 3, 15 ÷ 3, etc). The children, in groups of 4-

5, are in the center of the play area. Each group isgiven a notepad upon which to record theiranswers. The first child from each group runs tothe designated station, picks up a card, and returns. The group writes the problem, with the answer, ontheir notepad. The action is repeated until eachchild has retrieved a card from the station. Thecards are then returned to the hoop and then eachgroup rotates one station to the right. This activity can be modified by:



18

Changing the loco-motor skill used

Having the groups solve as many divisionproblems as they can within 60 seconds. At which time the signal is given to moveto the next station.

In closing, the physical educator is encouraged tomake sure the mathematical concepts used are age

appropriate. In fact it is advisable to discuss theactivities with the classroom teacher. In addition,it is recommended that these activities not becompetitive in nature. Rather than organize eachas a relay “race”, design the activities so that thereis not a group that wins, but rather the childrenstrive to complete each task correctly.



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Enhancing Exercise Behaviors: Application of Self-Efficacy ConceptShawn Mitchell and Lori W. Turner,University of Alabama

Introduction According to the American College of Sports Medicine (2006) more than 33% of the USpopulation is considered obese. Coupled with asedentary lifestyle, obese individuals are at greaterrisk for stroke, heart disease, diabetes type II, andmyocardial infarction (American College of SportsMedicine, 2007; Center for Disease Control andPrevention, 2007). More than 860,000 deaths eachyear are attributed to cardiovascular disease (e.g.,heart disease, stroke, diabetes type II, myocardialinfarction), with approximately 700,000 deathsresulting from heart disease alone (U.S. SurgeonGeneral Report, 2006; Center for Disease Control

and Prevention; 2007). Annual health care costsassociated with cardiovascular disease exceed morethan 448 billion dollars each year (American Heart Association, 2007). Cardiovascular disease isconsidered the greatest health care cost in the US(American Heart Association, 2007; Center forDisease Control and Prevention, 2007). Moreover,exercise has long been touted to have significanteffects on an individual’s psychological well-being,such as alleviating mild forms of depression andreducing daily stress and anxiety levels (Bixby, &Lochbaum, 2005; Petruzzello, Jones, & Tate, 1997; Yeung 1996).

Current recommendations for exercise state thatindividuals between 18 to 65 years of ageparticipate in moderate exercise intensity, which isdefined as intensity high enough to break a sweatbut able to carry on a conversation, five times a week, or participation in vigorous intensity exercise three times a week for 20 minutes perbout (American Heart Association, 2007; American College of Sports Medicine, 2007. According to the American Heart Association(2007) and the American College of SportsMedicine (2007), strength training is recommendedtwo times per week, with eight to ten strengthexercises for eight to twelve repetitions perexercise. When comparing adherence rates tocurrent recommendations, only 49% of thepopulation meet or exceeds the new recommendations (Haskell, Lee, Pate, Powell,Blair, Franklin, Macera, Heath, Thompson, &Bauman, 2007). Specifically, 51% of men are morelikely to exercise when compared to women at48%, and overall, younger populations (59.6%) aremore likely to meet the current recommendations

when compared to those 65 years of age or older(39%) (Haskell et. al., 2007; American College of Sports Medicine, 2007). Due to a lack of adherence to the current recommendations set forby the American Heart Association (2007) and the American College of Sports Medicine (2007),coupled with a sedentary lifestyle, the USpopulation is faced with a new dilemma of increased obesity rates, as well as increased risk factors for cardiovascular disease (Center forDisease Control and Prevention; 2007; Haskell et.al., 2006)

At present, our society has never had as muchaccess to information regarding the benefits of exercise; yet obesity and sedentary lifestyles are onthe rise among adults and near epidemicproportions among children (Bouchard, Blair, &Haskell, 2007; Center for Disease Control and

Prevention, 2007, Haskell et. al., 2007). As Americans, we have witnessed first hand the rising incidents of cardiovascular disease, often resulting in death (American Heart Association, 2007). Even with increased access to exercise and healthinformation, fewer than half of Americansparticipate in the recommended weekly standardsfor exercise/physical activity set forth by the American College of Sports Medicine (2007) andthe American Heart Association (2007)(Bourchard et. al., 2007; Center for DiseaseControl and Prevention, 2007). While healthprofessionals struggle with the problem of

inactivity among Americans, concepts of self-efficacy offer promising insights. The purpose of this paper is to describe the concepts of self-efficacy and to discuss applications of this theory to enhance exercise behaviors.

Self-EfficacyBuilding upon psychology’s Social Learning Theory (SLT) (Miller & Dollard, 1941; Rotter,1954), Bandura (1986) introduced a new theory incorporating aspects of SLT, as well as constructsnew to the field of psychology. His theory wouldbecome known as Social Cognitive Theory (SCT).SCT approached learning from a new perspective,focusing on the dynamics between a person andtheir environment, each playing a crucial role inlearning new tasks (Bandura, 1986). One of thenew constructs introduced into SCT was that of self-efficacy. Self-efficacy is termed as confidencein one’s ability to take action and overcome barriers (Bandura, 1986). In essence, self-efficacy isits own theory housed within Social Cognitive Theory.



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When defining self-efficacy, Bandura (1977)proposes several key points, all of which directly influence the role of self-efficacy during thelearning and behavior change process. First,Bandura (1986) emphasized the notion that thetheory of self-efficacy is not directly concerned with the abilities or skills that one may possess butinstead with the perceptions and judgments of what one can do with those abilities or skills. Inessence, it focuses on perceptions of ability asopposed to actual ability, and in turn, perceptionshave the potential to dictate levels of self-efficacy (Bandura, 1986; Bandura, 1977). For example, if anindividual lacks the actual ability or talent of excelling in a specific area, but they believe orperceive themselves as having a high amount of ability or skill, then self-efficacy would be high. The reciprocal would also hold true (Bandura,1986; Bandura, 1977). Overall, those with a highersense of self-efficacy take on more difficult tasks,

approach these tasks with more effort, and persistlonger in the face of obstacles and barriers. Therefore, self-efficacy would be viewed as task related, meaning that just because self-efficacy ishigh in regard to a specific task, it does not carry over into other unrelated tasks (Bandura, 1986;Bandura, 1977).

Self-Efficacy Constructs Within self-efficacy, four constructs exist, eachgiving way to increasing one’s perceptionsregarding abilities and skills related to specifictasks. These include 1) performanceaccomplishments also termed mastery experience,

2) vicarious experience, also termed modeling, 3) verbal persuasion, also termed social persuasion,and 4) physiological states, also called somatic andemotional states (Bandura, 1977). Although notspecifically designed for the field of health andexercise, these constructs have the potential toprovide strategies for health behavior changeincluding enhancement of exercise behaviors. Table 1 displays each construct and presentsspecific applications regarding enhancing exercisebehaviors.

Table 1Enhancing Exercise Behaviors Using Self-Efficacy Constructs

Construct* Definition* PotentialChangeStrategies

Within anExerciseSetting

Performance Accomplishments

Source of efficacy that is based on

personal mastery expectations; success raise mastery expectations; repeated failures lower them

Within anexercise setting,continualperformance of exercisemovementsleading torepeatedsuccessfulperformance.

VicariousExperience(Modeling)

Observing others perform threatening activities without experiencing adverse consequences

Modeling correct andappropriateform andtechnique of exercisemodalities.

VerbalPersuasion

Suggestions from others leading to the belief that

people can cope successfully with

an overwhelming situation

During performance,providepositivereinforcement

via verbal

encouragement when exercisemodality is new or unfamiliar.

PhysiologicalStates

Arousal state responses from an overwhelming situation (e.g.,increased heart rate,

perspiration,ventilation).

Agitated arousal states can lead todecrease in

performance.

Recognize thatarousal statesare normal

when a new orunfamiliarexercisemodality isintroduced.

Work ontechniques to

reduce agitatedstates.

*Adapted from : Bandura. A. (1977). Self-efficacy: toward a unifying theory of behavioral change .Psychological Review, 84(2), 191-215.



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The first construct is performance accomplish-ments. Performance accomplishments can bedefined as a source of efficacy that is based onpersonal mastery expectations (Bandura, 1977).For example, a successful performance during aspecific task would result in an increase in mastery expectations; however, repeated failures during aspecific task would be expected to lower them. Inregard to a potential change strategy within anexercise setting, continual performance of exercisemovements leading to repeated successfulperformances would increase mastery expectations via performance accomplishment. It has been viewed that practice makes perfect; however, fromBandura’s perspective, perfect practice makesperfect perception.

Second, vicarious experiences make up anotherconstruct within the theory of self-efficacy. Vicarious experience has also been termed

modeling. Regardless, both are defined asobserving others perform threatening activities without experiencing adverse consequences(Bandura, 1977). Within an exercise or healthsetting, modeling correct form and technique of exercise modalities could serve as a template in which others may learn. It is imperative, however,that the form and technique being modeled isconsidered appropriate and the standard of performance. Otherwise, modeling impropertechnique and form could lead to injury, whichmay be viewed as an unsuccessful attempt during performance accomplishments. As mentioned

above, failures during a specific task would beexpected to lower performance accomplishments,thus lowering self-efficacy.

Next, Bandura (1977) defines the construct of verbal persuasion, which is the concept of suggestions from others leading to the belief that aperson can cope successfully with anoverwhelming situation. Applying the construct toan exercise setting, during performance, others canprovide positive reinforcement vial verbalencouragement when an exercise modality is new or unfamiliar. This type of reinforcement is crucialfor beginners embarking on a new exercise orfitness regimen. More positive reinforcement canenhance self-efficacy by increasing perceptions of ability (Bandura, 1977).

Finally, there is the construct of physiologicalstates. Physiological states are defined as arousalstate responses from an overwhelming situation.Examples would include, but are not limited to,increased ventilation, heart rate, and perspiration(Bandura, 1977). In addition, agitated arousal statescan lead to a decrease in performance. Therefore,

it is vital to recognize and not oppose thesephysiological states. Within an exercise setting, it isimportant to recognize that arousal states arenormal when a new or unfamiliar exercise modality is introduced, and conversely, work on techniquesto control these increased physiological states.Such techniques for reducing agitated physiologicalstates could include deep and controlled breathing,as well as visualizing success of performance.

Overall, these aforementioned constructs may appear independent, when in fact they work inconcert with one another to increase or enhanceperceptions of abilities and skills related to specifictasks. It is perceptions that are of most value whenthe desire is to increase self-efficacy. Without anincrease in perception of ability or skill, self-efficacy cannot be enhanced. Finally, as mentionedearlier, it is equally important to introduce new andchallenging tasks in an effort to increase self-efficacy. Performing tasks that are perceived as

lacking in challenge may not be helpful in paving the path to increased self-efficacy.

Studies Conducted Employing Theory of Self-Efficacy As mentioned earlier, self-efficacy has proven a viable theory in its application toward healthbehaviors and health behavior change, and inregard to exercise modalities, self-efficacy has beenused in numerous studies to examine exercisebehaviors (Bozoian, Rejeski, & McAuley, 1994;McAuley & Courneya, 1992; Mihalko, McAuley, &Bane, 1996; Treasure & Newberry, 1998). Overall,the consensus has been that an increase in self-

efficacy is typically accompanied by an increase inaffect. In 1992, McAuley & Courneya examinedrelationships of self-efficacy with affectiveresponses. Affect was measured during exercise, with a total of 88 participants, all of which hadrecently completed some type of exercise protocol. The exercise protocol was a graded exercise test at70% of heart rate reserve. All participants wererequired to participate in the exercise protocol.Experimental groups were assigned toexperimental groups based levels of self-efficacy and two groups, which were a high self-efficacy group and a low self-efficacy group.

Results suggested that those with higher measuresof self-efficacy reported a greater sense of affectduring exercise and less fatigue post-exercise bout,resulting in a more elevated mood during thegraded exercise test (McAuley & Courneya, 1992). When compared to the lower self-efficacy group,those with higher self-efficacy did not view theexercise protocol as difficult, which may beinterpreted as those with higher self-efficacy aremore likely to take on greater challenges and



22

respond with higher levels of affect (McAuley &Courney, 1992).

As opposed to dividing the experimental groupbased on self-efficacy, Treasure & Newbery (1998)assigned their participants to either a non-exercising control group, a moderate exercise

intensity group exercising at 45-50% of heart ratereserve, or a high intensity exercise groupexercising at 70-75% of heart rate reserve. Exercisetook place on a cycle ergometer. Overall, only themoderate intensity exercise group was shown toexperience elevated mood and feeling states during and post-exercise bout; however, the moderateintensity exercise group did not increase self-efficacy from pre-exercise to post-exercise.Conversely, the high intensity exercise group didnot show increases in mood or feeling states, butthey did show higher levels of self-efficacy post-exercise, supporting Bandura’s (1977) belief thatchallenging tasks will increase self-efficacy

(Treasure & Newberry, 1998).

In a similar manner, Mihalko et. al. (1996)randomly assigned participants to either a walking or biking exercise protocol for a total of 20 weeks. After completion of the program, participants were then required to complete a graded exercisetest. For the study, a total of 94 participantscompleted the exercise protocols, with 47 malesand 47 females making up the sum total of thesample size. In addition, all participants hadrecently participated in some type of exerciseregimen. Mihalko et. al. (1996) found that maleparticipants, when compared to female

participants, reported a greater amount of self-efficacy prior to and following the graded exercisetest. Furthermore, a statistically significant increasein positive well-being was shown among femaleparticipants but not in males. Both groups didshow in increase in self-efficacy for biking or walking, indicating that self-efficacy increased as aresult of participation in the 20 week protocol(Mihalko et. al., 1996). Results from the study indicate that when designing exercise protocols,intensity of exercise may need to be manipulatedbased on gender. For example, females may need abit lower exercise intensity to increase self-efficacy (Brooks et. al., 2002). Similarly, males may need alower level of exercise intensity to increase feeling states and mood resulting from exercise.

Focht, Knapp, Gavin, Raedeke & Hickner (2007)brought a unique approach to their study in that allparticipants had been previously sedentary. Bothexperimental groups experienced a reduction inself-efficacy as a result of the exercise protocol. Inaddition, both groups experienced a significantreduction in mood and feeling states during and

post-exercise (Focht et. al., 2007). Results from thestudy suggest that as health educators, whendealing with a previously sedentary population, itmay be more appropriate to start new exercisers ata low level of intensity. Once exercisers haveadjusted and grown accustomed to the level of intensity, gradual increases can be made.

Next, in a study examining exercise intensity andthe effects of self-efficacy in anxiety reductionduring exercise, Katula, Blissmer, & McAuley (1999) recruited a total of 80 older adults. Themean age of the participants was 67 years of age.Results showed a non-significant inverserelationship between anxiety and self-efficacy inthe light-intensity group, with a decrease in anxiety and an increase in self-efficacy post-exercise.Overall, the moderate intensity group displayed anincrease in self-efficacy and a decrease in anxiety during the bout of moderate intensity exercise.

Results from the high intensity group were theexact reciprocal those of the light intensity exercisegroup, showing a decrease in self-efficacy and anincrease in anxiety during exercise.

Following the exercise bout, the high intensity exercise group reported lower anxiety scores,suggesting that high intensity exercise, may indeed,have the capability of lowering anxiety levels(Katula et. al., 1999). This finding is in stark contrast to other research findings, which havesuggested high intensity exercise only increasesanxiety (Mihalko et. al., 1996).

Lastly, a study by Jones et al. (2005), started with

participants who had low levels of fitness and well-being and engaged them in a fitness program. Self-efficacy was not correlated with the amount of exercise undertaken. However, when compared todropouts, self-efficacy was shown to be higheramong participants who finished the program(Jones et al., 2005).

Strategies for Health Professionals Referring back to Bandura (1986 & 1977), tasksneed to be challenging enough to increase self-efficacy, but not so challenging that psychological well-being and affective mood suffer as a result. There appears to be a fine line the health educator

must walk when desiring to increase self-efficacy atthe sake of increasing psychological well-being oraffect. It is up to the health educator to deem whatis most important, and the decision to do so mustbe based on the needs of the populations with whom we work. In addition, the researchdemonstrates different results when the theory of self-efficacy was used to examine feeling moodstates, affect, or psychological well-being.



23

Again, health professionals need to be aware of these differences when looking to enhance affector psychological well-being. For example, anexercise protocol shown to increase self-efficacy and affect may not be the appropriate protocol when the desire is to increase psychological well-being. Therefore, it is imperative that healthprofessionals remain abreast of findings not only from more recent research, but also remainknowledgeable regarding findings from paststudies. It is from an established knowledge basethat our current body of literature and scientificstudies are most often based. Past studies, whenused correctly, provide a foundation for futuredirections in the research, and by making ourselvesaware of all pertinent research and its findings, a vast array of tools can be developed to implementa lasting healthy behavior change.

Next, we need to be aware and knowledgeable of the target population. For example, if we are

working with a sedentary population, our approachto exercise program design would differ from thatof program designed for participants currently exercising on a regular basis. Again, being familiar with the literature can serve as a guide or template when designing exercise programs that have thegreatest chance for increasing physiological andpsychological quality of life. In the same manner, if we are working with a group younger in age, thedesign of the exercise program would differ fromthat of a program created for those older in age.By being aware of findings from sound, empirical,scientific literature, we are on the right path to

ensuring the greatest amount of success for thehealth and exercise programs we design and create.

Finally, it is important for health professionals tobe knowledgeable regarding various exercisemodalities and psychological well-being.Otherwise, it is difficult to interpret findings fromspecified studies. Just because an author claimstheir findings as statistically significant, there couldhave been confounding factors influencing theresults, so caution, no matter what the statisticalanalysis(ses) reveals, should always beimplemented when making any type of interpretations and generalization regarding

scientific findings. While no study is perfect, ourknowledge regarding the types of exercisemeasurements, exercise protocols, andpsychological measurements will ensure we aretaking the best part of any study and applying it tothose with whom we work.

References

American College of Sports Medicine. (2006). Physical Activity and Public Health Guidelines . RetrievedNovember 1, 2008, from

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American Heart Association (2007). Facts and Statistics: updated physical activity guidelines release today . Retrieved November 1, 2008, from

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American Heart Association (2008). Cardiovascular Disease Cost , Retrieved from

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Bandura, A. (1986). Social Foundations of Thoughtand Action: A social cognitive theory. Englewood Cliffs,

NJ: Prentice-Hall.

Bandura. A. (1977). Self-efficacy: toward a unifying theory of behavioral change . Psychological Review, 84(2), 191-215.

Bozoian, S., Rejeski, W, & McAuley, E. (1994). Self-efficacy influences feeling states associated

with acute exercise. Journal of Sport & Exercise Ps ychology, 16, 326-333.

Bouchard, C., Blair, S., & Haskell, W. (2007). Physical Activity and Health . Human Kinetics, Champaign, IL.

Bixby, W., & Lochbaum, M. (2005). Affectresponses to acute bouts of aerobic exercise in fit andunfit participants: an examination of opponent-process theory . Journal of Sport Behavior . 29(2), 111-125.

Brooks, G., Fahey, T., White, T., & Baldwin, K.(2000). Exercise Physiology: Human Bioenergetics and Its

Applications (3 rd ) ed . Mayfield Publishing, Mountain View, CA.

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www.cdc.gov/heartdisease.

Focht, B., Knapp, D., Gavin, T., Raedeke, T., &Hickner, R. (2007). Affective and self-efficacy responses to acute aerobic exercise in sedentary olderand younger adults. Journal of Aging and Physical

Activity , 15, 123-138.

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Jones, F., Harris, P., Waller, H., & Coggins, A.(2005). Adherence to an exercise prescriptionscheme: The role of expectations, self-efficacy, stageof change and psychological well being. British Journal of Health Psychology . 10, 359-378.

Katula, J., Blissmer, B., & McAuley, E. (1999).Exercise intensity and self-efficacy effects on anxiety reduction in healthy, older adults. Journal of Behavioral

Medicine , 22(3), 233-247.

McAuley, E. & Courneya, K. (1992). Self-efficacy relationships with affective and exertion responses toexercise. Journal of Applied Social Psychology , 22(4), 312-326.

Mihalko, S., McAuley, E., & Bane, S. (1996). Self-efficacy and affective responses to acute exercise inmiddle-aged adults. Journal of Social Behavior and Personality , 11(2), 375-385.

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Aerobic Strength Training as a Weight ControlSolution Andy Mooneyhan, Arkansas State University - Jonesboro and Allen Mooneyhan, Arkansas StateUniversity - Newport

Abstract This study was undertaken in an attempt todetermine the effect aerobic strength training hason body weight, body composition, andcardiorespiratory endurance. The populationsample consisted of an aerobic strength training course offered over several semesters at an Arkansas two-year university. There were 87participants in a study measuring body weight,body composition, and aerobic capacity. Thefindings of this study indicated that aerobicstrength training had no significant effect on thebody fat of participants while there was a

significant effect on body composition. A reasonfor this finding is that as lean body mass increases,body fat decreases causing the total weight of theindividual to remain unchanged. The findings alsoindicated that there was an increase incardiorespiratory endurance as a result of aerobicstrength training. Therefore, while aerobicstrength training had no significant effect on body weight, it seemed to have a significant effect onboth body composition and cardiorespiratory endurance.

IntroductionOur society seems to be constantly seeking new

ways to help its members deal with weight controlproblems. Over the past few decades Americans,specifically, have begun to have more difficulties with weight control. According to Mood et al.(2003) Americans are now carrying more fat thantheir ancestors. Among the reasons for this trendinclude advances in modern technology. Thesesadvances have almost completely eliminated thenecessity for physical exertion throughout daily life(Hoeger & Hoeger, 2002). For example, society now provides elevators, escalators, and othertechnological equipment that allows the individualto complete tasks with little or no effort.

The most prevelant form of malnutrition indeveloped countries are overweight and obseity (Payne & Hahn, 2002). The fact that moreaffluent nations may have a food supply thatexceeds the needs of the population explains why those who live in more developed nations aremore likely to become overweight. The sameauthors suggest that obesity puts the body at risk for many diseases including colon cancer, breastcancer, hypertension, heart disease, and diabetes.

This evidence suggests that Americans canimprove both their longevity and their quality of life by focusing attention on their weight andobesity.

Many materials are available to the individual thatfocus on weight control and weight loss,specifically. These materials typically centeraround diet and exercise. One's diet plays a crucialrole in the control of weight. Additionally, one'slevel of exercise as well as the type of exercise play a sufficient role in the control of weight. Aerobictraining is probably the most recommended typeof exercise for those attempting to lose weight. This is because aerobic activities burn a significantamount of calories and are preformed at anintensity that allows the individual to continue theactivity for an extended period of time. Anothertype of exercise that has been suggested for

controlling one's weight is strength training.Strength training promotes weight control by helping to increase muscle mass. This additionalmuscle mass uses more energy causing theindividual's metabolism to actually increase. Thisincrease in metabolism allows the individual toburn many more calories throughout the day than would be burnt without the additional musclemass. When combining aerobic training withstrength training, one can achieve cardiorespiratory benefits while developing additional muscle mass. According to Washington et al. (2001), aerobicconditioning should be coupled with resistance

training if general health benefits are theindividual’s goal. By focusing on aerobic training and strength training simultaneously, one may bebetter able to control body weight and enhancetotal body health.

Controlling one's weight does not necessarily meanlowering one's weight. The weight scale only tellsus how much gravity pulls on our body rather than what that body is made up of. For example, thereare height and weight charts individuals can look to for information regarding the degree to whichthey are overweight. However, these height and weight charts do not differentiate between fat andnon-fat components of the human body. Therefore, while they may indicate a degree of overweight compared to a given standard, they donot necessarily indicate a degree of health for theindividual. Those who are focusing on weightcontrol first need an understanding of thedifferences between being overweight and being obese. In order to understand these terms, apractical definition of obesity should be addressed. Whereas being overweight can mean different



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things to different people, being obese requires adegree of body fat beyond a specific standard. According to Floyd et al. (1998), to be consideredobese, at least 30% of the individual’s weight mustconsist of fat. Therefore, just because one hasexcessive body weight doesn’t mean that individualhas excessive body fat.

A greater measure of one’s weight control withregard to health is one’s body composition. Body composition is referred to as the measure of thefat and non-fat components of the human body (Seaman et al. 1999). Generally, what theindividual is concerned about is the percent of body weight that consists of body fat. If thepercentage of fat is over a specified value, thatperson is considered obese and must deal withincreased risks for several chronic diseases. Onereason individuals have typically relied upon the weight scale to judge their health is because of thedifficulty in acquiring an accurate body

composition value. Traditionally, one would haveto visit a health club, hospital, or research facility in order to get an accurate body compositionscore. Although body composition assessmentremains more difficult than simply weighing oneself on a scale, body composition testing hasbecome more available and easier to complete overthe past several years. While expensive means of measuring body composition remain in existence,there are now methods which are not as expensiveand are more available to individuals throughhealth centers and colleges (Hoeger & Hoeger,2002). Furthermore, it is likely that there will soon

be devices which can be made available to thegeneral public that will allow individuals to assesstheir own body fat.

Given that body composition is, quite likely, of greater importance than body weight with regardto one's health, individuals may be overly concerned about their weight. Often individualsstrive to maintain a certain weight with little or nothought of what that weight is made up of. Weight is rarely a sufficient indicator of overallhealth for the individual and may be misleading interms of the health benefits of an exerciseprogram. For example, one may contribute effortto a weight-training program with the result being that the individual gains weight. However, if the weight gained is muscle weight, that individual ismost likely healthier rather than when he or shebegan the weight-training program. Thisindividual has controlled his or her weight in apositive, healthy way rather than simply losing weight with no regard to whether the lost weight islean tissue or fat tissue. According to Hoeger &Hoeger (2002), weight loss resulting from diet

alone decreases lean body mass whereas weightloss resulting from diet coupled with exercisedecreases body fat. Therefore, maintaining proper weight control involves controlling one's body composition with regard to the percentage of body fat. If individuals can periodically access theirbody fat they may have a more accuraterepresentation of their level of physical health.

This study will attempt to determine the impact anaerobic strength-training program will have onbody weight of individuals participating in thestudy and the body composition of thoseindividuals. Additionally, cardiorespiratory endurance will be assessed to determine if aerobictraining can be combined with strength training not only to provide a healthy means for controlling weight but to allow the individual to develop his orher cardiorespiratory endurance.

Circuit training may be the answer to individuals

seeking a workout program that will benefit thecardiorespiratory system while allowing them tocontrol their body weight in a meaningful way. Various studies have shown that cardiorespiratory endurance can be enhanced with high-intenseresistance training (Washington et al. 2000). If individuals can improve both the cardiac musclethrough aerobic training and the musculoskeletalsystem through weight training simultaneously,they will be able to enhance their total health to agreater degree. According to Pryor & Kraines(2002), circuit training combines aerobic training to build cardiorespiratory endurance with weighttraining to develop muscle strength and endurance.

Circuit training is a system of utilizing strengthtraining in a way that also enhances thecardiorespiratory system. When one participates ina circuit, a series of exercise stations are completedcombining aerobic exercise with strength training exercises (Prentice, 1996). The same authorindicates that circuit training can benefit strengthand flexibility as well as the cardiorespiratory system. Therefore, this study was undertaken inan attempt to determine what effect aerobicstrength training has on body weight, body composition, and cardiorespiratory endurance. Alogical framework of what is to be investigatedfollows. There was a pre-test for each of thesecomponents as well as a post-test which occurredfollowing the training.Logical Framework

Population and Sample



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The sample population consisted of two-yearcollege students enrolled in an Aerobics I coursebetween the fall of 1998 and the spring of 2002. Approximately fifteen students enrolled in eachcourse, one offered in the spring and one offeredin the fall of each year. As several students did notcomplete the regiment each semester and did notcomplete the post-test exams, the sample used inthis study consisted of the students whocompleted the regiment as well as the pre-test andpost-test assessments each semester.

Instrumentation This study utilized an instrument in whichassessments were made concerning the level of fitness subjects posses regarding several fitnesscomponents. These components consisted of body composition and aerobic capacity. Additionally, body weight was obtained in order tocompare differences in body composition and

body weight of individuals. The instrument wasused to score students on each fitness componentboth before the treatment and after the treatment.

Upon completion of the pre-tests, students beganparticipation in a thirteen week aerobic strengthtraining program. This program consisted of fifteen stations which were part of a circuit. Eachstation involved individual student participation inthat activity for 30 seconds with fifteen secondsbeing allocated for the student to get to the nextstation. The exercises that made up the fifteenstations are (1) Seated Pec Dec, (2) Seated Leg

Press, (3) Lateral Pull-Down, (4) Jump Rope, (5)Seated Abdominal Crunch, (6) Seated Chest Press,(7) Seated Row, (8) Seated Bicep Curl, (9) SeatedLeg Extension, (10) Seated Triceps Extension, (11)Seated Leg Curl, (12) Seated Shoulder Press, (13)Seated Back Extension, (14) Dip Bar, and (15)Bicycle

Students complete a circuit by completing each of the fifteen stations. A single circuit is undertakenat the beginning of the semester. After two weeks,students advance to a double circuit which they participate in for two weeks. Finally, after two weeks of double circuits, students progress to

three circuits where they remain until the end of the semester. A week before the semester ends,students participate in a post-test regime. Thisseries of assessments is identical to the pre-testundertaken prior to the training.

A pre-test and post-test exam regiment was usedas the instrument to gather information for eachstudent enrolled. This exam regiment consistedof measuring values for body weight, body

composition, and cardiorespiratory endurance.Body weight was determined by weighing studentson a scale upon beginning the semester and uponending the training. Body composition wasestimated using the skinfold caliper test to obtainbody composition scores. Cardiorespiratory endurance was measured using a step test toevaluate students’ aerobic capacity. The dataobtained from this sample was then analyzeddetermining the extent to which they contributedto the objectives of the study and the degree to which they answered the research questions.Research Objectives/Questions

The objectives/questions of this study are asfollows.

Does aerobic strength training have asignificant effect on body weight?

Does aerobic strength training have a

significant effect on body composition?Does aerobic strength training have asignificant effect on cardiorespiratory endurance?

Results The descriptive statistics for body weight, body composition, and aerobic capacity for the pre-testare as follows (see Table 1). For body weight therange was 195, with a mean of 153; the minimumof 93 and the maximum of 288. Therefore, theaverage score on the body weight pre-test was 153.For body composition the range was 34.5, with amean of 22.6; the minimum of 7.3 and the

maximum of 41.8. Therefore, the average scoreon the body composition pre-test was 22.6. Foraerobic capacity the range was 92.0, with a meanof 39.4; the minimum of 4.0 and the maximum of 96.0. Therefore, the average score on the aerobiccapacity pre-test was 39.4.

The descriptive statistics for body weight, body composition, and aerobic capacity for the post-testare as follows (see Table 2). For body weight therange was 190 with a mean of 153; the minimumof 95 and the maximum of 285. Therefore, theaverage score on the body weight post-test was153. For body composition the range was 32.1

with the mean of 17.8; the minimum of 3.5 andthe maximum of 35.7. Therefore, the averagescore on the body composition post-test was 17.8. For aerobic capacity the range is 97 with the meanof 58.6; the minimum of 19 and the maximum of 116. Therefore, the average score on the aerobiccapacity post-test was 58.6.

The average body weight for participants in thestudy differed between the pre-test and the post-test by less than one pound. The mean for the



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pre-test was 153.14 whereas the mean for the post-test was 153.16 (see Table 3). Therefore,according to this study, there was no significantdifference in body weight as a result of aerobicstrength training. This correlation of .997 (see Table 4) was almost a perfect correlation,indicating that as pre-test body weight for thegroup increased, post-test body weight for thegroup increased. This supports the premise thataerobic strength training has no significantstatistical effect on body weight.

There was a significant difference in the pre-testand post-test scores of participants for body composition. The mean score for body composition in the pre-test was 22.6 whereas themean score for body composition in the post-test was 17.8 (see Table 5) indicating a mean differenceof 4.7. This finding was significant at asignificance level of .000. A very high correlationof .946 (Table 6) indicates that as individual

participant’s pre-test scores increased, theindividual participant’s post-scores increased. Thisshows that body composition scores actually improved as a result of aerobic strength training aslower body composition scores represent betterscores on that measure.

The means for the pre-test and post-test foraerobic capacity were substantially different. Thepre-test mean for aerobic capacity was 39.4 whereas the post-test mean was 58.6 resulting in amean difference of 19.2 (see Table 7). This meandifference indicated a significant difference in pre-test and post-test scores with improved scores

occurring in the post-test. This yields evidencethat aerobic strength training may have a positiveeffect on one’s aerobic capacity and was significantat a level of .000 with a correlation of .860 (Table8). This correlation indicates that as participants’pre-test scores increased, their post-test scoresincreased.

Summary The findings of this study resulted from aninvestigation of students of an aerobic strengthtraining course offered over several semesters at an Arkansas two-year university. There were 87participants in a study which measured several

variables including body weight, body composition, and aerobic capacity. The findingsof this study indicated that aerobic strengthtraining had no significant effect on the body fat

of participants while there was a significant effecton body composition. This may be due to theprobability that as muscle strength increases, one’spercentage of body fat decreases. Therefore, aslean body mass increased, body fat decreased inthe participants causing the total weight of theindividual to remain virtually unchanged while thepercentage of body fat actually decreased. Finally,the findings in this investigation indicate that there was an increase in the participants’ scores on theaerobic capacity assessment. This lends evidenceof the positive effect aerobic strength training hadon the cardiorespiratory endurance of participants. Therefore, while aerobic strength training had nosignificant effect on body weight, it seemed tohave a significant effect on both body compositionand cardiorespiratory endurance.

References

Floyd, P. , Mimms, S. , & Yelding-Howard, C.(1998). Personal Health Perspectives & Lifestyles . 2nd Ed. Englwood, CO: Morton Publishing Company.

Hoeger, W. & Hoeger, S. (2002). Principles and Labs for Physical Fitness. 3rd Ed. Stamford, CT: Thompson Learning, Inc.

Mood, D. , Musker, F., & Rink, J. (2003). Sports and Recreational Activities . 13th Ed. New York, NY:McGraw-Hill.

Payne, W. & Hahn, D. (2002). Understanding Your Health . 7th Ed. New York, NY: McGraw-Hill.

Prentice, W. (1996). Get Fit Stay Fit . St. Louis, MO:Mosby-Year Book, Inc.

Pryor, E. & Kraines, M. (2002). Keep Moving! Fitness Through Aerobics and Step. 4th Ed. Mountain View, CA: Mayfield Publishing Company.

Seaman, J., Corbin, C., & Pangrazi, B. (1999).Physical Activity and Fitness for Persons withDisabilities. President’s Council on Physical Fitness and Sports , Washington, DC .

Washington, R., Bernhardt, J., & Johnoson, M.(2001). Strength training by children andadolescents. Pediatrics . 107. 1470-1472.

Washington, R., Hagerman, F., Walsh, S., Staron,R.& Hikida, R.(2000). Effects of high-intensity

resistance training on untrained older men.Strength, Cardiovascular, and MetabolicResponses. The Journals of Gerontology . 55A. B336-B346.



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Table 1Descriptive statistics Pre-tests:

N Minimum Maximum Mean Std. Deviation WT_PRE 87 93.00 288.00 153.1494 39.0067BC_PRE 87 7.32 41.77 22.5592 7.7904

AC_PRE 87 4.00 96.00 39.4253 23.4172

Valid N (listwise) 87

Pre-tests (cont.):N Skewness Kurtosis

Statistic Statistic Std. Error Statistic Std. Error WT_PRE 87 1.438 .258 2.642 .511BC_PRE 87 .060 .258 -.383 .511

AC_PRE 87 .459 .258 -1.002 .511 Valid N (listwise) 87

Table 2Descriptive statistics

Post-tests:N Minimum Maximum Mean Std. Deviation

WT_POST 87 95.00 285.00 153.1609 38.4278BC_POST 87 3.52 35.66 17.8491 7.1922

AC_POST 87 19.00 116.00 58.5862 25.0537 Valid N (listwise) 87

Post-tests (cont.):N Skewness Kurtosis

Statistic Statistic Std. Error Statistic Std. Error WT_POST 87 1.466 .258 2.692 .511BC_POST 87 .132 .258 -.621 .511

AC_POST 87 .364 .258 -.986 .511 Valid N (listwise) 87

Table 3Paired Samples Statistics

Mean N Std. Déviation Std. ErrorMean

Pair 1 WT_PRE 153.1494 87 39.0067 4.1820 WT_POST 153.1609 87 38.4278 4.1199

Table 4Paired Samples Correlations

N Correlation Sig.Pair 1 WT_PRE &

WT_POST87 .997 .000

Table 5Paired Samples Statistics

Mean N Std. Deviation Std. Error MeanPair 1 BC_PRE 22.5592 87 7.7904 .8352

BC_POST 17.8491 87 7.1922 .7711

Table 6Paired Samples Correlations

N Correlation Sig.

Pair 1 BC_PRE &BC_POST

87 .946 .000



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Enhancing the Practice of OsteoprotectiveBehaviors: Application of the Health Belief Model

Meg Sheppard, Lori Turner and Sharon Hunt,University of Arkansas - Fayetteville

AbstractOsteoporosis is a debilitating disease that affectsover 44 million Americans. One in every two women and one in eight men (50 years old orolder) will suffer an osteoporotic fracturesometime during their lifetimes. These staggering statistics barely scrape the surface of the need in America for effective osteoporosis preventionprograms based in health education theory. Thisliterature review addresses the disease of

osteoporosis, provides an epidemiological review of osteoporosis, discusses the financial burden,and outlines preventive behaviors. The paper alsodiscusses attempts to address the issue of osteoporosis and focuses on the Health Belief Model and its potential to enhance effectiveness of osteoporosis prevention programs.

IntroductionOsteoporosis, which literally means “porousbones,” is a debilitating disease that affects over 44million Americans (National OsteoporosisFoundation [NOF], 2002). The majority of thosesuffering from osteoporosis are post-menopausal,

light-skinned (Caucasian and Asian) females (El-Hajjfuleihan, Baddoura, Awada, Okais, Rizk, &McClung, 2002). One in every two women andone in eight men (50 years old or older) will sufferan osteoporotic fracture sometime in their life(McBean, Forgac, & Finn, 1994). These staggering statistics barely scrape the surface of the need in America for osteoporosis prevention programsbased in health education theory.

This literature review addresses the disease of osteoporosis, provides an epidemiological review of osteoporosis, discusses the financial burden,and outlines preventive behaviors. The paper alsodiscusses attempts to address the issue of osteoporosis and focuses on the Health Belief Model and its potential to design and implement effectiveosteoporosis prevention programs.

The Disease The National Osteoporosis Foundation (NOF,2006) has defined characteristics of osteoporosisto include low bone mass and structuraldeterioration of bone tissue, bone fragility, and

increased susceptibility to fractures. The NOF’sdefinition has limitations as it does not quantify low bone mass. The World Health Organization(WHO, 1998) has defined osteoporosis using T-scores, which is a number of standard deviations(SD) below peak bone mineral density normsdetermined by postmenopausal Caucasian women’s DEXA measurements (El-Hajj Fuleihanet al., 2002). The WHO (1994) categories of bonemass are defined as normal (t-score ±1 SD),osteopenia (t-score between -1 and -2.5 SD),osteoporosis (t-score of -2.5 or more SD), andsevere osteoporosis (t-score of -2.5 or more SDand fractures).

Osteoporosis is a silent disease because it makesthe bones fragile, porous, and brittle without any symptoms (NOF 2006). Often, the first knowledgethat an individual has the disease is when his or

her (usually her) vertebrae collapse (NOF, 2006).Collapsed vertebrae not only cause severe pain, butalso loss of height, and possible spinal deformitiessuch as kyphosis, a curvature of the spine due to vertebral compression (NOF, 2006). Painfollowing an osteoporotic fracture usually lastsbetween four to six weeks during the healing process; however some spinal injuries may produce long term pain because of changes in themechanics of the back (Pocock, 2007).

Since the disease is silent, it is important to assessrisk factors prior to the presentation of negativeside effects from the disease. Some non-modifiable

risk factors associated with osteoporosis includegender (being female), genetics, family history of disease, ethnicity (Caucasian and Asian women),body build (small), age (65 years and older), certainmedications, and other diseases (Bachrach, 2001;NOF, 2006). In addition, some modifiable risk factors for osteoporosis include smoking,excessive alcohol use, excessive proteinconsumption, inadequate daily calcium and vitaminD intake, and insufficient weight-bearing exercise.

The best way to combat osteoporosis is throughprevention. According to the National Institute of Health Consensus Development Panel (2001),

bone strength is a combination of bone density and quality. It is well documented in the literaturethat greater bone mass warrants greater protectionagainst osteoporosis (Bachrach, 2001; El-Hajjfuleihan et al., 2002; Jamal, Ridout, Chase,Fielding, Rubin & Hawker, 1999; McBean, Forgac,& Finn, 1994). However, there is some debateover the age by which peak bone mass occurs (Lin,Lyle, Weaver, McCabe, McCabe, Johnston, & Teegarden, 2003). The age range for peak bone



31

mass is between 20 to 35 years based on the bonesite (wrist, spine, femoral neck) being measured(Lin et al., 2003; McBean et al., 1994).Osteoporosis can occur anytime during a woman’slife even though postmenopausal women are at agreater risk due to reduced levels of osteoprotective estrogen. Therefore, preventionprograms targeting female adolescents, collegestudents, and young adults who have not yetreached peak bone mass is crucial to reducing osteoporosis rates later in life (Kasper, Peterson, Allegrante, Galsworthy, & Gutin, 1994; Klohn &Rogers, 1991).

Epidemiological Review The actual prevalence of osteoporosis is unknowndue to the silent nature of the disease. However,prevalence data compiled by the NOF on bothmales and females in the United States depicts thenational problem. In 2002, 43.6 million Americans(aged 50 years and older) had either osteoporosis

or low bone mass. The NOF projects by 2020,roughly 61.4 million Americans will suffer fromthese diseases. Table 1 below shows the prevalencefigures of osteoporosis and low bone mass inpeople 50 years and older (NOF, 2002).

The annual incidence of osteoporotic fractures(1,456,000) is more frequent than stroke (373,000),heart attack (345,000), or breast cancer (269,730)in women (NOF, 2007). Fractures are the leading cause of morbidity in osteoporotic individuals(Turner, Hunt, Kendrick, & Eddy, 1999) withmore than 2 million fractures in 2005 (Burge,Dawson-Hughes, Solomon, Wong, King, &

Tosteson, 2007). By 2025, Burge et al. (2007)project a 50% rise in osteoporosis-related fracturesfrom 2005. Burge et al. (2007) also reported theincidence of fractures (by skeletal sites) to include vertebral (27%), wrist (19%), hip (14%), pelvic(7%), and other (33%). These statistics suggest thatthis is not just a prevalent disease, but it is severe.

Negative Outcomes Around 50% of all women (50 years old or older) will suffer an osteoporotic fracture sometime intheir lifetimes (McBean et al., 1994). Osteoporoticfractures may result in significant disability (Pocock, 2007). While death may not result from

most fractures; one study found that roughly 20%of individuals who suffer a hip fracture will die within one year (McBean et al.,1994). Riggs andMelton (1995) found a ten to twenty percentmortality rate six months following a hip fracture.Death following a hip fracture is a real risk.

Even if an individual does not die after a hipfracture, his or her risk of disability is increased.Fifty percent of previously ambulatory individualsare never able to walk unassisted again after a hip

fracture (McBean et al., 1994). There are also non-fatal complications associated with osteoporoticfractures; 25% of individuals require long-termassisted healthcare after a serious fracture andmost individuals experience severe physical pain inactivities of daily living after any type of osteoporosis-related fracture (Turner et al., 1999).

Some suffering may not cause severe pain, butrather unsightly physical changes such as kyphosis.Kyphosis is the forward curvature of the spinecaused by compression fractures to the vertebrae.Kyphosis is not necessarily painful, but can causeheight reduction that affects activities of daily living.

Quality of life encompasses both the physical andemotional wellbeing of an individual. Individuals who are post-hip fractures are often more withdrawn from social situations due to physicallimitations and emotional suffering. An individual

who has experienced a fracture may avoid socialinteraction and become more anxious aboutsimilar situations (McBean et al., 1994; Turner,Hunt, DiBrezzo, & Jones, 2004). As previously mentioned, many individuals who experience hipfractures either need assistance to walk or long-term assisted healthcare. This dependency oftenleads to depression because the individual is nolonger independent and must rely on another totake care of basic needs such as feeding, dressing,and using the toilet (Turner et al., 2004).

The toll of osteoporosis does not end withphysical and emotional suffering; there are also

severe financial burdens placed on the nation’ssocial system. Projected annual costs for 2025 is$25.3 billion (Burge et al., 2007) and over $50billion in 2040 (Ray, Chan, Thamer, & Melton,1997). Osteoporotic fractures alone range in costfrom $12.2 - $17.9 billion annually in directmedical expenses (roughly $18.0 billion in 2002)and costs are rising (NOF, 2006; Tosteson &Hammond, 2002). Fractures overload thehealthcare system with more than 492,000hospitalizations, 4,290,000 hospital days, 83,000nursing home stays (averaging one year per stay),and roughly 2.5 million physician visits (Burge etal., 2007; Ray et al.,1997; Riggs & Melton, 1995). These numbers do not account for billions of dollars wasted on days lost at work and reducedproductivity due to physical and emotional painand suffering (Tosteson & Hammond, 2002).

Preventive Behaviors A wide variety of risk factors exist forosteoporosis. The modifiable risk factors if adapted appropriately can become preventivetechniques such as limiting alcohol and caffeine.



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The NOF (2006) has delineated five suggestedsteps to optimal bone health. These steps includeeating a balanced diet with calcium and vitamin D,participating in weight-bearing exercise, nosmoking or excessive use of alcohol, talking to ahealthcare professional about family history andpotential risks, and receiving bone density assessments when necessary.

Two modifiable behaviors that yield notablechanges in bone density and thus the reduction of osteoporosis are calcium consumption and weight-bearing activity. Specker (1996) conducted a meta-analysis of exercise intervention in young adultsand found that increased activity only promotedgains in females who consumed a minimum of 1000 mg/day of calcium.

According to the National Academy of Science,individual calcium needs range from 500 - 1300mg (2 - 4 servings) per day based on age (National

Dairy Council, 2004). The National Academy of Science encourages 1 - 3 year olds to consume 500mg of calcium a day, 9 - 18 year olds to consume1300 mg/day; 19 - 50 year olds to consumeroughly 1000 mg/day; and 51 years and oldershould consume roughly 1200 mg/day (NationalDairy Council, 2004).

Calcium is a vital nutrient that contributes to bonemineral accrual during adolescence and young adulthood and it aids in bone loss prevention afterpeak bone mass occurs (Bachrach, 2001). Thesignificant influence calcium consumption has onbone mineral density is well established in theliterature (Bachrach, 2001).

The next step to optimal bone health is weightbearing and resistance exercise (NOF, 2006). Likethe muscles, bones must be overloaded in order togain strength. Children, adolescents, and young adults who participate in intense childhood weight-bearing activity have significantly greater bonedensity than do less active individuals (Bachrach,2001). Increases in bone density are specific to the weight bearing activity, making varied weight-bearing exercise ideal. For example, an elite tennisplayer, who started playing in childhood, will havehigher bone mineral density in his or her dominantarm compared to the non-dominant arm. In

addition, accrual of bone mineral density is greaterbefore and during puberty rather than inadulthood (Bachrach, 2001).

Osteoporosis Prevention Goals and Objectives The two overarching osteoporosis preventiongoals addressed by Healthy People 2010 (HP 2010)include increasing quality of years of healthy lifeand eliminating health disparities. There are twenty eight focus areas, each of which contains specific

objectives. Focus area number two addresses“Arthritis, Osteoporosis, and Chronic Back Conditions” (U.S. Department of Health andHuman Services, 2005). There are two objectives(2-9 and 2-10) specifically addressing osteoporosis,and three objectives that indirectly addressosteoporosis (15-28, 19-11, and 22.1 – 22.15).

HP2010 objective 2-9 attempts to “Reduce theproportion of adults with osteoporosis” from abaseline of ten percent (between 1994 and 1998)to eight percent. HP2010 objective 2-10 attemptsto “Reduce the proportion of adults who arehospitalized for vertebral fractures associated withosteoporosis” from the baseline of 17.5 per 10,000(in 1998) to 14.0 per 10,000 adults in 2010. OtherHP 2010 objectives relate to reducing hip fractures(15-28), increasing calcium intake (19-11), andincreasing physical activity (22.1 – 22.15). Thetarget audience for the osteoporosis objectives isCaucasian women due to this group of having the

highest incidence of osteoporosis (U.S.Department of Health and Human Services, 2004;2005).

HP2010 is one of many attempts to reduceosteoporosis through setting national goals andobjectives. There have been statewide and nationalattempts to address, reduce, and preventosteoporosis. According to the National Councilof State Legislatures (2007), 36 states have enactedosteoporosis-related laws that have establishedstatewide education, prevention, and publicawareness programs. In addition, legislatures infifteen states have mandated that health insurance

companies cover osteoporosis diagnostic andtreatment services (NCSL, 2007).

The Surgeon General’s Report on Bone Health(2004)outlines national resources, initiatives, andcampaigns that address osteoporosis related issues.National Institute of Health (NIH) founded aNational Resource Center for osteoporosis andrelated bone diseases. This resource centerprovides information and resources on bonediseases to health professionals, patients, and thegeneral public. The National Bone HealthCampaign is a nation-wide campaign utilizing websites to promote bone healthy behaviors. This

campaign targets teenage girls and their parents with a fun, age-appropriate “high-tech”intervention addressing calcium consumption andappropriate weight-bearing exercise. Anothernational campaign, Steps to a Healthier USInitiative, attempts to increase the general healthof Americans through the promotion of personalresponsibility in addressing public policy. Steps toa Healthier US Initiative encourages participants toaddress bone health issues through public policy.



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Lastly, “VERB. It’s what you do” is a nationalcampaign encouraging teenagers to participate inphysically active lives thus promoting healthy bones. These resources, campaigns, and initiativescan be beneficial; however, it is important to havea theoretical basis and an evaluation component todetermine the efficacy of the effort.

Other attempts include theoretical efforts toaddress osteoporosis preventive behaviors.Researchers have used the Theory of Reasoned Action (TRA) to predict milk consumption(Tussing & Champman-Novakofski, 2005);combined the Psychosocial Models with othermodels (such as HBM) to successfully target women in an osteoporosis prevention program(Schmiege, Aiken, Sander, Gerend, 2007).Researchers have used other theories such as theHealth Promotion Model (Ali, 1996) and Self-Efficacy (Sedlak, Doheny, & Jones, 1998) as afoundation for osteoporosis-related prevention

programs.

Health Belief ModelHealth educators utilize the Health Belief Model (HBM) as a framework to create osteoporosisprevention interventions. The HBM is one of theearliest health education models created by Hochbaum and Rosenstock in the 1950s. TheHBM is a value-expectancy theory, whichpostulates that behavior is a function of anindividual’s perceived value of an outcome and theexpectation that the behavior will result in thedesired outcome. The HBM suggests that anindividual will make a behavior change if he or she

perceives the risk of developing a disease is highand the disease has serious consequences, believesthe suggested plan of action will be useful inreducing the threat of the disease, and perceivesthe benefits outweigh the barriers of making thebehavior change.

Measurement Techniques Various approaches in the literature describe themeasurements of HBM constructs. The Osteoporosis Health Belief Scale measures individual perceptions(perceived severity and susceptibility; Chang,Chen, Chen, & Chung, 2003; Sedlak et al., 1998;Sedlak, Doheny and Jones, 2000; Tussing &

Chapman-Novakosfski, 2005; Wallace, 2002).Modifying Factors (such as perceived threat, cuesto action, self-efficacy, and knowledge, etc.) can bemeasured by Facts on Osteoporosis Quiz (FOQ; Wallace, 2002), Osteoporosis Knowledge Test(OKT; Sedlak et al., 1998; 2000), and OsteoporosisSelf-Efficacy Scale (Sedlak et al., 1998; 2000; Wallace, 2002). Likelihood of Action (such asperceived barriers and benefits and likelihood of change) can be measured through the use of the

Osteoporosis Preventing Behaviors Survey (OPBS;Sedlak et al., 2000), and Exercise and CalciumBenefits/Barriers Scale (Ali, 1996). Lastly, anindividual’s health beha viors can be measuredthrough the use of self-reported weight-bearing exercise, and calcium consumption reports(Tussing & Chapman-Novakosfski, 2005; Wallace,2002).

Perceived SusceptibilityPerceived susceptibility is an individual’s opinionof how at risk he or she is at getting osteoporosis.Perceived susceptibility is different than actualsusceptibility because perceived susceptibility is anindividual’s perception of how at risk he or she israther than his or her actual risk. According to acouple of studies and national data, few womenmeet recommended levels of osteoprotectivebehaviors of calcium consumption (roughly 1200mg/day) and weight bearing exercise (≥90minutes/week). One study had only 15% of the

sample of women meeting both calcium andexercise recommendations (Wallace, 2002) andanother study found only 7% of the sample metthe recommendations (Kasper et al., 1994).

The aforementioned data suggest that there is anactual susceptibility to osteoporosis based onbehaviors. However, when a sample of college-aged women was asked how concerned they wereof developing osteoporosis, the mean score of thesample was “somewhat concerned” (mean of 2.9in a 5-point likert scale). Most of these college women believed osteoporosis would not developin them and they were more concerned about

developing heart disease and breast cancer thanosteoporosis (Kasper et al., 1994). It is interesting to note that the incidence of osteoporotic fracturesis drastically higher than stroke, heart attack, andbreast cancer in women (NOF, 2007).

In another study, Sedlak et al., (2000) collected andassessed data from an osteoporosis preventionprogram and found that the women felt they needed to change their behaviors to reducesusceptibility to osteoporosis. Several responsesfrom participants suggested a need for more weight-bearing activity (“to walk more”).Participants were also able to identify risk factors

associated with osteoporosis. One participantcommented that she found out her grandmotherhad osteoporosis and that made her realize she wasmore susceptible to the disease (Sedlak et al.,2000).

Perceived susceptibility is a significant predictor inosteoprotective behaviors (Wallace, 2002) andaccording to the general HBM predictors of change; perceived susceptibility is one of the most



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powerful predictors (Janz & Becker, 1984).Schmiege et al. (2007) found that

perceived susceptibility relates to calcium intake inolder adult women; however, this was not true forcollege-aged women.

Various strategies can be used by educators topromote a healthy understanding of perceivedsusceptibility. Turner, Hunt, DiBrezzo, & Jones(2004) used a powerful visual aid consisting of apicture of healthy and unhealthy bones to addresssusceptibility in an osteoporosis preventionprogram. The picture of the healthy bonebelonged to a 75-year-old woman and the pictureof the unhealthy bone belonged to a 45-year-old woman. This visual aid reinforced thatosteoporosis does not only occur in older women,but it can occur earlier if women do not adoptpreventive behaviors.

Another useful educational aid is prevalence andincidence rates of osteoporosis, as well as,knowledge and assessment of risk factors (Turneret al., 2004; Tussing & Chapman-Novakofski,2005). A simple wrist circumference, heightmeasurement (Tussing & Chapman-Novakofski,2005), family health history assessment, or a moreextensive bone mineral density screening (Jamal etal., 1999; Jones & Scott, 1999; Turner et al., 2004)can be utilized to increase awareness of possiblesusceptibility to osteoporosis. An individual cannotbe concerned about a disease if he or she is notaware of its existence; however, awareness doesnot equate to concern (Anderson, Auld & Schiltz,

1996).Perceived Severity An individual’s assessment of how serious adisease is describes the HBM construct of perceived severity. Perceived severity incombination with perceived susceptibility willcreate the perceived threat of the disease. Kasperet al. (1994) found that the majority of college-aged women felt that the seriousness of osteoporosis was “very strong;” however, thesesame women ranked osteoporosis fifth in severity preceded by heart disease, breast cancer, AIDS,and Alzheimer’s (only the common cold was

perceived as less severe than osteoporosis). Thissame sample of women felt as responsible fordeveloping osteoporosis as they did forcontracting the common cold (Kasper et al., 1994).

Perceived severity can be augmented throughincreasing knowledge and beliefs of theconsequences and dangers of osteoporosis.Consequences can include bone fractures, reducedquality of life, disability, and disfigurement

(Hazavehei, Taghdisi, & Saidi, 2007; Klohn &Rogers, 1991; McBean et al., 1994). Klohn andRogers (1991) described osteoporosis asdisfiguring and having highly visible negativeeffects (e.g. severe kyphosis), which increasedperceived severity and strengthened participantintentions to participate in preventive behaviors.Based on these findings, educators shouldemphasize the immediate onset and any visibleeffects of osteoporosis (Klohn & Rogers, 1991).

Tussing and Chapman-Novakofski (2005) createdan innovative and fun approach to raise perceivedseverity of osteoporosis based on the idea of thefragility of bones with a game called “Bone Jenga.” This interactive game provided participants anopportunity to see the fragility of an unsoundstructure (the board game Jenga). This sameosteoporosis prevention program also utilized roleplaying (health care provider/client) to increaseperceived severity (Tussing & Chapman-

Novakofski, 2005). It may be beneficial foreducators to use fun, interactive programming strategies while dealing with such a heavy disease.

Perceived Threat An individual’s perception of how likely he or he isto get a disease and how serious it will be is theindividual’s perceived threat. This HBM constructcombines perceived susceptibility and severity;therefore, the literature does not always contain adescription or an emphasis on the perceived threatconstruct.

Hazavehei et al. (2007) used a 42-year old femae volunteer to participate in group discussion abouther two osteoporotic fractures and her unhealthy lifestyle behaviors that led to these fractures. This“teachable moment” was then followed-up witheducational materials addressing appropriatelifestyle behaviors such as calcium consumptionand weight-bearing exercise. According to thestatistical analyses of this study (Hazavehei et al.,2007); the group that participated in thisintervention had more lasting changes in allmeasured constructs.

Klohn and Rogers (1991) found that describing osteoporosis as a threat likely to occur in the nearfuture had a stronger influence on behavioral

intention than describing osteoporosis as a distantthreat. These researchers also found that likelihoodto prevent osteoporosis remained high regardlessof time of onset of disease (near- or distant-future)if participants believed the effects would be highly visible. The rate of onset of osteoporosis (gradualor sudden) did not appear to influence behavioralintentions (Klohn & Rogers, 1991).



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The findings from the literature suggest thateducators should provide a vicarious learning experience that integrates an individual’s perceivedsusceptibility and severity into one lesson. Theeducator should also focus on the highly visibleeffects of osteoporosis and that it may occur in thenear future, in order to increase intentions tochange behavior.

Cues to ActionCues to Action remind or cause an individual toparticipate in a specific action. In the case of osteoporosis prevention, a cue to action wouldprovide a reminder to an individual to consumecalcium or participate in weight-bearing exercise(or both).

Cues to action can be as simple as educationalmaterials, reminders (Turner et al., 2004), advicefrom family and friends, teacher’s encouragementof students to participate in preventive behaviors,

group discussion, workshops on osteoporosis(Hazavehei et al., 2007), and increased awarenessof susceptibility (Sedlak et al., 2000). Mediacampaigns using celebrities to remind individualsto drink milk to promote strong bones have thepotential to be successful (e.g. “Got Milk?”campaign; McBean et al., 1994; Schmiege et al.,2007).

Personal or vicarious experiences, such as a recentosteoporosis diagnosed or poor results from abone mineral density (BMD) assessment, can causean individual to take preventive action.

A BMD screening can be an effective cue to

action. An initial cue to action may have resultedin the BMD assessment; however a BMD test may stimulate an individual to action especially if theresults are not good. Two separate BMD feedback programs (which combined BMD screening andosteoporosis prevention education) produced self-reported increases in calcium consumption (Jamalet al., 1999) and influences on weight-bearing exercise for at least one year post-intervention(Jones & Scott, 1999). Another study found thatindividuals who had low BMD, but receivededucational materials had more changes inbehavior and knowledge (Jamal et al., 1999; Jones& Scott, 1999).

Other forms of cues to action include discussing the dangers of osteoporosis, graphic images of thespine, and photographs of a severely disfigured woman (Turner et al., 2004). Even though thesecan be ways to increase perceived severity orperceived threat, these visual images can alsoremind and motivate women to participate inpreventive health behaviors.

Self-Efficacy

Self-efficacy is a combination of an individual’sconfidence and ability to complete a specific task or skill. In terms of osteoporosis prevention,exercise self-efficacy addresses an individual’s skillsand confidence to effectively participate inappropriate weight-bearing exercise and calciumself-efficacy addresses an individual’s skills andconfidence to adequately consume calcium.Calcium self-efficacy is specific to the behavior of consuming roughly 1200 mg/day of calcium andexercise self-efficacy is specific to participating in weight-bearing exercise for at least 90 minutes a week (Wallace, 2002). Adequate knowledge mustfirst be present before participants can learnappropriate skills. Positive relationships existbetween self-efficacy and the total minutes of exercise and calcium consumption (Jamal et al.,1999; Schmiege et al., 2007; Wallace, 2002). Wallace (2002) found that exercise self-efficacy was a stronger predictor of behavior change

(calcium consumption and weight-bearing exercise) than calcium self-efficacy.

Due to the nature of self-efficacy, educatorsshould focus on skill-building strategies(Hazavehei et al., 2007; Kasper et al., 1994; Sedlak et al., 1998; Turner et al., 2004) relating to calciumconsumption including providing educationalinformation to aid participants in identifying calcium rich foods, read food labels, appropriately determine portion serving sizes of calcium, andidentify and taste non-dairy sources of calcium(Tussing & Chapman-Novakofski, 2005). Skill-building activities related to weight-bearing

exercise can be as simple as leading exercise classes(Turner et al., 2004) or practicing specificbalancing exercises (Tussing & Chapman-Novakofski, 2005). An individual must feelconfident and able to participate in the prescribedbehaviors in order for action to occur.

Perceived BenefitsPerceived benefits are an individual’s opinion on what he or she will gain from a specific behavior. As applied to osteoporosis prevention, perceivedbenefits are an individual’s perception of what isgained from weight-bearing exercise and calciumconsumption. The actual benefits of a behavior arenot always analogous to the perceived benefits.

Ali (1996) utilized a modified CalciumBenefits/Barriers Scale and an ExerciseBenefits/Barriers Scale to assess college women’sperceived benefits and barriers to exercise andcalcium consumption. Upon examination of theresults, Ali found several statistically significantrelationships between benefits of calcium, exercise,total calcium consumption, and total minutes of exercise. There were weak direct relationships



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between benefits to calcium and total calciumintake (r=0.36), benefits to exercise and totalminutes of exercise (r=0.18), and benefits toexercise and total calcium intake (r=0.22). Thereare other studies that support these positiverelationships between perceived benefits of calcium consumption and exercise; and reportedcalcium intake and participation of weight-bearing exercise (Schmiege et al., 2007; Wallace, 2002). Although there are positive relationships betweenbenefits and action, perceived benefits are not astrong indicator of behavior (Ali, 1996).

Some examples of perceived benefits to educatorscould discuss include improved muscle strength,increased self-esteem and sense of wellbeing, theprevention of back pain and obesity through theuse of weight-bearing exercise (Hazavehei et al.,2007). It is important to assess, address, andmaximize perceived benefits so participants areable to gain motivation or remain motivated as

barriers become more pronounced (Ali, 1996; Wallace, 2002).

Perceived BarriersPerceived barriers are an individual’s opinion on what it will cost him or her to participate in aspecific behavior or what is preventing him or herfrom participating in the behavior. Perceivedbarriers as applied to osteoporosis preventioninclude what is preventing an individual fromparticipating in weight-bearing exercise orconsuming adequate amounts of calcium.Perceived barriers are significant predictors of calcium consumption and weight-bearing exercise

(Schmiege et al., 2007). Ali (1996) found several statistically significantinverse relationships between barriers to calciumand exercise; and calcium consumption and totalminutes of exercise. There was a moderate inverserelationship between barriers to calcium and totalcalcium consumption (r=-0.55); and weak inverserelationships between barriers to calcium and totalminutes of exercise (r=-0.22), barriers to exerciseand total minutes of exercise (r=-0.23), andbarriers to exercise and total calcium consumption(r=-0.21). Other studies support these findings of inverse relationships between exercise and calcium

consumption and perceived barriers (Schmiege etal. 2007).

There are common barriers to osteoporosisprevention, one barrier is the misconception thatosteoporosis is not severe (Turner et al., 2004).Other common barriers preventing women fromparticipating in prevention programs include a lack of childcare or time and the expense orconvenience of the program. Barriers toconsuming calcium include palatability, high

calorie content of food, inconvenience, anddigestive complications such as lactose intolerance(Tussing & Chapman-Novakofski, 2005). Barriersto engaging in regular physical activity include alack of social support, the difficulty associated withstarting a new habit, and intrusion of currentlifestyle (Tussing & Chapman-Novaskofski, 2005).

Significant Predictors of ChangeMany researchers have utilized the HBM topromote positive belief and behavior changes inparticipants. After reviewing the literature andidentifying significant predictors based on variousstudies, the most significant predictors in changing behavior include: self-efficacy (Jamal et al., 1999;Hazavehei et al., 2007; Schmiege et al., 2007; Wallace, 2002), perceived barriers (Hazavehei etal., 2007; Schmiege et al., 2007; Wallace, 2002), andperceived susceptibility (Hazavehei et al., 2007; Jamal et al., 1999; Wallace, 2002). It is important tonote that Wallace (2002) stated that exercise self-

efficacy and barriers to exercise were morepredictive than calcium related constructs.Hazavehei et al. (2007) stated that all of the HBMconstructs were equally important and essential topromoting osteoprotective behaviors.

Health professionals have opportunities to educateadolescent females and young women on theimportance of calcium consumption and weight-bearing exercise in order to increase peak bonemass. Health educators should create healthpromotion efforts founded on a theoreticalframework in order to provide the mostefficacious program possible. Table 1 provides a

summary of strategies useful to an educator who istrying to create an osteoporosis preventionprogram based on the Health Belief Model .

There are common barriers to osteoporosisprevention, one barrier is the misconception thatosteoporosis is not severe (Turner et al., 2004).Other common barriers preventing women fromparticipating in prevention programs include a lack of childcare or time and the expense orconvenience of the program. Barriers toconsuming calcium include palatability, highcalorie content of food, inconvenience, anddigestive complications such as lactose intolerance

(Tussing & Chapman-Novakofski, 2005). Barriersto engaging in regular physical activity include alack of social support, the difficulty associated withstarting a new habit, and intrusion of currentlifestyle (Tussing & Chapman-Novaskofski, 2005).

Significant Predictors of ChangeMany researchers have utilized the HBM topromote positive belief and behavior changes inparticipants. After reviewing the literature andidentifying significant predictors based on various



37

studies, the most significant predictors in changing behavior include: self-efficacy (Jamal et al., 1999;Hazavehei et al., 2007; Schmiege et al., 2007; Wallace, 2002), perceived barriers (Hazavehei etal., 2007; Schmiege et al., 2007; Wallace, 2002), andperceived susceptibility (Hazavehei et al., 2007; Jamal et al., 1999; Wallace, 2002). It is important tonote that Wallace (2002) stated that exercise self-efficacy and barriers to exercise were morepredictive than calcium related constructs.Hazavehei et al. (2007) stated that all of the HBMconstructs were equally important and essential topromoting osteoprotective behaviors.

Health professionals have opportunities to educateadolescent females and young women on theimportance of calcium consumption and weight-bearing exercise in order to increase peak bonemass. Health educators should create healthpromotion efforts founded on a theoreticalframework in order to provide the most

efficacious program possible. Table 1 provides asummary of strategies useful to an educator who istrying to create an osteoporosis preventionprogram based on the Health Belief Model .

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Ali, N. (1996). Predictors of osteoporosis preventionamong college women. American Journal of Health Behavior, 20, 379-388.

Chang, S., Chen, C., Chen, P. & Chung, U. (2003).Predictors of community women’s osteoporosisprevention intention - A pilot study. Journal of Nursing Research, 11(4), 231 - 239.

El-Hajj Fuleihan, G., Baddoura, R., Awada, H.,Okais, J., Rizk, P., & McClung, M. (2002). Practiceguidelines on the use of bone mineral density measurements. Who to test? What measures to use?

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Glanz, K., Rimer, B., Lewis, F. (Eds). (2002). Healthbehavior and health education: Theory, research, andpractice (3rd ed.). San Francisco: Jossey-Bass.

Hazavehei, S., Taghdisi, M., & Saidi, M. (2007). Application of the health belief model forosteoporosis prevention among middle school girlstudents, Garmsar, Iran. Education for Health, 20(1),Retrieved November 25, 2007, from

www.educationforhealth.net.

Jamal, S., Ridout, R., Chase, C., Fielding, L., Rubin,L., & Hawker, G. (1999). Bone mineral density testing and osteoporosis education improve lifestylebehaviors in premenopausal women: A prospectivestudy. Journal of Bone and Mineral Research, 14(12),2143-2149.

Janz, N. & Becker, M. (1984). The health belief model: A decade later. Health Education Quarterly, 11,1-47.

Jones, G. & Scott, F. (1999). Low bone mass inpremenopausal parous women. Journal of Clinical Densitometry, 2 (2), 109-115.

Kasper, M., Peterson, M., Allegrante, J., Galsworthy, T., & Gutin, B. (1994). Knowledge, beliefs, andbehaviors among college women concerning theprevention of osteoporosis. Archives of Family Medicine,3(8), 696-702.

Klohn, L.& Rogers, R. (1991). Dimensions of theseverity of a health threat: The persuasive effects of

visibility, time of onset, and rate of onset on young women’s intentions to prevent osteoporosis. Health Psychology, 10 (5), 323-329.

Lin, Y., Lyle, R., Weaver, L., McCabe, L., McCabe,G., Johnston, C., & Teegarden, D. (2003). Peak spineand femoral neck bone mass in young women. Bone,32 (5), 546 - 553.

McBean, L., Forgac, T., & Finn, S. (1994).Osteoporosis: Visions for care and prevention - aconference report. American Dietetics Association, 94(6),668-671.

National Conference of State Legislatures (2007,October). 50 States Summary of Osteoporosis Laws .Retrieved on November 8, 2007, fromhttp://www.ncsl.org/programs/health/who-steo.htm

National Dairy Council. (2004). Calcium Recommendations . Retrieved on Dec. 1, 2007, from

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National Osteoporosis Foundation (2006). Fast facts .Retrieved October 29, 2007, fromhttp://www.nof.org/osteoporosis/diseasefacts.htm

National Osteoporosis Foundation (2002). America's Bone Health: The State of Osteoporosis and Low Bone Mass .Retrieved October 29, 2007, fromhttp://www.nof.org/advocacy/prev-alence/index.htm

National Osteoporosis Foundation (1998). Stand upto osteoporosis. Washington, DC: NOF.

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Ray, N., Chan, J., Thamer, M., & Melton, L. (1997).Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995;report from the National Osteoporosis Foundation.

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Table 1. Application of the Health Belief Model to Osteoprotective Behaviors

HBM Construct Definition Strategies to EducatePerceived Severity How serious will osteoporosis be? Focus on disfigurement caused by osteoporosis, visibility of effects of

osteoporosis, consequences of disease

Perceived Susceptibility How likely am I to getosteoporosis?

Bone Mineral Density (BMD) assessmentPersonalize risk based on assessed risk factors

Perceived Threat How bad will it be and how likely am I to get osteoporosis?

Vicarious learning experiencesIntegration of perceived severity and susceptibility

Cues to Action What will remind/cause me toexercise and consume calcium?

Media campaigns with celebrities (Got milk?)BMD feedback programEducational information

Self-Efficacy Do I have the skills and confidenceto exercise and consume calcium?

Provide knowledgeSkill building strategies and training Guidance in exercise and calcium consumption

Perceived Benefits What will I gain from exercise andcalcium consumption?

Assess, address and maximize benefits from exercise and calciumconsumption

Perceived Barriers What is preventing me fromexercising, consuming calcium, orattending a program?

Create plans of action to address barriers Assess and address barriersReduce misconceptions and misinformationProvide low-calorie, calcium-rich food options



ArkAHPERDMitch MathisBox 240State University, AR 72467

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Material for publication and editorial correspondence should be address to Mitch mathis,PO Box 240, State University, AR 72467 [[email protected]]. Deadline for thesubmission is March 1. Guidelines for materials submitted are those of the Publication

Manual of the American Psychological Association. For manuscripts, submit 3 copies. Thetitle should be included on a separate page with the author(s) name, position, address, phonenumber and email address. The title of the manuscript, without the author(s) name, shouldappear on the first page of the manuscript. If accepted, a final copy of the manuscript mustbe submitted on disk, saved in Microsoft Word or Text format.

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