Effects of a Transtheoretical Model Based Exercise Behavior Improving Program on Blood Pressure and Physical Activity for Older Adults with Hypertension

범이론모형(Transtheoretical Model) 기반의 운동행위강화 프로그램이 고혈압 노인의 혈압 및 신체활동량에 미치는 효과

  • Received : 2011.09.27
  • Accepted : 2011.11.10
  • Published : 2011.12.28


This study was done to evaluate the effects of a transtheoretical model (TTM) based exercise behavior improving program for older adults with hypertension on the stage of change, processes of change, decisional balance, exercise self-efficacy, blood pressure and physical activity. A non-equivalent control pre-post design was used for this study. The subjects were 41 adults over 65 years of age with hypertension who did not practice regular exercise. The experimental group (n=20) received the 8-week TTM based exercise behavior improving program. The control group received hypertension self care management education. Descriptive analysis, $x^2$-test, t-test, paired t-test were used for analyzing the data using SPSS for Windows 14.0. As a results, there was a significant increase in stage of change, total score for processes of change, behavioral process of change, exercise self-efficacy, total physical activity, and walking in the experimental group compared to the control group. But, there were no significant differences between the two groups on the experiential processes of change, decisional balance, and blood pressure. The results of this study suggest that a TTM based exercise behavior improving program has positive effects on improving exercise behavior among older adults with hypertension.


Transtheoretical Model (TTM);Hypertension;Older Adults;Physical Activity


  1. 질병관리본부, 2008 국민건강통계: 국민건강영양 조사 제4기 2차년도(2008년), 서울, 질병관리본부, 2009.
  2. 통계청, 사망원인 통계연보, 대전, 통계청, 2008.
  3. D. G. Hackam, N. A. Khan, B. R. Hemmelgarn,S. W. Rabkin, R. M. Touyz, and N. R. Campbell,"The 2010 canadian hypertension educationprogram recommendations for the managementof hypertention: part 2 - therapy," Can J Cardiol,Vol.26, No.5, pp.249-258, 2010.
  4. American College of Sports Medicine, ACSM's Guidelines for Exercise Training and Prescription (3rd ed.), Boltimore: Williams & Wilkins, 2000.
  5. M. J. Findorff, H. H. Stock, C. R. Gross, and J. F. Wyman, "Does the transtheoretical model (TTM) explain exercise behavior in a community-based sample of older women?," J Aging Health, Vol.19, No.6, pp.985-1003, 2007.
  6. 이평숙, 장성옥, "운동행위변화단계에 근거한 노인 운동 동기화 중재프로그램의 효과에 대한 연구", 대한간호학회지, 제31권, 제5호, pp.818-834, 2001.
  7. 배상열, 고대식, 노지숙, 이병훈, 박형수, 박종, "한국 노인의 신체활동과 건강관련 삶의 질의 관계", 한국콘텐츠학회논문지, 제10권, 제10호, pp.255-266, 2010.
  8. J. O. Prochaska and C. C. DiClemente, "Stages and Processes of Self-Change of smoking: Toward An Integrative Model of Change," J Consult Clinl Psychol, Vol.51, No.3, pp.390-395, 1983.
  9. B. H. Marcus, V. C. Selby, R. S. Niaura, and J. S. Rossi, "Self-efficacy and the stages of exercise," Res Q Exerc Sport, Vol.63, pp.60-66, 1992.
  10. J. O. Prochaska, C. A. Redding, and K. E. Evers, The transtheoretical model stages of change. In Glanz, K., Rimer, B. K., Viswanath, K. (Eds.). Health behavior and health education. San Francisco: Jossey-Bass Publishers, 2008.
  11. L. K. Daley, A. F. Fish, D. J. Frid, and G. L. Mitchell, "Stage-specific education / counseling intervention in women with elevated blood pressure," Prog Cardiovasc Nurs, Vol.24, No.2, pp.45-52, 2009.
  12. R. Jackson, K. Asimakopoloulou, and A. Scammell, "Assessment of the transtheoretical model as used by dietitians in promoting physical activity in people with type 2 diabetes," J Hum Nutr Diet, Vol.20, pp.27-36, 2007.
  13. 김춘자, Transtheoretical Model을 이용한 운동 행위 변화단계별 중재프로그램 개발 및 효과검증 : 제2형 당뇨병 환자를 중심으로, 연세대학교 대학원 박사학위논문, 2001.
  14. A. F. Kirk, N. Mutrie, P. D. MacIntyre, and M. B. Fisher, "Promoting and Maintaining Physical Activity in People with Type 2 Diabetes," Am J Prev Med, Vol.27, No.4, pp.289-296, 2004.
  15. 권윤정, "노인 운동행위 변화단계별 중재프로그램의 개발 및 평가 : 범이론적 모형의 적용", 지역사회간호학회지, 제13권, 제2호, pp.205-215, 2002.
  16. 서남숙, "변화단계별 운동프로그램이 뇌졸중 환자의 신체적 기능과 심리적 상태에 미치는 효과", 대한간호학회지, 제33권, 제7권, pp.954-964, 2003.
  17. L. Spencer, T. B. Adams, S. Malone, L. Roy, and E. Yost, "Applying the transtheoretical model to exercise: A systematic and comprehensive review of the literature," Health Promot Pract, Vol.7, No.4, pp.428-448, 2006.
  18. T. H. Westhoff, N. Franke, S. Schmidt, K. Vallbracht-Israng, R. Meissner, and H. Yildirim, "Too old to benefit from sports? The cardiovascular effects of exercise training in elderly subjects treated for isolated systolic hypertension," Kidney Blood Press Res, Vol.30, No.4, pp.240-247, 2007.
  19. 변영순, "초기성인의 운동변화단계에 따른 변화 과정", 기본간호학회지, 제10권, 제2호, pp.138-144, 2003.
  20. 김순용, 김소인, 전영자, 이평숙, 이숙자, 박은숙 과 장성옥, "한국노인의 운동행위 변화단계의 예측모형구축: 범이론적 모델(Transtheoretical Model)을 기반으로", 대한간호학회지, 제30권, 제 2호, pp.366-379, 2000.
  21. 이윤미, "중년여성의 운동행동변화단계에 따른 변화과정, 의사결정균형 및 자기효능감", 대한간호학회지, 제34권, 제2호, pp.362-371, 2004.
  22. 이연희, 초등학교 비만아동을 대상으로 한 운동 행위변화 단계별 중재프로그램의 효과, 가톨릭대학교 보건대학원 석사학위논문, 2005.
  23. C. R. Nigg, G. J. Norman, J. S. Rossi, and S. V. Benisovich, "Process of Behaviors change : Redeveloping the Scale," Poster presented at SBM. San Diego, CA, 1999.
  24. C. R. Nigg, J. S. Rossi, G. J. Norman, and S. V. Benisovich, "Structure of decisional balance for exercise adoption," Ann Behav Med, Vol.20, pp.211, 1998.
  25. 오지연, 국제신체활동설문 국문판 신뢰도, 타당도 조사, 인제대학교 대학원 박사학위논문, 2007.
  26. S. Marshall and S. J. H. Biddle, "The transtheoretical model of behavior change: a meta analysis of applications physical activity and exercise," Ann Behav Med, Vol.23, pp.229-246, 2001.
  27. M. Lowther, N. Mutrie, and E. M. Scott, "Identifying key processes of exercise behaviour change associated with movement through the stages of exercise behaviour change," J Health Psychol, Vol.12, No.2, pp.261-272, 2007.
  28. L. L. Lee, A. Arthur, and M. Avis, "Evaluating a community-based walking intervention for hypertensive older people in Taiwan: A randomized controlled trial," Prev Med, Vol.44, No.2, pp.160-166, 2007.
  29. M. E. Nelson, W. J. Rejeski, S. N. Blair, B. W. Duncan, J. O. Judge, and A. C. King, "Physical activity and public health in older adults: Recommendation from the american college of sports medicine and the american heart association," Circulation, Vol.116, No.9, pp.1094-1105, 2007.
  30. M. H. Murphy, A. M. Nevill, E. M. Murtagh, and R. L. Holder, "The effect of walking on fitness, fatness and resting blood pressure: A meta-analysis of randomised, controlled trials," Prev Med, Vol.44, No.5, pp.377-385, 2007.

Cited by

  1. Effects of Peer Mentoring Program on the Health Conservation in Elderly Women with Osteoarthritis vol.28, pp.3, 2017,
  2. Analysis of Spatial Distribution of Hypertension Prevalence and Its Related Factors based on the Model of Social Determinants of Health vol.29, pp.4, 2018,