Abby C. King, Ph.D., Michaela Kiernan, Ph.D., David K. Ahn, Ph.D., and Sara Wilcox, Ph.D.
Stanford University School of Medicine
ABSTRACT
The potential effects of making a marital transition on subsequent physical activity were evaluated across a ten-year period in a population-based sample of 302 women and 256 men ages 25 to 75 years. Subjects completed a structured interview at five timepoints throughout the ten-year period during which they reported on their physical activity level as well as marital status. The transition from a married to a single state did not affect physical activity relative to remaining married when analyses of either slopes or mean values were used, In contrast, the transition from a single to a married state resulted in significant positive changes in physical activity relative to remaining single throughout the study period when physical activity slopes, though not means, were compared. The results suggest that marriage may potentially set the stage for natural changes in physical activity that could be capitalized on through appropriate intervention, but additional research is needed to verify this in light of the inconsi~ent pattern of findings.
(Ann Behav Med 1998, 20(2):64-69) INTRODUCTION
The health effects of regular physical activity are now well-established for a variety of chronic diseases and conditions, including coronary heart disease, stroke, some forms of cancer, non-insulin-dependent diabetes mellitus, osteoporosis, and obesity (1). Despite these known benefits, the majority of the U.S. population remains underactive (2). Identifying strategies for facilitating sustained exercise participation at a level sufficient to provide such health benefits across a person 's lifetime constitutes a major public health challenge (2,3). Increasingly, health behavior change has been conceptualized as a series of
References: (1) Bouchard C, Shephard RJ, Stephens T (eds): Physical Activity, Fitness, and Health: International Proceedings and Consensus Statement. Champaign, IL: Human Kinetics, 1994. (2) U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion: Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: 1996. (3) King AC, Blair SN, Bild DE, et al: Determinants of physical activity and intervention in adults. Medicine and Science in Sports and Exercise. 1992, 24:$221-$236. (4) Prochaska JO, DiClemente CC: States and processes of self-change in smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology. 1983, 51:390-395. (5) Marcus BH, Simkin LR: The transtheoretical model: Applications to exercise behavior. Medicine and Science in Sports and Exercise. 1994, 26:1400-1404. (6) Felner RD, Farber SS, Primavera J: Transitions and stressful life events: A model for primary prevention. In Felner RD, Jason LA, Moritsugu JN, Farber SS (eds), Preventive Psychology: Theory, Research, and Practice. New York: Pergamon Press, 1983, 42-67. (7) King AC: Community intervention for promotion of physical activity and fitness. Exercise and Sport Sciences Reviews. 1991, 19:211-259. (8) Winett RA, King AC, Altman DG: Health Psychology and Public Health: An Integrative Approach. Elmsford, NY: Pergamon Press, 1989. (9) Bloom BL: Community Mental Health: A General Introduction (2nd Ed.). Belmont, CA: Brooks/Cole, 1984. (10) Klorman R, Hilpert PL, Michael R, LaGana C, Sveen OB: Effects of coping and mastery modeling on experienced and unexperienced pedodonticpatients ' disruptiveness.Behavior Therapy. 1980,11:156168. (11) Owens JF, Matthews KA, Wing RR, Kuller LH: Can physical activity mitigate the effects of aging in middle-aged women? Circulation. 1992, 85:1265-1270. (12) Gove W: Sex, marital status, and mortality. American Journal of Sociology. 1973, 79:45-67. (13) House J, Landis K, Umberson D: Social relations and health. Science. 1988, 241:540-545. (14) Goldman N, Korenman S, Weinstein R: Marital status and health among the elderly. Social Science and Medicine. 1995, 40:17171730. (15) Hu YR, Goldman N: Mortality differentials by marital status: An international comparison. Demography. 1990, 27:233-250. (16) Reissman C, Gerstel N: Marital dissolution and health: Do males or females have greater risk? Social Science and Medicine. 1985, 20:627-635. (17) Stroebe M, Stroebe W: Who suffers more? Sex differences in health risks of the widowed. PsychologicalBulletin. 1983, 93:279-301. (18) Wingard D: The sex differential in morbidity, mortality, and lifestyle. Annual Review of Public Health. 1984, 5:433--458. (19) Umberson D: Family status and health behaviors: Social control as a dimension of social integration. Journal of Health and Social Behavior 1987, 28:306-319. (20) Umberson D: Gender, marital status, and the social control of health behavior. Social Science and Medicine. 1992, 34:907-917. (21) Joung IM, Strortks K, van de Mheen H, Mackenbach JP: Health behaviours explain part of the differences in self-reported health associated with partner/marital status in The Netherlands. Journal of EpidemioIogy and Community Health. 1995, 49:482-488. (22) Case RB, Moss AJ, Case N, McDermott M, Eberly S: Living alone after myocardial infarction: Impact on prognosis. Journal of the American Medical Association. 1992, 267:515-519. (23) Ford ES, Jones DH: Cardiovascular health knowledge in the United States: Findings from the National Health Interview Survey, 1985. Preventive Medicine. 1991,20:725-736. (24) Temple MT, Fillmore KM, Hartka E, et al: A meta-analysis of change in marital and employment status as predictors of alcohol consumption on a typical occasion. British Journal of Addiction. 1991, 86:1269-1281. (25) Wickrama K, Conger RD, Lorenz FO: Work, marriage, lifestyle, and changes in men 's physical health. Journal of Behavioral Medicine. 1995, 18:97-111. (26) Kahn HS, Williamson DF: The contributions of income, education, and changing marital status to weight change among U.S. men. International Journal of Obesity. 1990, 14:1057-1068. (27) Kahn HS, Williamsou DF, Stevens JA: Race and weight change in U.S. women: The roles of socioeconomic and marital status. American Journal of Public Health. 1991, 81:319-323. (28) Farquhar JW, Fortmann SP, Maccoby N, et al: The Stanford Five-City Project: Design and methods. Journal of the American Medical Association. 1985, 122:323-334. (29) Farquhar JW, Fortmann SE Flora JA, et al: The Stanford Five-City Project: Effects of community-wide education on cardiovascular disease risk factors. Journal of the American Medical Association. 1990, 264:359-365. (30) Young DR, Haskell WL, Taylor CB, Fortmann SP: Effect of community health education on physical activity knowledge, attitudes, and behavior: The Stanford Five-City Project. American Journal of Epidemiology. 1996, 144:264-274. (31) Blair SN, Haskell WL, Ho E et al: Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments. American Journal of Epidemiology. 1986, 122:794804. (32) Spector PC, Goodnight JH, Sail JP, Sarle WS: The GLM procedure. In SAS User 's Guide: Statistics, Version 5 Edition. Cary, NC: SAS Institute Inc., 1985, 433-506. (33) Kraemer HC, Thiemann SA: A strategy to use "soft" data effectively in randomized clinical trials. Journal of Consulting and Clinical Psychology. 1989, 57:148-154. (34) Verhoef MJ, Love EJ: Women 's exercise participation: The relevance of social roles compared to non-role-related determinants. Canadian Journal of Public Health. 1992, 83(5):367-370. (35) Waldron I, Hughes ME, Brooks TL: Marriage protection and marriage selection--Prospective evidence for reciprocal effects of marital status and health. Social Science and Medicine. 1996, 43:113-123. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.