Ambivalence is associated with decreased physical activity and cardiorespiratory fitness among adolescents with critical congenital heart disease

Kristen R Fox; Steven P Neville; Victoria R Grant; Kathryn Vannatta; Jamie L Jackson

doi:10.1016/j.hrtlng.2022.12.014

Ambivalence is associated with decreased physical activity and cardiorespiratory fitness among adolescents with critical congenital heart disease

Heart Lung. 2023 Mar-Apr:58:198-203. doi: 10.1016/j.hrtlng.2022.12.014. Epub 2022 Dec 30.

Authors

Kristen R Fox¹, Steven P Neville², Victoria R Grant², Kathryn Vannatta³, Jamie L Jackson³

Affiliations

¹ Center for Biobehavioral Health, Nationwide Children's Hospital, Near East Office Building, 3rd Floor, 431 S. 18th St., Columbus, OH, USA 43205. Electronic address: kristen.fox@nationwidechildrens.org.
² Center for Biobehavioral Health, Nationwide Children's Hospital, Near East Office Building, 3rd Floor, 431 S. 18th St., Columbus, OH, USA 43205.
³ Center for Biobehavioral Health, Nationwide Children's Hospital, Near East Office Building, 3rd Floor, 431 S. 18th St., Columbus, OH, USA 43205; Department of Pediatrics, The Ohio State University, 370 W. 9th Ave., Columbus, OH, USA 43210.

Abstract

Background: Adolescents with congenital heart disease (CHD) are insufficiently physically active. Given that increasing physical activity may reduce their cardiovascular risk, it is important to identify correlates of this behavior. Perceived benefits of and barriers to physical activity are associated with physical activity engagement. Existing research has only considered these constructs separately. This population may be ambivalent toward physical activity (i.e., perceive both strong benefits and barriers). The association of ambivalence and physical activity related outcomes is unknown among this at-risk population.

Objective: Determine the association of ambivalence and sedentary behavior, moderate-to-vigorous physical activity (MVPA), and cardiorespiratory fitness (VO_2Peak) among adolescents with CHD.

Methods: The present study is an analysis of data from an eligibility assessment for a randomized clinical trial of an intervention to promote MVPA among adolescents aged 15 to 18 years with moderate or complex CHD. Participants (N = 84) completed a survey assessing perceived benefits and barriers from which ambivalence toward physical activity was calculated, an exercise stress test to measure VO_2Peak, and wore an accelerometer for one week to determine their engagement in sedentary behavior and MVPA. Linear regression analyses determined associations between ambivalence and physical activity related outcomes_. RESULTS: Greater ambivalence toward physical activity was associated with increased sedentary behavior, decreased MVPA, and reduced VO_2Peak, adjusting for demographic and clinical covariates.

Conclusions: Ambivalence is associated with objectively measured physical activity (sedentary behavior, MVPA) and a biomarker of cardiovascular health (VO_2Peak). Screening for ambivalence may help clinicians identify those most likely to benefit from physical activity-related education.

Keywords: Adolescents; Ambivalence; Cardiorespiratory fitness; Congenital heart disease; Physical activity; Sedentary behavior.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Cardiorespiratory Fitness*
Exercise
Exercise Test
Heart Defects, Congenital*
Humans
Physical Fitness
Risk Factors

Abstract

Publication types

MeSH terms

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