Understanding regular exercise behavior in frail older adults: a structural equation model based on social-cognitive variables

Abstract Background Regularly engaging in exercise has been recognized as the only therapy found to consistently manage frailty. This study applies structural equation modeling (SEM) to integrate the theoretical perspective of Social cognitive theory (SCT) to better understand and promote regular ex...

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Main Authors: Shiqi Yu, Jie Lin, Siping Song, Shuqi Huang, Fan Liu, Mingzhao Xiao
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-05702-5
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author Shiqi Yu
Jie Lin
Siping Song
Shuqi Huang
Fan Liu
Mingzhao Xiao
author_facet Shiqi Yu
Jie Lin
Siping Song
Shuqi Huang
Fan Liu
Mingzhao Xiao
author_sort Shiqi Yu
collection DOAJ
description Abstract Background Regularly engaging in exercise has been recognized as the only therapy found to consistently manage frailty. This study applies structural equation modeling (SEM) to integrate the theoretical perspective of Social cognitive theory (SCT) to better understand and promote regular exercise behavior among frail older adults, providing a foundation for enhancing exercise engagement in this vulnerable population. Methods A total of 306 frail older adults in Chengdu, China, were selected in this cross-sectional study. Participants completed the the FRAIL scale, the Self-Efficacy for Exercise (SEE) Scale, the behavioral regulation in exercise questionnaire (BREQ-2), the Outcome Expectations for Exercise (OEE), the Exercise Social Support (ESS) Scale. Structural equation modeling (SEM) was used to specify hypothesis between components of social-cognitive theory on regular exercise behavior among frail seniors. Results The percentage of regular exercise behavior was 29.1% among participants. There were statistically significant differences in the regular exercise behavior for demographic characters of occupation, disposable monthly income, frail phenotype of fatigue, resistance and weight loss (p < 0.05). SEM showed that the exercise self-efficacy (β = 0.52, p < 0.001) and exercise outcome expectation (β = 0.45, p < 0.011) are the strongest determinants of regular exercise behavior, while social support (β = 0.092, p > 0.05) and self-regulation (β = 0.05, p > 0.05) are non-determinant. Conclusion Our study underscores that adherence to regular and structured exercise regimens remains low among frail older adults, suggesting that this population may not be fully benefiting from scientifically guided exercise programs. Integrating self-efficacy and outcome expectations into further exercise promotion is critical. Patient-centered approach is essential for developing more effective and sustainable exercise interventions.
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spelling doaj-art-2fda262a9f684c3d80d40cf1861f27ec2025-02-02T12:41:47ZengBMCBMC Geriatrics1471-23182025-02-0125111110.1186/s12877-025-05702-5Understanding regular exercise behavior in frail older adults: a structural equation model based on social-cognitive variablesShiqi Yu0Jie Lin1Siping Song2Shuqi Huang3Fan Liu4Mingzhao Xiao5State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Nursing, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Nursing, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Nursing, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Nursing, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Nursing, West China Hospital of Stomatology, Sichuan UniversityDepartment of Nursing, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background Regularly engaging in exercise has been recognized as the only therapy found to consistently manage frailty. This study applies structural equation modeling (SEM) to integrate the theoretical perspective of Social cognitive theory (SCT) to better understand and promote regular exercise behavior among frail older adults, providing a foundation for enhancing exercise engagement in this vulnerable population. Methods A total of 306 frail older adults in Chengdu, China, were selected in this cross-sectional study. Participants completed the the FRAIL scale, the Self-Efficacy for Exercise (SEE) Scale, the behavioral regulation in exercise questionnaire (BREQ-2), the Outcome Expectations for Exercise (OEE), the Exercise Social Support (ESS) Scale. Structural equation modeling (SEM) was used to specify hypothesis between components of social-cognitive theory on regular exercise behavior among frail seniors. Results The percentage of regular exercise behavior was 29.1% among participants. There were statistically significant differences in the regular exercise behavior for demographic characters of occupation, disposable monthly income, frail phenotype of fatigue, resistance and weight loss (p < 0.05). SEM showed that the exercise self-efficacy (β = 0.52, p < 0.001) and exercise outcome expectation (β = 0.45, p < 0.011) are the strongest determinants of regular exercise behavior, while social support (β = 0.092, p > 0.05) and self-regulation (β = 0.05, p > 0.05) are non-determinant. Conclusion Our study underscores that adherence to regular and structured exercise regimens remains low among frail older adults, suggesting that this population may not be fully benefiting from scientifically guided exercise programs. Integrating self-efficacy and outcome expectations into further exercise promotion is critical. Patient-centered approach is essential for developing more effective and sustainable exercise interventions.https://doi.org/10.1186/s12877-025-05702-5FrailtySocial cognitive theory (SCT)Regular exerciseSelf-efficacy
spellingShingle Shiqi Yu
Jie Lin
Siping Song
Shuqi Huang
Fan Liu
Mingzhao Xiao
Understanding regular exercise behavior in frail older adults: a structural equation model based on social-cognitive variables
BMC Geriatrics
Frailty
Social cognitive theory (SCT)
Regular exercise
Self-efficacy
title Understanding regular exercise behavior in frail older adults: a structural equation model based on social-cognitive variables
title_full Understanding regular exercise behavior in frail older adults: a structural equation model based on social-cognitive variables
title_fullStr Understanding regular exercise behavior in frail older adults: a structural equation model based on social-cognitive variables
title_full_unstemmed Understanding regular exercise behavior in frail older adults: a structural equation model based on social-cognitive variables
title_short Understanding regular exercise behavior in frail older adults: a structural equation model based on social-cognitive variables
title_sort understanding regular exercise behavior in frail older adults a structural equation model based on social cognitive variables
topic Frailty
Social cognitive theory (SCT)
Regular exercise
Self-efficacy
url https://doi.org/10.1186/s12877-025-05702-5
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