1. Relationship between exercise motivation types, self- determination and acculturation among Latinas Amber Vermeesch, PhD, MSN, RN, FNP-C

2. Dissertation Committee −Victoria B. Mitrani, Ph.D. −Nilda (Nena) Peragallo, Dr.P.H., R.N., F.A.A.N. −Doris Ugarriza, Ph.D., A.R.N.P. −Christine Stevens, M.P.H., Ph.D., R.N. Funding –Sigma Theta Tau International Beta Tau Chapter Research Grant –Florida Nurses Foundation Research Grant Program –University of Miami School of Nursing and Health Studies –Michigan State University College of Nursing Research Center –This study received support from, and the parent study for this research was funded by, the Center of Excellence for Health Disparities Research: El Centro, National Institute of Minority Health and Health Disparities grant P60MD002266

3. Background Latinas not engaging in recommended exercise Increased risk for obesity and related health consequences Investigating the relationship between exercise motivation types, self-determination and acculturation may increase overall understanding of what factors may influence exercise participation

4. Purpose & Significance To investigate the relationship between exercise motivation types, self-determination and acculturation among Latinas Exercise is linked with reduction in stroke, obesity, and developing weight related illness such as diabetes (CDC, 2008; Reimers, Knapp, & Reimers, 2009) Latinas exercise less than non-Latinas (Crespo, Smit, Andersen, Carter-Pokras, & Ainsworth, 2000). In general, Latinas are more likely (74%) to be overweight than non-Latina whites (57%) (National Center for Health Statistics, 2009).

5. Theoretical Framework: Self-Determination Theory (Deci & Ryan, 1985)

6. Factors associated with self-reported exercise Acculturation exercise (Abraido-Lanza et al. 2005;Slattery et al. 2006) Income exercise (Crespo et al. 2001; Neighbors et al. 2008; Slattery et al. 2006) Education exercise ( Crespo et al. 2001; Neighbors et al. 2008; Slattery et al. 2006 ) # of children exercise ( Crespo et al. 2001; Neighbors et al. 2008; Slattery et al. 2006)

7. Exercise Motivation Lack of motivation is reported as a major barrier to exercise (Eyler et al., 1998). Literature suggests women have an underlying intrinsic aspect to their exercise motivation (Frederick, Morrison, & Manning, 1996; Moreno, Cervello, & Martinez, 2007). The more intrinsic the motivation, the more likely to engage in and continue to exercise (Deci & Ryan, 1985 ).

8. Research Aim To investigate the relationship between exercise motivation types, self- determination and acculturation among Latinas in South Florida.

9. Methods Data was collected from 169 participants Acculturation measures- Bidimensional Acculturation Scale for Hispanics, BAS Demographics Exercise motivation form - Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2) Self-report exercise logs & pedometers (worn for 1 week) IRB approval was obtained All data collection and informed consent was conducted by the researcher.

10. Instruments ConstructVariableInstrumentDescriptionReliability/ Validity Acculturation Proposed Predictor BAS (Marin & Gamba, 1996) 24 items, 2 subscales; Hispanicism & Americanism α =.86 Hispanic α =.94 Americanism (current study) Exercise Motivation Types Proposed Predictor BREQ-2 (Markland & Tobin, 2004) 19 items, 5 subscales α =.81 to α =.89 (Moreno, Cervello, & Martinez, 2007) ExercisePrimary Outcome Pedometers Self-report logs Step counting device Paper record of date, activity type, & daily step total α =.95 (Felton, Tudor-Locke, & Burkett, 2006) Spearman’s rho self- report & pedometer, r s = 0.607 (p = 0.003) (Speck & Looney, 2006)

11. Relative Autonomy Index (RAI) (Ryan, Connell, & Grolnick, 1992 ): –Assumes subscales equal continuum of self-determination –Computed from multiplying BREQ-2 weighting subscale score and summing results (Markland & Tobin, 2004) –Index of the degree of self-determination –Physical activity was strongly associated with RAI in BREQ-2 (Markland and Ingledew (2007) Weightings (increasing self-determination): Amotivation -3External -2 Introjected -1 Identified +2Intrinsic +3 Range: -24 to 20 (Markland & Ingledew, 2007)

12. Inclusion & Exclusion criteria SEPA II: Latina Between 18 and 50 years old English or Spanish Report being sexually active in the past 3 months Additional: Read and write in Spanish or English No serious health problem that prohibits exercise Recruitment In person during last follow-up assessment of SEPA II study and by phone

13. Data Analysis SEM (Mplus version 5.21; Muthen & Muthen, 1998-2007) & SPSS (vs 18) – Investigate the relationship among acculturation, motivation types and self-determination – Control for demographic factors

14. Research Questions and Hypotheses H1. Acculturation will predict motivation (Intrinsic and Extrinsic – e.g.External, Introjected, Identified) H2. Acculturation will predict self-determination (RAI) Self-determination theory (Deci & Ryan, 1985)

15. Sample: Demographics (N = 169) Mean age was 38.7 years, SD = 7.74, range from 20 to 52 years Average monthly income was $1400 Mean years of education was 14.12 years, SD = 3.21 From 16 different countries including US 21% did not have children 61% had 1 or 2 children

16. Results H1. Acculturation will predict motivation (Intrinsic and Extrinsic – e.g. External, Introjected, Identified) H 1a = Americanism domain Intrinsic & Extrinsic Not significant predictor: Intrinsic (β = -0.02, p =.78) Extrinsic (β = -0.12, p =.20) H 1b = Hispanicism domain Intrinsic & Extrinsic Not significant predictor (β = 0.07, p =.27) of Intrinsic nor Extrinsic (β = 0.17, p =.09)

17. Results H2. Acculturation will predict self-determination (RAI) Americanism domain (β = 0.00, p =.92) Hispanicism domain (β = 0.00, p =.89) For each standard deviation change in Hispanicism domain score, there was a non-significant increase of.00 SD in the RAI score

18. Acculturation and Exercise Acculturation Scores (n =174) range 1-4 BASMean%n Americanism2.353.56 Hispanicism3.5698170 Pedometer means by quartiles (n = 169) PedometerMean Sample6,685 25%3,927 50%6,070 75%8,882 Results

19. Hypothesis Results: Model of motivation and exercise H2 H1 Average # of Steps Self-determination Motivation Acculturation Demographics

20. Exercise Motivation BREQ-2 Scores BREQ-2MSDAlpha Amotivation.38.60.63 External Regulation.92.89.71 Introjected Regulation2.141.26.81 Identified Regulation2.95.57.39 Intrinsic Regulation3.28.83.89

21. Limitations Measure of exercise Selection bias of sample Self-reported data Reliability of instruments

22. Discussion & Implications Education on exercise Understanding Latinas’ perceptions of exercise is imperative Exercise motivation is a complex issue for Latinas