Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 11;25(1):169.
doi: 10.1186/s12905-025-03706-2.

Determinants physical activity in middle-aged women: application trans theoretical model

Zakieh Khoramaki  1 , Leila Fallahipour  1 , Masoud Karimi  2 , Mahin Nazari  3
Affiliations

Determinants physical activity in middle-aged women: application trans theoretical model

Zakieh Khoramaki et al. BMC Womens Health. .

Abstract

Background and aims: Physical activity is one of the most important indicators of health in the society and plays an important role in the lives of people, especially women. Nevertheless, one of the major challenges in modern society is the inactivity and lack of optimal physical activity of women, which has caused a rising prevalence in chronic diseases. Models and theories help to better understand these behaviors and better planning for behavior change in target groups. This study was conducted with the aim of investigating the predictors of regular physical activity among middle-aged women based on the trans-theoretical model.

Design: The present study was conducted cross-sectionally on 250 middle-aged women (age range 45-59) covered by comprehensive health databases.

Method: Inclusion conditions included willingness to participate, living in the area under study, not having certain diseases and disorders that would cause changes in lifestyle or physical activity. The random sampling method was simple. In this study, questionnaires of transtheoretical model constructs and short international questionnaire of physical activity were used. Data were analyzed using SPSS version 26 and Amos 24 software.

Results: In path analysis, change methods with path coefficient β = 0.20 are the strongest predictors of physical activity behavior in middle-aged women, and it clearly shows a significant positive relationship with the amount of physical activity (P < 0.05). Also, the stimulus control substructure with a factor loading of β = 0.17 and a confidence interval (CI) of 95% also has a high predictive power of the tendency to physical activity behavior. Chi-square ratio to degrees of freedom (χ²/DF) < 3 and RMSEA = 0.065 indicate a good fit of the model with the data (GFI = 0.91, CFI = 0.98).

Conclusion: The path analysis revealed that the proposed model by Prochaska fits well with the research data, indicating that change processes are strong predictors of physical behavior. These findings can serve as a foundation for developing targeted, evidence-based interventions to promote physical activity among middle-aged women.

Keywords: Middle-aged women; Physical activity; Trans theoretical model.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval was obtained from Shiraz University of Medical Sciences and Shiraz organization of Education (Ethics Committee code: IR.SUMS.REC.1398.452). At the beginning of the research, the necessary information about how to conduct the research and confidentiality was given to the participants and their informed written consent was obtained for their willingness to enter the study. The study was conducted in accordance with the 2013 Helsinki Declaration (including its 2020 updates). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Theoretical model of TTM structures with physical activity levels of middle-aged women * In this form, only the paths that are meaningful are shown
Fig. 2
Fig. 2
The fitted model predicting physical activity behavior of middle-aged women based on TTM structures
Fig. 3
Fig. 3
The fitted model predicting the physical behavior levels of middle-aged women based on TTM structures
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World health organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451–62. - PMC - PubMed
    1. Organization WH. WHO guidelines on physical activity and sedentary behaviour. World Health Organization; 2020. - PMC - PubMed
    1. Organization WH. Global status report on physical activity 2022: country profiles. World Health Organization; 2022.
    1. Ghosn B, Benisi-Kohansal S, Ebrahimpour-Koujan S, Azadbakht L, Esmaillzadeh A. Association between healthy lifestyle score and breast cancer. Nutr J. 2020;19:1–11. - PMC - PubMed
    1. Al-Jawaldeh A, Abbass MM. Unhealthy dietary habits and obesity: the major risk factors beyond non-communicable diseases in the Eastern mediterranean region. Front Nutr. 2022;9:817808. - PMC - PubMed