Are regular exercisers encouraged by their spouses?

Abstract: This study examined the degree to which regular exercisers received support for their active lifestyles from their spouses. Subjects (n = 106) were married men and women with a history of regular exercise. Perceived health status, quality of life, and social support were measured by questionnaire. There was a significant difference between spousal exercise patterns and subjects' perceived levels of spousal support, with those having spouses who were also active perceiving greater levels of spousal support. Although there was a correlation between levels of perceived spousal support and quality of life, there was no relationship between exercise patterns of a spouse and quality of life or health status of subjects.

Physical activity and social support are two variables that may strongly influence life satisfaction (Cousins, 1995; Gillett, 1988; McAuley & Rudolph, 1995). The exercise habits of a spouse may influence the level of social support that a spouse gives to a partner for exercise. We examined the possibility that spousal support for exercise may influence the health status and quality of life in regularly exercising individuals. We also examined other factors that might sustain regular exercise in married subjects.

Marriage, or long-term relationships, have been purported to play a significant role in contributing to the quality of life of an individual. Gove, Style and Hughes (1990) concluded that marriage was strongly correlated with perceived well-being. One key to happiness in a relationship was quality of interaction, companionship, and, specifically, social support (Mookherjee, 1997). A couple's commitment to physical activity could contribute to perceived quality of life in a number of ways. Wallace, Raglin, and Jastremski (1995) examined 12-month adherence and dropout rates, and the reasons cited for each by couples who joined a fitness club together versus married individuals who joined the club singly. Attendance for the 12-month period was significantly greater for the married pairs than for married individuals who joined the facility alone. Only 6.3% of married pairs dropped out of the program within a year, whereas 43% of married singles dropped out. The most frequently cited reason for dropout (50%) was the combination of family responsibilities and lack of spousal support. It became clear that spousal support played a large role in exercise adherence, but what role it played in the quality of life scores for each participant was not measured.

Wan, Jaccard, and Ramey (1996) measured perceived social support on each of four support dimensions including emotional support, tangible help, companionship, and information support. Sources of support included spouse or partner, other relatives, close friends, and coworkers. Support from a spouse was the primary correlate of life satisfaction for married couples (Wan, Jaccard, & Ramey, 1996). Correlations between life satisfaction and spousal support were the highest compared to all other sources of support measured. The authors suggested that a supportive spouse may have promoted an increased level of marital satisfaction, which led to improvements in life satisfaction. Though Wan et al. (1996) found that spousal support was more highly correlated with life satisfaction in women than it was in men, this study found no gender differences.

The purpose of this study was to examine the effects of spousal exercise patterns on the perceived quality of life and health status of a regular exerciser. It was hypothesized that there would be a significant difference in quality of life scores between regular exercisers with a spouse who also exercised versus regular exercisers with a non-exercising spouse.

METHODS

PARTICIPANTS

Married males (n = 39) and females (n = 67) with a history of regular physical activity (20-30 minutes of activity on most days of the week for a minimum of 6 months), age 18 and above were eligible for the study. Subjects were self-selected from six recreational facilities in central Indiana.

MATERIALS

Surveys were deposited at six sites with a locked collection box placed within two feet of the questionnaires. Surveys were collected from a locked box at each site by the researcher on a bi-weekly basis. All procedures were approved by the Institutional Review Board of Purdue University, West Lafayette, Indiana. All surveys were utilized with the permission of the original authors.

Baecke Questionnaire of Habitual Physical Activity. The Baecke questionnaire (Baecke, Burema, & Frijters, 1982) was used to measure work, sport, and leisure activity. Intensity for those activities was scored according to American College of Sports Medicine guidelines (Mahler, Froelicher, Miller, & York, 1995). More information on the Baecke questionnaire may be found in Treiber, Baranowski, Braden, Strong, Levy, & Knox (1991).

Sallis Social Support and Exercise Survey. Included in the questionnaire was a revised version of the Sallis Social Support and Exercise Survey (Sallis, Grossman, Pinski, Patterson, & Nader, 1987). While social support may come from a variety of sources, we elected to delimit our focus to spouses as the agents of social support for our regular exercisers and termed this "spousal support." The survey was specific to the social support obtained for exercise and a modification was made to the original scale. The 'Friends' subscale was deleted and the 'Family' subscale was changed to the heading of 'Spouse.' The questions were not altered in any other way and scoring remained the same as originally intended. More information on the Sallis Social Support and Exercise Survey may be found in Sallis et al. (1987).

Short Form-36 Health Survey. The Short-Form 36 was used to assess perceived health status. The eight dimensions were combined to give two separate health status scores: physical health and mental health. For information on reliability and validity see Ware (1993).

Ferrans and Powers Quality of Life Index. The Ferrans and Powers Quality of Life Index (Ferrans & Powers, 1985) was used to measure quality of life in the sample. This first section of the survey was an assessment of the subject's view about satisfaction with multiple facets of life. The second section included the importance of these facets to the subject. Scoring was such that each satisfaction item was weighted by its paired importance item. For this reason, the highest score was obtained by a subject who rated a statement as very satisfactory, and also rated that same statement as very important to the subject. When scored, the survey produced four subscales (health and functioning, social and economic, psychological/spiritual, and family) with a total score ranging from 0 (poor quality of life) to 30 (high quality of life). See Ferrans and Powers (1985, 1992) for information on reliability and validity.

Demographic items included age, gender, marital status, length of marriage, number of dependents, years of education, income, and years physically active. Spousal exercise was treated as an independent variable with subjects being asked simple yes or no questions about whether their spouses participated in 20-30 minutes of physical activity on most days of the week for at least the past 6 months.

RESULTS

The purpose of this study was to examine the effects of spousal exercise patterns on the quality of life and health status of a regular exerciser. Social support was also examined as a possible moderator in the relationship between the two aforementioned variables. Also examined was whether quality of life scores for women were more influenced by perceived levels of social support than were quality of life scores for males in the study.

Eighteen of the 39 males were married to regularly exercising spouses, while 40 of the 67 females had an exercising spouse. Subjects between the ages of 40-49 made up the greatest percent (29) of the sample. A large percentage (43%) of subjects were college graduates and 41.7% had a yearly income of between $71,500 and $126,549. While all subjects were married, the average length of marriage at the time of this study was 23.5 (range < 1 year -58 years). Subjects reported engaging in regular physical activity for an average of 14.5 years, with a minimum participation of 6 months and a maximum of 75 years.

An independent t-test was performed to compare spousal exercise patterns with levels of perceived spousal support for exercise among the subjects. There was a statistically significant difference in mean spousal support scores for subjects who described their spouses as regular exercises (M = 35.57) as compared to subjects who had non-exercising spouses (M = 25.00).

No statistically significant difference existed between the quality of life scores for those subjects with spouses who regularly exercised and those with spouses who did not. There were also no differences in mean quality of life scores by gender. Additionally, no difference was found between the mental and physical health status scores of those subjects with exercising spouses and the mental and physical health status of those without exercising spouses. Spousal support did not appear to act as a moderating variable between spousal exercise patterns and quality of life scores. Regardless of gender therefore, subjects who had active spouses received support for their exercise regimens from their partners.

DISCUSSION

Past research has suggested that social support would be strongly correlated with both quality of life and health status. Numerous studies have compared perceived social support with quality of life and health status, consistently finding that levels of social support had strong influences on overall quality of life (Cousins, 1995; Shumaker & Brownell, 1984; Wan, Jaccard, & Ramey, 1996). However, studies have not focused specifically on spousal support for exercise. Though a significant correlation was found in this study between spousal exercise patterns and quality of life, the relationship was weak. Contrary to the findings of Wan et al. and Treiber et al., the hypothesis that females would be more influenced by levels of perceived social support was also not confirmed (Treiber, Baranowski, Braden, Strong, Levy, & Knox, 1991 ; Wan, Jaccard, & Ramey, 1996). Research in this area has not consistently shown the gender effect found by previous authors, however, rendering this lack of gender difference somewhat unsurprising (Fuhrer, Stansfeld, Chemali, & Shipley., 1999; Gove et al., 1990). It was evident that questions remain regarding gender and spousal support related to perceived quality of life and health status.

Subjects who stated that their spouses were also regular exercisers reported significantly greater levels of perceived spousal support (M = 35.57) as compared to subjects with non-exercising spouses (M = 25.00). This finding was consistent with Wallace et al. (1995) who found that married couples who joined a fitness facility together had much higher levels of adherence, while those who dropped out frequently cited a low level of spousal support as their principal reason for doing so. The exercise patterns of a spouse could significantly influence the overall perceived spousal support of a partner. While this finding may be important when trying to improve adherence rates for exercise in the general population, this study examined participants already considered regular exercisers.

A suggestion for those trying to increase exercise adherence rates in health and fitness centers would be to consider special memberships that make it convenient for spouses to join together, possibly increasing the exercise adherence rates of both individuals. On-site childcare and special pricing for couples joining together are also incentives that may help increase levels of physical activity in the general population.

No published research was found that directly addressed whether spousal exercise patterns significantly influenced the quality of life scores of regularly exercising subjects. The likelihood that spousal exercise patterns influenced perceived quality of life for the regular exercising subjects seemed minimal.

Previous research has supported the influence of spousal exercise patterns on exercise adherence, and that perceived levels of social support for exercise from a spouse was the major reason for adherence or dropout (Gillett, 1988), but quality of life and health status were not addressed. Had the issues of the present study been addressed in a longitudinal study such as that conducted by Gillett, it is possible that a relationship between spousal exercise, adherence, and spousal support could have been examined.

CONCLUSIONS

IMPLICATIONS

A cross-sectional survey method was utilized for this research. Quality of life and health status are constructs that may vary and are difficult to measure using only a survey method. Subjects volunteered for the study by electing to complete a survey and return it to the collection site, suggesting the possibility of self-selection bias. By limiting the subjects to an exercising population only, it was possible to compare the quality of life and health status of subjects who had an exercising spouse, versus those with a non-exercising spouse; but we were not able to compare these scores with those of non-exercising individuals. The hypothesis that those with exercising spouses would perceive greater spousal support for exercise was supported by the current and previous research. However, the finding that increases in spousal support did not lead to significantly different quality of life scores was surprising. It may be that regular exercisers are unique in that their perceived quality of life scores are not as influenced by external factors, including the social support they may receive from their spouses. Regular exercisers in health and fitness facilities also may receive significant social support from exercising peers, facility staff, and/or others who support the exercisers' lifestyle choices.

This research may also have implications for those trying to improve levels of physical activity in the general public. Both corporate and public fitness facilities can apply this research to increase exercise adherence rates. Because support from a partner influences perceived social support and possibly adherence, health professionals may seek ways to increase this support. For example, corporate wellness programs could allow employees' spouses to join employee fitness facilities with their partners. Public facilities could offer price reductions for couples joining together, childcare services, or other incentives to promote partner membership. Beginning exercisers or those considering an exercise program may be advised about the importance of having a support network in place, especially spouses.

This research may also be beneficial for those working to improve the health of America's aging population. In the year 2000, a group of researchers from the AARP, American College of Sports Medicine, American Geriatrics Society, The Centers for Disease Control and Prevention, National Institute on Aging, and The Robert Wood Johnson Foundation came together to develop the National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older (2001). This publication addressed some of the same issues raised by the current research. For example, they recommended that communities explore new models for planning and implementing physical activity initiatives--a new model may include increasing awareness about the importance of spousal support for exercise. The Blueprint also cited many of the key barriers that stand in the way of increasing the activity of the aging population. For example, the document called for more studies, such as this one, to examine strategies for achieving long-term increases in physical activity and more translation of these research findings into practical intervention strategies. They also acknowledged the challenges for the aging population at home and in the community. Many older Americans serve as caregivers for others or are isolated by transportation issues, restricting their ability to participate in regular activity. These are people who could possibly benefit from programs in the community that serve to increase support for exercise from a spouse, friend, relative, or exercise professional. The Blueprint also acknowledged challenges to workplace promotions, citing the high degree of variability among worksites. However, worksites may benefit by focusing on something that is universal to most all worksites--the fact that employees likely benefit from systems of social support. Medical systems and public policy are two other areas cited as places needing to change in an effort to increase physical activity in an aging population. Whereas healthcare professionals may lack the expertise or referral networks to successfully treat inactivity, they could help their patients by educating them and their families about the importance of social support in increasing exercise behavior and improving health status in general. Public policy could also support change by providing programs to increase social support for exercise, such as two-for-one park memberships or reduced price public transportation to exercise cites. Readers are encouraged to refer to the Blueprint for more information on increasing physical activity among aging Americans and how research such as this can be used to benefit this population.

By increasing awareness about the importance of social support in exercise adherence, health educators and others in the community may be able to positively influence adherence rates. Due to the pervasiveness of a sedentary lifestyle in the United States, techniques that can be used to increase adherence to a physical activity regimen should be examined and subjected to empirical evaluation.

SUMMARY

This study examined the effects of spousal exercise patterns on the quality of life and health status in a population of regular exercising subjects. There was a statistically significant relationship between spousal exercise patterns and levels of perceived spousal support received by the regular exercisers. However, there was no direct relationship found between the exercise patterns of a spouse and the quality of life or health status of the subjects. The relationship between spousal exercise patterns, perceived spousal support, and quality of life or health status is complex and requires additional investigation.

RECOMMENDATIONS

Both exercising and non-exercising subjects should be included in future research for a comparison of perceived quality of life and health status scores of the exercising group to those of a non-exercising group. A longitudinal study may reveal that the social support gleaned from a spouse who exercises is more important to an individual only during certain times across the life course. Further research should be conducted to determine those factors that distinguish regular exercisers from the largely inactive general population, especially with respect to the effects of external influences such as social support on perceived quality of life.

Acknowledgements: We wish to thank Roseann Lyle and Donald Corrigan for their support and assistance during the entire course of this investigation. Our sincere thanks also go to Heather Claypool and the Purdue Statistical Consulting Services for their assistance in the analysis of the data. We also wish to thank Deborah B. Gray for her editorial assistance. An overview of this research was presented at the American Public Health Association's 130th Annual Meeting and Exposition November 9-13, 2002 in Philadelphia, PA.

REFERENCES

Baeke, J., Burema, J., & Frijters, J. (1982). A short questionnaire for the measurement of habitual physical activity in epidemiological studies. The American Journal of Clinical Nutrition, 36, 936-942.

Cousins, S. (1995). Social support for exercise among elderly women in Canada. Health Promotion International, 10(4), 273-282.

Ferrans, C., & Powers, M. (1985). Quality of life index: Development and psychometric properties. Advances in Nursing Science, 8(1), 15-24.

Ferrans, C. & Powers, M. (1992). Psychometric assessment of the Quality of Life Index. Research in Nursing and Health, 15, 29-38.

Fuhrer, R., Stansfeld, S., Chemali, J., & Shipley, M. (1999). Gender, social relations and mental health: Prospective findings from an occupational cohort (Whitehall II study). Social Science and Medicine, 48, 77-87.

Gillett, P. (1988). Self-reported factors influencing exercise adherence in overweight women. Nursing Research, 37, 25-29.

Gove, W., Style, C., & Hughes, M. (1990). The effect of marriage on the well-being of adults. Journal of Family Issues, 11(1), 4-35.

Mahler, D., Froelicher, V., Miller, N., & York, T. (1995). ACSM's guidelines for exercise testing and prescription (5th ed.). Philadelphia: Williams & Wilkins.

McAuley, E., & Rudolph, D. (1995). Physical activity, aging, and psychological well-being. Journal of Aging and Physical Activity 3(1), 67-96.

Mookherjee, H. (1997). Marital status, gender, and perception of well-being. Journal of Social Psychology, 137(1), 95-105.

Robert Wood Johnson Foundation. (2001). National blueprint for increasing physical activity among adults 50 and older: Creating a strategic framework and enhancing organizational capacity for change. Journal of Aging and Physical Activity 9 (Suppl.), $5-$28.

Sallis, J., Grossman, R., Pinski, R., Patterson, T., & Nader, P. (1987). The development of scales to measure social support for diet and exercise behaviors. Preventive Medicine, 16, 825-836.

Shumaker, S. & Brownell, A. (1984). Toward a theory of social support: Closing conceptual gaps. Journal of Social Issues, 40(4), 11-36.

Treiber, F., Baranowski, T., Braden, D., Strong, W., Levy, M., & Knox, W. (1991). Social support for exercise: Relationship to physical activity in young adults. Preventive Medicine, 20, 737-750.

Wallace, J., Raglin, J., & Jastremski, C. (1995). Twelve month adherence of adults who joined a fitness program with a spouse vs without a spouse. Journal of Sports Medicine and Physical Fitness, 35, 206-213.

Wan, C., Jaccard, J., & Ramey, S. (1996). The relationship between social support and life satisfaction as a function of family structure. Journal of Marriage and the Family, 58, 502-513.

Ware, J. (1993). SF-36 Health Survey: Manual & interpretation guide. Boston: The Health Institute, New England Medical Center.

CHES AREAS

Responsibility I - Assessing Individual and Community Needs for Health Education

Competency B - Distinguish between behaviors that foster and those that hinder well-being

Responsibility VII - Communicating Health and Health Education Needs, Concerns, and Resources

Competency A - Interpret concepts, purposes, and theories of health education

Competency B - Predict the impact of societal value systems on health education programs

Responsibility VIII - Apply Appropriate Research Principles and Methods in Health Education

Competency A - Conduct thorough reviews of literature

Competency B - Use appropriate qualitative and quantitative research methods

Competency C - Apply research to health education practice

Heidi L. Hancher-Rauch, M.S. Gerald C. Hyner, Ph.D.

Heidi L. Hancher-Rauch, PhD and Gerald C. Hyner, PhD are affiliated with the Department of Health and Kinesiology at Purdue University. Address all correspondence to Heidi L. Hancher-Rauch, PhD , Purdue University, 800 West Stadium Ave., West Lafayette, IN, 47907-2046 ; PHONE: [phone] ; FAX: [phone]; E-MAIL: [e-mail].

Table 1. Perceived Spousal Support for Subjects with Exercising
Spouse Compared to Subjects with Non-Exercising Spouse.

 Spouse         N    Mean     SD       95% CI        t-score   p-value

Exerciser       60   35.57   10.76   32.82 - 38.3     5.358     <.001
Non-Exerciser   48   25.00    9.41   22.34 - 27.66