Table 3.

Physical Activity Mindset Level of Engagement and Example Quotes From Study Participants

Mindset Attributes	Example Quotes
Engaged
Acceptancea	(1714)”You have to make the best of it to live.” (1702) “Without this [dialysis] technology, I’d be dead. And I should have been dead a few times ago. Without me being born in this day and age, I would have died a long time ago.”
Positive reappraisal	(1700) “So, my daughter said, well, Ma, you gotta be careful. I said I am careful. I take my time; I take my steps as far as I can go. When I’m tired, I stop. Okay. But I just wanted to get my legs back in order again. I can’t run as fast as I used to, but I can run a little bit like that, right. But I’m so glad, with dialysis—if it wasn’t for dialysis, I don’t think I would have been here.” (1702) “I want to live. I don’t wanna survice, either. I wanna enjoy life. I realize that my attitude is mine, my attitude. Nobody’s responsible to make me happy but me. I don’t sit there and dwell on negativity.”
Purposeful	(1714) “So when I feel weak, I’m like no, I can’t just be down like this. I’ve got to push myself. I can’t stiffen up, and I can’t just be tired like this. I’ve got to go take care of my business. I’ve got to go. I’ve got to go take care of my business.” (1716) “When I go to do a project, or go to do some painting work, or go to just install a door, or do some plumbing job, or install a water heater, the next day. And that help me due to my condition. It help me feel good. It helps me feel real strong. Helps me feel positive.” (1706) “One of my dreams—I like to cook. That’s my—that was my passion, cooking. Pulls me outta my bed. Uncle you can cook for me? Okay. I’ll cook for you.” (1716) “I fixed a door for her. How much do I owe you? Uh-uh, no. No, nothing. No, no, no. Mm-mm. It was me. I did that from the bottom of my heart. And make me feel so good, so useful.”
Refocus on planning	(1702) “Make an agenda of what I need to get done. I make an agenda of prioritizing the things that I need to do, the things that I wanna do and the things that I have to do. And I usually categorize them like that, the most important first.” (1700) “I said, you gotta come better than this, you gotta do something better. So, what I did was this. I would get up out of my bed and I would hold onto the wheelchair and I would step. And I learned how to walk myself in my daughter’s house, okay. They had to carry me down the stairs. From there, they brought me into the ambulance and brought me to dialysis. And from there I said, you know what? I gotta practice on my own. So, I used to go up and down the stairs. Take my time up and down the stairs, to where I didn’t have to use the wheelchair anymore.” (1714) “But my life is different now being on dialysis because I’m taking more control. It’s not like I have to go to work. I have to come to the hospital because it’s my health, but I have a choice, too. When I was in the workforce, it was just set. So, I wasn’t really planning.”
Desire to help others	(1716) “And you know what I did for three months? I went 4:30 in the morning to pick her up, bring her to the clinic and take her back, for three months. And that made me feel so good.” (1703) “We have an advocacy program at my dialysis center. They asked me to be the one for Tuesday, Thursday, Saturday, knowing all of this because the social worker keep telling me I don’t see how. I’m just being myself. But she keeps telling me I’m such a help to the other patients.” (1702) “When I help somebody, I really feel good. It gives me a sense of purpose.”
Intermediate Engagement
Acceptancea	(1704) “I was upset about it, but I was like, well, I’ve got to go back—when they told me I had to go back on dialysis, they—matter of fact, the doctors didn’t want to put me back on dialysis, and I didn’t want to go back on dialysis. So they did everything they could to try to save the kidney, but it just didn’t work. So I went back on dialysis, and I said, hey, chalk it up to this. You’re still alive, kid. Deal with it.”
Goals with no plans	(1715) “As soon as I get my documentation, I want to start traveling. I don’t want to be stuck in just one place. I want to be six months here, six months in Brazil. I want to be like—travel. I want to change my life. I don’t want to be like this—getting too depressing so easy now. I don’t want to—I want to put some motivation in my life. I want to have something to do. So, I’m going to keep on traveling.”
Ruminationb	This participant talks about his desire to drive five times during the interview. (1707) “So when I would, like if somebody let me drive, I’m like okay. I’m like I can prove to you that I can still drive. I can show you that right now. So I’ll show them, and I’m like okay. I can drive. But they’re like but you’re not medically cleared. You’ve got to wait until you get your kidney, and I’m like but I just proved to you that I can drive. I’m like ‘I have a license. Can I just have the keys?’ That’s all. And even if somebody said well, I’m going to come with you—okay. I have no problem with that. But I want to drive.”
Disengaged
Ruminationb	(1711) “I feel disabled. I really am disabled, but I feel disabled more. Yeah. Because I can’t do the things I wanna do now. Can’t do the things. I can’t walk three blocks.”
Denial	(1709) “I don’t let—I’m with my normal life before this happened. It doesn’t bother me and I won’t think about it. I don’t have no purpose.” (1721) “I don’t even wanna think about it. I think about my normal life.”
Cognitive dissonance	(1721) “I’m not sure. Well, I got a son and I don’t want him to see me all down and out, so I just keep it cheerful, keep moving, keep it going.” Interviewer: So, you want to show your son you’re strong? “Yeah. I don’t wanna—this is somethings that is down and bad. So, just keep a little cheerful part.” Interviewer: But what do you do when you don’t feel so cheerful? “TV. Phone. Other than that, I’m already motivated and happy.”
No planning or goal setting	No quotes

^aAcceptance is an attribute in the engaged and intermediately engaged mindset

^bRumination is an attribute in the intermediately engaged and disengaged mindset