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Adherence

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									        Motivation and Adherence
Exercise specialists play an important role in
 educating the public about why regular physical
 activity is absolutely essential for good health and
 how to exercise safely and effectively
                  Adherence
Dropouts

Of those individuals starting an exercise program,
 half will drop out within six months.
        Motivation and Adherence
As an exercise specialist, you must help the client
 develop a positive attitude toward physical
 activity and make a firm commitment to the
 exercise program.
                 Adherence
To increase adherence, you need to be aware of
 factors related to attrition.
                   Adherence
Adherence to an exercise program is related to
 biological, psychological, behavioral, social, and
 environmental factors.
  See p 51 in Heyward book.
                   Adherence
The most critical factors characterizing the exercise
 program dropout are:
Being overweight
Having low self-motivation
Having anxiety about exercise
                  Adherence
Lack of spousal/family support
Inconvenient exercise facility
Exercise intensity that is too high
No social support during and after exercise.
                      Adherence
As the exercise specialist, you should focus
 particularly on those factors which are under your
 control such as
     setting individualized goals for the client,
     providing social support and reinforcement,
     and prescribing low-to-moderate exercise intensities.
               FIT
Corbin
F = Fun
I = Intrinsically motivating
Two Cs
  C = Builds self-competence
  C = Builds self-confidence
                   Adherence
To motivate your clients to exercise on a regular
 basis, prescribe physical activity that is enjoyable
 and fun.
                   Adherence
Variety is the spice of life

In an aerobic exercise program, for example, the
 participant does not need to do the same thing
 during every exercise session.
                  Adherence
Cross train

Other aerobic activities, such as swimming, cross-
 country skiing, and step aerobics may be
 substituted as long as the client exercises at the
 prescribed training intensity.
        Motivation and Adherence
Peer reinforcement

     Some individuals need the added motivation of exercising
      with a partner or with a formal group.
                    Adherence
Schedule and keep a log

Consistency is a critical factor for instilling the
 exercise habit.
                   Adherence
Help change behavior

You can use behavior modification techniques to
 increase program retention

  Positive reinforcement works best
                    Adherence
Extrinsic motivation

  Sometimes it can be effective to give rewards such as
   T-shirts, certificates, emblems, and pins to recognize
   the attainment of specific goals, such as walking a total
   of 50 miles in one month.
                    Adherence
Extrinsic motivation

  At other times, these incentives may bring about a
   certain degree of dependence on them.
                   Adherence
In the long run, intrinsic motivation is most
 effective

See Whitehead article
                    Adherence
Developing intrinsic motivation

Help your client set both short-term and long-term
 goals that are attainable
  Insure success
                 Adherence
You can state goals in performance or
 physiological terms

An example of a short-term performance goal is
 to complete a 3-mile fun run in less than 33
 minutes
                Adherence
A long-term physiological goal might be to
 increase maximum oxygen uptake (VO2MAX) by
 15% in four months
       Motivation and Adherence
Focus on process initially

Focus on product in the long-term
                   Adherence
Increasing intrinsic motivation

Periodically re-evaluate your client’s fitness
 levels to assess improvement
  Demonstrates progress
  Allows for necessary modification
  Allows to reassessment of goals
                  Adherence
Be a leader – actions speak louder than words!

The key to increasing exercise program adherence
 lies in the leadership, education, and motivation
 which you provide.
                 Adherence
Be a positive role model

Practice what you preach
                  Adherence
Educate your client

You must also be knowledgeable, able to educate
 clients about exercise and fitness, and able to
 provide motivation and encourage social support.
  See p. 54 in Heyward book
                   Summary
1. Emphasize enjoyable participation in physical
 activities that are easily done throughout life.

2. Offer a diverse range of noncompetitive and
 competitive activities for different ages and
 abilities.
                 Summary
3. Give people the skills and confidence they need
 to be physically active.

4. Provide physical and social environments that
 encourage and enable people to engage in safe and
 enjoyable physical activity.
     Prochaska’s Stages of Change
Process of health behavior change that can best be
 represented as a series of stages.
  Precontemplation
  Contemplation
  Preparation
  Action
  Maintenance
  Termination
             Precontemplation
Stage of change in which the individual does not
 intend to take action within 6 months.
               Contemplation
Stage of change begins when the person starts to
 think seriously about changing in the near future
 (within 6 months).
                  Preparation
Stage of change in which the individual intends to
 take action within the next 30 days.
                     Action
Stage of change in which the individual has made
 significant effort to change and, more importantly,
 has achieved some degree of success with that
 change.
                Maintenance
Stage of change in which the individual continues
 to implement behavior strategies in an attempt to
 avoid relapses regarding their behavior.
                Termination
Stage of change in which the former problem
 behavior presents no threat or temptation.

								
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