Week 1 Topic 2 Methods for Changing Exer

Week 1 Topic 2Methods for Changing Exercise Behaviors : 

HM734 Prof. Warren Payne Week 1 Topic 2Methods for Changing Exercise Behaviors Prof. Warren Payne

Exercise Compliance : 

HM734 Prof. Warren Payne Exercise Compliance Dropout rates: 9-87% - generally highest in first 3 months (approx. 50% in 1 year) Similar to other health related behavior change Why the high dropout rate: exercise is voluntary, time consuming, results are not immediate, can be costly, can involve some discomfort.

Exercise Compliance : 

HM734 Prof. Warren Payne Exercise Compliance Two approaches: Assistance with reinvolvement Identification of dropout prone individuals: Psycho-social problems (perception, convenience): leads to half of drop outs

Exercise Compliance : 

HM734 Prof. Warren Payne Exercise Compliance Dropout Prone Individuals: Personal Factors Cigarette smoking Blue collar employment Inactive leisure Inactive occupation Type A personality Increase physical strength Extroverted

Exercise Compliance : 

HM734 Prof. Warren Payne Exercise Compliance Dropout Prone Individuals: Personal Factors Poor credit rating Overweight Poor self-motivation Depressed Hypochondriacal Anxious Introverted Low ego strength

Exercise Compliance : 

HM734 Prof. Warren Payne Exercise Compliance Program Factors Inconvenient time or location Excessive cost High intensity exercise Lack of exercise variety Exercising alone Lack of positive feedback Inflexible exercise goals Low enjoyment ratings Poor exercise leadership

Exercise Compliance : 

HM734 Prof. Warren Payne Exercise Compliance Other factors Lack of spouse support Inclement weather Excessive job travel Injury Job Change and/or move

Adult Learning Principles : 

HM734 Prof. Warren Payne Adult Learning Principles Learning Influenced by: Individual Social Environmental Medical Cultural factors

Principles of Adult Learning : 

HM734 Prof. Warren Payne Principles of Adult Learning Self direction Participation in decision making Base learning on past experience Use problem solving Learn only when ready (physically and emotionally stable)

Psychological Components of Behavior Change : 

HM734 Prof. Warren Payne Psychological Components of Behavior Change Behavior Modification Theory Social Cognitive Theory Readiness for Change Theory

Behavior Modification Theory : 

HM734 Prof. Warren Payne Behavior Modification Theory Patient actively involved in the process Setting realistic short term goals Determining their confidence to achieve each goal Receiving feedback on success and revise plan Receiving lifestyle/physical activity counseling (prompts to increase adoption and maintenance) Develop social support systems

Social Cognitive Theory : 

HM734 Prof. Warren Payne Social Cognitive Theory Interrelationship between: beliefs,understanding, environment and behavior Behavior is driven by beliefs

Social Cognitive Theory : 

HM734 Prof. Warren Payne Social Cognitive Theory Perceived ability to successfully change Self efficacy Can assess by asking clients to rate their confidence to change (0 –100%) If below 70% have low chance of success Low self efficacy: need to increase education and overcome barriers.

Readiness for Change Theory : 

HM734 Prof. Warren Payne Readiness for Change Theory Precontemplation Patients express lack of interest in making change. Moving patients through this stage involves utilization of multiple resources to stress the importance of the desired change. This can be achieved through written materials, education classes, doctor and family persuasion, and other means

Readiness for Change Theory : 

HM734 Prof. Warren Payne Readiness for Change Theory Contemplation: Patients are ‘thinking’ about making a desired change. This stage can be influenced by helping patients define the risks and benefits of making or not making the desired change (eg. Starting and exercise program).

Readiness for Change Theory : 

HM734 Prof. Warren Payne Readiness for Change Theory Preparation: Patients are doing some physical activity but not meeting the recommended criteria ie. 30 min of moderate intensity physical activity for 5 or more days, or 3-5 days/week of vigorous intensity activity for 20 minutes.

Readiness for Change Theory : 

HM734 Prof. Warren Payne Readiness for Change Theory Action: Patients are meeting the above-referenced (preparation) criteria on a consistent basis but they have not maintained the behavior for 6 months.

Readiness for Change Theory : 

HM734 Prof. Warren Payne Readiness for Change Theory Maintenance: Patients have been in action for 6 months or more.

Strategies to Improve Behavior Change Outcomes : 

HM734 Prof. Warren Payne Strategies to Improve Behavior Change Outcomes Integrating strategies from various theories Avoid considering our own behaviors as the gold standards Not necessary to use all strategies

Practical Recommendations to Enhance Exercise : 

HM734 Prof. Warren Payne Practical Recommendations to Enhance Exercise Testing and Prescription are often over emphasized in relation to behavioral components. Specifics: Recruit doctor to support exercise program Minimize injuries with moderate exercise prescription Advocate exercising with others Emphasize variety Positive reinforcement through periodic testing Recruit support amongst family members

Practical Recommendations to Enhance Exercise : 

HM734 Prof. Warren Payne Practical Recommendations to Enhance Exercise Specifics: Include recreational games Establish regularity of workouts Use progress charts to record achievements Recognition through a system of rewards Qualified, enthusiastic professionals

Program Models : 

HM734 Prof. Warren Payne Program Models Group v’s Individual (Home) Based Programs: Group Program Benefits: Safety where complicated pathology is involved Social reinforcement Facilitate education Group Program Negatives: Travel Shyness/Lack of Confidence

Practical Recommendations to Enhance Exercise : 

HM734 Prof. Warren Payne Practical Recommendations to Enhance Exercise Group v’s Individual (Home) Based Programs: Home Program Benefits: Reduced cost Convenience Independence Has been shown to effectively increase functional capacity and decrease CVD risk factors

Practical Recommendations to Enhance Exercise : 

HM734 Prof. Warren Payne Practical Recommendations to Enhance Exercise Group v’s Individual (Home) Based Programs: Home Program Negatives: Reduced effectiveness of education Reduced peer support Problems can be overcome by telephone contact, videos and internet.