Why Do People Maintain an Exercise Program?

December 3, 2002

How Many People Exercise?

Behavior Risk Survey (1997):

Popular belief:

Important Considerations

Interventions Stage of Life Cycle

– Major life changes lead to declines in exercise

Adherence Models for Exercise

Most are developed from health psychology Why do people stop or continue smoking? What is the problem with this logic?

Adherence Models

Self-Efficacy/Social Cognitive Theory Health Belief Model Theory of Reasoned Action Theory of Planned Behavior Decision Theory Transtheoretical Model

Self-Efficacy/Social Cognitive Theory (Bandura, 1988)

Not as much of a health theory Efficacy Expectation-->Behavior-->

Outcome Expectations

Health Belief Model (Rosenstock, 1966)

Focus on preventative health behavior Most widely recognized conceptual

framework for health behavior Developed to encourage behaviors that

prevent unwanted negative conditions

Health Belief Model

Principle considerations– Individual must perceive a threat, and have– Sense of personal vulnerability– Disease will have at least moderate severity on

some component of life– Action will reduce severity or susceptibility– Very rational approach

Research on Health Belief Model

Slecker et al. (1984) used HBM to try to distinguish joggers from non-exercisers– Joggers = 3X/week for 20 minutes– Non-exerciser = hadn’t exercised regularly in past 6

months– Joggers = greater perception of severity, more

benefits of and cues to jogging, and less barriers to jog

– Perceived susceptibility did not distinguish joggers/non-exercisers

Health Belief ModelProblems

Theory of Reasoned Action(Azjen & Fishbein, 1980)

Applicable to volitional behaviors Assumes that people:

Theory of Reasoned Action(Azjen & Fishbein, 1980)

Intentions

Theory of Reasoned Action

Attitudes:

Theory of Reasoned Action

Subjective Norms:

Theory of Reasoned ActionProblems

Not appropriate for predicting or explaining behavior in situations where people had little power over events around them

If behavior is not fully under volitional control, a person may be highly motivated by attitudes and subjective norms, yet may not perform behavior

Theory of Planned Behavior(Azjen, 1985)

To improve predictive power, Azjen added another construct to the original model

Perceived Behavioral Control

Perceived ease or difficulty in performing a behavior

Extent that non-volitional factors interfere with ones' attempt to perform a behavior

Limitations

Decision Theory (Janis & Mann, 1977)

Use of cost-benefit analysis of behavior change

Costs of involvement in exercise may be high– time away from family, $$, social opportunities

Used as a strategy to make a decision May ask person to fill out a worksheet of

both, to draw attn. to benefits

Transtheoretical Model (Prochaska & DiClemente, 1983) 5-stage model Precontemplation

Contemplation

Transtheoretical Model

Preparation

Action Maintenance

Transtheoretical Model

Three advantages of dividing population into stages of change:

Transtheoretical Model