change behaviour
to make exercise stick

Reasons for sticking with an exercise regime can change over time. By understanding behaviour change you can help increase exercise adherence in those struggling to make their good intentions an ongoing reality, says Fitness Australia’s David Menzies.

Initiating and maintaining a habitual exercise program is a process involving several stages: the decision to start exercising, the early stages of adoption, eventual change of behaviour, and then successful integration of these new behaviours into an individual’s lifestyle so that they are maintained over time. Although each stage has its own unique challenges, it is the last of these that perhaps presents the biggest obstacle. Imagine the health benefits achieved across the population if every client and member who had ever started working out with your fitness business had continued doing so. In addition to having a hugely successful fitness enterprise, your number one business problem – constantly having to replace lapsed members and clients with new ones – would cease to exist.

Studies suggest it may take more than just a great atmosphere, great trainers and a great workout to keep people exercising. Childhood exercise habits and psychological, physical, social and situational factors are all variables influencing exercise adherence.1

Initial interest in an exercise program is often related to a desire to obtain functional health and fitness benefits that will positively impact quality of life, both physically and mentally. The reasons for continuing with that exercise program, however, are fluid and often change over a lifetime. As an exercise or health professional you will sometimes require additional skills that enable you to better support people struggling to maintain an exercise program.

Health Change Australia (HCA) is one of a number of training organisations and thought leaders in the area of person-centred health behaviour change that has made it its mission to relay these skills. One approach that can be adopted is ‘health coaching’, which HCA defines as a practice in which health practitioners apply evidence-based health behaviour change principles and techniques to help clients adhere to treatment and lifestyle recommendations. Successful health coaching can empower clients to achieve better health outcomes.2

Services like the Get Healthy Information and Coaching Service, developed by the NSW Government, provides adults with free one-on-one phone coaching and goal setting from qualified health professionals to help set lifestyle goals, overcome barriers and setbacks, maintain motivation and achieve long-term lifestyle changes.

The Get Healthy Service also helps to reach people who are not being engaged by traditional fitness industry or other health services. These people often require repeated intensive contact to help move them along a behaviour change continuum toward a healthier, more active lifestyle.

This type of service is helping to reach sedentary people in the community who probably haven’t previously considered undertaking lifestyle changes, let alone using the services of the fitness industry. A Get Healthy coach is trained in behaviour change principles, such as motivational interviewing, that allow them to initiate and reinforce lifestyle changes with individuals. While promoting an increase in physical activity, the service where appropriate may also encourage people to seek Fitness Australia-registered fitness services.

The Get Healthy model is similar to that offered by tobacco cessation quitlines, whereby telephone counselling is offered to smokers or recent quitters. This type of service has been proven to be more effective than self-help interventions. Three or more telephone calls increases the odds of quitting compared to a minimal intervention such as providing standard self-help materials or brief advice, or through pharmacotherapy alone. Telephone quitlines provide important and easily accessible support for smokers, and call-back counselling enhances their usefulness.4

The physical, psychological, emotional, and social benefits associated with physical activity at all ages are well documented. Nonetheless, statistics from several studies on exercise adherence indicate that approximately 50 per cent of individuals who start a self-monitored exercise program will drop-out of that program within six months.5  In comparison, the extra lifestyle support offered through government initiatives like the Get Healthy Service has been demonstrated to lead to an improvement in healthy lifestyle factors such as elevated moderate physical activity levels, increased daily vegetable intake and decreased consumption of takeaway meals.6

Understanding the variables that influence exercise adherence, theoretical models of exercise adherence and strategies for behaviour change, and applying this knowledge to individual situations, can assist in developing regular exercise and its associated health benefits.


Make the change

To learn more about health behaviour change visit www.fitness.org.au/gethealthy or consider attending workshops such as those delivered by Health Change Australia, Wellness Coaching Australia or the Heart Research Centre.

David Menzies
David has 30 years’ experience in exercise science, physical activity promotion, primary health and population health. He has specific experience in chronic disease self-management, behaviour change theory, Aboriginal and Torres Strait Islander Health, programming for chronic disease and resistance training for people with chronic heart failure. David is the Quality Systems Development Manager at Fitness Australia.

References

1. www.ericdigests.org/pre-9219/exercise.htm
2 The HCA Model of Health Change: An integrated model of health behaviour change for chronic disease prevention and chronic condition self-management.
3. Miller, W. R., & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change, Guilford Publications.
4. www.ncbi.nlm.nih.gov. Telephone counselling for smoking cessation.Stead LF, Perera R, Lancaster T. Oxford University, Department of Primary Health Care, Old Road Campus, Headington, Oxford, UK
5. www.ericdigests.org/pre-9219/exercise.htm
6.Top line summary of results from the first three years (February 2009 to December 2011) of the NSW Get Healthy Information and Coaching Service®