Exercise adherence has only been studied systematically for the past 20 years.  Only one adult in four meets the Surgeon General’s recommendations for adequate physical activity necessary for providing health benefits. 

It is frequently cited that as many as 50% of those who begin an exercise program drop out within the first 6 months (1).  As a result of research it is quickly found that those dropouts were lower in self-motivation (2).  Many also quoted “lack of time” as a deterring factor. These dropouts also appeared to have little self-efficacy (belief that you can accomplish the task).  Among the determinants most often found to be highly associated with adoption and maintenance of physical activity are high levels of self-efficacy and self-motivation as well as positive decisional balance, (that is, a belief in the benefits of activity and a lack of perceived barriers. Social support from friends and family also is important for regular exercisers, as is enjoyment of activity (3).  Numerous interventions have been designed to improve exercise adherence with individual clients and large groups, and have yielded less than spectacular results. Unfortunately, the most effective strategies and interventions have often been complex, time consuming and expensive.

Researchers continue to seek ways to study and understand exercise behavior, and one of the most effective instruments for doing so is the:
   
    “STAGES OF CHANGE MODEL” (4)
1.    Precontemplation:  currently not considering becoming physically active.
2.    Contemplation:  thinking about it.
3.    Preparation:  exhibiting some activity behavior.
4.    Action:  fully engaged in physical activity
5.    Maintenance:   active for 6 months
6.    Termination/Adoption:  active for more than a year and having internalized physical activity as a lifestyle.

It is found that long-term exercisers were higher in psycho logic characteristics such as self-motivation and self-efficacy and lower in negative decisional balance (they had fewer barriers).  The major purpose for studying the long-term exercisers was to examine their motivations, exercises behaviors, strategies and feelings they associated with regular physical activity.  It was no surprise to find that the number one reason given for long- term exercise activity was to “achieve fitness”.  The most surprising result was the powerful influence that “feelings” had in motivating these exercisers.  The feelings included:  (1) pep and energy, (2) enjoyment of activity, (3) better sleep, (4) feeling more alert and (5) feeling more relaxed. They exercise for fitness, make activity a priority, and they are highly motivated to maintain activity because of the POSITIVE FEELINGS they derive from doing so.

The study confirmed Gauvin’s description of long-term exercisers as primarily “autonomous exercisers” (5).  62% in the study always exercised alone and 35% exercised alone and occasionally in supervised programs, but only 3% were involved in a supervised program only.

We can empower individual by providing the challenge for them to examine daily and weekly schedules in an effort to designate space for exercise. Setting long-term global goals such as being healthy and fit has been found to be more effective than focusing on short-term results, i.e. “I need to lose 8 pounds before I go on that trip”.

New clients or those with motivational problems need to know that many positive emotions do not appear for some time but are worth waiting for.

Fitness professionals and exercise adherence researchers know there is no “silver bullet” or motivational strategy that works universally for all clients.  Both research and experience confirm that starting an exercise program is easier to accomplish than maintaining it. 

REFERENCES

1.    U.S. Department of Health and Human Services, Physical Activity and Health: A Report of the Surgeon General.  Atlanta, GA:  U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.

2.    Stone, W.J., and B. A. Norrid.  The effectiveness of an a priori prediction of exercise adherence in a voluntary aerobics class.  Arizona Journal of Health, Physical Education, Recreation & Dance 28(5):11-13, 1990.

3.    Fern, A. K., Social support:  What can it do for your clients exercise program?  ACSM’s Health & Fitness Journal 6(5):7-9, 2002.

4.    Prochaska, J. O., and C. C. DiClemente, Stages of processes of self-change in smoking: toward an integrative model of change.  Journal of Consulting & Clinical Psychology 51:390-395, 1983.

5.    Gauvin, I., An experiential perspective on the motivational features of exercise and livestyle.  Canadian Journal of Sports Science  15(1):51-58, 1990.

Frank O'Rourke