Changing behaviour: Avon FireFit Conference 2006

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Changing behaviour Avon FireFit Conference 2006

• Dr Melvyn Hillsdon
• University of Bristol

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King AC, Circulation. 1995912596-2604
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Things that behaviour change theories have taught
us

• Rewards and punishments (response consequences)
  influence the likelihood that a person will
  perform a particular behaviour again in a given
  situation.
• Humans can learn by observing others as well as
  by performing a behaviour personally.
• We are most likely to model a behaviour observed
  by others if we identify with that person.
• We are more likely to perform a behaviour if we
  predict that it will lead to outcomes that we
  desire or value and the costs of change are not
  too great.
• We are more likely to engage in a particular
  behaviour if significant others do so (social
  norm)
• We are more likely to perform a behaviour if we
  are confident we will be successful (self
  efficacy)

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The Impact of Physical Fitness Tests on Behaviour
at 12 weeks
Key to Activity Score 1 - Never 2 - lt 1/month 3
- about 1/month 4 - 2 to 3 times/month 5 - 1 or 2
times/week 6 - gt 3 times/week
Godin et al. 1987
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Increasing adherence via decisional balance
Hoyt Janis J Personality and Soc Psych 1975 31
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Week by week attendance for choice or not of
exercise programme
Thompson and Wankel J Appl Soc Psych 1980 10
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The effect of efficacy training on the frequency
of walking
MaAuley et al Prev Med 1994 23
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Effect of telephone prompts on meeting ACSM
physical activity recommendations via
walking Lombard et al Health Psychology 1995 14
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Effect of exercise, frequency, intensity and
location on adherence
King AC, Circulation. 1995912596-2604
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Expectations and adherence
Neff King Med Ex Nut Health 1995 4
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Life events and exercise adherence
Oman King Health Psych 2000 19
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Relapse prevention and reinforcement
Marcus Stanton RQES 1993 64
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Readiness/Motivation
Importance
Confidence
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Factors that influence readiness to change
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Does the interaction between practitioner and
client influence the likelihood of change?

• Motivation to change is elicited from the client,
  and not imposed from without.
• It is the clients task, not the health
  professionals to articulate and resolve the pros
  and cons of change.
• Direct persuasion is not an effective method for
  resolving ambivalence.
• Client resistance predictive of failure to change
• Changing negotiating style between
  confrontational and client centred also changes
  level of resistance.
• The professionals empathy is associated with
  more favourable outcomes

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Summary

• At the outset of a programme get clients to
  systematically go through the anticipated pros
  and cons of exercise for them. This should
  preferably be done verbally.
• Adopt a client centred interpersonal style during
  the initial consultation.
• Make sure that clients have realistic
  expectations about the changes they can expect
  and how long such changes take to achieve.
• Have clients actively involved in the
  decision-making processes that lead to their
  first programme. This means avoiding the idea of
  best or ideal programmes. Introduce a menu
  approach to programming.
• Increase clients confidence for exercise by
  selecting low skill exercises and frequently
  reinforcing successful completion of these
  exercises.
• If possible introduce clients to others who have
  been successful at changing behaviour.

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Summary

• Maintain regular contact with clients especially
  during the early weeks.
• Have regular meetings with clients to reassess
  progress towards their goals. Members who dont
  think their expectations are being met rapidly
  reduce their workout frequency.