Lecture 8: Goal Setting and Behavioral Management Flashcards
What is the difference between exercise adoption and exercise adherence
Adoption: Beginning a program
Adherence: Maintaining a program
What are the 3 factors that influence OA participation?
- Personal Characteristics
- Program related factors
- Environmental factors
What is the first question to ask
Are OA active Vs. YA?
What 3 personal characteristics can be negatively correlated with exercise participation?
- Demographic factors
- Health-Related factors
- Psychological factors
What are 5 demographic factors negatively correlated with exercise participation?
- Females
- Ethnic minority group
- Older (+85)
- Rural residence
- Low socioeconomic status
What are 5 health related factors negatively correlated with exercise participation?
- Poor health and physical condition
- illness
- arthritic pain
- smoker
- weight problems
Is willingness to commit to change a sufficient psychological factor to exercise adoption?
No, it is necessary but not sufficient
What psychological factors are needed for exercise adoption
- Exercise self-efficacy
2. Perception of greater benefits of exercise vs. barriers
What are the 5 physical personal characteristic motivators
- Improve health
- Prevent disease and disability
- manage chronic illness (dec. meds and pain)
- Improve mobility
- Improve appearance
What are the 3 psychological personal characteristic motivators
- Decrease stress and anxiety
- Reduce risk for depression
- Enjoyment
What is the relationship between PA and depressive symptoms in community dwelling elders
The prevalence of depressive symptoms decreases and PA increases.
Active OA have a better mood vs less active OA
What are the 4 personal characteristic barriers to exercise
- Lack of self motivation
- Lack of time
- Fear of falling/injury
- Lack of knowledge/experience w exercise
For program factors, the majority of OA like?
- programs of moderate intensity
- convenient programs
- inexpensive programs
- unstructured/independent PA
- Home programs (inc. adherence)
For program factors, the majority of OA dislike?
- programs to be competitive
2. group exercise programs
What fraction of OA prefer PA to be done outside a formal class/group setting
2/3
What fraction of OA prefer a group program
1/3
What are the 2 main environmental factors
- Social support
- from family, friends, health care providers - Physical factors
- distance from facility
- climate
- neighbourhood (safe?)
Can we change behavior?
Not that easy, but feasible
Is behavior change the new trend in our field?
yes
What are the 5 stages from the transtheoretical model
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
What is the precontemplation phase
Does not perform the desired behavior and has no intention of doing so in the foreseeable future (Within 6 months)
What is the contemplation phase
Thinking about adopting desired behavior within the next 6 months
What is the preparation phase
Plans to perform the desired behavior in the next month; may be trying it out but doesnt do it consistently
What is the action phase
performs the desired behavior consistently, but has been doing so for fewer than months
What is the maintenance phase
Continued to perform the behavior consistently for 6 months or more without faltering
What are the 6 steps to improve exercise program adoption and adherence
- Explore expectations and exercise objectives
- Set goals
- Provide feedback and monitor goals
- Use rewards and incentives
- Use problem solving to overcome obstacles
- Promote long-term adherence
In step 1: Explore expectations and exercise objectives, give an example of the importance
Different for an overweight OA who wants to lose weight vs OA with arthritis who wants to inc. mobility and dec. pain
TEAM EFFORT
In step 1: Explore expectations and exercise objectives
Want to verify?
Help choose/design?
Want to verify if expectations are realistic or not
Help design/choose the best exercise program
What do you do in step 2: Set goals?
You assist the participant in setting goals for achieving his/her overall objectives
Participant takes primary responsibility for setting his/her goals
Your role is to ask questions and request clarification
In step 2 (set goals) what are the characteristics of good goals
- Measurable: Participant can determine whether or not the goal was met
- Specific: Target a specific area for improvement
- Realistic: Goal that your participant is sure to achieve will increase self-efficacy
- Behavioral: Your participant has more control over goals that are behavioral (walks 3 times a week) vs goals that are outcome oriented (lose 15 lbs)
What initiating a new behavior, participants must set _____-term goals that are almost ______ to achieve
What initiating a new behavior, participants must set short-term goals that are almost certain to achieve
Short term goals help maintain ______ and ________
Short term goals help maintain motivation and increase self efficacy
Long term goals help to move from a stage of ______ to ______ to action
Long term goals help to move from a stage of contemplation to preparation to action
In step 3: Provide feedback and monitor goals, PA instructors often help their clients to set goals then then….?
PA instructors often help their clients to set goals then then never review their progress towards these goals
How often should the review progress be?
At the start: Weekly or biweekly
Once they have met some of their goals: monthly or bimonthly
Why should instructors encourage self monitoring
to help increase adherence
What is a behavioral analysis
A systematic method of examining the factors that increase or decrease the likelihood of exercising also called the A,B,C’s
What does a behavioral contract outline
The participants specific goals
How they will be measured
Consequences of the participants behavior
According to step 4: Does punishment have a greater impact on behavior than does reinforcement
No, reinforcement does
Participants should be encouraged to ________ for meeting their behavioral goals
Participants should be encouraged to reward themselves for meeting their behavioral goals
For new behvaior reinforcements should be _____ &______
For new behvaior reinforcements should be regular & constant
With time participants will find exercise reinforcing in and of itself (________ motivation) and will rely less on external motivation (_______ motivation)
With time participants will find exercise reinforcing in and of itself (intrinsic motivation) and will rely less on external motivation (extrinsic motivation)
Which is the best possible solution to address a problem or overcome obstacles (step 5)
- You think of an easy solution to this barrier. Share your solution with the client
- Ask your client if he has any ideas for overcoming the barrier
Ask your client if he has any ideas for overcoming the barrier.
Client can prob come up with his own solution and more likely to act on his own ideas
In step 6: A participants risk of dropping out of an exercise program is significantly lower when he or she has maintained participation for ___ months or longer
6
What is the difference between a lapse and a relapse
Lapse: Missing several exercise sessions
Relapse: Returning to a sedentary state
Why are lapses and relapses often triggered by
Often triggered by high risk situations with absence of coping responses
How to prevent relapse?
-Encourage participants to identify when they are likely to experience lapses or relapses
- Try to identify negatives thoughts associated
- -> i am not in the mood
- -> all or nothing thinking
- -> feeling discouraged
- Encourage participants to challenge their thoughts
- -> when we feel down we tend to exaggerate negative thoughts/perception
What are the most common situations to identify when likely to experience a lapse or relapse
- Travel
- Holidays
- Illness
- Stress
- Bad weather
- Family obligations
