Lecture 8: Goal Setting and Behavioral Management

Question 1

What is the difference between exercise adoption and exercise adherence

Answer 1

Adoption: Beginning a program

Adherence: Maintaining a program

Question 2

What are the 3 factors that influence OA participation?

Answer 2

1. Personal Characteristics
2. Program related factors
3. Environmental factors

Question 3

What is the first question to ask

Answer 3

Are OA active Vs. YA?

Question 4

What 3 personal characteristics can be negatively correlated with exercise participation?

Answer 4

1. Demographic factors
2. Health-Related factors
3. Psychological factors

Question 5

What are 5 demographic factors negatively correlated with exercise participation?

Answer 5

1. Females
2. Ethnic minority group
3. Older (+85)
4. Rural residence
5. Low socioeconomic status

Question 6

What are 5 health related factors negatively correlated with exercise participation?

Answer 6

1. Poor health and physical condition
2. illness
3. arthritic pain
4. smoker
5. weight problems

Question 7

Is willingness to commit to change a sufficient psychological factor to exercise adoption?

Answer 7

No, it is necessary but not sufficient

Question 8

What psychological factors are needed for exercise adoption

Answer 8

1. Exercise self-efficacy

2. Perception of greater benefits of exercise vs. barriers

Question 9

What are the 5 physical personal characteristic motivators

Answer 9

1. Improve health
2. Prevent disease and disability
3. manage chronic illness (dec. meds and pain)
4. Improve mobility
5. Improve appearance

Question 10

What are the 3 psychological personal characteristic motivators

Answer 10

1. Decrease stress and anxiety
2. Reduce risk for depression
3. Enjoyment

Question 11

What is the relationship between PA and depressive symptoms in community dwelling elders

Answer 11

The prevalence of depressive symptoms decreases and PA increases.

Active OA have a better mood vs less active OA

Question 12

What are the 4 personal characteristic barriers to exercise

Answer 12

1. Lack of self motivation
2. Lack of time
3. Fear of falling/injury
4. Lack of knowledge/experience w exercise

Question 13

For program factors, the majority of OA like?

Answer 13

1. programs of moderate intensity
2. convenient programs
3. inexpensive programs
4. unstructured/independent PA
5. Home programs (inc. adherence)

Question 14

For program factors, the majority of OA dislike?

Answer 14

1. programs to be competitive

2. group exercise programs

Question 15

What fraction of OA prefer PA to be done outside a formal class/group setting

Answer 15

2/3

Question 16

What fraction of OA prefer a group program

Answer 16

1/3

Question 17

What are the 2 main environmental factors

Answer 17

1. Social support
   - from family, friends, health care providers
2. Physical factors
   - distance from facility
   - climate
   - neighbourhood (safe?)

Question 18

Can we change behavior?

Answer 18

Not that easy, but feasible

Question 19

Is behavior change the new trend in our field?

Answer 19

yes

Question 20

What are the 5 stages from the transtheoretical model

Answer 20

1. Precontemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance

Question 21

What is the precontemplation phase

Answer 21

Does not perform the desired behavior and has no intention of doing so in the foreseeable future (Within 6 months)

Question 22

What is the contemplation phase

Answer 22

Thinking about adopting desired behavior within the next 6 months

Question 23

What is the preparation phase

Answer 23

Plans to perform the desired behavior in the next month; may be trying it out but doesnt do it consistently

Question 24

What is the action phase

Answer 24

performs the desired behavior consistently, but has been doing so for fewer than months

Question 25

What is the maintenance phase

Answer 25

Continued to perform the behavior consistently for 6 months or more without faltering

Question 26

What are the 6 steps to improve exercise program adoption and adherence

Answer 26

1. Explore expectations and exercise objectives 2. Set goals 3. Provide feedback and monitor goals 4. Use rewards and incentives 5. Use problem solving to overcome obstacles 6. Promote long-term adherence

Question 27

In step 1: Explore expectations and exercise objectives, give an example of the importance

Answer 27

Different for an overweight OA who wants to lose weight vs OA with arthritis who wants to inc. mobility and dec. pain TEAM EFFORT

Question 28

In step 1: Explore expectations and exercise objectives Want to verify? Help choose/design?

Answer 28

Want to verify if expectations are realistic or not Help design/choose the best exercise program

Question 29

What do you do in step 2: Set goals?

Answer 29

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

Question 30

In step 2 (set goals) what are the characteristics of good goals

Answer 30

- 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)

Question 31

What initiating a new behavior, participants must set _____-term goals that are almost ______ to achieve

Answer 31

What initiating a new behavior, participants must set short-term goals that are almost certain to achieve

Question 32

Short term goals help maintain ______ and ________

Answer 32

Short term goals help maintain motivation and increase self efficacy

Question 33

Long term goals help to move from a stage of ______ to ______ to action

Answer 33

Long term goals help to move from a stage of contemplation to preparation to action

Question 34

In step 3: Provide feedback and monitor goals, PA instructors often help their clients to set goals then then....?

Answer 34

PA instructors often help their clients to set goals then then never review their progress towards these goals

Question 35

How often should the review progress be?

Answer 35

At the start: Weekly or biweekly | Once they have met some of their goals: monthly or bimonthly

Question 36

Why should instructors encourage self monitoring

Answer 36

to help increase adherence

Question 37

What is a behavioral analysis

Answer 37

A systematic method of examining the factors that increase or decrease the likelihood of exercising also called the A,B,C's

Question 38

What does a behavioral contract outline

Answer 38

The participants specific goals How they will be measured Consequences of the participants behavior

Question 39

According to step 4: Does punishment have a greater impact on behavior than does reinforcement

Answer 39

No, reinforcement does

Question 40

Participants should be encouraged to ________ for meeting their behavioral goals

Answer 40

Participants should be encouraged to reward themselves for meeting their behavioral goals

Question 41

For new behvaior reinforcements should be _____ &______

Answer 41

For new behvaior reinforcements should be regular & constant

Question 42

With time participants will find exercise reinforcing in and of itself (________ motivation) and will rely less on external motivation (_______ motivation)

Answer 42

With time participants will find exercise reinforcing in and of itself (intrinsic motivation) and will rely less on external motivation (extrinsic motivation)

Question 43

Which is the best possible solution to address a problem or overcome obstacles (step 5) 1. You think of an easy solution to this barrier. Share your solution with the client 2. Ask your client if he has any ideas for overcoming the barrier

Answer 43

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

Question 44

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

Answer 44

6

Question 45

What is the difference between a lapse and a relapse

Answer 45

Lapse: Missing several exercise sessions Relapse: Returning to a sedentary state

Question 46

Why are lapses and relapses often triggered by

Answer 46

Often triggered by high risk situations with absence of coping responses

Question 47

How to prevent relapse?

Answer 47

-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

Question 48

What are the most common situations to identify when likely to experience a lapse or relapse

Answer 48

- Travel - Holidays - Illness - Stress - Bad weather - Family obligations