HEALTH PROMOTION READINESS TO CHANGE

The benefits of keeping active are now well established but far less is known about the best methods that health pro- fessionals can use to help people con- vert their good intentions into regular activity which is then sustained.

The publication of the Allied Dunbar National Fitness Survey (1) illustrated the size of the challenge we face. It stated that “around 70% or more of each age group were below an acceptable activity level threshold that would confer significant health and functional benefits”. There is a new challenge to develop skills and strate- gies to encourage the sedentary majority of adults to be more active, more often.

Many people at some point in their lives make the decision to begin exercising reg- ularly and start with good intentions, unfortunately a large majority fail to sus- tain this effort. The physical activity “life- time” model (Fig.1) suggests the different stages of activity and inactivity that peo- ple will move through at different periods in their lifetime. The journey through these stages is not only driven by an individual’s biological (eg. gender, age, weight, health), social and environmental (eg. access to facilities, available leisure time) circum- stances but also by psychological and behavioural factors (2). The combination of these factors is unique to each individual, as will be their own activity “lifetime” his- tory. Understanding these factors is key to assessing their readiness (biological, psy- chological, social and environmental) and confidence to change to a more active lifestyle and developing the best course of actions to support them. It should also be recognised that these factors will change from stage to stage. It therefore follows that the required actions to support an individual in their journey from ‘sedentary’

to ‘adoption’ will be different from those required to ‘maintain’ their active lifestyle.

This article provides an overview of the key skills and strategies an exercise and health professional will need to employ to deter- mine someone’s readiness to change and prepare them for a successful move to an active lifestyle. These methods will be dis- cussed in more detail in future issues.

Methods of influencing confidence and readiness to change Self-confidence is a very important factor in moving a sedentary person through the journey to an active lifestyle. One of the leading theorists on confidence and behav- iour describes self-confidence as some- thing that is ‘situationally specific’ (2), ie.

Maintenance Sedentary Adoption Drop-Out Figure 1: A model of a physical activity “lifetime” (3) 24 SportEX Resumption

it changes with the environment around us.

Try to imagine a situation where you

have felt lacking in confidence or embar- rassed and relate that to how a normally sedentary person (who may be very confi- dent in other aspects of their life eg. work) may feel when they begin adopting a more active lifestyle.

1. Getting the environment right - first impressions The attitude and behaviour of the health and exercise professional is vital in estab- lishing a friendly and genuine relationship with the person and putting them at their ease. Try to see the exercising environ- ment, the staff and the activities which occur, through the eyes of a first time vis- itor. Depending on the context of the first meeting, for example in a health centre or leisure club, the person may be worried or concerned about wearing the correct cloth- ing, thoughts about their body shape and image and the possibility of saying the wrong thing or looking and feeling foolish. First impressions of the exercising environ- ment can have a positive or negative impact on the client. Look at the environ- ment and answer these questions from the view of a sedentary person.