HEALTH PROMOTION

MAKING THE PLAN BECOME REALITY

By Dr Sylvia Titze, PhD

While past research on the health benefits of exercise has been focused on vigorous exercise, new guidelines confirm that one can also derive health benefits from those regular daily life activities of moderate intensity which accelerate breathing, such as brisk walking, climbing stairs or cycling. Increasing the number of indi- viduals who partake in physical activity is therefore a major pub- lic health challenge.

The Health Education Authority’s booklet entitled “Getting Active Feeling Fit - a simple guide to active living for all ages” (1) con- tains - with a good dose of humour - a lot of useful and motivat- ing information on how to plan and start getting active. The mes- sage is ‘it is easy to become a little more active every day’. The goal is to take part in 30 minutes of physical activity every day. Unfortunately, approximately two thirds of the population in industrialised societies are not active enough to derive health benefits.

This article presents a model about behaviour change and is fol- lowed by a description of two projects promoting health enhanc- ing physical activities. One is situated in a workplace setting and the other involves obese women. In both projects the target group were healthy adults aged between 25 and 60 years.

Yes, but.... Everyone knows, either from personal experience or from others, that sometimes we enthusiastically intend to change a behaviour pattern but it never happens. However on some occasions we are able to alter a behaviour pattern almost immediately and then continue to maintain this pattern for an extended period of time - begging the question, is it possible to predict whether our intentions become true or not? A model known as the transtheo- retical model can be helpful in understanding that behaviour change can happen quickly and also last a long time. The model suggests that individuals who are attempting to change their health behaviour move through a series of stages (2): a) precontemplation (not intending to make changes or denying the need to change)

b) contemplation (seriously considering making a change) c) preparation (making small changes) d) action (actively engaging in exercise but for less than six months)

e) maintenance (exercising regularly for the past six months)

From the exercise professional’s point of view people in the con- templation and preparation stages are the most sensible group to target as these people seriously intend to partake in physical

Reproduced with kind permission from the Greater Glasgow Health Board

activity. Research has demonstrated that the individuals in the contemplation and preparation stages will seek out more informa- tion about the benefits of exercise and the debilitating conse- quences of inactivity. They go through the process of evaluating the benefits and barriers of physical activity. Commonly the cons are more powerful than the pros. The exercise professional should help to overcome the barriers. A successful negotiation method for enhancing a person’s behaviour change is that the individual is the one to recognise and express the pros and cons rather than the exercise professional.

For people who have already started exercising (belonging to the stages of preparation, action and maintenance) it is important that the exercise professional works with them individually to organise incentives, before or after exercise, for maintaining the active lifestyle. For example if a walker achieves their goals they should allow themselves a reward, perhaps to buy some new clothes or trainers. The transtheoretical model tells us that the

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