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Changing behaviour: Avon FireFit Conference 2006. Dr Melvyn Hillsdon University of Bristol. King AC, Circulation. 1995;91:2596-2604 . Things that behaviour change theories have taught us.

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changing behaviour avon firefit conference 2006

Changing behaviour: Avon FireFit Conference 2006

Dr Melvyn Hillsdon

University of Bristol

things that behaviour change theories have taught us
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)
the impact of physical fitness tests on behaviour at 12 weeks
The Impact of Physical Fitness Tests on Behaviour at 12 weeks

Key to Activity Score

1 - Never

2 - < 1/month

3 - about 1/month

4 - 2 to 3 times/month

5 - 1 or 2 times/week

6 - > 3 times/week

Godin et al. 1987

increasing adherence via decisional balance
Increasing adherence via decisional balance

Hoyt & Janis J Personality and Soc Psych 1975; 31

week by week attendance for choice or not of exercise programme
Week by week attendance for choice or not of exercise programme

Thompson and Wankel J Appl Soc Psych 1980; 10

slide8

Effect of telephone prompts on meeting ACSM physical activity recommendations via walking:

Lombard et al: Health Psychology 1995; 14

slide9

Effect of exercise, frequency, intensity and location on adherence

King AC, Circulation. 1995;91:2596-2604

expectations and adherence
Expectations and adherence

Neff & King Med Ex Nut Health 1995; 4

slide11

Life events and exercise adherence

Oman & King Health Psych 2000; 19

relapse prevention and reinforcement
Relapse prevention and reinforcement

Marcus & Stanton RQES 1993; 64

slide13

Readiness/Motivation

Importance

Confidence

does the interaction between practitioner and client influence the likelihood of change
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 client’s task, not the health professional’s 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 professional’s empathy is associated with more favourable outcomes
summary
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.
summary17
Summary
  • Maintain regular contact with clients especially during the early weeks.
  • Have regular meetings with clients to reassess progress towards their goals. Members who don’t think their expectations are being met rapidly reduce their workout frequency.