ADHERENCE

By: Grant Ammann

Adherence to an exercise program, defined as the “level of participation in a behavioral regimen once a person has agreed to undertake it” (Dishman, 1994), can be challenging for even the most advanced fitness enthusiast, but for the beginner, it can be nearly impossible. According to research, half of those people who begin an exercise program quit within six months (Cox, 2007; Roberts, 1992; Young, 2005). As indicated by Glyn C. Roberts (1992), most people who do adhere to an exercise program fail to meet the minimal requirements to see any health gains.

Over the last few years many health officials have been promoting the benefits of fitness; they suggest that 30 minutes of exercise or physical activity three days a week will help reduce morbidity and mortality rates. Exchanging a sedentary lifestyle for a more physically active lifestyle will have physiological and psychological benefits. Physiological benefits include reduced symptoms of Type II diabetes, obesity, hypertension, increased high density lipids (HDL), and increased metabolism to name a few. The psychological benefits to exercise include reductions in anxiety and depression plus increases in psychological well-being (Cox, 2007; Jones, Harris, Waller & Coggins, 2005; Roberts, 1992). With so many benefits linked with exercise and physical activity, it is important that people adhere to a program.

There are many factors that do not allow people to adhere to a program and need to be addressed for success. The three main categories that affect adherence are: personal factors (demographic variables, psychological health, education, values, beliefs, and behaviors), environmental factors (family support, social reinforcement, convenience of exercise location, and perceived availability of time), and program factors (intensity of the activity, perceived effort, perceived choice of activity, and support of the program or activity leader) according to Theresa Dwyre Young, MS (2005), with personal factors being the leading contributor.

Motivation is a large part of the personal factors and helps with adherence. According to Cox (2007), there are different motivations depending on age. The top five factors for people between the ages of sixteen and forty-four are: a) to feel in good physical shape, b) to improve and maintain health, c) to achieve mental alertness, d) to have fun, and e) to get outdoors. For people between the ages of forty-five and seventy-four the motivators are: a) to achieve mental alertness, b) to feel in good physical shape, c) to get outdoors, d) to feel independent, and e) to relax and forget careers.

As well, self-efficacy is a good predictor of exercise adherence (Jones et al., 2005); by increasing self-efficacy along with self-motivation one can increase levels of adherence (Dishman, 1994). Self-efficacy refers to how well an individual feels they can carry out a task; if the individual feels that they can succeed in an exercise program, they are more likely to. This is linked to a higher intrinsic motivation which, rather than any extrinsic motivation, helps with adherence (Cox, 2007). Intrinsic motivation is motivation that comes from within the individual and extrinsic motivation comes from an external source. By having more intrinsic motivation the individual may freely engage in the activity and have a full sense of personal control.

Another common factor that affects people's adherence to an exercise program is the distractions that are faced in everyday life including time constraints and commitment with families. Exercising takes time out of an already busy schedule for most people, which can make it hard to fit it in. By scheduling it into one's life, keeping consistent days each week and time of day, it becomes a regular appointment that has to be kept. Often even if they can find the time, there is a feeling of guilt that it is taking time away from other activities, for example spending time with children. It is important however that people do not dwell on the negative aspects, rather they think of the positive things that are associated with exercising (Rejeski & Kenney, 1988). For example, instead of thinking about not spending time with the family, individuals can think about the increased energy that they will have, which in turn can be spent playing with the family. Additionally Rejeski and Kenney (1988) state “do not view exercise as guilt, view it as a time you have earned.”

A big factor that is often overlooked is the support network that surrounds an individual who is starting to exercise. Support can come in many different forms, from a pat on the back to the buddy system (Dishman, 1994). If a significant other in a person's life does not support their partner's goals, the chances of that person adhering to the program drops off. Therefore it is vital for an individual to find out early on who will and who will not support the goals set forth. Implementing this social influencing into a program will provide assistance with the goal of adhering to a program.

Exercise adherence is very important for individuals because of the many health factors that are associated with being physically active. We have talked about a few different ways that will help with adherence, but there are many other ways. Personal factors have been proven the most effective way to change an individual's adherence scheme towards exercise. Changing personal factors makes an individual more accountable for his or her actions and also makes an individual more in control of their own goals. The key to adhering to a program is belief in one's self worth and maintenance of a high sense of self-efficacy.

References:

Cox, R. H., (2007). Sport psychology: Concepts and applications 6 th ed.. New York , NY : McGraw Hill.

Dishman, R. K. (1994). Advances in exercise adherence. Champaign , IL : Human Kinetics.

Jones, F., Harris, P., Waller, H., & Coggins, A., (2005). Adherence to an exercise prescription scheme: The role of expectations, self-efficacy, stage of change and psychological well-being. British Journal of Health Psychology, 10, 359-378. Retrieved September 25, 2007 , from SPORTdiscus database.

Rejeski, W. J., & Kenney, E. A., (1988). Fitness motivation: Preventing participant dropout. Champaign , IL : Human Kinetics.

Roberts, G. C., (1992). Motivation in sport and exercise. Champaign , IL : Human Kinetics.

Young, T. D., (2005, January/February). Factors determining exercise adherence. American Fitness. Retrieved September 25, 2007 , from SPORTdiscus database.