Active Lifestyle. Part 5

Monday, October 15, 2012 12:45
Posted in category Health

Applying the theories

Several of the theories presented in Chapter 6 of the Surgeon General’s Report apply to various aspects of one or more of the three frameworks just described. This section addresses the application of the theories to each framework as if the frameworks are not linked to each other. However, keep in mind that these frameworks are intricately intertwined. Thus, there is some overlap in theory application since each framework supports the others.

Stages of adoption models. Learning theory provides the theoretical justification for stages of adoption models (see Chapter 6, p.211). Learning theories emphasize that a new behavior, such as changing a sedentary lifestyle to an active one, requires modifying many small behaviors that contribute to the overall complex behavior. To keep people moving forward toward the ultimate desired behavior, learning theorists suggest a system of rewards. The theory is simple in its approach: complete a step and get a reward, then complete the next step and get a reward, and so on. A properly designed marketing strategy using behavior modification theories can be effective if the correct rewards are directed at the appropriate stages.

The transtheoretical perspective acknowledges that human behavior often entails a bit more cognitive activity (Chapter 6, p.213). A different “process of change” is used at each stage. A process of change is an activity that an individual can use to modify thinking, behavior or feelings about sport and exercise. It is the therapist’s job, or, in this case, the fitness marketer’s job, to encourage the correct change processes at each specific stage.

Psychotherapy research suggests that six change processes are applicable to changing sedentary behavior. These are provided in Table 1. As would be expected, if people are at the precontemplation stage, none of the change processes are activated. Most people in the U.S. appear to be aware that they should be physically active, however undertaking exercise is not a priority. Thus, fitness marketing and its immediate relevance to those in the pre-cognitive phase remains unnoticed and is ignored at the unconscious level. People move to the awareness and comprehension stage after some form of “consciousness raising.” That is, they recognize the self-relevance of the message and understand how it fits with their personal needs. The marketing task here is to stimulate consciousness-raising by prodding self-evaluation. During the action stages (evaluation, decision and trial), an individual moves through the stages toward the active lifestyle. Self-liberation, contingency management and helping relationships are all processes that people can use to help them adopt new behaviors. Finally, the individual will reach the adoption and maintenance stages. Counter-conditioning and stimulus control are valuable processes at these stages for preventing relapse. (See “Change process definitions” in Table 1.)

The main lesson from learning theory is that it is sometimes possible to keep people moving forward through the stages by offering rewards at each step. The reward strategy involves creating positive consequences for breaking habitual behaviors that are often satisfying, and undertaking new, initially not-so-satisfying behaviors. This is an external motivation strategy and can quite often move people into action in the short-term.

The health belief model, on the other hand, generally assumes that people must be internally motivated to progress through the stages. In this case, the threat of disease acts as the internal stimulant, and individuals must feel personally susceptible to a disease to really feel motivated to change their behavior. An individual must also perceive that there are benefits to taking preventive action that outweigh the perceived barriers. This implies a marketing strategy designed to stimulate thoughts about the perceived health threats if an individual does not perform that behavior.

At each stage, there is a major problem of relapse. The relapse prevention model (Chapter 6, p.213) addresses this directly by identifying factors that contribute to relapse and suggesting intervention strategies. So, whereas other models suggest processes to move people forward, the relapse prevention model focuses more on preventing people from sliding back. Factors contributing to relapse include:

1. Negative emotional state

2. Limited coping skills

3. Social pressure

4. Interpersonal conflict

5. Limited social support

6. Low motivation

7. High risk situations

8. Stress

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