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Why Do People Maintain an Exercise Program? December 3, 2002 How Many People Exercise? Behavior Popular Risk Survey (1997): belief: Important Considerations Interventions Stage of Life Cycle – Major life changes lead to declines in exercise Adherence Models for Exercise Most are developed from health psychology Why do people stop or continue smoking? What is the problem with this logic? Adherence Models Self-Efficacy/Social Health Cognitive Theory Belief Model Theory of Reasoned Action Theory of Planned Behavior Decision Theory Transtheoretical Model Self-Efficacy/Social Cognitive Theory (Bandura, 1988) Not as much of a health theory Efficacy Expectation-->Behavior--> Outcome Expectations Health Belief Model (Rosenstock, 1966) Focus on preventative health behavior Most widely recognized conceptual framework for health behavior Developed to encourage behaviors that prevent unwanted negative conditions Health Belief Model Principle considerations – Individual must perceive a threat, and have – Sense of personal vulnerability – Disease will have at least moderate severity on some component of life – Action will reduce severity or susceptibility – Very rational approach Research on Health Belief Model Slecker et al. (1984) used HBM to try to distinguish joggers from non-exercisers – Joggers = 3X/week for 20 minutes – Non-exerciser = hadn’t exercised regularly in past 6 months – Joggers = greater perception of severity, more benefits of and cues to jogging, and less barriers to jog – Perceived susceptibility did not distinguish joggers/non-exercisers Health Belief Model Problems Theory of Reasoned Action (Azjen & Fishbein, 1980) Applicable to volitional behaviors Assumes that people: Theory of Reasoned Action (Azjen & Fishbein, 1980) Intentions Theory of Reasoned Action Attitudes: Theory of Reasoned Action Subjective Norms: Theory of Reasoned Action Problems Not appropriate for predicting or explaining behavior in situations where people had little power over events around them If behavior is not fully under volitional control, a person may be highly motivated by attitudes and subjective norms, yet may not perform behavior Theory of Planned Behavior (Azjen, 1985) To improve predictive power, Azjen added another construct to the original model Perceived Behavioral Control Perceived ease or difficulty in performing a behavior Extent that non-volitional factors interfere with ones' attempt to perform a behavior Limitations Decision Theory (Janis & Mann, 1977) Use of cost-benefit analysis of behavior change Costs of involvement in exercise may be high – time away from family, $$, social opportunities Used as a strategy to make a decision May ask person to fill out a worksheet of both, to draw attn. to benefits Transtheoretical Model (Prochaska & DiClemente, 1983) 5-stage model Precontemplation Contemplation Transtheoretical Model Preparation Action Maintenance Transtheoretical Model Three advantages of dividing population into stages of change: Transtheoretical Model