Experts say self-efficacy is key to adhering to fitness program
Misperceptions, misinformation can be barriers to ongoing exercise
It’s the $64 Question of the wellness profession: Now that we’ve got our employees on a program, how do we ensure that this becomes a permanent lifestyle change?
An article in the November/December issue of the American College of Sports Medicine’s (ACSM) Health & Fitness Journal offers the assertion that self-efficacy is the key to program adherence.
"One of the greatest barriers to exercise is the perception that it takes special skill, ability, or knowledge to have a successful experience," writes Jeff Schlict, PhD, director of the Physical Activity Counseling Center at the University of Connecticut, and one of the article’s authors. "And we know that the most important thing a personal trainer or exercise leader can do is help people overcome that misinformation."1
Other experts in exercise psychology agree. "I think self-efficacy is really a scientific way of describing what we talk about as self-confidence," notes Shane Murphy, PhD, of Gold Medal Consultants, a sports psychology consulting firm in Trumbull, CT. "Research shows it is the critical factor in adherence." Murphy’s practice involves working with athletes, teams, and organizations to improve all aspects of their performance.
"What we have found and what the literature supports is that one’s confidence level is a better predictor [of success] than past performance," adds Susan Watts, MeD, NCC, associate director, behavioral science and health promotion, at The Cooper Institute for Aerobics Research in Dallas.
Taking a closer look
The authors of the ACSM article spend a great deal of time defining and parsing self-efficacy. Defining self-efficacy as "a person’s perception of his or her own ability to perform a given task," they identify it as a component of Social Cognitive Theory (SCT), created by Stanford University’s Albert Bandura, PhD.1
People with high exercise self-efficacy, they explained, "believe they have the knowledge and the skill to engage in exercise successfully. It is important to note that self-efficacy is behavior-specific, which means that someone with high self-efficacy regarding cardiorespiratory exercise does not necessarily have high self-efficacy regarding resistance training."1
"I think the key issue SCT took up was what exactly is self-efficacy — what are the dimensions that make it up?" offers Murphy. "I think [the authors] have helped us clarify exactly what sort of factors have an effect on long-term success. They also illustrate the importance of what we say to ourselves, the images we carry around about how we will perform in certain situations, and our emotional response to certain situations."
Building self-efficacy
To build or improve self-efficacy, said the ACSM authors, four key elements must be present:
1. Performance mastery. Generally considered the best way to enhance self-efficacy, this involves teaching proper exercise principles and techniques, and then giving employees the opportunity to practice what they have learned.
2. Vicarious experience. Also known as modeling, this involves having successful role models to observe.
3. Verbal persuasion. Employees need positive feedback about their ability and progress.
4. Emotional arousal. Inform your employees about the benefits of exercise and the health risks associated with sedentary lifestyles. (For helpful hints on putting those elements into practice, see article, p. 15.)
"This description is very accurate in terms of the stages presented," says Chuck Eier, senior fitness specialist with Quaker Oats Co. in Chicago.
Eier describes how he seeks to create performance mastery for his employees. "We give a demonstration of how to do [the exercise] properly and safely. Then, we make sure the employee is doing the exercise in a manner that will get the best results. This is especially important in strength training; in that field, technique and methodology are everything — if you don’t do things properly, you’re more likely to hurt yourself. Running, walking, and using the treadmill are not so technique-oriented."
Typically, his staff will demonstrate technique on an individual basis. The fitness center is kept open 14 hours a day to give employees ample opportunity to practice the techniques they have learned.
Eier and his staff strive to be decent role models for their employees by getting regular exercise themselves, "but we like to use other people’s successes here in the fitness center as role models," he says. "When we know someone has had a significant weight loss, or has lowered their blood pressure, we post those success stories on the wall in the fitness center."
"Research indicates there are two factors that help modeling," adds Murphy. "First, there’s modeling similarity. In other words, someone who’s in optimal shape may not help motivate you. But, if someone who looks much like you is doing it, you start to feel that if they can do it, you can, too. Another important factor is not necessarily mastery modeling, but coping modeling. Seeing another person struggle, but persist and overcome, seems to provide more inspiration."
Turning to verbal persuasion, Murphy’s recipe is simple: "People really like that external pat on the back. Often, a client will not need much more than that. But people also need to internalize that pat on the back, to say to themselves, I’m doing well. I enjoy this,’" he says. "The challenge for wellness programs is to get people away from the attitude that this exercise is good for me, but I hate it.’ We need to change that around to, This is a fun activity.’"
You can do this, Murphy suggests, by designing programs that are fun, and involve things people like to do anyway. "Some employees are well-suited to more traditional forms of exercise, but others want to hang out with their friends. For those people, something like a workplace volleyball league would work much better."
As for emotional arousal, Murphy recommends that you accentuate the positive aspects of exercise. "The research is clear: The fear factor doesn’t lead to persistent change in behavior," he says. "People need to feel the benefits of what they’re doing. For example, most people who become more active very quickly recognize the benefits in terms of energy, concentration, and better sleep. You can induce them to focus on these positive changes by asking them how they feel. This will help make them aware that they feel better. Some research shows that self-monitoring is also an excellent positive reinforcer, so suggest to your employees that they keep a diary or a log book."
Not every wellness professional is going to be an expert at emotional arousal, Eier warns. "I see it as having some kind of gift, to be able to get people pumped up — kind of like a coach being able fire up a team," he says. "Some people can do it really well, while others may be so-so."
That doesn’t mean you don’t try, he adds. "If you tell employees the positive aspects of exercise and what they can gain, you may really get them stoked up, or you just may help them realize the importance of exercise. Sometimes, that may be enough."
Incentives are always a good idea for encouraging program adherence, notes Murphy. "Every-thing we’ve learned about how people their manage own behaviors tell us that reward and punishment are critical factors. If there are incentives to try certain things, they will. Then, there needs to be some maintenance reinforcement — whether it’s group activities or benefits they can earn. You need to be able to continually reward yourself [for adherence]."
Watts notes that where an employee falls within the "Stages of Change" model (precon-templation, contemplation, preparation, action, or maintenance) is directly related to self-efficacy. "Self-efficacy really comes into play when you’re dealing with someone who is ready to take action or who is maintaining," she explains. "We use self-efficacy as a measure to predict future performance. When we look at someone who is just beginning to regularly perform, we question whether they will continue to exercise when they are tired, when it’s raining, when they travel, and so forth."
Avoiding relapse
As a behavioralist, says Watts, it’s very important to measure self-efficacy. "If we see that self-confidence is not there, we know that we need to go back and keep the person in a behavioral program for a longer period of time, or in one where they teach skill-building. Otherwise, there’s a very real danger of relapse."
It’s very important for wellness professionals to understand that the Stages of Change model should never be used in a vacuum. "You must also measure self-efficacy," she asserts, "but many people tend to neglect this when using the stage model. If you’re not utilizing self-efficacy and then the decisional balance (pros and cons) measures, then the total Transtheoretical Model’ simply won’t work."
Reference
1. Schlict J, Godin J, Camaione DC. How to help your client stick with an exercise program. Health & Fitness Journal 1999; 6:27-31.
• Susan Watts, The Cooper Institute for Aerobics Research, 12330 Preston Road, Dallas, TX 75230. Telephone: (972) 341-3233. E-mail: swatts@ cooperinst.org.
• Chuck Eier, The Quaker Oats Co., 321 N. Clark St., Suite 3-7, Chicago, IL 60610. Telephone: (312) 222-2828.
• Shane Murphy, PhD, Gold Medal Consultants, 500B Monroe Turnpike, Suite 106, Monroe, CT 06468. Telephone: (203) 459-0515. Fax: (203) 459-4237. E-mail: [email protected].
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