Psycology - Case Study - 2 Pages
John.Quality
Chapter6Presentation.pptxhttp://www.free-powerpoint-templates-design.com
Physical Activity Interventions
Chapter 6
Why use intervention strategies?
Intervention strategies based on a sound theoretical framework
offer the greatest potential for
altering physical activity behavior
Interventions may not directly change behavior, but they can modify one or more PA determinants (which can, in turn, increase PA)
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PA Intervention Approaches
Change knowledge and attitudes about benefits of and opportunities for PA
Informational Approaches
Teaches behavioral management skills needed for adoption and maintenance
Behavioral Approaches
Creating social environments to facilitate and enhance behavior change
Social Approaches
Change structure of physical and organizational environment to provide safe, attractive and convenient places for PA
Environmental and policy approaches
Behavioral Approaches
Teach BEHAVIORAL SKILLS to adopt and adhere to an exercise regimen
Techniques taught through some form of counseling intervention
Behavioral Skills
Recognize/manage situations that can sabotage progress
Recognize cues and opportunities for PA
Develop strategies to maintain PA levels
Develop strategies to prevent relapse
Behavioral Interventions
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Behavioral Technique: The Exercise Contract
Assess current level of fitness
Create SMART Goal
Detail actions to achieve goal
Action Planning
Determine fitness level: Fitness assessment
Quantify exercise goal:
Write SMART goal, short term goals
Action Plan:
Use FITT Principle; implementation intentions
Track Progress: Self-Monitoring & Self reinforcement.
Relapse Prevention: Avoiding abstinence violation effect
Why is setting a goal so important?
Motivational Tool
A clear target
Feedback
↑self-efficacy
Roadmap
Step by step guidance
Clarifies expectations
Provider-Client understanding
Potential benefits and risks of goal setting
Consider your approach…
Benefits
Enhances focus and concentration
Risks
Goal setting might create a ceiling on performance
Boosts self-confidence
Helps prevent or manage stress
Creates a positive mental attitude
Increase intrinsic motivation to excel
Improve the quality of practice by making training more challenging
Enhance playing skill, techniques, and strategies
Improve overall performance
Fixation on goals may encourage shortcuts or drastic measures to get there
E.g. Client with weight loss goals fasts for 2 days before evaluation day
Goals can take the fun out of fitness
If this is true, you need to re-evaluate program
Stay away from “no pain no gain” principle
Every moment of exercising does not have to include monitoring, evaluation of whether or not goals are getting met, etc.
I am going to lose weight.
I will lose 10 pounds by December so that I can fit in my cocktail dress.
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Potential failures in goal setting
Goals should be challenging, yet realistic to accomplish and as specific as possible
If not challenging enough, may offer insufficient reward to “make it worth it”
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Not setting specific goals
No performance or process goals
Too many goals
Failure to acknowledge individual differences
Not providing follow up or evaluation
Action Plan
Concrete plans that specify when, where, and how a person will translate
exercise intentions into
action
e.g. Exercise Mondays, Wednesdays, Fridays for 30 minutes at moderate intensity at the campus gym, at 12:30 after I eat lunch.
https://www.verywellfit.com/f-i-t-t-principle-what-you-need-for-great-workouts-1231593
Self-Monitoring
Paying attentions to thoughts/feelings/behaviors then gauging against standard
Examples:
Rating of Perceived Exertion
Exercise logs
Track weight changes
GPS tracking
My Fitness Pal app
Runkeeper app
Fitbit
Awareness can modify behavior!!
Try to receive feedback regarding progress toward goal
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Relapse
High risk situations can trigger relapse
Injury, vacation, finals week, bad weather, boredom,
tired, distractions
Relapse: when an individual fails to resume regular exercise following a lapse in activity
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High Risk Situation
Negative Coping Response
Positive Coping Response
Increased self-efficacy
Decreased probability of relapse
Decreased self-efficacy
Initial exercise relapse
Abstinence violation effect
Increased probability of relapse
Abstinence
violation effect
All hope is lost All or nothing approach to exercise
Accompanied by negative emotional response
Feelings of guilt or shame, and self-attributions for failure (self-blame)
Positive Coping
Strategies
helps an individual be less likely to have exercise lapses and have greater self-efficacy
Cognitive
Strategies
Statements we make about ourselves which can be used to increase confidence, regulate arousal, and focus effort in order to overcome high-situations
E.g. “I shouldn’t skip the gym, I will study better after I go for a run”
1. Self Talk.
Seeing and feeling an experience in one’s mind.
E.g. get psyched up for work out class by visualizing how fun it is, plus how energized and refreshed you are post workout.
E.g. imagine how exciting it will be to reach long term goal
2. Visualization.
Positive Coping Strategies
Behavioral coping strategies
Developing and implementing overt plans to manage high risk situations
Examples?
Vacation
Weather
Work/School demands
Injury
.
Behavioral Interventions
Effectiveness?
Most effective strategy to increase PA.
Nearly 5 times more effective than other types of intervention (Dishman & Buckworth, 1996)
35% ↑ in time spent being physically active (Kahn et al. 2002)
Nearly 65% ↑ in energy expenditure (Kahn et al. 2002)
Behavioral Interventions
Drawbacks?
Not innately known strategies- must be taught.
Success depends on availability of resources
Huge number of people inactive!
Informational Interventions
Informational Interventions
Change knowledge and attitudes about benefits of and opportunities for physical activity
Objectives:
Provide info about benefits of PA
Arouse fear or concern about risks of inactivity
Increase awareness of opportunities
reach large #s of people
Explain techniques for overcoming barriers to activity
Provide strategies to overcome negative attitudes towards PA
Mass Media campaigns
Non-direct contact
Internet, commercials, PSAs, pamphlets
Effectiveness in changing people’s attitudes?
Mixed success (recall of information?)
What are their drawbacks?
$$$
May not reach target audience
May send wrong message
Examples:
Health risk appraisals (free community screenings)
Fitness appraisals
Physician counseling
Community health & wellness fairs
https://www.eatsmartmovemorenc.com/ProgramsNTools/ProgramsNTools.html
Interventions that engage community members and organizations in the development and delivery of information and strategies to increase PA
Community-Wide Campaigns
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Community-wide Campaigns
Effectiveness?
Effective for increasing the percentage of people who are active
Energy expenditure
Amount of active time
Drawbacks?
Dependent on:
Careful planning & coordination
Well-trained staff
Sufficient Resources
Extent to which key community members “buy into”/support the intervention
Point-of-Decision Prompts
Signs placed at points where people must choose between a sedentary or active option
Effectiveness?
Increase stair use by 54% in men and women
(Kahn et al., 2002)
Drawbacks?
Only effective as long as posted.
After a couple weeks of being removed, stair use goes back to normal
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Tailor the message – Cultural tailoring
“Gain-frame” the message
Emphasize specific PA benefits
Don’t focus on risk of not being PA
Can modify attitudes (TPB/TRA)
Increase motives (SDT)
Increase “pros” (TTM)
Enhance self-efficacy/perceived control (SET/TPB)
Provide simple “how to” information
Focus on why they should be active and how they can become more active
Tips for Effective Informational Interventions
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Social Approaches
Social Approaches
Insert the title of your subtitle Here
Structure people’s social
environments to help
support physical activity
endeavors.
Create new
social networks and
strengthen existing networks to ensure that people have
the necessary support.
Objective:
Face to face approaches
Mediated approaches
Types
FACE to FACE Approaches
People are often more motivated when exercising with other people than alone
Exercise Groups
Group Support System
Buddy Systems
Mediated
Approaches
Telephone and email support
systems
Calls from exercise counselor or interventionist
Provides informational and emotional support
Email may be more effective for younger population
Social Networking
E.g. Fitbit app, MapMyRun, PACT, RVA Runners, Facebook, etc.
Effectiveness
Social approaches often combined with behavioral and informational, so it is difficult to study separately.
Obese individuals benefited more from interventions with social approaches than healthy weight counterparts
Drawbacks
Contingent on the cooperation of group members or significant others
Must like each other/get along
Must work together
e.g. Active Winners program
Rival neighborhoods
Distruptions impeded delivery and deterred participation
Environmental Approaches
Environment & Policy Approaches
Policy (e.g. school)
Built environment
Social/cultural factors
Urban Planning
Ensure new neighborhoods are built with characteristics that promote physical activity
Sidewalks
Green spaces
Grid lay outs
Transportation
Create policies to promote non-motorized transport
Example: Bike sharing programs
RICHMOND! Denver, NYC, Philadelphia, D.C, Toronto, etc
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Increase number of weekly PE classes
Add new classes to appeal to kids
Lengthen duration of existing PE classes
Increase time spent being active during PE classes
Effectiveness? Very
Drawbacks? Funding
Modify
School-Based PE
Make sure the classes/activities are non-competitive, fitness-enhancing, and non-exclusive
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Access to Facilities
Build new facilities
Enhance access to existing facilities
Communities
Cities
Workplaces
Schools
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Effectiveness?
25% increase in proportion of people who exercise 3x per week
Interventions result in weight loss and decreases in body fat
Relative impact of increased access is unclear
Drawbacks?
Cost – time and resource consuming
No guarantee it will increase activity
Will depend on the other interventions
PA Interventions In the Real World
Interventions in a research setting may not directly translate to the “real world”
Why??
Study participants may be different from the general population
Research staff may have more time, expertise, and training in how to best deliver the intervention
Some interventions just aren’t feasible in the real world
RE-AIM Framework
Developed in 1999 to help evaluate interventions in real-world settings:
Reach: the percentage of people from a given population who participate in the intervention (and characteristics of these people)
Effectiveness: the positive/negative consequences experienced by participants
Adoption: proportions and representiveness (number/types of communities/settings that adopt an intervention) that adopt the intervention
Implementation: how well the intervention is delivered in the real world
Maintenance: extent to which the intervention is sustained over time
How about the “fun theory”?
https://www.youtube.com/watch?v=2lXh2n0aPyw
Can we encourage people to take the stairs instead of the elevator through built environment
interventions?
Conclusion
Four approaches to determining PA in interventions:
Behavioral
Goal setting (S.M.A.R.T.)
Relapse and coping strategies
Informational
Media/outreach campaigns
Tailor to your audience
Focus on benefits of activity, not risks of inactivity
Social
Exercise groups, buddy system, group support
Mediated approaches (apps, texting alerts)
Environmental/Policy
Built environment, PA in schools, PA facilities
Physical Activity Interventions in the “real world”
RE-AIM
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