ACSM’s Behavioral Aspects of Physical Activity and Exercise 2 ACSM’s Behavioral Aspects of Physical Activity and Exercise EDITOR Claudio R. Nigg, PhD Director: Health Behavior Change Research Workgroup Department of Public Health Sciences, John A. Burns School of Medicine University of Hawaii at Manoa Honolulu, Hawaii 3 Acquisitions Editor: Emily Lupash Managing Editor: Meredith L. Brittain Marketing Manager: Shauna Kelley Vendor Manager: Alicia Jackson Manufacturing Coordinator: Margie Orzech Designer: Holly McLaughlin Compositor: S4Carlisle Publishing Services ACSM Publication Committee Chair: Walter R. Thompson, PhD, FACSM, FAACVPR ACSM Group Publisher: Katie Feltman Umbrella Editor: Jonathan K. Ehrman, PhD, FACSM Copyright © 2014 American College of Sports Medicine All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data ACSM’s behavioral aspects of physical activity and exercise / editor, Claudio R. Nigg. p. ; cm. Behavioral aspects of physical activity and exercise Includes bibliographical references and index. E-ISBN 978-1-4511-3211-3 (alk. paper) I. Nigg, Claudio R., editor of compilation. II. American College of Sports Medicine, issuing body. III. Title: Behavioral aspects of physical activity and exercise. [DNLM: 1. Exercise—psychology. 2. Health Behavior. 3. Motivation. 4. Patient Compliance—psychology. QT 255] RA781 613.7’1—dc23 2013012305 DISCLAIMER Care has been taken to confirm the accuracy of the information present and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: http://www.lww.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST. 4 To my daughter, Zoe Nigg — You make it all worthwhile. 5 Preface Our understanding of why people change their physical activity has grown substantially in the past century. But much less is written or known about how people change their physical activity, or what people do or use to become physically active on a regular basis. (If physical activity were available as a pill, it would be the most often prescribed pill!) ACSM’s Behavioral Aspects of Physical Activity and Exercise was written to fill this gap for the practitioner and student alike. For practitioners, the book provides information for use in the field for trying to motivate individuals to become more active. For students, the text shows how to change and promote physical activity. Whether you are a practitioner or a student, you will find useful the tools, tricks, techniques, how-to’s, and strategies for the promotion of physical activity provided by our expert authors. ORGANIZATIONAL PHILOSOPHY The book is organized as follows: First, Chapter 1 provides a theoretical foundation — the leading theories of physical activity behavior change, in the belief that practical applications are based on good theories. Second, Chapter 2 addresses the idea that we cannot change what we cannot measure by providing know- how to assess the relevant aspects of physical activity (i.e., what you need to know about the people you are trying to motivate). Third, the main body of the book addresses how to change physical activity behavior. These chapters contain the majority of the tools, tricks, techniques, how-to’s, and strategies that you can use to help people get active and stay active. This part of the book covers a broad range of topics, from how you can help clients acquire the necessary skills (Chapter 3), to addressing how ready the client is (Chapter 4), to how to communicate with the client (Chapter 5), to delivering physical activity messages using different media (Chapter 6). Fourth, we provide the broader picture. This includes chapters about how to influence the environment and policy to help motivate people (Chapter 7), how to approach different populations (Chapter 8), and how to practically evaluate physical activity programs (Chapter 9). Finally, the last chapter (Chapter 10) focuses on the practical applications of professional skills, behaviors, and other factors that can facilitate or impede behavior change. FEATURES The book is intended to be engaging, easily applied, and useful in your efforts to help people become more physically active. To this end, most of the chapters include each of the following features: • Concept Overview briefly sets the stage for the chapter. • From the Practical Toolbox sections contain forms, checklists, charts, worksheets, and other resources that can be used immediately. (A collection of all the tools in the book is available on the book’s companion Web site; see the “Additional Resources” section that follows for more information.) • Evidence sections include explanations of the latest research that support concrete recommendations. • Step-by-Step applications are specific, user-friendly instructions that explain client-motivation techniques. • Case Scenarios emphasize real-world application of the material. • Take-Home Messages highlight the most important parts of the chapter. In addition, for those of you who are instructors, several resources are included on the book’s companion Web site, such as a Brownstone test generator, PowerPoint presentations, an image bank, and Learning Management System cartridges. See the “Additional Resources” section that follows for more information. All the people involved in this project sincerely hope that it will help you to help people become physically active. Thank you for what you do and enjoy the book. 6 ACKNOWLEDGMENTS I would like to thank the following people for their valuable contributions, without which this book would not have happened: the chapter authors for buying into this approach and writing to make a difference; Katie Amato and Ashley Tsumoto for editorial support for the chapters; Angie Chastain for keeping me organized (and on top of e-mails); Amanda Whittal for her support in copyediting Chapter 2; and the ACSM and Wolters Kluwer editorial team for their professionalism and their expertise. Finally, I would like to acknowledge ACSM for their vision in asking me to put this book together. Claudio R. Nigg, PhD Editor ADDITIONAL RESOURCES ACSM’s Behavioral Aspects of Physical Activity and Exercise includes additional resources for both instructors and students that are available on the book’s companion Web site at http://thepoint.lww.com/ACSMBehav. Instructors Approved adopting instructors will be given access to the following additional resources: • Brownstone test generator • PowerPoint presentations • Image bank • Learning Management System cartridges Students Students who have purchased ACSM’s Behavioral Aspects of Physical Activity and Exercise have access to the following additional resources: • A collection of all the practical tools in the book, such as forms, checklists, charts, worksheets, and other resources In addition, purchasers of the text can access the searchable full text on-line by going to the ACSM’s Behavioral Aspects of Physical Activity and Exercise Web site at http://thePoint.lww.com/ACSMBehav. See the inside front cover of this text for more details, including the passcode you will need to gain access to the Web site. 7 Contributors Kacie Allen, BS Virginia Tech Blacksburg, Virginia Chapter 9: Evaluating Physical Activity Behavior Change Programs and Practices Adrian Bauman, MD, MPH, PhD University of Sydney Sydney, New South Wales, Australia Chapter 7: Influencing Policy and Environments to Promote Physical Activity Behavior Change Ute Bültmann, PhD University Medical Center Groningen Groningen, The Netherlands Chapter 2: Assessing Your Client’s Physical Activity Behavior, Motivation, and Individual Resources Lauren Capozzi, BSc University of Calgary Alberta, Canada Chapter 8: Promoting Physical Activity Behavior Change: Population Considerations Brian Cook, PhD University of Kentucky Lexington, Kentucky Chapter 4: Building Motivation: How Ready Are You? S. Nicole Culos-Reed, PhD University of Calgary Alberta, Canada Chapter 8: Promoting Physical Activity Behavior Change: Population Considerations Danielle Symons Downs, PhD The Pennsylvania State University State College, Pennsylvania Chapter 1: Why Do People Change Physical Activity Behavior? Paul Estabrooks, PhD Virginia Tech Blacksburg, Virginia Chapter 9: Evaluating Physical Activity Behavior Change Programs and Practices Carol Ewing Garber, PhD, ACSM-PD, ACSM-RCEP, ACSM-HFS Columbia University New York, New York Chapter 10: Professional Practice and Practical Tips for the Application of Behavioral Strategies for the Physical Activity Practitioner Klaus Gebel, PhD University of Sydney Sydney, New South Wales, Australia Chapter 7: Influencing Policy and Environments to Promote Physical Activity Behavior Change 8 Heather Hausenblas, PhD Jackson University Jacksonville, Florida Chapter 1: Why Do People Change Physical Activity Behavior? Eric Hekler, PhD Arizona State University Phoenix, Arizona Chapter 6: How to Deliver Physical Activity Messages Sara Johnson, PhD Pro-Change Behavior Systems, Inc. West Kingston, Rhode Island Chapter 4: Building Motivation: How Ready Are You? Julia Kolodziejczyk, MS San Diego State University University of California, San Diego Chapter 6: How to Deliver Physical Activity Messages Kristina Kowalski, BSc, MSc, PhD(c) University of Victoria British Columbia, Canada Chapter 3: Building Skills to Promote Physical Activity Blake Krippendorf, BS Virginia Tech Blacksburg, Virginia Chapter 9: Evaluating Physical Activity Behavior Change Programs and Practices Sonia Lippke, PhD Jacobs University Bremen, Germany Chapter 2: Assessing your Client’s Physical Activity Behavior, Motivation, and Individual Resources Rona Macniven, MSc, BSc University of Sydney Sydney, New South Wales, Australia Chapter 7: Influencing Policy and Environments to Promote Physical Activity Behavior Change Greg Norman, PhD University of California - San Diego San Diego, California Chapter 6: How to Deliver Physical Activity Messages Serena Parks, PhD Virginia Tech Blacksburg, Virginia Chapter 9: Evaluating Physical Activity Behavior Change Programs and Practices Heather Patrick, PhD National Cancer Institute, National Institutes of Health Bethesda, Maryland Chapter 5: Communication Skills to Elicit Physical Activity Behavior Change: How to Talk to the Client Kimberly Perez, MA, ACSM-HFS Focus Personal Training Institute New York, New York Chapter 10: Professional Practice and Practical Tips for the Application of Behavioral Strategies for the Physical 9 Activity Practitioner Ernesto Ramirez, MS University of California - San Diego San Diego, California Chapter 6: How to Deliver Physical Activity Messages Erica Rauff, MS The Pennsylvania State University State College, Pennsylvania Chapter 1: Why Do People Change Physical Activity Behavior? Ken Resnicow, PhD University of Michigan Ann Arbor, Michigan Chapter 5: Communication Skills to Elicit Physical Activity Behavior Change: How to Talk to the Client Ryan Rhodes, PhD University of Victoria British Columbia, Canada Chapter 3: Building Skills to Promote Physical Activity Erin Smith, MA Virginia Tech Blacksburg, Virginia Chapter 9: Evaluating Physical Activity Behavior Change Programs and Practices Pedro J. Teixeira, PhD Technical University of Lisbon Cruz Quebrada, Portugal Chapter 5: Communication Skills to Elicit Physical Activity Behavior Change: How to Talk to the Client Claudia Voelcker-Rehage, PhD Jacobs University Bremen, Germany Chapter 2: Assessing your Client’s Physical Activity Behavior, Motivation, and Individual Resources Geoffrey Williams, MD, PhD University of Rochester Rochester, New York Chapter 5: Communication Skills to Elicit Physical Activity Behavior Change: How to Talk to the Client 10