Exercise Part 4: Action
The Stages of Change model postulates behavioural change as a process of 5 identifiable stages through which patients pass: pre contemplation, contemplation, preparation, action and maintenance.
The model illustrates that for most persons a change in behaviour occurs gradually, with the patient moving from being uninterested, unaware or unwilling to make a change (pre contemplation), to considering a change (contemplation), or deciding and preparing to make a change (preparation); genuine, determined action is then taken and, over time, attempts to maintain the new behaviour occur.
This ‘stage’ concept allows for applying a temporal dimension to the Stages of Change . Within the model, relapses are almost inevitable and become part of the process of working toward life-long change . from http://www.jnrbm.com/content/10/1/13
| Stage of exercise behaviour and appropriate strategies | ||
| Stage | Definition | Appropriate Strategy |
| Pre-contemplation | Inactive & do not intend to become active in the next six months | Information on risks of inactivity, benefits of activity |
| Contemplation | Inactive, but thinking about becoming active in the next 6 months | Decision balance (weigh up pros and cons of becoming active).Discuss and overcome barriers. |
| Preparation | Made some attempts to become more active | Develop realistic activity goals.Establish support. |
| Action | Active, but only began in the last six months | Re-enforce successful attempts.Re-emphasise experienced benefits, overcome experience barriers. |
| Maintinance | Active for longer than 6 months | Relapse prevention.Alternative activities. |
Action Stage: THE Place to Be
The stage in which individuals modify their behaviour, experiences, or environment in order to overcome their problems. Action involves the most overt behavioural changes and requires considerable commitment of time and energy.
“My action is to go to the gym every second day for 45 minutes”
So, you are having your dose of exercise, great.
The questions to ask your self:
- Is it safe?
- Is it providing the desired effect?
- Am I adjusting my meal plan correctly?
- Do I have a wet weather / hot day plan?
- Am I having fun!?!
- What needs to happen to maintain this plan?
- What is my blood pressure / cholesterol / HbA1c – and as I continue with my exercise plan, are they improving?
- Has my podiatrist assessed my feet and given any special advice for the type of exercise that I have started?
- Shall I include an exercise physiologist in next years health care plan (again) with my GP?
- What are the things that will take me out of this action phase and back to the planning phase. And who can I talk to for support within the family?
Some Evidence : Research About Exercise
From: http://www.medscape.com/viewarticle/440097
Results: Patients in preparation and actions stages achieved a significantly larger reduction in hemoglobin A1c levels in a shorter time than patients in the combined precontemplation-contemplation stage.
Average change in hemoglobin A1c levels at 12 months was -1.06 ± 1.80 (P = .17) for the precontemplation-contemplation stage, -1.82 ± 1.84 (P = .006) for the preparation stage, and -2.56 ± 2.12 (P = .0006) for the action stage.
Patients had significantly more hemoglobin A1c measurements in the preparation stage (4.63 ± 2.42, P = .036) and the action stage (4.94 ± 2.38, P = .013) than patients in the precontemplation-contemplation stage (3.00 ± 1.22) during the 24-month study.
Conclusions: In this small population, stage of change as determined by a simple clinical tool was significantly associated with clinical improvement in hemoglobin A1c levels at 3 months after an educational intervention.
Significant differences in clinical improvement between groups persisted for at least 12 months. This tool could be used to tailor the most effective clinical diabetes interventions for patients and to address the needs of patients in a more targeted manner.
Self Care Planning can keep you happy and healthy, able to do all the things you want to achieve. Exercise is a crucial part of your self care plan.
From: http://strathprints.strath.ac.uk/25760/
Objective: Investigate the relationship between physical activity and components of the Transtheoretical model (TTM), in an older clinical population. Method: 85 people with Type 2 diabetes and/or cardiovascular disease (age 64.8 8.2 yrs) completed TTM questionnaires. Physical activity was assessed using the 7-day recall questionnaire. Results: Differences across stage of change were found for physical activity, self-efficacy, the pros of more physical active and 5 processes of change. Physical activity, self-efficacy and the pros of more activity were greater in the maintenance than contemplation stage. Stage differences in processes were: consciousness raising (increased contemplation to action), self-liberation (increased contemplation to maintenance), helping relationships (increased preparation to maintenance), counter conditioning (increased contemplation to preparation, action and maintenance) and reinforcement management (increased contemplation and preparation to maintenance). Experiential processes were used more than behavioural processes in the preparation stage. Conclusions: Findings support the theoretical predictions of the TTM and the use of this model in older clinical populations.
Safety
Have fun with your exercise, and don’t be afraid to ask questions of your team. Safety first – after all the purpose of exercise is to increase your health and future quality of life.
Im surrounded by people of all shapes and sizes at present. They are doing at least 2 weeks of a long distance walk. Its amazing the things they are doing NOT to be safe. In fact so many people are having injuries because they are on a deadline – e.g. have a plane to catch.
You have no deadline. So take your time.
Exercise at a level of comfort….
NOT the old and outdated adage of “NO PAIN NO GAIN”
It’s likely if it is painful then you are causing damage to your body.
Kind Regards,
David
Diabetes Educator @ Diabetes Counselling Online
