7/29/2019 It s Time for a Change Behavior Change.9

http://slidepdf.com/reader/full/it-s-time-for-a-change-behavior-change9 1/2

by Deborah Riebe, Ph.D., FACSM

It’s Time for a ChangeIBehavior Change

There is a great deal of scientific

evidence that supports the rela-

tionship between health and

 physical activity. This information is not 

only found in peer-reviewed scientific

 journals but is consist ently reported by

the media using a variety of venues such

as print, television, and the Internet. A

Google search of ‘‘physical activity and

health benefits’’ yields more than 22 mil-

lion hits. In 1995, theU.S.Centers for Dis-ease Control and Prevention and the

American College of Sports Medicine

(ACSM) established the initial public

health recommendations for a physically

active lifestyle. These guidelines have

 been regularly updated to include the latest 

scientific information on how much exer-

cise is needed to promote good health,

most recently in the 2011 ACSM position

stand (2). Although exercise professionals

are very familiar with these recommenda-

tions, only one third of adults are aware of 

the guidelines (4).

Despite an overwhelming amount of 

information regarding the importance of 

 physical activity to health and the exis-

tence of national guidelines, most adults

in the United States do not engage in the

recommended amounts of physical activ-

ity. Even when individuals begin an ex-

ercise program, more than 50% will drop

out within the first 6 months (5). Pro-

viding knowledge and promoting aware-

ness of exercise recommendations is not 

enough to get most people exercisingregularly. For many years, we believed

that conducting fitness tests and showing

sedentary individuals ‘‘how out of shape

they were’’ would be enough to motivate

them to exercise regularly. This tech-

nique also was not effective. The bottom

line is that it is hard for most people to

maintain exercise habits over time, even

when they intend to. Therefore, the role

of the exercise professional should extend

 beyondcreating safe and effective exercise

 programs and includethe use of behavioral

techniques to help individuals become and

stay active. Integrating techniques that 

support sustainable behavior change re-

sults in far greater value to the clients we

serve.

There is a large scientific community

that focuses on understanding how peo-

 ple change behaviors. Behavioral scienceis theory driven and can be applied to

many health behaviors, including physi-

cal activity. Behavior change theories

have gained recognition for their possi-

 ble effect iveness in expla ining health-

related behaviors and provide insight 

into methods that would encourage in-

dividuals to develop and maintain healthy

lifestyles. Practitioners need to understand

and apply these theories to their clients

when they are trying to change health

 behaviors, such as adopting a physically

active lifestyle, changing theireating habits,

or quitting smoking.

Exercise practitioners are already

aware of the importance of behavioral

science. For example, in a recent sur-

vey of ACSM’s Certified Health Fitness

Specialists, almost 90% rated

‘‘optimizing the adoption and ad-

herence of exercise and other 

health behavioral strategies’’ as

important or very important, and

66% reported that they frequently

use behavioral strategies to helpclients become and remain active.

Many exercise professionals are

already using principles from be-

havioral science when working

with clients, such as goal setting,

increasing self-efficacy, and de-

creasing barriers to exercise. A

deeper understanding of behavioral

science allows practitioners to

more appropriately use these behavioral

techniques.

ACSM and the Committee of Certifi-

cation and Registry Boards have been pro-

active in incorporating behavioral science

into new and upcoming resources.

• Behavioral sciencehas beenincorporated

into two recent ACSM position stands:

) Quantity and Quality of Exercise for 

Developing and Maintaining Cardio-

respiratory, Musculoskeletal, and Neurom otor Fitne ss in Appare ntly

Healthy Adults: Guidance for Pre-

scribing Exercise (2)

) Exercise and Type 2 Diabetes: Amer-

ican College of Sports Medicine and

the American Diabetes Association:

Joint Position Statement (1)

• A new chapter entitled ‘‘Behavioral

Theories and Strategies for Promoting

Exercise’’ will be included in the ninth

edition of  ACSM’s Guidelines for Ex-

ercise Testing and Prescription, sched-uled to be published in 2013.

• A newtextbook dedicated to thescience

and practice of physical activity behav-

ior change also is scheduled to be pub-

lished in 2013.

ACSM Certification

VOL. 16/ NO. 4 ACSM’s HEALTH & FITNESS JOURNALA 33

Copyright ©2012 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.

7/29/2019 It s Time for a Change Behavior Change.9

http://slidepdf.com/reader/full/it-s-time-for-a-change-behavior-change9 2/2

In addition to the position stands and

 books , the new emphasis on behavior 

change also will be reflected in ACSM

certification workshops, webinars, and

examinations. In 2013, ACSM will tran-

sition from the current KSAs (knowl-

edge, skills, and abilities) to performancedomains (critical aspects of the profes-

sion) with specific knowledge and skill

statements. The science and practice of 

 behavior change will have a more promi-

nent role in each of ACSM’s major cer-

tifications, and both clinical and health

fitness professionals will be expected to

 possess and demonstrate in-depth knowl-

edge of behavior change. Workshops,

webinars, and the examinations themselves

will be changed to reflect this new emphasis

on behavior. Specific dates for the transition

will be available on the ACSM certificationWeb site http://certification.acsm.org.

Other health-related fields are recog-

nizing the importance of behavioral sci-

ence. A 2011 report from the Association

of American Medical Colleges states that 

a complete medical education must in-

clude findings from behavioral and

social sciences. The report provides medi-

cal schools pedagogic methods and per-

formance outcomes to aid faculty indesigning and evaluating their curricula

in behavioral sciences (3). Undergraduate

and graduate kinesiology and exercise

science programs also are beginning to

offer course work that flows from the

 behavioral sciences alongside that from

the physiological and biological sciences

as they embrace this new competency

framework and professional role for ex-

ercise practitioners. Our field is recog-

nizing that physical inactivity cannot be

addressed without attention to the behav-

ioral factors that contribute to it.Our field has reached a tipping point in

the transition of the role of the exercise pro-

fessional to include the promotion and sup-

 port of sustainable behavior change. With

the recent and upcoming changes in po-

sition stands, books, and certifications,

ACSM is once again ‘‘leading the way.’’

References 

1. American College of Sports Medicine.

Exercise and Type 2 Diabetes: American

College of Sports Medicine and the American

Diabetes Association: Joint position

statement. Med Sci Sports Exerc. 2010;42(12):

2282 Y 303.

2. American College of Sports Medicine.

Quantity and quality of exercise for 

developing and maintaining cardiorespiratory,

musculoskeletal, and neuromotor fitness in

apparently healthy adults: Guidance for 

 prescribing exercise. Med Sci Sports Exerc.

2011;43(7):1334 Y 59.

3. Association of American Medical Colleges.

Behavioral and Social Science Foundations for 

Future Physicians. Association of Medical

Colleges; Washington DC, USA; 2011:5 Y 16.

4. Bennett GG, KY Wolin EM, Puleo LC, Masse

LC, Atienza AA. Awareness of national

 physical activity recommendations for health

 promotion among U.S. adults. Med Sci Sports

 Exerc. 2009;41(10):1849 Y 55.

5. Dishman RK. Exercise Adherence: Its Impact 

on Public Health. Champaign (IL): Human

Kinetics; 1988.

Disclosure: The author declares no con-

flict of interest and does not have any fi-

nancial disclosures.

 Deborah Riebe,Ph.D.,

 FACSM , is a pro -

 fessor and chair of  

the Department of  

 Kinesi ology at the

University of Rhode

 Island. Dr. Riebe is

a past president of the New England Chap-

ter of ACSM and is the current chair of   

 ACSM’s Committee on Certification and 

 Registry Boards. Her research focuses on promo ting phys ical activity in spe cial 

 populations, with an emphasis on obesity

and aging.

TABLE: An Expert’s Point of ViewDr. Bryan Blissmer, an expert in the area of exercise psychology, provides insight into

incorporating physical activity behavior change into the professional practice of the health fitness

professional.

Throughout your career training you have learned how to develop exercise prescriptions to helpindividuals build or maintain fitness and improve performance based on fundamental scientific

principles and an understanding of how the body reacts to physical stressors. However, that

knowledge only is effective when and if people actually implement the programs you design.

Studying and learning about behavior change will give you tools to help translate your plans into

their actions.

Unfortunately there is no ‘‘one way’’ to help someone change his or her behavior or to motivate

him or her to follow through with his or her plans. Therefore, it is important that you learn about

a lot of different theories and principles that have been shown to be effective at helping people

change their behavior. The new resources being developed by ACSM are great places to start

getting this information. You can read textbooks that are focused on exercise psychology and read

journals devoted to the topic.

I like to think of the knowledge that you will be gaining as new ‘‘tools’’ at your disposal — or in

your toolbox. Once you understand the basic theories and principles behind them, you have anunderstanding of the science of behavior change. However, changing behavior among individuals

also requires mastering the art of knowing which tool to use for which person. A hammer isn’t

always the right tool for the job and in much the same way you need to be able to tailor your

motivational techniques to get the job done — helping people adopt and maintain your

well-developed exercise prescriptions.

VOL. 16/ NO. 434 ACSM’s HEALTH & FITNESS JOURNALA | www.acsm-healthfitness.org

ACSM Certification

Copyright ©2012 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.