Increasing Exercise With A Little Boost
As we struggle to become more physically active, simple programs
that provide feedback and motivation can play a crucial role in
getting people off to a good start, according to a study of the
July issue of Health Psychology.
Researchers found feedback delivered via mail was equally as
effective at increasing physical activity in the short-term and
potentially more effective long-term than feedback delivered via
The study enrolled 239 healthy, underactive adults into two individualized
programs either with telephone-based or print-based feedback for
one year. A control group received generic health information
with no physical-activity specific information. They then could
chose either the print or phone program after one year. Study
participants submitted data about their physical activity in personal
logs and surveys.
The print and telephone based programs incorporated social cognitive
theory and the transtheoretical model both of which emphasize
the importance of increasing motivational readiness for physical
activity, balancing the pros vs. cons of activity, and developing
strategies for becoming and remaining physically active, said
Melissa Napolitano, Ph.D, an author of the study at Temple University
and expert in physical activity initiation, adoption and maintenance.
"Both programs offer a cost-effective way to promote healthy
behaviors, such as exercise," Napolitano said.
Feedback, whether delivered via phone by a health educator or
via a printed letter, pointed out areas for improvement and recognized
successful efforts by the participants.
Researchers designed the program to encourage participants to
reach the national guidelines for physical activity at 150 minutes
per week. They completed a physical activity log and brief survey
each month, and two in person visits. Compensation was provided
for each completed activity.
Currently, people can find phone counseling programs through
outlets such as their health insurance providers. Other programs
are available online and in print-based formats. For example,
the American Heart Association has a program designed for women,
Choose to Move (www.choosetomove.org,
print materials available by calling 1-888-MY-HEART), which promotes
healthy eating and physical activity.
Inactive adults nearly double their risk for cardiovascular disease.
Only 25 percent of Americans meet the recommended levels of physical
activity, defined by engaging in moderate intensity activity four
days or more each week for 30 minutes or vigorous activity for
30 minutes for 3 days or more each week, according to the Centers
for Disease Control and Prevention.
However, CDC data suggests more people are trying to increase
their physical activity levels. People engaging in no physical
activity decreased from about 31 percent in 1989 to 25 percent
in 2005 in an analysis of 36 states.
"With print, computer and telephone-based programs it is possible
for larger numbers of inactive and underactive adults to receive
critical help, support, and advice for becoming more physically
active and ultimately preventing disease and disability," Napolitano
At 6 months, the print group and telephone group reported 129
and 123 minutes of physical activity, respectively. By the end
of the study at 12 months, those in the print program reported
160 minutes of physical activity a week compared to 100 minutes
in the phone group and 90 minutes in the control group.
While this finding was unanticipated, there are some explanations
why the researchers think this might have happened. First, the
print group received hard-copies of all the materials which they
could use as a resource throughout the 12 months, whereas the
phone group only received verbal feedback and information.
Secondly, it is possible that the print group had to develop
more internal or intrinsic motivation as they didn't have the
specific social support and contact with a personal health educator.
Whereas the phone participants may have been relying more on extrinsic
motivation, or the support and encouragement of the counselor.
The counseling was helpful in the short-term, but may not have
been as effective as the contact tapered off through the maintenance
Future studies should examine whether the combination of the
print and phone programs could produce even better results, and
different delivery channels, such as email, text messaging and
the Internet, Napolitano said.