Current Trends In Exercise & Fitness: Aging well Across the LifespanUnit 2 Seminar

AgendaWelcome, Review and look aheadPA vs ExerciseMatching Game with the Transtheoretical Model of ChangeMediators in PACase StudiesSummary and Wrap Up

Welcome, Review and Look ahead

PA vs ExerciseWhats the difference?

PA vs ExerciseAccording to the ACSM, what is the recommendation for PA?

PA vs ExerciseAccording to the ACSM, what is the recommendation for PA? 30 Minutes, moderate intensity, on most if not all days of the week

PA vs ExerciseWhat about recommendations for exercise?

PA vs ExerciseWhat about recommendations for exercise?3-5 days/week of vigorous aerobic activity

PA vs ExerciseWhy do we need more daily PA?What changes have occurred that has made us more sedentary?

PA vs ExerciseWhy do we need more daily PA?What changes have occurred that has made us more sedentary?Technology, fast food, sedentary computer jobs, TV, internet, etc

PA vs ExerciseWhy do we need more daily PA?What changes have occurred that has made us more sedentary?What are some ways that we can incorporate more PA into our everyday lives?

PA vs ExerciseWhy do we need more daily PA?What changes have occurred that has made us more sedentary?What are some ways that we can incorporate more PA into our everyday lives? short walks/breaks at work, walk vs email, stairs instead of elevator, park farther away, fix our own food

Stages of Change..A Review

Stages of Change..A ReviewStage 1---Precontemplation

Stages of Change..A ReviewStage 1---PrecontemplationStage 2---Contemplation

Stages of Change..A ReviewStage 1---PrecontemplationStage 2---ContemplationStage 3---Preparation

Stages of Change..A ReviewStage 1---PrecontemplationStage 2---ContemplationStage 3---PreparationStage 4---Action

Stages of Change..A ReviewStage 1---PrecontemplationStage 2---ContemplationStage 3---PreparationStage 4---ActionStage 5---Maintenence

Stages of Change..A ReviewStage 1---PrecontemplationStage 2---ContemplationStage 3---PreparationStage 4---ActionStage 5---Maintenance

Stage 6---Adoption/Termination

Matching Game with the Transtheoretical Model of Change

Hmmmmmm

RelapseCommonDoesnt mean failureFailure is when we give up and dont build on prior experience

Remember.Changing behaviors is challengingChange doesnt happen all at once, but in stagesThis model can be applied to any behaviorIs not linear, but circular

Mediators of PAMechanism through which the intervention is believed to influence PA behaviorIs always a factor that we can help a client change

Self EfficacyConfidence in abilities to perform a certain task

Social SupportInstrumentalGiving a ride to the fitness center, giving a treadmill for a gift, etcInformationalTell about a walk/run, tell about how you stay motivatedEmotionalEmpathizing, letting them know you careAppraisingFeedback and encouragement

Decisional BalanceRatio of perceived benefits to barriers of change

Outcome ExpectationsValue that is placed on the consequences of being physically activeAcute Chronic

EnjoymentAssociated with adherence to exercise programs

Case StudiesJoe is 55 years old and has been told by his doctor that he needs to start working out and watching his diet. He is overweight, BP is borderline hypertensive and his cholesterol levels keep creeping up. Besides the occasional after dinner walk with his wife, Joe does not currently engage in PA and is seeing you only because his wife is making him.

Case StudiesSally is a very busy 35 year old mother of two who is also going back to school to get her degree. She is frustrated that she cannot take off her baby weight that she put on with her two pregnancy's and complains of always being tired. She knows that the extra weight she is carrying is not healthy, but she says she has very little time to work out. She does not have money to go to a gym and when she tries to work out at home, she gets interrupted by her husband or her kids.

Summary and Wrap Up

*Welcome to Unit 2 Seminar

*Here is the schedule for tonightWell start with a quick look back at what we did last week and briefly introduce the new information for this weekThen we are going to discuss the difference between Physical Activity (PA) and ExerciseNext we are going to play a matching gameWell then discuss Mediators in PASince you did so well last week with the case studies, they will be back again this week And, finally well wrap up and summarize the material from seminar this eveningAny questions about the agenda for tonight?*Well, Welcome to Unit 2! Quickly, lets summarize what we learned last week in seminar. Anyone remember what we talked about? (PA, good and bad of fitness profession, risk factor stratification, case studies)Tonight we will be talking a lot about change. The process of change, barriers to change, and what weas fitness professionalscan do to assist our clients in making positive lifestyle changes.*But first we need to make sure that we understand the difference between Physical Activity (PA) and Exercise. So, what is the difference? (PA can be accomplished at any timemovement, Exercise is planned, structured activity)

Quickly, lets review the recommendations for PA and Exercise. According to the ACSM, what is the recommendation for PA? (30 min most if not all days of the week) *Quickly, lets review the recommendations for PA and Exercise. According to the ACSM, what is the recommendation for PA? (30 min most if not all days of the week) *What about for exercise...to improve fitness levels? (3-5 days/week of vigorous aerobic activity)

*What about for exercise...to improve fitness levels? (3-5 days/week of vigorous aerobic activity)

*Why do we need to incorporate more PA into our everyday lives? What are some of the big changes that have occurred in the last 50-100 years in society that has caused us to become more sedentary? (technology, fast food, sedentary computer jobs, TV, internet) What are some ways that we can incorporate more PA into our everyday lives? (short walks/breaks at work, walk vs email, stairs instead of elevator, park farther away, fix our own food)

*Why do we need to incorporate more PA into our everyday lives? What are some of the big changes that have occurred in the last 50-100 years in society that has caused us to become more sedentary? (technology, fast food, sedentary computer jobs, TV, internet) What are some ways that we can incorporate more PA into our everyday lives? (short walks/breaks at work, walk vs email, stairs instead of elevator, park farther away, fix our own food)

*What are some ways that we can incorporate more PA into our everyday lives? (short walks/breaks at work, walk vs email, stairs instead of elevator, park farther away, fix our own food)

*What are some ways that we can incorporate more PA into our everyday lives? (short walks/breaks at work, walk vs email, stairs instead of elevator, park farther away, fix our own food)

*Ok, so lets move on to the Stages of Change Model. First, lets review the stages of change.

*First, lets review the stages of change. What is the first stages of change? (stage 1: inactive and not thinking about becoming more active, also called precontemplation In this stage, the person is not considering change and doesnt want to change. Often they are in denial or are unaware of a problem. They have no intention of changing and often have an active resistance to change. In this stage it is most difficult to inspire to change. What is stage 2?

*What is stage 2? (Inactive and thinking about becoming more active, also called contemplation stage. In this stage there is acknowledgement of a problem and the person starts to think about ways to overcome it. They are not quite ready for change, but are weighing the pros and cons. A person may remain in this stage for years but plans to take action with in 6 months.)How about stage 3*How about stage 3?(Doing some physical activity, but not enough to meet the minimum requirements. Also called preparation. It is this stage that the person may try out the new activity for a few days/week, but will not stick with it on a regular basis. What is stage 4?

*What is stage 4? (Doing enough physical activity also called the action stage. This stage requires the greatest commitment of time and energy. Relapse and regression to previous stages is common. Once behavior is maintained for 6 months, they move to the maintenance stage, which is stage 5: making physical activity a habit, or maintenance. In this stage, the person continues the behavior for 3-5 years as well as adheres to the guidelines that govern behavior. So, in other words, they meet at least the minimum requirements for exercise and PA.)

*Once behavior is maintained for 6 months, they move to the maintenance stage, which is stage 5: making physical activity a habit, or maintenance. In this stage, the person continues the behavior for 3-5 years as well as adheres to the guidelines that govern behavior. So, in other words, they meet at least the minimum requirements for exercise and PA.)

Some sources also list a 6th stage: Adoption/Termination--Once a behavior is maintained for 5 years they believe that there is no fear of relapseHowever, for negative behaviors (such as smoking, drugs, etc) many believe you never reach this stage, as the likelihood for relapse is always high.The same seems to be true for exercise and weight control.

*Some sources also list a 6th stage: Adoption/Termination--Once a behavior is maintained for 5 years they believe that there is no fear of relapseHowever, for negative behaviors (such as smoking, drugs, etc) many believe you never reach this stage, as the likelihood for relapse is always high.The same seems to be true for exercise and weight control.

**Moving on, lets get to our game

Im going to show you some pictures, and I want you to tell me what stage of change they are associated with, ok?*Here is your first one.Good, why would you say stage 1? (not thinking about change)(Very good. Stage 1 or the precontemplation stage.)

*Ok, heres your next one.(Good! What tipped you off?)(Yes, good job! Contemplation or Stage 2)*How about this one? (Good! It could be stage 3,4, or 5. Preparation, Action, or Maintenance)

*Relapse is very, very common.The key is not to give up! Often we try to change too many things at one time. A better strategy is to work on one behavior or change at a time. Once we have adopted one behavior, we can move on to another. Can you think of an exercise related example of how to make small changes at first? (aim to be active 2-3x/week instead of every day, aim for 15-20 min of activity vs 60 min)*It takes a long time to change a behavior. And, remember, for some behaviors, the incidence of relapse is so high that the behavior is never truly adopted or terminated. By the way, termination refers to getting rid of a bad behavior, whereas adoption refers to embracing a healthy behavior. What do you think I mean when I say that change is not linear, but circular? (Yes, very good! There is no guarantee that we will move through each stage in the order listed. A person may move from stage 1 to stage 2 to stage 3 and then relapse back to stage 1)Can anyone think of a behavior that they have terminated or adopted and can share with the class?*Good job with the matching game! Moving on to Mediators of PA.Were going to discuss 5 different mediators of PA. It is important to know how to help our clients improve their adherence to an exercise program.*Self efficacy is basically having confidence in your ability to do something.Give me an example of something in which you feel very confident about yourself (cooking, writing, working out)How about an example of something in which you dont have much confidence (math)When referring to PA and exercise, some people may have a lot of self efficacy in their ability to work out on their own while they are in their normal environment. However, if this person goes on vacation, or has to travel for work, their self efficacy may plummet. I see this ALL the time in the corporate fitness world. There are a lot of individuals that I work with who are very regular in the fitness center when they are in town. However, when they travel (which can be frequently) they do not exercise and eat poorly, and then ask why they are not making any progress. We are creatures of habit. When we get into a routine we can be very good about getting adequate amounts of PA. However, if our routine gets out of whack, so does our workout. Self efficacy could also refer to confidence in a certain mode of exercise. For example: some people are very confident in their ability to do cardiovascular activity (walk, run, bike, etc). However, they steer clear of the weight room b/c it intimidates them or they dont know what to do, feel like everyone is looking at them, etc, etc. This is especially true for a lot of women. If self efficacy is a barrier to fitness for a client, how can we help them overcome it? (introduce them to new activities, come up with strategies to keep them active when not at the gym, work with them on different routines/programs so they are comfortable,etc)*Social support can take several different forms: instrumental, informational, emotional, and appraising.Instrumental is something tangible. For example picking up a friend and taking them to the gym if they dont have a ride. Meeting a friend at the gym and working out with them. Giving the gift of fitnessdumbells or a treadmill, etcthat will allow them to be more active. Sometimes knowing a buddy is waiting for you at the gym is that extra umph you need to motivate yourself to go. You wouldnt want to stand up your friend would you?? Informational tends to be what we do a lot in the corporate fitness world. Making information available to people so that they have options of various ways that they can be active. We will post information about runs and walks, allow people to sign up for incentive programs, etc. Emotional support may include calling someone to ask how their program or activity is progressing. Letting them know that you are thinking about them and about the behavior change that they are trying to make and letting them know that they are not alone. Appraising support would be typical feedback and encouragement that one would receive from a personal trainer or a group fitness instructor. It may include correcting form and technique, providing feedback on proper positioning, encouraging the individual and commenting on their progress. Out of these 4 types of social support techniques, which one do you think would be most beneficial to you and why?It is important to find out which type(s) of social support appeal to our clients and then to find ways to implement that support.

*Decisional balance is the ratio of perceived benefits to barriers of change.In regards to PA and exercise, it is a persons perception of the benefits of PA versus its negative aspects.What are some perceived barriers to PA and exercise? Or, what are some reasons people give why they are not active? (environmentbad weather, unsafe neighborhood, no parks, sidewalks, bike paths, etc, not enough time, not enough energy, fear becoming injured, lack motivation, unhelpful friends/family members)The key is to identify the perceived barriers and then to implement strategies to overcome them.

*What are some of the acute or immediate outcomes that occur after being physically active? (feel energized, feel better about self, happier)What are some outcomes that take a lot longer to achieve? (weight loss, improve body composition, improve flexibility, improve CV fitness, improve muscle strength and endurance, improve health variablesblood pressure, cholesterol levels, decrease stress, improve body image)Would you agree with the statement that we are a society of instant gratification? Why? Can you give me an example of why this is true? (fast food, tanning beds, quick fix pills and supplements)For the most part, people do not like to be patient. The same is true in regards to exercise and PA. Even though it took months and years to put on weight, we want it to fall off immediately. We are often not patient enough and do not continue with our exercise routine long enough to see the benefits of it. And, if we are focusing too much on the long term benefits and not the acute benefits, our new behavior will not last long. *Bottom line is we will not continue an activity that we do not enjoy.So, choose an activity that is enjoyable for your client---not for you!!We dont all like the same things. It is important to get our clients to try a LOT of different activities. Sometimes they dont know what they like until they try it! It is important to make activity fun!PA and exercise should not be a punishment. Did any of you have to run or do pushups in school if you misbehaved or did something incorrectly? Did you enjoy running or doing the pushups? For those of us who like PA it may not have been a deterrent, but for those who dont really enjoy activity to begin with, making them run or do pushups leaves them with a bad taste in their mouth regarding PA. If someone had a bad association with activity as a youngster, chances are they do not participate in activity today. The same is true of the no pain, no gain mentality. PA and exercise doesnt HAVE to hurt to be beneficial. Some people (like me) enjoy feeling a little sore after working outthat way I know that I accomplished what I set out to do. Other people do not like feeling that wayand thats ok!! PA doesnt have to hurt. You dont have to go through pain to get benefits from PA. The most important thing is to choose activities that are enjoyable and that we will WANT to participate in and that we find FUN! If we enjoy it, it becomes something that we look forward to doing and we are much more likely to stick with for life. This is also why it is important to find lifestyle activities that we enjoynot just sports. Eventually there will come a day when we cant play football or basketball. So, although PE should include sports, it shouldnt focus solely on sports as the way that we accomplish our exercise and PA requirements. *Here is your first case study. Take a minute to read it and then respond to these two questions..What stage of change is Joe in? (stage 1, precontemplation) What strategies would you use with Joe? (fill out HH form, fill out PA stages of change, PA History, Processes of change, self-efficacy, decisional balance, social support, outcome expectations, enjoyment scale forms. Educate Joe about the benefits of working out. Find out what activities Joe enjoys. If he enjoys walking, encourage him and his wife to make the nightly walks a habit. Encourage social support via his wife.)*Ok, you did so well with Joe, lets see what you have in store for Sally. Read over her bio and then answer the same two questions.what stage of change is Sally in? (Stage 3preparation. She is trying to be active, but most likely not meeting the minimum requirements) What strategies would you use with Sally?(fill out HH form, fill out PA stages of change, PA History, Processes of change, self-efficacy, decisional balance, social support, outcome expectations, enjoyment scale forms. It sounds like Sally is already educated about the benefits of PA, however needs to make it a priority. Encourage social support via her husband and kids. Suggest workouts that involve the kids. Create a program that uses body weight or items from around the house since she doesnt have money to go to the gym.

*Very good job tonight everyone!Summarize for me what you learned tonight.What is the most important thing that you learned tonight that you will take away with you?Any other questions or comments that you have about what we discussed tonight or about the class in general?Have a nice evening everyone, goodnight!