Exercise adherence, or more appropriately exercise attrition, has been a problem for exercise professionals and public health officials for many decades, but it has only been studied systematically for the past 20 years. For the client, lack of adherence can mean a loss of the many health benefits that accrue from regular physical activity, whereas for the exercise professional, it may spell doom for an exercise program. Presently, only one adult in four meets the Surgeon General’s recommendations for adequate physical activity necessary for providing health benefits (1). Our interest in exercise adherence grew from conducting both adult exercise programs and following up on participants in exercise research studies. It is frequently cited that as many as 50% of those who begin an exercise program drop out within the first 6 months (1). We began to ask the question, “If exercise is so good for us, why aren’t more people able to consistently maintain activity?”
Exercise Determinants and Motivation
Our early exercise adherence research focused primarily upon self-motivation and exercise program dropouts. We studied the psychologic characteristics of dropouts, whether we could predict exercise behavior, and what might be done to improve adherence rates. We quickly learned that dropouts were lower in self-motivation (a generalized characteristic to persevere in a task), but they also were more difficult to predict than adherers (2). Recent research confirmed that self-motivation is not only lacking in those who are not sufficiently active to achieve health benefits but may actually underlie the commonly reported “lack of time” barrier (3). Research also has identified the importance of self-efficacy (believing that you can accomplish the task) in adopting an exercise program, although it does not appear to be as powerful an influence in maintaining exercise.
Personal trainers, group exercise leaders, and exercise researchers are constantly seeking ways to motivate clients and improve adherence (4). Much of the exercise adherence research has focused on the determinants of physical activity, that is, the demographic, psychologic, social, and environmental characteristics associated with being active. Among the determinants most often found to be highly associated with adoption and maintenance of physical activity are high levels of self-efficacy and self-motivation, as well as a positive decisional balance, that is, a belief in the benefits of activity and a lack of perceived barriers. Social support from friends and family also is important for many regular exercisers, as is enjoyment of activity (5). Numerous interventions have been designed to improve exercise adherence with individual clients and large groups, and in general, they have yielded less than spectacular results. Unfortunately, the most effective strategies and interventions have often been complex, time consuming, and expensive.
Researchers continue to seek ways to study and understand exercise behavior, and one of the most effective instruments for doing so is the Stages of Change Model, which describes how individuals go about making health behavior change (6). It is described as “transtheoretical,” which means that it is rooted in several psychologic theories. When the model is applied to physical activity it can be described as the stages of exercise behavior model (SOEB) (7). The SOEB includes six stages of change:
- Precontemplation: currently not considering becoming physically active
- Contemplation: thinking about it
- Preparation: exhibiting some activity behavior
- Action: fully engaged in physical activity
- Maintenance: active for 6 months
- Termination/Adoption: active for more than a year and having internalized physical activity as a lifestyle
Long-Term Exercisers: The Terminators
We recently turned our attention to the “terminator,” or long-term exerciser. Our purpose was to learn what keeps the habitual exerciser regularly active over a period of many years. We administered an extensive questionnaire that examined the characteristics, behaviors, and motivations of 833 adult men and women (aged 18–84 years), including 375 terminators. The terminators in our study were active for a minimum of 2 years, an average of 13 years, and some for more than 5 decades. Finding a sufficiently large sample of terminators required that we visit health clubs, hiking trails, running clubs, corporate gyms, and university exercise classes.
Because there were no statistically significant differences between some groups (stages of exercise behavior), for analysis purposes we collapsed those who were not terminators into three groups: precontemplation/contemplation, preparation, and action/maintenance. As would be expected, the terminators were significantly higher in psychologic characteristics such as self-motivation and self-efficacy and lower in negative decisional balance (they had fewer barriers) than individuals in the other stages of exercise behavior. The major purpose for studying the terminators, however, was to specifically examine their motivations and exercise behavior, especially the strategies they used to stay active, the reasons they attributed for their long-term adherence, and the experiential feelings they associated with regular physical activity. Respondents were asked if those strategies, reasons, and feelings were important in helping them continue their exercise behavior. Table 1 summarizes the ratio of “yes” to “no” responses to those inquiries and provides a profile of those characteristics for individuals in the various stages of exercise behavior. We included only those items that yielded at least a 2:1 ratio, that is, at least two thirds of the respondents indicated that the item was a strong factor in remaining active.
What the Terminators Revealed
The strongest reason to exercise given by the terminators was to achieve fitness (15:1). This response was to be expected because fitness and health are among the most frequently cited reasons for being physically active. The most surprising result to the investigators was the powerful influence that their experiential feelings had in motivating terminators to continue exercise. Six of the top ten influences that kept terminators active were feelings, and they included well being (8:1), pep and energy (5:1), enjoyment of activity (3:1), better sleep (2:1), more alert (2:1), and relaxed (2:1). Appearance (2:1) and weight management (2:1) were two other influential reasons that the terminators gave for staying active. Although appearance and weight control are typically cited as important reasons for being active, they were not the most powerful motivators for these long-term exercisers. The terminators made exercise a priority (3:1). This characteristic is very important for beginners to appreciate if they expect to be successful in adopting and maintaining activity. Unfortunately, it was the only strongly influential strategy terminators acknowledged that they use to stay active. That result was disappointing to us, as we had hoped that the terminators would reveal more strategies that could be shared with new clients or those who seek assistance in staying active.
Terminators in our study indicated that they did not view exercise as a social event. That confirms Gauvin’s (8) description of long-term exercisers as primarily “autonomous exercisers,” that is, 62% of the terminators in our study always exercised alone and 35% exercised alone and occasionally in supervised programs, but only 3% were involved in a supervised program only. Gauvin also reported that autonomous exercisers did not give a great deal of previous thought to planning their exercise sessions, thus they “just did it.” We believe that the terminators in this study were more mindful of their actions because they indicated strong support for prioritizing exercise.
A profile of the terminators reveals a group of individuals who do the following:
- exercise primarily to be fit
- do so by making physical activity a priority
- persist long-term because of a cluster of positive feelings that accrue from being regularly active
Table 1 also reveals that exercisers report many more influential factors for remaining active than individuals in the other exercise stages.
What have we learned from the terminators that could help in counseling beginning exercisers or those with motivational problems? It should be noted initially that the precontemplators and contemplators placed more emphasis on “lack of motivation” (2:1) than “not enough time” as their primary barrier to physical activity. We have encountered a similar response in conducting an intervention study with known physical activity dropouts, and both of those barriers must be addressed. However, we must make clear to clients or participants that whereas we can make helpful suggestions such as “get a partner,” we cannot somehow “infuse” them with motivation. Conversely, we can make suggestions as to how individuals can manage to find the time to be more physically active. We also can help to empower individuals by providing the challenge for them to examine daily and weekly schedules in an effort to designate space for exercise.
The terminators made activity a priority, and anyone wishing to be successful in adopting and maintaining exercise must also prioritize. Terminators choose activities that they enjoy, and that is an essential part of motivation for the beginner or for those who have difficulty maintaining activity. Terminators were conscious of their weight and appearance, but they did not focus on their physical appearance nearly as much as their desire to be physically fit. Setting long-term global goals such as being healthy and fit has been found to be more effective than focusing on short-term results such as “I need to lose 8 pounds before I go on that trip.” The Surgeon General’s Report recommends moderate physical activity for those who are sedentary or insufficiently active. This recommendation is made, however, as potentially the first step on the road to more vigorous activity and greater fitness. Higher levels of fitness are associated with greater reductions in morbidity and mortality, and the terminators in our study clearly demonstrated that they aspire to achieve greater fitness.
Except for their desire to be fit, nothing was more powerful in bringing the terminators back to exercise repeatedly as much as the feelings they derived from being physically active. The terminators cited many more factors for remaining active than individuals in the other stages of exercise behavior, especially those positive feelings. Our data confirm that a sense of well being and greater pep and energy may appear in the early months after beginning an exercise program. We also can assume, however, that some of the positive emotions became evident only after an extended experience with regular exercise. New clients or those with motivational problems need to know that many positive emotions (as well as some physical benefits) do not appear for some time but are worth waiting for. What we have learned from the terminators is that positive feelings derived from exercise may actually create a strong incentive to continue exercise behavior. For the fitness professional, these feelings emphasize the importance of using strategies and reinforcement that enhance persistence in the early stages of exercise behavior, that is, until the positive feelings provide strong internal motivation.
Fitness professionals and exercise adherence researchers know there is no “silver bullet” or motivational strategy that works universally for all clients. Both research and experience confirm that starting an exercise program is easier to accomplish than maintaining it. Knowing, however, what aids the long-term exerciser in maintaining physical activity over many years does provide essential guidelines for new clients or those with motivational problems. As fitness professionals, we need to share that information with our clients.
Condensed Version and Bottom Line
There are a number of determinants associated with adopting and maintaining physical activity, and they include demographic, psychologic, social, and environmental characteristics. The Stages of Exercise Behavior provides a convenient model for studying and understanding exercise behavior. Long-term exercisers are in the final stage, have internalized exercise, and are designated as “terminators.” Our study of terminators indicates that they exercise for fitness, they make activity a priority, and they are highly motivated to maintain activity because of the positive feelings they derive from doing so. If new clients or those with motivational problems are to succeed, they need to know how and why long-term exercisers stay physically active.
1.U.S. Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General.
Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.
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