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It’s Time for a Change…Behavior Change

Riebe, Deborah Ph.D., FACSM

doi: 10.1249/FIT.0b013e31825a6f10
COLUMNS: ACSM Certification

It’s Time for a Change… Behavior Change.

Deborah Riebe, Ph.D., FACSM, is a professor and chair of the Department of Kinesiology at the University of Rhode Island. Dr. Riebe is a past president of the New England Chapter of ACSM and is the current chair of ACSM’s Committee on Certification and Registry Boards. Her research focuses on promoting physical activity in special populations, with an emphasis on obesity and aging.

Disclosure: The author declares no conflict of interest and does not have any financial disclosures.



There is a great deal of scientific evidence that supports the relationship between health and physical activity. This information is not only found in peer-reviewed scientific journals but is consistently 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 million hits. In 1995, the U.S. Centers for Disease 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 exercise is needed to promote good health, most recently in the 2011 ACSM position stand (2). Although exercise professionals are very familiar with these recommendations, 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 existence of national guidelines, most adults in the United States do not engage in the recommended amounts of physical activity. Even when individuals begin an exercise program, more than 50% will drop out within the first 6 months (5). Providing knowledge and promoting awareness of exercise recommendations is not enough to get most people exercising regularly. 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 technique 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 beyond creating safe and effective exercise programs and include the use of behavioral techniques to help individuals become and stay active. Integrating techniques that support sustainable behavior change results in far greater value to the clients we serve.

There is a large scientific community that focuses on understanding how people change behaviors. Behavioral science is theory driven and can be applied to many health behaviors, including physical activity. Behavior change theories have gained recognition for their possible effectiveness in explaining health-related behaviors and provide insight into methods that would encourage individuals 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 their eating habits, or quitting smoking.

Exercise practitioners are already aware of the importance of behavioral science. For example, in a recent survey of ACSM’s Certified Health Fitness Specialists, almost 90% rated “optimizing the adoption and adherence of exercise and other health behavioral strategies” as important or very important, and 66% reported that they frequently use behavioral strategies to help clients become and remain active. Many exercise professionals are already using principles from behavioral science when working with clients, such as goal setting, increasing self-efficacy, and decreasing barriers to exercise. A deeper understanding of behavioral science allows practitioners to more appropriately use these behavioral techniques.

ACSM and the Committee of Certification and Registry Boards have been proactive in incorporating behavioral science into new and upcoming resources.

  • Behavioral science has been incorporated into two recent ACSM position stands:
    • ○ Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise (2)
    • ○ Exercise and Type 2 Diabetes: American 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 Exercise Testing and Prescription, scheduled to be published in 2013.
  • A new textbook dedicated to the science and practice of physical activity behavior change also is scheduled to be published in 2013.


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 transition from the current KSAs (knowledge, skills, and abilities) to performance domains (critical aspects of the profession) with specific knowledge and skill statements. The science and practice of behavior change will have a more prominent role in each of ACSM’s major certifications, and both clinical and health fitness professionals will be expected to possess and demonstrate in-depth knowledge 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 certification Web site

Other health-related fields are recognizing the importance of behavioral science. A 2011 report from the Association of American Medical Colleges states that a complete medical education must include findings from behavioral and social sciences. The report provides medical schools pedagogic methods and performance outcomes to aid faculty in designing 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 exercise practitioners. Our field is recognizing that physical inactivity cannot be addressed without attention to the behavioral factors that contribute to it.

Our field has reached a tipping point in the transition of the role of the exercise professional to include the promotion and support of sustainable behavior change. With the recent and upcoming changes in position stands, books, and certifications, ACSM is once again “leading the way.”



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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):2282–303.
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):1334–59.
3. Association of American Medical Colleges. Behavioral and Social Science Foundations for Future Physicians. Association of Medical Colleges; Washington DC, USA; 2011:5–16.
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):1849–55.
5. Dishman RK. Exercise Adherence: Its Impact on Public Health. Champaign (IL): Human Kinetics; 1988.
© 2012 American College of Sports Medicine.