Self-monitoring and selected measures of aerobic and strength fitness and short-term exercise attendence.(Report)

While many individuals tend to acknowledge the benefits of exercise and initiate fitness programs, relatively few people persist at their exercise regimen. Approximately 60-70% of adults who begin an exercise program will quit within 6-9 months, despite the widespread belief (82%) that exercise is beneficial to good health (King, 1994). Nonadherence with most organized exercise programs ranges from 20% to 90% in the U.S. (Marcus, King, Bock, Borelli, & Clark, 1998), a figure that is similar in the United Kingdom (Biddle & Mutrie, 2001). It is important, therefore, that researchers examine the effectiveness of various strategies and interventions that enhance exercise participation and adherence that markedly affect quality of life. Thus, a particular challenge to researchers and practitioners is developing interventions that promote exercise adherence. The concept of adherence, however, has different meanings in the extant literature.

For the purposes of this study, it is important to clarify the definition of adherence. Rand and Weeks (1998) broadly define adherence as "the degree to which patient behaviors coincide with the clinical recommendations of health care providers" (p. 115). King (1994) defines adherence as "the level of participation achieved in a behavioral regimen once the individual has agreed to undertake it" (p. 186). Other definitions of adherence include sticking to or faithfully conforming to a standard of behavior in order to meet some goal, and long-term behavior changes associated with preventing undesirable symptoms or outcomes (Haynes, 2001). Thus, for the present study, adherence was defined as the person's decision to maintain his or her participation in an 8-week exercise program after the participant agreed to undertake it.

There are many reasons for non-adherence to exercise programs. These include sustaining an injury, self-consciousness about one's appearance in an exercise facility, engaging in an exercise activity that one finds overly strenuous, failure to quickly meet (often unrealistic) goals, the absence of an exercise facility located near home or work, job-related travel, physical and mental fatigue, lack of interest, poor weather, family demands, and perceived lack of time (Biddle, Fox, Boutcher, & Faulkner, 2000; Biddle & Mutrie, 2001; Sallis & Owen, 1999). Other reasons include lack of instruction, perceived lack of fitness improvement, and the lack of social support (Anshel, Reeves, & Roth, 2003; King, 1994; Lox, Martin, & Petruzzello, 2003). Taken together, these reasons for non-adherence suggest that many individuals do not have the requisite knowledge and skills to perform exercise tasks successfully (Anshel, 2006). It is plausible to surmise, therefore, that novice exercisers require emotional and instructional support to sustain their initial motivation in maintaining their exercise program (Buckworth & Dishman, 2002).

Strategies that significantly improve compliance with exercise programs are referred to as relapse prevention (Marlatt & George, 1998). Relapse is an individual's failure to permanently change an undesirable behavior, such as returning to a sedentary lifestyle and not carrying out (or continuing) a prescribed exercise program. Exercise relapses are an important component of exercise dropout. Lox and colleagues (2003) concluded "a single lapse may lead an individual to believe that all hope of behavior change is lost, resulting in full relapse, termed the abstinence violation effect" (p. 99). Relapse prevention consists of "a self-control program designed to help individuals to anticipate and cope with the problem of relapse in the habit-change process" (Marlatt & George, 1998, p. 33). For example, in their review of related literature, Buckworth and Dishman (2002) concluded that more research is needed to examine the effectiveness of conceptually-based interventions addressing the problem of exercise adherence and relapse prevention. One way to reduce relapse is to enhance the patient's feelings of self-control (Marcus et al., 1998, 2002), which is the primary goal of a process called self-regulation (SR).

Self-regulation is defined as self-generated thoughts, feelings, and actions that are planned and cyclically adapted to the attainment of personal goals" (Zimmerman, 2000, p. 14). To Zimmerman, SR is cyclical because "the feedback from prior performance is used to make adjustments during current efforts" (p. 14). According to the Encyclopedia of Health Psychology (Christensen, Martin, & Smyth, 2004), self-regulation theory posits that "behavior is guided by a motivational system of setting goals, developing and enacting strategies to achieve those goals, evaluating progress, and revising goals and actions accordingly" (p. 263-264). Along these lines, Zimmerman (2000) categorizes self-regulation as behavioral, environmental, and covert. Behavioral SR entails self-observing and adjusting performance (e.g., improving exercise technique). Environmental SR refers to observing and adjusting environmental conditions or outcomes such as selecting situational (e.g., time of day) and environmental conditions (e.g., home versus exercise facility; exercising with friends or alone) that meet the exerciser's needs. Covert SR involves monitoring and adjusting cognitive and affective states (e.g., positive self-talk, imagery, "psyching up"). Each of these forms of SR is relevant to the current study.

SR is central to exercise adherence. According to Biddle and Mutrie (2001), "In addition to exercise being reinforcing through positive psychological outcomes, maintenance of exercise is likely to be enhanced, at least for some people, through the operation of self-regulatory strategies and skills" (p. 142). Techniques designed to improve self-regulatory functioning have been effective in various performance domains. For example, with respect to sport performance, SR improves and maintains motivation, and is generally characteristic of elite athletes (Anshel, 1995; Anshel & Porter, 1996; Anshel, Porter, & Hass, 1996). In promoting desirable health-related behaviors, adherence to effective self-regulatory functioning is more likely if the person can effectively carry out predetermined SR behaviors that, in turn, lead to desirable outcomes (Clark& Becker, 1998). Exercise adherence is unlikely without effective self-regulation (Biddle & Mutrie, 2001; Dishman, 1994). Dishman suggests, "self-regulatory skills and interventions such as relapse prevention seem necessary for individuals to maintain or resume a physical activity pattern" (p. 16). According to Biddle and Mutrie (2001), one popular form of self-regulation for improving health and performance is called self-monitoring.

Self-monitoring (SM) is defined as "the systematic observation and recording of target behaviors" (Baker & Kirschenbaum, 1993, p. 377). To Christensen and colleagues (2004), SM "is a technique used for health behavior assessment and intervention, which involves observing and recording information regarding one or more health behaviors" (p. 263). Types of data that are recorded include target behaviors (e.g., duration, frequency), contextual factors that surrounded the target behavior (e.g., time, setting, antecedents, consequences), and subjective information (e.g., mood, thoughts), each of which may be recorded quantitatively or qualitatively to understand the factors that promote desirable outcomes.