Agree a plan

Don't be tempted to impose your own plan at this stage - they may agree with you just to end the conversation.

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1
Summarise

“Can I summarise what I think you have said?”

Summarise the main points of the conversation without adding any new information.

This may sound something like: ‘so some of the benefits of physical activity for someone like you with X include A and B and C. The most important reasons for you personally would be P and W’.

Using a summary can be a good way to demonstrate and express empathy, that you can see the world from their perspective. Empathy contributes to outcomes in a range of settings.

2
Decide

‘So, what do you think you will do?’

If they decide that they are NOT ready
Thank them for taking the time to talk with you about physical activity and offer an opportunity to review the conversation. Reassure them that help is available when they feel ready to change.

If they decide to become more active, THEN move on to planning
Continue to keep the focus on them generating their own ideas for change, rather than telling and instructing. People are much more likely to make successful changes if they develop their own plans.

The individual has heard about the benefits of physical activity for someone like them and has had chance to consider the benefits they would most like to experience. They have heard their ideas spoken back to them, which can help to reinforce them. Now it’s decision time.

Asking an open question ‘what do you think you will do?’ rather than a closed question ‘so, are you going to exercise?’ helps remind them that they – not you – are the decision maker.

If they are not ready to change now this can be challenging for you, but they might have good reasons to keep things the same for now. Encouraging further reflection can be an important part of the process of helping people to make successful changes over time. Offer an opportunity to follow up on this conversation to review their thoughts about making changes.

3
Build activity

Can they think of any easy and/or enjoyable ways of fitting in opportunities to move more during their daily routine?

Useful questions to ask include:

  • How do you think you might get started?
  • What kind of help might you need?
  • How often do you see yourself doing that?
  • What changes do you think you would notice?
  • What might get in the way of your plan?
  • How could you find a way round that?
  • Some people find it helpful to have a chat in the future. Is that something you would find helpful?
  • Can I tell you a little about our exercise referral scheme?
  • Can I tell you a little about our healthy walks programme?

You may need to give some information here – about starting slow and building up, starting with moderate, stopping if they notice any particular symptoms, etc.

Reflect back and expand on relevant points from your earlier discussion.

Build activity into everyday life

Home

Gardening

Stand during advert breaks

Housework – doing the hoovering

Avoid Prolonged sitting

Travel

Bicycle

Walk

Public transport

Activity and Exercise

Swimming

Join a Group for social interaction and motivation

Walk

Cycle

Dancing

4
Agree a plan

Different options suit different people and can be effective when used alone or with each other.

Explore the options below and print out the relevant PDF for your patient or print the workbook in Information for Patients.

1

Motivational support

Use this document for people who are keen to review and develop their motivation for behavioural change

2

Action planning

Action planning is good for those who hope to set structured goals to create a roadmap for behaviour change

Individuals are more likely to change their behaviour if they are following a set of goals they have committed to.

For action planning theory visit:

Gollwitzer P, Social RK-J of P and, 1989 undefined. Effects of deliberative and implemental mind-sets on illusion of control.

psycnet.apa.org

http://psycnet.apa.org/fulltext/1989-25917-001.html

Gollwitzer PM, Oettingen G. The emergence and implementation of health goals. Psychol Health 1998;13:687–715. doi:10.1080/08870449808407424

For a comprehensive overview of action planning visit:

Woodcock B. Action Planning. Univ. Kent. 2018.

https://www.kent.ac.uk/careers/sk/skillsactionplanning.html

3

Step counting

Use this for those keen to use self-monitoring devices such as pedometers, wrist worn accelerometers or even smartphones to monitor their daily step counts.

References

Kang M, Marshall SJ, Barreira T V, et al. Effect of pedometer-based physical activity interventions: a meta-analysis. Res Q Exerc Sport 2009;80:648–55. doi:10.1080/02701367.2009.10599604
Ogilvie D, Foster CE, Rothnie H, et al. Interventions to promote walking: systematic review. BMJ 2007;334:1204. doi:10.1136/bmj.39198.722720.BE
Jee H. Review of researches on smartphone applications for physical activity promotion in healthy adults. J Exerc Rehabil 2017;13:3–11. doi:10.12965/jer.1732928.464

4

Make a diary

Creating a personalised monthly schedule helps work out where and when someone can start to fit opportunities to become more active into their own life.

Did you know?

All physical activity counts towards moving more

Brisk walking can count and is a great activity to start with

Build strength with exercises which help develop muscle strength - Pilates and light weights can help and physical activity in the home and garden can be good too.

Move more by breaking up sitting time - stand up during TV advertisement breaks or walk around the office.