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...individuals had trained for at least one marathon. Findings demonstrated three major themes reflecting the elements participants perceived as important to maintaining physical activity. Themes included: a) a supportive environment, b) goal setting, and c) a focus on mental health. This study provides a basis for a potential future grounded theory aimed at the maintenance of physical activity.
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In 2000, in the United States, poor diet and physical activity accounted for an estimated 17% of total deaths (United States Department of Health and Human Services [USDHHS], 2004). The Centers for Disease Control and Prevention (CDC) has stated that a direct relationship exists between physical inactivity and coronary heart disease (USDHHS, 1996). Despite the known risks of physical inactivity, a large proportion of the population lives a sedentary lifestyle (USDHHS, 2004).
Because of the relationship between physical inactivity and various chronic diseases, several objectives of Healthy People 2010 were developed to increase physical activity (USDHHS, 2004). Numerous barriers to maintaining physical activity have been reported by the general public including time, seasonal and geographic influences, safety, increase in technology, structural factors, fatigue, lack of commitment, and access to facilities (Kohl & Hobbs, 1998; Guggenbuhl, 2004; Conn, Tripp-Reimer, & Maas, 2003; Marcus, Rakowski, & Rossi, 1992). Approximately 50% of individuals who initiate an exercise program will drop out during the first three to six months (Marcus, Rossi, Selby, Niaura, & Abrams, 1992). A consistent theme in current literature, however, is that an exercise program will be effective to alleviate serious medical problems only if it is regularly followed and that casual adherence does not seem sufficient to effect beneficial change in health (Litt, Kleppinger, & Judge, 2002). "It is important, therefore, to determine what factors are most predictive of adherence to exercise, particularly in the long term, if exercise regimens are to have their optimal effects" (Litt et al., p. 84).
Development of theory-based frameworks for health education programs is included as a competency for Certified Health Education Specialists. Numerous health education models/theories have been applied to physical activity, including the Transtheoretical Model of Behavior Change, the Theory of Planned Behavior, and Social Cognitive Theory (Janz, Champion, & Strecher, 2002, Maibach & Cotton, 1995; Montano & Kasprzyk, 2002; Prochaska, Redding, & Evers, 2002). Few of these models, however, have been applied to the maintenance of physical activity, and therefore, health educators attempting to apply these models/theories to initiation of physical activity most likely will struggle to keep program participants engaged over time. The basis of the Transtheoretical Model of Behavior Change is that individuals engaging in a new behavior move through a series of stages (Marcus, Rossi, et al., 1992; Marcus, Rakowski, et al., 1992). These stages include precontemplation, contemplation, preparation, action, and maintenance (Prochaska et al., 2002). Several studies have shown that people use certain processes when transitioning from the action stage to maintenance which include counter conditioning, helping relationships, and stimulus control (Prochaska). There is little literature to suggest, however, if these processes are still effective in maintenance of behavior change longer than six months.
Social Cognitive Theory also has been applied to physical activity. "Social Cognitive Theory (SCT) describes human behavior as being reciprocally determined by internal personal factors and the environment in which a person lives" (Maibach & Cotton, 1995, p. 43). Self-efficacy, which is included in Social Cognitive Theory, as well as several other models, refers to personal beliefs about how capable one is of performing a behavior that produces favorable outcomes (Bandura, 1997). Litt, Kleppinger, and Judge (2002) applied components of Social Learning Theory to initiation and maintenance of exercise behavior in older women. Results demonstrated that self-efficacy was a stronger determinant at 12 months than at initiation of physical activity. Rimal (2001) also studied longitudinal influences on exercise behavior and found that self-efficacy was a strong predictor of maintenance.
The Theory of Planned Behavior includes constructs that are concerned with an individual's motivational factors as determinants of the likelihood of performing a specific behavior (Montano & Kasprzyk, 2002). Stiggelbout, Hopman-Rock, Lechner, and van Mechelen (2005) applied an adapted planned behavior model that included Social Learning Theory and the Theory of Planned Behavior to predict exercise maintenance among older adults. Results demonstrated that to promote maintenance of exercise participation for older adults, programs must address preventing lapses, coping with lapses, and improving attitudes towards exercise participation in planning efforts (Stiggelbout et al., 2005).
Few studies have examined predictors of maintenance of physical activity beyond the six month time period. The purpose of this study was to examine the important elements in the maintenance of physical activity. For the purposes of this study, the definition of maintenance was based on the CDC's (2005) recommendation of 30 minutes or more of physical activity that increases heart and breathing rates for three to five days per week for at...
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