Exercising

Healthy
Behavior
Change
A Self-Directed Study

Alexandra Tracchio
Georgia Southern University

Introduction

Behavior change refers to modification of particular behavior

Physical activity has many beneficial properties that enhance health and even reduce the risks of chronic disease.

According to the 2008 Physical Activity Guidelines for Americans, it is recommended that adults ages 18-65 years receive
at least 150 minutes of moderate intensity physical activity each week or 75 minutes of vigorous physical activity per
week (http://health.gov/paguidelines/).

This can be done through aerobic and anaerobic exercises. Examples of physical activity include swimming, running,
brisk walking, strength training, stretching, kayaking, hiking, and sport activities, to name a few.

Leading a physically active lifestyle can reduce the risks of chronic disease such as: coronary heart disease, stroke, high
cholesterol, type 2 diabetes, some cancers, high blood pressure.

In addition, regular physical activity can prevent weight gain, promote weight loss, improve heart and lung health and
reduce depression.

The following paper vulnerably illustrates my journey through my own transformation, containing the highlights and
the struggles. My hope is that through this adventure, I become more confident in myself as well as grow in my capacity
as a motivator to my clients.

Step One - The Skills of Self-Direction

For as long as I can remember, I have been fairly active. Many of my childhood memories consist of family hiking trips at
state parks, running through the woods with my brother, roller-skating, skateboarding, and biking.

My high school years I competed in sports such as soccer, tennis, and cheerleading year round many times one sport
would overlap with another.

Once I began college, I was no longer on sports teams but kept active in other ways mainly running. Now, as an adult
and student in graduate school, I am no longer nearly as active as I used to be.

The majority of my days are spent sitting and staring at a computer screen and at nights I crave to get to bed early to
catch up on sleep. Working out and running have become the last things on my long list of To Dos. They no longer hold
any sort of priority when compared to deadline assignments.

 continued

My goal is to become more physically active and indirectly improve my nutritional health.

I plan to make an effort to wake up forty minutes earlier in the morning so I can feel the energizing sense of
accomplishment all day long. The mornings are also when I have the most energy after a night of sleep.

By waking up earlier and making working out the first thing I do - it will eliminate the opportunity to make excuses later
as to why I can not fit it into my day.

I will seek to work out (through running and strength training) at least four days a week for a minimum of twenty five
minutes.

Step Two- Forethought: Planning for Success

I plan to take this day-by-day.

When I make mistakes - such as not being physically active during the day, I will plan to be physically active the next day.

There are some temptations I can foresee that would inhibit my goal from happening such as immediately beginning
homework when I come home from my rotations, and spending time watching Netflix or social media.

To motivate myself, I have signed up for my first half marathon in April and made a public announcement on social
media.

If I begin to feel tempted to immediately do homework, then I will remind myself of the following: I will feel healthier
and more energized after I am physically active. I will be in shape and feel more confident with myself. To further help
me resist temptations, I will ask someone to help keep me accountable by reminding me of my goal if I feel like giving up.

By being physically active each day, I will feel healthier and more confident with myself. It will also give me a feeling of
accomplishment for following through and making a behavior change.

I do not have any sub goals per se, but I have decided on a few components that will count as being physically active
such as: running/jogging, strength training, yoga, kayaking, hiking and cycling. I will allow myself to choose from any of
the previous list of components to reach my goal of increasing my physical activity.

Step Three - Self-Knowledge: Observation and Recording

After observing myself for one week, I noticed I have a difficult time waking up in the morning and sleep in till the last
possible minute.

I spend approximately ten hours at my rotations and when I finally get home, I am anxious to begin my homework in
order to have the opportunity to go to bed early. I usually take a few minutes looking on social media - approximately 20
minutes, and then begin my homework.

I have had to make some alterations to my initial plan. Originally, I planned to wake up 40 minutes earlier in the
morning to work out. Since my schedule is inconsistent, I find it difficult and almost too unrealistic for me to wake up
earlier in the morning.

Therefore, I am modifying it to be physically active when I get home from work.

To keep track of my progress, I plan to keep a log, such as Table 1 below, that will keep track of the number of minutes I
am physically active each day Monday-Saturday as well as what kind of physical activity I partake in. Sunday will count
as a rest day.

 continued
Table 1
Physical Activity Log by Day of the Week, Number of Minutes and Type of Activity

Week One
Monday, 02/01
Tuesday
Wednesday
Thursday
Friday
Saturday

Total Minutes

Table 1

Minutes

Type of Activity

Step Four - Theory and Practice

One of the most effective stimuli is a person who keeps me accountable or even goes with me until I get into the habit of
doing it on my own.

Often, I find excuses as to why I can not work out if I am starting alone. If I am tired from a long day or if it is really cold
outside, I tend to not want to work out.

My undesirable behavior is not working out or being physically active. I do not typically react to any cues with unwanted
emotions.

Before the behavior, I am excited and pride myself for going. The behavior is me being physically active. My behavior is
strong and not very frequent. I enjoy being physically active and the feeling of accomplishment I have after it. However,
it is not frequent because I make excuses as to why I do not have time for it. I should work on eliminating the excuses.

 continued

My goal involves overcoming avoidance behaviors to change my behavior.

As previously stated, I avoid being physically active because I am afraid of the negative consequences which may (or
may not) occur.
Consequences of my current behavior are being out of shape and not living a fully healthy lifestyle. The consequences of
a new behavior include being physically active and healthy, however it could trigger unwanted consequences.
My desired behaviors are positively reinforced through my own sense of accomplishment and a healthier body. My
desired behavior is to be more physically active through working out, running, hiking or kayaking, etc.
Actions that make my desired behavior difficult include feeling tired and making excuses to not go, mainly due to fear.
Currently, my desired behavior is being punished since I am not doing it.
When I am in the midst of a run, I usually talk to myself when I get too tired and want to quit. Phrases like, You can do
this, You got this, Only a little bit further, and Youve gotten this far, dont quit now, are frequent phrases I use to
motivate myself to keep going.
It rewards my behavior to continue being active and not give up when it gets challenging.

Step Five - Antecedents

Antecedents of not being physically active, as stated in Step 4:

1. Cold weather

2. I have a lot of homework or studying to complete

3. I have had a particularly long day and I am tired

Unfortunately, these antecedents can not be avoided or narrowed. Therefore, I have to change the way I perceive them.
Instead of thinking, It is too cold to work out, I have so much to do - I do not have time to work out, or I am too tired,
I will instead say to myself What an awesome opportunity to get your blood pumping and warm up! and The
adrenaline produced will make you more productive by giving you energy.
I have always been told by others and prided myself on having a glass half full mindset - so why should this behavior be
any different? By changing my perception on the situation, I will be more successful in modifying it to reach my goal.

 continued

I have thought about my current social support systems and created a table to show how each system either hinders or
supports my behavior modification.
I had the most difficult time brainstorming a support system who is hindering my behavior. In fact, I realized the only
one who is hindering me is myself.
I am lucky and blessed to have an incredible amount of people supporting me to reach my goal.
Table 2
Current Social Support Systems

Sources of Influence

Table 2

Supportive of My Goals

Hindering to My Goals

Dad, Mom, Brother

Church friends
Fellow Interns
Social media friends/family

Myself

Step Six - Behaviors: Actions, Thoughts & Feelings

Each day, I am dreaming about my future workout and have (for the most part) looked forward to it.
I realized this to be called imagination rehearsal, since I am imagining how my workouts will go.
My main struggle is feeling tired after my long day at work, or having too much to accomplish for homework that
evening.

I have already been really successful in my behavior change thus far and I am happy with where I am at. Of course, there
are some days where I should be doing a physical activity and I am just too tired.

Most times I have conditioned myself to just change clothes and into sneakers. The sheer act of doing this motivates me
to go be physically active.

There have been times when I decided to listen to my body and have refrained from working out.
I follow three girls on social media who post about their exercises and I look to them as role models for what I want to
accomplish. It has been a helpful motivator to observe their accomplishments and practices.

Step Seven - Consequences

I have come to really crave the soreness and burning of my muscles associated with increased exercise and physical
activity.

It has become a positive reinforcer that I did not anticipate having. If I go too many days without the soreness or
burning, I become anxious and impatient to begin exercise again.

I have also noticed my physical activity is increased when I am in a group setting. The presence of others helps serve as
an additional positive reinforcer.

On the other hand, when I am not being physically active in a group setting and I am alone, it negatively affects my
activity level and duration.

I believe the observation chart has also helped keep me accountable as I have begun challenging myself to increase
physical time from the previous week.

I continue to include verbal self-reinforcement as well as imagined rehearsals, which seem to help motivate in my
behavior change.

Other reinforcers/behaviors such as self-rewarding or self-punishment do not seem to motivate me and therefore I do
not believe it applies to me for this behavior change.

Step Eight - Developing a Successful Plan

I have concluded my current behavior is not only meeting, but exceeding my original goal.

Originally, I did not state any subgoals, but have unconsciously created one since the beginning of my behavior change. I
previously mentioned I signed up for a half marathon in April. The training that is involved requires me to increase
running time and distance each week, of which I have been fairly successful. This has become a subgoal in and of itself.

I sought to change my perception of working out and carry over my glass half-full attitude to include physical activity
during my days when it is most difficult.

In addition, I have continued the imagination rehearsal and have learned the consequence of not being physically active
is not feeling fit. I have come to really enjoy the feeling of burning muscles after a long workout.

Furthermore, being physically active has become a way for me to cope with the stress of being a dietetic intern. It has
become an outlet for frustration and an escape from the duties of everyday.

Step Nine - Problem Solving & Relapse Prevention

I have not found it too difficult to perform my target behavior. I have come to crave the feelings I get from working out
and being physically active, so I have been pretty successful in my goals practicing my wanted behavior thus far.

I have kept good records, which helps serve as positive reinforcer for my behavior.

Although I have dominantly had success, I have had some instances that could be described as high risk for relapse.
They have been uncontrollable, however, since they were due to injury; in which case physical activity needs to be
modified or halted for a period of time.

Step Ten - Staying in Control

Most of my behavior change has been reinforced by the half marathon I will be running in three weeks. I have been
consistently training through running or strength training most days of the week, therefore succeeding in my target
behavior goals.

This chapter focuses on the transfer of your newly learned behavior to real world situations. I began to consider how I
will transfer this behavior of being physically active after the race is completed. I like to think it will be sustained, but I
know I will need to make a conscious effort to maintain it through required practice and vigilance. The transfer may
become challenging again when I move home after graduation.

In preparation for that time, I have already signed up for a running club that meets near my house. This will help serve as
a social reinforcer and support system for me as I continue in my target behavior. Once I begin receiving a paycheck, I
hope to join a gym to facilitate strength training and physical activity.

In addition, I plan to continue keeping record of my running mileage and I want to make a goal of running 500 miles in
one year. This will require 10 miles per week for 50 weeks.

 continued

The end of this chapter suggests beginning a self-directed happiness project and presents different activities to increase
happiness.

Using the checklist and chapter content as a guide, I began reflecting on how I maintain my happiness as well as how it
can be improved. More frequently than not, I exert positive emotions. However, there are times when I let stress in and
my happiness diminishes.

To maintain/increase my happiness, I would like to keep a journal of my blessings. I believe a written record will
certainly maintain/increase my happiness as it will reinforce me to find the silver lining in clouds. Furthermore, I would
like to continue exercising and being physically active on a regular basis.

Findings
Data for the project was collected from February 1 - April 15, 2016 and are presented in Table 3.
Table 3
Behavior Modification Observations by Date, Duration and Type of Activity
Date
Duration
Type of Activity
Monday, 02/01
25 minutes
Run 2.5 miles
Tuesday, 02/02
30 minutes
Cycle, Abs
Wednesday, 02/03
35 minutes
Run 3.5 miles
Thursday, 02/04
10 minutes
Yoga
Friday, 02/05
Rest
Rest
Saturday, 02/06
115-120 minutes
Hike 4 miles

Monday, 02/08
Tuesday, 02/09
Wednesday, 02/10
Thursday, 02/11
Friday, 02/12
Saturday, 02/13

30 minutes
Rest
40 minutes
Injury
Injury
Injury

Run 3 miles
Rest
Run 2 miles, Abs
Injury
Injury
Injury

Monday, 02/15
Tuesday, 02/16
Wednesday, 02/17
Thursday, 02/18
Friday, 02/19
Saturday, 02/20

35 minutes
35 minutes
25 minutes
Rest
35 minutes
45 minutes

Run 3.3 miles

Run 1.5 miles, Abs, Arms
Run 2.5 miles
Rest
Run 3 miles
Run 4 miles

Monday, 02/22
Tuesday, 02/23
Wednesday, 02/24
Thursday, 02/25
Friday, 02/26
Saturday, 02/27

35 minutes
Rest
50 minutes
Rest
Rest
Rest

Run 3 miles
Rest
Run 5.3 miles
Rest
Rest
Rest

Monday, 02/29
Tuesday, 03/01
Wednesday, 03/02
Thursday, 03/03
Friday, 03/04
Saturday, 03/05

60 minutes
30 minutes
60 minutes
20 minutes
25 minutes
140-150 minutes

Run 4 miles, Abs, Arms

Run 1.3 miles, Abs, Legs
Run 3 miles, Abs, Arms
Run 2 miles
Run 2 miles
Kayak 95 minutes, hike

Monday, 03/07
Tuesday, 03/08
Wednesday, 03/09
Thursday, 03/10
Friday, 03/11
Saturday, 03/12

25 minutes
50 minutes
40 minutes
Rest
Rest
30 minutes

Run 3 miles
Run 30 minutes, Abs, Leg
Run 4 miles
Rest
Rest
Run 3 miles

Monday, 03/14
Tuesday, 03/15
Wednesday, 03/16
Thursday, 03/17
Friday, 03/18
Saturday, 03/19

25 minutes
30 minutes
Rest
Rest
35 minutes
90 minutes

Run 2.5 miles

Run 30 minutes
Rest
Rest
Run 3 miles
Run 40 min, Bike 50 min

Monday, 03/21
Tuesday, 03/22
Wednesday, 03/23
Thursday, 03/24
Friday, 03/25
Saturday, 03/26

55 minutes
35 minutes
35 minutes
Rest
Rest
90 minutes

Run 6 miles
Strength Train
Run 4 miles
Rest
Rest
Run 4 miles, Bike 45 min

Monday, 03/28
Tuesday, 03/29
Wednesday, 03/30
Thursday, 03/31
Friday, 04/01
Saturday, 04/02

Injury
20 minutes
15 minutes
20 minutes
Injury
Injury

Injury
Chair exercises
Chair exercises
Chair exercises
Injury
Injury

Monday, 04/04
Tuesday, 04/05
Wednesday, 04/06
Thursday, 04/07
Friday, 04/08
Saturday, 04/09

Injury
15 minutes
Injury
Injury
Injury
30 minutes

Injury
Run 1.5 miles
Injury
Injury
Injury
Run 2.5 miles

Monday, 04/11
Tuesday, 04/12
Wednesday, 04/13
Thursday, 04/14
Friday, 04/15
Saturday, 04/16
Table 3

60 minutes
15 minutes
90 minutes
Rest
45 minutes
Rest

Run 5 miles
Chair exercises
Run 8 miles
Rest
Cycle 20 min, Abs, Glutes
Rest

I maintained regular physical activity forty-one of the total sixty six days (62.2%) which is a nearly 85% increase from my
baseline.

Additionally, ten of the twenty-five Rest Days were from injury. If the injury days are excluded, I maintained my goal of being
physically active 73.2% of the days.

A total of 1770 minutes of physical activity, including 102.4 miles have been run since the beginning of my behavior change
project.

Discussion

The data in Table 3 shows the progress of my behavior change based on day, duration of physical activity as well as type
of physical activity.

During the implementation of this behavior change project, I felt confident that I was doing well and succeeding at my
goal, especially since I was keeping close observations of what I was doing.

Although my expectations for success going into this project were real, demonstrated by my small goal of working out
25 minutes per day, I was initially disappointed I only reached my goal 73.2% of the time.

I am rejoicing with this victory, now, because it is a dramatic increase in physical activity from where I was four months
ago. It is extremely challenging to maintain a behavior change for an extended period of time because you are
essentially breaking a habit and then rebuilding a new one.

Some days were much more difficult than others and I have realized making a plan is good, but will not always be
feasible. I am looking forward with great anticipation to maintaining my behavior change in the future.

Conclusion

This project has been one of the most challenging projects I have done as it was an opportunity to make a behavior
change improving my health.

I sincerely believed this project would be easy in the beginning. What I didnt realize is the difficulty in maintaining a
goal or behavior change for an extended period of time.

I believe the experience I had will enable me to be a better dietitian in the future to my clients when counseling them on
behavior change. I have more empathy for the challenges they will face and how important the little victories are.

As with any behavior change, it must be something that is done for the individual and not for anyone else. However,
through motivational interviewing techniques, I believe I can be more effective in counseling those clients. I am thankful
for the opportunity to have completed this project and would recommend it to anyone going into a field where behavior
change is important.