By Keegan Knittle, University of Helsinki, Finland

Here’s a familiar story from primary care: an individual who would clearly benefit from more physical activity comes into the clinic. We discuss their physical (in)activity, and in the end, the person says they just aren’t motivated to change. What’s a clinician supposed to do? How can we motivate this person to at least consider changing their behavior for the better? Or better yet, how can we help them to form good intentions for being active?

In consultations with “unmotivated” individuals, clinicians commonly start by offering information about the benefits of physical activity. They might also advise the person to become more active, but in doing so, may forget to account for the individual’s own exercise preferences.  While these informational and advice-giving efforts are well-intentioned, they aren’t likely to produce any real changes. In fact, if 26 inactive people receive physical activity advice, chances are that only one of them will subsequently reach recommended levels of physical activity.

Other clinicians take their advice giving a step further, and impel people to change by saying things likes “you have to change” or “you need to become more active NOW.”  These more forceful approaches to physical activity promotion can actually backfire, and serve to increase the person’s resistance to change.  In extreme circumstances, a clinician might even try to scare the person into changing, by listing the adverse health consequences of not changing. Efforts to scare people into changing are usually ineffective, unless the individual sees herself as capable of making a change. So the question remains: What is the best way to motivate people to increase their physical activity?

In 2018, our group published a large meta-analysis which tried to answer this question. We first looked at more than 100 different physical activity promotion interventions, and identified the behavior change techniques each one contained. Then, we tried to identify which behavior change techniques led to increases in motivation for physical activity. The results revealed two main groups of behavior change techniques that seem to increase motivation.

The first group consisted of self-regulation techniques. In our analyses, self-regulation techniques (i.e., self-monitoring of physical activity levels, getting feedback on performance, setting physical activity goals, making action plans and using problem solving strategies to overcome barriers to physical activity) all had effects on motivation.  In addition, interventions which used self-monitoring coupled with at least one other self-regulation technique increased motivation more than other interventions.  Previous studies have shown that self-regulation techniques are very important in changing behaviors (e.g., physical activity, diet, smoking) and our study showed that they are very important in increasing motivation as well. Therefore, getting people to try out some self-regulation techniques can help them to both become more active and feel more motivated.

The second group consisted of behavior change techniques related to participation in exercise classes, including instruction on how to perform physical activity, demonstrations, and opportunities to practice new modes of physical activity.  Interventions which used this set of techniques, and interventions which were delivered in person or to groups of people, led to increases in motivation for physical activity. This could be due to the social support received from trainers, or from the opportunities for social comparison (and having fun) provided by other participants in the class.  While it might seem daunting for an inactive individual to jump into a group exercise class right away, there is a good chance that doing so would increase their motivation for being active.

In conclusion, there are no 100% successful ways to motivate someone to become physically active, but our research suggests that fostering self-regulation and participation in exercise classes might be a good start.  So the next time you are faced with a client or patient who would benefit from moving a little more, try out some of the practical tips below. They might not work for all individuals, but at least they will give you a couple more tools to use in your efforts to motivate others. Happy motivating!

Practical recommendations

1. Monitor. Ask individuals to track their physical activity levels using an app, an activity tracker, or a paper diary. Offer them a printout which lists a few options for self-monitoring that you yourself would recommend.
2. Review. Have the individual review their self-monitoring to see whether they are as active as they thought, and to identify times when physical activity might fit into their schedule.
3. Set a goal and make plans. Have the individual set an activity goal that is realistic in light of what they currently do (from steps 1 and 2 above), and to make a plan of when, where and how they will achieve it.
4. Just do it. Offer the individual a list of various physical activity classes, adult sports leagues or parks in the area, and help them to choose the opportunities for activity that are most interesting for them. Also, acknowledge that getting started is very difficult, but that doing so can help them to feel more motivated.
5. Focus on motivation. Let the person know that it is normal to feel unmotivated, and that research evidence suggests that these strategies can help them become more active and boost their motivation at the same time.