Motivation and emotion/Book/2021/Physical activity motivation

Overview


Have you ever found it hard to be motivated to exercise?

Have you ever wondered how health professionals can help you get motivated to exercise?

If yes, this book chapter is for you! Psychology can answer both of those questions with theory and health promotion suggestions.

Firstly, motivation can be understood from a psychological perspective. Motivation is the driver behind the selection, action and maintenance of behaviour (Kazen & Quirin, 2018). The three types of motivation that underlie behaviour include intrinsic, extrinsic and amotivation (Reeve, 2018). Motivation can be specific to particular behaviours, including physical activity. Physical activity motivation can be explained as the motivation to participate in exercise (Egli et al., 2011).

Exercise is well-known to positively contribute to a healthy lifestyle (Smith et al., 2008). Physical activity is beneficial to health as it assists in the prevention and maintenance of chronic conditions, musculoskeletal and psychological well-being (Australian Institute of Health and Welfare, 2020). The World Health Organisation (2020) provides guidelines for the recommended amount of physical activity that adults should be participating in to maintain health. Psychological literature contains physical activity specific theories to explain motivation (Moreno et al., 2010).

Physical activity motivation can be explained by psychological theories such as the self-determination theory and the achievement goal theory (Duncan et al., 2010; Moreno et al., 2010). These theories can assist health professionals in understanding their patients' motivation for exercise and in turn assist the promotion of physical activity in health care settings (McPhail & Schippers, 2012). The most common stream for health practitioners to promote adherence to minimum physical activity recommendations is by utilising counselling during consultation with patients (McPhail & Schippers, 2012). Other interventions are available to suit patients' motivation type and lifestyle including referral to allied health professionals (Tulloch et al., 2006), exercise prescriptions (Bauman et al., 2002), and encouragement of active social relationships (Kilpatrick et al. 2002). Keep reading to learn more about physical activity motivation and the role of health professionals.


 * How do the self-determination theory and the achievement goal theory explain physical activity motivation?
 * How can health practitioners motivate patients to be physically active?

What is motivation?
Motivation can be defined as "the extent to which behaviour is selected, directed, energised, and maintained to satisfy a particular motive" (Kazen & Quirin, 2018). The concept of motivation spreads across multiple fields of psychology, for example, behavioural psychology, social psychology, and sport and exercise psychology (Knittle et al., 2018). There are three underlying categories of motivation which are intrinsic, extrinsic, and amotivation, as displayed in Figure 2.



Intrinsic motivation
Intrinsic motivation involves an internal source of motivation which stems from enjoyment or satisfaction when engaging in a behaviour (Legault, 2016). Intrinsic motivation separates outcomes and behaviours (Legault, 2016). The basis of intrinsic motivation has been reported to be personal growth and psychological satisfaction (Reeve, 2018). Psychological satisfaction is underpinned by the concepts of autonomy, relatedness, and competence (Reeve, 2018). These three concepts are highlighted in the self-determination theory, explored later in the chapter (Reeve, 2018). Case Study Tom is competing in an athletics race. He has run many races in his life and hopes to continue competing for some time. Tom does not compete to win medals, he competes because he enjoys the feeling of running. Tom displays intrinsic motivation for running.

Extrinsic motivation
Extrinsic motivation refers to motivation occurring from external sources (Legault, 2016). Extrinsic motivation does not separate outcomes and behaviours (Legault, 2016). For extrinsically motivated individuals, performance is dependent on the desired outcome (Legault, 2016). Extrinsic motivation is suggested to have four subtypes of motivation which include external, introjected, identified, and integrated (Reeve, 2018). Each of the subtypes is dependent on the autonomy of the motivation and can be further explained by the self-determination theory, discussed later in the chapter (Reeve, 2018). Case Study Manal is in a high ranking soccer team. Her athletic career is at the highest it has ever been. Manal's team is playing in a gold medal match next week. Manal is motivated to win purely to attain a gold medal and cash bonus that she will receive. Manal displays extrinsic motivation.

Amotivation
Amotivation displays a complete lack or absence of motivation (Shen et al., 2010). In this state, individuals are neither intrinsically nor extrinsically motivated; one is not motivated at all (Shen et al., 2010). Amotivation has been linked to negative psychological wellbeing and disengagement (Duncan et al., 2010). In this motivational state, one does not possess the energy nor effort to complete activities that may involve learning or achievement of a goal (Reeve, 2018). Case Study Cyrus usually rides his bicycle to work everyday. Lately, Cyrus no longer cares for the benefits of riding to work, and he does not enjoy doing it anymore. Cyrus displays amotivation for cycling.

Physical activity motivation
Various other motivation types fall under the aforementioned three. Motivation types can be specialised to specific behaviours, for example, physical activity motivation. Physical activity motivation can be understood as the motivation for exercise participation (Egli et al., 2011). The top reported motives for physical activity participation include (Egli et al., 2011):
 * weight management
 * health issues
 * physical appearance
 * strength
 * endurance

Reported barriers include a lack of (Hoare, 2017):
 * time
 * interest
 * enjoyment
 * confidence
 * social support

Case Study Abigail recently received a diagnosis of diabetes from her doctor. As part of her management plan, her doctor advised she should lose 5 kilograms of weight. To help Abigail lose weight, the doctor provided various examples of physical activity that she should try. Abigail took a particular interest in water aerobics and looks forward to starting exercising to get her health on track. Abigail can be described as having physical activity motivation.

What are the guidelines for physical activity?


This chapter focuses on adults (18-64 years old), as children and older adults have varying guidelines. The physical activity guidelines are based on the recommendations provided by the World Health Organisation (2020). Due to increased research and understanding of physical activity levels, physical activity recommendations are constantly being updated. In 1999, the recommendations outlined in the Australian National Physical Activity Guidelines were basic compared to current guidelines (Smith et al., 2008). Adults were recommended at least 30 minutes per day of moderate physical activity on 5 or more days per week (Smith et al., 2008). The current recommendations have been broken down further to include different intensities of exercise. The guidelines state that adults should be engaging in physical activity most days, preferably every day (The Australian Department of Health, 2014). The World Health Organisation (2020) has set out the following weekly guidelines:
 * 2.5 to 5 hours of moderate-intensity physical activity, for example:
 * A brisk walk
 * Swimming
 * Mowing the lawn
 * 1.25 to 2.5 hours of vigorous intensity activity, for example:
 * Jogging.
 * Basketball (as seen in Figure 3)
 * Fast cycling
 * An equal combination of moderate and vigorous activity.
 * Muscle-strengthening activities at least 2 days a week, for example:
 * Push ups
 * Squats
 * Weight training
 * Household tasks involving lifting (e.g., carrying the laundry)

Case Study Judy is a 50-year-old woman. She goes for an hour-long walk with her dogs every day. Jenny also visits her local pilates studio twice a week for a muscle-strengthening based class, and once a week for a stretching class. Once a week she may increase her walking pace or include a run.

The example of Judy illustrates how guidelines for physical activity can be met. Judy displays the three recommended types of physical activity in her weekly routine, moderate intensity, vigorous intensity and muscle strengthening.

 {How many days minimum per week of muscle-strengthening activities are recommended for adults?: + 2 days - 5 days - 7 days - 3 days
 * type=""}

How does psychological theory explain physical activity motivation?
Psychology has long been interested in motivation, its origins and its function (Wang et al., 2016). Sport and exercise psychology contains physical activity specific theories to explain motivation (Moreno et al., 2010). The self-determination theory and achievement goal theory explain the function of motivation in relation to physical activity.

The self-determination theory


The self-determination theory was developed by Richard Ryan and Edward Deci in 1977, and is commonly applied in exercise settings (Duncan et al., 2010). The self-determination theory explains three innate psychological needs (as seen in Figure 4):
 * Autonomy
 * Relatedness
 * Competence

The desire to meet these needs motivates participation in activities that will fulfil the need that must be met (Kilpatrick et al., 2002). Current literature is conflicting regarding which of the three needs is the most relevant to physical activity motivation (Standage et al., 2003). The continuum of motivation types included in the self-determination theory can be seen in Table 1 (Duncan et al., 2010).

Integrated and identified motivation are explained as 'controlled' forms of motivation as the individual places value on the behaviour (Teixeira et al., 2012). Research suggests that motivation higher in intrinsic value is critical for long-term engagement in physical activity (Teixeira et al., 2012). Intrinsic motivation has the potential to be promoted through fun, skill improvement, personal accomplishment and excitement around physical activity (Teixeira et al., 2012).

Introjected and external motivation are regulated by external forces (Teixeira et al., 2012). For example, judges in a gymnastic competition decide an athletes' ranking, the athlete cannot control how the judges rate their performance (Teixeira et al., 2012). Extrinsic identified motivation is highly regarded as it places value on the outcomes of physical activity (Teixeira et al., 2012). Extrinsic motivation can be promoted by health professionals through highlighting the value of physical activity on health and quality of life (Teixeira et al., 2012). A systematic review of the self-determination theory and exercise suggested identified, integrated and intrinsic motivation to be the best predictors of long-term physical activity participation (Teixeira et al., 2012). Health practitioners should encourage individuals to aim for these types of motivation (Teixeira et al., 2012).

Achievement goal theory


The achievement goal theory was first introduced by Nicholls in 1989 in a classroom setting (Moreno et al., 2010). More recently, it has been increasingly applied to sport and exercise in both high performance and every day physical activity (Wang et al., 2016). Achievement goal theory postulates two goal orientations that are concerned with an individual's competence in an achievement setting which results in different behaviour, affective and cognitive outcomes (see Figure 5; Moreno et al., 2010). The goal orientations include:
 * Mastery orientation
 * Performance orientation

Mastery orientation involves the individual striving to perform at their personal best, or at a higher level than previously (Moreno et al., 2010). For example, if a person usually walks five kilometres a day, a mastery oriented person might set a goal to walk six kilometres per day, to improve their achievement.

Performance orientation involves striving to perform better than someone else (Moreno et al., 2010). For example, a person is at a dirt bike obstacle track with their friends, with a performance orientation the person may want to have the fastest time on the track compared to their friends.

A study by Lochbaum et al. (2008) suggested that people who actively participate in physical activity reported higher perception of exercise competence and mastery orientation when compared to non-exercisers. This may suggest that mastery orientation is best to strive for when individuals are looking to engage in long-term physical activity. Health professionals have the opportunity to educate patients on the type of goal orientations and promote mastery rather than performance orientation.

How can health practitioners motivate patients?
Health practitioners are advised to encourage patients to engage in the recommended amounts of physical activity and discourage sedentary lifestyles (Smith et al., 2008). Counselling is the most commonly suggested form of support that health practitioners can provide. Physical activity counselling has shown positive effects in the short-term, although, long-term effects are yet to be determined (McPhail & Schippers, 2012). A specific counselling approach utilised in health settings is known as preventative counselling (Smith et al., 2008).



Preventative counselling consists of the "five As" approach:
 * Ask; about the patient's current activity level.
 * Assess; level of activity and willingness to change behaviour to increase activity.
 * Advise; of the guidelines and benefits. Create an activity plan for the patient that suits their lifestyle.
 * Assist; with potential barrier situations and help find solutions.
 * Arrange; a follow-up, self-monitoring activities (e.g., diary) and ongoing support for the plan.

Other forms of counselling may include:
 * Education of exercise guidelines and recommendations (Tuso, 2015).
 * Brief motivational interviewing (McPhail & Schippers, 2012).
 * Promotion of self-improvement and increasing self-perceptions of exercise ability (Lochbaum et al.,2008).

Health professionals can also provide assistance towards increasing physical activity through other means, such as:
 * Referral to community-based interventions (McPhail & Schippers, 2012).
 * Referral to allied health professionals (Tulloch et al., 2006).
 * Prescriptions for exercise (Bauman et al., 2002).

Promotion during intervention may include:
 * Follow up appointments (Smith et al., 2008).
 * Encouragement of the development of active social relationships (Kilpatrick et al. 2002).

Interventions through health professionals have benefits for practitioners and patients. Namely, the ability to reduce barriers for patients, and it produces the opportunity for health practitioners to provide ongoing management (McPhail & Schippers, 2012). Tulluch et al. (2006) suggested combined health professionals (e.g., referral and management between a general practitioner and an exercise physiologist) treatment to be the most effective. A combination of practitioners involved in treatment has been reported to reduce time barriers and allow for individualised care for the patient (Tulloch et al., 2006). Further, it is important to consider the barriers faced by health professionals when attempting to promote physical activity to patients (McPhail & Schippers, 2012). Such barriers for patients may include being amotivational and unwilling to change their exercise behaviours (McPhail & Schippers, 2012; Teixeira et al., 2012). Barriers for practitioners include lack of confidence in counselling skills, inability to distinguish motivation type, limited consultation time, and negative responses from patients (McPhail & Schippers, 2012; Teixeira et al., 2012). Overall, health professionals are tasked with the role of identifying suitable interventions and providing education for each patient and their motivation type. This aims to encourage an increase in physical activity motivation and create behaviour change.  {Physical activity interventions involving a combination of health professionals are considered _________: - ineffective - a barrier + effective - motivational
 * type=""}

Conclusion
Physical activity motivation can be explained through two psychological theories, the self-determination theory and the achievement goal theory. The self-determination theory explores physical activity motivation by means of three psychological needs which are autonomy, relatedness, and competence (Kilpatrick et al., 2002). The achievement goal theory centres around an individual's perceived level of competence which may facilitate mastery or performance orientation (Moreno et al., 2010). Goal orientation should be taken into consideration by health professionals to guide patients and promote long-term physical activity motivation. The principles of self-determination theory and achievement goal theory support health professionals' understanding of physical activity motivation and interventions to promote physical activity.

People wishing to explore their physical activity motivation should consult a health professional. Various intervention options such as referral to allied health professionals, exercise prescriptions, and preventative counselling are available for people looking to increase physical activity. Health practitioners can provide a solution that is most suitable for different patients.

If you are looking to explore your physical activity motivation, try this quiz as a starting point. Remember to engage with your health practitioners to search for the best way to increase your physical activity.