Motivation and realistic goal setting: a step-by-step approach

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Understanding behaviour is important for improving health literacy and health

A healthy lifestyle is one of the major predictors of healthy ageing. Major components of a healthy lifestyle are physical activity, healthy eating, non-smoking and stress-management. However, many people do not meet the recommendations for a healthy lifestyle, especially people with low health literacy. This is one of the reasons why health literacy is linked to poor health, mortality and increased healthcare costs. Thus, it is important to understand human behaviour and what drives it.

We describe six steps for improving health literacy for older people here. To support behavioral change, we need to know more about what exactly is going on in individuals’ heads: are they motivated to become or stay active? Do they intend to change their behaviour? In order to understand what drives human behaviour, we need to appreciate the desires that lead individuals to become or stay active. This specific inquiry can be titled “motivation.”

Supporting individuals to achieve their goal behaviour

For the individual, we can gain much insight into the ‘readiness’ to become and remain active. Intention and motivation are important determinants of behaviour. Stage assessments also include behavioural aspects, which opens avenues for fast measurements of which level people are at in the behaviour change process, and how close they are to the goal behaviour.

Such measurements can provide the basis for successful interventions in helping individuals to adopt and maintain their goal behaviour. Goal setting is one important target in such an intervention. Healthy ageing can be supported by interventions that help people to set realistic goals, matching their own and contextual resources.

How does motivation affect behaviour?

People might be motivated to perform the recommended physical activity, which is an important prerequisite for actually adopting the behaviour. Similarly, if people lack motivation, it is unlikely that a change in behaviour will occur. Thus, it is essential to obtain more knowledge about the ‘readiness’ for behaviour change: how close people are to actually changing their behaviour, or how far they have habituated a behavior and intention. ‘Readiness to change’, also known as ‘stage (of change)’, is conceptualised as a measurable indicator of behaviour change and its psychological antecedents. People may or may not intend to change their behavior. This can be measured by intention assessments.

Individuals could also be distinguished by whether they perform the recommended behaviour, which can also be measured by the behaviour tools described above.

How to assess motivation and intention?

Intention to perform behaviour should be assessed in a way similar to behaviour itself. This could be accomplished by rating the following three items: ‘I intend to perform the following physical activities at least five days per week for 30 minutes…’

  1. ‘vigorous physical activities (heart beats rapidly, sweating)’;
  2. ‘moderate physical activities (not exhausting, light perspiration)’;
  3. ‘mild physical activity (minimal effort, no perspiration).’

Answers can be assessed on a six-point scale from not at all true (1) to absolutely true (6). On this basis, it can be concluded whether a person is active enough or not.

How to assess the state of change?

According to stage theories, health behaviour change consists of an ordered set of categories or ‘stages’ into which people can be classified. These categories reflect psychological or behavioural characteristics such as motivation and physical activity behaviour.

Classical stage assessments take time frames (e.g. 30 days, half a year) into account. Contemporary assessments measure stages without using a specific time frame. Individuals could potentially be asked to think about the last month, and then can be presented with the following question:

“Did you engage in physical activity for at least five days a week for 30 minutes or more?”

Further, they should be asked:

‘For the following month: do you intend to perform physical activities five times per week for 30 minutes or more?’

Based on their answers to the rating scale, individuals are categorised as nonintenders, intenders, or actors:

  • Actors: Individuals who indicate that they were active in the past.
  • Intenders: People who answer that they were not active, but do intend to perform the recommended goal activity.
  • Non-intenders: Individuals answering that they have not been active, and are not intending to perform the recommended goal activity in the future.

The assessment can also be adapted to other behaviours that are relevant for health promotion. With the necessary information, interventions can be tailored to psychological and behavioural characteristics of the stages. These are known as stage-specific interventions. We can capture stage movements prior to or after the actual behaviour change by measuring stages, rather than just behaviour (e.g. development of an intention when moving from the pre-intentional stage to the intentional stage). These changes might be important if we are interested in following-up with changes that might not be visible in behaviour change.

Setting realistic goals

Goal setting is one important milestone when people become motivated and increase their intention. If people set too high goals such as performing to difficult activities or intending to be active too often per week/day, they are likely to not translating their goals into actual behaviour. Therefore, we should rather help people to set realistic goals which are sometimes even below the recommended behavioural level. Adopting this behaviour can represent an intermediate step towards to actual goal behaviour. In that sense, every little step should be appreciated, but at the same time, also increased to actually meeting the recommended behaviours which are connected to health outcomes. Realistic goal setting depends on the individual resources a person has. For instance, social support, self-efficacy and environmental factors should be taken into account, especially, if contextual factors cannot be changed. The goal should be set depending on those resources. A comprehensive approach is needed, you can find more information about that here.

Source

Bültmann, U. (2013). Assessing your client’s physical activity behavior, motivation, and individual resources. In Claudio R. Nigg (Ed.). ACSM’s behavioral aspects of physical activity and exercise (p. 39-69). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Further reading

Lippke, S. (2014). Modelling and Supporting Complex Behavior Change related to Obesity and Diabetes Prevention and Management with the Compensatory Carry-Over Action Model. Journal of Diabetes & Obesity, 1(2), 1-5.

Lippke, S., & Plotnikoff, R. C. (2014). Testing two principles of the health action process approach in individuals with type 2 diabetes. Health Psychology, 33(1), 77-84.

Schwarzer, R., Lippke, S. & Luszczynska, A. (2011). Mechanisms of Health Behavior Change in Persons With Chronic Illness or Disability: The Health Action Process Approach (HAPA). Rehabilitation Psychology, 56(3), 161-170.

Wiedemann, A. U., Lippke, S., & Schwarzer, R. (2012). Multiple plans and memory performance: results of a randomised controlled trial on fruit and vegetable intake. Journal of Behavioral Medicine, 35, 387-392.

Ziegelmann, J. P., & Lippke, S., (2007). Use of Selection, Optimization, and Compensation strategies in health self-regulation: Interplay with resources and successful development. Journal of Aging and Health, 19, 500-518.