Study suggests two factors crucial to maintaining healthy routine

Published on Sunday, September 1, 2019

By: Karen Bascom

Whether it’s eating less, exercising more or quitting smoking, making changes to improve your health can be challenging.

It’s one thing to know a gym routine can help you stay fit, but knowing how to get into that routine and keep it going is another matter.

Dr. Vinayak K. Nahar, assistant professor of dermatology at the University of Mississippi Medical Center, studies health behavior and promotion. He said forming better health habits can be divided into two stages: initiation and sustenance.

“Initiation is starting that healthy behavior and taking those first steps,” said Nahar, who has a secondary appointment in the Department of Preventive Medicine. “Sustenance is maintaining that behavior for months, for years or for the rest of one’s life.”

This two-stage framework, called the multitheory model, can help explain what factors influence people to change and maintain health behaviors.

Nahar and his colleagues published a study in the August issue of the Journal of the American Osteopathic Association that showed how these factors might help medical school students who do not exercise 150 minutes per week achieve that goal.

Nahar said many students use physical activity as a way to control their stress levels, but their workloads and obligations create challenges.

“Among students, the biggest barrier we see is time,” Nahar said.

The students in the study thought the most significant factor influencing their ability to initiate an exercise routine is believing that they can actually do it.

“We see that behavior confidence is an important factor in promoting health behaviors,” Nahar said.

To sustain physical activity, students said there were two factors that could help them. The first was changes in social environment.

“This is about changes in their support system, whether that be seeking help from their family, friends or health care professionals,” Nahar said. For example, they could find a gym buddy or get advice from a doctor.

The other factor that might help them maintain a routine is emotional transformation, or refocusing their feelings into actions.

For instance, Nahar said, when a student feels stressed, he or she can use that as a cue that it’s time to go for a quick run.

The American Heart Association recommends adults get at least 150 minutes of moderate-intensity physical activity per week. Regular exercise can lower the risk of disease, improve cognition and relieve some symptoms of stress and anxiety.

Among the students surveyed for Nahar’s study, nearly 40 percent were not meeting that goal.

“Nearly half of all adults in the U.S. do not engage in the recommended 150 minutes of physical activity per week,” said Dr. Manoj Sharma, a professor of behavioral health at Jackson State University and lead researcher on this study. “This basic lack of exercise is tied to myriad health problems, so it is important to address it early.”

Nahar, Sharma and their colleagues have used the multitheory model to study health promotion around diet, smoking cessation, binge drinking, sleep behaviors and excessive tanning. The model includes other factors that might help explain why someone starts or maintains a behavior, such as their understanding of its benefits and disadvantages or their access to physical resources.

“It’s a robust tool for explaining how healthy and risky behaviors are,” Nahar said. “If someone is trying to eat healthier, the behavioral confidence construct says that someone might know that cooking at home is going to be better for them, but they may not feel confident about their ability to actually cook a meal for themselves.”

The study doesn’t show if the participants managed to initiate or maintain an exercise plan. Instead, it helps health care professionals assist individuals and populations to reach their health goals.

“The next step for this study is to develop brief interventions that can help increase physical activity, whether that be signs or other kinds of reminders to engage in physical activity,” Nahar said. "Access to internal and external sources of inspiration and resilience is an effective and sustainable model for positive change."

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