I complete four personal training sessions with a client, and then she does not follow through with her remaining paid, new-year’s-resolution training sessions. When queried at a later point in time, she explains that her schedule became too demanding to incorporate workouts. Prior to that, a therapy client did not implement specific parenting strategies that we had developed together during the previous week’s hour-long session. What happens in between our desire to engage in a task, the actual initiation of engaging in such a task, and then maintaining healthy behaviors over time?
As a medical term, adherence is defined as the extent to which a person’s behavior coincides with medical regimens and health advice (this concept can also apply to other behaviors in life, such as financial spending and enhancing adaptive communication with family members). Problems with adherence have been constant throughout history; even Hippocrates was known to declare that his patients lied about taking their medications. In general, following through with treatment programs for preventive health behaviors, such as diet and exercise, is lower than for those behaviors requiring long-term management of chronic conditions. Although this information is not surprising due to the mind-body fortitude involved with lifestyle changes, it is indeed quite upsetting given that many disease states such as hypertension and diabetes can be preventable.
So, how can we enhance our adherence rates? First, we need to understand obstacles to adherence, which can range from cognitive factors such as self-esteem and self-efficacy (our belief in our ability to effect change) and environmental factors such as social support and finances. Subsequently, we need to appreciate that efforts to improve adherence rates are best enhanced by implementing multi-component strategies, which can include: 1) tailor plans/goals to fit into a daily routine and lifestyle (behavioral sticker charts are rarely maintained over time, setting parents up for feelings of failure); 2) use the environment as cues (e.g., leave vitamin supplements/medications next to toothbrush); 3) give yourself rewards (e.g., working out three times per week allows a trip to the manicurist); and 4) seek social support from positive sources such as trainers, support groups, financial advisors and helpful family members.
Don’t be afraid to use trial and error; see what strategies work best for you and your lifestyle. Don’t be afraid to make mistakes. Don’t listen to others’ criticisms or ridicules of your quest for change. Don’t quit. Remember…
“You will never change your life until you change something you do daily.”