Adherence to an exercise prescription scheme: the role of expectations, self-efficacy, stage of change and psychological well-being.

OBJECTIVES: Poor rates of adherence to exercise prescription schemes present a potential barrier to the goal of increasing physical activity in patient samples. This study investigated the role of participant expectations, self-efficacy, stage of change and psychological well-being in adherence to a 12-week course of gym based exercise. It also aimed to assess the impact of failure to adhere on self-efficacy and psychological well-being.
METHOD: The 119 participants, referred by their medical practitioner for a course of exercise, completed questionnaires at the start of the course and 77 went on to complete second questionnaires. Objective measures included a range of physiological measures based on gym assessments.
RESULTS: Participants typically had high expectations of the scheme. Those who completed the course had more modest expectations of change and came closer to achieving these expected changes than those who dropped out. Initial stage of change and self-efficacy did not discriminate between the two groups. While self-efficacy improved over the scheme for completers, it tended to deteriorate for drop-outs. GHQ scores also failed to improve over time for drop-outs.
CONCLUSION: Overly optimistic expectations of inexperienced exercisers may lead to disappointment and attrition. Interventions to ensure realistic expectations might increase success and prevent potential negative effects of failure.