From a Vital Sign to Vitality: Selling Exercise So Patients Want to Buy It

Abstract

Exercise is Medicine® (EIM) and physical activity as a vital sign are based on health-focused research and reflect ideal frames and messages for clinicians. However, they are nonoptimal for patients because they do not address what drives patients’ decision-making and motivation. With the growing national emphasis on patient-centered and value-based care, it is the perfect time for EIM to evolve and advance a second-level consumer-oriented exercise prescription and communication strategy. Through research on decision-making, motivation, consumer behavior, and meaningful goal pursuit, this article features six evidence-based issues to help clinicians make physical activity more relevant and compelling for patients to sustain in ways that concurrently support patient-centered care. Physical activity prescriptions and counseling can evolve to reflect affective and behavioral science and sell exercise so patients want to buy it.

Health Benefits of Physical Activity: A Strengths-Based Approach

“…As we recently argued [2], the poor uptake of physical activity guidelines may (at least in part) be a result of an overreliance on health outcomes and physical activity dosages required to reduce risk (i.e., deficits-based messaging) rather than effectively addressing the key determinants of healthy lifestyle behaviors. This supports the recent movement to engage in knowledge mobilization activities (e.g., the creation of knowledge translation resources) that highlight evidence-based means of promoting physical activity/exercise enjoyment and adherence [2,[41][42][43][44]. For instance, Rhodes and colleagues (and others) have demonstrated strong support that affective judgment constructs (such as affective attitude, enjoyment, intrinsic motivation) are key predictors of physical activity behavior [42][43][44].…”

“…For instance, Rhodes and colleagues (and others) have demonstrated strong support that affective judgment constructs (such as affective attitude, enjoyment, intrinsic motivation) are key predictors of physical activity behavior [42][43][44]. Exercise enjoyment particularly appears to be a key determinant of behavioral change related to healthy lifestyle behaviors (such as physical activity) [41]. A growing body of research has supported the efficacy of promoting the positive affective benefits of physical activity (such as "feeling good") for eliciting behavioral change.…”

“Everything else comes first”: a mixed-methods analysis of barriers to health behaviors among military spouses

“…These results suggest that future health-promoting interventions might be better received if they are framed as holistic health programs to enhance mental health and quality of life. This strategy is likely to facilitate autonomous motivation among participants because health behaviors such as physical activity and diet are linked to outcomes they truly value, as opposed to extrinsic outcomes (e.g., weight loss) that take a long time to achieve (if they are achieved at all) and contribute to perceptions that one “should” be exercising and/or dieting [ 29 ]. In addition, to directly address mental health, interventions can incorporate strategies such as problem-focused coping, which empower individuals to take constructive steps to cope with stressors, and have been shown to alleviate physical symptoms of stress even when perceptions of control are low [ 6 , 30 ].…”

Testing the Effects of Message Framing on Physical Activity Motivation in Active and Non-Active Adults

“…In sum, theory and research supports that positive affect facilitates increased PA intention and continued participation. Therefore, promoting PA based upon these benefits or outcomes, as suggested by Segar et al (2016), might be an effective way for HCPs to sell PA. Message framing might be one way to accomplish this sell.…”

“…However, a key question is whether "selling" exercise as a "vital sign" is appealing to the consumer? Recently, Segar, Guérin, Phillips, and Fortier (2016) have argued the answer might be "no". A better approach, according to these scholars, would be for HCPs to "sell" exercise as a way for people to get what they want now.…”