Assessment Methods

Assessment Methods

(Assessment Methods)

Self-Monitoring: Influencing Effective Behavior Change in Your Clients,” article below

Select a health behavior other than exercise. Write a 1,200 word paper including the following:

Develop your own self-monitoring scale for this health behavior.

Explain how you would use this scale as an assessment tool in a behavioral health intervention.

Summarize three current behavioral assessment techniques. Include a minimum of three scholarly references.

Use article below Format your paper consistent with APA guidelines.

Self-Monitoring: Influencing Effective Behavior Change in Your Clients by Melissa Burgard, B.S., and Kara I. Gallagher, Ph.D., FACSM

Learning Objective To understand how to effectively use self-monitoring to assist clients with behavior change and improve client outcomes.

Key words: Behavior Change, Self-Monitoring, Weight Loss, Feedback, Clients.

Behavior change is a difficult process. As a health/ fitness professional, assisting clients with behavior change can be particularly challenging because client interaction is often limited. Many times, these meetings are not sufficient to target both eating and exercise behaviors and address the many barriers clients face. Because many health behaviors need to be targeted outside of these meetings, finding ways to track progress also is necessary to successfully provide clients with appropriate feedback and direction.

Thus, teaching clients to self-monitor is an effective strategy for targeting both eating and exercise behavior change. Self-monitoring allows you to review your clients’ current eating and exercise behaviors, identify what needs to be modified so clients can reach their personal health/fitness goals, and provide feedback. By definition, self-monitoring is ‘‘the systematic observation and recording of target behavior’’(Assessment Methods)

(1) and has been described as the most effective technique and the ‘‘cornerstone’’ of behavioral treatments for weight loss

(2). Self-monitoring increases a client’s self-awareness, and this has been shown to positively influence eating and exercise behaviors

(3). Several weight loss studies have shown that the more consistent participants were at self-monitoring and the more self-monitoring diaries were completed, the greater was the weight loss

(4–6). In a review of studies, D.S. Kirschenbaum, Ph.D., determined that consistency is best defined as recording at least 75% of eating and exercise behaviors

(7). This relationship also has been found in high-risk situations. In a study examining weight change during the holiday season, only the most consistent self-monitors lost weight

(8).Although self-monitoring is considered to be a valuable tool for behavior change, it does require the consideration of several factors to be applied and used appropriately with your clients. Teaching your client to effectively and consistently self-monitor is a process that is dependent upon the client’s personality, goals, and knowledge regarding his or her behavior. Taking individual differences into account, your goal as the health/fitness professional should be to ‘‘help clients be the best self-monitors they can be’’

(8).As a guide, you can use the following ‘‘Four Ps of Self-Monitoring’’ to determine the best self-monitoring fit for your clients.

Purpose of Self-Monitoring It is helpful to explain the benefits of self-monitoring to your clients so they understand the value and importance it has in promoting behavior change. Self-monitoring can lead to self-awareness regarding behaviors and can help the client regulate behavior more effectively by avoiding and coping with situations that often lead to failure. Self-monitoring records can help identify the specific nature of these situations by answering questions of how, what, when, where, and why. For example, self-monitoring can provide information regarding specific details of client behavior such as:(Assessment Methods)

How many calories do they eat? How much activity do they perform? What type of foods do they eat? What foods do they tend to overeat? What time of day are they most likely to exercise? What types of exercise do they enjoy? When do they eat the majority of their calories? When are they most likely to miss a planned exercise session? Where do they make poor food choices? Where do they have opportunities for exercise? Why do they miss exercise sessions? Why do they want to lose weight or begin an exercise program? By addressing the specific details of clients’ behaviors that occur outside of in-person sessions, you can better assist them with recognizing patterns of behavior that may impact progress.

Personalized Approach What to Monitor Once you have explained to the client the underlying purpose and benefits of self-monitoring, the next step is to decide with the client what behaviors to monitor in order to best reach their health/fitness goals. It is essential to keep in mind that this should not be a one-size-fits-all approach. Take a personalized approach to tracking client behavior that is based upon personality, environment, and individual characteristics and goals. For example, for clients who wish to lose weight, monitoring both eating and exercise information is the best way to determine if they are on track. For other clients, eating behaviors may be related to stressful situations, and thus, feelings of stress may be an additional variable you may want to monitor to assist with weight loss.(Assessment Methods)

Collecting baseline data is an important component of self-monitoring because it provides you with an understanding of what your clients are currently doing, which behaviors require minor modification, and which behaviors you may need to target more heavily. More information is helpful, but it is not necessary to have clients heavily self-monitor at the beginning of a program. Rather, collecting a typical weekday and a typical weekend day of information may be sufficient to capture a snapshot of current behaviors. Once this information is collected, it is beneficial to discuss these initial self-monitoring records with your clients. This will allow you to identify what areas or behaviors they find to be most troublesome and to gain greater insight into how they believe these behaviors can be changed.

Amount of Detail Some clients may prefer to keep highly detailed self-monitoring records that include, for example, date, time, place, mood, description of food, quantity of food, calories, grams of fat, and hunger level (Figure 1). Others will simply want to record whether they made healthy eating choices at each meal. In determining the amount of detail your clients should use, pay careful attention to clients’ attitudes regarding monitoring, personalities, and time constraints. For some, more will be better, and this will provide you with ample information to offer feedback and direction; others may become overwhelmed and disheartened by trying to attend to too many variables.

There are pros and cons to having clients provide a large amount of detail regarding behaviors. For example, although measuring body weight can tell you whether a client is on track, it does not provide you with information regarding the behaviors that may influence that weight. Conversely, having clients keep detailed self-monitoring records may offer too much information, thus making it more difficult to focus on the most crucial behaviors that need to be targeted for change.(Assessment Methods)

Persistence The frequency and consistency with which clients selfmonitor also may be a factor in the success of behavior change. If clients only self-monitor once a month, this is not likely to provide enough information for you to assess progress or for them to make positive behavior changes. The self-monitoring process should be frequent and consistent enough to provide valuable information yet not so cumbersome that clients become overwhelmed. Because self-monitoring is a skill that may need to be developed, your role is to encourage and guide your clients as they become more consistent with this behavior.

When determining the appropriate amount of self-monitoring for your clients, consider the following points: Will daily self-monitoring be beneficial? Will self-monitoring three times per week be adequate? What format will be most convenient for your clients?

Accurate Recording Encourage your clients to be accurate in their selfmonitoring efforts. Some clients may record only the healthy behaviors and fail to include the less healthy behaviors. For example, they may omit the handful of M&Ms they grabbed from a candy dish at work or forget to record the amount of salad dressing they used at lunch. One way to increase accuracy is to have clients carry a self-monitoring tool with them so they can record information immediately. For example, if a client is eating on the run and does not have time to sit down and record what they eat, they can use a small notebook to jot down this information. Alternatively, they can record this information on a small handheld voice recorder. This tool can be especially useful for monitoring exercise behaviors when a client may not have time to record information in writing. Although immediate recording may not always be possible, encourage your clients to record information as soon as they can after the behavior occurs.(Assessment Methods)

Positive Reinforcement Encourage your clients to positively reinforce themselves for effective self-monitoring. If clients have achieved their self-monitoring goals for the week or have improved upon their consistency, they should recognize and reward their efforts. This recognition and reward can take many forms and should be based on individual preference. Some clients may appreciate verbal recognition, while others may prefer a more tangible reward such as purchasing new workout gear. The important aspect is that the recognition and reward are commensurate with the effort the client has put forth. The importance of positively reinforcing clients cannot be overstated. Recognizing successful self-monitoring efforts will not only increase the likelihood of continued success but also will foster a positive client/trainer relationship.

A Tool for Health/Fitness Professionals Self-Monitoring Tools In addition to the benefits that self-monitoring can provide your clients, self-monitoring also can be a useful tool for you. The information gathered from your clients’ self-monitoring records can provide you with valuable insight into areas that may need to be targeted for change. For example, if a client consistently misses morning workouts, it may be helpful to explore whether these missed workouts are related to lack of time, dislike of morning exercise, or some other factor.

By examining self-monitoring records, you also may be able to identify patterns of behavior that may be contributing to a lack of success. This information can help you modify your approach and develop strategies to better assist your clients in reaching their health/fitness goals. Self-monitoring is an effective tool for facilitating behavior change. The information gathered from selfmonitoring records allows you to tailor interventions to target specific behaviors that are crucial to your clients’ success. By teaching your clients to self-monitor, you can empower them to take an active role in their behavior change process and provide them with the skills they need to maintain positive behavior changes long term.

References(Assessment Methods)

1. Baumeister RF. Self-regulation and depletion of limited resources: Does self-control resemble a muscle? Psychol Bull. 2002;128: 247–66.
2. Kirschenbaum DS, Gillis R, Smith GP. The Psychology of Weight Control. Champaign, IL: Human Kinetics; 1982.
3. Burke LE, Choo J, Music E, Warziski M, Styn M, Kim Y, Sevick MA. PREFER study: A randomized clinical trial testing treatment preference and two dietary options in behavioral weight management—Rationale, design and baseline characteristics. Contemp Clin Trials. 2006;27:34–48.
4. Boutelle KN, Kirschenbaum DS. Further support for consistent self-monitoring as a vital component of successful weight control. Obes Res. 1998;6:219–24.
5. Linde JA, Jeffery RW, French SA, Pronk NP, Boyle RG. Self-weighing in weight gain prevention and weight loss trials. Ann Behav Med. 2005;30:210–6.
6. McGuire MT, Wing RR, Klem ML, Lang W, Hill JO. What predicts weight regain in a group of successful weight losers? J Consult Clin Psychol. 1999;67:177–85.
7. Kirschenbaum DS. Self-regulatory failure: A review with clinical implications. Clin Psychol Rev. 1987; 7:77–104.
8. Wing RR, Hill JO. Successful weight loss maintenance. Annu Rev Nutr. 2001;21:323–41.

15ACSM’S HEALTH & FITNESS JOURNALA JANUARY/FEBRUARY 2006 VOL. 10, NO. 1 Copyr ight © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

 

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