A client’s use of the processes of change for physical activity behavior can be measured with questionnaire 4.1 in appendix A, which we and our colleagues developed (Marcus, Rossi, Selby, Niaura, & Abrams, 1992). This questionnaire has been used in many exercise studies. When people’s scores on these items increase, it is usually a good indicator that they are becoming more active (Dunn et al., 1997). The processes of change are the strategies and techniques people use to change their thinking and their behavior; your clients are therefore likely to increase their use of many of the processes of change long before they are meeting national guidelines for a physically active lifestyle.
You may want to have clients complete this questionnaire every 3 months so that you can learn whether they are making progress toward behavior change even if they are not meeting their specific physical activity goals. Recall that a person’s stage of motivation for change when she first comes to see you has a great impact on how quickly she increases her use of the processes of change. The setting in which you work might also affect which processes of change increase first and how quickly the client puts them to use. For example, if you are a personal trainer at a health club, you are more likely to start working with clients on behavior change, and thus you are more likely to see increases in the behavioral processes of change. However, if you work at a community center, YMCA, or YWCA implementing a program such as the Active Living Program (Blair, Dunn, Marcus, Carpenter, & Jaret, 2001), you may see changes in your clients’ cognitive processes before changes in their behavioral processes. Most published studies indicate that it is important for people to first increase their use of the cognitive processes and then of the behavioral processes. However, some studies indicate that the order is not important; people need to increase their use of all (or most) of the processes of change to become and stay regularly active (Marcus et al., 1992).