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Andrew J. Hutchison and Lynne H. Johnston

The purpose of this article is to expand the literature on case formulation as a clinical tool for use within exercise psychology, generally and lifestyle behavior change interventions, specifically. Existing research offers limited support for the efficacy of current physical activity behavior change intervention strategies, particularly in the long-term. The present paper argues that intervention strategies need to pay greater attention to the complex and individualistic nature of exercise and health related behaviors. It has been suggested that existing intervention designs tend to conform to a medical model approach, which can at times potentially neglect the complex array of personal and situational factors that impact on human motivation and behavior. Case formulation is presented as a means of encouraging a dynamic and comprehensive approach to the development and implementation of practical interventions within the health behavior change field. The adoption of these clinical techniques may facilitate the careful consideration of variations in the development, manifestation, and maintaining mechanisms of problematic behaviors (e.g., inactivity). An overview of case formulation in its different forms is presented alongside a justification for its use within exercise psychology.

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Sarah E. Scott, Jeff D. Breckon, Robert J. Copeland, and Andrew Hutchison

Background:

Physical activity is promoted to help adults manage chronic health conditions, but evidence suggests that individuals relapse after intervention cessation. The objective of this study was to explore the determinants and strategies for successful and unsuccessful physical activity maintenance.

Methods:

A qualitative study using semistructured interviews was conducted with 32 participants. Purposive sampling was used to recruit 20 successful and 12 unsuccessful maintainers. Adults with chronic health conditions were recruited having completed a physical activity referral scheme 6 months before study commencement. The IPAQ and SPAQ were used to categorize participants according to physical activity status. Data were analyzed using framework analysis.

Results:

Eleven main themes emerged: 1) outcome expectations, 2) experiences, 3) core values, 4) trial and error, 5) social and practical support, 6) attitudes toward physical activity, 7) environmental barriers, 8) psychological barriers, 9) physical barriers, 10) cognitive-behavioral strategies for physical activity self-management (eg, self-monitoring), and 11) condition management (eg, pacing).

Conclusions:

The findings identified determinants and strategies for successful maintenance and highlighted the processes involved in physical activity disengagement. Such findings can guide the development of physical activity maintenance interventions and increase activity engagement over the long-term in adults with chronic health conditions.