Issue 3 March 2005 - BASES

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PROFESSIONAL PRACTICE Changing athletes’ behaviour: Lessons learnt Dr Claire Palmer reflects on her own professional practices in applied sports science to highlight some key lessons she has learned along the way Introduction In my opinion, Claire’s reflections are of relevance to all sport and exercise scientists who are in the business of trying to change other people’s behaviours. The work that Phil Moore, Dave Wilkinson and I did for the BASES/Sports Council Interdisciplinary Review in 1992 revealed that adherence to any form of training or intervention was one of the five most important problems for all sports. The findings of a follow-up survey published in the BASES Newsletter in 1999 confirmed this view. As an interdisciplinary issue, you would have thought that it was of real importance for physiologists, biomechanists, sport psychologists and performance analysts. However, the evidence is that the participants in the BASES Adherence to Training workshops since 2003 have been predominantly from sport psychology, with only 20% coming from any of the other disciplines. It does seem to me, however, that adherence is relevant across the sports science board. ■ Prof Les Burwitz THIS article aims to pick out some of the key lessons that I’ve learned from 10 years of applied work as a sports scientist. My research and applied focus relates to adherence issues. On a practical level, there is little value in prescribing programmes if athletes are either unable or unwilling to adopt and maintain any recommendations made. For me, a number of questions arose concerning the problem of adherence: what factors influence adherence and can intervention strategies be successfully used to increase adherence? Through research with sports groups, I have attempted to answer some of these questions and interested parties are directed to read Palmer et al. (1999; 2000). Rather than repeat those findings in this article, I have sought to take advantage of the potentially unique forum that The SES provides by sharing reflections on some key events that have significantly influenced my work practice – the issue of training adherence is merely used as the vehicle through which those lessons were learned. Across a time period of 10 years inevitably there have been changes to the way elite performers are supported. For example, Lottery funding has become available, enabling the UK's top sportsmen and women to access a package of scientific support through their respective sports. The World Class Performance Programme is designed to develop athletes and provide them with all the necessary elements to perform. This has undoubtedly assisted with adherence issues for this elite sport community. However, sport and exercise scientists, involved with team-sport athletes unable to access such individualised support and performing most training in unsupervised settings, continue to report issues with training adherence. 1. In “my universe” I’m the norm In 1992, a close friend was selected to compete in a team sport at a World Youth Cup. Whilst juggling summer vacation jobs, we both religiously followed the fitness training set for the squad by the team’s sport physiologist. We both genuinely enjoyed the training and were even happy doing plyometrics in front of bemused ground staff. However, although my Agree the role of testing friend trained hard, she often complained about teammates who were not completing the recommended training. My experiences with adherence problems came closer to hand when I started working with a team sport on a Sports Science Support Programme and started a PhD looking at adherence. Other sport and exercise scientists and I were surprised at a general lack of fitness among the athletes relative to our expectations. Moreover, despite the provision of training programmes, some athletes appeared to not improve across seasons and this was often associated with half-filled training diaries. I, like many sport scientists that I talk to, are the types of individuals that wouldn’t dream of not following a programme. But whilst in “our universe” we are the norm, to be effective practitioners it is important not to assume that our values and beliefs are representative of our clients. As part of the preliminary needs analysis with the client, an understanding of the athletic context in which the athletes operate should be gained (e.g., assess the athletes’, the coach’s and the sporting organisation’s knowledge of and commitment to fitness or indeed any other aspect of training). This assessment can involve asking questions about previous training histories and looking at what normally happens at the level below. If the training that you aim to introduce is not integral at the level that the athlete has just progressed from, then the behaviour will probably not be habitual and its adoption may require a dramatic lifestyle change. Such an assessment will allow the practitioner to establish whether his or her expectations regarding training prescriptions are realistic and what support is required. I think this is particularly relevant for probationary sport and exercise scientists who are typically enthusiastic in their own training to become accredited and may make the mistake of assuming this enthusiasm exists in whoever they are working with. 2. This applies to everyone but me Aware of the adherence issues within the squad in which I worked, I ran a group workshop aimed at improving adherence. I thought the session went well until an hour later I bumped into one of the athletes, whom I considered to be a low-adherer, and asked her what she thought of the session. She responded, “It was good, cos the whole squad’s really fed up with Nicky (not her real name) not training and it’s good that that’s been highlighted.” I left in silence because clearly this athlete (and I feared most of the squad) had sat throughout the whole session thinking the message was aimed at only one athlete. How could an athlete who regularly handed me a half-empty training diary and under-performed in fitness monitoring regard herself as a trainer? Surely the relevancy of the workshop’s messages to her would be clear? Obviously not and I had DR CLAIRE PALMER 12 Issue 3 March 2005 The Sport and Exercise Scientist www.bases.org.uk
PROFESSIONAL PRACTICE made the mistake of assuming otherwise. I now consider intervention checks, formal and/or informal, as critical to evaluating my effectiveness. These checks range from formal paper-based evaluation forms completed anonymously by both athletes and support staff to an informal question such as, “What did you think of that session?” As rapport and trust builds up, I found individuals to be fairly honest in their appraisals. Additionally, as a result of my initial ‘waste-oftime’ group adherence workshop session I decided in future to run group sessions only if I considered it to be the most appropriate intervention format. My view is that it’s difficult to be effective if you can’t work on an individual basis. Early in my career I would take whatever sessions were made available, keen for whatever experiences I could get. But I wouldn’t run a session unless a coach was prepared to allow adequate time and priority for me to do a job properly. All too often I notice that sport science workshops are timetabled late in the evening when athletes would rather rest and recover. By continually agreeing to work the ‘graveyard slot’ I think the role of sport science in positively impacting on performance is in danger of being devalued. I think the important thing is to not always agree straight away to running a session, particularly if you think the timing is not ideal. This does not mean being unaccommodating but in my experience, by challenging the timetable and requesting more time I actually gained credibility. 3. You won’t know you have a problem unless you look I soon learned that the prescription of a training programme does not ensure the adoption and maintenance of the target behaviours, even in high-level sport groups where motivation is often assumed to be high. Provision of a fitness training programme should represent only an initial stage of an intervention and monitoring both training adherence behaviour and fitness is important. Most sports now monitor training adherence via various methods, including training diaries, some of which are now webbased or can be completed electronically. In terms of good practice, it is important that the athlete is made aware of who will have access to this diary information and how it will be used, especially in terms of the development/selection process. Otherwise this could lead to problems with confidentiality and fabrication of data. What is monitored, in terms of training and fitness, and how it is undertaken undoubtedly influences training behaviour. I will use a story regarding the ‘bleep test’ to illustrate how the use of one test dramatically influenced training behaviour. In the fitness testing in which I was involved, the bleep test was the first test to be performed and all the coaches would watch this one test before disappearing off to various planning meetings. This selective coach observation was soon noticed by athletes and as a consequence, performance in the bleep test was massively over-emphasised and took on the only definition of ‘fitness’. However, once aware of this issue, the coaches soon changed their behaviour. But is it a coincidence that there was a trend to ‘over-adhere’ to aerobic fitness training and ‘under-adhere’ with other types of training such as speed and power? Whilst there are many possible explanations for these over- and under-adherence findings, my own thoughts are that the myth of defining fitness by performance on one test certainly contributed. My aim here is to debate neither the advantages of certain fitness tests over others, nor the merits of laboratory versus field-based testing, but rather to highlight the need to carefully select appropriate tests, not just fitness ones, and ensure their relative importance is clearly communicated to all, including key support staff. CUES-TO-DECISION (INITIATION PHASE) SELF-EFFICACY FOR NEW BEHAVIOUR ATTITUDE TOWARD NEW BEHAVIOUR ATTITUDE TOWARD CURRENT BEHAVIOUR* PERCEIVED SOCIAL NORMS (REPETITION) * Includes perceived vulnerability to negative consequences 4. There is nothing so practical as a good theory ‘Theory-based practice’ has become an accepted part of many professions and it took me a while to grasp what it actually meant. In my work I became aware of the revised Theory of Planned Behaviour (TPB; Maddux, 1993; see Figure 1). Positively influenced by a successful intervention aimed at improving training adherence (see Palmer et al., 2000), I became a real fan of this revised theory’s practical utility. This theory has influenced how I strategically plan to change behaviour, yet I suspect that many practitioners are not aware of it, let alone use it to influence their work practice. What I like about it is that it distinguishes between current and new behaviours. Maddux argued for an independent assessment of an individual’s attitudes toward current and new behaviour because an individual contemplating a behaviour change will compare the costs and benefits of both behaviours. My applied work indicated that in an analysis of the benefits and costs of current training compared to following a recommended training programme, athletes did not view their current training as sufficiently poor to invoke a behaviour change. In my example, most of the athletes had reached their initial goal of playing for England on their current training, so unless the benchmark is changed to being World Class there may be a tendency to think, ’Why change a winning formula?’ Providing information about the benefits of a new training behaviour is only part of the necessary support service - practitioners need to make athletes perceive the need to change from their current training behaviours. Achieving this may require delivering a harsh message and making athletes feel vulnerable. Such an approach may conflict with many criteria included in Consultant Evaluation Forms that focus on being easy to relate to, positive and constructive. But ultimately we’re not there to be liked, but to be effective. ■ References INTENTIONS CUES-TO-ACTION (HABIT PHASE) Burwitz, L., Moore, P.M. & Wilkinson, D. (1994). Future directions for performance-related sports science research: an interdisciplinary approach. Journal of Sports Sciences, 12, 93-109. Maddux, J.E. (1993). Social cognitive models of health and exercise behavior: An introduction. Journal of Applied Sport Psychology, 5, 116-140. Palmer, C.L., Burwitz, L., Smith, N.C. & Collins, D. (1999). Adherence to fitness training of elite netball players: A naturalistic inquiry. The Sport Psychologist, 13, 313-334. Palmer, C.L., Burwitz, L., Smith, N.C. & Borrie, A. (2000). Enhancing fitness training adherence of elite netball players: An evaluation of Maddux’s revised theory of planned behaviour. Journal of Sports Sciences, 18, 627-641. Dr Claire Palmer BEHAVIOUR Figure 1. Revised Theory of Planned Behaviour, adapted from Maddux (1993) Claire currently works as the BASES Executive Officer. She has over 10 years experience working as an applied sport scientist with high-level athletes and her PhD was in fitness training adherence. She is a BASES Accredited Sport and Exercise Scientist (Psychology and Interdisciplinary – Scientific Support). www.bases.org.uk Issue 3 March 2005 The Sport and Exercise Scientist 13
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Page 4 and 5: FEATURE Carbohydrates - the pros an
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Issue 3 March 2005 - BASES

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