Saturday, February 12, 2011

Why the NHS Couch to 5K Program Works!

The National Health Service in UK has hit a home run with their plan to get couch potatoes to run 5K in 9 weeks.  Why did it create such a buzz when hundreds of other sites have exercise plans and don't seem to be quite as popular?


Bandura wrote about self-efficacy and I summarized this recently.
The key point is that for a person to adopt a behavior like exercise to improve their health, 2 things must happen:

  1. They must believe that they can do the exercise
  2. They must believe that the exercise can help improve their health.
Thus, most couch potatoes will believe that if they could run 5K they would be healthier but they don't believe they can run 5K.  On the flip side most couch potatoes probably can walk 15 minutes slowly and they believe they can, but they probably believe that that amount of exercise will not make them healthier.  So they don't even start exercising.

Here is a short example of how a doctor might be able to use this information to help motivate a patient.  This is just for educational purposes and patients should consult their doctors before trying this out.


What the NHS program does is give people hope that anyone (who is reasonably healthy) can go on and run a 5K.  They provide a series of podcasts with music and commentary that guides the listener to walk and jog at appropriate times gradually getting them to jog for longer periods each week.  It seems to work because:
  1. There is no mention about how fast to jog/walk.  (I tell my patients who cannot jog to instead just walk as fast as they can when the podcast asks them to jog).
  2. The first 3-4 weeks are very achievable for most people and creates a sense of confidence, 
  3. There is a very active and supportive forum where people can see how others struggled like them and were able to succeed.  Some of the comments of people who were not sure they could get through a particular week, and were able to succeed are heartwarming and very encouraging for others.
It is quite possible that when folks get to week 4 or 5 they will already be seeing changes in their health, how they feel and that will create a cycle of success --> results --> self-motivation that will then be self-sustaining.

Big question is what will NHS come up with for those who complete the 5K?  Will it even be needed?  Will folks to struggled so hard to get to this goal, need ongoing motivation and tools to keep going?  Will they want to run faster, further, longer?  It will be interesting to follow the forums.