Long-Term Adherence to Health Behavior Change

The utility of lifestyle-based health promotion interventions is directly affected by participant adherence to prescribed behavior changes. Unfortunately, poor adherence to behaviors recommended in lifestyle interventions is widespread, particularly over the long term; thus, the "adherence problem" represents a significant challenge to the effectiveness of these interventions. The current review provides an overview of the adherence problem and describes a theoretical framework through which the factors that affect adherence can be understood. To further understand the difficulties individuals face when adhering to health behavior changes, we focus our discussion on the challenges associated with adherence to lifestyle behaviors recommended for weight loss and healthy weight management (ie, reductions in dietary intake and increases in physical activity). We describe strategies that improve long-term adherence to health behaviors related to healthy weight management, including the provision of extended care, skills training, improving social support, and strategies specific to maintaining changes in dietary intake and physical activity. Finally, we discuss difficulties involved in implementing long-term weight management programs and suggest practical solutions for providers.