The barrier-belief approach: A new perspective of changing behavior in primary care

Regular physical activity has a proven relationship with health. In Western society, however, a significant proportion of the population does not meet the guidelines of a healthy lifestyle. There is a need for more insight into the causes of inactivity and effective behavioral change methods. The aim of this thesis was to develop a more effective intervention for stimulating physical activity compared to existing methods within healthcare. For this purpose, barrier beliefs were first identified that impede physical activity in adults. In this thesis psychological mechanism of different types of barriers in physical activity were described. Then, change strategies were developed to reduce different types of barrier beliefs. This has resulted in a new approach to lifestyle change: the barrier-belief approach, by individual coaching. The results showed that the barrier-method is more effective in stimulating physical activity and quality of life and reduces experienced barrier beliefs in the long term, compared to the 'usual care'. The barrier-method can also be applied to other lifestyle behaviors and within other types of interventions (apps, community-based). Additionally, the motivation of Dutch general practitioners to referral to lifestyle interventions was researched and the decision-making process. To improve the motivation and referrals to lifestyle interventions, firstly, official guidelines for screening eligible patients are recommended. Secondly, web resources with tools and information about lifestyle programs can be provided within primary health care in the Netherlands. Thirdly, the implementation of lifestyle interventions should be supported by allied health care professionals. In the end, broadly providing effective interventions for physical activity stimulation has the potential to contribute to an increase in life expectancy and quality of life in all societal segments