The 10,000 Steps Program is funded by the Queensland Government as part of the “Healthier. Happier.” initiative.
The goal of the 10,000 Steps program is to help you make movement a part of your everyday life. If you are already regularly active, focus on maintaining your existing habit. If you are not sufficiently activity, now is the time to take the first step to better health and wellbeing by increasing your activity. Here are some tips to get started.
First, set small achievable goals. Set manageable goals that will make you feel better physically and mentally. Make your goal specific and measurable, for example a 10-minute walk every day, taking the stairs instead of the elevator, going for a swim once a week or setting an alarm and getting up from your desk every hour.
Second, increase your activity. Whether you are an elite athlete, or someone who does little physical activity, the principles are the same. You must progressively increase your daily activity levels. Start tracking your steps and make small increases in your normal routine and gradually increase these over time. Your body will respond, no matter you age or fitness and you will feel better, stronger and able to take on more activity.
Do activities you like, with people you like! Your body is meant to move, and it has a great ability to do so in many different ways. Find an activity which you enjoy and ask your family and friends to join you, you can increase your physical activity and enjoy it at the same time!
Measuring Your steps
A pedometer is a portable, user friendly device that counts steps by detecting motion of the hips. A pedometer should be clipped securely to a belt, pants or skirt just above the hip in line with the knee. The pedometer must remain vertical, as it counts steps using a pendulum and spring mechanism, which moves up and down as you walk.
The goal of 10,000 steps is the recommended daily step target for healthy
adults. This goal encourages the accumulation of incidental activity throughout the entire day. The use of a pedometer or activity tracker to record steps is a vital part of the program.
Most wrist worn physical activity trackers such as Fitbit, Jawbone Up, and Withings Pulse convert the number of steps with algorithms into measures, such as the distance covered and the number of calories burned. Associated mobile applications provide insight into individual physical activity behaviour over a certain period of time.
Why 10,000 Steps
The goal of 10,000 steps is the recommended daily step target for healthy adults to achieve health benefits. With continual advances in technology and workplaces becoming more sedentary it now takes a concerted effort to make active choices. Steps can be accumulated during every day activities such as parking further from the entrance to shops, taking stairs instead of escalators, walking while at work and walking to socialise with friends and family.
Activity trackers provide data which enables you to become aware of your physical activity levels, work towards a goal and monitor progress. Studies using the 10,000 steps per day goal have shown weight loss, improved glucose tolerance, and reduced blood pressure from increased physical activity toward achieving this goal. The following pedometer indices have been developed to provide a guideline on steps and activity levels:
- Sedentary is less than 5,000 steps per day
- Low active is 5,000 to 7,499 steps per day
- Somewhat active is 7,500 to 9,999 steps per day
- Active is more than 10,000 steps per day
- Highly active is more than 12,500
Although the program promotes the goal of reaching 10,000 steps each day for healthy adults, this goal is not universally appropriate across all ages and physical function. There are some groups where the goal of 10,000 steps may not be accurate, such as the elderly and children. Your individual step goal should be based on current activity levels and overall health and fitness goals. For people who normally do substantially fewer than 10,000 steps, almost any increase in daily activity will pay off in the long-term.
Always consult with a doctor or healthcare professional before commencing a physical activity program.
Combining Two Recommendations
For healthy adults, the goal of reaching 10,000 steps each day should be encouraged along with the Australian Physical Activity and Sedentary Behaviour Guidelines. To reach 10,000 steps, active choices should be made throughout the day as many adults struggle to reach 10,000 steps without also doing some form of planned moderate activity.
Thirty minutes of moderate physical activity such as walking, is approximately 3,000 – 4,000 steps. By combining both the goal of 10,000 steps each day and 30 minutes of moderate activity as recommended in the Australian Physical Activity and Sedentary Behaviour Guidelines, people are more likely to reach a physical activity level associated with health benefits.
Benefits of Being Active
Regular physical activity is an important contributor to good overall health, including promoting healthy weight and reducing the risk of chronic
disease. Not being active enough contributes to disease and mortality across the globe. It is estimated that inactivity is the main cause for approximately 21–25% of breast and colon cancers, 27% of diabetes and 30% of ischemic heart disease burden.
The 2013 Australian Health Survey reports 60% of Australian adults did less than the recommended 30 minutes of moderate intensity physical activity per day. Adults who participated in a pedometer study recorded an average of 7,400 steps per day. Less than one in five adults (19%) recorded the recommended 10,000 steps per day on average which is needed to achieve health benefits.
Physical activity recommendations are relevant to everyone. Unless specific medical conditions indicate the contrary, physical activity guidelines apply to all people, irrespective of gender, race, ethnicity or income level. They also apply to individuals with or without a chronic disease or disability. Regular physical activity helps to maintain a healthy body. Participating in regular physical activity can:
- improve muscular and cardiovascular fitness
- improve posture, mobility and balance
- improve bone health
- assist with sleep difficulties
- lower rates of heart disease, high blood pressure, stroke, diabetes, colon
and breast cancer
- lower the risk of falling and of hip or vertebral fractures
- help to maintain a healthy weight
- help to prevent and manage mental health problems
- create opportunities for socialising and meeting new people
Both moderate and vigorous intensity physical activity bring health
benefits. Intensity refers to the rate at which the activity is being performed. It can be thought of as “how hard a person works to do the activity”. Intensity depends on an individual’s relative level of fitness. Examples of moderate physical activity are brisk walking, dancing or household chores. Examples of vigorous physical activity are running, fast cycling, fast swimming or moving heavy loads.
Doing some physical activity is better than none. Research shows that those who increase activity levels from nothing to something gain the most health benefits. The more active people become, the more health benefits will be gained, however it will be proportionally harder to gain more health benefits when people are very active. For optimal health benefits, you should participate in at least 150 minutes of moderate intensity physical activity per week. Inactive people are best to start with small amounts of physical activity and gradually increase duration, frequency and intensity over time. Inactive adults, older adults and those with disease limitations will have added health benefits when becoming more active.
The Australian Bureau of Statistics (2013) indicate that only 35.2% of Australians are of normal weight and 62.8% and overweight or obese. Ensuring that you are within a healthy weight range is one way to reduce your risk of chronic disease; however your level of fitness is also very important.
Motivation Tips
Make every step count with these tips to boost your motivation!
If it is hard to get started, why not ask friends and family to be active with you and make it a regular occurrence. When someone else expects
you to be there it will be harder to skip being active if you don’t really
feel like it or feel like you are too busy.
- Listen to music on your phone or iPod while being active. Pick something
upbeat to get you moving just that little bit faster.
- If the weather is too hot or too cold, find something you can do in an
environment that is more enjoyable e.g. inside in air-conditioned controlled environments, or swimming instead of walking in warmer climates. Excluding extreme conditions, don’t let this stop you. Being active warms you up and a bit of sweat is good for you too!
- Set goals! If you know why you are being active, it will be easier for you to get started and keep going.
- Record what activities you have been doing to see your change over time.
- Join a sporting or walking group in your community, check your local council website.
- Participate in group events, for example walks such as ‘Relay for Life’ or ‘RSPCA Million Paws Walk’, or even try a Parkrun or fun run event in your community.
Staying Motivated
The first weeks of becoming active are the most critical period to sticking with a new physical activity routine, give yourself the best chance of “sticking with it” and commit to it for at least a month. Here are some more helpful tips to maintain your motivation:
- If you slip out of routine, forgive yourself and begin again (and again). Don’t give up, and avoid the “all or nothing” pitfall.
- Expect to notice an improvement in how you feel in about four to eight weeks.
- Walk with a friend or your dog, and you will be encouraged to walk even on those days when you feel don’t feel like it.
- Introduce change every so often to keep it interesting. If walking is your thing, take a different walking route.
- Reward yourself! Each month, particularly for the first 6 months, reward yourself for sticking with your activity program goals. Pick something you enjoy and that is healthy.
- If you miss more than a week, resume your physical activity routine at one-half to two-thirds of your normal level and build back up gradually.
- Look at the time spent doing physical activity in perspective of the hours in a day and week. Doing 30 minutes of physical activity within the 24
hours in the day or spending 2.5 hours being active broken up within the 168-hour week is manageable when you may usually spend this amount of time doing other activities like watching TV or looking at your phone.
- Walk during lunch or coffee breaks, 10 minute chunks of physical activity at least three times a day do make a difference.
- Park your car further away from where you are going and enjoy the walk. Or even better, walk all the way if you can or take a bicycle. That way even on the days you may not get to do your chosen activity, you will have done some physical activity and keep your motivation up.
- Take a mental break. Use your walking time to think about pleasant things. Avoid using the time to ponder family problems or bills. It is essential to feel good about what you are doing
Keeping Positive
When you consider that you spend considerably more time with your “self” than anyone else, it pays to have your thoughts in check. What you say to yourself in your head goes on 24 hours a day, 7 days a week. Therefore, it is no wonder that what we say to ourselves has a big influence on how we feel and what we do.
Our bodies react as if all our thoughts were real. What we say to ourselves in our head has physical outcomes. For example, when we think “Who am I kidding, I can’t increase my physical activity”, we feel less able to function and put our bodies under stress. This makes it difficult for us to get up and start. We should do whatever we can to not let our negative thoughts make it harder on ourselves.
Negative thoughts get the loudest when you need them the least. When the pressure is on, we revert to default mode. For instance, when learning something new we become more stressed than usual. When feeling stressed, our negative thoughts can often increase which is self-defeating. By listening to thoughts such as, “I’ll never reach my activity goal”, “Other people can lose weight and get fit, but I will never be able to do that”. You will ultimately talk yourself into believing that you will not be able to achieve what it is you set out to do, and often this couldn’t be further from the truth.
Our thoughts can be a major positive force in our lives. While negative thoughts are a part of life for us all, so too are positive thoughts. The thoughts which are strongest and have the most effect on us are the ones we pay most
attention to. While there will be times when things just won’t go our way, we have a choice as to which thoughts we pay most attention to. Do we let negative thoughts de-rail our efforts all together or do we learn to roll with our difficulties and pick ourselves up and go again?
You talk to yourself in ways you would never think of talking to someone else. If you walked up to someone else and said, “You will never be fit enough to walk 5 km” they would be very upset. However, it’s not uncommon to have those kinds of thoughts going on inside your own mind, and these thoughts do not help you to achieve your goals. Pay attention to your thoughts, they have more impact on your actions than you may realise.
Thought Stopping
One of the greatest obstacles of self-talk is being able to identify negative thoughts. Once this is accomplished the next step is to make a conscious effort to introduce positive thoughts and eliminate negative thoughts.
Thought Stopping is the most common technique used to introduce positive thoughts and eliminate negative thoughts. To put a stop to negative thoughts, follow these steps:
1. Become aware of negative thoughts
The first step in gaining control of negative self-talk is by increasing awareness of what you tend to say to yourself in situations in which these thoughts typically occur. Try recording these thoughts in a logbook. Is your self-talk helpful or harmful?
2. Stop the negative
Once negative self-talk is identified, you need to learn to “park it” or stop it (which is easier said than done!). Saying “park it” or visualising a big, red stop sign are good cues to use to help halt negative thoughts.
3. Replace with positive
Imagine the mind is like a cup, if it is filled to the top with positive thoughts, there will be no room for negative self-talk. You need to identify positive self- talk in advance and replace the negative thoughts with positive ones.
4. Practice thought stopping
A final step is to practice, practice, practice. It is important to practice stopping and replacing negative self-talk. For a while you will need to be very conscious of your internal self-talk as the thought stopping technique will not occur
automatically. With enough practice having positive thoughts will become second nature.
Healthy Eating
A healthy diet improves quality of life, and overall health and wellbeing. Healthy eating will reduce your risk of dietary related conditions such as high cholesterol, high blood pressure and obesity and it can protect against chronic diseases such as type 2 diabetes, cardiovascular disease and some types of cancers.
Many of the health problems in Australia are due to an unhealthy diet. An unhealthy diet stems from excessive intake of foods that are high in energy, saturated fat, added sugars and/or added salt but relatively low in nutrients. These include fried and fatty take-away foods, baked products like pastries, cakes and biscuits, savoury snacks like chips, and sugar-sweetened drinks. If these foods are consumed regularly they can increase the risk of excessive weight gain and other diet-related conditions and diseases.
Try keeping some healthy snacks handy to avoid falling into the trap of buying a chocolate bar or packet of chips when you start to feel hungry. Many diet- related health problems in Australia are also associated with inadequate intake of nutrient-dense foods, including vegetables, legumes/beans, fruit and wholegrain cereals. A wide variety of these nutritious foods should be consumed every day to promote health and wellbeing and help protect against chronic disease. Make the choice to start small changes to your eating habits every day.
Try to do at least 5 of the following healthy habits every day:
- eat two serves of fruit
- eat five serves of vegetables
- eat fish
- eat whole grain bread (instead of white bread)
- eat and drink low fat milk products (instead of full cream)
The Australian Government has developed the Australian Guide to Healthy Eating, which encourages Australians to drink plenty of water and to also enjoy a wide variety of nutritious foods from the five food groups.
Active Transport
Active transport describes walking, cycling and other physical modes of travel to work, school, parks, cafes, shops, a friend’s house or other destinations. Using public transport such as catching a bus or train also involves active travel when walking or cycling to and from stops, stations, home and
destinations. Choosing to walk or cycle for transport offers many important benefits for your health, your community and also the environment.
By choosing regular active transport, you will be gaining all the benefits of increasing your physical activity while also decreasing noise and air pollution. Other benefits include:
reducing local traffic congestion
reducing greenhouse emissions and environmental impacts
increasing community safety and cohesion
improving community health and wellbeing
being a low-cost activity that is easily accessible
supporting local businesses with more people shopping locally
Forty years ago, about 75% of Australian children walked or rode to school and only 25% were driven or used other means of transport. Now those figures are reversed and the streets around schools are congested. Here are some ways to use active transport:
- Park the car further from school, work or the shops each day to get some more steps and avoid the busy traffic.
- When using public transport, hop off a stop or two early and walk or cycle the rest of the way.
- Choose a cafe within walking distance to work as the destination for a meeting with a colleague.
- Incorporate walking or bike riding to the park or beach as a part of your family outings.
Tips and Tricks
Here are some tips and tricks which may help to keep you motivated and active throughout the year.
- You can be physically active at work! Take the stairs instead of the lift, walk down the hall instead of using the phone or E-mail, take a walk during a morning or afternoon break or ask a work mate to go with you.
- Have you set a physical activity or weight loss goal? If so, practice visualization to help yourself reach your goals. The mind is powerful when used in the right way.
- Many things in life are out of your control but physical activity is not one of them. Physical activity is something you control and do solely for yourself. Select activities you enjoy most and find exciting, it might be bike riding, bushwalking, walking, running or doing classes at your gym. Do your favourite activities with friends, family or your dog. Whatever activities you choose, be consistent so you develop a deeply ingrained habit that you keep up, even if the weather is bad or if you are just feeling tired.
- Each day focus on how good you feel about yourself and the steps you’re taking to be more active. Remember progress can be measured in many ways such as mood, sleep, self-esteem, energy or how your clothes fit. The longer you stick with a physical activity program, the more benefits you will feel.
- If you are new to physical activity, it’s best to start slowly, increasing the intensity and length of your workout as you go. You will see noticeable improvement within a few weeks. As your stamina improves, the activity will become easier. Enjoy physical activity at a comfortable pace so it doesn’t leave you absolutely exhausted.
- One way to monitor your pace and determine intensity level is the talk test – if talking is too easy, speed up!
- Why is it so hard to stick with a physical activity program in the beginning? It’s because you are changing something. You are breaking old deeply ingrained habits and replacing them with new ones. If you have been in the same bad routine for a long time, it won’t go away easily. Habits cling to you as much as they can. The good thing is that over time this can work for you! Your body will become used to being active on most days of the week, and it will become a habit in its own right.
- We all have days where we don’t feel like doing physical activity. But before you decide to skip, think of how you will feel if you do the activity. Then, think of how you will feel if you don’t do your activity.
More Than Just Physical Activity
Physical activity, smoking, nutrition, alcohol consumption and a healthy weight are all widely regarded as being other lifestyle behaviours that have the most impact on our health and wellbeing.
While you are improving your physical activity level, it is important to consider improving other behaviours too. You could set yourself the goal to target one of these other behaviours after you are comfortable with your new, higher level of activity. Finding opportunities to move more can benefit us in so many ways including the:
- reduction of aging related illnesses
- reduction of joint swelling in sufferers of arthritis
- prevention of cardiovascular disease
- prevention of some cancers, including bowel and breast cancer
- prevention of some injuries such as falls
- prevention and control of type 2 diabetes
- improvement of mental and emotional health
- improvement of immunity
Understanding how each of these lifestyle choices can affect us is a good first step towards making change. We have compiled a brief description of these behaviours and have provided links to national guidelines, further information and support for those who are seeking to make changes to their lifestyles.
Smoking
When smokers kick the habit, they will immediately experience huge benefits to their health in terms of looks, sense of taste and smell, fitness and finances. When smokers quit, they feel better about themselves and improve the health of surrounding family and friends. Did you know that within 20 minutes of quitting smoking your heart rate lowers? Within 72 hours the sense of taste and smell improves and within 2 weeks to 3 months’ lung function and circulation will improve. For more reasons to quit smoking, check out
these reasons to quit smoking provided by the Queensland Government.
The Queensland Government has provided some great online resources to assist in quitting smoking which are available here. You can call Quitline on 13 78 48, it is a confidential, free service for people who want to quit smoking. Talk to your General Practitioner about quitting, they’ll be able to discuss
options such as nicotine replacement therapy (NRT) with you as well as other pharmaceutical treatments.
Nutrition
Proper nutrition is vital for good health and wellbeing. Food provides our bodies with the energy, protein, essential fats, vitamins and minerals to live, grow, function properly, and avoid disease. Australians have access to a wide range of foods, but most people need to choose foods and drinks more wisely to help protect our health.
It can be hard to choose nutritious foods and drinks, especially when those high in saturated fat, added sugars, added salt and alcohol are readily available and affordable, and the environment in which we live promotes over- consumption.
Aim for a healthy lifestyle, make positive choices and take control of your health. Look at all your areas of wellbeing and don’t just focus on your weight. Feel good about yourself for making small changes as these can lead to big improvements. For further information on healthy eating, go
to eatforhealth.gov.au. Further resources relating to Diet and
Nutrition including recipes, information and links to resources and publications are provided by the Queensland Government. For further information on nutrition, view our article on Healthy Eating.
Alcohol
For many Australians, drinking alcohol is strongly linked with times of celebration and relaxation. While drinking is a source of pleasure for many, it is important to understand safe drinking levels. Drinking unsafe levels of alcohol can pose risks to health and can also lead to risky behaviours.
The National Health and Medical Research Council (NHMRC) has published
the Australian Guidelines to Reduce Health Risk from Drinking Alcohol and also provides information on standard drink sizes. The NHMRC recommends that adults drink no more than 2 standard drinks on any day to reduce the lifetime risk of harm from alcohol-related disease or injury. It is important to remember that you can still socialise and have a good time without alcohol.
Healthy Weight
Maintaining a healthy weight is important for people of all ages. People who are of a healthy weight experience physical, psychological and social benefits; they may also avoid many lifestyle related conditions such as type 2 diabetes. You can use a tape measure to measure waist circumference or use your height and weight to measure your BMI. Using one or both of these measures you can assess your risk of chronic disease. You can calculate your BMI here. For further information on the prevention and reversal of obesity and overweight see the Shape Up website or visit the National Health and Medical Research Council website.
Sun Safety
Australia has the highest rates of skin cancer in the world. Skin cancer occurs when skin cells are damaged, for example, by overexposure to ultraviolet (UV) radiation from the sun. There are three main types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma (the most dangerous form of skin cancer).
For best protection, we recommend a combination of sun protection measures:
- slip on some sun-protective clothing that covers as much skin as possible
- slop on broad spectrum, water resistant SPF30+ sunscreen. Put it on 20
minutes before you go outdoors and every two hours afterwards
- slap on a hat that protects your face, head, neck and ears
- seek shade
- slide on some sunglasses and make sure they meet Australian standards
For more information on preventing skin cancer, visit Cancer Council Australia. Mental, Social and Emotional Health
Most of us will face challenges with our own mental health, or the mental health of a friend, family member or colleague at some stage in our lives. Mental health is a complex concept and includes a sense of vitality, happiness and wellbeing. Creating an environment of understanding and acceptance as well as reducing stigma and discrimination is important to us all, and there are many excellent resources available online. Information and resources provided by Queensland Health relating to mental health and wellbeing are
available here.
Beyondblue is working to reduce the impact of anxiety, depression and suicide in the community by raising awareness and understanding, empowering people to seek help, and supporting recover, management and resilience.
Beyondblue provides information and support to help everyone in Australia achieve their best possible mental health, whatever their age and wherever they live. You can also view our article on Keeping Positive.
5 Cognitive Behavioural Strategies for Losing Weight that Work
When we think of weight loss, we often think about what we eat. The questions we ask ourselves tend to revolve around how much fat, protein and carbs to eat, or whether beets help take off the pounds.
Diets touted in the media as optimal for weight loss abound, yet we remain a nation with an obesity problem.
What we tend to ignore, when we think of weight loss, is how we are approaching and managing the process of change. As important as it is to focus on what you eat to lose weight and keep it off, it is equally crucial to consider physical activity and maintaining lifestyle changes over time.
How to make behavioural changes, what strategies we use to adhere to new ways of eating and increasing physical activity cannot be ignored.
The problem is that making changes to your lifestyle is hard. If it weren’t, we wouldn’t have an obesity epidemic in this country, nor would estimated health care costs for physical inactivity have been $76.6 billion in 2000 (admittedly an older statistic, but unlikely to have improved significantly in recent years).
Cognitive behavioural therapy (CBT), which focuses on changing how you think about yourself, how you act, and circumstances that surround how you act, is an effective treatment for a wide range of problems, including weight loss. Key to it is its focus on making changes and sticking to them.
So, what CBT strategies help people to lose weight and change lifestyle behaviour?
1. Goal setting.
If you want to meet the goals you set, consider the following three factors:
- the more specific a goal, the more likely you are to achieve it;
- ambitious goals are good, but overly ambitious goals can be
discouraging;
- regular feedback on progress improves outcomes
When it comes to weight loss, then, a goal to eat fruit for dessert, rather than
cake, is specific and can be clearly tracked. Specific goals around exercise or types of food you will eat — behaviours you have control over — are better than goals to improve cholesterol or glucose levels, which may fluctuate for reasons outside your immediate control.
2. Self-monitoring.
Self-monitoring requires that rather than beating yourself up for not attaining a goal, you attend to your own individual experiences. When you self-monitor, you begin to notice barriers, pay attention to physical cues and identify challenges to changing your behaviour. Too often we rely on negative self- judgment to stay motivated and, in so doing, fail to recognize and plan for real barriers.
You can think of yourself as a scientist when you self-monitor. You may want to keep a log of your food intake or exercise routines, for example. Doing so will help you to problem-solve when life has gotten busy or you get off
track. With greater awareness of your own experience, you are better able to find ways to maintain new behaviours when initial motivation is waning.
3. Feedback and reinforcement.
It can be helpful to get feedback from outside sources. Having a health care provider regularly check in with you can provide an external measuring
stick. Feedback about your diet or exercise routine can provide motivation or help you adjust your behaviour. Outside feedback also can help you keep your expectations ambitious but realistic.
4. Boosting the belief that you can do it.
When you go into any situation with the attitude that you will surely fail, you greatly reduce your odds of succeeding. It is essential to focus not just on behaviour, but also on your perception of your ability to make the changes you want.
The best way to improve your belief in your ability to succeed is actually to have some success. Setting concrete and achievable goals, such as eating fruit at breakfast or replacing an after-dinner TV show with a walk, can build your confidence to set more ambitious goals.
If you’re looking to improve your sense that you can do it, it also can help to look for people in similar circumstances who have made the difficult changes you are trying to make and to surround yourself with people who will
encourage your efforts.
5. Incentives.
The use of incentives to support change in behaviour has been extensively studied and the concept is now being applied to regaining and maintaining physical health. Examples include companies that offer lower-priced onsite fitness facilities as an incentive to exercise, offering cash incentives and gift cards, providing free health coaching and offering insurance premium discounts to those who meet certain standards.
Adopting a healthier lifestyle isn’t simply a matter of changing the foods in your cupboards. Lifestyle changes take sustained efforts over time and whether we achieve our goals depends on how we make them, our mindset and what we put in place to maintain motivation.
References
Rosamond, W., Flegal, K., Furie, K., Go, A., Greenlund, K., Haase, N., … Hong, Y. (2008). American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics — 2008 update: a report
from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 117:e25–e146.
Strecher, V.J., Seijts, G.H., Kok, G.J., Latham, G.P., Glasgow, R., DeVellis, B., … Bulger, DW. (1995). Goal setting as a strategy for health behavior
change. Health Educ Q.22:190–200.