JMIR Publications

ABSTRACT

Background:

The transtheoretical model (TTM) explains the behavioral changes through sequential stages influenced by the balance of perceived benefits and barriers. Although prior studies have identified the inhibitors and facilitators of exercise behavior, only few have elucidated how these factors vary across the stages of behavioral change.

Objective:

This study aimed to identify the inhibitors and facilitators of each stage of behavioral change using text mining.

Methods:

A survey was conducted among 1,500 Japanese adults aged 20–69 years, recruited through stratified sampling based on sex, age group, and geographical region. The participants self-assessed their stages of change. Two open-ended questions captured the perceptions of inhibitors and facilitators of exercise behavior. Text responses were analyzed in a four-step process: morphological analysis to extract frequently used words, correspondence analysis to visualize relationships between frequently used words and the five change stages, conceptual categorization with coding rules, and creation of heat maps to illustrate stage-specific categories in inhibitors and facilitators.

Results:

The respondents included 754 males and 355 individuals in the 50–59 age group. Among them, 356 and 388 were in the precontemplation and maintenance stages, respectively. The inhibitors and facilitators were described using 9,893 words and 8,372 words, respectively. The inhibitors were categorized into seven groups: motivation, health, weather, family, time, opportunity, and working. The facilitators were classified into eight categories: reward, subjectivity, opportunity, relationship, health, record, digital device, and time. The stage-specific inhibitors included motivation and health in precontemplation; family, time, and working in contemplation and preparation; opportunity in action; and weather and health in maintenance. Facilitators, such as reward, health, and record, increasingly contributed as individuals progressed from precontemplation to maintenance.

Conclusions:

The findings of this study provide quantitative insights into the dynamics of inhibitors and facilitators across TTM stages. The inhibitors were low motivation, health issues, lack of time due to poor work–life balance, limited opportunities, and adverse weather conditions, which need to be sequentially addressed to acquire exercise habits. Recording personal progress and providing rewards for health improvements and consistency gradually emerged as facilitators. Intervention strategies targeting these inhibitors and facilitators can serve as effective new approaches for sustainable exercise habits.