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Effect of a Storyboarding Technique on Selected Measures ofFitness Among University EmployeesMark H. Anshel a & Toto Sutarso ba Department of Health and Human Performance , Middle Tennessee State Universityb Information Technology Division , Middle Tennessee State UniversityPublished online: 23 Jan 2013.

To cite this article: Mark H. Anshel & Toto Sutarso (2010) Effect of a Storyboarding Technique on Selected Measures of Fitness AmongUniversity Employees, Research Quarterly for Exercise and Sport, 81:3, 252-263

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Key words: employee fitness, exercise intervention, narra-tive inquiry, storytelling

The ability to promote favorable changes in health behavior has challenged researchers and practitio-

ners for many years. Interventions to replace negative, unhealthy habits with positive, healthier routines have met with only limited success as measured in outcome studies. Among the problems of existing intervention research has been the assumption by researchers and practitioners that any behavior change that is externally imposed is desirable, as opposed to behavior change that is self-generated (Buckworth & Dishman, 2002). Buck-worth and Dishman contended that one false assumption among health behavior researchers is that the person’s desire for behavior change is sufficient to result in actual behavior change, particularly over the long term.

Another partial explanation of these results, ac-cording to Klesges, Estabrooks, Dzewaltowski, Bull, and Glasgow (2005), is that efficacy studies are conducted under highly controlled, optimal conditions, including participants with similar characteristics. The participant, not surprisingly, experiences the benefits of making expected behavior changes relatively soon after new be-haviors are enacted. Individualized personal instruction and feedback, and other forms of social support, further enhance changes toward desirable behavioral outcomes. Numerous studies in the exercise psychology and be-havioral medicine literature have not included these intervention components, thereby reducing program effectiveness, particularly with respect to encouraging exercise adherence (Buckworth & Dishman, 2002).

The decision to refrain from or maintain a program of regular exercise depends on exercise barriers. Barriers usually stem from past experiences related to sport and exercise (Lox, Martin, & Petruzzello, 2006). Examples in-clude children who are excluded by their peers from sport participation due to poor sport skills, and physical educa-tion teachers and coaches who punish their students and athletes by requiring additional exercise (e.g., taking two laps due to being tardy to class or 20 push-ups for making an error). Other psychological exercise barriers include feelings of intimidation and self-consciousness about

Effect of a Storyboarding Technique on Selected Measures of Fitness Among University Employees

Mark H. Anshel and Toto Sutarso

Submitted: November 11, 2008 Accepted: March 5, 2009 Mark H. Anshel is with the Department of Health and Human Performance at Middle Tennessee State University. Toto Sutarso is with the Information Technology Division at Middle Tennessee State University.

The purpose of this study was to determine the effectiveness of storyboarding (i.e., participants’ written narrative) on improving fitness among university employees over 10 weeks. Groups consisted of storytelling during the program orientation, storytelling plus two coaching sessions, or the normal program only (control). Using difference (pretest from posttest) scores, a one-way multivariate analysis of variance indicated significant differences between groups (p < .01). For percent body fat, only the coached group was sta-tistically superior to the control group (p < .03), while the two experimental groups were statistically similar. For submax VO2, both storyboarding groups were superior to the control group (p < .04). It was concluded that storyboarding may be an effective means for changing selected health behaviors.

Epidemiology

ResearchQuarterlyforExerciseandSport©2010 by the American Alliance for Health,Physical Education, Recreation and DanceVol. 81, No. 3, pp. 252–263

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exercising in public settings, lack of social support, self-defeating (irrational) thoughts, and depression (Anshel, 2006). These issues are important factors that reflect the individual’s personal history and experiences regarding lifestyle choices, specifically in relation to unhealthy habits (Loehr, 2007; Lox et al., 2006). One neglected approach to changing health behavior is the use of storyboarding as a means to generate a person’s self-motivation to un-dertake a healthy lifestyle, including exercise.

Storyboarding

Storyboarding, often referred to in the literature as storytelling (Loehr, 2007; Pennebaker, 1997) and similar to the research method called narrative inquiry (Smith, 2010; Smith & Sparkes, 2009), is the process of creating and disclosing to ourselves and others our past experi-ences, perceptions, and impressions that reflect our life. Stories reflect our unique interpretation of life’s experi-ences. The purpose of storyboarding is to understand the ways society and culture have shaped a person’s experi-ences. An important goal of storyboarding is to frame a person’s behaviors that could lead to better intervention strategies (Smith & Sparkes, 2008). As Loehr (2007) described, “...our stories may or may not conform to the real world…. But since our destiny follows our stories, it’s imperative that we do everything in our power to get our stories right” (p. 5). Thus, the stories we tell represent the a powerful tool for managing energy and achieving an important mission in life.

People live stories, and in the telling of these stories, reaffirm them, modify them, and create new ones (Pen-nebaker, 1997). As humans, we continually tell ourselves stories about our successes or failures, our needs and wants, and our hopes and dreams. Stories often concern our work, families, relationships, health, and what we are capable of achieving. The context of these stories may endure for an hour, a day, or an entire lifetime, and they profoundly affect how others see us and how we see our-selves. Yet we often fail to recognize that we can change our stories and thereby transform our destiny, for example to improve our health (Smith & Sparkes, 2009). The story we tell about ourselves becomes our reality.

Pennebaker (1997) and Loehr (2007) posited that each of us has two voices, a public voice and a private (in-ner) voice. The primary objective of storyboarding is to recruit the private voice, which often distracts us from “the truth” about our life, resulting in a dysfunctional outcome. We want to avoid this old, dysfunctional inner voice that disengages us, blocks personal growth, and makes us vic-tims of our circumstances. Instead, in order to achieve a high quality of life and good physical and mental health, the goal is to recruit the “true” inner voice that creates maturity and tells the truth about who we are and how we want to live—a lifestyle consistent with our values.

Accurate stories bring us to the truth, mobilize us to dig deeper and make tough value-based choices that lead to expanded growth. They also deepen our engage-ment in life, keep hope alive, and, despite risks, inspire us to take courageous action (Loehr, 2007). Successful personal change invariably requires that we change our story. Stories that deepen engagement and facilitate difficult life changes allow researchers to examine the individual’s history that has contributed to the current unhealthy lifestyle; help practitioners to understand the mechanisms to change those behaviors, leading to new, healthier routines; and provide a focus for future efforts to change unwanted, undesirable behavioral patterns, resulting in a more satisfying life.

The most powerful method of storytelling is through written narrative, which is why storytelling is viewed as a component of the research method, narrative inquiry (Clandinin, & Connelly, 2000). In his meta-analysis of related literature, Frattaroli (2006) found that written expression of one’s inner voice is more beneficial for im-proving health, quality of life, and performance outcomes than talking about it. The process of writing changes a person’s thinking perspective (King, 2001; Ramirez-Esparza & Pennebaker, 2006). The authors contended that writing connects meaning to neurological pathways. It has been posited that storytelling increases emotional intensity, which increases dopamine and serotonin in the brain. The process by which these changes occur, however, is through written expression of one’s inner voice. Emo-tion drives the “favorable effect” of storytelling (Smith & Sparkes, 2006).

Several studies have addressed the influence of writ-ten expression on health-related outcomes. For example, Burton and King (2008) asked participants to write about a personal trauma, a positive life experience, or a control topic for 2 min each day for 2 days. Emotion-word usage in the essays was examined, and physical health com-plaints were measured 4–6 weeks after the last writing session. They found that essays about trauma and positive experiences contained more emotional content than the control essays. In addition, both the trauma and positive experience conditions reported fewer health complaints at follow-up than the control. Storyboarding has similari-ties to the research method called narrative inquiry.

Narrative inquiry is a method of research, consisting of the individual’s interpretation of previous personal experience (Smith, 2007). While storyboarding consists primarily of self-disclosure about one’s real and perceived personal history (a matter of “telling tales” to ourselves about ourselves; Loehr, 2007), narrative inquiry, on the other hand, is a research method that allows the investiga-tor to test or generate a theoretical framework based on the individual’s responses to open questions. Researchers look for common themes among narratives obtained in a series of interviews from a specific group of individuals

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(Smith, 2010). Narrative inquiry, which relies on mul-tiple interviews, incorporates storytelling as part of its information gathering process (Reissman, 2008). Similar to both storytelling and narrative inquiry, Loehr (2007) and Smith and Sparkes (2009) asserted that narratives are personal. They are intended to lend insight into the reasons and explanations of one’s needs, habits, aspira-tions, and behavior patterns, both “good” (healthy) and “bad” (unhealthy). Similar to narrative inquiry, storytell-ing is a form of therapy that promotes a person’s healthy body image, which is especially important in exercise and wellness program settings (Leahy & Harrigan, 2006).

In a study of 14 English rugby athletes who suffered a spinal cord injury, Smith and Sparkes (2005) sought to determine the ways in which their debilitating injury and sense of identity as athletes influenced their future health and quality of life. The researchers asked each participant to tell their life story on three occasions over one year. Briefly, the researchers found that a common denominator among the athletes was “concrete hope,” that is, the sense that they were once healthy, than be-came disabled, and will one day become healthy again. The use of narrative inquiry allowed the researchers to understand the underlying psychological and emotional factors that accompany rehabilitation for a life-chang-ing injury. Testimony to this process is the researchers’ conclusion that, to these injured athletes, “the present is filled with stories of concrete hope and life is narrated in the future tense as the individual waits for a cure that will return them to an able-bodied state of being” (p. 1102). By allowing the athletes to “tell their story,” medical and mental health practitioners can tailor their respective treatments in assisting each patient to adjust to a new lifestyle, while avoiding possible psychopathology, such as depression, hopelessness, and thoughts of suicide.

Loehr (2007) separated storytelling into “old story” and “new story” categories (discussed in more depth later). Our old story consists of revealing our past and thoughts and actions that help us define who we are to-day, specifically in relation to five subjects: work, family, health, happiness, and friendships. Typically, our old story consists of the ways our behavioral patterns are inconsis-tent with our core values. Our new story is focused on where we want to go and how we plan to get there—our “ultimate mission” (p. 45). Revealing our old story helps us explain the sources of our unhealthy habits, such as lack of physical activity and poor nutrition.

Self-disclosure of our personal history through our old story allows us to generate a new story that, predict-ably, will change our reality (Loehr, 2007). The present study was a first test of Loehr’s eight-step storyboarding program that promotes this process. There is an apparent absence of research using the storytelling methodology as an intervention to promote exercise behavior.

Method

Participants

The study, subsidized by a university grant, included faculty and staff employed at a university located in the southeastern United States, who paid a $25 registration fee to participate in a campus wellness program. The program, financially supported by an internal grant, in-cluded fitness and nutrition coaching, and fitness testing prior to and immediately following the intervention. All participants were recruited at the program’s orientation, which consisted of 100 registrants. The orientation’s purpose was to review the program and introduce staff. At the conclusion of the orientation, all attendees were invited to become involved in an additional component of the program that included experiencing an eight-step program, authored by Loehr (2007), which will be explained later. Specific program content, however, was not revealed at this time. Participants were informed that participation was optional and an additional component to their regular fitness and nutrition coaching in the well-ness program, and that they could leave the study at any time without any negative repercussions.

A total of 46 individuals, 36 women and 10 men, all Caucasians and full-time employees of the university, ranging in age from 28.4 to 58.6 years (M age = 43.7 years, SD = 3.21), volunteered to participate in the study. The participants acknowledged that they have not engaged in regular exercise over the past 30 days and categorized themselves as “unfit” with respect to both strength and cardiovascular fitness. In addition, obese individuals (whose body mass index was 30 or more) were excluded from the study so that all participants were able to carry ourt the exercise program. Written approval to engage in the program was obtained from their personal care provider (PCP). PCP approval was an integral part of obtaining campus Institutional Review Board (IRB) ap-proval, and it ensured that each participant was medically cleared to engage in an exercise program that was suf-ficiently intense to produce significantly improved fitness. This study was approved by the university’s IRB.

Group assignments were based on the individual’s willingness to engage in a particular intervention (i.e., time for individualized coaching and completing writing tasks), resulting in uneven group sample sizes. The coach-ing group (n = 15, 11 women and 4 men, M age = 44.13 years, SD = 10.04) completed the program orientation and the storyboarding task, and then interacted with a performance coach on two occasions during the 10-week program. The orientation-only group (n = 13, 10 women and 3 men, M age = 44.33 years, SD = 10.13) wrote out their story during the orientation, but did not subsequently interact with a coach. The third (control) group (n = 18, 15 women and 3 men, M age = 42.85 years, SD = 10.40)

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consisted of individuals who wanted to receive the well-ness program, but were not interested in experiencing the storyboarding treatment. Despite the lack of random assignment, demographic data indicated that participants in each group were similar with respect to gender and mean age. Means (and standard deviations) for initial cardiovascular fitness level were 34.78 years (7.57) for the coached group, 37.07 years (8.68) for the orientation only group, and 39.52 years (7.13) for the control group.

Fitness Tests and Equipment

Four fitness tests were conducted within 72 hr of the program’s formal beginning, consisting of a 3-hr seminar (described later), and again, at the conclusion of the in-tervention 10 weeks later. The dependent variables in this study consisted of four measures that reflected the results of the 10-week fitness program: body composition (i.e., percent body fat), cardiovascular fitness (submax VO2), upper body strength, and lower body strength.

Body Composition. Body composition was measured using a Lange skinfold caliper (Beta Technology, Santa Cruz, CA). Trained technicians performed a seven-site assessment to ensure accuracy and consistency (Pollock & Jackson, 1984). Body fat percentage was calculated from estimates of body density using the Siri equation (Siri, 1961).

Cardiovascular Fitness. Estimated VO2 max was assessed by the use of the Single-Stage Treadmill Test. Each test was performed on a Quinton Treadmill model number Q55 (Quinton, Inc., Bothell, WA), using standard pro-tocol (Ebbeling, Ward, Puleo, Widrick, & Rippe, 1991). Participants were asked not to hold onto the handrails during the test unless absolutely necessary. Heart rate was manually palpated for 10 s during the final minute of the test for use in the prediction equation.

Muscular Strength (Estimated 1-RM Testing). Upper and lower body strength was estimated using a Univer-sal weight machine (Universal Gym Equipment, Cedar Rapids, IA). Each participant was briefly instructed on proper form and breathing technique before perform-ing each test. The bench press was used for upper body and leg press was used for lower body testing. Participants were asked about their involvement in weight training to estimate the appropriate weight load for the test. They were then instructed to perform as many repetitions at the selected weight until fatigue, up to 15 repetitions. Prediction conversions were used with weight lifted and repetitions performed to determine the estimated one repetition maximum (1-RM).

Procedures

Outcome evaluation, also called process-outcome studies, encompasses program assessment and outcomes (Schalock, 2001); in-session behaviors are linked to treat-

ment outcome. Specific methods include performance planning and reporting and performance indicators that are commensurate with program goals. The current study was conducted in accordance with Schalock’s recommen-dations: (a) establishing baseline data, (b) determining desired outcomes, and (c) aligning program services with desired outcomes.

The orientation began by introducing the par-ticipants to their respective fitness coach (i.e., university students who specialized in exercise science) and the program’s nutrition coach, a registered dietician (RD), with whom they would work during the 10-week interven-tion. Clients made appointments to receive pretesting and initial consulting sessions with their respective fitness and nutrition coach. A 90-min seminar was then completed, which included receiving a workbook, watching a Power-Point presentation, interacting with group members, and listening to a lecture.

Clients were given four fitness tests—upper strength, lower strength, submax VO2, and percent body fat (PBF)—and then provided an exercise prescription based on the test results. While clients were asked to exercise a minimum of three times per week, coaches met each cli-ent in person only once a week during the intervention. The weekly meeting had four purposes: (a) to provide verbal and written instruction about proper exercise techniques, particularly related to use of weight machines and proper lifting techniques; (b) to give instruction on cardiovascular training, and in some cases to exercise with the client; (c) to develop strategies to overcome perceived barriers to completing the program (e.g., lack of time, physical discomfort, feeling uncomfortable at the exer-cise venue [the Campus Fitness Center], need for social support); and (d) to provide positive feedback on desir-able performance and improvement. Coaches obtained exercise adherence data, either verbally or via e-mail, from their respective clients at the end of each week. The adher-ence data consisted of the number of cardiovascular and strength- (weight-) training sessions in which the client engaged. Full adherence, based on the client’s exercise prescription, consisted of three cardiovascular sessions and two strength-training sessions each week.

In addition, clients had a single 30-min private session with the RD in the program’s first week to discuss ways to improve eating habits. After the first week, clients attended weekly small group nutrition seminars led by the RD. The control group engaged in the regular 10-week wellness program, including fitness and nutrition coaching, but with no exposure to the storytelling and other aspects of the Loehr (2007) program.

Intervention

The intervention, experienced by two of the three groups, followed the concept of “energy management

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training” developed by Loehr (2007), Loehr and Schwartz (2003), and Groppel (2000). This consists primarily of helping individuals to recognize their unhealthy habits and to develop cognitive and behavioral strategies that improve physical, mental, emotional, and spiritual func-tioning—what the authors call “expanding their capacity” to replace those “bad” habits with desirable, healthier routines. While members of all three groups in the study experienced this 90-min program, participants in the two experimental groups engaged in an additional 90-min program that incorporated Loehr’s (2007) eight-step storyboarding program. This program has clinical content that requires individuals to divulge personal information about their hopes and dreams and helps the clients plan the strategies to accomplish them. While a particular diet was not integrated into the program, suggested guidelines for maintaining particular nutritional habits followed sug-gestions by Groppel (2000) and Whitnesy and Rady-Rolfes (2004). Sample guidelines include the following: eat a low-fat breakfast daily; eat until satisfied not full, while keeping portions reasonably small; eat small meals, including low glycemic snacks, every 3–4 hr each day; and drink 48–64 ounces [1.42–1.89 L] of water daily. Eating high glycemic, high fat food before bedtime was also discouraged.

Loehr’s (2007) Eight-Step Program

In the eight-step program, the client performs the following tasks: (a) determine the individual’s “ultimate mission,” or purpose, that reflects his or her “wants or needs,” and to identify the client’s preferred legacy—the areas of life in which the client wants to be extraordinary to “fulfill their destiny;” (b) “face the truth” by identifying one’s “old story,” answering two questions: “In which of the following area(s) of your life is your story not work-ing?” and “In which areas do you need or want to be more engaged to fulfill your Ultimate Mission?” (Loehr, 2007, p. 228). Answers—areas of one’s life—to both questions consist of a checklist, including “work/job/boss, family, health, happiness, friendship, religion, trust, spirituality, love, food/diet, exercise, children, and spouse/partner” (p. 228); (c) select which of these old stories individuals want to address first; (d) write the story that individuals have been telling themselves “that has allowed the mis-alignment to occur; this means including the faulty think-ing and the strange logic that helped to form the story you now wish to edit” (Loehr, 2007, p. 229); (e) reflect on one’s “old story” and answer the following questions: “How does it make you feel? Sick? Stupid? Dumb? Embar-rassed? Does it stir powerful feelings of disgust? Can you see and feel [his italics] the story’s dysfunctionality?” (p. 231); (f) write a new story that “is fully aligned with [the individual’s] ultimate purpose, reflects the truth, [and] inspires [the individual] to take hope-filled action; (p. 228); (g) design explicit rituals that ensure the “new story”

will become reality (e.g., making time for the behaviors that are consistent with one’s values); and (h) establish a system by which the individual is held accountable each day for conducting these new rituals. It is important to note that Loehr’s program provided written tasks for cli-ents to complete, but there are no quantitative data (i.e., dependent variables) that result from this program.

Loehr (2007) defined a story as “those tales we create and tell ourselves and others, and which form the only reality we will ever know in this life” (p. 5). He contended that our future, or destiny, follows our stories; therefore, “it’s imperative that we do everything in our power to get our stories right” (p. 5). He further divided our stories into “old story,” and “new story.” The old story consists of what people had been telling themselves that allowed them to justify their thoughts and actions, or to explain their pain or problems. Among the objectives of his program is to encourage individuals to “edit” their dysfunctional story by answering the following question: “In which important areas of my life is it clear that I cannot achieve my goals with the story I’ve got?” (p. 5). To Loehr (2007), individu-als reach their ultimate mission in performing consistently at the highest level when the story they tell themselves reflects their “fundamental purpose, which henceforth will drive everything [they] do” (p. 44).

The final stage of Loehr’s program consisted of “My Mission” (e.g., “To be more energized and engaged in the afternoon at work and with my family at home” (p. 236), and a “Daily Training Log” that includes a list of rituals for each day of the week. Sample rituals include doing daily mental preparation at 5:45 a.m., eating breakfast (eat until satisfied, not full), breaking every 90–120 min to exercise (maintain proper exercise intensity), drinking water (carry water bottle), being fully engaged for 30 min at home, and engaging in evening with family.

Loehr (2007) made the following important recom-mendations in completing the program by using a “daily accountability system” for the rituals that each individual has established: (a) to make one’s accountability system easy to complete and accessible; (b) to view this procedure as a way to foster time management and energy manage-ment (e.g., “Did you do what you said you would at the time you committed to?”); (c) to review one’s account-ability log with someone the person respects, and to ask that person to serve as a coach during the 90-day mission of this program; (d) to be obsessive about record-keeping and compliance during the 90 days; and (e) if enthusiasm wanes and boredom sets in, that participants should review the entire process again in a much shorter time frame. This entails rewriting one’s story to “reignite excitement and commitment to change” (p. 238).

Coach-Client Interaction

During the individual coaching sessions, participants were asked to briefly describe observations about their

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lives and the barriers and negative habits that kept them from becoming their truest selves. The participants were already familiar with the concept of storytelling, so this portion of the interview was mainly focused on develop-ing a relationship with the clients and allowing them to openly voice and claim responsibility for bad habits and self-destructive behaviors. The environment was positive and constructive and deliberately not focused on how the individuals should change, but rather on how they could alter their schedules to pursue higher goals. The first coaching session also asked the participants to develop what Loehr (2007) refered to as an “ultimate mission,” whereby the clients envisioned a new story. This new story involves removing undesirable habits, emotions, thoughts, fears, and other negative mindsets. It is a picture of what can be achieved with certain modifications.

Essential to the attainment of a new story and ulti- mate mission is the process of developing smaller “train-ing missions” unique to the participant. The client was coached to program specific rituals into his or her daily life based on the attainment of a specific goal (i.e., con-necting abstract values with concrete activities). For example, if a participant stated that he or she wanted to be more involved with family, we would ask him or her to set aside certain times during the week to pursue this goal. The aim was to facilitate accountability and adherence to a new way of living. At the conclusion of the first session, participants were asked to recall their “old (dysfunctional) story” and to replace it by crafting a “new story,” that is, to create a different way of thinking. In addition, they were asked to provide feedback about specific rituals that they were implementing to transition between the old and new stories. Again, we did not want the individuals to be overwhelmed by negative circum-stances in the present. Instead, we wanted them to leave with a new vision for their lives.

Each client was asked to follow three “rules” in mov-ing from one’s “old” to “new” story, as described by Loehr (2007). The first rule was for the participant to link his or her new story to a primary value such as family, integrity, faith, or kindness. The second rule asked the individual to represent “the truth” as much as humanly possible in his or her new story. The third rule was that the new story should contain a strong message of inspiration, optimism, and hope, that the change the individual sought would happen if he or she remainee dedicated and persistent.

Three weeks after the first coaching session, a second session was scheduled at a time convenient to the client and researcher to review the process of storytelling and to refine and craft new stories. Participants were asked about their progress and again encouraged to connect abstract values with concrete behaviors. At this point, it was possible to ensure that the client was getting the maximum benefit of the intervention. The aim was for clients to make strides toward their ultimate mission and new story. At the conclu-

sion of this second session, clients were asked to submit their old and new stories and were given the assignment to attach additional rituals to their schedules. The second session marked the end of the treatment. Participants returned to the regular health and fitness routines of the regular wellness program. Appendix A provides sample old and new stories from two study participants.

Data Analysis

Before the intervention we measured the partici-pants’ PBF, VO2, upper-body strength, and lower-body strength (described in the Procedures section). The “Storyboarding Technique” was a primary source of moti-vation to help participants feel capable of achieving their fitness goals (e.g., decrease PBF, increase cardiovascular fitness and strength) during the intervention. After the intervention, these dependent variables were measured again. Because we were interested in improvement, we used the difference between before- and after-program measurements.

A one-way multivariate analysis of variance, using difference scores (improvement) between before and after treatment, was computed to examine the effect of the interventions on selected physical fitness measures. If the overall multivariate statistic was significant, a post hoc test was conducted to examine which dependent measures and which values of a factor contributed to the significant overall test. Tukey’s HSD would be used to compare multiple group means if significant improve-ments were found and the assumption of homogeneity of variance of the three groups was achieved. Because group sample sizes were unequal, least square means were used to compare group means.

Results

Fitness Measures

The overall multivariate statistic result indicated a significant difference between groups, Wilks’s Lambda = .64, F(8, 80) = 2.52, p < .02. Post hoc analyses indicated that two measures, PBF, F(2, 43) = 4.08, p < .02, and submaximal VO2, F(2, 43) = 4.91, p < .01, differed signifi-cantly between groups. Specifically, multiple comparisons using Tukey’s HSD on the VO2 measure indicated that both storyboarding groups were superior to the control group from pre- to posttest (p < .05 between the coached group and control; p < .02 between the orientation-only group and control). For PBF, the coached group, but not the orientation-only group, was statistically superior to the control group (p < .03). The two experimental groups were statistically similar on these measures, and group comparisons on the other fitness measures were

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also nonsignificant. Comparisons of group means for improved performance, and descriptive statistics for pre and post physical fitness measures, are located in Table 1. The assumption of normality was satisfactory.

Exercise Adherence

In this study, exercise adherence was defined as the extent that each participant engaged in his or her pre-scribed aerobic and strength exercise programs. Aerobic exercise was prescribed a minimum of three times per week, in accordance with the existing scientific literature for marked improvement on cardiovascular fitness, while strength training was prescribed a minimum of twice per week. Thus, full exercise adherence for aerobic exercise was operationally defined as exercising at least three times per week over 10 weeks, or 30 sessions. Full adherence for strength exercise included a minimum of two sessions per week over 10 weeks, or 20 sessions.

Adherence data came from self-reports, which the fitness coaches obtained at the end of each week by e-mail or phone contact with their respective clients. Corrobora-tive evidence of adherence rates was also collected from posttest fitness scores. Adherence rates for the coaching

group averaged 23 out of 30 aerobic exercise sessions (77%), and 16 of 20 sessions (80%) for strength training. The orientation- only group recorded adherence rates of 21 of 30 (70%) and 15 of 20 sessions (75%) for aerobic and strength conditioning, respectively. Finally, the control group adherence rates were 15 of 30 (50%) and 16 of 20 sessions (80%), respectively. Thus, while adherence was far greater for the two treatment groups, as opposed to the control group, adherence rates were very similar for strength training. None of the 46 participants who volunteered for the study dropped out.

Survey Responses

Immediately after the 10-week wellness program, each participant in the two treatment groups was sent an online survey that provided additional meaning to the storytelling task by exploring the ways in which this procedure influenced their thoughts, emotions, and ac-tions in the program. Here are the questions and selected responses obtained from a small sample of participants that reflect the effect of storyboarding on the factor(s) that led to their change in health behavior. This survey also provided a manipulation check clearly indicating

Table 1. Group improvement comparisons on physical fitness measures

Measures Group Test M SD N Improvement Significant M SD improvement (p)

Percent body fat* Coaching Pre 32.54 5.27 15 -3.59 1.90 Coaching > control Post 28.95 5.56 15 (p < .03) Orientation only Pre 30.22 8.65 13 -3.24 1.49 Post 26.98 7.65 13 Control Pre 26.34 8.03 18 -1.56 2.75 Post 24.78 8.48 18 Submaximal VO2 Coaching Pre 34.78 7.57 15 3.55 4.02 Coaching < control Post 38.33 6.04 15 (p < .05) Orientation only Pre 37.07 8.68 13 4.11 2.85 Orientation only > control Post 41.18 9.30 13 (p < .02) Control Pre 39.52 7.13 18 0.51 3.48 Post 40.03 8.29 18Upper strength Coaching Pre 67.65 37.58 15 12.39 9.68 Post 80.04 37.24 15 Orientation only Pre 81.15 36.25 13 20.72 16.36 Post 101.87 44.82 13 Control Pre 59.98 30.10 18 20.02 24.30 Post 80.00 34.95 18 Lower strength Coaching Pre 256.78 156.94 15 62.00 40.27 Post 318.78 157.93 15 Orientation only Pre 308.04 100.85 13 73.72 41.93 Post 381.76 98.18 13 Control Pre 241.48 78.05 18 45.62 40.28 Post 287.10 72.97 18

Note. M = mean; SD = standard deviation; VO2 = oxygen uptake; negative mean improvement in percent body fat = less per-cent body fat.

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that participants had, in fact, applied Loehr’s (2007) eight-step program.

Question: Describe how your old story pre-vented you—until now—from reaching your mission of improved fitness, health, and energy?Answer: To see it written makes it more tan-gible and gets your attention. My old story was full of excuses. I saw how much time I was wast-ing instead of taking better care of myself.Question: How has your “new story” provided you with the incentive to overcome “bad” (unhealthy) habits and to accomplish the goals in your new story? Answer: It has provided me with the incentive to want to erase (change) the written old story. My new story was full of action, not just reasons why I could not achieve my goals.Question: As part of your new story, in what areas of your life have you been—and must you truly be—extraordinary to fulfill your destiny? Answer: I must be focused on my goals and truly engaged in only those things that im-prove my situation. I must embrace the mo-ment and plan fun activities.Question: What was your daily average energy level before the wellness program on a scale of 1 (very low) to 10 (extremely high)? How has your energy improved since the program’s completion?Answer: The average preprogram energy level was 3.55 (SD = .83), and the postprogram energy level was 7.75 (SD = .91).Question: On a scale from 1 (very low) to 10 (extremely high), how confident are you that you will maintain these new rituals that you learned in the wellness program? (M = 8.50, SD = 0.71).Answer: I realized that excuses are just that, and that nothing can be lost in trying. I real-ize how self-destructive my old story was, and I won’t let that happen to me again. It was very telling about why so many people do not achieve their new story—out of sight, out of mind—but with the support I have received in this program I am confident I will stick with my new program.

Discussion

The purpose of this study was to examine the effect of an intervention based on the concept of storytelling, also called storyboarding or narrative inquiry, on replacing

negative, unhealthy habits with positive, healthy routines, the result of which was to improve fitness and maintain participation in the 10-week program, or exercise adher-ence. Participants were assigned to one of two groups, a group that experienced the orientation and Loehr’s (2007) eight-step storyboarding program, which included two additional coaching sessions during the 10-week well-ness program, or a group that experienced the same ori-entation and eight-step program, but without additional coaching during the 10-week wellness program. The third (control) group consisted of individuals who engaged in the wellness program only and were not exposed to the orientation.

Participants who received the storytelling treatment in this study were profoundly affected by their experience. As revealed in the postprogram survey comments, the individuals felt a degree of vastly improved self-control in their lives and were on a new “mission” to invest in a new set of rituals that improved their health and energy. Not surprisingly, the storytelling procedure was the first time they expressed very personal issues in written form.

In Pennebaker (1997), we found two additional pos-sible explanations for the marked improvement in fitness for the two treatment groups in this study as compared to the control group: (a) the nature of storytelling, and (b) a person’s motivation to change his or her health behavior. According to Pennebaker, the writing process can result in behavior change, because it “requires” the individual to organize past traumas that may have led to their dysfunctional (i.e., unhealthy) habits. Traumas, he contended, are the sources of our old story, which prevents many individuals from living a life consistent with their values and achieving at the highest level. When individu-als write about significant events in their life, they begin to organize and understand them. This allows them to reduce the experience’s complexity and make it more understandable and, thus, move beyond the trauma.

With respect to a person’s motivation to change his or her health behavior, Pennebaker (1997) reflected a plethora of existing clinical literature that the self-motivation to change is the best predictor of replacing unhealthy, often self-destructive habits with improved, healthier routines. Writing, he contends, allows people to explore their motives for health behavior change, to scrutinize their deepest thoughts and feelings about why they think change is necessary. The participants who engaged in the two treatment groups, particularly those who invested time and effort, and were unafraid to expose their inner thoughts and feelings that may help explain their self-destructive nature, were highly self-motivated to improve their health and quality of life. This was clear in their writing, in both their old and new stories, and was reflected in their poststudy survey responses.

An important outcome of this study was the strong influence of storyboarding on the treatment group’s ex-

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perience in the wellness program. As indicated earlier, this study provided the first test of Loehr’s (2007) eight-step storyboarding program. Storyboarding presents a poten-tially effective method for understanding the individual’s resistance to health behavior change. For the individuals in this study, it created what Clandinin and Connelly (2000) called “an experience of the experience” (p. 5). The authors asserted that educators are interested in life as an educational tool, and that storytelling allows educators to examine how people’s lives are composed and lived out. In addition, however, storyboarding provides researchers and practitioners with the incentive to overcome their personal storms, and to improve their sense of self-control in improving quality of life.

As a form of manipulation check, each participant assured us that they followed the “daily accountability system” for their rituals, as suggested in Loehr’s (2007) program. These included keeping records; making their accountability system easy to complete and accessible (e.g., near their bed, on the kitchen table, on their office desk); asking themselves, daily, whether they carried out the rituals to which they had committed themselves; re-viewing their accountability log with another person (i.e., someone they designated as their coach); and reviewing the entire process and rewriting their stories if enthusiasm waned and boredom set in. All participants in the coach-ing group indicated full adherence to these tasks.

The task of reflecting on the foundations of one’s lack of fulfillment is grounded in identifying the inconsistency between a person’s values—what is considered important in life—and the person’s unhealthy or ineffective behav-ioral patterns (Anshel & Kang, 2007). For example, one client (see Appendix) stated, about changing his life and improving his future health:

The truth is my new “New Story” is one of a “New Life.” It is no longer one of personal lies with imaginary plans, but actual action. In July 2007 I got married into a family with Jennifer and her daughter Meggan. All my decisions now have consequences beyond myself. My life is no longer day-to-day, but part of a lifelong journey.

This person found new meaning in life from his family; his values changed, and his journey was now focused on maintaining good health. He had more to live for than meeting personal needs. In the parlance of Loehr and Schwartz (2003), he connected “to a deeply held set of values and to a purpose beyond our self-interest” (p. 110). The result was a renewed sense of “spiritual energy [that was] sustained by balancing a commitment to others with adequate self-care” (p. 110). He now thought of the long-term consequences of his negative habits and felt a renewed sense of purpose in his journey to live a fulfilling

life. The ability to tell one’s story—old and new—reflects the effectiveness of storytelling and the unique contribu-tions of narrative inquiry in understanding the factors that influence human behavior. To Smith (2007), in explain-ing the value of narrative inquiry research methodology, “People understand themselves as selves through the sto-ries they tell and the stories they feel part of” (p. 391).

Smith (2007) also provided insights into another fac-tor that helps explain the strong influence of narratives on self-understanding and behavior change—that narra-tive is also a form of social action. To Smith, “narratives are done in social interactions [because] people do things with narratives and they have important social functions. Thus, stories do things in relation to others” (p. 391). The present study included full social support of coaches in the areas of fitness, nutrition, and storytelling, and ad-ditional social support from family members and work colleagues with whom many of the participants exercised. There is an apparent prominent social role in provid-ing people with the incentive to develop, carry out, and adhere to new rituals that influence the stories they tell. Additional research is needed to more closely examine the social influence of the stories that lead to developing new, permanent changes in health behaviors.

One possible limitation to this study was that both the participants and the researchers were members of the same university faculty. Although full confidentiality was promised (and acknowledged by the participants), it is possible that the participants felt a degree of inhibi-tion and “holding back” when disclosing their personal story. This issue is intrinsic to the narrative inquiry pro-cess (Clandinin & Connelly, 2000). It should also be noted, however, that the stories were very personal and intimate relating to the participants’ professional career and personal relationships. In addition, the relationship established between the researchers and each participant was sincere and respectful. All meetings were held in a private office, and the participants expressed full comfort in expressing their “old” and “new” stories, which they wrote on their own time and in the privacy of their home or office. At no time did the researchers feel that clients were providing story content they thought the researchers wanted to hear (i.e., social desirability effect); however, this issue could not be controlled.

Another limitation in the study was that the assign-ment of participants to groups was not random. While all individuals were registered to participate in a 10-week wellness program, group assignment was based on selec-tive criteria. For example, only those willing to meet with their coach to engage in the intervention were assigned to the coaching group, while others were assigned to the orientation-only (no-coaching) group. The remaining individuals constituted the control (wellness program only) group. The self-selection of participants to condi-tions, as opposed to random assignment, may result in a

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behavioral artifact called volunteerism, or volunteer bias (Rosenthal & Rosnow, 1975), that reflects heightened motivation and other characteristics of individuals who volunteer to participate in a program or study. Never-theless, participants in all three groups demonstrated similarly low fitness level and interest to participate in the wellness program.

We also acknowledge the important potential of qualitative research in future examinations of the ways that storyboarding may influence health behavior change, par-ticularly with respect to exercise. Stories lend themselves to structured interview questions about the antecedents and underlying factors that help explain the mechanisms for decisions to develop, carry out, and adhere to new rituals that improve health and lead to permanent lifestyle changes (Smith & Sparkes, 2008).

In summary, the results indicated that the orientation-plus-coached group, but not the orientation-only group, was significantly superior for reduced PBF and improved cardiovascular fitness, as opposed to the control group. The two treatment groups, however, were statistically simi-lar for PBF. On the submax VO2 measure, both treatment groups scored significantly better than the control group and, again, were statistically similar. Exercise adherence rates were superior for the two treatment groups when engaging in aerobic fitness, but all three groups demon-strated similar adherence to the strength-training part of the program. The results of this study strongly suggest that storyboarding may be effective in attempts to change health behavior, particularly with respect to encouraging exercise, by allowing the individual to “discover” mental and emotional factors that have fostered negative habits, while impeding behaviors that promote happiness and high quality of life. The effect of storyboarding on long-term changes in health-enhancing behavioral patterns, particularly exercise, awaits further research.

References

Anshel, M. H. (2006). Applied exercise psychology: A practitioner’s guide to improving client health and fitness. New York: Springer.

Anshel, M. H., & Kang, M. (2007). Effect of an intervention on replacing negative habits with positive routines for improv-ing full engagement at work: A test of the Disconnected Values Model. Consulting Psychology Journal: Practice and Research, 59, 110–125.

Buckworth, J., & Dishman, R. K. (2002). Exercise psychology. Champaign, IL: Human Kinetics.

Burton, C. M., & King, L. A. (2008). Effects of (very) brief writ-ing on health: The two-minute miracle. British Journal of Health Psychology, 13, 9–14.

Clandinin, D. J., & Connelly, F. M. (2000). Narrative inquiry: Experience and story in qualitative research. San Francisco: Jossey-Bass.

Ebbeling, C. B., Ward, A., Puleo, E. M., Widrick, J., & Rippe, J. M. (1991). Development of a single-stage treadmill walking test. Medicine & Science in Sports & Exercise, 23, 966–973.

Frattaroli, J. (2006). Experimental disclosure and its moderators: A meta-analysis. Psychological Bulletin, 132, 823–865.

Groppel, J. (2000). The corporate athlete: How to achieve maximal per-formance in business and life. New York: John Wiley & Sons.

King, L. A. (2001). The health benefits of writing about life goals. Personality and Social Psychology Bulletin, 27, 798–807.

Klesges, L. M., Estabrooks, P. A., Dzewaltowski, D. A., Bull, S. S., & Glasgow, R. E. (2005). Beginning with the application in mind: Designing and planning health behavior change interventions to enhance dissemination. Annals of Behavioral Medicine, 29, 66–75.

Leahy, T., & Harrigan, R. (2006). Using narrative therapy in sport psychology practice: Application to a psychoeducational body image program. The Sport Psychologist, 20, 480–494.

Loehr, J. (2007). The power of story: Rewrite your destiny in business and in life. New York: Free Press.

Loehr, J., & Schwartz, T. (2003). The power of full engagement: Managing energy, not time, is the key to high performance and personal renewal. New York: Free Press.

Lox, C. L., Martin, K. A., & Petruzzello, S. J. (2006). The psychology of exercise: Integrating theory and practice (2nd ed.). Scottsdale, AZ: Holcomb Hathaway Publishers.

Pennebaker, J. S. (1997). Opening up: The healing power of expressing emotions. New York: Guilford Press.

Pollock, M. L., & Jackson, A. S. (1984). Research progress in vali-dation of clinical methods of assessing body composition. Medicine & Science in Sports & Exercise 16, 606–615.

Ramirez-Esparza, N., & Pennebaker, J. (2006). Do good stories produce good health? Exploring words, language and culture. Narrative Inquiry, 16, 211–219.

Riessman, C. (2008). Narrative methods for the human sciences. Thousand Oaks, CA: Sage.

Rosenthal, R., & Rosnow, R. (1975). The volunteer subject. New York: John Wiley & Sons.

Schalock, R. L. (2001). Outcome-based evaluation (2nd ed.). New York: Kluwer.

Siri, W. E. (1961). Body composition from fluid spaces and density: Analysis of methods. Nutrition, 9, 480–491.

Smith, B. (2007). The state of the art in narative inquiry. Narrative Inquiry, 17, 391–398.

Smith, B. (2010). Narrative inquiry: Ongoing conversations and questions for sport and exercise psychology research. Inter-national Review of Sport and Exercise Psychology, 3, 87–107.

Smith, B., & Sparkes, A. C. (2005). Men, sport, spinal cord injry, and narratives of hope. Social Science & Medicine, 61, 1095–1105.

Smith, B., & Sparkes, A. C. (2006). Narrative inquiry in psycho-logy: Exporing the tensions within. Qualitative Research in Psychology, 3, 169–192.

Smith, B., & Sparkes, A. C. (2008). Narrative analysis and sport and exercise psychology: Understanding lives in diverse ways. Psychology of Sport & Exercise, 9, 1–10.

Smith, B., & Sparkes, A. C. (2009). Narrative inquiry in sport and exercise psychology: What can it mean, and why might we do it? Psychology of Sport & Exercise, 10, 1–11.

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Authors’ Notes

We offer our appreciation to Sidney A. McPhee, president of Middle Tennessee State University, whose discretionary funds supported the employee wellness program from which this study was conducted. In addition, the Human Performance Institute (HPI), Orlando, FL, provided program content and instructional materials. The authors

express gratitude to Jim Loehr, HPI president and chief executive officer, for his consultation services and for sharing intervention materials in support of this study. Please address correspondence concerning this article to Mark H. Anshel, Department of Health and Human Performance, Box 96, Middle Tennessee State University, Murfreesboro, TN 37132.

E-mail: manshel@mtsu.edu

Appendix. Storyboarding Samples (unedited)

Participant A

Old StoryI was a former high school and college athlete who enjoyed working out when I would actually get off my lazy-boy and get to the gym. My lifestyle for many years was one of living alone, irregular eating habits and bachelor tendencies. I drank too much and had no portion control. I usually ate anything and everything until uncomfortably stuffed. A regular weekend dinner might include a two liter of cola and a large pepperoni pizza. My finances consisted of multiple credit cards maxed out and living from paycheck to paycheck, while making minimal payments on my delinquent accounts. I never really planned much, living day-to-day and week-to-week. The only person I usually ever had to worry about was myself.My life had little or no direction. I finished my MBA, but usually only did enough to just get by. I never saw myself as overweight or out of shape, and part of me wanted to be the college athlete again…so I put on the act. Working out consisted of infre-quent visits to the Campus Recreation Center where I would sweat and look like I was a man trying to get in better shape. In all actuality, it was wasted time and in some ways more harmful than it was good.

New StoryThe truth is, my new “New Story” is one of a “New Life.” It is no longer one of personal lies with imaginary plans, but actual ac-tion. In July 2007 I got married into a family with Jennifer and her daughter Meggan. All my decisions now have consequences beyond myself. My life is no longer day-to-day, but part of a lifelong journey. In January of this year, while on our honeymoon in Las Vegas, we made a decision to change our lives. We decided to start working out regularly, eat better foods and work on controlling our portions and cravings. No longer does food control our lives. We eat five to six “meals” a day including snacks, and try to eat something every 2 hours or so. This has kept us from being hungry and giving our bodies only what it needs.Since beginning our “lifestyle changes” I have lost close to 30 pounds and attend the gym, including 45 to 60 minutes of car-diovascular activities and lifting weights four to five times a week. Working out has become part of my daily routine, and days without it seem empty. I have more energy and have become more focused in all aspects of my life.I have since paid off most of my debt, have worked my fifth year as an instructor of marketing, and won “Professor of the Year” in the College of Business. My life now has focus, and it’s my wife and daughter. My habits have balance between work, home, and personal well being. I have prioritized my actions and live to be a father to my daughter, a loving husband to my wife, and to take back control of my life.

Participant B

Old StoryI dislike my life. While I like parts of my job, I feel that there is too much work, particularly paperwork and administrative duties. I am constantly experiencing low-level ill health, and I don’t find time to do the things I want. I always feel overwhelmed by every-thing I should be doing.I always imagine things I want to do “some day” or in the future, and often imagine better choices I could have made in the past—but I never do those things now, and I don’t prepare to do them in the future. I am in denial about how I spend my time—every day, every semester, I just try to “get through the day”—but that feeling never ends. I never feel like I have arrived where I want to be, or even that I have made progress. I would be embarrassed to admit to almost anyone how I spend my days—on activities I feel have little importance.The truth is, I feel like a fraud, a failure. My procrastination gives me an escape from feeling overwhelmed—but the irony is, it only adds to the feeling in time, and makes my feeling of failure come true. I can’t imagine this changing—which makes me panic I allow myself to entertain the thought, rather than pushing it away.

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Appendix (Cont.)

New StoryThe truth is, even though I have wasted many opportunities, I have accomplished many things in my life, and had many good experiences. The truth is, I use my ill-health and my excess of work as excuses, and I indulge in behaviors that continue them, because this allows me a temporary denial of the larger problems and issues in my life – but it makes them much worse in the long-term.The truth is, I have been lucky to have the opportunities and experiences I have had throughout my life. While I cannot change the past, I can make better choices now, and continue to make the most of the opportunities I am given. If I fail to cor-rect my lifestyle and the way I spend my time, my life will continue to worsen, with possible unemployment, continued living in a place I dislike, the loss of friends and family, and continued general malaise.To quote Sojourner Truth, “I’m sick and tired of being sick and tired.” I want to respect myself and others by living out my life in the best way possible. Although I do not currently adhere to a particular faith tradition, I having been pondering the notion that it is a “sin” not to make the most of the talents and gifts we have been given, to waste our lives. I choose not to do this anymore.I will build a better balance between the three parts of my life: body, mind, and spirit. I will use my time to its fullest, and plan time each day for each aspect of my life. I will celebrate my work, and celebrate my leisure. I know that if I stop simply plan-ning what I should/want to do, and follow through, I will be energized, and a positive cycle will begin, which will make all of these goals easier. As I often say to my Women’s Studies students, changing the world (and yourself!) is not about the one moment of heroism where you get to slay the dragon. Rather, the personal is the political, and your values are reflected in the “unextraordinary” things you do every day, just as your life is the sum of these small pieces of time. I choose to enact this. My new values are health, intellectual development, spiritual growth, family, integrity, harmony, generosity, social justice, helping others, and creativity.My Ultimate MissionTo be an excellent teacher, good researcher, good friend & family member, good role model, spend my days – even in the small things – engaged in activities that reflect my values, Carpe diem, a sense of satisfaction at the end of the day of time well spent, a balance in my life, passion in my life—one of my gifts, and a living situation with which I am pleased.BarriersTime management, sleep patterns, habits, inertia, procrastination, fear of failure, avoidance, denial, lack of follow-through, and disconnect between stated values and actions.My Essential Life PurposeTo leave a legacy to the people who knew me that my life was an example of how to live an abundant life by loving, serving, learning, laughing and seeing beauty in all situations.Specific Life Mission StatementsTo have resilient, unquestionable and loving family relationships;To practice my profession as an educator with integrity and effectiveness;To live life to the fullest by using time and money wisely; andTo inspire others, by my example, to love themselves, to respect other people and to seek beauty.

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