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Journal of Human, Earth, and Future Exercise Motivation among Fitness Center Members: A Combined Qualitative and Q-Sorting Approach

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Abstract

This study aimed to explore the components of Exercise Maintenance Motivation (EMM) and identify its consensus and distinguishing aspects among members of fitness centers (FCs) in Vietnam. The study incorporated both qualitative and Q-sorting methodologies across two stages. The first stage involved conducting ten in-depth and four focus-group interviews with 39 members of six different FCs in Vietnam, resulting in the generation of 40 EMM statements. In the second stage, these statements were subjected to Q-sorting by 39 participants. The KADE application for the Q method was used for data analysis, and Principal Component Analysis was employed to determine the optimal number of factors. The analysis yielded four factors, encompassing 34 statements and accounting for 86% of the variance in EMM components among participants. These components, labeled "F1. Exercise achievements", "F2. Exercise environments", "F3. Exercise enjoyment", and "F4. Workout-aholic", achieved consensus among 17 (37%), 14 (30%), 5 (12%), and 3 (7%) participants, respectively. The leading motivational expressions were "get to be healthier", "a better-looking appearance", and "get a fit body appearance". These were followed by FC-based supportive exercise conditions, positive feelings, and exercise addiction. There were five consensus statements that spanned all four factors. The numbers of distinguishing statements varied across factors, with F1, F3, and F4 each contributing 11 (28.2%) and F2 contributing 15 (38.5%). This study contributed to the four central drivers of EMM. To facilitate the development of a comprehensive EMM scale, future research should incorporate larger samples, allowing for a dissection of motivational paradigms.
ISSN: 2785-2997
Available online at www.HEFJournal.org
Journal of
Human, Earth, and Future
Vol. 4, No. 3, September, 2023
345
Exercise Motivation among Fitness Center Members: A
Combined Qualitative and Q-Sorting Approach
Truong Thanh Nam 1, 2, 3 , Charuai Suwanbamrung 1, 2 , Omid Dadras 4, Xiang-Yu Hou 5,
Doan Hoang Phu 6, Pham Trung Tin 1, 3, Huynh Khai Quang 3, Thai Thi Ngoc Thuy 7, Temesgen
A. Ageru 1, 8 , Saifon Aekwarankoon 9, 10, Sang-arun Isaramalai 11, Cua Ngoc Le 1, 2
*
1 Public Health Research Program, School of Public Health, Walailak University, Nakhon Si Thammarat, 80160, Thailand.
2 Excellent Center for Dengue and Community Public Health (EC for DACH), Walailak University, Nakhon Si Thammarat, 80160, Thailand.
3 Faculty of Public Health, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam.
4 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
5 Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Australia
6 Doctoral Program in Health Sciences, College of Graduate Studies, Walailak University, Nakhon Si Thammarat, 80160, Thailand.
7 Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam.
8 Department of Medical Laboratory, Wolaita Sodo University Teaching and Referral Hospital, Wolaita Sodo, Ethiopia.
9 School of Nursing, Walailak University, Nakhon Si Thammarat, 80160, Thailand.
10 Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat, 80160, Thailand.
11 Faculty of Nursing, Prince of Songkla University, Songkla 90110, Thailand.
Received 09 May 2023; Revised 11 August 2023; Accepted 19 August 2023; Published 01 September 2023
Abstract
This study aimed to explore the components of Exercise Maintenance Motivation (EMM) and identify its consensus and
distinguishing aspects among members of fitness centers (FCs) in Vietnam. The study incorporated both qualitative and
Q-sorting methodologies across two stages. The first stage involved conducting ten in-depth and four focus-group
interviews with 39 members of six different FCs in Vietnam, resulting in the generation of 40 EMM statements. In the
second stage, these statements were subjected to Q-sorting by 39 participants. The KADE application for the Q method
was used for data analysis, and Principal Component Analysis was employed to determine the optimal number of factors.
The analysis yielded four factors, encompassing 34 statements and accounting for 86% of the variance in EMM
components among participants. These components, labeled “F1. Exercise achievements”, “F2. Exercise environments”,
“F3. Exercise enjoyment”, and “F4. Workout-aholic”, achieved consensus among 17 (37%), 14 (30%), 5 (12%), and 3
(7%) participants, respectively. The leading motivational expressions were “get to be healthier”, “a better-looking
appearance”, and “get a fit body appearance”. These were followed by FC-based supportive exercise conditions, positive
feelings, and exercise addiction. There were five consensus statements that spanned all four factors. The numbers of
distinguishing statements varied across factors, with F1, F3, and F4 each contributing 11 (28.2%) and F2 contributing 15
(38.5%). This study contributed to the four central drivers of EMM. To facilitate the development of a comprehensive
EMM scale, future research should incorporate larger samples, allowing for a dissection of motivational paradigms.
Keywords: Exercise Maintenance; Motivation; Fitness Center; Q-Sorting; Vietnam.
*
Corresponding author: cua.le@wu.ac.th
http://dx.doi.org/10. 28991/HEF-2023-04-03-07
This is an open access article under the CC-BY license (https://creativecommons.org/licenses/by/4.0/).
© Authors retain all copyrights.
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346
1. Introduction
Regular physical activity, specifically through sustained exercise routines, has been empirically linked to numerous
health benefits [1, 2]. Conversely, a lack of physical activity is associated with increased morbidity and mortality due
to non-communicable diseases [3]. This is particularly pertinent in the context of Vietnam, where diminishing levels
of physical activity among the populace contribute to pressing public health challenges, negatively impacting overall
health and well-being [4]. Recent trends indicate a propensity for individuals to engage in exercise routines within
fitness center (FC) environments, primarily motivated by health benefits [5]. According to the 2020 report by the
Global Health and Fitness Association, 2.36% of the worldwide population are FC members [6]. In urban Vietnam,
28% of males and 21% of females report participation in FC activities [7]. Engaging in sustained exercise within an
FC setting is posited as a strategy to counteract sedentary lifestyle consequences [8]. Nevertheless, empirical data
reveal a concerning trend, as between 40% and 65% of individuals who commence exercise routines in fitness settings
discontinue their participation within the first 12 months, a pattern that persists across diverse demographic groups,
regardless of age, gender, or perceived guidance of the exercisers [911].
Prior research on FC patrons has highlighted the diverse motivations for joining and maintaining membership [5,
1214]. The main motivational components for those initially engaged in exercise were related to health benefits and
enhancement in physical appearance, with factors such as tangible physical transformations and a heightened sense of
autonomy boosting commitment levels [14]. Similarly, long-standing FC members exhibit a tendency toward realizing
desired health outcomes and improved physical appearance [5]. Motivational dimensions such as “weight loss”,
“health”, “aesthetics”, and “hypertrophy” are mainly associated with participants’ continuing exercise at FCs [15].
From demographical aspects, young and middle-aged individuals exhibited more concerns about physical appearance,
with women being more concerned than men. Middle-aged people valued the sense of being in control the most, with
women appreciating it more than men. Older adults valued FC attributes less than their younger counterparts
(convenience, extra amenities, and time-related issues), while women valued these qualities more than men [14].
Besides, regular exercise has been associated with higher levels of motivation for enjoyment and challenge within the
first year of membership in an FC [13]. Engaging in diverse activities within the fitness environment, coupled with
commitment-building strategies and bolstering encouragement from both staff and fellow members, serves to enhance
the overall exercise experience, thereby nurturing a conducive atmosphere for sustained participation [5].
Interestingly, findings of a recent systematic review indicated that FC members reported higher motivation levels
compared to those who exercised in other settings [16], such as public areas [17], academic institutions [18], and
healthcare facilities [19, 20].
Given the multifaceted nature of human motivation in exercise, studies are recommended to identify and support a
variety of motivational styles [21, 22]. Self-determination theory (SDT) serves as a robust framework to describe
various types of self-determined motivation, playing a critical role in predicting the sustainability of exercise practices
among FC members [23, 24]. The SDT indicates three forms of motivation, including amotivation, extrinsic
motivation, and intrinsic motivation [23, 25]. While intrinsic motivation more strongly predicts long-term exercise
adherence, extrinsic motivation more strongly predicts initial exercise adoption [26]. Both amotivation and extrinsic
motivation have been identified as contributors to increased discontinuation rates in exercise routines, illustrating a
negative trajectory [26]. This implies that external pressures may instigate a transient change in exercise habits;
however, they fall short of facilitating enduring alterations in long-term exercise behaviors. In contrast, intrinsically
motivated individuals, perceiving exercise as an indispensable part of their lifestyle, are more likely to maintain
regular exercise over extended periods [27].
Previous studies have described the factors that drive the initiation and sustained adherence to exercise in fitness
settings, predominantly focusing on English-speaking populations [11, 13, 26, 28]. However, there is a significant
research gap in understanding these phenomena within various global contexts, particularly within Vietnam. Despite
the substantial proportion of FC members in the population, there is a noticeable absence of comprehensive research
exploring their exercise habits, with existing studies often being limited in scope and methodological rigor, such as
mixed-methods approaches [28, 29]. Furthermore, they represent a particularly intriguing demographic, as their
motivations for exercise may change from the initial stages of engagement to the maintenance phase [5, 12]. Thus, the
present study has employed a mixed-methods approach to delve into the motivations underpinning regular exercise
maintenance within the fitness setting, extending beyond the initial weeks of membership to encompass sustained
engagement over several months. Assuming that the motivation for exercising varies from person to person, FC
patrons have contrasting and consensual views about what drives them to engage in consistent exercise routines. The
primary objectives of this study are to identify various components of Exercise Maintenance Motivation (EMM) and
to ascertain the levels of consensus and variation related to EMM among FC members in Vietnam. Hence, the study
seeks to answer the following research questions to achieve these objectives: (1) What constitute the motivational
components among FC members for maintaining regular exercise? (2) How do these individuals quantitatively vary in
their consensus and disagreement regarding statements related to EMM?
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2. Research Methodology
2.1. Study Protocol
To ensure the comprehensiveness and rigorousness of this study, adherence to established methodological
standards was prioritized. Specifically, the Critical Appraisal Skills Programme (CASP) checklist for appraisal of
qualitative research (version 2018) was utilized to guide the evaluation process, serving the needs of information
professionals and researchers [30, 31]. Additionally, established guidelines for the implementation of the Q-Sorting
methodology were rigorously followed [3235].
2.2. Study Design
This study employed a hybrid approach, integrating both qualitative research and Q-Sorting techniques, structured in
two distinct stages (see Figure 1). The first stage was to qualitatively explore the components of EMM, achieved
through conducting ten Individual Depth Interviews [36] and four Focus Group Discussions (FGDs) with FC
members, personal trainers (PTs), and managers at FCs. Based on the results of the qualitative method, statements
were generated within the dimensions of EMM. The second step of the study leveraged the Q-Sorting approach,
engaging 39 FC members to quantitatively assess the levels of consensus and distinguish between the various EMM
statements.
Figure 1. Study process for a combined qualitative and Q-Sorting approach
Stage I. The Qualitative Study
Purposive sampling was utilized to set the study areas based on high-density numbers of FCs in Can Tho City,
Vietnam, and then select and recruit FC members [37]. Six FCs were purposely selected for data collection in two
districts. A convenience sample of ten individuals, including two FC managers, two PTs, and six FC members, were
recruited. In addition, four FGDs were arranged, involving two groups of FC members and two groups of PTs with
prior experience working with FC members. Each FGD comprised a convenience sample of 810 participants. Full
considerations were made to ensure that participants engaged in IDIs did not overlap with those in FGDs, maintaining
an equal distribution across the six selected FCs. The inclusion criteria were as follows: 1) A minimum age of 18
years; 2) Owners/managers of FCs, running the present FCs for at least a year; 3) A minimum of one year’s
experience for PTs in guiding FC patrons; and 4) A minimum of six months of exercise engagement in FCs for FC
members. Individuals aiming for a bodybuilding competition or becoming a professional athlete, those engaged in
physical exercises outside of FC workouts, and those with any chronic physical and/or psychological conditions or on
any form of medication were excluded from the study.
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In the data collection process, researchers approached six selected FCs and obtained voluntary and informed
consent from FC owners/managers and PTs to join the study. This was followed by an invitation extended to FC
members to participate in the qualitative study, with the completion of the survey being deemed consent for
participation. All IDIs and FGDs were conducted in private rooms within the FCs, each session lasting approximately
one hour, scheduled at convenient times for participants meeting the eligibility criteria. Following the initial three IDIs
and two FGDs, the research team meticulously reviewed field notes, evaluating the contributions of each participant’s
insights to the overarching narrative of the study. This iterative process not only refined the data collection procedure
but also facilitated the identification of the point of data saturation, marking the completion of the data collection
phase.
Topic and question guides for IDIs and FGDs were developed, drawing upon extensive reviews of self-determined
motivation and incorporating elements of both intrinsic and extrinsic motivations [22, 23, 38]. There were four main
questions: 1) What motivates FC members to integrate exercise into their daily routines at FCs?, 2) What factors
contribute to the sustained regular exercise habits among FC members?, 3) What are the barriers to maintaining
regular exercise?, and 4) What strategies or motivations enable regular exercise maintenance?. Further techniques for
IDIs [3941] and FGDs [4243] are described in Table A1. All materials related to the IDIs and FGDs, including
fieldwork diaries, session minutes in hard copy, and audio recordings, were securely stored by the investigators in a
locked cabinet and on a personal laptop to ensure the security of the data. Moreover, a comprehensive coding system
was employed to anonymize the data from each IDI and FGD, ensuring the confidentiality of the information provided
by the participants.
Content analysis was employed to analyze the qualitative data, consisting of five main steps: 1) Selecting the
pertinent content for analysis; 2) Defining the units and categories of analysis; 3) Developing a set of coding rules; 4)
Coding the text according to the rules; and 5) Analyzing the results and drawing conclusions [44]. The line-by-line
coding of each participant’s interview responses was informed by key terms of EMM. The two researchers
independently coded each interview, entering all codes manually into an Excel matrix of qualitative data. The IDIs and
FGDs were conducted in Vietnamese and then analyzed in the native language, ensuring a thorough comprehension of
the meanings within the appropriate cultural and contextual frameworks. Sequentially, the English translation of the
main findings was performed to allow discussion with the non-Vietnamese collaborators.
The qualitative study ensured its credibility, dependability, transferability, and confirmability through triangulation
processes to establish trustworthiness [45, 46]. Fourteen IDIs and FGDs conducted among FC members, PTs, and FC
owners/managers by four investigators added credibility to the study. The purposive selection of key informants,
encompassing a diverse range of experiences, substantially increased the probability of garnering multifaceted insights
into the research questions, as emphasized in prior studies [46]. This methodological rigor ensured a holistic
understanding and interpretation of the phenomena under investigation, aligning with the established qualitative
research protocols.
Stage II. The Q-Sorting Method
The first stage was followed by the connecting step (see Figure 1), where raw data derived from the qualitative
study were used to generate a list of statements reflecting the EMM of FC members. This process involved data
screening, data summarization, statement generation, and subsequent modification, ensuring alignment with the
perspectives of the research team [47]. Following this, a panel of 11 domain experts conducted an evaluation to
ascertain the content validity of the statements, ensuring an acceptable content validity index of a minimum of 0.83.
Parallelly, 11 FC members were engaged to appraise the face validity of the statements, aiming for a face validity
index of >0.83. This dual-phase validation process was meticulously undertaken to rigorously assess both the
relevance and comprehensibility of the EMM statements, adhering to the methodological guidelines provided by
Yusoff [48, 49].
Sequentially, the Q-Sorting approach, a quotative technique, was employed in the second stage. Thirty-nine
participants in the qualitative study were re-invited to participate in the Q-Sorting step by conducting individual
interviews. The number of participants and the process of interviews were based on the sampling criteria and guidance
[35, 47]. Participants were invited to read, score, and allocate statements into a quasi-normal grid of cards according to
their opinions. The statements were subject to a seven-point scoring scale, extending from -3 for strongly disagreeing
to +3 for strongly agreeing. All four facilitators involved in this process had undergone comprehensive training in the
Q-sorting technique before the study. Each interview session lasted for roughly an hour. A digital voice recorder was
used to gather information throughout the conversations. Before enrolling in each interview, all participants provided
written, informed consent.
Participants were instructed to express their level of agreement with each statement, and these rankings were
subsequently converted into scores. The compiled dataset from Q-Sorting interviews was analyzed by the Principal
Component Analysis (PCA), where the correlation matrix included EMM statements as observations and participants
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as variables [33, 50]. The optimal number of factors that best characterized groups of participants were identified by
using Varimax rotation, contingent on the heterogeneity of participant views as subjectively evaluated by the
researchers [33, 50]. Factors that constituted a minimum of 5% of the total Q-Sorting and exhibited significant
loadings were retained, with the most advantageous combination of factors elucidating over 40% of the cumulative
percentage of variation [33]. Participants designated as confounders were those aligned with more than one factor.
Distinguishing and consensus statements were identified based on the Q-Sort and Z-score values, indicating the
relationship between statements and factors when the difference between the scores attained in any pair of factors was
statistically significant (p<0.05). Datasets from the Q-sorting interviews were stored and extracted using the KADE
a desktop application specifically designed for Q methodology [50].
3. Results and Discussion
3.1. Study Population
In the first stage, 50 individuals were totally invited for the qualitative study. However, three FC members and
eight PTs could not attend the schedule due to personal commitments. As a result, the participant pool was comprised
of 39 individuals, encompassing six FC members, two PTs, and two FC managers who participated in 10 IDIs, as well
as 17 FC members and 12 PTs who took part in 4 FGDs. In the second stage, 39 participants were re-invited to
participate in the Q-Sorting interviews. The average age (in years) and length of exercise (in months) of participants
were 24.8±4.1 and 47.3±29.7, respectively. The prevalence of male FC members was more than female (84.6% vs.
15.4%). Students accounted for the highest number of participants (38.5%), followed by personal trainers (35.9%),
businessmen (7.7%), and others. Participants with undergraduate degrees made up 92.3%.
3.2. Themes of Exercise Maintenance Motivation from the Qualitative Study
The qualitative component of the study elucidates the EMM, drawing on the perspectives of key informants and
categorizing their viewpoints into five thematic dimensions: (1) EMM by social effects, (2) EMM by personal exercise
achievements, (3) EMM by exercise integration with life goals, (4) EMM by exercise interests and enjoyment, and (5)
EMM by workout-aholic. Each thematic dimension was supported by participant quotes, selectively chosen for their
representativeness and depth of insight. A summary of all quotes can be found in the Table A2.
EMM by Social Effects
It was predominantly driven by external stimuli, encompassing support from peers, familial encouragement, and
conducive exercise environments. External evaluations concerning body image and health status from family, friends,
physicians, and others play a pivotal role in maintaining exercise regimes. Some participants highlighted the
significant impact of spiritual and financial support in facilitating critical decisions regarding their exercise
commitment.
"I think that for FC members, to be able to spend that time exercising every day, their families must also provide
spiritual and financial assistance. I think that their family must provide support." (male, 32 years old, IDI_FC
member_3).
Within the fitness environments, individuals draw inspiration and guidance from FC managers, PTs, and admired
public figures. Additionally, the interviewees emphasized the importance of the accessibility and convenience
provided by the FCs’ facilities and policies in shaping their exercise habits. They valued a diverse range of modern
and up-to-date exercise equipment, proximity, indoor cleanliness, spaciousness, and financial feasibility, while in their
opinion, affordability of exercise-related costs through promotional packages, legislation, and extended operational
hours also played a crucial role. Conversely, the persistence of exercise routines was hindered by negative external
influences, inadequate exercise conditions, and unforeseen disruptions in the FCs.
"In my opinion, EMM can come from FCs. Specifically, I like the FC to be empty, but the fact that too many people
come to exercise will affect my exercise. For example, when I exercise with a large number of people, there will not be
enough machines and tools to exercise, leading to boredom. I have to arrange another time so that the FC is less
crowded. In addition, a variety of exercise equipment or the close distance to the FC also motivate to maintain a
workout routine easily" (male, 22 years old, FGD_FC member_2).
EMM by Personal Exercise Achievements
Motivated FC patrons maintained their exercise routines through personal achievements derived from regular
exercise habits. These achievements encompass a range of benefits, including enhanced health, building social
relationships, knowledge acquisition, and a positive self-perception of exercise benefits, particularly within the FC
setting compared to other exercise environments. The long-term members reported utilizing these facilities to attain
the desired health benefits. It was commonly observed during interviews that these long-term members expressed a
desire to sustain positive alterations in their physical appearance and body composition. This was motivated by a fear
Journal of Human, Earth, and Future Vol. 4, No. 3, September, 2023
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of weight gain, an aspiration to fit into previously worn clothing, a reduction in abdominal circumference, an increase
in muscle mass, a decrease in fat tissue, and, interestingly, an enhancement in sexual health. Furthermore, members of
FCs commonly reported experiencing holistic health benefits, including stress relief, improved overall health with
fewer illnesses, and an enhanced ability to concentrate accompanied by feelings of positivity, strength, and vitality.
Consequently, improved quality of life was observed, manifested through healthier eating habits and improved sleep
patterns. However, it is imperative to note that neglecting exercise sessions may result in adverse effects on one's
health, eating habits, and sleep quality.
"The common exercise motive is the health advantages of working out. Actually, when I initially started exercising,
I frequently had sinusitis and headaches. I noticed that after being an FC member for about a 3-month duration of
regular exercising, my sinusitis had subsided. I was more comfortable with the benefits of good health that I had, to
work well, eat well, and sleep well. I feel my body is healthier, and I feel more positive energy" (Male, 27 yeasr old,
FGD_FC member_2).
Additional benefits of exercise are observed when participants acquire knowledge about a healthy diet and the
appropriate modalities of physical activity, subsequently enhancing employment prospects and fostering social
connections. Individuals with prior experience in various sports often engage in comparative analyses, evaluating the
merits of fitness-oriented exercise associated with other physical activities. They particularly emphasize the
convenience of fitness exercise in achieving specific exercise objectives, establishing a precise exercise regimen, and
effectively managing their time dedicated to physical activity.
“I realize that regular exercise in the FC is to communicate with more people and expand relationships. For
example, some friends who accompany us or some other friends share knowledge, make questions and exchange
exercise lessons” (female, 23 years old, FGD_FC member_1).
"For other kinds of sports, such as volleyball, I used to play with my friends in the afternoon, so it depended on the
time of my friends. I will get bored playing alone if nobody has time to go with me. Therefore, I go to exercise in the
FC to control my time positively." (male, 30 years old, FGD_PT_2).
EMM by Exercise Integration with Life Goals
Participants were motivated to work out in the FCs driven by a determination to cultivate consistent exercise
routines aimed at modifying their body weight, enhancing physical appearance, and bolstering both physical and
mental health as a part of their life goals. Some emphasized the crucial role that exercise plays in achieving their
objectives.
"The top two goals of my life are weight and appearance, followed by physical and mental wellness." (male, 23
years old, IDI_FC member_1).
EMM by Exercise Interests and Enjoyment
The interviewees characterized the pleasurable sensations associated with engaging in physical activity in terms of
enjoyment, tranquility, contentment, and a sense of well-being, whether undertaken individually or in a social context.
Participants exhibited a sustained commitment to regular exercise, perceiving it as a voluntary duty and demonstrating
resilience and perseverance in their pursuit of physical activity. Nevertheless, a discernible decrease in motivation for
regular exercise was observed when participants experienced a diminishing interest in and enjoyment of the activity.
“When I get used to going to the FC, I am very delighted because I could exercise with friends. Currently, going to
the FC is like a usual habit, which I have to do as fun. I find that most FC members quit exercise because they don't
have enough interest to keep going. First, FC members must have the discipline to go to the enough number and time
of exercise sessions weekly. Second, everyone considers going to exercise in the FC as a non-responsibility.
Otherwise, regular exercise is too difficult for themselves. It is just to exercise for health." (male, 23 years old,
IDI_FC member_1).
EMM by Workout-aholic
Fitness enthusiasts agreed that consistent daily exercise contributed to the formation of a habitual routine, while the
omission of workout sessions could result in adverse emotional impacts.
“A person will feel addicted to exercise after engaging in it for a long time. My clients used to exercise regularly.
However, they were forced to cease exercising due to their daily workload. I got to urge them to get back into working
out for a while. They honestly admitted that they felt worn out and weak because of skipping exercise” (male, 29 years
old, IDI_PT_1).
"They felt uncomfortable if they skipped a workout session. They experienced the same kind of fatigue. Some
claimed that something was lost" (male, 27 years old, FGD_PT_2).
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3.3. Components of EMM of FC Members from the Q-Sorting Method
3.3.1. Descriptions of the Principal Component Factor Analysis
Following the qualitative study, 40 final EMM statements were generated based on the list of opinions from
dierent key informants. These statements underwent a rigorous validation process to ensure their relevance and
appropriateness. Specifically, content validity was assessed by a panel of 11 experts in the field, resulting in
acceptable content validity indices of 0.83, confirming the statements’ adequacy in capturing the intended constructs
[48, 49]. Comprehensive details of the statements, categorized across five distinct themes of EMM, are provided in
Table A3.
From 8 factors in unrotated factor matrix of the Principle Component Analysis (PCA), four factors (F1 F4) were
identified, each with an Eigenvalue of >1 [33, 50]. These factors cumulatively elucidated 86% of the total variance,
with individual contributions of 37%, 30%, 12%, and 7%, respectively, as revealed by post-Varimax rotation. The
Pearson correlation coefficients (r) calculated between these 4 factors were < 0.3, showing a low association level and
hence affirming their distinctiveness. The composite reliability of each factor was above average (0.8), which
indicated its consistency and reliability. It is important to note, however, that due to the prioritization of participant
subjectivity inherent in the Q-Sorting approach, issues of validity and reliability were not primary concerns in this
study [47]. In addition, Figure 2 illustrates groups of participants without confounders contributing to 4 factors with
their factor loadings.
Figure 2. The group of participants contributing to 4 factors with its factor loadings. Each scartter plot uses dots to
represent participants
Utilizing the Q-Sort analytical method, 34 statements related to EMM were extracted and subsequently
interpreted across four distinct factors, derived from the initial pool of 40 statements (see Table 1). The assignment
of descriptive labels to each factor was meticulously carried out based on the synthesis of results from various
relevant statements, in conjunction with their respective Z-score values. It is imperative to note that the most
pronounced Z-score values utilized for factor interpretation are those progressively approximating the extremities
of the Q-Sort distribution table.
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3.3.2. Descriptions of Four Factors for EMM Components
In the following, descriptions of each factor, the EMM statement ordinal numbers, and the Q-Sort values are
displayed with short descriptions in brackets. For example, statement number 1 (“EMM 1. I maintain exercise because
others around ask me to exercise”) with its Q-Sort value of (+3) is presented as “others around ask to exercise” (1, +3).
Factor F1: “Exercise Achievements
Factor F1 represented the majority of participants who were primarily focused on the beneficial outcomes achieved
in the fitness exercise settings. Of the 39 interviewees, 17 FC members (43.6%) contributed to the F1. These
participants highlighted that they were motivated to maintain exercise because of getting “a fit body appearance” (12,
+3), “more muscular body physique” (13, +3), and “a better-looking appearance (11, +3). They also stated being
“healthier” (7, +2) as the health-related motive for FC members.
Factor F2: “Exercise Environments
Factor F2 encompasses responses from 14 participants (35.9%), highlighting the influence of external
environments on the exercise behaviors of FC members. This includes the impact of external encouragement and
support, as well as conditions related to the FC itself. A predominant concern for these respondents centered around
the financial feasibility of exercising, with emphasis on cost affordability (6, +3). Moreover, the availability of
adequate exercise facilities at the FCs was acknowledged as a motivational factor for maintaining a regular exercise
routine (4, +3). Similarly, the highest agreement was expressed regarding the effects of external support by
surrounding people for fostering consistent exercise habits (3, +3). In addition, “others around ask to exercise” (1, +2)
and “try to have the similar body image of favorite idols” (2, +2) were noted as contributing factors to sustaining
exercise commitment.
Factor F3: “Exercise Enjoyment
Five respondents (12.8%) were allocated to factor F3, demonstrating positive joyful experiences as doing workouts
in FCs. Specifically, they confirmed that exercise sessions at the FC brought a feeling of “fun” (30, +3),
convenience (26, +3), pleasure” (25, +3), “relaxation (27, +2), “refresh” (29, +2), and “happiness (31, +2).
Contrary to these positive sentiments, this subgroup expressed disagreement with the notion of discontinuing exercise
due to “losing exercise enjoyment” (32, -2). Furthermore, they remained neutral in their response to associating
exercise with a feeling of “joy” as doing exercise (28, 0).
Factor F4: “Workout-aholic”
The responses from three participants (7.7%) aligned with factor F4, highlighting the self-cognition of FC
members about exercise passion and patience to maintain exercise, while also acknowledging the adverse
psychological impacts associated with missed workout sessions. This group confirmed being “passionate to exercise”
(33, +3), “addicted to exercise” (36, +3), “patient to exercise” (34, +2), and reluctant to give up exercise” (35, +3) as
motivators. Furthermore, participants also acknowledged negative feelings, such as “frustrated” (38, +2), “upset” (39,
+2), and “uneasy” (40, +2), and even “regretful” status (37, +2) due to missing exercise sessions, contributed to the
long-term exercise commitment.
3.3.3. Consensus and Distinguishing EMM Statements
Utilizing consensus EMM statements enables the elucidation of perspectives unanimously agreed upon by all
participants. This methodology not only unveils the participants’ interpretations of the pertinent issues but also
provides insight into the rationale behind their positions and contextualizes the central topics at hand. By proactively
engaging individuals with divergent viewpoints, this approach serves as a strategic mechanism to bridge the
significant knowledge gap in the field [34].
There were five consensus EMM statements expressed by all participants across four factors. They concurred that
EMM 14, "get weight balance" and EMM 10 "get to eat well" served as pivotal motives for sustaining exercise, with
ratings ranging from (+1) to (+2). In contrast, they disagreed with EMM 32 I will not maintain exercise if I lose
exercise enjoyment”, and EMM 22 “maintaining exercise for appearance is a goal of life” to be strong motivators,
with ratings ranging from (-1) to (-3). The neutral opinion (level 0) was given for the EMM 28I maintain exercise
because I feel joyful as doing exercise” by all respondents. On the other hand, factor 2 exhibited 15 distinguishing
statements, accounting for 38.5% of the responses, while the remaining factors (F1, F3, F4) each presented 11
statements, making up 28.2% of the responses. These EMM statements achieved statistical significance, with p-values
falling below 0.05. Figure 3 provides a visual representation of participant opinions, showcasing the numbers of both
consensus and distinguishing statements. Details of these statements are provided in Table A4.
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Figure 3. Consensus and distinguishing EMM statements for factors (F1 F4)
3.4. Discussion
This study adapted the criteria for a combined qualitative and Q-Sorting approach conducted in previous studies
[3235], allowing respondents to participate and express their ideas and perceptions actively. In the Q-sorting
interviews, actual knowledge regarding concrete EMM statements was generated from IDIs and FGDs, which were
then evaluated by the experience and knowledge of the researchers and experts. Moreover, open-ended questions were
used to triangulate the acquired data both within and between interviews. As a result, 40 statements were obtained,
encapsulating four factors that collectively defined the components of EMM. The EMM label of “exercise enjoyment”
reflected the intrinsic motivation of the SDT, defined as FC members maintaining exercise because of their interests
and enjoyment rather than other secondary benefits [23–25]. The three remaining categories of “exercise
achievements”, “exercise environments”, and “workout-aholic” represented motivational styles of identified
regulation, external regulation, and introjected regulation as extrinsic motivation [2325]. These EMM components
collectively depicted how FC members sustained their exercise practices in pursuit of diverse outcomes,
acknowledging the multifaceted impactsboth positive and negativeon exercise maintenance.
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355
Exercise Achievements
In examining the "exercise achievements" dimension of the EMM, the majority of statements predominantly
discussed the personal benefits associated with sustained physical activity within FC settings. This encompasses
advantages relevant to both overall well-being and the enhancement of physical appearance, culminating in an
improved body image. In a parallel qualitative investigation conducted by Riseth et al., physical appearance emerged
as a secondary motivational factor following health benefits as articulated by FC members [5]. These observations are
consistent with the findings from a prospective longitudinal study undertaken by Gjestvang et al., wherein 37.0% of
consistent exercisers during their initial year of FC membership cited positive health outcomes and augmented
physical fitness as primary exercise motivators [13]. Participants in the present study also expressed “the desire to get
a fit body appearance” as a motive to maintain exercise. Interestingly, a similar study delineated a preference among
FC members for articulating their motivation in terms of maintaining a fit body shape rather than a pursuit of aesthetic
appeal [51]. Furthermore, our results indicate that participants emphasized the desire for increased muscularity and
enhanced health. A pivotal factor for the continuation of exercise activities, as highlighted by participants, was the
acknowledgment of positive bodily transformations over time. Whaley et al. similarly identified that individuals
frequenting FCs, irrespective of age or gender, predominantly cited motivations such as "becoming stronger" and
"observing improvements in physical appearance" as driving factors for engagement in exercise [14]. These elements
generally constitute central motivations for individuals opting to participate in physical activities within a FC context,
corroborating findings from previous studies [5, 13, 14, 51].
The prioritization of body fitness among FC attendees is significantly influenced by social media exposure,
necessitating an examination of whether FCs should underscore these motivational factors in their advertising and
promotional activities [52]. Historically, the FC industry has predominantly marketed fitness-setting-based exercises,
emphasizing outcomes such as physical fitness, body composition, and weight loss [7, 53, 54]. However, there has
been a recent shift in FCs’ focus, with a growing trend towards promoting exercise services that enhance positive body
image and health-related outcomes, as opposed to purely aesthetic appearances [55]. This shift is partly due to
concerns that an overemphasis on appearance could potentially lead to adverse outcomes, including eating disorders
and excessive exercise [56-58]. Ensuring a balanced approach in promotional content could, therefore, contribute to
healthier motivations and outcomes among fitness-goers.
Exercise Environments
The current study also underscores the pivotal role of supportive exercise environments, emphasizing the
availability of comprehensive fitness facilities and their cost-effectiveness in motivating participants. The geographical
proximity of FCs further fosters consistent exercise habits among FC members, facilitating easy access and
contributing to a conducive and comfortable setting for physical activity. Consequently, these elements collectively
influence FC utilization for exercise purposes [5]. Furthermore, fitness environments extend beyond physical
workouts, fostering social interactions. Critical players in this domain include FC managers, PTs, and fellow
exercisers, all of whom play a significant role in externally supporting FC memberships. Empirical evidence
establishes a robust correlation between such social interactions, exercise commitment [59, 60], and physical activity
levels [61-63]. While measures such as pre-booking services and payment consensus contracts may exert pressure on
FC members, integrating personal commitments with reward-based utilization of exercise equipment has demonstrated
efficacy in altering exercise habits [60, 64]. The creation and maintenance of social interaction networks were valuable
for engagement in physical exercise [5, 60, 65]. Therefore, amplifying opportunities for social support could
potentially serve as a catalyst, fostering regular exercise practices not only among FC members but also within the
broader population.
Exercise Enjoyment
In the present investigation, participants reported that engaging in exercise sessions within fitness facilities fostered
positive affective responses, primarily associated with opportunities for relaxation and social interaction. However, it
is noteworthy that while the expression of comfort and enjoyment was prevalent, it did not unequivocally translate to a
cessation of exercise activities in the absence of enjoyment. Contrarily, existing literature delineates a significant
correlation between heightened levels of motivational factors, specifically enjoyment and challenge, and the
maintenance of regular exercise routines among facility members across a 12-month membership duration [13].
Individuals who exercised regularly assigned a greater value to the elements of enjoyment and challenge compared to
their less active counterparts [13]. Notably, frequent fitness-goers demonstrated a lower propensity to cite enjoyment
as a primary motivator for exercise engagement than individuals partaking in physical activities in alternative settings,
such as sports clubs and public venues [66].
Workout-aholic
Our study showed that participants manifested intrinsic motivation and resilience in adhering to their exercise
regimens. According to Gjestvang et al., FC-based exercise is likely to meet the current physical activity
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356
recommendation by increasing the prevalence of reaching the weekly requirement of 150 minutes of moderate-
intensity physical exercise from 37.7% at onset to 45.9% after 12 months of FC memberships [67]. While a few cases
claimed they did not use the FC as regularly as they planned, the majority of FC patrons had worked out more
frequently as being a workout-aholic. In fact, the incidence rates of exercise addiction across diverse fitness exercisers,
ranged from 3% to 9% globally [68, 69]. Excessive and compulsive exercise behaviors that may inevitably result in
emotional distress are the characteristic features of exercise addiction [68-70]. However, the present study did not
confirm negative psychological issues, such as missing exercise sessions, to be motives for participants.
Strengths and Limitations
The study was the first to explore the motivation of FC members who maintained exercise for long-term in
Vietnam. Previous studies reporting on motivation in the fitness setting have used qualitative and quantitative methods
separately, and these studies were predominantly conducted over five years ago. The novel design of this
investigation, integrating qualitative techniques with the Q-Sorting methodology, has preliminarily enriched the
empirical knowledge base concerning exercise motivation within fitness settings. A further strength of this study lies
in the direct interviews utilized to facilitate the elicitation of motivation-related insights from a heterogeneous sample
across various FCs.
Nevertheless, the study had some limitations, which require consideration. First, the study's geographical scope
was restricted to a specific southern city in Vietnam, and data collection was situated within authentic natural settings.
Second, despite the study's intention to include a substantial number of participants, the actual number of interviewees
fell short of the target, concerning the number of FC members invited to participate. Third, comparisons between
regular and irregular exercisers were not performed to determine the impact of workout commitment, although such
comparisons could have provided valuable insights [71]. Additionally, the study only focused on long-term
participants, excluding those who continued their exercise routines for other reasons. This selection criterion might
have introduced a potential bias, as those who opted not to participate could possess differing characteristics and
motivations from those who did engage in the study [26]. Gender disparity existed among the participants since the
overwhelming majority of the included participants were male. In fact, men self-reported with the higher rate of fitness
exercise participation in Vietnam [7]. This imbalance might have influenced the results, failinig to fully represent the
motivantion of female fitness center members [72]. While the study acknowledged the absence of older participants,
with potentially distinct life experiences and motivations for exercising in FCs, the alignment of the findings with
previous studies on exercise maintenance suggests that this limitation might not have significantly skewed the results
[73, 74].
4. Conclusion
This study described the four main drivers of EMM components among FC members in Vietnam. The "F1.
Exercise achievements" factor emerged as pivotal for sustaining long-term engagement in fitness-related physical
activities, underscored by a consensus on the perceived benefits for physical health and aesthetic enhancement.
Additional factors, including “F2. Exercise environments”, “F3. Exercise enjoyment”, and “F4. Workout-aholic”, were
identified as critical components of EMM. "Getting to be healthier," "a better-looking appearance," and "getting a fit
body appearance" were the top three motivating statements of study participants. Other statements related to positive
exercise emotions, exercise addiction, and FC-based supportive exercise situations emerged afterward. Five statements
that represented all four factors were in agreement. Different factors contributed various amounts of distinguishing
statements of FC members: F1, F3, F4, and F2 contributed 11 (28.2%), whereas F2 contributed 15 (38.5%). To explain
complicated perspectives of motivation, future studies with larger samples are recommended to develop and validate a
comprehensive scale to measure EMM, ensuring rigorous assessment og its psychometric properties to establish
reliability and validity.
5. Declarations
5.1. Author Contributions
Conceptualization, T.T.N., C.S., C.N.L., O.D., X.Y.H., and S.A.; methodology, T.T.N., C.S., C.N.L., O.D., S.I.,
X.Y.H., and S.A.; formal analysis, T.T.N., D.H.P., T.T.N.T., P.T.T., and T.A.A.; resources, C.S.; data curation,
T.T.N., P.T.T., T.T.N.T., and H.K.Q.; writingoriginal draft preparation, T.T.N., O.D., and C.N.L.; writingreview
and editing, T.T.N. and C.N.L.; visualization, T.T.N., T.A.A., and D.H.P.; supervision, C.S., C.N.L., O.D., S.I.,
X.Y.H., and S.A.; project administration, C.S. All authors have read and agreed to the published version of the
manuscript.
5.2. Data Availability Statement
The data presented in the study are available in Appendix I.
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Table A1. Techniques of FGDs and IDIs
Table A2. Summary of concepts, definitions and quotes of EMM
Table A3. Forty EMM statements for the Q-Sorting
Table A4. Distinguishing statements from the Q-Sorting method
5.3. Funding
This work has been funded by Walailak University Graduate Studies Research Fund (No. CGS-RF-2023/08).
5.4. Acknowledgements
The author would like to extend the heartfelt appreciation to the support by Walailak University PhD scholarships
for High Potential Candidates to Enroll in Doctoral Programs (Contract No. HP015/2021); Walailak University
Graduate Studies Research Fund; Public Health Research Program, School of Public Health, Walailak University; and
Can Tho University of Medicine and Pharmacy.
5.5. Institutional Review Board Statement
The research ethics application was submitted and approved by the Ethics Committee in Human Research of
Walailak University (WUEC-23-029-01).
5.6. Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
5.7. Declaration of Competing Interest
The authors declare that there is no conflict of interests regarding the publication of this manuscript. In addition,
the ethical issues, including plagiarism, informed consent, misconduct, data fabrication and/or falsification, double
publication and/or submission, and redundancies have been completely observed by the authors.
6. References
[1] Rhodes, R. E., Janssen, I., Bredin, S. S. D., Warburton, D. E. R., & Bauman, A. (2017). Physical activity: Health impact,
prevalence, correlates and interventions. Psychology and Health, 32(8), 942975. doi:10.1080/08870446.2017.1325486.
[2] WHO. (2018). Global action plan on physical activity 20182030: More active people for a healthier world. World Health
Organization, Genève, Switzerland. Available online: https://apps.who.int/iris/bitstream/handle/10665/272722/9789241514187-
eng.pdf (accessed on May 2023).
[3] WHO. (2009). Global Health Risks: Mortality and burden of disease attributable to selected major risks. World Health
Organization, Genève, Switzerland. Available online: https://www.who.int/publications/i/item/9789241563871 (accessed on
May 2023).
[4] Lee, I. M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., Katzmarzyk, P. T., Alkandari, J. R., Andersen, L. B., Bauman, A.
E., Brownson, R. C., Bull, F. C., Craig, C. L., Ekelund, U., Goenka, S., Guthold, R., Hallal, P. C., Haskell, W. L., Heath, G. W.,
Inoue, S., … Wells, J. C. (2012). Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of
burden of disease and life expectancy. The Lancet, 380(9838), 219229. doi:10.1016/S0140-6736(12)61031-9.
[5] Riseth, L., Nøst, T. H., Nilsen, T. I. L., & Steinsbekk, A. (2019). Long-term members’ use of fitness centers: A qualitative
study. BMC Sports Science, Medicine and Rehabilitation, 11(1), 9. doi:10.1186/s13102-019-0114-z.
[6] IHRSA (2020). The 2020 IHRSA Health Club Consumer Report. Advocating for the Health & Fitness Industry (IHRSA),
Massachusetts, United States. Available online: https://www.ihrsa.org/publications/the-2020-ihrsa-health-club-consumer-report/
(accessed on May 2023).
[7] Nguyen, M. N. (2017). Participation and interest level in going to the gym in Vietnam 2017, by gender. Sports and Recreation,
2020. Available online: https://www.statista.com/statistics/1096401/vietnam-level-of-gym-training-participation-by-gender/
(accessed on May 2023).
[8] Chen, P., Mao, L., Nassis, G. P., Harmer, P., Ainsworth, B. E., & Li, F. (2020). Coronavirus disease (COVID-19): The need to
maintain regular physical activity while taking precautions. Journal of Sport and Health Science, 9(2), 103104.
doi:10.1016/j.jshs.2020.02.001.
[9] Middelkamp, J., van Rooijen, M., Wolfhagen, P., & Steenbergen, B. (2017). The effects of a self-efficacy intervention on
exercise behavior of fitness club members in 52 weeks and long-term relationships of transtheoretical model constructs. Journal
of Sports Science and Medicine, 16(2), 163171.
Journal of Human, Earth, and Future Vol. 4, No. 3, September, 2023
358
[10] Annesi, J. J. (2003). Effects of a cognitive behavioral treatment package on exercise attendance and drop out in fitness centers.
European Journal of Sport Science, 3(2), 116. doi:10.1080/17461390300073206.
[11] Rand, M., Goyder, E., Norman, P., & Womack, R. (2020). Why do new members stop attending health and fitness venues?
The importance of developing frequent and stable attendance behaviour. Psychology of Sport and Exercise, 51, 101771.
doi:10.1016/j.psychsport.2020.101771.
[12] MacIntosh, E., & Law, B. (2015). Should I stay or should I go? Exploring the decision to join, maintain, or cancel a fitness
membership. Managing Sport and Leisure, 20(3), 191210. doi:10.1080/23750472.2015.1025093.
[13] Gjestvang, C., Abrahamsen, F., Stensrud, T., & Haakstad, L. A. H. (2020). Motives and barriers to initiation and sustained
exercise adherence in a fitness club setting-A one-year follow-up study. Scandinavian Journal of Medicine and Science in
Sports, 30(9), 17961805. doi:10.1111/sms.13736.
[14] Mullen, S. P., & Whaley, D. E. (2010). Age, gender, and fitness club membership: Factors related to initial involvement and
sustained participation. International Journal of Sport and Exercise Psychology, 8(1), 2435. doi:10.1080/1612197X.2010.9671931.
[15] Sperandei, S., Vieira, M. C., & Reis, A. C. (2016). Adherence to physical activity in an unsupervised setting: Explanatory
variables for high attrition rates among fitness center members. Journal of Science and Medicine in Sport, 19(11), 916920.
doi:10.1016/j.jsams.2015.12.522.
[16] Nam, T. T., Le, C. N., Phu, D. H., Stanikzai, M. H., Shohaimi, S., Dadras, O., Isaramalai, S. A., & Suwanbamrung, C. (2023).
Assessment of Self-Determined Motivation in Exercise: A Systematic Review and Meta-analysis. Journal of Human, Earth,
and Future, 4(2), 241256. doi:10.28991/HEF-2023-04-02-08.
[17] Cavicchiolo, E., Sibilio, M., Lucidi, F., Cozzolino, M., Chirico, A., ..., & Alivernini, F. (2022). The Psychometric Properties of
the Behavioural Regulation in Exercise Questionnaire (BREQ-3): Factorial Structure, Invariance and Validity in the Italian
Context. International Journal of Environmental Research and Public Health, 19(4), 1937. doi:10.3390/ijerph19041937.
[18] Durán-Vinagre, M. Á., Ibáñez, S. J., Feu, S., & Sánchez-Herrera, S. (2023). Analysis of the motivational processes involved in
university physical activity. Frontiers in Psychology, 13, 1080162. doi:10.3389/fpsyg.2022.1080162.
[19] Fresno-Alba, S., Leyton-Román, M., Mesquita da Silva, S., & Jiménez-Castuera, R. (2023). Predicting Quality of Life in
Women with Breast Cancer Who Engage in Physical Exercise: The Role of Psychological Variables. Healthcare (Switzerland),
11(14), 2088. doi:10.3390/healthcare11142088.
[20] Jenkins, M. (2023). The association between motivation and physical activity among forensic and rehabilitation inpatients in
Aotearoa New Zealand. The Journal of Sport and Exercise Science, 7(2), 917. doi:10.36905/jses.2023.02.02.
[21] Wininger, S. R. (2007). Self-determination theory and exercise behavior: An examination of the psychometric properties of the
exercise motivation scale. Journal of Applied Sport Psychology, 19(4), 471486. doi:10.1080/10413200701601466.
[22] Ryan, R. M., & Deci, E. L. (2000). Intrinsic and Extrinsic Motivations: Classic Definitions and New Directions. Contemporary
Educational Psychology, 25(1), 5467. doi:10.1006/ceps.1999.1020.
[23] Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development,
and well-being. American Psychologist, 55(1), 6878. doi:10.1037/0003-066X.55.1.68.
[24] Wilson, P. M., Mack, D. E., & Grattan, K. P. (2008). Understanding motivation for exercise: A self-determination theory
perspective. Canadian Psychology, 49(3), 250256. doi:10.1037/a0012762.
[25] Ng, J. Y. Y., Ntoumanis, N., Thøgersen-Ntoumani, C., Deci, E. L., Ryan, R. M., Duda, J. L., & Williams, G. C. (2012). Self-
Determination Theory Applied to Health Contexts: A Meta-Analysis. Perspectives on Psychological Science, 7(4), 325340.
doi:10.1177/1745691612447309.
[26] Teixeira, P. J., Carraça, E. V., Markland, D., Silva, M. N., & Ryan, R. M. (2012). Exercise, physical activity, and self-
determination theory: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 9, 78.
doi:10.1186/1479-5868-9-78.
[27] Matsumoto, H., & Takenaka, K. (2004). Motivational Profiles and Stages of Exercise Behavior Change. International Journal
of Sport and Health Science, 2, 8996. doi:10.5432/ijshs.2.89.
[28] Knittle, K., Nurmi, J., Crutzen, R., Hankonen, N., Beattie, M., & Dombrowski, S. U. (2018). How can interventions increase
motivation for physical activity? A systematic review and meta-analysis. Health Psychology Review, 12(3), 211230.
doi:10.1080/17437199.2018.1435299.
[29] Middelkamp, J., & Steenbergen, B. (2015). The Transtheoretical Model and Exercise Behaviour of Members in in Fitness
Clubs. Journal of Fitness Research, 4(2), 4354.
[30] CASP Checklists (2023). Critical Appraisal Checklists. CASP qualitative checklists, Oxford, United Kingdom. Available
online: https://casp-uk.net/casp-tools-checklists/ (accessed on May 2023).
Journal of Human, Earth, and Future Vol. 4, No. 3, September, 2023
359
[31] Hong, Q. N., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M. P., Griffiths, F., Nicolau, B.,
O’Cathain, A., Rousseau, M. C., Vedel, I., & Pluye, P. (2018). The Mixed Methods Appraisal Tool (MMAT) version 2018 for
information professionals and researchers. Education for Information, 34(4), 285291. doi:10.3233/EFI-180221.
[32] Catley, A., Alders, R. G., & Wood, J. L. N. (2012). Participatory epidemiology: Approaches, methods, experiences. Veterinary
Journal, 191(2), 151160. doi:10.1016/j.tvjl.2011.03.010.
[33] Truong, D. B., Doan, H. P., Tran, V. K. D., Nguyen, V. C., Bach, T. K., Rueanghiran, C., Binot, A., Goutard, F. L., Thwaites,
G., Carrique-Mas, J., & Rushton, J. (2019). Assessment of drivers of antimicrobial usage in poultry farms in the Mekong Delta
of Vietnam: A combined participatory epidemiology and Q-sorting approach. Frontiers in Veterinary Science, 6(MAR), 84.
doi:10.3389/fvets.2019.00084.
[34] Rahma, A., Mardiatno, D., & Rahmawati Hizbaron, D. (2020). Q methodology to determine distinguishing and consensus
factors (a case study of university students’ ecoliteracy on disaster risk reduction). E3S Web of Conferences, 200.
doi:10.1051/e3sconf/202020001003.
[35] Karafil, A. Y. (2023). Examination of the Factors That Encourage University Students to Sports Betting. A Q-Method Study.
Journal of Gambling Studies, 1-13. doi:10.1007/s10899-023-10192-4.
[36] Zarotis, G., Athanailidis, I., Arvanitidou, V., & Mourtzios, C. (2017). Age-specific reasons for dropping out of the fitness-
sport. Journal of Physical Education and Sport, 17(2), 916924. doi:10.7752/jpes.2017.02140.
[37] Stannard, D. (2012). Essentials of Nursing Research: Appraising Evidence for Nursing Practice. AORN Journal (9th ed.),
95(2), 1-2. doi:10.1016/j.aorn.2011.10.009.
[38] Brand, R., & Cheval, B. (2019). Theories to explain exercise motivation and physical inactivity: Ways of expanding our
current theoretical perspective. Frontiers in Psychology, 10(May), 1-4. doi:10.3389/fpsyg.2019.01147.
[39] Simister, N. (2019). Complex M&E Systems: Raising standards, lowering the bar. Praxis Series Paper No.6. Oxford, United
Kingdom.
[40] Hall, T. G. K., & Lubman, D. I. (2012). Motivational Interviewing Techniques. Peripheral Brain for the Pharmacist, 41, 660
667. Available online: https://www.racgp.org.au/afp/2012/september/motivational-interviewing-techniques (accessed on May
2023).
[41] Mears, J., & Kilpatrick, M. (2008). Motivation for exercise: Applying theory to make a difference in adoption and adherence.
ACSM’s Health and Fitness Journal, 12(1), 20–26. doi:10.1249/01.FIT.0000298460.30006.00.
[42] USAID. (1996). Conducting Focus Group Interviews: Performance Monitoring and Evaluation Tips, 10. Available online:
https://pdf.usaid.gov/pdf_docs/pnadw110.pdf (accessed on May 2023).
[43] Hennink, M. M. (2017). Cross-cultural focus group discussions. A New Era in Focus Group Research: Challenges, Innovation
and Practice, 59-82. doi:10.1057/978-1-137-58614-8_4.
[44] Luo, A. (2023). Content Analysis | Guide, Methods & Examples. Scribbr, Amsterdam, The Netherlands Available online:
https://www.scribbr.com/methodology/content-analysis/ (accessed on May 2023).
[45] Stahl, N., & King, J. (2020). Expanding Approaches for Research: Understanding and Using Trustworthiness in Qualitative
Research. In Journal of Developmental Education, 44(1), 2628.
[46] Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and
measures to achieve trustworthiness. Nurse Education Today, 24(2), 105112. doi:10.1016/j.nedt.2003.10.001.
[47] Senapati, R., Prusty, A., & Padhy, C. (2020). An Overview of Q Methodology: Process, Application and Challenges. Indian
Journal of Natural Sciences, 10(60), 24772-24778.
[48] Yusoff, M. S. B. (2019). ABC of Response Process Validation and Face Validity Index Calculation. Education in Medicine
Journal, 11(3), 5561. doi:10.21315/eimj2019.11.3.6.
[49] Yusoff, M. S. B. (2019). ABC of Content Validation and Content Validity Index Calculation. Education in Medicine Journal,
11(2), 4954. doi:10.21315/eimj2019.11.2.6.
[50] Banasick, S. (2019). KADE: A desktop application for Q methodology. Journal of Open Source Software, 4(36), 1360.
doi:10.21105/joss.01360.
[51] Jakobsen, A. M., & Evjen, E. (2018). Gender differences in motives for participation in sports and exercise among Norwegian
adolescents. Baltic Journal of Health and Physical Activity, 10(2), 92101. doi:10.29359/bjhpa.10.2.10.
[52] Schlegel, P., & Fialová, L. (2015). Body Image and Sensation Seeking In Gym-Goers. Proceedings of the Faculty of Physics
Education of the Comenius University, 55(1), 5463. doi:10.1515/afepuc-2015-0007.
Journal of Human, Earth, and Future Vol. 4, No. 3, September, 2023
360
[53] Gjestvang, C., Stensrud, T., & Haakstad, L. A. H. (2019). Are changes in physical fitness, body composition and weight
associated with exercise attendance and dropout among fitness club members? Longitudinal prospective study. BMJ Open,
9(4), 27987. doi:10.1136/bmjopen-2018-027987.
[54] Vu, M. T., & Pham, T. T. T. (2023). Still in the shadow of Confucianism? Gender bias in contemporary English textbooks in
Vietnam. Pedagogy, Culture & Society, 31(3), 477-497. doi:10.1080/14681366.2021.1924239.
[55] Andreasson, J., & Johansson, T. (2018). Glocalised fitness: the franchising of a physical movement, fitness professionalism
and gender. Leisure/ Loisir, 42(3), 301321. doi:10.1080/14927713.2018.1535910.
[56] Lichtenstein, M. B., Griffiths, M. D., Hemmingsen, S. D., & Støving, R. K. (2018). Exercise addiction in adolescents and
emerging adults - Validation of a youth version of the Exercise Addiction Inventory. Journal of Behavioral Addictions, 7(1),
117125. doi:10.1556/2006.7.2018.01.
[57] Eriksson, L., Baigi, A., Marklund, B., & Lindgren, E. C. (2008). Social physique anxiety and sociocultural attitudes toward
appearance impact on orthorexia test in fitness participants. Scandinavian Journal of Medicine and Science in Sports, 18(3),
389394. doi:10.1111/j.1600-0838.2007.00723.x.
[58] Bratland-Sanda, S., & Sundgot-Borgen, J. (2015). I’m concerned - What Do I Do?” recognition and management of
disordered eating in fitness center settings. International Journal of Eating Disorders 48(4), 415423. doi:10.1002/eat.22297.
[59] Mendonça, G., Cheng, L. A., Mélo, E. N., & De Farias Júnior, J. C. (2014). Physical activity and social support in adolescents:
A systematic review. Health Education Research, 29(5), 822839. doi:10.1093/her/cyu017.
[60] Riseth, L., Ivar Lund Nilsen, T., Mittet, Ø., & Steinsbekk, A. (2021). The effect of initial support on fitness center use in new
fitness center members. A randomized controlled trial. Preventive Medicine Reports, 24(24), 7. doi:10.1016/j.pmedr.2021.101605.
[61] Humpel, N., Owen, N., & Leslie, E. (2002). Environmental factors associated with adults’ participation in physical activity. A
review. American Journal of Preventive Medicine, 22(3), 188199. doi:10.1016/S0749-3797(01)00426-3.
[62] Powell, L. M., Chaloupka, F. J., Slater, S. J., Johnston, L. D., & O’Malley, P. M. (2007). The Availability of Local-Area
Commercial Physical Activity-Related Facilities and Physical Activity among Adolescents. American Journal of Preventive
Medicine, 33(4), 292300. doi:10.1016/j.amepre.2007.07.002.
[63] Eriksson, U., Arvidsson, D., & Sundquist, K. (2012). Availability of exercise facilities and physical activity in 2,037 adults:
Cross-sectional results from the Swedish neighborhood and physical activity (SNAP) study. BMC Public Health, 12(1), 607.
doi:10.1186/1471-2458-12-607.
[64] Rogers, T., Milkman, K. L., & Volpp, K. G. (2014). Commitment devices: Using initiatives to change behavior. JAMA,
311(20), 20652066. doi:10.1001/jama.2014.3485.
[65] Allender, S., Cowburn, G., & Foster, C. (2006). Understanding participation in sport and physical activity among children and
adults: A review of qualitative studies. Health Education Research, 21(6), 826835. doi:10.1093/her/cyl063.
[66] Deelen, I., Ettema, D., & Kamphuis, C. B. M. (2018). Sports participation in sport clubs, gyms or public spaces: How users of
different sports settings differ in their motivations, goals, and sports frequency. PLoS ONE, 13(10), 205198.
doi:10.1371/journal.pone.0205198.
[67] Gjestvang, C., Stensrud, T., Hansen, B. H., Kolle, E., & Haakstad, L. A. H. (2020). Are fitness club members likely to meet
the current physical activity recommendations? Translational Sports Medicine, 3(2), 7583. doi:10.1002/tsm2.120.
[68] Lindwall, M., & Palmeira, A. (2009). Factorial validity and invariance testing of the exercise dependence scale-revised in
Swedish and Portuguese exercisers. Measurement in Physical Education and Exercise Science, 13(3), 166179.
doi:10.1080/10913670903050313.
[69] Griffiths, M. D., Szabo, A., & Terry, A. (2005). The exercise addiction inventory: a quick and easy screening tool for health
practitioners. British Journal of Sports Medicine, 39(6), 30. doi:10.1136/bjsm.2004.017020.
[70] Adams, J. (2009). Understanding exercise dependence. Journal of Contemporary Psychotherapy, 39(4), 231240.
doi:10.1007/s10879-009-9117-5.
[71] Karoly, P., Ruehlman, L. S., Okun, M. A., Lutz, R. S., Newton, C., & Fairholme, C. (2005). Perceived self-regulation of
exercise goals and interfering goals among regular and irregular exercisers: A life space analysis. Psychology of Sport and
Exercise, 6(4), 427442. doi:10.1016/j.psychsport.2004.03.004.
[72] Elijah, G. R., & Eric, D. K. N. (2012). Motivational gender differences in sport and exercise participation among university
sport science students. Journal of Physical Education and Sport, 12(2), 180187.
[73] Stehr, P., Luetke Lanfer, H., & Rossmann, C. (2021). Beliefs and motivation regarding physical activity among older adults in
Germany: results of a qualitative study. International Journal of Qualitative Studies on Health and Well-being, 16(1), 1932025.
doi:10.1080/17482631.2021.1932025.
[74] Schutzer, K. A., & Graves, B. S. (2004). Barriers and motivations to exercise in older adults. Preventive Medicine, 39(5),
10561061. doi:10.1016/j.ypmed.2004.04.003.
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Appendix I
Table A1. Technique of Focus Group Discussions and In-Depth Interviews
Steps
Focus group discussions
In-depth interviews
Preparation
The moderator, a member of the research team, leads the
investigation. The secretary, also part of the team, is responsible for
documenting the session's minutes and has a comprehensive
understanding of the content, culture, and knowledge pertinent to
the research topics. Groups consisting of 8 to 10 FC members or
personal trainers are selected to participate in discussions, which
last between 60 and 90 minutes and take place at a convenient
location. The discussions follow a Focus Group Discussion (FGD)
manual and are recorded using a voice recorder or mobile phone.
Additional materials provided include batteries, colored pens,
poster papers, an FGD manual, and a fieldwork diary.
The interviewer is a member of the research team, conducting
investigations. Participants in the interview may be a FC member,
owner, manager, or personal trainer, all of whom have scheduled a
60-minute interview session at a location that is convenient for
them. The interviews are conducted following an in-depth
interview manual (IDI) and are recorded using a voice recorder or
mobile phone. Additional materials used during the interview
include batteries, pens, papers, and a hard copy of the in-depth
interview manual.
Introduction
The moderator begins by presenting a brief three-minute overview,
outlining the objectives of the study and the focus group discussion
(FGD) session's purpose. Following this, the moderator requests
permission to use a voice recorder during the session and opens the
floor to any questions or concerns from the participants.
Additionally, the process of obtaining informed consent is
conducted at this stage.
The interviewer begins by outlining the purposes and objectives of
the study, as well as explaining the in-depth interview (IDI)
process. They then request the participant's permission to use a
voice recorder during the session and encourage them to ask any
questions or voice any concerns they may have. Additionally, the
interviewer ensures that the step of obtaining informed consent
from the participant is completed.
Implementation
The moderator uses a topic guide for FGD involving FC members
and personal trainers, aiming to stimulate conversation and
encourage participants to share their thoughts. During the session,
all participants are actively encouraged to answer questions
positively and engage in meaningful interactions with one another.
Moderators summarize and synthesize opinions in accordance with
the objectives of the discussion topic. Some essential skills need to
be applied such as listening skills, giving feedback, and asking
questions. To visually aid the discussion, the moderator writes
down the most important points for everyone to review.
Meanwhile, a designated secretary diligently records the
proceedings in a fieldwork diary, capturing the nuances of the
conversation. Using a ten-seed technique, which has been found to
increase participation and build group consensus, participants are
given the opportunity to identify intrinsic and extrinsic motivation
and influencing factors for exercise motivation as the session
comes to a close.
The interviewer uses the question guide for IDIs with members and
FC personal trainers and FC owners or managers. During the
meeting, the participant is encouraged to respond questions
positively. The interviewer summarizes and synthesizes opinions in
accordance with objectives of the topic observing and taking field
notes that could be applied to inform the analysis while an audio
device records the interview. Some essential skills need to be
applied such as listening skills, giving feedback, and asking
questions. General questions include “What’s else”, “Can you tell
me about your experience of…”, “You mentioned […], can we talk
more about that?”, “What was your view on that”, “How did you
feel”. Going deeper questions consist of “Could you please give me
an example?”, “Can you be more specific?”, “In what way?”, “Why
do you say that?”, and “Can you tell me more about that?”.
Back up
The secretary emphasizes key information in the minutes of the
session. The moderator concludes the meeting, expressing gratitude
to the participants for their time and involvement. Once travel
expenses have been disbursed to the participants, and their contact
addresses noted if required, the session is officially adjourned.
The interviewer concludes the session, expressing gratitude to the
participant for their time and contribution. Following this, the
meeting is deemed complete once a travel reimbursement is issued
to the participant, and their contact address is recorded, if required.
ResearchGate has not been able to resolve any citations for this publication.
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