+Unit 3: Physical activity participationand physiological performance

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Area of Study 1– Monitoring and Promotion of Physical Activity

Changing Physical Activity Behaviour

+Physical Activity Behaviour Change

• Mediators – intervening variable that is necessary to complete a cause and effect link between an intervention strategy and physical activity.

• Determinants – casual factors (i.e. personal, environmental or characteristics of exercise) that can affect physical activity behaviour.

• Self-efficacy - deals with the strength of belief an individual has in his or her capacity to successfully perform an activity. It forms the basis of motivation,

well being and personal achievement. Unless people believe that their actions will produce desired

outcomes, there is little motivation to become involved and persevere with activities.

+Physical Activity Promotion

• Effective physical activity interventions target changes at the following levels:-

• individual• social• physical environment• policy

• Strategies to Promote Physical Activity

Individual Level Population Level

Print and web based material

Environmental change

Counselling Policy

Process of change Mass media

+Physical Activity Behavioural Change

Cognitive Strategies Behavioural Strategies

Increasing knowledge Substituting alternatives

Awareness of risks Enlisting social support

Concern about impact to others

Rewarding yourself

Understanding benefits Committing yourself

Awareness of opportunities to be active

Reminding yourself

+Print and Web-based Media

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+Counseling

• Counseling strategies:-

• assessing motivational readiness

• matching process of change with motivational readiness

• contracting

• enlisting social support

• reminder systems

• gradual programming

• tailoring

+Socio-ecological Model

• The socio-ecological model recognises the interwoven relationship that exists between the individual and their environment. While individuals are responsible for instituting and maintaining the lifestyle changes necessary to improve health, individual behaviour is determined to a large extent by social environment, e.g. community norms and values, regulations and policies.

• In order to increase physical activity levels health promotion efforts need to focus not only on the behaviour choices of each individual, but also on factors that influence those choices. These factors operate our of several spheres of influence including:-

• the individual• social environment• physical environment • policy components

+Socio - ecological Model

Policy

Environmental

Social

Motivating change in individual behavior by increasing knowledge, or influencing atti-tudes or challenging beliefs.

Individual

Developing and enforcing state and local policies that can increase beneficial health behaviors. Developing media campaigns that promote public awareness of the health need and advocacy for change.

Recognizing that groups provide social identity and support, interpersonal interventions target groups, such as family members or peers.

Changing the physical environment or the environment of an organization (e.g. workplace, school, or another type of community organization) to support behavior change.

+Socio-ecological Model Changing Physical Behaviours

Barriers to healthy behaviors are shared among the community as a whole. As these barriers are lowered or removed, behavior change becomes more achievable and sustainable. It becomes easier to "push the ball up the hill. "The most effective approach leading to healthy behaviors is a combination of the efforts at all levels--individual, interpersonal, organizational, community, and public policy.

• Individuals• Eat reasonable food and beverage portion sizes

at home and when eating out. Eat 5 to 9 fruits and vegetables each day, or more

• Walk or bicycle more often

• Be a better driver

+• Parents

• Serve as good role models by practicing healthy eating

habits and by being  physical active every day.

• Make sure tasty, attractive fruits and vegetables are available for

meals and snacks at home and when eating out.

• Set limits on television viewing.

• Limit access to sugar-sweetened drinks.

• Work with your children’s schools to develop policies regarding: vending machines, use of foods as rewards in classrooms, adequate lunch and recess time, daily PE, safe walking and bicycling routes to school.

• Organize Walk to School Day events in your children’s schools.

+• Employers

• Offer walk/bike/transit incentives like bicycle parking

and transit passes.

• Provide exercise and changing facilities at work.

• Post signs near elevators encouraging people to take the stairs.

• Make the stairway a safe and inviting place.

• Support community-wide events that promote physical activity.

• Set standards for foods served at cafeterias, in vending machines, and at meetings.

• Use price incentives in the cafeteria and in vending machines to increase consumption of healthy foods.

+• Community Member

• Participate in neighborhood, community, and transportation planning groups.

• Support funding for sidewalks, bicycle paths, parks, recreation centers, and swimming pools.

• Declare and organize an annual National “No-TV” Week.

• Join or start a walking or bicycling group in your neighborhood.

• Support policies to promote healthy eating such as disclosing the calorie content of restaurant food and requiring calorie labeling on menus and  menu boards at chain restaurants.

• Join advocacy groups promoting community design supportive of safe and accessible walking and bicycling.

• Let your community leaders and elected officials know that you support healthy, active communities.

+• Architects, Community and Transportation Planners

• Design buildings where stairs are visible, accessible and safe.

• Adjacent to buildings, provide sidewalks, convenient bicycle parking and safe connectivity to public transit.

• Consider public transit, sidewalks, bicycle lanes, and bicycle paths for walking and bicycling to be as essential as streets and roads for vehicles.

• Design frequent and safe street crossings.

• Design neighborhoods and communities where children and adults can easily and safely travel between home, work, school, retail establishments, parks and recreation facilities on foot and

bicycle.

+• Community Leaders and Policy Makers

• Consider health consequences along with financial impact when developing school policies such as offering daily PE,  promoting walking and bicycling to school, or district support

for school meal programs.

• Prioritize funding for increasing and improving pedestrian and bicycle facilities in communities.

• Consider public health impacts in land-use planning decisions such as siting of schools, development of mixed-use neighborhoods.

• Consider zoning regulations.

• Assure access to full-service grocery stores in all neighborhoods and limit density of fast food restaurants.

• Prioritize funding for effective public health interventions to increase physical activity, promote healthy eating, and reduce obesity and chronic diseases.

+Top 10 Causes of Death Worldwide

Based on data from World Health Organisation

Fact Sheet No 310: 2008World Deaths in Millions % of DeathsCoronary heart disease 7.2 12.2

Stroke and other cerebrovascular diseases

5.71 9.7

Lower respiratory infections

4.18 7.1

Chronic obstructive pulmonary disease

3.02 5.1

Diarrhoeal diseases 2.16 3.7

HIV/AIDS 2.04 3.5

Tuberculosis 1.46 2.5

Trachea, bronchus, lung cancers

1.32 2.3

Road traffic accidents 1.27 2.2

Prematurity and low birth weight

1.18 2.0

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WHO Library Cataloguing-in-Publication DataGlobal health risks: mortality and burden of disease attributable to selected major risks. 2009

+Lifestyle Diseases

+Physical Activity Measurement

Physical activity measurement has several important uses, in informing the overall health promotion effort and is used in:

• research, to understand the relationship between physical activity and a range of physical health and mental health outcomes.

• the monitoring and surveillance of physical activity levels in and among populations.

• understanding the correlates and determinants of physical activity, and to explain why some people or groups are more active than others.

• measuring the impact and effectiveness of health promotion programmes and interventions designed to increase physical

activity.

• providing a sound and strong evidence base for broader initiatives in health promotion policy and practice.

+Measurable Components of Physical Activity

Physical activity is a set of complex physical behaviours, with possible measurements made of its duration, frequency, intensity or setting.

• How often activity is undertaken: measures of frequency

• Duration of physical activity per session: expressed as total time per day

• Intensity of activity: activities may be classified as light, moderate or vigorous based on their assigned energy expenditure values (‘MET’ values or Multiples of Basal Resting Energy)

• Type: specific physical activity or sport performed

• Domains or settings where the physical activity is performed: leisure time (organised – non organised), occupational, domestic, active commuting, incidental and sedentary.

+Metabolic Equivalent (METS)

Intensity Classificatio

n

METS Energy Expended

(kJ/min

% Max HR Examples of Activities

Low Intensity <3 <15 <50 Walking slowly, golf, gardening, household chores, sitting

Moderate Intensity

3-6 15-30 50-70 Surfing, performing massage, social badminton

Vigorous intensity

7+ 30+ 70+ Australian rules football, shovelling ditches, squash

+National Activity Guidelines

0 – 5 Years

• 0 – 1 floor based play should be encouraged

• 1 – 3 – should be physically active for at least three hours each day

• 2 – 5 – sitting using electronic media should be limited to less than one hour per day

+National Activity Guidelines

5 – 12 Years

• At least 60 minutes (and up to several hours) of moderate to vigorous intensity activity should be completed every day

• no more than 2 hours per day should be spent using electronic media for entertainment

+National Activity Guidelines

12 – 18 Years

• At least 60 minutes (and up to several hours) of moderate to vigorous intensity activity should be completed every day

• no more than 2 hours per day should be spent using electronic media for entertainment

+National Activity Guidelines

Adults 18 - 65

• Think of movement as an opportunity, not an inconvenience

• Be active in as many ways as possible

• Put together at least 30 mins of moderate intensity activity on most, preferably all, days

• If possible enjoy some regular vigorous activity

+National Activity Guidelines

Older Adults 65+

• Continue to be active no matter what your age

• Be active every day in as many ways as possible

• Accumulate at least 30 mins of moderate intensity activity on most, preferably all, days

• If commencing exercise for the first time begin gradually

• If maintained activity levels continue to exercise at a safe level which you are capable of maintaining

+Measuring Physical Activity

Accurate assessment of physical activity is influenced by “behavioural reactivity” – in which the use of measurement tools can change physical activity behaviours. • Objective methods of data collection do not need the participant to process information and exists independently of what the participant thinks. Objective measures include:-

- Direct observation- Pedometers- Accelerometers- Heart rate monitors

• Subjective measures of data collection require some level of cognitive or perceptual processing by the participant to create the data. These measures require participants to think about, and record, information about their physical activity levels.

Subjective measure include:-• Self Report include assessment methods such as

interviews, diaries, logs and questionnaires and rely on people to estimate or recall their own activity level

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