Unit 1 Flashcards
(229 cards)
1
Q
Physical activity
A
All bodily movement that cause increases in physical exertion beyond that which occurs during normal activities of daily living
2
Q
Exercise
A
A form of leisure physical activity that is undertaken in order to achieve a particular objective, such as improved appearance, improved cardiovascular fitness or reduced stress
3
Q
Exercise is more of a subcategory of physical activity, not related to ___
A
Work
4
Q
Psychology
A
A field of study concerned with various mental processes people experience and use in all aspects of their lives
5
Q
Exercise Science
A
The study of all aspects of sport, recreation, exercise / fitness and rehabilitative behaviour
6
Q
What is exercise psychology and why study it?
A
The application of psychological principles to the promotion and maintenance of leisure physical activity. The psychological and emotional consequences of regular, leisure physical activity
Why study exercise psychology?
- to understand the psychological antecedent of exercise behaviour
- to understand the psychological consequences of exercise
7
Q
Rehabilitation Psychology
A
Relationship between psychological factors are the physical rehabilitation process (motives of involvement). Also involved as a complementary strategy for treating diseases. Returning the individual to a healthy physical and / or mental state
Questions to ask …
1 - what psychological issues facilitate or hinder the injury rehabilitation process?
2 - what forms and amount of exercise provide psychological benefits for cancer, AIDS, spinal cord injury or cardiac rehabilitation patients?
3 - can exercise improve quality of life for those individuals dealing with injury, disease or illness
8
Q
Health Psychology
A
Psychological processes related to health and health care (nutrition, smoking cessation, medication adherence)
9
Q
Behavioural Psychology
A
Interrelationships of behavioural, physical and psychological factors in treatment of disease and disability (ex. investigating the biological and mental factors associated with stress) (ex. emotional, social and biological implications of exercise for pregnant women)
10
Q
Sport Psychology
A
Focuses on the psychological antecedents and consequences of sport performance (self-confidence, anxiety and attentional focus and their bi-directional relationships with sport performance)
11
Q
What is adoption vs. adherence?
A
Adoption is the beginning stage of an exercise regimen (starting out) while adherence is maintaining an exercise regimen for a prolonged period of time following the initial adoption phase
12
Q
What is non-compliance?
A
Talked about when exercise is actually prescribed, medical professional, someone not going along with exercise prescription
13
Q
Psychological consequences of exercise …
A
Reduce acute and chronic negative and promote positive psychological / emotional states and to reduce stress and anxiety
14
Q
Common benefits of physical activity
A
Lowers morality and morbidity rates, reduces risk of many diseases (diabetes, hypertension, heart disease, certain cancers), enhances positive general mood, improves body image, self-esteem and self concept, maintain healthy weight, enhances ability to perform tasks of daily living (improved reaction time, cognitive function and ability to process information)
15
Q
Reasons to exercise …
A
Enhanced physical appearance, improved physiological and psychological health, improved social relations
16
Q
Common said barriers to physical activity
A
Perceived barriers - things people believe are insurmountable obstacles to exercise - the perception of lack of time and boredom / lack or enjoyment
Genuine barriers - convenience / availability (transportation, equipment, facilities), environment / ecological factors (weather, climate, safety) and physical limitations (injuries, disease, fatigue)
17
Q
Barriers to exercise are common excuses, helping people adopt a healthier lifestyle and adhere to it, you want to …
A
Alter people’s perception on exercise and physical activity
18
Q
Females tend to exercise __ than men
A
Less
19
Q
Older individuals tend to exercise __ than younger populations
A
Less
20
Q
Why are there so few studies of non-exercisers?
A
Can be difficult to find non-exercisers who want to participate in studies
Negative outlook on exercise
Harder to find them, exercisers can be found in the gym or sports clinic, etc..
Can be awkward with non-exercisers to talk about why they don’t exercise (may feel guilty, negative experience)
21
Q
Why use focus groups in studies?
A
Focus groups are small groups formed a common characteristic or interest (ex. age), the interaction can help the conversation flow and allows the participants to bounce ideas off each other
22
Q
Study of female non-exercisers and their opinion on exercise details
A
40 women aged 25-75 years, divided into focus groups by age, non-exerciser was someone who engaged in exercise 1 time a week or less in the past 6-months to a year
23
Q
Study: how often do non-exercisers think about exercising (different age groups)
A
25-35 and 45-55 years - everyday, multiple times a day
65-75 years - don’t actively think about it
24
Q
Study: what non-exercisers think about exercise
A
Time consuming, boring, not enjoyable, can be lonely, can see themselves working hard but not enjoying it, associates exercise with “work” and thought of it as a “chore”
25
Study: thoughts from non-exercisers on the benefits of not exercising
25-35 age group - they like that they don't have to be around fit people and constantly compare themselves to them, less stress
45-55 age group - spending more time with family, not wanting to make an effort into fitting it into their day
26
Emergence of exercise psychology - philosophy of physical fitness
Since late 1700s (industrial revolution)
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Fitness craze begins ..
1970s to 1980s, advocating for greater physical fitness really took off in Hollywood in particular, introduction of fitness videos. Focuses on aerobics, weight training, jogging and racket sports
28
Increased emphasis on what in the 70s to 90s
Emphasis on physical appearance - females getting smaller and men getting more muscular. Majority of emphasis came through the media, set standards and norms implemented
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How was the emphasis of exercise changed in the last 30 years or so?
Used to be more of an emphasis on appearance of the body but now it is beginning to have a bit more focus on using exercise to reduce stress and improve one's health. Greater emphasis on taking charge of one's own health and trying to avoid medical assistance as much as possible. Used to have medical model which indicating a focus on medicine and health care professionals being in charge of everyone's bodily health, but recently people have been recognizing their own value in keeping themselves healthy
Development of the biopsychosocial approach to behaviour - the belief that the body, mind and social environment influence one another, and ultimately, behaviour
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Case study A - someone with commitments with work, family and are generally fatigued, not enough time to exercise (how do you get them moving?)
Changing negative perspective of exercise, most people know about the benefits of exercise already, find something they enjoy doing, find a way to adopt a more healthy lifestyle to fit it into their day (to minimize extra time requirement)
Ensure they know the value of exercise in reducing stress and fatigue in someone's life
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Case study B - injury, physical rehabilitation, pain, fear of returning to action
Allow the patient to speak with others who have experienced similar injuries and who have successfully rehabilitated may help to alleviate some anxiety and increase confidence
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Case study C - self-consciousness, low self-esteem, negative attitudes toward exercise
Suggest getting involved in an exercise program that is geared towards people who are overweight so that she has social support and may help to reduce her concern with others looking at her body in a negative fashion
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What is an epidemic?
Anything that affects a large number of people, study of patterns of disease, risk factors and causes
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What is epidemiology?
Study of epidemics, dealing with the incidence, distribution and control of a disease in a population
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Epidemic of Physical Inactivity
Physical inactivity and poor diet - responsible for at least 16% of deaths each year. Contributes to cardiovascular disease, type II diabetes and some cancers. Reduced occupational physical activity, not involved in lifestyle. Increased stress of lifestyle
36
BMI of obesity
BMI over 30, pounds overweight for individuals 5'4
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Healthy people 2020
U.S Department of Health and Human Services task force builds upon Healthy People 2020 to create specific objectives for the U.S physical activity by 2020
Goal is to improve health, fitness and quality of life of the U.S population through daily physical activity
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Measurements of physical activity behaviour
self report / survey (questionnaire, interview, daily activity logs) (Godin Leisure Time Exercise - recall exercise of las week or typical week)
objective / technological devices (heart rate monitor, pedometer, accelerometer, GPS)
observation (direct or indirect, class attendance)
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Epidemiology of physical in(activity) - the 5 W's
WHO - to what extent are individuals within a particular society physically active
WHERE - where are people most likely to engage in physical activity
WHEN - what variations exist in physical activity patterns across groups of individuals
WHY - why are certain individuals physically active while others are not
WHAT - in what are physical activities are people most engaged in
40
Canadian physical activity guidelines for children aged 5-11 and youth 12-17
At least 60 minutes of moderate to vigorous intensity, vigorous at least 3 times per week, muscle and bone strengthening at least 3 days per week
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Canadian physical activity guidelines for adults 18-64 years
At least 150 minutes of moderate to vigorous intensity of aerobic physical activity in bouts of 10 minutes or more, benefits of muscle and bone strengthening at least 2 days per week
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Canadian physical activity guidelines for older adults of 65 years plus
At least 150 minutes of moderate to vigorous intensity of aerobic physical activity in bouts of 10 minutes or more, benefits of muscle bone strengthening at least 2 days per week, if poor mobility, they should perform activities to enhance balance and prevent falls
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Countries studies for physical activity around the world ...
Australia, Canada, England, Scotland, U.S
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Demographics studied for physical activity ...
Age, gender, ethnicity, socioeconomic status and educational level
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Sedentary lifestyle across the globe
In general, 50-70% of adults in countries studied do not meet recommendations
Australia (15%)
United States (40%)
Brazil (87%)
Canada (increase from 40% in 1997 to 49% in 2005)
46
Increased age means ..
Decreased physical activity
47
In Australia, sedentary rates ___ from 18-29 years to 60-70 years
Triples from 6.3% to 18%
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In Canada, children 1-4 years spend approximately ___ per week being physically active, while teenagers 13-17 years spend ___ the time
28 hours per week, teens half the time
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Relationship between childhood and adult physical activity levels
No relationship between the two activity level
50
Relationship between age and no activity in Canada
Relatively linear increase between age no activity
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English adults 75+ years engagement in medium and high levels of PA
More than 20% engagement
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Gender and physical activity
Men have historically been more physically active then women
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Men and PA in Canada
54% men, 48% moderately active (at least 30 minutes of moderate to vigorous physical activity daily)
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Men vs. women with type of PA
Men are more likely to engage in vigorous activities, while women engage in more moderate intense activity
55
Ethnicity and PA
Whites tends to be more physically active engaging in more moderate vigorous PA than other ethnic groups. Both whites and blacks engage in more vigorous physical activity than Asians
56
Percentages of ethnicities and TV watching in the U.S
Fewer white high school students (26%) watch TV for more than two hours compared to Hispanic (38%) and African Americans (54%) students
57
Income and PA relationship
Relatively direct and linear relationship but not consistent across countries and varies by other factors such as gender. Relationship holds best for Canadian and Brazilian adults
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Education and PA relationship
For most countries including Canada, moderate to vigorous physical activity levels increase with higher education levels. Sedentary rates decline sharply with increased education levels
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If parents education is less than a high school education ..
50% teens engage in vigorous PA
60
If parents education is high school graduate ..
54% teens engage in vigorous PA
61
If parents education is some college...
68% teens engage in vigorous PA
62
PA participation patterns
Worldwide PA levels are extremely low, time engaged in PA declines with age. Men are more likely to engage in vigorous exercise, but women tend to engage in as much, if not more, moderate activity. Low income groups and ethnic minorities tend to participate in less physical activity than the general population. Higher education = more PA
63
Consequences of PA and Inactivity
Physically active people have lower overall all-cause mortality rates than sedentary people. Midlife increases in PA is associated with reduced risk of mortality
64
Morbidity (disease) in U.S percentages
6% of Americans have CHD (coronary heart disease)
Over a million have a heart attack each year
12% have adult-onset diabetes (type II)
32% have high blood pressure
70% are overweight or obese
65
How do we investigate the relationship between PA and morbidity / mortality rates?
Surveys will have association but it is hard to see a cause and effect. Best way - longitudinal studies which are large scale studies that examine the behaviour of a specific group of people over a long period of time. There are few longitudinal studies because of the cost and it is hard to conduct
66
Most data presented is ..
Cross-sectional that we find through questionnaires
67
San Francisco Longshoremen Study
Participants were thousands of long shore workers, 22 year follow up period, measures - work activity, CHD records, mortality data
Findings - mean who expended 8,500 kcal / week on the job had lower risk of death from coronary heart disease at any age. Age wasn't a factor here, if more active, less likely to die from a heart attack
68
Harvard Alumni Study
17,000 Harvard alumni involved in the study, 16-year follow up period (1962-1978), measures - self-reported leisure time physical activity, CHD records, mortality data
Findings - men had a 53% reduction in all-cause mortality when participating at least 3 hours / week of leisure-time activity, on average, active individuals lived 2 years longer than inactive individuals
69
True or false - people with a disability or chronic disease are insufficiently healthy to participate in exercise and do not reap benefits from exercise?
False
70
PA and people with disability
They tend to be less active then the normal population. People with a disability or chronic disease are far less active than general population and are at increased risk for secondary physical and psychological health problems
71
Stat about PA of people with disability vs. general population
23% of people with disabilities are PA 20 min / day, 2 days / week vs 33% of the general population
72
Amount of people in the U.S population with at least 1 chronic disease or disability
45%
73
Major barrier for people with disability and PA
Access to programs is a major barrier to PA for people with a disability, difficult going into a regular fitness center. May need special equipment, different workout (need a program that will fit their disability), different facility. We need to create PA opportunities for people with special needs
74
Theory
Explains why phenomenon or behaviour occurred, can be graphically represented
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Importance of theories
Allows us to better understand and predict physical activity behaviour, gives us a scientifically validated blue print from which to formulate affective behavioural intervention. Enables us to organize exercise behaviour variables in a coherent manner (for example, self-efficacy and motivation theories, which one is the theory based on or is the focus)
76
Model
Acts as a visual representation of a phenomenon or behaviour, does not always indicate why phenomenon occurred, they just show you the situation is but do not describe why it is that way
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Example of a behavioural model of exercise
Habitual exercise --> relapse (no exercise) --> resumption of exercise --> habitual exercise (back to start)
Repetitive cycle, exercise then no exercise then resumes and exercise
This is a model that represents the behaviour but does not explain why this happens, we need a theory to explain the reason or the why. Does not explain why at all, just shows what happens
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Motivation
Degree of determination, drive or desire with which an individual approaches (or avoids) behaviour, direction and intensity of ones effort
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Origin of motivation
Intrinsic - motivation from within
Extrinsic - motivation from a force outside the individual
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Expectancy value theories
Motivation (and thus behaviour) is predicted on the following - an individual's expected behaviour outcome, the value (or importance) that the individual places on that predicted outcome
81
Expectancy-value approach applied to exercise behaviour
Value = high, expected outcome = inability to exercise, failure to adopt
Value = low, expected outcome = ability to exercise, failure to adopt
Value = low, expected outcome = inability to exercise, failure to adopt
Value = high, expected outcome = ability to exercise, successful adoption
82
Theories that have grown from Expectancy-Value approach
Social cognitive theory (SCT), theory of planned behaviour (TPB), theory of reasoned action (TRA) and self-determined theory (SDT)
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Social Cognitive Theory / Self-Efficacy Theory
Exercise behaviour is influenced by both (1) human cognition and (2) external stimuli
Human cognition - expectations, intentions, beliefs, attitudes
External stimuli - social pressures, experiences
A person may intend to be physically active, but external forces may prevent their from engaging in exercise (friends don't so they don't)
84
Self-efficacy
Describes how individuals form perceptions about their capability to engage in specific behaviours. Focuses on the extent to which individuals feel they will be successful, given a particular set of abilities and their unique situation. Not concerned with an individuals perception of their ability. A situation-specific form of self-confidence
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Four primary sources of self-efficacy
Past performance accomplishments, vicarious experiences, social persuasion and physiological / affective states
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Self-efficacy - past performance accomplishments
An individual's perception of degree of success, having previously engaged in similar activities (running associated with walking)
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Self-efficacy - vicarious experiences
Modeling and imagery, one individual viewing the performance of a behaviour by another individual (the model), the greater the perceived similarity, the greater the influence
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Self-efficacy - social persuasion
Verbal and nonverbal persuasive tactics
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Self-efficacy - physiological / affective sates
Feelings of pain or fatigue, positive or negative emotions
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Diagram of social cognitive theory
How the behaviour, cognition and affect dries the influence and self-efficacy
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Measuring self-efficacy
The level (referring to an individual's belief that they can successfully perform various elements of a task) and strength (the individual's degree of conviction that they will successfully accomplish each level) of self-efficacy
Scale and rate confidence (questionnaire)
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Measuring self-efficacy is with ..
Level of strength and confidence. Level is the individual's belief in themselves, strength is the degree of conviction to complete the task
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Self-efficacy research
Researchers have identified different types of self-efficacy in exercise: task (ability to do a task, measured in terms of level and strength like running), coping (overcoming challenges in regards to exercise, measured in strength) and scheduling (being able to have confidence in managing and maintain the exercise program, measured in strength)
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They are independent to each other ..
Research has shown relationships between self-efficacy and a variety of psychological, emotional and behavioural responses to exercise
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Task self-efficacy -->
Initiate exercise, self-efficacy remains stable
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Coping self-efficacy -->
Self regulation (can you handle some of the barriers (ex. exercising when tired, goes up)
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Scheduling self-efficacy -->
Maintaining exercise (can you make exercise fit into your routine)
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Limitations of self-efficacy
Theory is most predictive of behaviour when the behaviour is challenging or novel. Influence is reduced as exercise becomes habitual or well learned
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Theory of Reasoned Action
Originally designed to predict single-instant behaviour (voting) and is based on social cognitive approach. Related to intention is determined by two factors..attitude and sense of subjective norm
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Theory of reasoned action - attitude
Positive or negative thought concerning the behaviour - is it worth it? Is it important?
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Theory of reasoned action - sense of subjective norm
Or the degree to which an individual feels social pressure to perform the behaviour (will friends / family be voting? Will she be perceived as lazy if not?)
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The strength of the relationship between intention and behaviour..
Weakens with longer time periods. The more we engage the more we do, the less we engage the less we want to do
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Diagram of the theory of reasoned action
Based on intentions with attitude, behavioural beliefs, attitude toward behaviour, intention, behaviour, normative beliefs, subjective norm, intention, behaviour
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Exercise and the Theory of Reasoned Action
Exercise interventions must focus on increasing the strength of ones intention to exercise
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Techniques to improve intention do the following ..
Serve to improve ones attitude towards exercise, cause the individual to feel external pressure to exercise
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Theory of planned behaviour
Extension of theory of reasoned action (TRA), perceived behavioural control (PBC) and attitude and subjective norm (intentions) plus RBC are all influential predictors of behaviour
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Theory of planned behaviour - perceived behavioural control
Refers to the degree of personal control the individual fees that he or she has over the behaviour - accounts for man potential barriers to a behaviour such as exercise
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Exercise and the theory of planned behaviour
Intervention techniques should be aimed at enhancing perceived behavioural control. Promote a sense of personal control of ones exercise behaviour. Allow exercises some input when designing their physical activity program. Teach exercises some methods to approach perceived barriers to PA
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Self-determination theory
Individuals seek challenges that will satisfy at least one of three psychological needs: of self determination (autonomy), to demonstrate competence, for relatedness or social interactions
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Self-determination theory - three forms of motivation are capable of driving achievement behaviours
Intrinsic motivation, extrinsic motivation, amotivation (lack of motivation / intention)
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Extrinsic motivation
Integrated regulation - engaging in behaviour to confirm ones sense of self (self-determined)
Identified regulation - motivated by personal goals
Introjected regulation - dictated by self-imposed pressure (pride and guilt) (exercise is good for you and you feel guilty if you don't do it)
External regulation - to obtain external reward (praise) for behaviour
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Classical conditioning
A reflective behaviour can be elicited through repeated pairing of behaviour with an antecedent cue
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Classical conditioning experiment
Experiment with the dog, pairing the bell with the dog getting food constantly, afterwards you don't need to present the food and the dog will salivate without the physical food there, they associate the bell with food. Limited application when we talk about exercise interventions
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Instrumental conditioning
A voluntary behaviour can be learned by pairing the behaviour with consequent reinforcement
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Instrumental conditioning experiment
Experiment with a dog and a trick, if the dog does the trick they will reward / reinforce the behaviour with a bone, the dog will more likely engage in the behaviour with the possibility of being given the bone
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Instrumental conditioning and activity
Activity is presented with a reinforcement, if it is constantly they will pair it together, if someone engages in physical activity and something positive happens, they are more likely to engage in that activity again
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Important factors in instrumental conditioning
Frequency and timing of the reinforcement is important - if it is occasional with the reward, there is a lower chance that the subject will associate the reward with the behaviour
Immediate vs. delayed - the strength of the association is stronger if the reward is immediate
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Stimulus-Response Theory
Future exercise behaviour depends primarily on whether the exerciser experienced positive or negative outcomes following previous exercise bouts. The reinforcement can be positive or negative
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4 Types of events that can follow a behaviour and affect future behaviour
Positive reinforcement
Negative reinforcement
Punishment
Extinction
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Positive reinforcement
An enjoyable or pleasant outcome that makes a person feel good and that strengthens a particular behaviour - more likely to occur
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Types of positive reinforcement
Intrinsic reinforcers - rewards that come from within oneself (enjoyment / pleasure), self-determination theory states that this is th best type of motivation
Extrinsic reinforcers - rewards that come from other people (or that you give yourself), self-determination theory distinguishes between different types like identified regulation / goals / introjection / praise
122
Negative reinforcement
Generally unpleasant or aversive stimuli that, when withdrawn after a behaviour, will decrease the frequency of that behaviour in the future (less likely to engage in the behaviour) (ex. if the subject doesn't like sweat, exercise that causes you to sweat is a negative reinforcement so the subject won't exercise)
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Positive vs. negative reinforcement - strength
Typically, negative reinforcement does not have as large of an impact as positive reinforcement, if you are more sedentary you increase your BMI, reducing BMI does not happen right away, so the impact is not as strong
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Punishment
Unpleasant or uncomfortable stimulus encountered after a behaviour, decreasing the probability of that behaviour happening in the future. Physical activity should never be used as a punishment, otherwise, individuals will see it as highly aversive
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Extinction
Withholding a positive stimulus after a behaviour in order to decrease the likelihood of that behaviour happening again in the future, not likely to include in physical activity interventions
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Examples of extinction
Decreasing opportunities to socialize, limiting this will cause extinction if people want to socialize
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Example of positive reinforcement
Adding something positive (money) to increase exercise
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Example of negative reinforcement
Taking away something negative (pain) to increase exercise
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Example of punishment
Adding something negative (injury) to decrease exercise
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Limitations of Stimulus-Response Theory (SR Theory)
Does not consider role of cognition of beliefs about an outcome, limited in its ability to predict and explain exercise behaviour. No information for developing interventions to change exercisers' perception of a particular outcome. Positive reinforcement is helpful but we need to go beyond it for long-lasting effects. If it is only PR and it is taken away the behaviour will revert to a non-exerciser, it is a temporary behaviour change
131
Behavioural Economic Theory
Brings in decision-making beyond SR theory. Make highly reinforcing sedentary activities less attractive
Integrate stimulus-response theory + basic research on cognitive psychology and decision-making
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Behavioural economic theory example
A way to help people make healthy choices about how they spend their leisure time. For a child, if they watch TV = they need to do chores. Child now has a decision, they can play video games, but then he has to do something he hates or he can go out to play with friends which isn't bad and he doesn't need to chores (bringing in elements of SR Theory and decision-making)
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Integrative Approaches
Combine concepts from various theories and models to explain exercise behaviour: Transtheoretical model (TTM) and social ecological model
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Transtheoretical model
Behaviour change is not a quick process but a gradual progression through a series of stages
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5 stages of transtheoretical model
Pre-contemplation, contemplation, preparation, action and maintenance
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Pre-contemplation stage of TTM
No intention to start exercising in the next 6 months, very stable (cons > pros)
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Contemplation stage of TTM
Intend to start exercising in the next 6 months (cons > pros), some intention
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Preparation stage of TTM
Intend to start exercising in immediate future, taking actions to prepare to exercise (pros > cons)
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Action stage of TTM
Exercising at optimal levels for health and fitness, hard to avoid falling back into old lifestyles, least stable stage (likely to move forward)
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Maintenance stage of TTM
Exercising at optimal levels for 6 months, easier to maintain routine than in action stage, highly confident that they can continue their exercise program, strong likelihood they will continue to do so in the future
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How people move through stages of TTM
Movement involves changing the following:
- how people think about exercise
- how people think about themselves
- environmental factors that influence exercise behaviour
Changes occur through a combination of 10 basic experimental and behavioural processes
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Experimental processes
Increases people's awareness of, and change their thoughts and feelings about, themselves and their exercise behaviour, consciousness raising / self re-evaluation / environmental re-evaluation / dramatic relief
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Behavioural processes
Change aspects of the environment that can affect exercise participation, self-liberation / stimulus control / reinforcement management / helping relationships
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How do we know someone is moving through the stages?
Shift in decisional balance - list more pros than cons of exercising. Increase in self-efficacy to overcome temptations - confidence that he or she can deal with high-risk situations that might tempt him or her to lapse into sedentary ways. Self-efficacy across stages should increase positively and linearly (not always)
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Interventions for people in pre-contemplation - moving them forward
Pre-contemplation - education about the link between exercise and well-being
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Interventions for people in contemplation - moving them forward
Contemplation - will you feel good about yourself as a "couch-potato" (pros and cons are balancing each other out)
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Interventions for people in preparation - moving them forward
Preparation - organize and start planning for new physically active lifestyle (plan out costs, find an exercise partner, goal setting, frequency, duration)
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Interventions for people in action stage - moving them forward
Action - tips an overcoming, barriers and maintaining motivation, make sure they are achieving objectives they would like to achieve, body image, appearance
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Interventions for people in maintenance stage - moving them forward
Maintenance - need to plan ahead an identify situations that might cause them to lapse, interventions --> helping people adopt and maintain an exercise program
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Limitations of the TTM
Cannot reliably predict which stage a person will move to and when (may skip a stage). Fails to fully explain the mechanisms by which people change their activity behaviour and move across the stages. Does not allow for the fact that many people do not exhibit a steady progression through the stages, they may skip forward or degree back
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Social ecological models
Considers individual influence on health behaviour as well as other levels of influence on health behaviours ..
- physical environment
- community
- society
- government
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More on social ecological models ..
Each person is significantly affected by interactions among overlapping ecosystems. Ecosystems - relationships between community of living things with each other and their physical environment. At each level, different theories and models can be sued to explain PA behaviour and create PA interventions
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Different levels of social ecological models
Individual, microsystems, mesosystems, exosystem, macrosystem
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Microsystem of social ecological model
Immediate places we interact (school, work, home, gym)
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Mesosystem of social ecological model
Microsystems interact (employer - work, gym - facility), team up = intramural league
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Exosystem of social ecological model
All systems influencing microsystems and mesosystems (school board, local health department)
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Macrosystems of social ecological model
Sociocultural context (societal values, political, economics)
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Social ecological model for physical activity
Support environments = increased PA in community. Community agencies and groups can influence policies to support PA environments (increased availability and access to facilities / programs) (active transportation - sidewalks, bike paths)
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Limitations of social ecological models
Time and cost of - changing environments and policies, creating community-wide incentive and education programs, building fitness facilities does not guarantee that people will use them
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Social influence
Real of imagined pressure to change one's behaviour, attitudes or beliefs
- can come from doctors, fitness leaders, family members and so on
- an understanding of this pressure may lead to the development of interventions that use social influence to increase physical activity participation
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Social support
Most important type of social influence in exercise and physical activity settings, two perceived comfort, caring, assistance and information that a person receives from others
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Two approaches of social support
(1) measures size of one's social network - measured by the number of groups or individuals an exerciser can turn for support (does not take into account quality or type of support provided)
(2) Measure amount and type of support that an exerciser receives
163
Social support - measuring amount and type of support that an exerciser receives
Instrumental support - practical, tangible assistance (care ride the parents provide), emotional support - encouragement, praise, empathy, concern, informational support -directions, suggestions, advice, feedback (fitness instructors), companionship support - friends, family members, exercise groups, validation - comparison with others to gauge progress
164
Research on relationships between social support and PA
Number of social contacts (people who have more available support sources reported greater levels of physical exertion)
Amount and type of social support (the most effective type of support depends on the exerciser's need at a given time, exercisers may need emotional support more than they need instrumental support)
165
Individual and group influence on exercise
Family (spouse, children, parents), important others (physician, friends, coworkers), fitness professionals and instructors, other exercise participants
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Influence of family / spousal or partner support
Individuals have better attendance and fewer drop-out rates when exercising with a spouse-emotional support + companionship support. Spouses / partners provide much needed support to mothers with young children, because mothers may have difficulty finding time to exercise - instrumental support
167
Social support from parents and family
Has been identified as one of the most important determinants of participation in PA
168
Parents provide many different types of social support
Instrumental - provide transportation, pay fees
Emotional - provide encouragement
Informational - teach a new activity
Companionship - play with their children
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Downside to family support
Behavioural resistance - when family members pressure a loved one to exercise, that person may respond in the opposite manner and actually exercise less
Social control - feeling that the family is in more control than you are
Overprotectiveness - the child wants to commit to a sport more dangerous and if the parent is protective they may discourage them from their chosen PA
Parental pressure - the child wants to get out of the sport but the parents keeps them in
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Influence of physician
Many people look to health professionals for advice on how to become physically active. Physicians who exercise regularly are important role models. Not all physicians prescribe exercise - don't perceive exercise as an immediate treatment, don't feel qualified to perform exercise counselling
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Dogs as social influence
People who own dogs are more likely to meet recommended PA levels than those who do not. Many dog owners report feeling guilty if they do not walk they dogs, guilt avoidance becomes a powerful incentive. Dogs provide companionship support
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Influence of exercise class leader
Single most important determinant of an exerciser's continued participation in an exercise program (fitness class situation makes the class good or not)
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Exercise leaders provide many different types of social support ..
Informational - show what exercises to do
Emotional - provode encouragement / praise
Instrumental - organize fitness classes
Companionship - distract from feelings of pain, fatigue, boredom
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Leadership styles of exercise class leaders
Socially support (encouragement, verbal reinforcement, praise, showing interest in participants, engaging in casual conversion before / after class)
Bland (verbal criticism of exercisers who made mistakes, no encouragement or praise, no interaction before / after class)
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Effects of socially supportive leadership style
Preference to the socially supportive class leader, greater exercise self-efficacy-greater task efficacy, belief they can do the task. More energy and enthusiasm towards the class. Less post-exercise fatigue. Less concern about embarrassing oneself and trying new things. More enjoyment. Stronger intentions to join another class in the future
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The exercise leader as role models
Emphasize importance of getting adequate rest between workouts and taking time to fully recuperate when sick or injured. Emphasize fitness and fun during exercise. Encourage participants to set realistic fitness and weight loss goals. Give praise and advice about future goals
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Influence of exercise group
Can promote or undermine exercise-related thoughts, feelings and behaviours. Most part is positive, but may be negative
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Three aspects of the exercise group affect exercise ..
Group cohesion
Group size
Group composition
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Group cohesion
A cohesive exercise group is one in which group members are drawn to a common goal and are integrated around the pursuit of that goal and satisfying social interactions and communication
Can be for fitness, grades, appearance, etc..thinking in a similar way and are integrated
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(ATG-T)
Attractions to the group-task - why are people attracted to the class, may be due to interest
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(ATG-S)
Attractions to the group-social - maybe you are interested because of the friendship and relationships
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(ATG-T + ATG-S) =
Individual attractions to the group
(GI-T) - group integration-task: everyone is keen to exercise, lose weight, get stronger
(GI-S) group integration-social: everyone likes to socialize amongst one another, social interaction
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(GI-T + GI-S) =
Group integration
- All 4 will contribute to group cohesion and reachers want to see which is the most important, more cohesive exercise groups, especially those higher in ATG-T
- Foster greater exercise adherence, team building results in improve adherence and fewer dropouts (team buildings has used been used in sport and now is being used in exercise setting)
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How to increase feelings of group cohesion (team building)?
Develop feelings of distinctiveness among members (make them feel special), assign group roles and / or positions (someone in charge of warm-up / cool down, getting equipment), establish group norms (no one leaves early, everyone gives 100%), provide opportunities to make sacrifices for the group, provide opportunities for interaction
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How does group cohesion foster adherence?
Cohesive groups may foster more positive attitudes towards class attendance, if they have a role to play, made sacrifices there is a reason to be there. People may feel more positively about exercising in cohesive groups because these groups provide greater social support and interaction. More cohesive groups may generate self-efficacy in group members than less cohesive groups
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Group size
As number of people increases, perceptions of group cohesiveness decrease because of the following:
- crowding
- fewer interactions
- less enjoyment
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As the group size increases..
Group cohesion decreases
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Group's perception of the instructor can be affected by ..
Group size, easier to instruct a small class so they tend to do better so there is a better perception
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Group composition
They work well because and if they are equal, but if there is a disparity in the genders, they may feel like the minority (females tend to go more often than males)
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Group composition - mixed gender makeup
May cause discomfort, may cause mixed feelings of being an oddity
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Group composition - similarity of members
Affects comfort level and motivation, the more similar they are the positive the influence (older adults would rather exercise with adults their own age) (obese / overweight would rather exercise with the same body type)
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Group composition - group enthusiasm
Results in greater enjoyment and future intentions to join an exercise group, may increase feelings of self-consciousness and worries about embarrassment and social evaluation
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Influence of co-exercisers and observers
Actual effect - people increase effort and performance when others are watching, may improve their performance. Self-reported effort - presence of others and the desire to make a good impression can influence self-report effort
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Ratings of perceived exertion (RPE)
People report a lower RPE when exercising next to a person who makes an exercise look easy (if it looks like they aren't working hard, you don't want to make it look like you are putting in a lot of effort). Men report lower RPE with tests involving heavy workloads when women are conducting the tests (even if they are working hard, they will say they weren't so they look stronger)
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Dangers of trying to make a good impression
People may exert themselves too strenuously when others are watching (they may overdo it). People may be concerned that others perceive them as weak if they reduce the amount of weight they are lifting
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Influence of society
Norms and stereotypes
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Norms
What is normal, reflected by a number of factors:
- media's portrayal of physical activity
- amount of resources dedicated to helping people to be physically active
- visibility of physically active individuals
- society promotes physical activity
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Stereotypes
Are beliefs about the characteristics of people in a certain group - "weight training is a man's activity", "non-exercisers are lazy and couch potatoes"
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Approaches to physical activity interventions
Informational, behavioural, social and environmental and policy
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Information approach to PA interventions
Providing information about PA and benefits of being active - to change knowledge and attitudes
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Behavioural approach to PA interventions
To teach necessary skills for adoption and maintenance of behavioural change
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Social approach to PA interventions
To create environments that facilitate and enhance behavioural change
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Environmental and policy approaches
To change the structure of environments, to provide better places for physical activity
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Goals of informational approaches
Benefits of physical activity, awareness of opportunities for PA, technique to overcome barriers to activity, strategies to overcome negative attitudes towards activity
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Interventions that use an informational approach
Motivational interviewing, mass media campaigns, community-wide campaigns and point of decision prompts
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Motivational thinking
A counselling technique that provides with the opportunity to talk about how to resolve their mixed feelings about exercise so they can move forward with change
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Motivational thinking can be effective in increasing..
Physical activity participation, but can be costly and only reaches a small number of people
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Motivational thinking focuses on..
One-on-one counselling, counsellor tries to get the person to talk about they feelings and attitude about being physically active. Guides the person to resolutions so they can move forward and become more physically active, intrinsic motivation to change behaviour
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Mass media campaigns - types of media
Television and radio - favoured, big influence, pamphlets and posters, powerpoint presentations, DVDs, world wide web, online
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Simple slogans
This tends to work well because people remember them easily (positive)
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Extensive information / eduction
Problem with the detailed information is many people won't read it
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Effectiveness of mass media campaigns
Reaches large number of people, are well remembered, mixed success in increasing PA
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Drawbacks of mass media campaigns
Do not provide adequate or sufficient information, can be expensive (cost factor), may not reach target audience
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Community-wide campaigns
Engage community members and organizations in the development and delivery of PA information
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Examples of community-wide campaigns
Health risk appraisals, fitness appraisals, training health care professionals, health and wellness fairs
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Effectiveness to community wide campaigns
Improvements in % of people who are active and EE
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Drawbacks to community wide campaigns
Requires careful planning, well-trained staff, and resources, may not reach enough people, required "buy in" from influential members of community
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Point of decision prompts
Remind people who wan to be more active that they are about to have an opportunity to engage in PA
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Point of decisions prompts use ..
Signs - place signs at points where people must decide (make people take the more active choice or not) (ex. elevator / escalator vs. stairs - benefits of stair climbing for health and weight loss). When a sign is placed in from of the physically active choice to take the stairs / healthy options, this increases people choices in taking the stairs, sign = increased activity
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Point of decision prompts - if the sign is left up too long ..
The effect wears off and there is no more increase and it reverts, if the signs is changed up then it stays effective if the message was different, the effect was maintained
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Effectiveness of point of decision prompts
Takes little time and money to implement, effective when messages about specific benefits are targeted to specific groups (targeting commuters who are going to work)
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Drawbacks of decision prompts
Effective only while sign is posted, effective only when alternative option such as stairs are safe and easy to find, doesn't guarantee people will find other opportunities to be active in daily life (there is no transfer to more PA during the day, usually not)
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Effective information interventions - what messages should do
Emphasize meaningful, specific, positive consequences or exercise to targeted audience
Create social pressure to exercise
Enhance people's beliefs that they have control over their physical activity behaviour
Provide simple but detailed information on how to start an activity program (TTM contemplation stage)
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Effective informational interventions - enhancing people's beliefs that they have control over their PA behaviour
What to (not necessarily enjoy it), may exercise because want to be more fit
People like to be in control of their lives, make sure you emphasize it's their choice
We can give them guidelines, but they have control
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Behavioural approaches to increasing PA - teach behavioural skills to help initiate and maintain a program
Recognize cues and opportunities, giving people tools they can use to change their behaviour. Want them to get health benefits and get them past the initial stage and get them to be the regular exercisers (recognize, maintain sabotages)
Develop strategies, want them to develop strategies, recognize cues and take opportunities
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Social approaches
To create environments that facilitate and enhance behaviour change
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Environmental and policy approaches
To change the structure of environments, to provide better places for PA
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Re-aim
Is used as a way to test how effective a program (community programs) in getting people to exercise or achieve a specific goal (maybe weight loss or improved health depending on the target population)
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RE-AIM meaning
R- Reach - the percentage of people in target population that you are able to get to with your program (more people = more effective)
E- Effectiveness - can be difficult to measure in community programs
A- Adoption - what proportion of the people out there that could perform the program, are actually adopting it into their lifestyle
I- Implementation - how was the program implemented
M- Maintaining - it's one thing to get the program going, but can you maintain it
