• Main health promotion messages
All adults should take part in half an hour of moderate physical activity on most days of the week. Moderate means activity that makes you warm and makes you breathe slightly harder than normal.
The half an hour can be split into two fifteen-minute sessions to allow for travelling to and from a destination.
The recommendation also focuses on lifestyle activity, rather than sports activity, although this is not discouraged. (Health Education Authority, 1995.)
All young people, aged 5 to 18yrs should take part in physical activity of at least one hour moderate activity per day. Young people who currently do little activity should take part in at least half and hour per day. At least two times per week some of these activities should enhance and maintain muscular strength and flexibility and bone health. The activity can be continuous or intermittently accumulated throughout the day.
In 1997, 26% of men and women were classified as sedentary. 39% of men and 30% of women were classified as achieving the internationally recommended level of at least moderate activity.
Most young people accumulate 30 minutes or more of moderate intensity physical activity on most days of the week. (HEA 1998) They are characterised by short rather than sustained bouts of activity. Boys are more active than girls from an early age, and both boys and girls reduce their physical activity as they mature – this is more marked in girls than boys and is steeper in adolescence than childhood.
• What has research shown to be the most effective health promotion approaches used in this setting or topic?
Hillsdon et al (1995) showed there are only 10 interventions that use a randomised controlled approach to evaluate effectiveness. They concluded that home based, moderate intensity activities, with frequent professional contact showed the most promising results. Encouraging walking was an effective approach. However, this research demonstrated the lack of evidence available.
The research so far shows some change is possible in the short term (if only attitudinal), but drop out is common in the long term. A common approach, ‘Exercise on Prescription’, produces an initial uptake at between 50-60%, and long term adherence as low as 14% at 6 months (Stockport Health Commission, 1994).
Using a stage of change approach (Prochaska and Di Clemente, 1982) which focuses on the current attitude of the person in a client-centered approach is more effective than treating all clients the same. (Simmonds et al, 1995 and Marcus et al, 1992.)
Booth et al (1992) showed that in Australia, a mass-media campaign can influence knowledge and behaviour, but it is unknown if changes were maintained over long periods.
Most research has focussed on one-to-one interventions, and whether a person changes as a result. Because behavior change is so complicated, especially when discussing getting active, it is difficult to consider one issue (e.g. counselling) without considering others (such as a safe, pleasant environment). Much research has also been carried out in other countries, and may not be applicable in the UK (for example the weather in Australia is not comparable to Britain and is a key factor in levels of activity).
Key factors which are likely to impact on activity are:
- Safer roads for walking and cycling
- Wide knowledge of the benefits and recommendations for being active
- Support from friends and family
- Perceived safer streets and parks
- Local facilities (e.g. shops, workplace, and leisure facilities including parks)
- A reduction in car use (60% of car journeys are less than five miles). This may be through legislation (e.g. charges to enter town centres).
• Web Sites
Active for Life website www.active.org.
HEA Corporate Website www.hea.org.uk
Booth, M., Bauman, A., Oldenburg, B., Owen, N. and Magnus, P. (1992) “Effects of a national mass media campaign on physical activity participation” Health Promotion International 7:4 241-247.
Dishman, R. (1995) Advances in Exercise Adherence Human Kinetics: Champaign, Illinois.
Dishman R K & Buckworth J (1996) “Increasing physical activity: a quantitative Medicine and synthesis.” Medicine and Science in Sports and Exercise. 28(6): pp706 –710
Health Education Authority (1995) Moving On: International perspective on promoting physical activity HEA: London.
Hillsdon, M., Thorogood, M., Anstiss, T. and Morris, J. (1995) “Randomised controlled trials of physical activity promotion in free living populations: a review” Journal of Epidemiology and Community Health 49:448-453.
Hillsdon, M., Thorogood, M., (1996) “A systematic review of physical activity promotion strategies.” British Journal of Sports Medicine 30(2): pp84-89
Health Education Authority (1998) Young and Active? Policy framework for young people and health –enhancing physical activity. HEA
Lombard, D., Lombard, T. and Winett R. 91995) “Walking to meet health guidelines: The effect of prompting frequency and prompt structure” Health Psychology 14:2 164-170.
Marcus, B., Selby, v., Niaura, R., Rossi, J. (1992) Self efficacy and the Stages of exercise Behaviour change Research Quarterly for Exercise and Sport 63:1 60-66.
Prochaska, J. and Di Clemente, C. (1982) Transtheoretical therapy: Toward a more integrative model of change Psychotherapy: Theory, Research and Practice 19:3 276-287.
Simmonds, G. J., Riddoch, Velleman, G., and Turton, P. (1995) Stage based counselling for exercise in primary care – a controlled trial – Presented to the British Association of Sport and Exercise Sciences.
Stockport Health Commission (11994) Exercise on Prescription: Does It Work? Stockport Health Commission: Stockport