subjective instruments recall questionnaire recall interview proxy-report activity diary...

Subjective Instruments

Recall Questionnaire

Recall Interview

Proxy-report

Activity Diary

Observations

Dietary Intake

Physical Readiness

Methods of assessing habitual physical activity

Objective Instruments

Motion Sensors

Pedometers

Accelerometers

Indirect calorimetry

Doubly labelled water

Heart Rate Monitoring

Combining Methods?

Traditional approach

Individuals sign up for a programme Attend orientation session

Risk assessment (PA, health) Education period Rules, regulations and equipment Fitness test Register participants in organisations programme

Meet a trained facilitator for a one-to-one session

“Physical readiness is not likely to be

the main barrier to activity for most of your clients; rather

it is their psychological readiness for

change”

(Marcus and Forsyth, 2003, Motivating People to be Physically Active, p109)

N o t th in kin g a b ou t it.S T A G E 1

N o

T h ink ing a bo u t it . ..S T A G E 2

Y e s

D o yo u in te nd to in c re a seyo u r P A ?

N o

In freq u en t exe rcise rS T A G E 3

Y e s

A ccu m u la ting > 30 m insM V P A p e r w e e k?

N o

C o n s is te n ly A c tive < 6 m n thsS T A G E 4

N o

C o n s is te n ly A c tive > 6 m n thsS T A G E 5

Y e s

R e g u la rly ac tive fo r thela s t 6 m o nth s?

Y e s

A ccu m u la ting > 30 m insM V P A d a ily?

R e ad in ess to C ha n ge

N o t th in kin g a b ou t it.S T A G E 1

N o

T h ink ing a bo u t it . ..S T A G E 2

Y e s

D o yo u in te nd to in c re a seyo u r P A ?

N o

In freq u en t exe rciserS T A G E 3

Y e s

A ccu m u la ting > 30 m insM V P A p e r w e e k?

N o

C o n s is te n ly A c tive < 6 m n thsS T A G E 4

N o

C o n s is te n ly A c tive > 6 m n thsS T A G E 5

Y e s

R e g u la rly ac tive fo r thela s t 6 m o nth s?

Y e s

A ccu m u la ting > 30 m insM V P A d a ily?

R e ad in ess to C ha n ge

Precontemplation Contemplation

Preparation Action Maintenance

What % of adults are in each stage?

Stage 5: Making physical activity a habit

Stage 4: Doing enough physical activity

Stage 3: Doing some physical activity

Stage 2: Inactive and thinking about becoming more active

Stage 1: Inactive and not thinking about becoming more active24%

22%

11%

10%

33%

People have differentreadiness to readiness to changechangethey require sequential interventionsthat reflect the natural cycles of behaviour change

Preparation

Precontemplation

Contemplation

Action

Maintenance

Not Regularly Active

Regularly Active

The spiral of self change showing five key stages

Preparation

Precontemplation

Contemplation

Action

Maintenance

Will-power

Skill power

The Challenge:

Develop

‘Will’ and ‘Can’

Read and think about physical activity

Understand that being inactive is unhealthy

Recognise that their inactivity affects their family, friends, co-workers.

Will Power

Understand the personal benefits of being active

Increase awareness of the opportunities to be active in local environment

Will Power

Skill Power

Every little helps, even when you’re tired, stressed or unlikely to want to be physically active.

Avoid going it alone, find a family member, friend, co-worker who will support your activity.

Skill Power

Reward yourself – recognise your improvements and praise your efforts.

Commit to be active, have a plan, choose exercise that fits in with your lifestyle.

Skill Power

Teach yourself how to set up reminders to be active, e.g. comfortable shoes by the

door ready to be used at any time.

What does this look like in the workplace?

1) Establish Workplace SOC

By phone (not mail or media) Immediately send on stage based material to

engage employees Ensure modest goals to avoid loss of interest

Registration for a talk/seminar add in two initial questions (SOC)

Offer a prize draw and get required stage information.

2) Recruitment

Reactive

Proactive

Stage-Based Approach

Individual

Organisational

Group

PC C P A M

Awareness Awareness Staying Motivated

“Why” “How” avoiding barriers

Peer Group Support/ Team Based

Activities

Peer Group Support/ Recognition

Endorsement/Sponsorship/Leadership/Policies/ Environmental Supports

Supportive Policies/ Facilities / Equipment/ Resources/ Leadership participation / Environmental Supports

Examples of Stage-Based Programmes

Prog. PC C P A M

Health Fair X XLunch & learn prog.

X X X

Exercise prescription

X X X

Exercise Classes

X X

Special Event

X X X X X

Preparation

Special Event: Climb Mountain

29,028 feet (Everest) One floor – 13 feet Aim: Climb 130 feet per

day (10 floors) for 5 weeks…

Teams

Examples of Stage-Based Programmes

Prog. PC C P A M

Health Fair X XLunch & learn prog.

X X X

Exercise prescription

X X X

Exercise Classes

X X

Special Event

X X X X X

In summary…

Stages 1-3

Messages

Barriers assessment workshop e.g. IDEA (individual or group)

Stages 3-5

Events

Action-oriented programmes e.g. walk-a-thon, cycle to X, exercise class.

In summary…

Undertaking regular moderate-intensity PA reduces the risk of chronic ill health and leads to physical and psychological health benefits in all age groups.

Thank you to all the HeartSmart participants

“Walking is one of the first things an infant wants to do, and one

of the last things any of us wants to give up”

Thank you: Questions?

Stages 1 and 2

most want to reach lack of motivational

readiness = the toughest.

Raise awareness of PA Normalise:

Anyone can be active.

(Marcus & Forsyth, 2003, p167)

Stage 1: Not thinking about change How to promote PA awareness

Health fair, Informational display, incentives to employees to read material.

What information might get your employees to consider PA? Common misconceptions exploded Recommended levels Give list of activities and their relative

benefits. Make PA personally relevant

Barriers assessment Health fair with free health check. Workshop on related topics e.g. stress

reduction, weight management. Include PA.

Special Events? Employee derived ‘Top 10’ excuses Offer support, guidance or suggestions

on how to overcome legitimate excuses.

Stage 2: thinking about change Ways to promote PA awareness

January and New Year. What information might get your

employees to consider PA? Common misconceptions exploded Recommended levels Give list of activities and their benefits. Workshop on planning for PA Barriers assessment

Strategies to prompt these individuals to try PA. Employees set a start date and complete a

10-minute PA goal. Follow up is NB Walk to lunch @ least 10 minutes Cues on lifts to use the stairs Swap a coffee break for a walking break

Special Events? Distance signs to areas of local interest (10

minutes plus) Buddy system, walk a route in pairs.

Stage 3: Doing some PA

Possible channels to use Lunch-time workshop on making time for PA. Email ‘tip of the day’ Energy expenditure charts around work-based PA.

Strategies to prompt these individuals to increase PA. Encourage them to keep track of how much activity

they are doing each week. (Points system?) Cues on lifts to use the stairs, replace sedentary

minutes with PA e.g. 2 minute walk every hour. Set realistic exercise goals Provide a safe, non-judgemental environment to try

out new activities

Special Events? “Conquering Mount Everest” 29,028 feet, One floor -13 feet. Aim to climb 130 feet per day (10 floors) X5 per

week. Teams…

Stages 4 and 5: Action and Maintenance

Activity programme e.g. fun run, fitness assessments

PA is different, can be a routine activity, ‘give praise for efforts’.

Educational newsletter on benefits, coping, training...

Why? Prevent boredom, Prevent relapse

Stage 4: Doing Enough PA

Possible channels to use Lunch-time workshop on preventing boredom

with PA Email ‘tip of the day’, provide feedback on

questions. Appropriate print materials

Strategies to help these individuals to keep up their PA. Skill development in alternative activities e.g.

kick boxing Employee coping and planning Sponsor an event that involves family/friends Negotiate deals for employees to use local

facilities

Special Events? Support groups, establish initial meeting

time, date and place. Invite an expert to provide advice Identify a potential group leader to assist in

communication and logistics. Attend an occasional meeting

3 Levels

•Awareness

•Health Management

•Supportive Environment

Stage 5: Making PA a habit

Strategies might help these individuals to prevent set-backs in their PA. Appropriate print materials for people

who have been active for at least 6 months

Skill development in alternative activities e.g. kick boxing

Sponsor an event that involves family/friends

Teach skills in alternative activities to prevent boredom

Give a workshop on injury prevention or training techniques

Special Events? Invite an expert to provide advice on

improving the quality of your training