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