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Promoting Physical Activity and Exercise

+Promoting Physical Activity

Exercise interventions must be applied based on the characteristic of the target group.

Exercise interventions must be applied based on the limitations of the setting.

Exercise interventions must be applied based on consideration of potential personal and environmental barriers.

+Individual Intervention

+Characteristics of the Target GroupPsychological and physical profiling of

the Client Level of Depression Level of life stress Level of sense of self Perceived and actual barriers to exercise Attitude toward exercise Stage of exercise Level of exercise self-efficacy Social physique anxiety level Motivation to exercise History of exercise

+Characteristics of the Target GroupMarried, single or divorced

Married or single with small children

Occupation

Income

Age

Gender

Disabilities

Injury

+Physical Activity Setting

Accessibility & Density of PA Resources

Home based equipment

Media based intervention

Traditional delivered interventions

Work site PA facility

Community access to PA facility

Access to hospital or private PA centers

Neighborhood access to parks, walking, etc.

+Physical Activity Setting

Exercise leader

Access to PA equipment and/or activity

Variety of spaces (pool, gym, weights, running track)

Number and type of programs

individual and group;

social and competitive;

high and lowly intensity;

stress management programs;

Access (time the center is open)

Distance to and from home and/or work

Safety

+Personal Barriers

Physical barriers Cost of PA facility Transportation Safety Characteristics of exercise program

Intensity Duration Frequency

Perceived barriers Attitude toward PA Exercise self-efficacy Schedule Time Intention of exercise

+Environmental Barriers

Climate

Social support

Spousal influence

Family influence

Friends influence

+Types of Individual Interventions Health Education

Health risk appraisal

Exercise prescription*

Physical Education Programs

Behavioral modification*

Stage-matched interventions**

*Exercise prescription & behavioral modification have the greatest effect on one adhering to exercise and are the primary individual interventions used by exercise specialists

**Stage-matched interventions is the number one methodology used in the field for exercise prescription and behavioral modification.

+Individual Interventions

What chance will one have in adhering to exercise in the absence of exercise prescription, behavioral interventions, and/or stage matching interventions?

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Found to increase adherence rates by as much as 38%

Identical effect is similar for both genders, across ages, and race.

Effect is greater for healthy clients then non-healthy Small to moderate effect size for people who were high risk for

CV disease & obesity Moderate to high effect size for healthy people

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Promoting Physical Activity in Women

+Interventions for Women

Interventions

Exercise Prescription

Behavioral Modifications

Personality matching

Lowing the Barriers of exercise

Promoting Self-efficacy

Body image considerations

Social support

+Exercise Prescription for Women

Studies have indicated for women: Women prefer moderate intensity Duration of exercise needs to be short Progressive in nature The mode of exercise most preferred by women is walking

Studies have indicated for men: Men prefer higher intensity PA activities Competitive rather than cooperative Progression & duration is unknown at this time

+Walking

Walking is the most popular form of exercise for adult Americans (Segal, 1995). Because it is safe (Procari, et al., 1988) Effective (Dishman, 1994) Simple (Kriska, et. al, 1986)

Walking at moderate (3-6 METs) can improve one’s health if done on a regular basis and meets CDC guidelines (Fletcher, et al, 1996)

Walking can be self-regulated by: Exertional perceptions (RPE) Without a great levels of physiological strain More enjoyable

+Behavioral Modification Interventions for Women

Activity needs to be enjoyable

Provide choice in the mode of exercise

Goal setting techniques

Self-monitoring techniques

Regular contact with a fitness professional

+Mode Preference (Miller, et.al., 2005)

Undergraduate females exercised on 5 different pieces of cardiovascular equipment (steppers, treadmill, rower, spinners, & cross-country ski simulator) Females completed 5 experimental sessions: two with their

most favorite modes of exercise, 2 with their least favorite modes, and a no-exercise control.

The high preference exercise session produced the greatest positive mood changes and elicited highest level of exercise enjoyment before, during, and 40 minutes past exercise.

Psychological states will vary as a function of exercise preference resulting in higher adherence levels.*

+Personality

Women & men who are extraverted and demonstrate conscientious have higher adherence rates in exercise than those that demonstrate neuroticism and/or are less extraverted. (Rhodes, 2006)

Personality matched interventions are warranted for both women and men who display neuroticism and/or are less extraverted

+Personality Match Interventions & PA Less extraverted clients require:

Strategies that strength one’s intention to exercise (e.g. gradually progress in intensity to assure success)

Goal setting Behavioral strategies (e.g. reinforcement, role models)

Neurotic clients require Normative based interventions (e.g., involving friends,

family) (Rhodes, 2006)

+Pairing Personality with Activity

Garvin (2004) article in The Physician & Sports Medicine provided fitness professional with means to match one’s personality to an activity .

Matching one’s personality traits to an activity is a tool that can help fitness specialists have a women or men clients reflect on what activities that are best for them.

+Barriers to exercise

Expected to be the caregiver

Single moms with children versus divorced fathers

Lack of social support for women

Fewer barriers exist for men in our society than women

+Self-Efficacy

Belief and expectations about how capable one is to perform PA or exercise to achieve an outcome( e.g. low weight, fitness).

Major determinate of adherence in women

+Sources of Self-efficacy

Personal accomplishment

Modeling

Verbal persuasion

Physiological states

Emotional arousal

Promoting one or more of these sources increases one’s efficacy expectations to exercise or be physically active

+Healthy Body Ideal

Relationship exists between perceived body image and exercise in both genders Recognition that human bodies naturally come in a wide

range of shapes/sizes and that genetic factors are instrumental in determining one’s weight and shape

A realistic level of health and fitness for one’s own unique, personal body shape

+Perceptual Measurement

+Body Image Disturbance (BID)

Inaccurate perceptions of one’s body shape and size; image differs from one’s actual shape/size

Negative thoughts and feelings about one’s body

Actions performed to hide or change the body without regard to health implications

Body Dissatisfaction in Adults

Berscheid et al. (1973); Berscheid et al. (1973); Garner (1997)Garner (1997)

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Correlation is much stronger for women than for men A woman’s feelings of self-worth are typically more strongly

influenced by her perceived physical attractiveness than those of a man

Are women or men more dissatisfied with their body?

+What do women or men want from their exercise program?

The problem areas for men are abdomen and overall weight. Men want to have more muscle mass, broad, muscular

shoulders, toned “six-pack” abdominals, a narrow waist, and muscular legs

The problematic areas for women are abdomen, hips, thighs, and overall weight Females want ultra-thin, shapely, toned, and firm body

+Why Is Body Image Important?

Healthy body image is related to better psychological well-being in two ways: Better self-esteem Lowered risk for depression and anxiety

Healthy body image is related to: Type of exercise Adherence levels

+ Body Dysmorphic Disorder (BDD)

An extreme case of body dissatisfaction

Excessive preoccupation with some aspect of one’s physical appearance

Obsessive-compulsive activities (e.g., constantly weighing oneself)

Muscle dysmorphia: Preoccupation with muscularity Fear of being muscularly small is estimated at 9% of the

male population (Olivardia, 2001) or 1-2 % of the population (Phillips & Dufresne, 2000)

Anxiety and dissatisfaction with muscles Steroid use and excessive work out routines Avoids social gathering

+ Social Physique Anxiety

Anxiety arises over concerns with self-presentation of the body

Self Presentation: The attempt by an individual to present one-self and to omit self-relevant information to maximize the likelihood that positive social impression will be generated and undesired impression will be avoided.

Usually affects women more than men.

+ Mechanisms by Which Exercise Might Improve Body Image

+Body Image & Exercise

Findings

-Exercise training can lead to significant improvements in body image of women (Martin & Lichtenberger, 2002) and men

-Both aerobic and weight training improved body image with weight training having the greatest impact.

- Exercisers frequently report bing dissatisfied with their weight

-Exercise participation motives for men and women are to lose weight and increase muscle (Rodger & Gauvin, 1994)

-Active women evaluated their physical appearance higher than inactive women

+ Physical Activity and Anxiety About the Body

Social Physique Anxiety (SPA)Women who possess high SPA view their

physical appearance more negativelyWomen with high SPA individuals often

exercise for self-presentation reasons (e.g. Weight loss, to improve appearance, and body tone)

Women low in SPA were more likely to exercise for the purpose of fitness, mood enhancement, & health.

Men have lower SPA levels as compared to women

+Chain Reaction

Individual attempts to present themselves

The individual doubts that he or she will be able to generate a positive impression because of their

physical appearance

Social Physique Anxiety results

+Physical Activity and SPA

Regular physical activity has been shown to reduce SPA

Women with high SPA stand in back and wear baggy clothing in aerobic classes ( Brewer, et al, 2004)

Women being in groups with people one perceives as similar physically also reduces SPA.

Females experience less SPA in group aerobic and weight training classes)

Instructors who lead classes primarily for self-presentation (e.g. an instructor who wants to show you that they are a better than you) have been found to possess a high SPA.

Instructor who lead classes primarily for leadership (e.g. sensitive to client’s level) opportunities possess a low SPA

+Exercise Recommendations specific to body image People who enjoy their workouts show the big exercise

related improvements in their body image.

Exercise needs to be moderate to high to produce the greatest changes in body image (could be problem for women).

Monitor progress of strength and aerobic ability throughout your program rather than body composition (e.g., testing, logs).

Fitness instructors should encourage clients to wear loose-fitted, comfortable exercise attire.

Media promotion materials of classes or exercise campaigns should show a wide range of body shapes, sizes, and physical abilities.

Exercise programs should focus on improving physical function, strength, and endurance rather than on changing body composition.

+Social support

Group activities promotes higher levels of vigorous exercise in women.

Men perceive and prefer solitary exercise than group activities to promote higher levels of exercise.

Social support is a more influential factor in the initiation stage of an activity, especially for men.

Perceived social support by a spouse or significant other is another key determinate in women adhering to exercise

+Summary

Offer low to moderate activities for women and higher more vigorous activities for men

Offer both mixed and women only classes

Duration of exercise should be short rather than long

Promote self-efficacy by developing a easy to difficult program to promote successful experiences, especially for women.

Provide social support by enlisting the spouse or significant other in exercise.

Exercise leader need to be socially enriching

Develop a program that included aerobic activities but emphasizes weight training

Engage men and women in behavioral interventions that promotes adherence such as goal setting, keeping a log, etc.

Be aware of SPA tendencies in women.