Promoting Physical Activity and Exercise

1. Promoting Physical Activity and Exercise

2. 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.

3. Individual Intervention Characteristics of the target group Physical Activity Settings Interventions Promote PA Personal barriers Environmental barriers

4. Characteristics of the Target Group Psychological 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

5. Characteristics of the Target Group Married, single or divorced Married or single with small children Occupation Income Age Gender Disabilities Injury

6. 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.

7. 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

8. 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

9. Environmental Barriers Climate Social support Spousal influence Family influence Friends influence

10. 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.

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

12. 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

13. Promoting Physical Activity in Women

14. Interventions for Women Interventions • Exercise Prescription • Behavioral Modifications • Personality matching • Lowing the Barriers of exercise • Promoting Self-efficacy • Body image considerations • Social support

15. 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

16. 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

17. 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

18. 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.*

19. 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

20. 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)

21. 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.

22. 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

23. 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

24. 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

25. 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

26. Perceptual Measurement

27. 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

28. Body Dissatisfaction in Adults Berscheid et al. (1973); Garner (1997)

29. Are women or men more dissatisfied with their body? • 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

30. 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

31. 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

32. 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

33. 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.

34. Mechanisms by Which Exercise Might Improve Body Image

35. 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

36. Physical Activity and Anxiety About the Body Social Physique Anxiety (SPA) • Women who possess high SPA view their physical appearance more negatively • Women 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

37. 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

39. 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

40. 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.

41. 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

42. 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.