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+ Unit 3: Physical activity
  participation
  and physiological performance
+




    Area of Study 1
    Monitoring and Promotion
    of Physical Activity
    Changing Physical Activity Behaviour
+
    Physical Activity Behaviour Change


    Mediators  intervening variable that is necessary to complete a
     cause and effect link between an intervention strategy and
     physical activity.

    Determinants  casual factors (i.e. personal, environmental or
     characteristics of exercise) that can affect physical activity
     behaviour.

   Self-efficacy - deals with the strength of belief an individual has in his
or her capacity to successfully perform an activity. It forms the basis
of motivation, well being and personal achievement.            Unless people
believe that their    actions will produce desired outcomes, there is little
motivation to become involved and persevere with activities.
+
    Physical Activity Promotion


    Effective physical activity interventions target changes at the following
     levels:-
    individual
              social
              physical environment
              policy

    Strategies to Promote Physical Activity


                 Individual Level               Population Level
               Print and web based             Environmental change
                      material
                   Counselling                         Policy
                Process of change                   Mass media
+
    Physical Activity Behavioural
    Change

           Cognitive Strategies            Behavioural Strategies

      Increasing knowledge             Substituting alternatives

      Awareness of risks               Enlisting social support

      Concern about impact to others   Rewarding yourself


      Understanding benefits           Committing yourself

      Awareness of opportunities to    Reminding yourself
      be active
+
    Print and Web-based Media
+
    Counseling

   Counseling strategies:-

           assessing motivational readiness

   matching process of change with motivational readiness

   contracting

   enlisting social support

           reminder systems

           gradual programming

           tailoring
+
    Socio-ecological Model

The socio-ecological model recognises the interwoven relationship
   that exists between the individual and their environment. While
   individuals are responsible for instituting and maintaining the
   lifestyle changes necessary to improve health, individual behaviour
   is determined to a large extent by social environment, e.g. community
norms and values, regulations and policies.

    In order to increase physical activity levels health promotion efforts
     need to focus not only on the behaviour choices of each individual,
     but also on factors that influence those choices. These factors
     operate our of several spheres of influence including:-
    the individual
             social environment
             physical environment
             policy components
+
    Socio - ecological Model
      Recognizing that groups                               Developing and enforcing state and
      provide social identity and                           local policies that can increase
      support, interpersonal                                beneficial health behaviors.
      interventions target groups,                          Developing media campaigns that
      such as family members or                             promote public awareness of the
      peers.                                                health need and advocacy for
                                                            change.


                              Social         Individual            Policy
                                        Motivating change in
                                        individual behavior by
                                        increasing knowledge, or
                                        influencing attitudes or
                                        challenging beliefs.




                                            Environmenta
            Changing the physical
            environment or the
                                                  l
            environment of an
            organization (e.g.
            workplace, school, or another
            type of community
            organization) to support
            behavior change.
+
    Socio-ecological Model Changing
    Physical Behaviours
Barriers to healthy behaviors are shared among the community as a
whole. As these barriers are lowered or removed, behavior change
becomes more achievable and sustainable. It becomes easier to "push the
ball up the hill.
"The most effective approach leading to healthy behaviors is a
combination of the efforts at all levels--
individual, interpersonal, organizational, community, and public policy.

   Individuals
       Eat reasonable food and beverage portion sizes at home and
when         eating out. Eat 5 to 9 fruits and vegetables each day, or more

       Walk or bicycle more often

   Be a better driver
+
 Parents
   Serve as good role models by practicing healthy eating
        habits and by being physical active every day.

       Make sure tasty, attractive fruits and vegetables are available for
        meals and snacks at home and when eating out.

       Set limits on television viewing.

       Limit access to sugar-sweetened drinks.

       Work with your childrens schools to develop policies regarding:
        vending machines, use of foods as rewards in classrooms,
        adequate lunch and recess time, daily PE, safe walking and
        bicycling routes to school.

       Organize Walk to School Day events in your childrens schools.
+
 Employers
       Offer walk/bike/transit incentives like bicycle parking
        and transit passes.

       Provide exercise and changing facilities at work.

       Post signs near elevators encouraging people to take the stairs.

       Make the stairway a safe and inviting place.

       Support community-wide events that promote physical activity.

      Set standards for foods served at cafeterias, in vending
machines,      and at meetings.

       Use price incentives in the cafeteria and in vending machines to
        increase consumption of healthy foods.
+
 Community Member
        Participate in neighborhood, community, and
         transportation planning groups.

        Support funding for sidewalks, bicycle paths, parks, recreation
         centers, and swimming pools.

        Declare and organize an annual National No-TV Week.

        Join or start a walking or bicycling group in your neighborhood.

        Support policies to promote healthy eating such as disclosing the
         calorie content of restaurant food and requiring calorie labeling
on       menus and menu boards at chain restaurants.

        Join advocacy groups promoting community design supportive of
         safe and accessible walking and bicycling.

        Let your community leaders and elected officials know that you
         support healthy, active communities.
+
 Architects, Community and Transportation Planners

   Design buildings where stairs are visible, accessible and
    safe.

       Adjacent to buildings, provide sidewalks, convenient bicycle
    parking and safe connectivity to public transit.

       Consider public transit, sidewalks, bicycle lanes, and bicycle
    paths for walking and bicycling to be as essential as streets and
    roads for vehicles.

       Design frequent and safe street crossings.

       Design neighborhoods and communities where children and
        adults can easily and safely travel between home, work, school,
        retail establishments, parks and recreation facilities on foot and
        bicycle.
+ Community Leaders and Policy Makers


       Consider health consequences along with financial impact
        when developing school policies such as offering daily PE,
        promoting walking and bicycling to school, or district support
        for school meal programs.

       Prioritize funding for increasing and improving pedestrian and
    bicycle facilities in communities.

       Consider public health impacts in land-use planning decisions
        such as siting of schools, development of mixed-use
        neighborhoods.

       Consider zoning regulations.

       Assure access to full-service grocery stores in all
    neighborhoods and limit density of fast food restaurants.

      Prioritize funding for effective public health interventions to
       increase physical activity, promote healthy eating, and reduce
    obesity and chronic diseases.
+
    Top 10 Causes of Death Worldwide
                                                        Based on data from World Health
    Organisation
                                                        Fact Sheet No 310:   2008




                   World           Deaths in Millions         % of Deaths
    Coronary heart disease                7.2                          12.2

    Stroke and other                      5.71                          9.7
    cerebrovascular diseases
    Lower respiratory infections          4.18                          7.1

    Chronic obstructive                   3.02                          5.1
    pulmonary disease
    Diarrhoeal diseases                   2.16                          3.7

    HIV/AIDS                              2.04                          3.5

    Tuberculosis                          1.46                          2.5

    Trachea, bronchus, lung               1.32                          2.3
    cancers
    Road traffic accidents                1.27                          2.2

    Prematurity and low birth             1.18                          2.0
    weight
+




    WHO Library Cataloguing-in-Publication Data
    Global health risks: mortality and burden of disease attributable to
    selected major risks.
    2009
+
    Lifestyle Diseases
+
        Physical Activity Measurement

   Physical activity measurement has several important uses, in informing the overall
    health promotion effort and is used in:

        research, to understand the relationship between physical activity and a
         range of physical health and mental health outcomes.

        the monitoring and surveillance of physical activity levels in and among
         populations.

        understanding the correlates and determinants of physical activity, and to
         explain why some people or groups are more active than others.

        measuring the impact and effectiveness of health promotion programmes and
    interventions designed to increase physical activity.

       providing a sound and strong evidence base for broader initiatives in health
    promotion policy and practice.
+
        Measurable Components of
        Physical Activity
   Physical activity is a set of complex physical behaviours, with possible measurements
    made of its duration, frequency, intensity or setting.

       How often activity is undertaken: measures of frequency

       Duration of physical activity per session: expressed as total time per day

        Intensity of activity: activities may be classified as light, moderate or
         vigorous based on their assigned energy expenditure values (MET values or
    Multiples of Basal Resting Energy)

       Type: specific physical activity or sport performed

       Domains or settings where the physical activity is performed: leisure time
        (organised  non organised), occupational, domestic, active commuting,
        incidental and sedentary.
+
    Metabolic Equivalent (METS)

       Intensity      METS    Energy    % Max HR    Examples of
     Classification          Expended                Activities
                              (kJ/min
    Low Intensity      <3      <15        <50      Walking slowly,
                                                   golf, gardening,
                                                   household
                                                   chores, sitting
    Moderate          3-6     15-30      50-70     Surfing,
    Intensity                                      performing
                                                   massage, social
                                                   badminton
    Vigorous           7+      30+        70+      Australian rules
    intensity                                      football,
                                                   shovelling
                                                   ditches, squash
+
     National Activity Guidelines

0    5 Years
     0  1 floor based play should be encouraged

     1  3  should be physically active for at least three hours
      each day

     2  5  sitting using electronic media should be limited to less
      than one hour per day
+
     National Activity Guidelines

5    12 Years
     At least 60 minutes (and up to several hours) of moderate to
      vigorous intensity activity should be completed every day

     no more than 2 hours per day should be spent using
      electronic media for entertainment
+
     National Activity Guidelines

 12    18 Years
      At least 60 minutes (and up to several hours) of moderate to
       vigorous intensity activity should be completed every day

      no more than 2 hours per day should be spent using
       electronic media for entertainment
+
     National Activity Guidelines

 Adults   18 - 65
     Think of movement as an opportunity, not an inconvenience

     Be active in as many ways as possible

     Put together at least 30 mins of moderate intensity activity on
      most, preferably all, days

     If possible enjoy some regular vigorous activity
+
     National Activity Guidelines

 Older   Adults 65+
     Continue to be active no matter what your age

     Be active every day in as many ways as possible

     Accumulate at least 30 mins of moderate intensity activity on
      most, preferably all, days

     If commencing exercise for the first time begin gradually

     If maintained activity levels continue to exercise at a safe
      level which you are capable of maintaining
+
        Measuring Physical Activity

   Accurate assessment of physical activity is influenced by behavioural reactivity  in
    which the use of measurement tools can change physical activity behaviours.

        Objective methods of data collection do not need the participant to process
         information and exists independently of what the participant thinks.
         Objective measures include:-
    - Direct observation
              - Pedometers
              - Accelerometers
              - Heart rate monitors

        Subjective measures of data collection require some level of cognitive or
         perceptual processing by the participant to create the data. These measures
         require participants to think about, and record, information about their
         physical activity levels.
         Subjective measure include:-
     Self Report include assessment methods such as interviews, diaries, logs
           and questionnaires and rely on people to estimate or recall their own
           activity level
+    Accelerometers are electronic motion
      sensors that detect movement in a vertical
      plane as a combined function of the
      frequency and intensity of the movement.
      Movement counts are averaged over
      defined time frames, which are stored in
      memory and
      subsequently
      downloaded to a
      computer.




    Accelerometer
+

     Involves watching subjects behave in a
      particular environment such as homes,
      workplaces, parks or school yards.




    Direct Observation
+    Heart rate monitors measures heart rate
      response to exercise which provides an
      indicator of activity that reflects
      physiological stress on the body.




    Heart Rate
    Monitors
+    Pedometers assess the total number of
      steps taken and some models can
      estimate total distance travelled, time of
      total movement and energy expenditure.

     The benchmark number of steps for
      achieving health benefits is 10,000 steps.




    Pedometers
+    Self Report can be divided into two basic
      categories:-
      i. Recall based approaches - obtain actual
      information on activity on specific days.
      ii. General measures - focus on typical
      activity behaviour and often involve a
      series of questions about general activity
      patterns.
     Global Physical Activity Questionnaire
      (CPAQ)
     International Physical Activity
      Questionnaires (IPAQ)




    Self Report

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Whi u3 changing physical activity behaviour

  • 1. + Unit 3: Physical activity participation and physiological performance
  • 2. + Area of Study 1 Monitoring and Promotion of Physical Activity Changing Physical Activity Behaviour
  • 3. + Physical Activity Behaviour Change Mediators intervening variable that is necessary to complete a cause and effect link between an intervention strategy and physical activity. Determinants casual factors (i.e. personal, environmental or characteristics of exercise) that can affect physical activity behaviour. Self-efficacy - deals with the strength of belief an individual has in his or her capacity to successfully perform an activity. It forms the basis of motivation, well being and personal achievement. Unless people believe that their actions will produce desired outcomes, there is little motivation to become involved and persevere with activities.
  • 4. + Physical Activity Promotion Effective physical activity interventions target changes at the following levels:- individual social physical environment policy Strategies to Promote Physical Activity Individual Level Population Level Print and web based Environmental change material Counselling Policy Process of change Mass media
  • 5. + Physical Activity Behavioural Change Cognitive Strategies Behavioural Strategies Increasing knowledge Substituting alternatives Awareness of risks Enlisting social support Concern about impact to others Rewarding yourself Understanding benefits Committing yourself Awareness of opportunities to Reminding yourself be active
  • 6. + Print and Web-based Media
  • 7. + Counseling Counseling strategies:- assessing motivational readiness matching process of change with motivational readiness contracting enlisting social support reminder systems gradual programming tailoring
  • 8. + Socio-ecological Model The socio-ecological model recognises the interwoven relationship that exists between the individual and their environment. While individuals are responsible for instituting and maintaining the lifestyle changes necessary to improve health, individual behaviour is determined to a large extent by social environment, e.g. community norms and values, regulations and policies. In order to increase physical activity levels health promotion efforts need to focus not only on the behaviour choices of each individual, but also on factors that influence those choices. These factors operate our of several spheres of influence including:- the individual social environment physical environment policy components
  • 9. + Socio - ecological Model Recognizing that groups Developing and enforcing state and provide social identity and local policies that can increase support, interpersonal beneficial health behaviors. interventions target groups, Developing media campaigns that such as family members or promote public awareness of the peers. health need and advocacy for change. Social Individual Policy Motivating change in individual behavior by increasing knowledge, or influencing attitudes or challenging beliefs. Environmenta Changing the physical environment or the l environment of an organization (e.g. workplace, school, or another type of community organization) to support behavior change.
  • 10. + Socio-ecological Model Changing Physical Behaviours Barriers to healthy behaviors are shared among the community as a whole. As these barriers are lowered or removed, behavior change becomes more achievable and sustainable. It becomes easier to "push the ball up the hill. "The most effective approach leading to healthy behaviors is a combination of the efforts at all levels-- individual, interpersonal, organizational, community, and public policy. Individuals Eat reasonable food and beverage portion sizes at home and when eating out. Eat 5 to 9 fruits and vegetables each day, or more Walk or bicycle more often Be a better driver
  • 11. + Parents Serve as good role models by practicing healthy eating habits and by being physical active every day. Make sure tasty, attractive fruits and vegetables are available for meals and snacks at home and when eating out. Set limits on television viewing. Limit access to sugar-sweetened drinks. Work with your childrens schools to develop policies regarding: vending machines, use of foods as rewards in classrooms, adequate lunch and recess time, daily PE, safe walking and bicycling routes to school. Organize Walk to School Day events in your childrens schools.
  • 12. + Employers Offer walk/bike/transit incentives like bicycle parking and transit passes. Provide exercise and changing facilities at work. Post signs near elevators encouraging people to take the stairs. Make the stairway a safe and inviting place. Support community-wide events that promote physical activity. Set standards for foods served at cafeterias, in vending machines, and at meetings. Use price incentives in the cafeteria and in vending machines to increase consumption of healthy foods.
  • 13. + Community Member Participate in neighborhood, community, and transportation planning groups. Support funding for sidewalks, bicycle paths, parks, recreation centers, and swimming pools. Declare and organize an annual National No-TV Week. Join or start a walking or bicycling group in your neighborhood. Support policies to promote healthy eating such as disclosing the calorie content of restaurant food and requiring calorie labeling on menus and menu boards at chain restaurants. Join advocacy groups promoting community design supportive of safe and accessible walking and bicycling. Let your community leaders and elected officials know that you support healthy, active communities.
  • 14. + Architects, Community and Transportation Planners Design buildings where stairs are visible, accessible and safe. Adjacent to buildings, provide sidewalks, convenient bicycle parking and safe connectivity to public transit. Consider public transit, sidewalks, bicycle lanes, and bicycle paths for walking and bicycling to be as essential as streets and roads for vehicles. Design frequent and safe street crossings. Design neighborhoods and communities where children and adults can easily and safely travel between home, work, school, retail establishments, parks and recreation facilities on foot and bicycle.
  • 15. + Community Leaders and Policy Makers Consider health consequences along with financial impact when developing school policies such as offering daily PE, promoting walking and bicycling to school, or district support for school meal programs. Prioritize funding for increasing and improving pedestrian and bicycle facilities in communities. Consider public health impacts in land-use planning decisions such as siting of schools, development of mixed-use neighborhoods. Consider zoning regulations. Assure access to full-service grocery stores in all neighborhoods and limit density of fast food restaurants. Prioritize funding for effective public health interventions to increase physical activity, promote healthy eating, and reduce obesity and chronic diseases.
  • 16. + Top 10 Causes of Death Worldwide Based on data from World Health Organisation Fact Sheet No 310: 2008 World Deaths in Millions % of Deaths Coronary heart disease 7.2 12.2 Stroke and other 5.71 9.7 cerebrovascular diseases Lower respiratory infections 4.18 7.1 Chronic obstructive 3.02 5.1 pulmonary disease Diarrhoeal diseases 2.16 3.7 HIV/AIDS 2.04 3.5 Tuberculosis 1.46 2.5 Trachea, bronchus, lung 1.32 2.3 cancers Road traffic accidents 1.27 2.2 Prematurity and low birth 1.18 2.0 weight
  • 17. + WHO Library Cataloguing-in-Publication Data Global health risks: mortality and burden of disease attributable to selected major risks. 2009
  • 18. + Lifestyle Diseases
  • 19. + Physical Activity Measurement Physical activity measurement has several important uses, in informing the overall health promotion effort and is used in: research, to understand the relationship between physical activity and a range of physical health and mental health outcomes. the monitoring and surveillance of physical activity levels in and among populations. understanding the correlates and determinants of physical activity, and to explain why some people or groups are more active than others. measuring the impact and effectiveness of health promotion programmes and interventions designed to increase physical activity. providing a sound and strong evidence base for broader initiatives in health promotion policy and practice.
  • 20. + Measurable Components of Physical Activity Physical activity is a set of complex physical behaviours, with possible measurements made of its duration, frequency, intensity or setting. How often activity is undertaken: measures of frequency Duration of physical activity per session: expressed as total time per day Intensity of activity: activities may be classified as light, moderate or vigorous based on their assigned energy expenditure values (MET values or Multiples of Basal Resting Energy) Type: specific physical activity or sport performed Domains or settings where the physical activity is performed: leisure time (organised non organised), occupational, domestic, active commuting, incidental and sedentary.
  • 21. + Metabolic Equivalent (METS) Intensity METS Energy % Max HR Examples of Classification Expended Activities (kJ/min Low Intensity <3 <15 <50 Walking slowly, golf, gardening, household chores, sitting Moderate 3-6 15-30 50-70 Surfing, Intensity performing massage, social badminton Vigorous 7+ 30+ 70+ Australian rules intensity football, shovelling ditches, squash
  • 22. + National Activity Guidelines 0 5 Years 0 1 floor based play should be encouraged 1 3 should be physically active for at least three hours each day 2 5 sitting using electronic media should be limited to less than one hour per day
  • 23. + National Activity Guidelines 5 12 Years At least 60 minutes (and up to several hours) of moderate to vigorous intensity activity should be completed every day no more than 2 hours per day should be spent using electronic media for entertainment
  • 24. + National Activity Guidelines 12 18 Years At least 60 minutes (and up to several hours) of moderate to vigorous intensity activity should be completed every day no more than 2 hours per day should be spent using electronic media for entertainment
  • 25. + National Activity Guidelines Adults 18 - 65 Think of movement as an opportunity, not an inconvenience Be active in as many ways as possible Put together at least 30 mins of moderate intensity activity on most, preferably all, days If possible enjoy some regular vigorous activity
  • 26. + National Activity Guidelines Older Adults 65+ Continue to be active no matter what your age Be active every day in as many ways as possible Accumulate at least 30 mins of moderate intensity activity on most, preferably all, days If commencing exercise for the first time begin gradually If maintained activity levels continue to exercise at a safe level which you are capable of maintaining
  • 27. + Measuring Physical Activity Accurate assessment of physical activity is influenced by behavioural reactivity in which the use of measurement tools can change physical activity behaviours. Objective methods of data collection do not need the participant to process information and exists independently of what the participant thinks. Objective measures include:- - Direct observation - Pedometers - Accelerometers - Heart rate monitors Subjective measures of data collection require some level of cognitive or perceptual processing by the participant to create the data. These measures require participants to think about, and record, information about their physical activity levels. Subjective measure include:- Self Report include assessment methods such as interviews, diaries, logs and questionnaires and rely on people to estimate or recall their own activity level
  • 28. + Accelerometers are electronic motion sensors that detect movement in a vertical plane as a combined function of the frequency and intensity of the movement. Movement counts are averaged over defined time frames, which are stored in memory and subsequently downloaded to a computer. Accelerometer
  • 29. + Involves watching subjects behave in a particular environment such as homes, workplaces, parks or school yards. Direct Observation
  • 30. + Heart rate monitors measures heart rate response to exercise which provides an indicator of activity that reflects physiological stress on the body. Heart Rate Monitors
  • 31. + Pedometers assess the total number of steps taken and some models can estimate total distance travelled, time of total movement and energy expenditure. The benchmark number of steps for achieving health benefits is 10,000 steps. Pedometers
  • 32. + Self Report can be divided into two basic categories:- i. Recall based approaches - obtain actual information on activity on specific days. ii. General measures - focus on typical activity behaviour and often involve a series of questions about general activity patterns. Global Physical Activity Questionnaire (CPAQ) International Physical Activity Questionnaires (IPAQ) Self Report