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VCE Physical Education - Unit 3

Chapter 2� Strategies for Promoting

Physical Activity & ‘Stages

of Change Model’Text Sources

1. Nelson Physical

Education VCE Units

3&4: 4th Edition –

Malpeli, Horton, Davey

and Telford 2006.

2. Live It Up 2: 2nd Edition –

Smyth, Brown, Judge,

McCallum and Pritchard

2006.

Mediators of Behavioural

ChangeStrategies for Promoting Physical Activity & ‘Stages of Change

Model’


Mediators for behavioural change

� A mediator is the mechanism through which the intervention (strategy) is believed to influence physical activity behaviour.

� Self-efficacy can be improved if a person is taught strategies to remind themselves to be more active.

� The improvement in these mediators combined might lead to a greater chance of behavioural change occurring.

Theoretical Social Models

Strategies for Promoting Physical Activity & ‘Stages of Change Model’


Theoretical Social Models

Many professionals are trying to change people’s physical activity levels.

The focus of their promotion is biological, cognitive and behavioural factors the influence physical activity participation.

Physical activity theories cover; determinants of physical activity, relationships between factors and the conditions required to get people involved in physical activity.

Social Models;

� Provide a framework of health behaviour that can enhance our understanding of participation in physical activity.

� Can direct the development of strategies used to increase physical activity levels.

The major theoretical models related to physical activity;

1. Social cognitive theory

2. Ecological framework

3. Behaviour-choice model


Social Models

Model Overview Key Factors Examples

Socio cognitive The social learning theory of emphasises the

importance of observing and modeling the

behaviors, attitudes, and emotional reactions

of others.

1. Behavioural capability

2. Observational learning

3. Expectations

4. Self-Efficacy

5. Reinforcements

A persons P.A. skills

Learn about P.A. by looking.

Expected results to from P.A.

Self control

Positive or negative events

The Ecological

Framework

Looks to explain the cause of inactivity by

looking at six sets of factors that are effectively

solutions to the problem of physical inactivity

1. Interpersonal Factors

2. Interpersonal

Processes

3. Institutional Factors

4. Community Factors

5. Public Policy

6. Environmental Factors

Knowledge, skills attitudes

social situations eg family or

friends.

interaction between

organisations.

local, state, national rules/laws

weather, facilities etc

The Behaviour-

choice model

Includes three reasons why people choose to

behave in certain ways.

1. Reinforcement Value

2. Environmental barriers

3. Preference

Consequences that result in a

choice.

Lack of bike paths results bike

being used less often.

Choose one behaviour over

another.

Psychological Models



Psychological Theories

These theories are used to guide individual approaches.

These models are used by practitioners and policy makers to justify, shape and focus health promotion strategies.

Theories;

� Health-belief model

� Pender’s health promotion model

� Theory of reasoned action

� Stages of Change *

*(Also called the ‘trans-theoretical model’)


Psychological Theories Summary

Theory Overview Key Factors

The Health-belief Model

Promotes healthy behaviour change by addressing the

patients health beliefs

1. Perceived susceptibility and severity of illnesses.

2. Perceived benefits

3. Information access to prompt action

4. Self-efficiency

Pender’s Health

Promotion

Model

Developed to describe and explain health enhancing behaviours

1. How people value their health

2. Self-efficiency

3. Perceived health status and benefits

4. Barriers to change

5. Interpersonal factors

6. Family members

7. Relationships with health professionals

Theory of

Reasoned Action

People intend to participate in

physical activity for a variety of reasons.

1. Benefits of physical activity is weighed up against long term health

2. Motivated by significant others such as family and peers.

Stages of Change

Shows the progression through several major

changes of behaviour towards becoming more active.

1. Pre-contemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance

6. Termination

Note. Relapse can occur at most stages.


Stages of Change Model –Stages 1&2

Stage 2. Contemplation

� Acknowledge that they need to become more active.

� Weighing up the pros and cons of being more active.

� Intention of becoming more active within the next 6 months.

� Some individuals remain in this stage for long periods.

Stage 1. Pre-contemplation• Not considering behavioural change

• No intention of being more active within the next 6 months.

• Not aware their lack of activity is a problem.

• Most difficult group

• Only start to think about change due to constant pressure or after a significant health event eg.

heart attack.


Stages of Change Model-Stages 3&4

Stage 4. Action

� Requires the largest effort, time and energy.

� Attempting to follow National Physical Activity Guidelines.

� Relapse is common, however if an individual maintains the active stage for six months they move into the maintenance stage.

Stage 3. Preparation•Seriously considering

becoming more active •May exercise once or

twice a week or several times a month.

•May be doing physical

activity but are not meeting the physical activity

guidelines.


Stages of Change Model-Stages 5&6

Stage 5-Maintenance

� Regularly active as part of their lifestyle

� Meeting NPAG for six months

� Person continually strives to overcome barriers.

� May be in this stage for up to five years.

Stage 6-Termination

� Regularly active for over five years

� Relapse very unlikely

� Permanent behaviour change has occurred.

Counselling options



Counselling options

Telephone counseling and automated telephone-delivered advice

� Programmed to call people automatically including during convenient times.

� Collect data for PA research.

� Counseling for people living in isolated or remote areas

� Social support for older adults if not familiar with using web-based technologies.

Health-professional counseling

• Advice from GPs is often highly regarded.

• GPs sometimes prescribe PA instead of a prescription for medication.


Counselling strategies- 1&2

1. Assessing motivational readiness

� One of the first steps is to assess a persons motivational readiness to become more active.

� Once their stage is determined, an individual’s motivation readiness can be matched with processes to change their behaviour.

2. Matching processes of change with motivational readiness

� Stages of change = when people change behaviour

� Processes of change = how people change their PA behaviour

� Processes of change can be grouped into two different categories: cognitive processes &behavioural processes.

� Individuals in early stages (Stages 1 or 2) focus on cognitive strategies eg increasing awareness and knowledge of the benefits of physical activity.

� Later Stages (Stages 3,4 and 5) might include behavioural strategies such as developing a reminder system an encouraging the use of rewards.


Readiness to change – (motivational readiness)

Are you accumulating at least 30 minutes of moderate-intensity physical

activity on most (five+) days of the week?

No Yes

Are you accumulating at least 30

minutes of moderate-intensity physical

activity at least one day per week?

Have you been doing this on a regular

basis for the last six months?

Do you intend

to increase your

physical

activity?

If you’re doing

physical activity

irregularly, you’re in

the preparation

stage.

If you’re not even thinking

about it, you are in the

precontemplation stage.

If you're giving it a thought now and

then but not doing it, you are in the

contemplation stage.

If you have been doing

this consistently but for

fewer than six months,

you are in the action

stage.

If you’re maintained the

new habit for six

months of more you

are in the maintenance

stage.

No

No

No

Yes

Yes Yes


Counselling strategies – 3&4

3. Identifying opportunities to be active

� Before you can identify opportunities to be more active you have to be aware of how often you move.

� Modern technology has minimised the need to move and people today sit longer hours than previous generations.

4. Contracting

� You could draw up a simple contract that states your activity goals and have a witness sign it with you.

� Set a date to reassess whether or not you have met your behavioural goal.

� Reward yourself if goals are achieved.

� Punishments can be used but should be determined by you.

� Punishments should not be in the form of physical activity; eg. no television for a week.



5. Enlisting social support

� Not having an exercise partner is often a barrier to physical activity.

� Many studies report that having someone to exercise with greatly increases your chances of being sufficiently active.

� Support may come from family members, partners, friends, work colleagues or other community members.

6. Reminder systems

� Reminding yourself to be active is especially important when you are in the ‘contemplation’ to ‘action’ phases of the Stages of Change Model.

� The following are some example reminder systems:

� Leave yourself a note on the refrigerator, computer or mirror.

� Use a diary.

� Poster on office wall or desk.

� Get friends to send email or text message to remind you

� Set reminders using your computer or mobile phone.



7. Gradual programming� Similar to ‘progressive

overload’ - gradual increase in workload, frequency or intensity.

� A slow, step-by-step approach desirable for inactive people

� For a beginner, being exhausted at the end of an activity greatly reduces likelihood of continuing to be active.

8. TailoringPrescribing a physical activity plan

to meet the individual needs of each person.

� Individual factors to consider include :

� social support,

� access to facilities,

� work hours,

� cultural factors,

� family structure,

� fitness levels and climate.

Cognitive and Behavioural

StrategiesStrategies for Promoting Physical Activity & ‘Stages of Change

Model’


Cognitive Strategies

� Increasing Knowledge � Encourage individual to read

and think about P.A.

� Being Aware of risks� Provide the individual with the

message that being inactive is very unhealthy.

� Caring about the consequences to others

� Encourage the person to recognise how their inactivity affects their family, friends and co-workers.

� Comprehending benefits

� Assist the individual to understand the personal benefits of being physically active.

� Increasing healthy opportunities.

� Help the individual increase their awareness of opportunities to be physically active


Behavioural Strategies

� Substituting alternatives

� Encourage the individual to participate in physical activity when they are tired, stressed, or unlikely to want to be physically active.

� Enlisting social support

� Encourage the individual to find a family member, friend, or co-worker who is willing and able to provide support for being active.

� shoes in the car/office, ready for use at any time

� Rewarding yourself� Encourage the individual to

praise themselves and reward themselves for being physically active

� Committing yourself� Encourage the individual to

make promises, plans and commitments to be active.

� Reminding yourself� Teach the individual how to set

up reminders to be active, such as keeping comfortable

Physical Activity Promotion



Promotion of Physical Activity

Population based promotion

� Environmental / Policy

� Mass media

Population approaches are designed to reach large segments of society or specific population groups.

Population based information is often collected by VicHealth, National Heart Foundation and various universities.

Information collected is used to establish government priorities and initiatives.

Individual based promotion

� Theoretical models of change

� Print and web-based media

� Counselling and screening

These strategies are often based on

theoretical models of individual

behaviour change


Environmental Strategies

1. Tailoring – Changing physical environments to suit community needs. Eg. Walking track along Wimmera river promotes walking.

2. Removing impediments to activity – Take away reasons for people not to participate in PA eg. Design walking tracks away from major highways/roads.

3. Introducing new resources and facilities – eg. New sports grounds, age specific playgrounds.

4. Support from other programs –eg. Reducing crime in an area will make people feel more safe to go for a walk.

5. Opening Hours – Opening sporting venues before and after business hours.


Sample Environmental Strategies


Print and Web-based Media

Print media can promote PA in;

� Booklets

� Brochures & handoutsIt is available from;

� Recreational centres� Regional Sports

Assemblies

� Health care centres� School and workplaces

� Mail outsDoesn’t require internet

access.

Web bases media promotes PA through;

� Interactive websites

� Works through the stages of change

� Great short term value – not long term


Examples of Media Campaigns


Mass Media & Participation

Mass media can influence participation by;

� Providing information on its health and non-health benefits

� Encouraging public participation

� Providing information regarding access to community based programs

� Motivating individuals to take action


Mass Media Campaigns

� Be Active (SA)

� Get Moving (National)

� Go for 5 & 2 (National)

� Go for Your Life (VIC)

� Find 30 (WA)

� 10,000 Steps (QLD)

Special Needs Groups



Specific ‘At Risk’ Groups

Groups at risk of being inactive include;

� Low socio-economic backgrounds

� Race and ethic minorities

� Disabled people

Intervention programs include;

1. Community involvement – Local planning to target specific groups

2. Needs assessment – Community surveys, interviews etc of focus group. One program doesn’t fit all.

3. Understanding the target group – Need to make the program with an understanding of key values, cultural beliefs and methods of overcoming barriers to PA.


� Complete the chapter questions on page 9-14 of Nelson Peak Performance Physical Education VCE Units 3 & 4.

Peak Performance


� Read the summarised information of pages 11-19 of PHYS ED Notes and complete the revision questions.

PHYS ED Notes


Web Links – Chapter 2•Australian Sports Commission: http://www.ausport.gov.au•Find 30 promotion (Government of WA Department of Health): http://www.find30.com.au•Walking School Bus promotion (UK): http://www.walkingbus.com•Ministry of Health (New Zealand) toolkits: http://www.newhealth.govt.nz•The 10,000 Steps Rockhampton project: http://www.10000steps.org.au/rockhampton/•Travelsmart Australia: http://www.travelsmart.gov.au•World Health Organisation: http://www.who.int•Heart Foundation Australia: http://www.heartfoundation.com.au•VicHealth (The Victorian Health Promotion Foundation): http://www.vichealth.vic.gov.au•Be Active promotion (Government of South Australia): http://www.beactive.com.au•Go For Your Life: http://www.goforyourlife.vic.gov.au•Physical Activity Resources for Health Professionals – Introduction (Centre for disease control and prevention – USA):

http://www.cdc.gov/nccdphp/dnpa/physical/health_professionals/index.htm•Health Promotion (Public Health Agency of Canada): http://www.phac-aspc.gc.ca/hp-ps/index.html•Strategic Inter-Governmental Forum on Physical Activity and Health (SIGPAH): http://www.nphp.gov.au/workprog/sigpah/•Healthy youth (Centre for disease control and prevention (USA): http://www.cdc.gov/HealthyYouth/•America On The Move promotion: http://www.americaonthemove.org•Papers from the International Journal of Behavioural Nutrition and Physical Activity: http://www.ijbnpa.org/home•Department of health and aging (Australian government): http://www.health.gov.au/internet/wcms/publishing.nsf/content/home•Building a healthy, active Australia (Australian government): http://www.healthyactive.gov.au•National Public Health Partnership: http://www.nphp.gov.au•Be Active promotion (Government of South Australia): http://www.beactive.com.au•Sport and Recreation Australia: http://www.sport.vic.gov.au

•The 10,000 Steps Rockhampton project: http://www.10000steps.org.au/rockhampton/•Find 30 promotion (Government of Western Australia Department ofHealth): http://www.find30.com.au•Go For Your Life: http://www.goforyourlife.vic.gov.au•America On The Move promotion: http://www.americaonthemove.org•Be Active promotion (Government of South Australia): http://www.beactive.com.au•Building a healthy, active Australia (Australian government): http://www.healthyactive.gov.au

• Go for green, active living and environment program (Canada): http://www.goforgreen.ca/home_e.html

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