how can we deliver better pa programmes? jim mckenna professor of physical activity and health leeds...
TRANSCRIPT
How can we deliver better PA programmes?
Jim McKenna
Professor of Physical Activity and HealthLeeds Metropolitan University
Active Lifestyles research centre
Successful: healthy people, superior care and fair
Sustainable: affordable, acceptable and adaptable
Better ways to promote PA so fewer people remain inactive
Eight constructs account for most variation in health-related behaviour
Intentions
Environmentalbarriers
Emotions
Self standards
Skills
Outcomeexpectancies
Socialnorms
Self efficacy
Shift from motivation
to motivators
TimeMoney
Physical effortBrain cycles
Social devianceNon-routine
Pleasure/painHope/fear
Acceptance/rejection
SignalFacilitator
Spark
Why do we need new approaches?
So, what works best then?
Positive effects
Negative effects
Potent PA programmes• 358 studies, 99K participants (median; 74% F); moderate mean effect size
(d=0.19, <500 steps/day) for studies with healthy adults* result from ...
• Project staff delivering standardised interventions using behavioural techniques (exercise prescription, goal-setting, self-monitoring, PA feedback/consequences), direct to participants
• *Health education did not increase effect size
Conn et al. (2011) Am J Pub H. 101(4), 751-8.
‘New’ ways to promote things
‘New’ ways to promote things?
‘Persuasion infrastructure’
‘Attention-omics’
Nudge
Time trigger+
One-off behaviour
Time trigger+
Repeated behaviour
Time trigger + short-term stopping
Time trigger + short-term behaviour
Time trigger + short-term behaviour
+ one-off behaviour
‘New’ messages for promoting PA
Avoid threat + Seek reward
Personal brain management
YOU facilitatethe growth
of YOUR brain
ExerciseExerciseMental stimulationMental stimulationStress managing/sleepStress managing/sleepDietDiet
Some key brain rules
1. Exercise boosts brain power
Our mental healthis as important
as our physical health
Some key brain rules
Exercise boosts brain powerHuman brains evolve
We ignore boring things
Normal lessons decrease time on task MOST for overweight children
(n=97)*Normal (inactive) lessons
Normal O’wt
Grieco et al. (2009). MSSE 41, 1921-26.*Mean age 8.9 years; 54% female.
Overweight/obesity in LeedsYears 7, 9 and 11 (Griffiths et al., 2012)
Fatter earlierFatter earlierStay fatter for longerStay fatter for longerFat children are fatterFat children are fatter
The cognitive value of exerciseOlder adults
Highest functioningLowest functioning
AfterBefore
During
Gender-specific interventions
What’s your score?A graded and progressive relationship between
these behaviours and both morbidity and mortality
Not smoking+
Regular PA+
5+/day f/veg+
Mod alcohol+
BMI
Behavioural clustersPoortinga (2007) Prev Med 44, 124-8.
• A majority of UK males have two+ behavioural risks:
4 risks – 5.5%3 risks – 23.6%2 risks – 39.9%1 risk - 25.3%0 risks – 5.7%
• From smoking, 6+units alcohol once per week, less than 5 fruit/veg portions yesterday and <5+ days 30mins continuous MPA in last 4 weeks.
• 28% smoked, 23% drank heavily, 76% ate too few fruits/veg and 66% lacked MPA
• ‘…people who are physically active are more likely to smoke and drink heavily…’ p127
