Course:KIN366/ConceptLibrary/Physical Activity Adherence

Physical Activity Adherence
KIN 366
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Instructor:	Dr. Shannon S.D. Bredin
Email:	shannon.bredin@ubc.ca
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Physical Activity Adherence

Physical Activity Adherence refers to the continuation of a physical activity routine for a prolonged period of time after the initial start up phase. It is voluntary, self-regulated, and often psychological in nature. Physical activity habits in adulthood are often established in childhood (Stucky-Ropp, & DiLorenzo, 1993), and physical activity programs in schools can be effective in improving fitness levels and increase participation in health-related activities in children (Seefeldt, 1986). We see that the time spent on sedentary activities within adolescences and youth is increasing from 65% to 76% between 2000 and 2009 (Statistic Canada, 2000). One of the sedentary activity is time spend in front of a screen, which is positively associated with obesity (Shields & Tremblay, 2008). It is also suggested that as children grow older, their level of physical activity will decrease (Strauss et al., 2001). That is why it is important to develop the habit of physical activity amongst children.

Importance of Physical Activity

• Improve physical fitness/physiological health: Increasing the frequency of physical activity could lead to decrease in cardiovascular disease risk factors as well as increase in cardiovascular fitness (Stucky-Ropp et al., 1993).
• Improve psychological/emotional health: Studies have shown that the development of self-esteem in children is correlated to high-level physical activity (Strauss, Rodzilsky, Burack, & Colin, 2001).
• Improve social relations: Intense physical activity is positively correlated to social influences (Strauss et al., 2001).

Children are shown to spend more than 10 hours a day sedentary. It is important for children to participate in physical activities to decrease the amount of time in sedentary activities. Physical activity is also associated with reduced bodily pain, improved general health and vitality, and reduced role-emotional scores (Ikuyo et al., 2013). Many evidence points to physical activity being critical to the short and long-term health of children and adolescence (Trost, Pate, Saunders, Ward, Dowda, & Felton, 1997).

Predicting Adherence to Physical Activity

Self-Determination Theory (SDT):

This theory distinguishes the different types of motivations that give us the ability to understand the reasons why the participation of certain physical activities is maintained (Deforche, Haerens, & De Bourdeaudhuij, 2011).

• Amotivation: A general lack in motivation to engage in physical activity.
• Controlled motivation: Participating in physical activity due to the feelings of internal or external pressure.
• Autonomous motivation: The reason that physical activities are maintained is because it is enjoyable, interesting and challenging. The idea of improving health and fitness is also part of the reason. This type of motivation has been shown to increase participation in physical activities in children (Deforche et al., 2011).

Health Belief Model:

This model consist of such things as how one views their perceived severity of illness, perceived susceptibility to the disease, perceived benefit of participating in physical activities, and perceived barrier of participation. Some researchers believe that the health belief model can allow us to predict physical activity participation. On the other hand, studies have shown that this model was minimally associated with adolescents’ physical activity participation, and contributed minimally in a community sample (Strauss et al., 2001).

Locus of Control:

This model suggest that people are either internal controllers who believe that they can control the outcomes in their lives, or external controllers who believe that their destinies are controlled by chance or by others (Rotter, 1966). Some studies show that internal locus of control is linked with increased exercise, but further research has to be done. Knowing whether or not the individual perceives the accomplishment of physical activity as chance or skill also helps predict the continuation of the activity. As a higher perceived self-competence will enhance the enjoyment and adherence to the activity (Deforche et al., 2011).

Adherence as a process:

This model focuses on the idea that adherence is an on-going process. It suggests that the behaviour of people changes in sequences instead of all at once.

Barriers to Adherence

Approximately 50% of the individual who start self-monitored exercise program will drop out of that program within six month (Dishman, 1991). Studies show that pubertal and postpubertal children only spend 8 to 10 minutes per day in aerobic activities (Strauss et al., 2001).

• Age: Individuals are more likely to drop out if they view that they are the youngest in the group participating in physical activity (Thomas, Cote, & Deakin, 2008).
• Convenience/ availability: As children are often reliant on their parents for transportation, access to locations that allows for physical activities also has an effect on the participation of physical activities for children (Strauss et al., 2001).
• Physical limitations: Perceived lack of ability is linked with lower self-efficacy, which can decrease maintenance of physical activities (Chase, 2001).
• Gender: Girls aged 7 to 15 years spend an average of 8 to 10 minutes on aerobic activities per day compared to 30 minutes for boys (Strauss et al., 2001).
• Lack of enjoyment: Enjoyment of physical activity is a significant predictor for both boys and girls participation in physical activity. It is believed that the enhancement of enjoyment has far reaching effects on the longevity of adherence of physical activity for children (Stucky-Ropp et al., 1993). Thus the lack of enjoyment will have an adverse effect on the participation for children.
• Lack of time: It is often the lack of time from the parents that limit the participation of physical activity for children. Children are often dependent on the parents to drive them or to participate with them.
• Environment: Easily accessible facilities is a likely prerequisite to successful maintenance of physical activity (Dishman, 1991).

Strategy for improving adherence

Family and social support: Support from family and friends will increase the motivations for a child to continue participation in the physical activities (Strass et al., 2001). Inactivity in the parents is also shown to be strong predictors of inactivity in children (Deforche et al., 2011). Parental support also has a strong correlation with youth physical activity participation through the role of self-efficacy (Trost, 2003). Enjoyment and commitment to physical activity increases when youth have positive relations with their peers (Thomas et al., 2008).

Perceived choice: Adherence will arise when the child perceives that the choice is self-determined. This allows the individual to receive the need for autonomy, which helps promote long-term physical activity adherence.(Deforche et al., 2011)

Feedback: Feedback has shown to increase the perceived competence in children (Deforche et al., 2011). It has also been related to enhance self-efficacy, which is linked to adherence (Williams, & French, 2011)It is more beneficial to give a child self-improvement feedback rather than comparative feedback to avoid unrealistic ideas of what is considered to be standard (Deforche et al., 2011). When children are given feedback early on, this gives them information on what to improve and often leads to persisting longer in physical activities (Chase 2001). Positive feedback also cultivates a child’s perceptions of competence, control, and intrinsic motivations (Harter, 1999).

Developmentally appropriateness: Allowing the children to have a positive experience will improve competency and self-efficacy towards physical activities. This will lead to the longevity of participation (Trost et al., 1997). Students who participate in quality physical education programs of sufficient length can increase levels of fitness, and acquire the necessary knowledge and enjoyment levels essential to impact future patterns of adherence to exercise programs (Seefeldt, 1986).

References

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Bush, P. T., & Iannotti, R. J. (1990). A Children’s Health Belief Model. Medical Care, 28(1), 69–86.

Chase, M. A. (2001). Children’s self-efficacy, motivational intentions, and attributions in physical education and sport. Research Quarterly for Exercise and Sport, 72(February 2015), 47–54. doi:10.1080/02701367.2001.10608931

Deforche, B., Haerens, L., & de Bourdeaudhuij, I. (2011). How to make overweight children exercise and follow the recommendations. International Journal of Pediatric Obesity : IJPO : An Official Journal of the International Association for the Study of Obesity, 6 Suppl 1(December 2010), 35–41. doi:10.3109/17477166.2011.583660

Dempsey, J. M., Kimiecik, J. C., & Horn, T. S. (1993). Parental influence on children’s moderate to vigorous physical activity participation: An expectancy-value approach. Pediatric Exercise Science, 5, 151–167.

Dencker, M., & Andersen, L. B. (2008). Health-related aspects of objectively measured daily physical activity in children. Clinical Physiology and Functional Imaging, 28, 133–144. doi:10.1111/j.1475-097X.2008.00788.x

Dishman, R. K. (1991). Increasing and maintaining physical activity and exercise. Behavior Therapy, 22, 345–378. doi:10.1016/S0005-7894(05)80371-5

Fraser-Thomas, J., Côté, J., & Deakin, J. (2008). Examining Adolescent Sport Dropout and Prolonged Engagement from a Developmental Perspective. Journal of Applied Sport Psychology, 20(February 2015), 318–333. doi:10.1080/10413200802163549

Garcia, a W., Pender, N. J., Antonakos, C. L., & Ronis, D. L. (1998). Changes in physical activity beliefs and behaviors of boys and girls across the transition to junior high school. The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine, 22, 394–402. doi:10.1016/S1054-139X(97)00259-0

Gudas, L. J., Koocher, G. P., & Wypij, D. (1991). Perceptions of medical compliance in children and adolescents with cystic fibrosis. Journal of Developmental and Behavioral Pediatrics : JDBP. doi:10.1097/00004703-199108000-00004

Ikuyo, I., Alfano, C. M., Mason, C. E., Wang, C., Xiao, L., Duggan, C., … McTiernan, A. (2013). Exercise adherence, cardiopulmonary fitness and anthropometric changes improve exercise self-efficacy and health-related quality of life. Journal of Physical Activity & Health, 10(5), 676–689. doi:10.1055/s-0029-1237430.Imprinting

Janz Becker, M. H., N. K. (1984). The Health Belief Model: A Decade Later. Health Education & Behavior, 11, 1–47.

Michie, S., Ashford, S., Sniehotta, F., Dombrowski, S., Bishop, a, & French, D. (2011). A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy., 26(11), 1479–1498. doi:10.1080/08870446.2010.540664

Shields, M., & Tremblay, M. S. (2008). Screen time among Canadian adults: a profile. Health Reports / Statistics Canada, Canadian Centre for Health Information = Rapports Sur La Sant?? / Statistique Canada, Centre Canadien D’information Sur La Sant??, 19(82), 31–43.

Strauss, R. S., Rodzilsky, D., Burack, G., & Colin, M. (2001). Psychosocial correlates of physical activity in healthy children. Archives of Pediatrics & Adolescent Medicine, 155, 897–902. doi:poa00590 [pii] Stucky-Ropp, R. C., & DiLorenzo, T. M. (1993). Determinants of exercise in children. Preventive Medicine. doi:10.1006/pmed.1993.1079

Trost, S. G., Pate, R. R. R., Saunders, R., Ward, D. S., Dowda, M., & Felton, G. (1997). A prospective study of the determinants of physical activity in rural fifth-grade children. Preventive Medicine, 26, 257–263. doi:10.1006/pmed.1996.0137 [doi] S0091-7435(96)90137-1 [pii]

Trost, S. G., Sallis, J. F., Pate, R. R., Freedson, P. S., Taylor, W. C., & Dowda, M. (2003). Evaluating a model of parental influence on youth physical activity. American Journal of Preventive Medicine, 25(4), 277–282. doi:10.1016/S0749-3797(03)00217-4

Williams, S. L., & French, D. P. (2011). What are the most effective intervention techniques for changing physical activity self-efficacy and physical activity behaviour - And are they the same? Health Education Research, 26(2), 308–322. doi:10.1093/her/cyr005