Über die Autorin bzw. den Autor

Lindsey Dugdill, Reader in Exercise and Health in the School of Health Care Professions, University of Salford, UK

Diane Crone, Reader in Exercise Science at the University of Gloucestershire, UK and BASES (British Association of Sport and Exercise Sciences) Accredited Sport and Exercise Scientist (Support and Research).

Rebecca Murphy, Lecturer in Exercise and Health at Liverpool John Moores University.

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Physical Activity and Health Promotion: Evidence-based Approaches to Practice evaluates the realities and complexities of working to reverse the adverse trend towards physical inactivity. It is a well-rounded, evidence-based analysis of interventions for physical activity practice, covering a range of settings and target groups. Expert contributors present case studies which help to translate the theory into practice, from individual to societal levels, enriched by explanations of the socio-political context.

The first section covers the concepts for the development of physical activity practice; influencing sustained health behaviour change, explaining the role and function of health policy in physical activity promotion, and developing the evidence base for physical activity interventions. Section Two explores the evidence base for interventions in physical activity practice, in varied settings and target groups. Physical Activity and Health Promotion concludes with a challenge to innovate in promoting physical activity.

Physical Activity and Health Promotion will be of relevant to health professionals and students with an interest in sport, physical activity and exercise, particularly health and exercise promotion specialists across the disciplines.

Aus dem Klappentext

Physical Activity and Health Promotion: Evidence-based Approaches to Practice evaluates the realities and complexities of working to reverse the adverse trend towards physical inactivity. It is a well-rounded, evidence-based analysis of interventions for physical activity practice, covering a range of settings and target groups. Expert contributors present case studies which help to translate the theory into practice, from individual to societal levels, enriched by explanations of the socio-political context.

The first section covers the concepts for the development of physical activity practice; influencing sustained health behaviour change, explaining the role and function of health policy in physical activity promotion, and developing the evidence base for physical activity interventions. Section Two explores the evidence base for interventions in physical activity practice, in varied settings and target groups. Physical Activity and Health Promotion concludes with a challenge to innovate in promoting physical activity.

Physical Activity and Health Promotion will be of relevant to health professionals and students with an interest in sport, physical activity and exercise, particularly health and exercise promotion specialists across the disciplines.

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Physical Activity and Health Promotion

John Wiley & Sons

Chapter One

Rebecca Murphy, Lindsey Dugdill and Diane Crone

Introduction

Physical activity research has clearly established the link between inactivity and poor health status in populations (United States Department of Health and Human Services, 1996; Department of Health, 2004 a,b,c; Department of Health, 2005). In addition, it is widely accepted that population physical activity levels in the UK are lower than that recommended for ensuring optimal health. Physical inactivity is becoming an issue of extreme public health importance to all health professionals and agencies within the UK, across Europe and in other Western industrialised countries. A range of global and international health policies outline the significance to public health of promoting healthy lifestyles in the twenty first century (Department of Health, 2004a, 2008; World Health Organisation [WHO], 2004; Wanless, 2004; Hillsdon et al., 2004). In the UK, physical activity is cited as a key intervention to tackle many health problems (Department of Health 2004a). The Department of Health has a joint public service agreement with the Treasury, the Department for Education and Skills and the Department for Culture Media and Sport (DCMS, 2002) to halt the year-on-year rise in obesity among children under 11 by 2010, in the context of a broader strategy to tackle obesity in the population as a whole (Dugdill and Stratton, 2007; Department of Health, 2008). In addition, the importance of physical activity as a risk factor for coronary heart disease is increasingly being recognised throughout Europe (Health Enhancing Physical Activity Guidelines [HEPA], 2000) and beyond (WHO, 2004).

Physical activity is a key component to maintaining a healthy lifestyle for all individuals. To assist in contextualising the significance of physical activity promotion to public health, this chapter outlines and considers definitions of health and health promotion, health trends, and current recommendations for physical activity within health promotion.

Defining exercise and physical activity

Physical activity is defined as any bodily movement produced by skeletal muscles that results in energy expenditure (Caspersen et al., 1985). It has dimensions of 'volume (how much), duration (how long), frequency (how often), intensity (how hard) and mode (what type)' (Cale and Harris, 2005, p. 7). It is, therefore, a multi-faceted, complex and broad-ranging behaviour that may encompass activities of daily living (housework, gardening, stair climbing), occupation-related activity completed as part of one's job (walking, hauling, lifting and packing), transportation physical activity [walking, biking or wheeling (for wheelchair users), to and from places)] also known as active travel or transport, leisure time activity (exercise, sports recreation or hobbies), or engagement in specific prescribed interventions (Dugdill and Stratton, 2007). Exercise is considered a subset of physical activity which includes planned, structured, and repetitive bodily movement which is undertaken to improve or maintain one or more components of physical fitness (Casperson et al., 1985).

Understanding the political climate

In recent years, the Chief Medical Officer has collated and summarised the scientific evidence on the contribution of active living to promoting health and well-being across the lifespan (Department of Health, 2004b). Evidence suggests that increasing physical activity participation could significantly contribute to the prevention and management of over 20 diseases and conditions. In addition it is estimated that the cost of inactivity in England could be 8.2 billon annually (DCMS, 2002). In recent years various targets for increasing participation levels in sport and physical activity have been proposed. These include a target to increase participation levels to 70% of individuals undertaking 30 minutes of physical activity 5 days a week by 2020 (DCMS, 2002), and a less ambitious target of an increase in participation to 50% by 2020 (Wanless, 2004) (see also Chapters 3 and 6). Physical activity promotion was a key target of the Public Health White Paper Choosing Health: Making Healthier Choices Easier (Department of Health, 2004a). Furthermore, Choosing Activity: A Physical Activity Action Plan (Department of Health, 2005) outlined the action that needs to be taken in order to promote physical activity in the UK, and documents Government priorities for physical activity promotion in the form of cross-departmental Public Service Agreement Targets, which are:

'To halt the year-on-year increase in obesity among children under 11 by 2010, in the context of a broader strategy to tackle obesity in the population as a whole. By 2008, increase the uptake of cultural and sporting opportunities by adults and young people aged 16 and above from priority groups by increasing the number of people who participate in active sports, at least 12 times a year by 3% and increasing the number who engage in at least 30 minutes of moderate intensity level sport, at least 3 times a week by 3%. Enhance the take-up of sporting opportunities by 5-16 year olds so that the percentage of school children in England who spend a minimum of two hours each week on high quality PE and school sport, within and beyond the curriculum, increases from 25% in 2002 to 75% by 2006 and 85% by 2008 in England, and at least 75% in each school sport partnership by 2008'. (Department of Health, 2005, p. 7)

Physical activity prevalence and trends

Worldwide, 60% of the population are insufficiently active to benefit their health (WHO, 2004) and physical activity levels in the UK are exceptionally low (Department of Health, 2004b); e.g. only 21% of the adult population are regularly participating in sport or recreational activity (defined as taking part, on at least 3 days a week, in moderate intensity sport and active recreation, for at least 30 minutes continuously in any one session) (Sport England, 2006). Variation in participation exists according to demographic variables. More males (37%) than females (25%), residing within the UK, attain current recommended activity guidelines (Department of Health, 2004c), participation declines with age for both men and women and, compared with the general population, men from certain ethnic groups (Indian, Pakistani, Bangladeshi and Chinese) are less likely to meet physical activity recommendations (Department of Health, 2004c). According to the National Travel Survey (Department for Transport, 2001) between 1975-1976 and 1999-2001 average miles travelled by foot and bicycle had decreased by approximately 26%. In contrast, participation levels in selected leisure time physical activity such as walking, swimming and keep-fit/ yoga were reported to have increased or at least remained the same between 1987 and 1996 (Department for Transport, 2001). In conclusion, therefore, over the past 20-30 years it seems that there has been a significant decrease in physical activity as part of daily routines and a small increase in activity during leisure time.

Health and health promotion

Health is a multidisciplinary concept, which encompasses states of both positive and...