Awareness of physical activity in healthy middle-aged adults: a cross-sectional study of associations with sociodemographic, biological, behavioural, and psychological factors

BMC Public Health

Esther MF van Sluijs²  Simon J Griffin²  Stephen Sutton¹  Kirsten Corder²  Clare Watkinson³  Job G Godino³ 

[1] Behavioural Science Group, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0SR, United Kingdom;UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, University of Cambridge, Box 296, Forvie Site, Robinson Way, Cambridge CB2 0SR, United Kingdom;MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Addenbrooke's Hospital, Box 285, Hills Road, Cambridge CB2 0QQ, United Kingdom

关键词: Personalised feedback;    Behaviour change;    Correlates;    Barriers;    Misperception;    Awareness;    Objective measurement;    Physical activity;   

Others  :  1131461
DOI  :  10.1186/1471-2458-14-421

 received in 2014-02-05, accepted in 2014-04-25,  发布年份 2014

【 摘 要 】

Background

Interventions to promote physical activity have had limited success. One reason may be that inactive adults are unaware that their level of physical activity is inadequate and do not perceive a need to change their behaviour. We aimed to assess awareness of physical activity, defined as the agreement between self-rated and objective physical activity, and to investigate associations with sociodemographic, biological, behavioural, and psychological factors.

Methods

We conducted an exploratory, cross-sectional analysis of awareness of physical activity using baseline data collected from 453 participants of the Feedback, Awareness and Behaviour study (Cambridgeshire, UK). Self-rated physical activity was measured dichotomously by asking participants if they believed they were achieving the recommended level of physical activity. Responses were compared to objective physical activity, measured using a combined accelerometer and heart rate monitor (Actiheart®). Four awareness groups were created: overestimators, realistic inactives, underestimators, and realistic actives. Logistic regression was used to assess associations between awareness group and potential correlates.

Results

The mean (standard deviation) age of participants was 47.0 (6.9) years, 44.4% were male, and 65.1% were overweight (body mass index ≥ 25). Of the 258 (57.0%) who were objectively classified as inactive, 130 (50.4%) misperceived their physical activity by incorrectly stating that they were meeting the guidelines (overestimators). In a multivariable logistic regression model adjusted for age and sex, those with a lower body mass index (Odds Ratio (OR) = 0.95, 95% Confidence Interval (CI) = 0.90 to 1.00), higher physical activity energy expenditure (OR = 1.03, 95% CI = 1.00 to 1.06) and self-reported physical activity (OR = 1.13, 95% CI = 1.07 to 1.19), and lower intention to increase physical activity (OR = 0.69, 95% CI = 0.48 to 0.99) and response efficacy (OR = 0.53, 95% CI = 0.31 to 0.91) were more likely to overestimate their physical activity.

Conclusions

Overestimators have more favourable health characteristics than those who are realistic about their inactivity, and their psychological characteristics suggest that they are less likely to change their behaviour. Personalised feedback about physical activity may be an important first step to behaviour change.

【 授权许可】

   
2014 Godino et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Lee I-M, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT: Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet 2012, 380:219-29.
• [2]Department of Health, Physical Activity, Health Improvement and Prevention: At Least Five a Week: Evidence on the Impact of Physical Activity and Its Relationship to Health. London: A Report from the Chief Medical Officer; 2004.
• [3]FAO/WHO/UNU: Human Energy Requirements: Report of a Joint FAO/WHO/UNU Expert Consultation. Rome: FAO Food and Nutrition Technical Report Series; 2001.
• [4]Bull FC, The Expert Working Groups: Physical Activity Guidelines in the UK: Review and Recommendations. Loughborough: School of Sport, Exercise and Health Sciences, Loughborough University; 2010.
• [5]Change4Life: Move More http://www.nhs.uk/Change4Life/ webcite
• [6]NHS Choices: Live Well http://www.nhs.uk/LiveWell/ webcite
• [7]Craig R, Mindell J, Hirani V: Health Survey for England 2008, Volume 1: Physical Activity and Fitness. London: The Health and Social Care Information Centre; 2009:395.
• [8]Tucker JM, Welk GJ, Beyler NK: Physical activity in U.S. Adults: Compliance with the Physical Activity Guidelines for Americans. Am J Prev Med 2011, 40:454-61.
• [9]Van Sluijs EMF, van Poppel MNM, van Mechelen W: Stage-based lifestyle interventions in primary care: Are they effective? Am J Prev Med 2004, 26:330-43.
• [10]Hillsdon M, Foster C, Thorogood M: Interventions for promoting physical activity. Cochrane Database Syst Rev 2005, 1:CD003180.
• [11]Müller-Riemenschneider F, Reinhold T, Nocon M, Willich SN: Long-term effectiveness of interventions promoting physical activity: A systematic review. Prev Med (Baltim) 2008, 47:354-68.
• [12]Orrow G, Kinmonth A-L, Sanderson S, Sutton S: Effectiveness of physical activity promotion based in primary care: Systematic review and meta-analysis of randomised controlled trials. BMJ 2012, 344:e1389.
• [13]Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW: Correlates of physical activity: Why are some people physically active and others not? Lancet 2012, 380:258-71.
• [14]Ronda G, Van Assema P, Brug J: Stages of change, psychological factors and awareness of physical activity levels in The Netherlands. Health Promot Int 2001, 16:305-14.
• [15]Lechner L, Bolman C, Van Dijke M: Factors related to misperception of physical activity in The Netherlands and implications for health promotion programmes. Health Promot Int 2006, 21:104-12.
• [16]Van Sluijs EM, Griffin SJ, Van Poppel MNM: A cross-sectional study of awareness of physical activity: Associations with personal, behavioral and psychosocial factors. Int J Behav Nutr Phys Act 2007, 9:1-9.
• [17]Watkinson C, van Sluijs EM, Sutton S, Hardeman W, Corder K, Griffin SJ: Overestimation of physical activity level is associated with lower BMI: A cross-sectional analysis. Int J Behav Nutr Phys Act 2010, 7:68. BioMed Central Full Text
• [18]Thompson D, Batterham AM, Markovitch D, Dixon NC, Lund AJS, Walhin J-P: Confusion and conflict in assessing the physical activity status of middle-aged men. PLoS One 2009, 4:e4337.
• [19]Ajzen I: The theory of planned behavior. Organ Behav Hum Decis Process 1991, 50:179-211.
• [20]Weinstein ND: The precaution adoption process. Heal Psychol 1988, 7:355-386.
• [21]Corder K, van Sluijs EM, McMinn AM, Ekelund U, Cassidy A, Griffin SJ: Perception versus reality: Awareness of physical activity levels of British children. Am J Prev Med 2010, 38:1-8.
• [22]Corder K, van Sluijs EM, Goodyer I, Ridgway CL, Steele RM, Bamber D, Dunn V, Griffin SJ, Ekelund U: Physical activity awareness of British adolescents. Arch Pediatr Adolesc Med 2011, 165:603-9.
• [23]Helmerhorst HJF, Brage S, Warren J, Besson H, Ekelund U: A systematic review of reliability and objective criterion-related validity of physical activity questionnaires. Int J Behav Nutr Phys Act 2012, 9:103. BioMed Central Full Text
• [24]Watkinson C, van Sluijs EMF, Sutton S, Marteau T, Griffin SJ: Randomised controlled trial of the effects of physical activity feedback on awareness and behaviour in UK adults: The FAB study protocol [ISRCTN92551397]. BMC Public Health 2010, 10:144. BioMed Central Full Text
• [25]Rolfe E, Loos R, Druet C, Stolk R, Ekelund U, Griffin S, Forouhi N, Wareham N, Ong K: Association between birth weight and visceral fat in adults. Am J Clin Nutr 2010, 92:347-352.
• [26]Ware J, Kosinski M, Dewey J, Gandek B: How to Score and Interpret Single-Item Health Status Measures: A Manual for Users of the SF-8 Health Survey. Lincoln, RI: QualityMetric Incorporated; 2001.
• [27]Brage S, Brage N, Franks PW, Ekelund U, Wareham NJ: Reliability and validity of the combined heart rate and movement sensor Actiheart. Eur J Clin Nutr 2005, 59:561-70.
• [28]Brage S, Brage N, Franks PW, Ekelund U, Wong M-Y, Andersen LB, Froberg K, Wareham NJ: Branched equation modeling of simultaneous accelerometry and heart rate monitoring improves estimate of directly measured physical activity energy expenditure. J Appl Physiol 2004, 96:343-51.
• [29]Strath SJ, Brage S, Ekelund U: Integration of physiological and accelerometer data to improve physical activity assessment. Med Sci Sport Exerc 2005, 37:S563-S571.
• [30]Thompson D, Batterham A, Bock S, Robson C, Stokes K: Assessment of low-to-moderate intensity physical activity thermogenesis in young adults using synchronized heart rate and accelerometry with branched-equation modeling. J Nutr 2006, 136:1037-1042.
• [31]Besson H, Brage S, Jakes R, Ekelund U, Wareham N: Estimating physical activity energy expenditure, sedentary time, and physical activity intensity by self-report in adults. Am J Clin Nutr 2010, 91:106-114.
• [32]Williams K, Prevost AT, Griffin S, Hardeman W, Hollingworth W, Spiegelhalter D, Sutton S, Ekelund U, Wareham N, Kinmonth AL: The ProActive trial protocol - a randomised controlled trial of the efficacy of a family-based, domiciliary intervention programme to increase physical activity among individuals at high risk of diabetes [ISRCTN61323766]. BMC Public Health 2004, 4:48. BioMed Central Full Text
• [33]Sutton S, French DP, Hennings SJ, Mitchell J, Wareham NJ, Griffin S, Hardeman W, Kinmonth AL: Eliciting salient beliefs in research on the theory of planned behaviour: The effect of question wording. Curr Psychol 2003, 22:234-251.
• [34]Crockett RA, Weinman J, Hankins M, Marteau T: Time orientation and health-related behaviour: measurement in general population samples. Psychol Health 2009, 24:333-350.
• [35]StataCorp: Stata Statistical Software: Release 12. 2011.
• [36]Hardeman W, Sutton S, Griffin S, Johnston M, White A, Wareham NJ, Kinmonth AL: A causal modelling approach to the development of theory-based behaviour change programmes for trial evaluation. Health Educ Res 2005, 20:676-87.
• [37]DiClemente CC, Marinilli AS, Singh M, Bellino LE: The role of feedback in the process of health behavior change. Am J Health Behav 2001, 25:217-27.
• [38]Proper KI, van der Beek AJ, Hildebrandt VH, Twisk JWR, van Mechelen W: Short term effect of feedback on fitness and health measurements on self reported appraisal of the stage of change. Br J Sports Med 2003, 37:529-34.
• [39]Bravata D, Smith-Spangler C, Sundaram V, Gienger A, Lin N, Lewis R, Stave C, Olkin I, Sirard J: Using pedometers to increase physical activity and improve health: A systematic review. JAMA 2007, 298:2296-2304.
• [40]Tudor-Locke C, Lutes L: Why do pedometers work?: a reflection upon the factors related to successfully increasing physical activity. Sport Med 2009, 39:981-93.
• [41]King AC, Ahn DK, Oliveira BM, Atienza AA, Castro CM, Gardner CD: Promoting physical activity through hand-held computer technology. Am J Prev Med 2008, 34:138-42.
• [42]Marcus B, Bock B, Pinto B: Efficacy of an individualised, motivationally-tailored physical activity intervention. Ann Behav Med 1998, 20:174-180.
• [43]Kroeze W, Werkman A, Brug J: A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors. Ann Behav Med 2006, 31:205-23.
• [44]Smeets T, Brug J, de Vries H: Effects of tailoring health messages on physical activity. Health Educ Res 2008, 23:402-13.
• [45]Van Stralen MM, de Vries H, Mudde AN, Bolman C, Lechner L: The long-term efficacy of two computer-tailored physical activity interventions for older adults: main effects and mediators. Heal Psychol 2011, 30:442-52.