Motivating people to get active

Encouraging exercise taking

This is a bit of a rehash of a blog which I wrote about two and a half years ago. How do we encourage people to increase their physical activity levels? It is all very well knowing that exercise is good for you but, like knowing that eating too much makes you fat, that does not necessarily lead to a change in behaviour. Telling someone that they should get more active is a very ineffective intervention and is sometimes counterproductive. One upcoming opportunity will be NY resolutions time which I will be addressing in a couple of weeks.

Is it necessary?

Well yes – the number of us who take enough exercise to meet the Department of Health’s recommendations is pathetically small and far less than declared by surveys of self-reported activity. One of my hopes for this blog is that telling people just how beneficial exercise is might have some small effect – but I am not hugely optimistic.

Referral networks that increase opportunities for physical activity

The American College of Sports Medicine (ACSM) published an article on “Strategies for partnering with health care settings to increase physical activity promotion”¹ which gives some good pointers. Granted that this comes from across the pond, but most of their excellent suggestions are applicable in the UK. They start by quoting that only 26% of men and 19% of women meet the minimal recommended levels of physical activity (which are the same in the US and the UK). Those of you who have read my Blog “Exercise, Obesity and Self-Deception” will realise that these figures for exercise-taking are likely to be gross exaggerations. The authors identify nine sectors of society which have the potential to promote increased physical activity: business and industry; community recreation; fitness and parks; education; faith-based settings; health care; mass media; public health; sport; transport, land use and community design. Each of these settings could keep me in Blog material for yonks but this ACSM article is written with healthcare in mind.

Medical profession awareness

The authors emphasise that training of medical students and doctors is sadly lacking for this topic. Moreover, although doctors can have a small effect on the physical activity of their patients, only a minority raise the possibility during consultations – their figure for the US is that physical activity counselling is given in 32% of consultations. I suspect that it is much lower in the UK where the “prescription” of exercise is not part of the thinking of most GPs. The authors suggest that one way of tackling this problem would be to “partner with providers of community physical services to form referral networks that increase opportunities for physical activity and ensure equal access of their patients to community resources, including patients living in rural areas”.

Get off the Couch!

If you have been paying any attention at all you will know that I have recently published a boo k to encourage exercise taking. (To get a copy just ping me an email to hjnbethell@gmail.com) A colleague and I are hoping to convert this into a text-book suitable for medical students and other clinicians – perhaps that will help?

A programme to provide exercise for older people

I run a programme which provides exercise for older people particularly those at increased risk of cardiovascular disease (mainly heart attacks and strokes). This was slow to take off but I am pleased to say that referrals from GPs has been gradually increasing. We have increased the numbers by persuading local GPs to send information about our programme to patients on their lists who have relevant risk factors such as high blood pressure, obesity, type 2 diabetes etc. Even so, the commonest reason for admission to our “Staywell” programme is that the patient, having heard about it, has requested referral.

Exercise on prescription

“Prescription for exercise” is available widely in the UK, usually involving local sports centres. Many, particularly older, people are not that keen on sports centre based activities which they view as being for Lycra clad youngsters. They need to know what else is available (walking for health, badminton, games and sports of one sort or another). Locally we have created a database of all the exercise opportunities – clubs, venues etc – in our area. This was published on the Alton Town Council website – see https://altonevents.co.uk/active-alton/  We have also produced a printed copy of the Active Alton Directory which is distributed around the town.

More of this in 2022!

Meanwhile if you own a dog you already have an excellent walking machine. Go walkies.

1. Doi: 10.1249/FIT.0000000000000486