Sometime last year – I can’t remember exactly when due to lockdown blur – I was asked by my mentor Caroline Dodd-Reynolds if I’d like to join the Fuse Physical Activity Network. I’d been to a number of workshops and I loved the focus on putting knowledge into practice, so I said yes and spent the rest of the year being in awe of the speakers we’ve had from across the world. And the discussion following the first workshop of 2021 (22nd January) was so rich that we wanted to do a bit of a follow-up to – as they say – ‘continue the conversation’.
- Inclusivity: How can we make sure that physical activity messages get to specific groups of people? (e.g. can we do this via carers?)
- Scalability: Physical activity interventions tend to be less effective when scaled up; is this because they are often adapted in the scaling-up process?
- ‘Business as usual’: Should we move away from thinking about physical activity programmes and towards encouraging physical activity by integrating it into people’s daily lives?
- Making every contact count: How can we measure the effects of conversations between health professionals and patients about regular physical activity in a way that meets the definition of ‘evidence’ for all of the different groups interested in this sort of practice and research?
This seems to be one of those areas where there’s an unfortunate disconnect between research and practice. At the workshop we discussed the value of academic research in understanding the needs of communities but also acknowledged the potentially lengthy timeframes involved before research hits policy and practice. On the other hand, limitations on the practice side can include timescales over which practitioners need to deliver interventions due to funding requirements, meaning that interventions may be shorter than they would ideally be. When it comes to people staying active, although studies with follow-ups do exist, interventions tend to try to give their participants the skills to stay active on their own once the programme finishes, rather than being ‘maintenance interventions’. Maybe we need to try an approach a bit like weight loss groups for ongoing support?
Anyone who knows me knows I love a bit of self-determination theory so I’m going to default to that for my answer, though of course other theories are available! Tying in with the above question, I think what we all want to see is interventions with long-term effects. Financial incentives might encourage physical activity while incentives are available, but we’re unfortunately not giving people the motivation to continue without these rewards and we know the rewards won’t last forever. On another level, those running the interventions have targets to reach to show the effects of their work, so they’re operating under short-term reward systems, too. Shifting our targets towards long-term effects may help.
Social determinants of health (conditions in which people are born, grow, work, live, and age) are well recognised by physical activity researchers and practitioners. On a broad level, interventions try to reduce anything that would hinder participation for the groups they aim to help. But an interesting area of thought is how we can use people’s sense of belonging to a group, and their perception of what that group does, to encourage them to be active (e.g. encouraging new parents to be active together at parent and baby groups). We just need to explore the best ways to do this when people identify with groups to different degrees and their group identifications can change over time.
Our efforts can be supported by following the 10 guiding principles for local physical activity practice, which bring together some of the issues discussed above including social determinants of health, inclusivity, and harnessing things that are already happening to promote physical activity. Over the years there have been many different initiatives to encourage people to get active, and some of them have really stuck. The Daily Mile is a simple idea to get children moving in schools, and it seems to be something that works for pupils and staff because it’s been running for over five years now. And Park Run has been successful around the world for over a decade. So it might seem like it’s difficult to get something in place that has an effect, that is sustainable and that people actually like, but sometimes with a bit of luck we can put research into practice and it all comes together.
I think the overall conclusion – summarised very nicely by Professor Bauman – was "keep trying".
What do you think? Let us know in the comments below.
Thank you to everyone who attended the webinar and contributed to the discussion, and to everyone involved in the Fuse Physical Activity Network for their support.