“What do we know about promoting physical activity?”

1. What do we know about
promoting physical
activity?
Prof David French
University of Manchester

2. Adrian E Bauman, Rodrigo S Reis, James F Sallis, Jonathan C Wells, Ruth JF Loos, Brian W Martin
Correlates of physical activity: why are some people physically active and others not? The Lancet (2012)
Correlates of Physical Activity

3. Why not just communicate risk?
• Where risk appraisals
were heightened across
217 studies:
• Effect d=+0.23 on
behaviour
• Where also change
response efficacy and
self-efficacy, get much
larger effects

4. Sheeran P, Harris PR, Epton T (2014). Does heightening risk appraisals change people’s intentions and behaviour? A
meta-analysis of experimental studies. Psychol Bull 2014; 140(2): 511-543.

5. An intervention to
increase walking
• Doesn’t require scheduling
• Free
• Not too intense
– If in poor health
– Worried about injury
• Don’t need other people
• Don’t need kit
• Can do it anywhere
• Already do some DP French, CD Darker, FF Eves, & FF Sniehotta (2013). The systematic
development of a brief intervention to increase walking in the general
public using an "extended" Theory of Planned Behavior. Journal of
Physical Activity and Health

6. Targeting self efficacy to alter
intentions to walk
• Intervention drew from Bandura’s work on self-
efficacy (mastery experiences) and Motivational
Interviewing
• Tried to elicit participants’ own reasons for why
walking (more) is under their own control
• Three motivational techniques:
– all describe previous instances of success
– why would be easy to walk more
Darker, French, Eves & Sniehotta (2010). Psychology & Health, 25, 71-88.
French, Stevenson & Michie (2012). Psychology, Health & Medicine, 17, 127-135.

7. Bridging the “intention – behaviour
gap”
• Four volitional techniques:
• Goal setting
• Action planning (when, where, how, with
whom)
• Coping planning (anticipate barrier, make
plans for how would overcome barrier)
• Supportive planning

8. Effects on walking (self-report)
Darker, French, Eves & Sniehotta (2010). Psychology & Health, 25, 71-88.
French, Stevenson & Michie (2012). Psychology, Health & Medicine, 17, 127-135.

9. What is the best way to
change self efficacy?
• Systematic review of intervention studies to alter
lifestyle/ recreational physical activity of non-
clinical samples of adults under 60 years
• Reported pre/post or between groups comparisons
of self efficacy
• Thereby estimated effect sizes for SE and for
physical activity
• Coded intervention content, using CALO-RE
taxonomy of behaviour change intervention
S Michie, S Ashford, FF Sniehotta, SU Dombrowski, A Bishop, & DP French (2011). A refined taxonomy of
behavior change techniques to help people change their physical activity and healthy eating behaviors - The
CALO-RE taxonomy. Psychology and Health 26; 1479-1498

10. Action planning (aka Implementation
Intentions)
p < 0.001

11. Barrier identification
p < 0.01

12. Effective BCTs (changed SE and
behaviour)
• Action planning
• Reinforcing effort or progress towards goals
• Provide instruction
• Set graded tasks
• Barrier identification
SL Williams, & DP French (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; 308-322

13. Which BCTs decreases
both self-efficacy and
behaviour? (over 60s)
 Plan social support/ social change
 Provide normative information about others’
behaviour
 Relapse prevention/ coping planning
 Goal setting (behaviour)
 Provide feedback on performance
 Prompt self-monitoring of behaviour
DP French, EK Olander, A Chisholm, & J McSharry (2014). Which behavior change
techniques are most effective at increasing older adults’ self-efficacy and physical activity
behavior? A systematic review. Annals of Behavioral Medicine 48; 225-234.

14. What interventions/
BCTs are acceptable
to older people?
 Systematic review of qualitative studies of
older adults’ (65+ years) experiences of
physical activity interventions, i.e. what do they
want from such interventions?
 Based on systematic search, 14 studies
identified that report some qualitative data on
experiences of interventions (1 from UK)
 None with low SES groups
 4 themes

15. Results of meta-synthesis
• ALL studies flag up that older adults want
experiences that are enjoyable/ fun/ social
• Valued improvements in function – being able to
do things, not “health”
• (initial) doubts over own competence/ concerns
about injury, but credible interventions helped
• Appreciated lack of pressure, going at own pace
– didn’t like diaries, logs, etc
• Importance of after intervention – what now?

16. What predicts objectively assessed
maintenance at walking groups?
• We recruited 114 walkers who already had
attended WfH schemes for at least three months
(range 3 to 123 months), in Coventry,
Birmingham, Stoke-on-Trent, or Nuneaton &
Bedworth.
• They completed questionnaires assessing theories
• Looked at their attendance records three months
later.
• Worked out what predicted continued attendance
at WfH groups, after adjusting for group
clustering.

17. Maintenance…
• Was not predicted by:
– Duration of past attendance
– Level of habit.
• Was predicted by:
– Overall satisfaction
– Satisfaction with health outcomes
– Satisfaction with social outcomes
– Recovery self-efficacy
A Kassavou, A Turner, T Hamborg & DP French (2014. Predicting maintenance of attendance at
walking groups: Testing constructs from three leading maintenance theories. Health
Psychology 33: 752-756.

19. Natural experiments
(effects of changing
environment on physical
activity)

20. In conclusion: promoting physical
activity
• There is a LARGE evidence base on this
• Risk communication not enough
• People must think they can do it
• Self-regulation approaches best for working age
adults (Maybe not older adults)
• Fun is central to uptake – not abstract ideas about
benefits
• Satisfaction with consequences is key to
maintenance
• Environment important (but evidence is shaky)

21. david.french@manchester.ac.uk
Thank you