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Readiness to change important when designing community physical activity interventions

This is an excerpt from Motivating People to Be Physically Active - 2nd Edition by Bess H. Marcus & LeighAnn Forsyth.

Stage-Specific Strategies for Community Physical Activity Programs

We created the following list of intervention strategies to help you design your own community program. As we have tried to stress in this and other chapters, no one program works for everyone, so we do not provide a step-by-step program development guide. Rather, we hope you pick some of the following strategies plus generate some of your own ideas so that you create a program that addresses the needs of your target audience, your community's stage of change, any time constraints you may be working under, and your financial resources.

Stage 1

Not Thinking About Change

For this segment of the population, your goal is to help increase awareness about the (a) benefits of physical activity, (b) support for it in the local community, and (c) acceptance of physical activity by other community members. Here are some strategies for increasing awareness and encouraging people to begin to think about the role physical activity could play in their lives.

What communication channels might you use to reach people not considering becoming active?

• Distribute print materials targeted toward people who are presently not thinking about becoming more physically active.
• Work with the media to gain visibility for your messages. You might achieve this by doing the following (USDHHS et al., 1999):
  • Invite newspaper reporters to visible or newsworthy events.
  • Work with reporters in writing feature stories.
  • Provide timely news releases or newspaper articles.
  • Participate as a guest on radio or television talk shows.
  • Purchase radio, television, or cable advertising time.
• Display key messages and your program logo in storefront windows, on community bulletin boards, on billboard signs, and on banners strung across the main street or at major community locations (USDHHS et al., 1999).
• Design bumper stickers with physical activity and health promotion messages (USDHHS et al., 1999).
• Ask utility companies, banks, physicians, and others to place promotional and educational information in their monthly billings. Ask to place promotional and educational materials in waiting rooms of hospitals and health maintenance organizations, private physicians' offices, clinics, mental health centers, and senior citizen centers (USDHHS et al., 1999).

What types of information are most relevant to people in this earliest stage?

• Host health fairs that include exercise testing, blood pressure screenings, or body fat composition assessments. Relate how these are affected by physical activity.
• Emphasize the short-term benefits of being active (e.g., feeling invigorated, sleeping better, reducing stress, feeling better about oneself) rather than the long-term benefits that these people might believe are unobtainable.
• Dispel misconceptions about physical activity (e.g., "No pain, no gain," overestimated risk of injuries such as heart attack).
• Increase awareness of what they might miss by choosing not to be active (e.g., enjoyment from being active, better self-esteem).

What are some other strategies that might move these people closer to considering change?

• Help people to visualize success-to visualize a happy, healthy, and active lifestyle.
• Encourage these people to read or think about how physical activity might benefit them. For this group, it is better to focus on the benefits of physical activity and not to dwell on the risks of a sedentary lifestyle.
• Link the benefits of a physically active lifestyle to people's highest priorities and values in life (e.g., relationship with family, personal faith, health, or happiness).
• Encourage these people to see how their sedentary behavior affects them personally and others in their lives (e.g., a sedentary parent models an unhealthy lifestyle to her children).

How might you show community support for physical activity?

• Encourage health care providers to advise their patients on how they might benefit from physical activity.
• Choose a spokesperson that the target audience trusts, respects, believes, or can identify with to help increase awareness. Identify role models within the community. Recruit local people to endorse your program (USDHHS et al., 1999).
• Conduct targeted informational campaigns and sessions (USDHHS et al., 1999) such as the following:
  • Lunch-'n'-learn or community lectures
  • Workshops, seminars, or adult education classes
  • Youth group programs
  • One-on-one counseling or instruction
  • Guest talk-show appearances on television and radio
  • Columns or featured articles in the newspaper
• Give informative presentations at work sites, in schools, and to community organizations such as Rotary Clubs, Business and Professional Women, or the American Association of Retired Persons (USDHHS et al., 1999).

Stage 2

Thinking About Change

For this segment of the community, one of your goals is to increase awareness of the benefits of physical activity, community support, and the social norms for this behavior. Another goal is to move these people closer to actually trying out the behavior. Here are some ideas for achieving these goals.

What communication channels might you use?

• Distribute print materials targeted toward people who are thinking about becoming more physically active or include health and physical activity tips in general publications (USDHHS et al., 1999).
• Increase awareness by working with the media to gain visibility for your messages (USDHHS et al., 1999):
  • Invite newspaper reporters to visible or newsworthy events.
  • Work with reporters in writing feature stories.
  • Provide timely news releases or newspaper articles.
  • Participate as a guest on radio or television talk shows.
  • Purchase radio, television, or cable advertising time.
• Display key messages and your program logo in storefront windows, on community bulletin boards, on billboard signs, and on banners strung across the main street or at major community locations (USDHHS et al., 1999).
• Design bumper stickers with physical activity and health promotion messages.
• Ask utility companies, banks, physicians, and others to place promotional and educational information in their monthly billings. Ask to place promotional and educational materials in waiting rooms of hospitals and health maintenance organizations, private physicians' offices, clinics, mental health centers, and senior citizen centers (USDHHS et al., 1999).
• Make health videos available at video stores and libraries.
• Set up a Web site with links to relevant stage-appropriate physical activity and health sites.

What types of information are most relevant to people who are considering becoming more active?

• Provide basic information about what is needed to achieve a physically active lifestyle such as selecting the appropriate shoes or clothing (USDHHS et al., 1999).
• Describe a variety of activities available to most people that can be done alone or with family and friends.
• Suggest ways to build in some activity into one's daily routine (e.g., taking the stairs at work).
• Dispel misconceptions about physical activity (e.g., "No pain, no gain," overestimated risk of injury such as heart attack).

What are some other strategies that might move these people closer to trying some physical activity?

• Provide messages that link physical activity to values or issues relevant to your target audience.
• Help them weigh the pros and cons of a physically active lifestyle. Focus on the costs of changing (effort, energy, and the things they must give up to overcome a sedentary lifestyle) and how they might deal with them.
• Encourage them to start off slowly (e.g., a 5- or 10-minute walk) and build gradually (add 5 minutes per day per week) and explain how to reward themselves when they achieve their goals.
• Give out self-assessment questionnaires such as the Physical Activity Readiness Questionnaire (PAR-Q, found in chapter 7) and the decisional balance questionnaire (questionnaire 4.4 in appendix A).
• Help people to visualize success-to visualize a happy, healthy, and active lifestyle.

How might you show community support for trying some physical activity?

• Host health fairs that include exercise testing, blood pressure screenings, or body fat composition assessments. Relate how these are affected by physical activity.
• Choose a spokesperson that the target audience trusts, respects, believes, or can identify with. Identify role models within the community. Recruit local people to endorse your program (USDHHS et al., 1999).
• Encourage health care providers to advise these patients on how they might benefit from physical activity and some steps they could take to begin a physically active lifestyle.
• Conduct targeted informational campaigns and sessions (USDHHS et al., 1999) such as the following:
  • Lunch-'n'-learn or community lectures
  • Workshops, seminars, or adult education classes
  • Youth group programs
  • One-on-one counseling or instruction
  • Guest talk-show appearances on television and radio
  • Columns or featured articles in the newspaper
• Give informative presentations at work sites, in schools, and to community organizations such as Rotary Clubs, Business and Professional Women, or the American Association of Retired Persons (USDHHS et al., 1999).
• Set up physical activity hotlines that people can call with questions about physical activity (USDHHS et al., 1999).

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