Document Type : Original Article
Authors
- . Emily C. L. Knox 1
- . Stuart J. H. Biddle 2
- . Ian M. Taylor 1
- . Amy E. Latimer‑Cheung 3
- . Oliver J. Webb 4
- . Lauren B. Sherar 1
1 School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough
2 School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, The NIHR Leicester‑Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester and Loughborough, Leicestershire,
3 School of Kinesiology and Health Studies, Queen’s University, Kingston, Canada
4 Academic Policy and Standards, University of Exeter, Exeter, UK
Abstract
Introduction: Mass‑media campaigns such as, “Change4Life’ in the UK and “get
active America” in the US, promote physical activity (PA) recommendations of at least
150 min/week of moderate‑to‑vigorous PA (MVPA). We investigated whether different
messages used in MVPA campaigns were associated with intention to engage in more
MVPA. Materials and Methods: Theory of planned behavior (TPB) constructs; subjective
norms, affective attitudes, instrumental attitudes and perceived behavioral control (PBC)
were applied to explain the associations between campaign messages and intentions to
engage in more MVPA. Results: A total of 1412 UK adults completed an online survey on
MVPA and TPB. The sample was 70% female and 93% white with 23% reporting meeting PA
guidelines. Participants received one of three messages: A walking message either with or
without the 150 min/week threshold (WalkT; WalkNT); a physiological description of MVPA
with the 150 min/week threshold (PhysT). ANCOVA examined group differences in intention.
Path analysis evaluated mediation by TPB variables. ANCOVA identified lower intentions to
increase MVPA in group PhysT relative to WalkT and WalkNT (P < 0.001). PBC mediated
this relationship in WalkT (β = 0.014, 95% confidence interval [CI] = 0.004–0.028) whereas
affective attitudes mediated this relationship in WalkNT (β = 0.059, 95% CI = 0.006–0.113).
Conclusions: Campaigns promoting MVPA guidelines need to choose their messages carefully.
Messages which exemplified MVPA through walking were associated with higher intentions to
increase MVPA than messages using a physiological description. Further, PBC was enhanced
when the 150 min/week threshold was promoted alongside the walking exemplar. Future
exemplars should be investigated to inform adults how to meet MVPA guidelines.
Keywords
Protection. Start Active, Stay Active: A Report on Physical Activity
for Health from the Four Home Countries’ Chief Medical Officers.
London: Department of Health; 2011.
2. National Coalition for Promoting Physical Activity. National Physical
Activity Plan for the United States; 2010.
3. Latimer‑Cheung AE, Rhodes RE, Kho ME, Tomasone JR,
Gainforth HL, KowalskiK, et al. Evidence‑informed recommendations
for constructing and disseminating messages supplementing the
new Canadian Physical Activity Guidelines. BMC Public Health
2013;13:419.
4. National Health Services. Change 4 Life; 2013. Available from:
http://www.nhs.uk/Change4Life/Pages/exercise‑activity‑ideas.aspx.
[Last accessed on 2013 Jul 15].
5. World Health Organization. Global Recommendations on Physical
Activity for Health. Geneva, Switzerland: WHO Press; 2010.
6. Blair SN, LaMonte MJ, Nichaman MZ. The evolution of physical
activity recommendations: How much is enough? Am J Clin Nutr
2004;79:913S‑20.
7. Lovell GP, El Ansari W, Parker JK. Perceived exercise benefits
and barriers of non‑exercising female university students in the
United Kingdom. Int J Environ Res Public Health 2010;7:784‑98.
8. Wimbush E. A moderate approach to promoting physical
activity: The evidence and implications. Health Educ J
1994;53:322‑36. Available from: http://www.hej.sagepub.com/
cgi/doi/10.1177/001789699405300310. [Last cited on 2013 Jun 10].
9. National Health Services. This Week’s Top Tips from Change 4 Life!
Change4Life Newsletter. Crown; 2012.
10. Kelly P, Murphy M, Oja P, Murtagh EM, Foster C. Estimates of the
number of people in England who attain or exceed vigorous intensity
exercise by walking at 3 mph. J Sports Sci 2011;29:1629‑34.
11. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis
Process 1991;50:179‑211.
12. Noar SM, Benac CN, Harris MS. Does tailoring matter? Meta‑analytic
review of tailored print health behavior change interventions.
Psychol Bull 2007;133:673‑93.
13. Hagger MS, Chatzisarantis NL, Biddle SJ. A meta‑analytic review of
the theories of reasoned action and planned behavior in physical
activity: Predictive validity and the contribution of additional
variables. J Sport Exerc Psychol 2002;24:3‑32.
14. Weinstein ND. The precaution adoption process. Health Psychol
1988;7:355‑86.
15. 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.
16. van Sluijs EM, Griffin SJ, van Poppel MN. A cross‑sectional study
of awareness of physical activity: Associations with personal,
behavioral and psychosocial factors. Int J Behav Nutr Phys Act
2007 8;4:53.
17. 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. Health
Psychol 2011;30:442‑52.
18. Oja P, Vuori I, Paronen O. Daily walking and cycling to work: Their
utility as health‑enhancing physical activity. Patient Educ Couns
1998;33 1 Suppl: S87‑94.
19. Dawson J, Boller I, Foster C, Hillsdon M. Evaluation of changes to
physical activity amongst people who attend the walking the way
to health initiative (WHI). Oxford: The Countryside Agency; 2006.
20. O’Dougherty M, Arikawa A, Kaufman BC, Kurzer MS, Schmitz KH.
Purposeful exercise and lifestyle physical activity in the lives of
young adult women: Findings from a diary study. Women Health
2009;49:642‑61.
21. Knox EC, Webb OJ, Esliger DW, Biddle SJ, Sherar LB. Using
threshold messages to promote physical activity: Implications
for public perceptions of health effects. Eur J Public Health
2014;24:195‑9.
22. Milton K, Bull FC, Bauman A. Reliability and validity testing
of a single‑item physical activity measure. Br J Sports Med
2011;45:203‑8.
23. Harris SS, Caspersen CJ, DeFriese GH, Estes EH Jr. Physical activity
counseling for healthy adults as a primary preventive intervention
in the clinical setting. Report for the US Preventive Services Task
Force. JAMA 1989;261:3588‑98.
24. Blue Cross and Blue Shield of Minnesota. Do‑groove; 2007.
Available from: http://www.do‑groove.com/tv‑ads/commercials.
[Last accessed 2014 Oct 26].
25. 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.
26. Raats MM, Sparks P, Geekie MA, Shepherd R. The effects of
providing personalized dietary feedback. A semi‑computerized
approach. Patient Educ Couns 1999;37:177‑89.
27. Ajzen I. Constructing a theory of planned behavior questionnaire.
TPB Questionnaire Construction; 2011. p. 1‑7. Available from:http://www.people.umass.edu/aizen/pdf/tpb.measurement.pdf.
[Last accessed 2014 Jun 12].
28. Rhodes RE, Brown SG, McIntyre CA. Integrating the perceived
neighborhood environment and the theory of planned behavior
when predicting walking in a Canadian adult sample. Am J Health
Promot 2006;21:110‑8.
29. Rhodes RE, Courneya KS, Blanchard CM, Plotnikoff RC. Prediction
of leisure‑time walking: An integration of social cognitive, perceived
environmental, and personality factors. Int J Behav Nutr Phys Act
2007 31;4:51.
30. Rhodes RE, Blanchard CM, Courneya KS, Plotnikoff RC. Identifying
belief‑based targets for the promotion of leisure‑time walking.
Health Educ Behav 2009;36:381‑93.
31. Scott F, Rhodes RE, Downs DS. Does physical activity intensity
moderate social cognition and behavior relationships? J Am Coll
Health 2009;58:213‑22.
32. Jones LW, Sinclair RC, Rhodes RE, Courneya KS. Promoting exercise
behaviour: An integration of persuasion theories and the theory of
planned behaviour. Br J Health Psychol 2004;9(Pt 4):505‑21.
33. Bellows‑Riecken KH, Rhodes RE, Hoffert KM. Motives for lifestyle
and exercise activities: A comparison using the theory of planned
behaviour. Eur J Sport Sci 2008;8:305‑13. Available from: http://
www.tandfonline.com/doi/abs/10.1080/17461390802195660.
[Last cited on 2012 Sep 06].
34. LatimerAE, RiversSE, RenchTA, KatulakNA, HicksA, Hodorowski JK,
et al. A field experiment testing the utility of regulatory fit messages
for promoting physical activity. J Exp Soc Psychol 2008;44:826‑832.
35. Green JH, Boyle FE. Lack of awareness of public health promotion
messages among a group of adult New Zealanders who meet
national guidelines for food intake and physical activity. Asia Pac J
Clin Nutr 2001;10:17‑20.
36. Muthén LK, Muthén BO. Mplus: Statistical Analysis with Latent
Variables‑User’s Guide. 6th ed. Los Angeles, CA: Muthén and
Muthén; 2010.
37. Hayes AF, Preacher KJ. Statistical mediation analysis with a
multicategorical independent variable. Br J Math Stat Psychol
2014;67:451‑70.
38. Wray RJ, Jupka K, Ludwig‑Bell C. A community‑wide media
campaign to promote walking in a Missouri town. Prev Chronic Dis
2005;2:A04.
39. Knox EC, Esliger DW, Biddle SJ, Sherar LB. Lack of knowledge
of physical activity guidelines: Can physical activity promotion
campaigns do better? BMJ Open 2013;3:e003633.
40. Latham GP, Locke EA. Self‑regulation through goal setting. Organ
Behav Hum Decis Process 1991;50:212‑47. Available from: http://
www.linkinghub.elsevier.com/retrieve/pii/074959789190021K. [Last
accessed 2014 Jul 09].
41. Latimer AE, Brawley LR, Bassett RL. A systematic review of three
approaches for constructing physical activity messages: What
messages work and what improvements are needed? Int J Behav
Nutr Phys Act 2010;7:36.
42. The NHS Information Centre. Health Survey for England 2008. In:
Craig R, Mindell J, Hirani V, editors. Physical Activity and Fitness.
Vol. 1. Leeds: The Health and Social Care Information Centre; 2009.
43. Bolman C, Lechner L, van Dijke M. Question order in the assessment
of misperception of physical activity. Int J Behav Nutr Phys Act
2007;4:42.
44. 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.
45. Vandelanotte C, Mummery WK. Qualitative and quantitative research
into the development and feasibility of a video‑tailored physical
activity intervention. Int J Behav Nutr Phys Act 2011;8:70.
46. Webb TL, Sheeran P. Does changing behavioral intentions engender
behavior change? A meta‑analysis of the experimental evidence.
Psychol Bull 2006;132:249‑68.
47. Why YP, Huang RZ, Sandhu PK. Affective messages increase
leisure walking only among conscientious individuals. Pers Individ
Dif 2010;48:752‑6. Available from: http://www.linkinghub.elsevier.
com/retrieve/pii/S0191886910000401. [Last cited on 2012 Mar 14].
48. Peetz J, Buehler R, Britten K. Only minutes a day: Reframing exercise
duration affects exercise intentions and behavior. Basic Appl Soc
Psych 2011;33:118‑27. Available from: http://www.tandfprod.
literatumonline.com/doi/abs/10.1080/01973533.2011.568870. [Last
cited on 2012 Jun 06].
)