Physical Activity in Australian Adults: A Public Health PerspectivePresentation Transcript
Physical Inactivity in Australian Adults: A Public Health Perspective Anthony Brooks Katherine Baldock Mary Russell Louise Miller Frost Holly Noack
Why physical inactivity?
It is an independent risk factor for CVD, NIDDM, & bowel cancer
It contributes significantly to the burden of disease in Australia ( Figure 1 )
It has a high population prevalence
It is a modifiable behaviour
Chronic lifetime physical inactivity
Premature death and a poorer quality of life
Physical activity guidelines
Sufficient physical activity: > 150 mins of moderate intensity activity per week (DHA, 1999)
Insufficient physical activity: reported some activity during the past week , but less than sufficient amount
Sedentary: no reported physical activity during the past week
Moderate intensity exercise = walking over level terrain @ a speed of 5.0 km/h
Prevalence of physical inactivity
Australia ( NHS, 2000) : 18-75 yrs of age
38.7 % did not undertake sufficient physical activity
15.5 % were sedentary
South Australia ( DH, 2002) : 18 yrs and over
47.5% did not undertake sufficient physical activity (18+ years of age)
16.9% were sedentary
Factors associated with physical inactivity
S ubgroups of the population, such as women, older people, people for whom English is a second language, and those with low levels of education , are much more likely to be physically inactive (Wen, 2002)
A significant association between physical inactivity and socioeconomic disadvantage has been shown in South Australia (SAMSS, 2004)
Not much information on Indigenous Australians
“ Obesogenic environments” (technology, transport , lifestyle )
Some evidence that interventions to increase physical activity lead to moderate, short and mid-term increases in middle age (Hillsdon et al., 2005)
Professional guidance appears to help
In older adults with pre-existing chronic disease, home based programs are more effective than centre based programs (Ashworth et al., 2005)
Is it just too hard ?
Likelihood that benefit will occur
Never Often Frequency of action required We want people to exercise for 30 minutes five times a week...forever... Fitness programs are on the right hand side of the graph - frequent effort required therefore unlikely to happen (John Moss, Personal Communication, 5 February 2005)
Interventions have ranged from environmental based reminders (awareness) to developing community based facilities like bike trails, adapting transport facilities, etc
Incentives , eg. Lotteries
Develop community facilities , eg. Fitness centres
Effectiveness appears to be modest
Combination of environmental, educational or motivational interventions are required
Population based approach (Sallis et al., 1998)
Physical inactivity poses health risks for a majority of the adult population in Australia
Strategies to promote physical activity through education have been partially successful
Environmental interventions have also shown limited success
On a population basis it appears that there has been no improvement in physical activity levels
It appears that intersectoral action may be advantageous
Mass media campaign
Why don’t the interventions work?
Health Belief Model :
A person will take a ‘health related action’ if:
they feel the health condition is negative
they have a positive expectation that taking the action will avoid the condition
they believe they can successfully take the required action
Hochbaum, Rosenstock and Kegels, quoted in www.tcw.utwente.nl/theorieenoverzicht/Theory%20clusters/Health%20communication
Ashworth N, Chad K, Harrison E, Reeder B, Marshall S. Home versus center based physical activity programs in older adults. The Cochrane Database of Systematic Reviews 2005;Issue 1 Art. No.: CD004017. DOI: 10.1002/14651858.CD004017.pub2.
Bauman A, Bellew B, Vita P, Brown W, Owen N. Getting Australia Active: Towards Better Practice for the Promotion of Physical Activity. Melbourne: National Public Health Partnership; 2002..
Dal Grande E, Taylor A, Jury H, Greenland N. South Australian Monitoring and Surveillance System (SAMSS) - The Health Status of South Australians by Socio-Economic Status (SEIFA) . Department of Health, South Australia, 2004 .
Department of Health and Ageing. National Physical Activity Guidelines for Australians. Canberra: Australian Government: Department of Health and Ageing; 1999.
Department of Health. Physical Activity in South Australian Adults. Adelaide: Department of Health: Centre for Population Studies in Epidemiology; 2002. Report No.: 2002-16.
Hillsdon M, Foster C, Thorogood M. Interventions for promoting physical activity. Cochrane Database of Systematic Reviews 2005;Issue 1. Art. No.: CD003180. DOI: 10.1002/14651858.CD003180.pub2.
Sallis JF, Bauman A, Pratt M. Environmental and policy interventions to promote physical activity. American Journal of Preventive Medicine 1998;15(4):379-397.
Wen LM, Thomas M, Jones H, Orr N, Moreton R, King L, et al. Promoting physical activity in women: Evaluation of a 2-year community-based intervention in Sydney, Australia. Health Promotion International 2002;17(2):127-37.