Physical Activity in Australian Adults: A Public Health Perspective


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  • Face to face interviews for both Australia – ABS SA – SA Dept of Health Less than half population undertaking sufficient physical activity Large proportion of sedentary Pattern of physical inactivity is fairly stable across age groups
  • “ obesogenic environments” – anecdotal evidence re changes in lifestyle over recent decades Because there is some differential distribution of physical inactivity, this would suggest that there is not a ‘one size fits all’ approach
  • Given that there are some socio-demographic differences, it may be necessary to target some subgroups of the population through policy and environmental interventions Health belief model – the perception people have about risks of not undertaking sufficient physical activity, and whether or not they feel enabled and empowered to undertake sufficient physical activity, determines in part whether or not they do Does not include the complexity or need for sustained change
  • Examples: inadequate car parking, distance from local shops through council planning
  • Once broader environmental and policy initiatives are in place, then individual behaviour modification can be addressed Incorporates some of Ottawa charter – Creating supportive environments, Building healthy public policy Addresses some issues associated with social inequality and economic disadvantage More coordinated big picture approach than what we have been able to uncover in the literature
  • Physical Activity in Australian Adults: A Public Health Perspective

    1. 1. Physical Inactivity in Australian Adults: A Public Health Perspective Anthony Brooks Katherine Baldock Mary Russell Louise Miller Frost Holly Noack
    2. 2. Why physical inactivity? <ul><li>It is an independent risk factor for CVD, NIDDM, & bowel cancer </li></ul><ul><li>It contributes significantly to the burden of disease in Australia ( Figure 1 ) </li></ul><ul><li>It has a high population prevalence </li></ul><ul><li>It is a modifiable behaviour </li></ul>
    3. 3. <ul><li>Chronic lifetime physical inactivity </li></ul><ul><li>Premature death and a poorer quality of life </li></ul>
    4. 4. Physical activity guidelines <ul><li>Sufficient physical activity: > 150 mins of moderate intensity activity per week (DHA, 1999) </li></ul><ul><li>Insufficient physical activity: reported some activity during the past week , but less than sufficient amount </li></ul><ul><li>Sedentary: no reported physical activity during the past week </li></ul><ul><li>Moderate intensity exercise = walking over level terrain @ a speed of 5.0 km/h </li></ul>
    5. 5. Prevalence of physical inactivity <ul><li>Australia ( NHS, 2000) : 18-75 yrs of age </li></ul><ul><ul><li>38.7 % did not undertake sufficient physical activity </li></ul></ul><ul><ul><li>15.5 % were sedentary </li></ul></ul><ul><li>South Australia ( DH, 2002) : 18 yrs and over </li></ul><ul><ul><li>47.5% did not undertake sufficient physical activity (18+ years of age) </li></ul></ul><ul><ul><li>16.9% were sedentary </li></ul></ul>
    6. 6. Factors associated with physical inactivity <ul><li>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) </li></ul><ul><li>A significant association between physical inactivity and socioeconomic disadvantage has been shown in South Australia (SAMSS, 2004) </li></ul><ul><li>Not much information on Indigenous Australians </li></ul><ul><li>“ Obesogenic environments” (technology, transport , lifestyle ) </li></ul>
    7. 7. Individual-focused Interventions <ul><li>Primary prevention </li></ul><ul><ul><li>Some evidence that interventions to increase physical activity lead to moderate, short and mid-term increases in middle age (Hillsdon et al., 2005) </li></ul></ul><ul><ul><li>Professional guidance appears to help </li></ul></ul><ul><li>Secondary prevention </li></ul><ul><ul><li>In older adults with pre-existing chronic disease, home based programs are more effective than centre based programs (Ashworth et al., 2005) </li></ul></ul>
    8. 8. Is it just too hard ? <ul><li>Max </li></ul><ul><li>Likelihood that benefit will occur </li></ul><ul><li>Min </li></ul>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)
    9. 9. Environmental Interventions <ul><li>Interventions have ranged from environmental based reminders (awareness) to developing community based facilities like bike trails, adapting transport facilities, etc </li></ul><ul><li>Incentives , eg. Lotteries </li></ul><ul><li>Develop community facilities , eg. Fitness centres </li></ul><ul><li>Effectiveness appears to be modest </li></ul><ul><li>Combination of environmental, educational or motivational interventions are required </li></ul>
    10. 10. Population based approach (Sallis et al., 1998)
    11. 11. Conclusions <ul><li>Physical inactivity poses health risks for a majority of the adult population in Australia </li></ul><ul><li>Strategies to promote physical activity through education have been partially successful </li></ul><ul><li>Environmental interventions have also shown limited success </li></ul><ul><li>On a population basis it appears that there has been no improvement in physical activity levels </li></ul><ul><li>It appears that intersectoral action may be advantageous </li></ul>
    12. 13. Back
    13. 14. Mass media campaign
    14. 15. Why don’t the interventions work? <ul><li>Health Belief Model : </li></ul><ul><ul><li>A person will take a ‘health related action’ if: </li></ul></ul><ul><ul><ul><li>they feel the health condition is negative </li></ul></ul></ul><ul><ul><ul><li>they have a positive expectation that taking the action will avoid the condition </li></ul></ul></ul><ul><ul><ul><li>they believe they can successfully take the required action </li></ul></ul></ul>Hochbaum, Rosenstock and Kegels, quoted in
    15. 16. References <ul><li>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. </li></ul><ul><li>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.. </li></ul><ul><li>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 . </li></ul><ul><li>Department of Health and Ageing. National Physical Activity Guidelines for Australians. Canberra: Australian Government: Department of Health and Ageing; 1999. </li></ul><ul><li>Department of Health. Physical Activity in South Australian Adults. Adelaide: Department of Health: Centre for Population Studies in Epidemiology; 2002. Report No.: 2002-16. </li></ul><ul><li>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. </li></ul><ul><li>Sallis JF, Bauman A, Pratt M. Environmental and policy interventions to promote physical activity. American Journal of Preventive Medicine 1998;15(4):379-397. </li></ul><ul><li>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. </li></ul>