Awareness of physical activity in healthy middle-aged adults: a cross-sectional study of associations with sociodemographic, biological, behavioural, and psychological factors

BMC Public Health, May 2014

Background Interventions to promote physical activity have had limited success. One reason may be that inactive adults are unaware that their level of physical activity is inadequate and do not perceive a need to change their behaviour. We aimed to assess awareness of physical activity, defined as the agreement between self-rated and objective physical activity, and to investigate associations with sociodemographic, biological, behavioural, and psychological factors. Methods We conducted an exploratory, cross-sectional analysis of awareness of physical activity using baseline data collected from 453 participants of the Feedback, Awareness and Behaviour study (Cambridgeshire, UK). Self-rated physical activity was measured dichotomously by asking participants if they believed they were achieving the recommended level of physical activity. Responses were compared to objective physical activity, measured using a combined accelerometer and heart rate monitor (Actiheart®). Four awareness groups were created: overestimators, realistic inactives, underestimators, and realistic actives. Logistic regression was used to assess associations between awareness group and potential correlates. Results The mean (standard deviation) age of participants was 47.0 (6.9) years, 44.4% were male, and 65.1% were overweight (body mass index ≥ 25). Of the 258 (57.0%) who were objectively classified as inactive, 130 (50.4%) misperceived their physical activity by incorrectly stating that they were meeting the guidelines (overestimators). In a multivariable logistic regression model adjusted for age and sex, those with a lower body mass index (Odds Ratio (OR) = 0.95, 95% Confidence Interval (CI) = 0.90 to 1.00), higher physical activity energy expenditure (OR = 1.03, 95% CI = 1.00 to 1.06) and self-reported physical activity (OR = 1.13, 95% CI = 1.07 to 1.19), and lower intention to increase physical activity (OR = 0.69, 95% CI = 0.48 to 0.99) and response efficacy (OR = 0.53, 95% CI = 0.31 to 0.91) were more likely to overestimate their physical activity. Conclusions Overestimators have more favourable health characteristics than those who are realistic about their inactivity, and their psychological characteristics suggest that they are less likely to change their behaviour. Personalised feedback about physical activity may be an important first step to behaviour change.

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Awareness of physical activity in healthy middle-aged adults: a cross-sectional study of associations with sociodemographic, biological, behavioural, and psychological factors

BMC Public Health Awareness of physical activity in healthy middle-aged adults: a cross-sectional study of associations with sociodemographic, biological, behavioural, and psychological factors Job G Godino 1 Clare Watkinson 1 Kirsten Corder 0 1 Stephen Sutton 2 Simon J Griffin 0 1 Esther MF van Sluijs 0 1 0 UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, University of Cambridge , Box 296, Forvie Site, Robinson Way, Cambridge CB2 0SR , United Kingdom 1 MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Addenbrooke's Hospital , Box 285, Hills Road, Cambridge CB2 0QQ , United Kingdom 2 Behavioural Science Group, Institute of Public Health, University of Cambridge , Forvie Site, Robinson Way, Cambridge CB2 0SR , United Kingdom Background: Interventions to promote physical activity have had limited success. One reason may be that inactive adults are unaware that their level of physical activity is inadequate and do not perceive a need to change their behaviour. We aimed to assess awareness of physical activity, defined as the agreement between self-rated and objective physical activity, and to investigate associations with sociodemographic, biological, behavioural, and psychological factors. Methods: We conducted an exploratory, cross-sectional analysis of awareness of physical activity using baseline data collected from 453 participants of the Feedback, Awareness and Behaviour study (Cambridgeshire, UK). Self-rated physical activity was measured dichotomously by asking participants if they believed they were achieving the recommended level of physical activity. Responses were compared to objective physical activity, measured using a combined accelerometer and heart rate monitor (Actiheart). Four awareness groups were created: overestimators, realistic inactives, underestimators, and realistic actives. Logistic regression was used to assess associations between awareness group and potential correlates. Results: The mean (standard deviation) age of participants was 47.0 (6.9) years, 44.4% were male, and 65.1% were overweight (body mass index 25). Of the 258 (57.0%) who were objectively classified as inactive, 130 (50.4%) misperceived their physical activity by incorrectly stating that they were meeting the guidelines (overestimators). In a multivariable logistic regression model adjusted for age and sex, those with a lower body mass index (Odds Ratio (OR) = 0.95, 95% Confidence Interval (CI) = 0.90 to 1.00), higher physical activity energy expenditure (OR = 1.03, 95% CI = 1.00 to 1.06) and self-reported physical activity (OR = 1.13, 95% CI = 1.07 to 1.19), and lower intention to increase physical activity (OR = 0.69, 95% CI = 0.48 to 0.99) and response efficacy (OR = 0.53, 95% CI = 0.31 to 0.91) were more likely to overestimate their physical activity. Conclusions: Overestimators have more favourable health characteristics than those who are realistic about their inactivity, and their psychological characteristics suggest that they are less likely to change their behaviour. Personalised feedback about physical activity may be an important first step to behaviour change. Physical activity; Objective measurement; Awareness; Misperception; Barriers; Correlates; Behaviour change; Personalised feedback - Background Regular engagement in physical activity offers many well-established health benefits, including reduced risk of obesity, type 2 diabetes, cardiovascular disease, and some cancers [1]. According to previous national and international guidelines, adults should accumulate at least 30 minutes of moderate to vigorous physical activity on 5 or more days of the week in order to derive such benefits (current guidelines encourage adults to engage in moderate-intensity aerobic physical activity for at least 150 minutes per week) [2-4]. Public health campaigns have been implemented to educate the general population about the wide-ranging benefits of physical activity and to increase awareness of the guidelines [5,6]. Despite these efforts, accelerometry data from the UK and the US indicate that fewer than 5% and 10% of the adult population are achieving the recommended level of physical activity, respectively [7,8]. The proportion of adults who meet the guidelines is unlikely to increase without the development of more effective physical activity promotion efforts. Multiple systematic reviews have concluded that existing interventions implemented in primary care and community settings are limited in that they produce only small, short-term changes in behaviour [9-12]. Reasons for this general lack of effectiveness remain unclear [13]. One hypothesis is that inactive adults do not perceive a need to change their level of physical activity because they are unaware that their current behaviour is inadequate [14-17]. Evaluating the adequacy of ones physical activity is difficult because it not only requires an accurate summarisation of the frequency, d (...truncated)


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Job G Godino, Clare Watkinson, Kirsten Corder, Stephen Sutton, Simon J Griffin, Esther MF van Sluijs. Awareness of physical activity in healthy middle-aged adults: a cross-sectional study of associations with sociodemographic, biological, behavioural, and psychological factors, BMC Public Health, 2014, pp. 421, 14, DOI: 10.1186/1471-2458-14-421