by Heartim Williams EdD, CSCS, NSCA-CPT, ACSM EP-C, EIM2, CIFT, CET, PAPHS, ACE-CHC, CWP
According to a report released by McKinsey & Company, the percentage of Americans who are prioritizing wellness rose from 42% in 2020 to 50% in 2022 (Callaghan et al., 2022). This may come as no surprise as the pandemic highlighted the importance of prioritizing health and wellbeing. A systemic review conducted by Stockwell et al. (2021) and a rapid review by Park et al. (2022) found the COVID-19 pandemic to negatively affect physical activity behaviors across several populations. While engaging in physical activity is widely understood to be beneficial for health, many struggle to follow through. Wellness practitioners may need to understand the multiple variables that could be influencing physical activity behaviors in order to develop an effective plan.
Social Determinants of Health
Social Determinants of Health are social and economic conditions that can influence health, such as education, housing, employment, and access to healthcare. Living an active lifestyle requires addressing more than the individual factors, it includes recognizing the economic and social influences. Individual factors, such as attitude and self-efficacy, are important for physical activity engagement; however, individual factors may not be enough to promote physical activity behaviors when environmental (e.g., lack of access to sidewalks and green space, living in a neighborhood high in crime) and social conditions (e.g., living in poverty, homelessness) are not supported. Recognizing the individual’s social and economic circumstances may help wellness practitioners determine what areas need to be addressed before physical activity engagement and adherence is possible.
Reviewing an individual’s health history can help reveal relevant chronic illnesses and physical and cognitive limitations that may put them at risk when engaging in physical activity. A health history includes medical history, family history, and lifestyle factors (e.g., nutrition, physical activity, tobacco and alcohol use). Preparticipation screening can help identify the level of risk when increasing physical activity levels, often broken down into low, moderate, and high risk, and should be used as a guide when prescribing physical activity. For instance, a physical activity program (e.g., resistance and aerobic training recommendations) for a person with diabetes would be different compared to one with no health limitations. An individual may have become diabetic due to a lack of physical activity, which may have stemmed from a lack of knowledge (e.g., unsure how to start), past injuries, poor lifestyle behaviors, and so on. Wellness professionals are better prepared to safely provide physical activity recommendations and provide support when they are familiar with the individual’s health and behaviors.
The cultural background should not be overlooked when promoting physical activity. Individuals who grew up outside of the Western world may likely be exposed to certain beliefs and ways of life that may not align with Western cultures. For instance, while being thin is idealized in the West, many African countries find being overweight and obese to be desirable. It can be a challenge for an individual to change their behaviors and live a healthy lifestyle when they were programmed to believe the more overweight and obese they get, the more beautiful and desirable they become. Wellness professionals should approach with respect and recognize where they may be within the transtheoretical model (stages of change). Practicing active listening, motivational interviewing, and empowerment is key.
When responsibilities ramp up, self-care is often the first thing that goes out the door. The COVID-19 pandemic forced many to take on new responsibilities, creating barriers to physical activity engagement. For instance, during the initial phase of the pandemic, many students were forced to do virtual learning, putting parents in a position to monitor their child’s education, including ensuring their child was not falling behind, assisting with their assignments and homework, and providing emotional support. Recognizing and understanding current responsibilities can help wellness practitioners develop an effective physical activity plan. Offering suggestions such as engaging in at least 10 minutes of physical activity a day can reduce the chance of premature death (Saint-Maurice et al., 2022) and improve cardiometabolic health (Gillen et al., 2016). Having an accountability partner (Jackson et al., 2015; Rackow et al., 2015) and adopting active transportation (Chaix et al., 2014) are other strategies that could be used to meet the physical activity recommendations.
There will be many cases as a wellness professional where the solution to increasing physical activity levels seems obvious. However, it is important to remember that behaviors are complex and many factors could be contributing to their behaviors. What may seem obvious to the wellness professional may not be so obvious to the individual who is being coached. It is important to ask the right questions and allow them to process their thoughts and take the initiative and participate in developing an action plan. They are in the driver’s seat. We as wellness practitioners are there to guide, support, and empower.
Callaghan, S., Lösch, M., Medalsy, J., Pione, A., & Teichner, W. (2022, September 19). Still feeling good: The US wellness market continues to boom. McKinsey & Company. https://www.mckinsey.com/industries/consumer-packaged-goods/our-insights/still-feeling-good-the-us-wellness-market-continues-to-boom
Chaix, B., Kestens, Y., Duncan, S., Merrien, C., Thierry, B., Pannier, B., Brondeel, R., Lewin, A., Karusisi, N., Perchoux, C., Thomas, F., & Méline, J. (2014). Active transportation and public transportation use to achieve physical activity recommendations? A combined GPS, accelerometer, and mobility survey study. International Journal of Behavioral Nutrition and Physical Activity, 11(1). https://doi.org/10.1186/s12966-014-0124-x
Gillen, J. B., Martin, B. J., MacInnis, M. J., Skelly, L. E., Tarnopolsky, M. A., & Gibala, M. J. (2016). Twelve weeks of sprint interval training improves indices of cardiometabolic health similar to traditional endurance training despite a five-fold lower exercise volume and time commitment. PLOS ONE, 11(4). https://doi.org/10.1371/journal.pone.0154075
Jackson, S. E., Steptoe, A., & Wardle, J. (2015). The influence of partner’s behavior on health behavior change. JAMA Internal Medicine, 175(3), 385. https://doi.org/10.1001/jamainternmed.2014.7554
Park, A. H., Zhong, S., Yang, H., Jeong, J., & Lee, C. (2022). Impact of COVID-19 on physical activity: A rapid review. Journal of Global Health, 12. https://doi.org/10.7189/jogh.12.05003
Rackow, P., Scholz, U., & Hornung, R. (2015). Received social support and exercising: An intervention study to test the enabling hypothesis. British Journal of Health Psychology, 20(4), 763–776. https://doi.org/10.1111/bjhp.12139
Saint-Maurice, P. F., Graubard, B. I., Troiano, R. P., Berrigan, D., Galuska, D. A., Fulton, J. E., & Matthews, C. E. (2022). Estimated number of deaths prevented through increased physical activity among US adults. JAMA Internal Medicine, 182(3), 349. https://doi.org/10.1001/jamainternmed.2021.7755
Stockwell, S., Trott, M., Tully, M., Shin, J., Barnett, Y., Butler, L., McDermott, D., Schuch, F., & Smith, L. (2021). Changes in physical activity and sedentary behaviours from before to during the COVID-19 pandemic lockdown: A systematic review. BMJ Open Sport & Exercise Medicine, 7(1). https://doi.org/10.1136/bmjsem-2020-000960