Psychology of physical activity : a 30-year reflection on correlates, barriers, and theory

This is a self-archived version of an original article. This version may differ from the original in pagination and typographic details. Author(s): Title: Year: Version: Copyright: Rights: Rights url: Please cite the original version: CC BY-NC-ND 4.0 https://creativecommons.org/licenses/by-nc-nd/4.0/ Psychology of physical activity : a 30-year reflection on correlates, barriers, and theory © 2022 International Society of Sport Psychology Accepted version (Final draft) Biddle, Stuart J. H.; Gorely, Trish; Faulkner, Guy; Mutrie, Nanette Biddle, S. J. H., Gorely, T., Faulkner, G., & Mutrie, N. (2023). Psychology of physical activity : a 30-year reflection on correlates, barriers, and theory. International Journal of Sport and Exercise Psychology, 21(1), 1-14. https://doi.org/10.1080/1612197x.2022.2147261 2023 PSYCHOLOGY OF PHYSICAL ACTIVITY 1 Psychology of Physical Activity: a 30-year reflection on correlates, barriers, and theory Stuart J.H. Biddle 1 2 Trish Gorely 3 Guy Faulkner 4 Nanette Mutrie 5 1. University of Southern Queensland, Australia 2. University of Jyväskylä, Finland 3. University of the Highlands and Islands, Scotland 4. University of British Columbia, Canada 5. University of Edinburgh, Scotland Correspondence: Professor Stuart Biddle Physically Active Lifestyles Research Group (USQ PALs) Centre for Health Research University of Southern Queensland Springfield Central, QLD 4300, Australia E: [email protected] Keywords: trends, theory, barriers, correlates. PSYCHOLOGY OF PHYSICAL ACTIVITY 2 Abstract Over a 30-year period, we have authored five versions of the textbook Psychology of Physical Activity. This provides us with more than three decades of experience to reflect on the field of the psychology of physical activity. Typically, the book has been structured around the three themes of determinants/correlates and theory, mental health outcomes, and behaviour change interventions. In the current paper, we delimit our reflections to physical activity correlates and barriers, and the use of theory. Overall, the field has expanded greatly. Physical activity is central to most national preventive health policy initiatives and is now highly visible. Over the 30 years of our book writing, we have seen trends in the correlates and barriers for physical activity that reflect an increasing recognition of the different types and intensities of physical activity, some reflecting in a ‘systems thinking’ approach that recognises the natural complexity of the behaviour and its settings. But further work is recommended in gaining clarity on the frequently stated barrier of ‘lack of time’ and assumed physical activity correlate of enjoyment. Moreover, the move to a dual-process approach to theory is one that will continue to develop but may need more work in its application to behaviour change. A reflection across recent editions of the book suggest that some good progress has been made, but not universally so. PSYCHOLOGY OF PHYSICAL ACTIVITY 3 Introduction Physical activity is an important health behaviour. Research on the benefits of a physically active lifestyle is extensive and includes evidence for positive psychological, social, physical, and other outcomes. However, levels of physical activity remain low across most, if not all, population groups. For example, global estimates from self-reported data show that 28% of adults and 81% of adolescents do not meet recommendations for aerobic exercise. This discrepancy by age is likely due to the different criteria adopted in recommendations for young people and adults. Moreover, the data for adults seems particularly optimistic. Trends suggest no overall improvement in global levels of physical activity participation over the last two decades (Guthold et al., 2018, 2020). The International Children’s Accelerometer Database (ICAD) has reported physical activity assessed by accelerometer in over 25,000 young people from several countries (Cooper et al., 2015). Using the criterion of at least 60 mins of moderate-to-vigorous physical activity each day, only 2% of girls and 9% of boys achieved this. Whichever way physical activity is assessed, there is a clear need for better understanding of how and why people might choose to be physically active and how physical activity levels can be increased. Part of the solution to this problem is through an understanding and application of psychology, notwithstanding that other perspectives and influences, including social and environmental factors, will also be important. We have authored five versions of the textbook Psychology of Physical Activity, with the 4th edition published in 2021 (Biddle et al., 2021) (see Figure 1). A predecessor of the current book was started in the 1980s but unfortunately had limited marketing and was very expensive (Biddle & Mutrie, 1991). Hence we moved to another publisher and started updating and writing the current series with the first edition being published in 2001 (Biddle PSYCHOLOGY OF PHYSICAL ACTIVITY 4 & Mutrie, 2001, 2008; Biddle et al., 2015). With the different editions of the book, including its predecessor, we have more than 30 years of experience to reflect on the field of the psychology of physical activity. Typically, we have organised the book around the three themes of determinants/correlates and theory, mental health outcomes, and behaviour change interventions. In the current paper, we will delimit our reflections to physical activity correlates and barriers, and the use of theory. Mental health and interventions will not be addressed. Figure 1 about here What’s in a word? We started with the book Psychology of Physical Activity and Exercise. This was the first English language textbook on ‘exercise psychology’, despite another publisher, a year later, claiming that their own book was the first! At the time, it was common to refer to the field as ‘exercise psychology’, and indeed it took some effort to change the ubiquitous use of the term ‘sport psychology’ to ‘sport and exercise psychology’, including its use in journal titles (see Biddle & Vergeer, 2019). Given that much of the early literature referred to structured exercise, we kept the word in the original book title. However, we were comfortable adopting the terminology proposed in the seminal paper by Caspersen and colleagues (1985), and hence preferred to use the term ‘physical activity’. Of course, this includes ‘exercise’ (see Table 1) and, as such, by adopting the term physical activity, exercise is not excluded. One could argue that physical activity is a more acceptable term than exercise for most people when promoting active lifestyles. Table 1 about here In addition to the definitions by Caspersen et al., we included a definition of ‘sport’, based on Rejeski and Brawley (1988) and Loy (1968), in all versions of our book. PSYCHOLOGY OF PHYSICAL ACTIVITY 5 Specifically, we have defined sport as “a sub-component of physical activity … (that is) rule governed, structured, competitive, and involves gross motor movement characterised by physical strategy, prowess, and chance” (Biddle et al., 2021, p. 22). When we first wrote our book in 1991, the primary focus, not surprisingly, was on the psychology of physical activity. However, over the years we have adopted a psychologybased approach that has become less constrained by the field of psychology whereby we look at psychology embedded in the wider framework of physical activity and public health. For example, the commonly adopted ecological framework (Sallis & Owen, 2015; Salmon et al., 2020) embeds intraand inter-individual factors (including psychological and social psychological variables) within a wider model of behavioural influences that include environments and policy. We also adopt such an approach that seeks to see the ‘bigger picture’ while also drilling down into important psychological issues. As we revised the different editions of the book, we have tried to achieve a better balance between psychology, behavioural medicine, and epidemiology, and hence have psychology embedded within the wider field of physical activity for health. Behavioural medicine can include a number of disciplines in addition to psychology, such as public health, geography, sociology, and health economics (Marteau et al., 2006). One relatively recent development which reflects a wider view of physical activity is the adoption of integrated 24-hour guidelines. Proponents of such an approach argue that it is better to study ‘movement behaviours’ as an integrated whole across a 24-h period. Such behaviours include not only moderate-to-vigorous physical activity, but also light-intensity physical activity and sedentary behaviour, with the latter being low energy sitting during waking hours. In addition, the 24-h period will include sleep. Within a finite time period, such as a full day, changes to one of these behaviours will inevitably affect others. For example, by reducing sedentary behaviour, this time will be displaced elsewhere, which PSYCHOLOGY OF PHYSICAL ACTIVITY 6 could be in light or more intense physical activity. Equally, the time could be allocated to sleep (Dumuid et al., 2022). This approach has been applied to guidelines, with the first being in Canada (Tremblay et al., 2016). Recent guidelines for young people in Australia state “for optimal health benefits, children and young people (aged 5-17 years) should achieve the recommended balance of high levels of physical activity, low levels of sedentary behaviour, and sufficient sleep each day”, and further details of these recommendations are provided (Okely et al., 2022; p.16). In our 2021 book edition, we said that further work may be required to know whether the expectation and load imposed on people from addressing three behaviours is considered too much, or whether such an integrated approach is helpful. Research as part of the Canadian 24-h guidelines has shown support when asking a range of stakeholders, including parents and health professionals (Faulkner et al., 2016; Riazi et al., 2017). Experimental research suggests that the integrated 24-h guidelines improve social cognitions, such as selfefficacy and planning, in the context of parental support for their children meeting the recommendations (Tennant et al., 2019). From a psychological perspective, research is also needed to see if adherence to such guidelines is improved relative to guidelines that address each behaviour separately. Correlates and Barriers One of the main themes of the psychology of physical activity concerns the behavioural antecedents of participation. Typically, this has involved the study of correlates of, and barriers to, physical activity, as well as theoretical perspectives underpinning behavioural choices in the physical activity context. Correlates and Determinants PSYCHOLOGY OF PHYSICAL ACTIVITY 7 The study of the ‘determinants’ of physical activity has a long history. The term ‘determinants’ assumes some level of causal determination, which often we cannot confirm. Perhaps the most common usage is in the term ‘social determinants of health’ (see Cockerham, 2022). While there is a great deal of recognition and agreement that social factors (e.g., socio-economic status, social context) are very important for health outcomes, true causal linkages can sometimes be hard to confirm. Nevertheless, the use of the word determinants can be an acceptable, if slightly imprecise, term, and it tended to be used more frequently when researchers first studied this field (Dishman et al., 1985). For consistency, we have kept the term in the sub-title of our book. More recently, determinants have been distinguished from ‘correlates’ of physical activity. The latter refers to factors associated with physical activity but not necessarily causally so. Many variables in physical activity are likely to be correlates rather than true determinants (Bauman et al., 2012). Early work in this field did study determinants and correlates associated with just the two domains of ‘structured exercise programs’ and ‘spontaneous physical activity’, but little on different intensities (Dishman et al., 1985). This was a reflection of the available data at the time. Moreover, determinants were a little more narrowly focussed than today, with categories labelled as personal, environmental, and activity characteristics (Dishman et al., 1985). The same authors stated in 1985 that “there is little standardization in defining and assessing determinants and physical activity” (p. 161). The early literature also reported motives for participation as correlates of different forms of physical activity. For example, young people being physically active through sport often reported motives of fun, skill development, social affiliation, fitness, and challenge, thus it was assumed that these factors were driving participation. While this can be the case, motives are self-reported reasons for participation and differ from factors associated with future participation. Motives are usually reported after the event, whereas correlates and/or PSYCHOLOGY OF PHYSICAL ACTIVITY 8 determinants, should be predictive of, or associated with, subsequent participation in a logical temporal sequence. That is, correlates should precede or at least be co-existing, with participation, and not necessarily be an outcome of participation. Correlates have subsequently been categorised into socio-demographic, biological, psychological, behavioural, social, and environmental factors (Sallis et al., 2000). In the latest edition of our book, we concluded that the main correlates of physical activity for young people are age, sex, intentions, self-efficacy, sedentary behaviour after school and at weekends, parental support, and time spent outside. Sedentary behaviour has become a highly visible research topic since the early 2000s and is now a significant focus of interest alongside physical activity (Bull et al., 2020; Tremblay et al., 2017). This led to the topic being addressed more fully in later editions of the book (Biddle et al., 2015; Biddle et al., 2021). For adults the main correlates of physical activity are sex, self-efficacy, activity history, social support, access to facilities, and the local transport environment (Biddle et al., 2021). It is clear to see, therefore, that correlates are multi-faceted and not just psychological. They may also vary by type or domain of physical activity, such as physical activity through active transport, in the home, or in sport. There will also be correlates of physical activity that might differ by the stages of behavioural adoption and maintenance, and Dishman et al. (1985) did comment on this nearly four decades ago. Over the past 30 years, we have become more aware of this distinction and the importance of physical activity maintenance. However, rather little progress has been made on the best ways to sustain physical activity, although a number of directions are evident from the literature (Kwasnicka et al., 2016). It is interesting to note that Chapter 2 in our first book was titled ‘Exercise Adoption and Maintenance’, although it is fair to say rather less was known about true maintenance (Biddle & Mutrie, 1991). Theories have now evolved to consider maintenance more explicitly PSYCHOLOGY OF PHYSICAL ACTIVITY 15 for this is uneven (Gourlan et al., 2016; Prestwich et al., 2014), and the number of papers in physical activity research that report no use of theory remains high (Rhodes & Nasuti, 2011). Two main developments in theory were evident across the 30-year period of the books. First, theories in the study of physical activity tended to be static and unidirectional, such as Theory of Planned Behaviour. By this we mean that linkages tended to be unidirectional, such as attitudes to intentions, rather than allowing for linkages in reverse. It is entirely plausible that intentions or behaviours will influence subsequent attitudes. As a result, more dynamic and nuanced frameworks emerged, such as the Transtheoretical Model and Health Action Process Approach. Both recognised that people move through different stages of decision making and this is important for understanding of intentions and behaviour – a so-called ‘one size does not fit all’ approach. What might be helpful for someone in the stage of contemplation may not be appropriate for those in the action stage. Such developments also reflected what we called a shift from emphasising the ‘left side’ of the model (e.g., attitudes in the Theory of Planned Behaviour) to the ‘right side’ of actionplanning and behaviours. The second major trend in the use of theory in the psychology of physical activity was the recognition that social-cognitive and motivational theories were insufficient as theoretical approaches. Such theories (e.g., Social Cognitive Theory) emphasise cognitive effort and reflect slow, reflective thinking, sometimes referred to as ‘Type 2’ processing. Recognising that not all actions follow such a path, greater emphasis has started to be placed on fast, automatic (‘Type 1’) processing, thus requiring less cognitive effort. This distinction led to the ‘dual-process’ approach now accepted in physical activity research (Brand & Cheval, 2019; Brand & Ekkekakis, 2018). Dual-process refers to both reflective and automatic processing. For example, while some situations may appear attractive for physical activity (e.g., open green spaces or colourful and accessible stairs), making choices to be active in PSYCHOLOGY OF PHYSICAL ACTIVITY 16 such contexts may also require some cognitive processing of, say, self-efficacy and intentions. Automaticity may also depend on the extent of prior experience and the need to process information. For example, we know that in novel situations, such as using gym equipment for the first time, behaviour will be more regulated by conscious decision making. However, as experience is gained, behaviour becomes more habitual as it is driven by familiar environments and routines. Less conscious effort is required as ‘habits’ are developed. In all of these cases, the processing of affective cues is also important and ‘reward’ is likely to be influential (Cheval et al., 2018). ‘Gut feelings’ of likes and dislikes can also act as strong drivers of behaviour with low conscious effort. In the 3rd Edition of the book (Biddle et al., 2015), we stated as a research direction “better integration of aspects across different psychological theories should be considered, including more automatic and conscious processing approaches” (see Biddle et al., 2021, p. 451). In our estimation, we felt that progress on this was ‘moderate’. Specifically, we said that “there is greater recognition that the theories most prevalent in physical activity … are not adequate and may reflect an over-commitment to certain theories by researchers in this field. Moreover, dual-process approaches … are more common” (Biddle et al., 2021, p. 451). In addition, we also suggested that social, environmental, and policy theories should be considered alongside psychological approaches. There was also ‘moderate’ progress on this over the past two book editions, but behavioural medicine research was adopting such approaches more readily. It is interesting to note that we wrote a chapter on perceptions of social environments in previous editions of the book but dropped it later as we felt that research was limited and not progressing. More extensive discussion on social, environmental, and policy theory was beyond the scope of the book. Conclusions PSYCHOLOGY OF PHYSICAL ACTIVITY 17 The field of ‘exercise psychology’ – what we have preferred to call “psychology of physical activity” through the three decades of our book writing – covers three broad areas: mental health outcomes, the correlates/determinants of physical activity, including underpinning theory, and interventions to change physical activity levels. The current paper has focussed only on correlates and theory. We have discussed trends that have been evident in the writing of five versions of our book since first being published in 1991. Overall, the field has expanded hugely, underpinned by a significant increase in the number of researchers, educators, and practitioners. Moreover, the synthesising of research evidence has been easier by the proliferation of systematic reviews. Physical activity is ‘front and centre’ of most national preventive health policy initiatives, whereas this was not always the case. The visibility and importance of physical activity for health has been helped greatly by the availability of national surveillance data and physical activity guidelines. It is probably true to say we no longer need to ‘make the case’ – it is clear to see. Nevertheless, physical activity, like other health behaviours, needs to continue to fight for resources and support. Over the 30 years of our book writing, we have seen trends in the corelates and barriers for physical activity that reflect an increasing recognition of the different types and intensities of physical activity. It could be argued that we have become more ‘nuanced’ and sophisticated, and this is reflected in a ‘systems thinking’ approach that recognises the natural complexity of the behaviour and its settings. In addition, the move to a dual-process approach, recognising both reflective and automatic theories, is one that will continue to develop. This trend is welcomed but may need further development in being integrated into intervention research designs. PSYCHOLOGY OF PHYSICAL ACTIVITY 18 Although interventions have not been the focus of the current paper, the role of correlates and barriers, as well as underpinning theory, is most important when considered in the context of, and applied to, behaviour change. To this end, our latest edition of the book highlights the importance of mixed methods, including qualitative methods, involvement of participants in the development of interventions, and the assessment of physical activity and associated contexts over time. These issues have grown considerable over the time of our book writing. We look forward to further progress over the next decade and beyond. PSYCHOLOGY OF PHYSICAL ACTIVITY 19 Declaration of Interest Statement All authors are co-authors of some or all of the textbooks that form the basis for this paper. As such, they are paid royalties on book sales. Data availability statement. Not applicable. PSYCHOLOGY OF PHYSICAL ACTIVITY 20 References Adams, J., & White, M. (2003). Are activity promotion interventions based on the transtheoretical model effective? A critical review. British Journal of Sports Medicine, 37, 106-114. https://doi.org/10.1136/bjsm.37.2.106 Adams, J., & White, M. (2005). Why don't stage-based activity promotion interventions work? Health Education Research, 20(2), 237-243. https://doi.org/10.1093/her/cyg105 Bauman, A. E., Reis, R. S., Sallis, J. F., Wells, J. C., Loos, R. J. F., Martin, B. W., & for the Lancet Physical Activity Series Working Group. (2012). 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