A Social Ecological Approach to Understanding Physical Activity. A Mixed Methods Exploration of the Individual, Family and Neighbourhood Characteristics That Influence Physical Activity Among Family Heart Health: Randomized, Controlled Trial Participants

Abstract

Study 1 - Individual - The purpose was to determine whether a 12-week behavioural risk reduction intervention caused self-reported MVPA to increase and to identify associated Theory of Planned Behaviour (TPB) constructs. Three hundred twenty-four physically inactive (<150 minutes/week moderate-vigorous PA) participants were included. Intervention participants were significantly more likely to meet PA guidelines at 12-weeks (OR=3.54, 95% CI 2.22-5.63, p<.001), which was significantly correlated with increases in TPB constructs. // Study 2 - Family - Semi-structured interviews were conducted with 36 participants to elicit perceptions of factors that influence PA. Interviews were audiotaped, transcribed, coded and analyzed. Spouses were more likely to engage in PA with their spouse after the CHD event; however this may be limited by their partners’ capabilities. The data suggests awareness of an increased susceptibility to CHD is not stimulating participants to increase their own PA to prevent future risk, particularly among offspring, but they may take other actions. The shared family environment can promote PA, although intensity may be limited. // Study 3 - Neighbourhood - Self-reported PA from a prospective behavioural risk reduction intervention was explored in the context of objectively measured Walk Scores and neighbourhood walkability in Ottawa, Canada. Participants in the intervention arm had significantly higher odds of meeting PA guidelines at 12-weeks compared to the standard care control group. This was not influenced by Walk Scores or walkability. This individual-level intervention was effective in assisting participants to overcome potential structural barriers presented by their neighbourhood to meet PA guidelines at 12-weeks.