Today’s research in the Lancet came with the eye-catching headline that a lack of exercise now causes as many deaths as smoking across the world. In the UK physical inactivity is a widespread problem with nearly two-thirds of adults failing to take enough exercise to keep themselves healthy, according to the research.
From a behaviour change perspective, prompting sustained action on physical activity is a considerable challenge. Many barriers to change exist both at an individual level (e.g. lack of time, enjoyment or self-efficacy) and at an external level (e.g. home entertainment, the reliance on the car, reduction in occupational activity or lack of facilities).
However one project has demonstrated that, by applying key behaviour change principles (summarised in our public health behaviour change checklist) it is possible to achieve positive action.
In 2011 The FitFans project in Hull supported over 300 people to lose on average 11lbs through a specialist lifestyle and exercise programme. Here’s how they applied behaviour change principles to their project;
Make it relevant – The project focused on a clear audience segment; men aged 40-65 who are overweight and likely to have an unhealthy lifestyle and poor diet – a group that is reluctant to access primary care health services. So rather than a ‘one size fits all’ approach the project was tailored to one specific audience.
Know your audience – The project undertook research to really understand the benefits and barriers from the audience’s perspective. They discovered that men considered weight loss as being a lonely, boring pursuit, primarily for women. Also, as many of the audience worked shifts any scheme would need to fit their lifestyle.
Involve stakeholders – The project involved local stakeholders and in particular the local football club (Hull City) and two Super League Rugby league clubs (Hull FC and Hull Kingston Rovers). This was vital for creating a beneficial exchange for the audience (see below).
Set clear goals – The behavioural objective was clear and simple. Participants were enrolled into the 12 week programme and their target was to lose 5% of their body weight by the end of 12 weeks and maintain that for a further 12 weeks.
Make it attractive – A positive exchange (i.e. when the benefits of action outweigh the barriers) was created. A major benefit was that the audience could exercise in the same stadia (and get the same dietary advice) as their sporting heroes, the programme was also activity based, social, enjoyable and competitive (teams of people compete to collectively lose most weight).
Make it easy – NHS Hull set up a single point of access for all their weight management and a smooth referral process to the FitFans programme. Other barriers were removed by running the programme at different times to cater for shift work, and providing indoor venues when the weather was bad.
Make it normal – The social element of the programme helped to create a feeling that participants weren’t on their own, or different to their peers. The promotion of the scheme (materials were pre-tested with the audience) also used humour, sporting terms the audience were familiar with and appropriate channels to ensure the scheme felt “part of their world”. Most people (37%) were introduced to the scheme by family or friends.
The programme has been so popular that the partners of the male participants asked if something could be created for them so “Fit Fans for Her” has been developed in Hull and has attracted approximately 300 participants in its first year. Other cities such as Portsmouth and Ipswich have also adopted the scheme.
Fit Fans demonstrates that by applying behaviour change principles, understanding the audience and designing interventions from their perspective even the most challenging behavioural challenges can be met.
The FitFans website is here