Physical activity and students

Physical activity

Children and adolescents are the most physically active age groups. However, as students progress from secondary to post-secondary settings, there is a lot of evidence that physical activity behaviors decrease into adulthood.¹  Various factors influence whether or not students participate in physical activity.^2,3,4 Regardless, students who participate in more physical activity appear to have better psychosocial well-being and fewer illnesses than those who are not regularly active.⁵  For example, in one study, students who were insufficiently active, on average, used university health services twice that of those who were physically active.⁵ 

Why university students are not physically active:⁶

• Intrapersonal barriers: lack of motivation, would rather relax, lack of sleep, illness, lack of money;
• Interpersonal barriers: social invitations impede workout time, lack of training partner, other social commitments, intimidated due to unfamiliar social environment;
• Institutional barriers: school workload too high, studying, job cuts into physical activity time, open gym does not coincide with schedule;
• Community barriers: lack of sports teams to join, lack of transportation to facilities;
• Physical environment barriers: weather is too cold, gets dark too early, lack of facilities/variety of facilities.⁷

Why occupational therapy?

Students might not come to you with physical activity concerns, but physical activity can be used to help students improve psychosocial well-being and become more efficient with their time, which are both correlated with academic success.

Evaluate physical activity behaviors

• Ask the student about pre-university history of physical activity behaviors.
• Ask the student to self-report physical activity levels or do a time diary of physical activity over a specified period of time (7 days).  It might be helpful to use a time geography that plots environment and social circumstances as well.  See previous blog on time use here.  
• Discuss with the student possible barriers and enablers to physical activity.

Occupational therapy intervention

The CDC recommends that:

“adults need at least 150 to 300 minutes of moderate-intensity aerobic activity, like brisk walking or fast dancing, each week. Adults also need muscle-strengthening activity, like lifting weights or doing push-ups, at least 2 days each week.”⁸

Interventions that target physical activity are most successful if self-monitoring and other self-regulatory techniques are incorporated. ⁹ Remember to discuss goal setting and strategies to reach goals when working on behavioral changes (like physical activity behaviors). And, don’t forget about using intention implementations and context modifications (see previous blog post on routines and habits). 

Some specific suggestions related to common barriers:

• Intrapersonal barriers
  • Self-efficacy impacts participation in physical activity⁷ – for example, if a student suggests that they have too much school work to do physical activity, they could benefit from working on time management to help with self-efficacy to the task at hand. 
  • Sensory issues may inhibit enjoyment of certain physical activity; on the contrary, sensory needs can be fulfilled through physical activity.  Be sure that you are assessing sensory concerns and suggest modifications to schedule and/or activity.
  • If students report being too tired to participate in physical activity, discuss physical activity as a way to help with sleep.  Help them improve their sleep behaviors.  Other sleep interventions can be found on a previous post on sleep.
• Interpersonal barriers
  • OT intervention in groups may help students develop social support networks for physical activity.¹⁰
  • Encourage students to find a physical activity partner for social support (use social media – apps like Meetup).
  • Students might benefit from specific interventions for social anxiety, if that is the reason they will not participate in physical activity regularly.  
• Institutional barriers
  • Help students explore a range of options on campus to help with physical activity.  
  • Help students schedule physical education classes into schedule or work with their current schedule to explore local classes or activities that can work.
• Community barriers
  • Student can benefit from the use of social media for physical activity (Meetup, Facebook groups from their community, etc).
  • Student can practice searching the community for free or low cost physical activities/teams/sports/classes to attend.
• Physical environment barriers
  • Schedule physical activity to avoid extreme weather/dark times of day.
  • Help student anticipate barriers to physical activity and develop coping plans to overcome or avoid perceived barriers (schedule changes/weather).¹¹

Other things to consider

INTENTION IMPLEMENTATION (discussed in a previous post):  Use “if-then” and “when-when” statements to make goals more specific.   The OT needs to help the student develop goals and plan for physical activity.  The OT should help the student create scenarios to help ‘fit’ physical activity into his/her daily activities.

Here are some examples with intention implementation:

• “If I have to go up into a building and the room I need to get into is on a floor lower than the fifth floor, then I will walk the stairs”. 
• “When I arrive home from class on Tuesdays and Thursdays, instead of watching TV, I will find a good podcast and go for a walk”.
• “If I am feeling frustrated about my coursework, I will go for a run instead of eating a bag of chips”.

CONTEXT MODIFICATION (discussed in a previous post):  Use environmental cues to encourage participation in physical activity (some examples):

• Leave workout clothes in an obvious spot before bed.
• Keep gym pass on key ring,
• Set-up reminders on cell phone,
• Schedule active things, 
• Get off the bus stop one stop early,
• Park the car far from campus and walk,
• Ride bike to class instead of drive or take the bus,
• Walk the stairs if the floor is less than 4,
• Set up an active study session (walk and study) with a classmate (social support helps!).

Final thoughts on physical activity

 If you are going to “prescribe” physical activity with a student or help them work it into their schedule, consider the following related to motivation for behavior change.

When motivation for change is low:  When the motivation for exercise behavior change is low, OTs can provide one-to-one psychoeducation and suggest specific physical activity behaviors that might fit the student’s needs, personality, and schedule.  The OT should share relevant information about the benefits of physical activity.  Praise and/or reward these students for practicing healthy behaviors.¹²  

When motivation for change is high:  When the motivation for exercise behavior change is high, students need to improve self-efficacy.  The OT should have students select and freely participate in all kinds of exercises – helping the student problem-solve issues along the way. The student needs to know that they can exercise under multiple circumstances.¹²

1.  Engberg, El, Alen, M., Kukkonen-Harjula, K., Peltonen, J.E., Tikkanen, H.O., & Peddarine, H. (2012).  Life events and change in leisure time physical activity.  Sports Medicine, 42(6), 433-447.  doi: 0112-1642/12/0006-0433/$49.95.0
2. Kwan MY, Faulkner GE. (2011) Perceptions and barriers to physical activity during the transition to university. Am J Health Stud, 26, 87–96.
3. Gyurcsik NC, Spink KS, Bray SR. (2006).  Chad K, Kwan M. An ecologically based examination of barriers to physical activity in students from grade seven through first-year university. J Adolesc Health, 38, 704–11.
4. Gómez-López M, Gallegos AG, Extremera AB. (2010).  Perceived barriers by university students in the practice of physical activities. J Sports Sci Med, 9, 374–81.
5. Bray, S. R. & Kwan, M. Y. W. (2006).  Physical activity is associated with better health and psychological well-being during transition to university life.  Journal of American College Health, 55(2), 77-82. 
6. McLeroy, KR., Bibeau, D., Stecckler, A., Glanz, K. (1988). An ecological perspective on health promotion programs. Health Educ Q., 15,351-377.
7. Gyurcsik, N. C., Bray, S. R., Brittain, D. R. (2004).  Coping with barriers to vigorous physical activity during transition to university.  Family Community Health, 27(2), 130-142. 
8. CDC reference for physical activity guidelines: https://health.gov/paguidelines/second-edition/pdf/Physical_Activity_Guidelines_2nd_edition.pdf
9. Michie S, Abraham C, Whittington C, McAteer J, Gupta S. (2009).   Effective techniques in health eating and physical activity interventions: A meta-regression. Health Psychol, 28,690–701.
10. Brown, D.M.Y, Bray, S. R., Beatty, K.R., & Kwarn, M.Y.W. (2014).  Healthy active living: A residence community-based intervention to increase physical activity and healthy eating during the transition to first-year university.  Journal of American College Health, 62(4), 234-242. 
11. Michie S, Johnston M, Francis J, Hardeman W, Eccles M. (2008). From theory to intervention: mapping theoretically derived behavioural determinants to behaviour change techniques. Appl Psychol Int Rev., 57, 660–680.
12. Jeon, D-J., Kim, K-J., & Hao, M. (2014).  Factors related to stages of exercise behavior change among university students based on the transtheoretical model. Journal Of Physical Therapy Science, 26, 1929-1932.