Persuading the inactive

I recently attended the 4th Congress of the International Society of Physical Activity and Health with conference attendees from around the world. I went mainly as an observer as I was not presenting anything. Thus, I was able to take it all in. So what did I take away? 

First, it is clear that physical activity levels are by and large falling all around the world. Even so, the determined researchers and public health interventionists shared many wonderful stories of incremental successes in their work. Any small step it seems was cheered enthusiastically by the converted audience. For me, the appropriate response should have been, “What’s going on? Why are we not shouting from the rooftops that being physically active is the next best thing we can do for our health besides not smoking?” We spend so much time getting the cholesterol level down or the A1c in line with the guidelines, when in fact, being physically active is far more important to our health in many ways.

Second, inactivity is seen as less of a risk factor in obesity, and physical activity is seen for the health benefits it provides: lower cardiovascular risk, less diabetes, better bone and muscle strength with fewer falls, reduced colon and breast cancer rates, better mental health and sense of well-being, and a longer, healthier life. Who wouldn’t want this?

So why do we see physical activity levels falling around the world? Perhaps we take the wrong approach. What if we said to our patients, “If you exercise you will feel better, have more energy, have fewer aches and pains, and have a better quality of life. As well, you will be able to do more things you enjoy, and feel more relaxed and less stressed.” But even this advice is seldom acted upon. So what are we to do?

Conveying knowledge and educating people about why something is good for them is seldom enough. What does seem to work, however, is the observation that when people realize that other people are doing something positive, they just might do it themselves. The evidence for this—strangely—comes from the towels provided to us in hotel rooms. We’ve all seen the signs in hotel bathrooms encouraging us to help save the environment by not having our towels changed every day. Studies show that this works when people are told that others are doing it too. Hotel guests don’t want to be seen as not doing their part for the environment, so they fall into line like everyone else. 

How could this translate into getting more people to be physically active? Public health initiatives around physical activity seem to reach those who already want to be active, whereas physicians see people who are not healthy or are in danger of becoming unhealthy with chronic diseases. How can physicians apply the idea that our patients should be active because others are too? Participate in the BCMA Walk With Your Doc initiative.

As you know, for several years we have been encouraging docs to invite their patients to go for a walk to emphasize the importance of being physically active. While many doctors are participating in this event, we are a long way from having the whole profession on board. Think of what we could do if the idea that everyone is getting active actually caught on with our patients. There’s a good chance that they wouldn’t want to be left behind and would join in the movement. 

This year, the BCMA wants to support Walk with your Doc in a bigger way. We are aiming to get more physicians and their patients participating in this annual event than ever before. It has already begun in some communities. Last year Port Alberni had a health fair on the day of the event. In Mackenzie, the docs have continued the program and now walk with their patients every week. Don’t get left behind—let’s get moving and take our patients along with us.

Kids in schools need help to be more physically active as well, which is why we started the Be Active Every Day campaign last year, encouraging school kids to be active for 60 minutes every day. The curriculum provides for 30 minutes of activity each day, but that’s not enough. We will again be asking physicians, particularly those who have school-age kids, to partner with a school in their community to encourage kids to be active. Studies show that only 7% of youth currently meet the target of 60 minutes of daily activity. More info on the 2013 Be Active Every Day initiative will be coming shortly, so stay tuned. Let’s get everyone moving!

For related information, read the British Journal of Sports Medicine article, “Investments that work for Physical Activity.”
—Ron Wilson, MD
Chair, Athletics and Recreation Committee

This article is the opinion of the Council on Health Promotion and has not been peer reviewed by the BCMJ Editorial Board.