HEALTH PROMOTION

● A further component of the exercise programme was to discuss ‘problems’ of the participants for 20 to 30 minutes conducted by a therapist. Initially, the participants did not like the change between being actively involved in joyful games and then having to speak about their problems. Therefore, after several attempts to stimulate the discussions it was deleted from the programme.

● Another component of the programme was to provide informa- tion about exercise and health (recommendations about exer- cise and health, measurement of the pulse, exact descriptions of stretching and strength exercises, walking demonstrations, etc.). This technique hopefully will support skill development, strengthen exercise competence and eventually give feedback on ability.

It is known that the dropout rate in fitness clubs is between 40% to 60% (7) so we applied two strategies to improve regular atten- dance. Firstly, each participant was assigned to a co-participant. If a woman missed the lesson twice without any apology, then the co-participant gave her a call to ask for the reasons.

Secondly all the activities were pitched at an intensity that was compatible with the fitness levels of the participants. Activities included dancing, games, stretching, strengthening, co-ordina- tion and relaxation. This sounds trivial, however, overestimation of personal levels of physical activity often happens - especially during the first lesson. The diversified programme was chosen not only for health reasons but also to make a more entertaining les- son. The participants are encouraged to say ”I exercise because I enjoy it and not because I must.”

After eight months and 21 lessons, 11 women attended the course on between 50% to 100% (mean participation frequency 66%) of occasions. Four women attended the course less than 50% and ten women dropped out. The result of a mood questionnaire applied several times before and after the lesson revealed an increase of good mood (27.8%) and a decrease of lack of energy (35%).

Factors worth considering are the quality of the exercise practi- tioner as well as of the programme. Another one could be the dis- tribution of programmes all over the city to shorten the distance between people’s homes and their local exercise facility.

Check list To develop or copy an exercise project the following considera- tions have to be taken into account: ● Target group - for instance age, gender, fitness level, exercise beginners or exercise re-starters

● Goal - what should the participants achieve? The more precise the goals the easier it is to evaluate the scheme

● Structure - frequency, place, co-operation, financial affairs ● Programme - a health-orientated programme should include physical dimensions (ie. endurance, strength, flexibility, relax- ation and co-ordination), psychological dimensions (ie. social support, self efficacy, meaningfulness) and cognitive dimen- sions to know how to go about taking part in exercise

● Evaluation - process evaluation (quality of the programme) and outcome evaluation (achievement of the objectives) conducted by oneself or by an external person

● Short report SportEX 25

It is important that if the participants have any health ailments, heart trouble, high blood pressure, unexplained pains in the chest, dizziness/fainting or a bone/joint problem that could be made worse by exercise, they should consult a doctor before embarking on any activity.

Dr Titze would be happy to answer any further questions with regards to these projects and can be contacted via e-mail at sylvia.titze@kfunigraz.ac.at

References 1.Getting Active Feeling Fit. Health Education Authority, 1996 2. Marcus BH, Simkin, LR, Pinto, BM. Longitudinal shifts in employees’ stages and process of exercise behaviour change. American Journal of Health Promotion 1996;10:195-200 3. Rollnick S, Kinnersley P and Stott N. Methods of helping with behav- iour change. BMJ 1993;307:188-190 4. Blamey A, Mutrie N and Aitchison T. Health promotion by encouraged use of stairs. BMJ 1995;311:289-90 5. Brownell KD, Stunkard AJ, Michelle Albaum J. Evaluation and modifica- tion of exercise patterns in the natural environment. Am J Psychiatry 1980;137:1540-1545 6. Barlow CE, Kohl HW, Gibbons LW and Blair SN. Physical fitness, mortal- ity and obesity. Int J Obesity 1995;19:(Suppl4):41-44 7. Pahmeier I. Sportliche Aktivität als Bewältigungshilfe beigesund- heitlichen Beeinträchtigungen. Frankfurt am Main, 1994

Take a step in the right direction ‘Health promotion by encouraged use of stairs’ (4) was a study carried out jointly by the Greater Glasgow Health Board and Glasgow University and involved placing posters and life size cut out cartoon figures at the foot of escalators. Overall baseline use of the stairs was 8% which increased to the order of 15-17% during the time the posters were present. The percentage of men using the stairs rose from 12% to 21%. Twelve weeks after the posters had been removed there were still significantly more people using the stairs than at baseline but there was a downward trend suggesting a possi- ble eventual return to baseline values. The study involved more than 22,275 observations.