Working with Inactive People

Working with Inactive People Manual

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Working with Inactive People | Manual | Version 1 © YMCA Awards 2021

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Working with Inactive People (M/618/6440)

Working with Inactive People (M/618/6440) Manual

Copyright © YMCA Awards 2021 The content of this document remains the intellectual property of, and is copyright to, Central YMCA (trading as YMCA Awards). No part of these materials may be reproduced, stored, copied, edited or distributed in any form or by any means including photocopying, publishing, recording or by any other electronic or mechanical methods, without the explicit written permission of YMCA Awards. YMCA Awards reserves the right to seek legal remedies for any such infringement.

Working with Inactive People | Manual | Version 1 © YMCA Awards 2021

Working with Inactive People (M/618/6440)

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Working with Inactive People | Manual | Version 1 © YMCA Awards 2021

Working with Inactive People (M/618/6440)

Contents Let’s get started .....................................................................................................................1 Working with Inactive People ................................................................................................2 Section 1: Target groups .........................................................................................................3 Research task ....................................................................................................................... 14 Mini project ......................................................................................................................... 17 Section 2: Working with inactive people ............................................................................... 18 Knowledge Check ................................................................................................................. 23 Section 3: Planning and delivering inclusive, safe and fun physical activity sessions for inactive people ................................................................................................................................. 24 Knowledge Check ................................................................................................................. 28 Mini project ......................................................................................................................... 29 Create your own glossary ..................................................................................................... 32

Working with Inactive People | Manual | Version 1 © YMCA Awards 2021

Working with Inactive People (M/618/6440)

Let’s get started This manual will support the development of the knowledge, skills, and behaviours of qualified group exercise instructors to be able to work with apparently healthy inactive adults, with no preexisting health conditions.

Overall, the role of an exercise professional is to support people to achieve their fitness goals. However, when working with inactive participant’s additional consideration needs to be given to planning, delivering, and evaluating programmes of physical activity to maximise engagement, support positive behaviours, and encourage them on their journey to a healthier more active lifestyle.

Throughout our manuals we include activities which provide opportunities for you to review and consolidate your learning. These activities, designed in red, include knowledge checks, notes, activities and an opportunity to create your own glossary.

You might also find the following icons to help you work your way through the content:

Key word A word that may unlock your understanding of a wider topic.

Spotlight on Where we provide additional information on a topic or piece of information.

Something extra!

Something related to the information in the section that we think is interesting.

Activity An opportunity for you to put what you’ve learned into practice.

Summary Summarising in depth topics can help consolidate learning.

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Working with Inactive People In this manual you will learn…

• How to identify different groups that are likely to be inactive.

• The barriers and enablers for participation in physical activity.

• The benefits and measures of participation in regular physical activity to individuals and society.

• A range of local, regional and national initiatives aimed at increasing levels of physical activity.

• The importance of building relationships and connecting with inactive people.

• To identify appropriate activities for inactive people.

• How to plan and deliver inclusive, safe and fun activities that could be used when planning physical activity sessions for inactive people.

• How to motivate and influence behaviour change.

• How effective feedback can promote retention and change in behaviour.

• • How to motivate and influence behaviour change

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Section 1: Inactivity – a global issue Introduction More than a quarter of the world’s adult population (1.4 billion adults) are insufficiently active.

Worldwide, around 1 in 3 women and 1 in 4 men do not do enough physical activity to stay healthy (WHO, 2020). In England 1 in 4 people do less than 30 minutes of physical activity a week, according to survey results from Sport England, (2020).

As an exercise instructor, it is important to understand individuals and groups that are likely to be inactive and some of the key barriers to participation in physical activity.

WHO, (2020) define physical activity as “Any bodily movement produced by skeletal muscles that requires energy expenditure. Physical activity refers to all movement including during leisure time, for transport to get to and from places, or as part of a person’s work. Both moderate- and vigorous-intensity physical activity improve health”.

Benefits of physical activity to the individual Health benefits The benefits of physical activity such as improved sleep, reduced stress, improved sense of purpose and quality of life, as well as improved posture and weight management, are all widely acknowledged and well evidenced. Numerous studies show a significant positive relationship between physical activity and reduced risk of developing a major disease such as coronary heart disease and the reduced risk of premature death. Physical activity is now recognised as an independent factor of health, regardless of other risk factors. Regular physical activity can help to prevent and manage over 20 chronic conditions and diseases. Many of these conditions and diseases are on the rise and affecting people at an earlier age; 1 in 3 of the working age population have at least 1 long term condition and 1 in 7 have more than one. More information can be found here: tinyurl.com/24davjnd.

Figure 1: Benefits of Exercise image taken from Health matters: getting every adult active every day - GOV.UK (www.gov.uk)

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When promoting and enabling inactive people to make changes to their behaviour, it is important that the sociological, physiological and psychological benefits, as well as the physical benefits are emphasised.

Sociological benefits •

Participating in regular social activity enhances a sense of community and can be a powerful motivator for individuals, offering them opportunities to speak with a wide range of people and participate in fun activities with friends.

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Where a person may have moved to a new town or city they may find participating in regular physical activity an effective way to help them adjust to new surroundings and meet like-minded people.

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Older or less mobile people may struggle with managing at home alone. Developing strength or flexibility can support them living independently for longer.

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Teamwork skills like problem solving, cooperation or communication are all transferable from the physical activity environment into the workplace and can enhance relationships and work satisfaction as well as productivity.

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Antisocial behaviours including aggressive or disruptive actions can be reduced through group activity where new relationships can be formed, or anger or stress can be positively addressed and managed.

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More information can be found in the Active Lives survey: www.sportengland.org/know-youraudience/data/active-lives.

Physiological benefits Promoting the physiological benefits of an active lifestyle can provide further incentives for participants.

By using regular health assessments, initial baselines can be established, and trackable physiological changes can be monitored. This provides precisely measurable evidence of their progress helping motivate them to continue. Health assessments could include: •

blood pressure

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heart rate

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blood glucose levels

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BMI

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fitness testing (strength test, bleep test, sit and reach etc)

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heart rate monitors during exercise

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pedometers.

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Psychological benefits There is strong scientific evidence that being physically active can support people to lead healthier and happier lives. The research shows the psychological benefits associated with being physically active can boost self-esteem, provide a sense of purpose and value, improve mood, memory, sleep quality and increase energy, as well as reducing the risk of stress, depression, dementia and Alzheimer's disease. More information can be found on the NHS website: www.nhs.uk/live-well/exercise/exercisehealth-benefits/.

Research has proved the benefits of ecotherapy and being active outdoors. Getting outside to enjoy some fresh air and sunshine is great for your mental and physical health, helping you produce the Vitamin D essential for the absorption of calcium and good bone health.

Although measuring the psychological benefits of physical activity may seem more challenging than weight loss or fitness testing, encouraging participants to keep a diary or a log of the activity they have undertaken and recording how they feel about it can be useful. An example of a basic (completed) log is shown below: Client activity log week 1 Were the goals met?

I only managed to do it 5 times this week, but I did hit the full 20 minutes each time.

Activity

Time of day

Duration

Brisk walk

Early evening

20 minutes every day

Exercise class

Morning

45 minutes

Yes, I did the whole class!

Stretching

Before breakfast

10 minutes at least 5 days a week

Mostly!

Mindfulness

Lunchtime

5-10 minutes every day

Mostly!

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Reflection on how you felt I missed 2 days as I was late home from work which was disappointing, but I felt good on the days I did it!

I felt nervous to start but as I go into it, I felt less self-conscious and enjoyed it.

I found it a bit of a rush some days but when I did it, I felt great and it helped with my backache.

It was hard to find a quiet space at work, so I went for a little walk outside and did some breathing exercises.

Amendments or other notes Extend the walk the following day if I miss one the evening before.

Book a 6-session block for Saturday mornings.

Set alarm for 10 minutes earlier so I make sure I have time.

Giving myself 10 minutes break at lunchtime really helped me concentrate in the afternoon.

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This can be used as a discussion point with participants to help them to adhere to their goals and can support them to stay focussed throughout the week. They could also be offered a questionnaire to track progress or use an online tool such as www.bemindfulonline.com/test-your-stress to measure perceived stress scale (PSS) improvements over time.

Figure 2: Image taken from Health matters: getting every adult active every day - GOV.UK (www.gov.uk)

Groups that are likely to be inactive The specific groups that have been identified through a variety of data sources as most likely to be inactive. These include those who have: •

Low numbers of participation in physical activity.

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Historically and/or culturally no history of participation.

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Falling numbers of participation creating ‘at risk’ groups.

Groups that are likely to be inactive

People from socially deprived areas

Young women and girls

People in key transition periods eg, leaving education

Specific cultural groups

People with disabilities

People with medical conditions

Older adults

People in rural communities

Overweight or obese people

People with mental health issues

In addition, significant health benefits of increasing participation can be gained by those in specific groups such as those on exercise referral programmes or overweight or obese individuals, people with long-term conditions like type II diabetes and people who suffer from mental health conditions.

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Inactivity According to UK Chief Medical Officers' Physical Activity Guidelines (2019), inactive and sedentary behaviours are related to sitting, reclining or lying down during waking hours, undertaking little movement or activity and using little energy above what is used at rest ie, inactive people do not achieve the recommended amount of physical activity of 150 minutes per week and many are doing less than 30 minutes per week.

How the target groups have been identified Information and research are gathered in several ways to support the identification of the target groups.

The UK Government Department of Health of Social Care, Sport England and Public Health England all work in partnership to support the ongoing collation of data and insights into the health and activity levels of the nation.

A national statistics publication, Scholes (2016) outlines the results of leisure and occupational physical activity data from adults who participated in the Health Survey for England. It shows the frequency and duration of participation across a range of activities and compares the levels with the UK guidelines for aerobic and muscle strengthening. For older people, exercise aimed at improving balance and coordination was also included.

The report also presents sedentary behaviour data showing only 66% of men and 58% of women aged 16 and over met the aerobic guidelines of at least 150 minutes of moderate activity or 75 minutes of vigorous activity per week (or an equivalent combination of both) in bouts of 10 minutes or more.

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Barriers to, and enablers for, participation in physical activity Barriers As far as barriers to physical activity are concerned, it is understood that there can be multiple reasons why a person cannot participate more in physical activity. Some of the most common factors that can decrease access to being active are: •

time constraints

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age, injury, ill-health or disability

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friends and family don't share the same interest in physical activity

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lack of motivation and/or energy

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family caregiving obligations

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lack of resources/equipment/accessibility

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transport issues

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finance to access classes or support services

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religious or cultural beliefs

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perception or fear of discrimination.

When attempting to fully understand the many factors and barriers to an inactive lifestyle, the exercise instructor must always ensure that they operate within the boundaries of safe and effective practice ie, only working with apparently healthy adults and who have successfully completed PAR-Q+ and informed consent forms.

NB: For more information on barriers to exercise see section 3 in the Lifestyle Management and Health Awareness manual.

Enablers An enabler is something that encourages or supports a person to be able to do something and is often directly linked to breaking down the barriers or challenges to participation. Every individual is likely to have different motivation levels and therefore will respond to enablers in their own way.

Examples of enablers include: •

social support or building new relationships and friendships.

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professional support from exercise instructors or community healthcare team.

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personal drivers, benefits or specific goals.

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maintaining independence.

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control of a physical or medical condition.

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Significant health benefits of increasing participation levels have been shown for groups of people such as those on an exercise referral programme, overweight or obese or those with long-term conditions such as type II diabetes or mental health conditions.

Summary •

A barrier is something that decreases access to something.

•

An enabler is something that encourages or supports a person to be able to do something.

Access to information and insight on barriers and enablers Many organisations aim to gather insights on activity, reduce barriers and enable more people to be more active.

British Universities and Colleges Sport (BUCS) is an example of a digital ideas, inspiration and resources platform which uses research-based evidence and partner collaboration to promote and support physical activity. More information can be found here: www.bucs.org.uk/.

According to Sport England, 1 in 4 people in England do less than 30 minutes of physical activity a week.

However, their research also shows that participants who do the least activity can benefit the most by making even the smallest changes and introducing regular activities.

The Sport England ‘Active Lives Adult’ survey collects data on engagement and attitudes to sport and physical activity which provides useful feedback from different groups of people, ages, gender, trends etc, on how they engage with physical activity. It gives a comprehensive overview of adult (age 16+) sport and physical activity in England in the 12 months from May 2018 to May 2019. Although the results show 28.6 million adults are regularly active (the highest number ever recorded), the findings show persistent inequalities for those from the lowest income families and those from black and south Asian backgrounds.

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The survey also showed that 1 in 20 adults have been put off doing physical activity because they found it too hard to book online. The OpenActive platform has been created to remove this barrier and make it as easy as possible for people to access activity. More information can be found here: activelives.sportengland.org/.

There are 43 active partnerships across England that work together with local partners aiming to engage communities to transform lives. They seek to make active lifestyles the social norm for everyone and address the worrying levels of inactivity in society. They offer a wide range of information, initiatives and resources to support people in getting more active. More information can be found here: www.activepartnerships.org/. ukactive have a range of information on breaking down barriers and enabling positive changes: www.ukactive.

Other organisations that offer insights and useful information are National Governing Bodies (NGBS) and charities such as Activity Alliance, StreetGames and Richmond Group.

Ways to provide support in overcoming barriers to participation Understanding specific challenges and then offering a plan to help an individual is the best way to improve uptake and retention and help them achieve their goals.

To support inactive people in overcoming barriers to participation the exercise instructor should aim to take a personalised approach, which may be by either working with one of the organisations or resources discussed above or on a 1 to 1 or group exercise basis. In addition to identifying an individual's personal priorities, and setting and adjusting goals to meet those priorities, promoting physical activity or focusing on activities that are engaging and in a social environment are some of the most tried and tested methods of increasing participation. These approaches can make individuals more inclined to continue physical activity.

Additionally, an exercise instructor with strong empathy, non-judgemental skills, and effective listening skills can greatly influence an inactive individual to become active if they can set appropriate, achievable goals and be a good role model for them.

It is also helpful to consider linking participants with others to maximise progress and motivate inactive individuals, as they could offer encouragement or social influence, provide transportation or childcare, or just be an exercise buddy.

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Examples of these include: •

family

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friends

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teachers

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health or social care workers.

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To further support participants through breaking down barriers and supporting behaviour change, see the Lifestyle Management and Health Awareness manual, Section 3.

Physical activity-promoting initiatives Physical inactivity, along with obesity and smoking, is one of the main causes of early death and illhealth.

The government paper titled Health matters: physical activity - prevention and management of longterm conditions (2020) states that “for good physical and mental health, adults should aim to be physically active every day. Any activity is better than none, and more is better still.”

As previously mentioned, regular physical activity provides a range of physical and mental health, and social benefits, many of which are increasing issues for individuals, communities and society. These include: •

Reducing the risk of many long-term conditions

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Helping manage existing conditions

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Ensuring good musculoskeletal health

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Developing and maintaining physical and mental function and independence

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Supporting social inclusion

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Helping maintain a healthy weight

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Reducing inequalities for people with long-term conditions.

Their ambition is to get everybody active during the 2020s. This includes the 1 in 3 adults who are already living with a health condition.

New technologies and data held by the NHS, and generated by smart devices worn by individuals, will support a new wave of intelligent public health. Everyone will have access to their health information and health interventions will become more personalised and each person will become a co-creator of their own health plan. They will be promoting further the key evidence showing that regular physical activity can help prevent or manage many common conditions such as type II diabetes, cardiovascular disease and some cancers. It also promotes how being active helps keep symptoms under control, prevents additional conditions from developing, and reduces inequalities. More information can be found here: tinyurl.com/xv37v9jp.

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Across the UK there is a range of local, regional and national initiatives aimed at increasing physical activity levels. The NHS advise that “Adults should do some type of activity every day” and they explain that any activity is good and generally the more people do the more benefits they can achieve. The NHS The Let’s Get Moving support pack gives advice and guidance and easy to follow information on how to start activity and become healthier. Information on this initiative can be found here: tinyurl.com/79kt34en.

Public Health England (PHE) is an executive agency of the Department of Health and Social Care who exist to protect and improve the nation’s health and wellbeing and reduce health inequalities. They offer a range of initiatives aimed at specific target audiences. More information can be found on this website: tinyurl.com/24davjnd.

In addition, there are many local and regional organisations and partnerships that work together to identify target groups of inactive people and they often support local initiatives aimed at supporting behaviour change.

Sport England is partly funded through the National Lottery. They have a 10-year strategy called Uniting the Movement to transform lives and communities through sport and physical activity. They aim to do this by gathering data, providing insights and awarding funding to initiatives.

This Girl Can is a well-known initiative to support and inspire females to become more physically active and make physical activity a way of life. More information and access to resources can be found here: www.thisgirlcan.co.uk/.

Towards an Active Nation is another Sport England initiative that ran from 2016-2020. The aim was to get everyone in England, regardless of age, background or level of ability to feel able to engage in sport and physical activity. The aspiration was to ensure the sport sector welcomed everyone – meeting their needs, treating them as individuals and valuing them as customers. More information can be found here: tinyurl.com/3ju8wu7b.

We are Undefeatable is a national campaign supporting approximately 15 million people in England living with 1 or more long-term health conditions. Started in 2019, the target is to help those with conditions such as diabetes, cancer, arthritis and Parkinson’s to build physical activity into their lives. 15 leading health and social care charities are working together with Sport England expertise and National Lottery funding to deliver this initiative. More information can be found here: tinyurl.com/nxvftcvu.

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NHS Couch to 5K is aimed at absolute beginners and has helped over 4 million people start running.

The Active 10 app is easy to download and anonymously records every minute of walking a person does.

It is designed to support ways to increase daily physical activity, with simple and achievable milestones and rewards along the way.

Walking for Health is one of the simplest and easiest ways to get more active but yet is sometimes undervalued. Brisk walking can build stamina and burn excess calories and a 10-minute walk counts towards the recommended 150 minutes a week. Helping individuals to build this into their routine can be a simple yet positive step. The NHS suggest using the Active 10 app alongside this to record activity, build up gradually and support motivation. More information can be found here: www.walkingforhealth.org.uk/.

InstructorLive is an on-demand platform with over 800 fitness sessions readily available, including a free 3-month beginner programme. More information can be found here: www.instructorlive.com/.

Healthy Lifestyle services are run by many local authorities, offering free coaching, advice and help to support people to move more and become healthier. More information can be found through local authority websites. ukactive exists to improve the health of the nation by getting more people, more active, more often.

They provide services and facilitate partnerships for a broad range of organisations. They are committed to promoting active lifestyles, offering a supportive, professional and innovative platform for partners to succeed in achieving their goals and create the conditions in which our sector can grow. More information can be found here: www.ukactive.com/.

Local leisure centres are usually owned and operated by the town, city, borough or district council.

Many leisure centres have a range of activities on offer which may include a pool, fitness suite and studio where people can participate in physical activity or relax.

Summary There are a number of local, regional and national organisations and initiatives aimed at increasing physical activity levels eg, Sport England, Public Health England and local councils.

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Research task Research a range of local, regional or national initiatives targeting inactive people and identify areas of good practice and areas for improvement. Use the table below to make notes.

Name of initiative and who it’s aimed at

Is it local, regional or national?

What is good about it?

What is not so good about it?

The benefits to society of engaging people with physical activity Engaging people in physical activity also has wider implications related to society and the economy. Lack of physical activity costs an estimated £7.4 billion a year in the UK, including £0.9 billion to the NHS alone. People in the UK are around 20% less active now than in the 1960s. More people have a car and fewer people have manual jobs. Technology continues to reduce our need to move at home and in the workplace, we have literally designed physical activity out of our lives and are the first generation to have to plan to do activity in our daily lives. If current trends continue, we will be 35% less active by 2030, (Gov. UK, 2016).

Inactivity can lead to serious illness or long-term health conditions which in turn can lead to an increased dependency on home, residential and nursing care. This can put extra strain on individuals, families and ultimately the health care services. Further information on this can be found here: tinyurl.com/24davjnd. On the other hand, if people are more active and can become healthier this will lead to fewer people on welfare, a more productive labour force and increased taxation income from those gaining and maintaining employment.

The Office for National Statistics (ONS) have in depth data on key indicators related to improved wellbeing through increased physical activity, including a reduction in obesity, reduced workplace sickness or those unable to work, fewer hospital admissions, reduced mortality and mental health to name a few. More information can be found on the ONS website here: www.ons.gov.uk/peoplepopulationandcommunity/wellbeing.

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A ukactive blog reports physical activity as ‘society’s golden thread’ – a valuable tool in fighting some of our national challenges; from an ageing society to community integration, reducing childhood obesity to supporting reductions in crime and antisocial behaviour. A good example is Iron Man triathlon champion John McAvoy, who at age 20 was facing life imprisonment but through focussing on fitness he transformed his life. The blog goes on to explain that most parents and their teenagers say that antisocial and criminal behaviour is linked directly to boredom, something that can be addressed through engaging in physical activity and initiatives. The full report can be read online here: www.ukactive.com/blog/the-impact-of-physical-activity-on-crime-and-anti-social-behaviour/.

Summary In summary the benefits to having more people engaged in physical activity can be seen in a healthier lifestyle across all ages, reduced pressure on the NHS, less antisocial behaviour, fewer people on welfare, a more productive labour force and increased taxation income from those gaining and maintaining employment.

Other nations and regions that benefit from having a culture of people engaged in regular physical activity The World Health Organization (WHO) provides evidence-based guidelines for physical activity for children, adolescents, adults, older adults, pregnant and postpartum women and those with disabilities or chronic conditions.

These guidelines, (which detail the frequency, intensity and duration required to gain significant health benefits and mitigate health risks), are intended to be used by policy makers around the world to implement national and regional plans to increase physical activity and reduce sedentary behaviours.

In Finland, national physical activity promotion and campaigns have successfully targeted every phase of the life-course with programmes to promote welfare and physical activity from children’s day care to the older age groups. The programmes target behavioural change and motivation. A particular success is the ‘sport and physical activity close to home’ programme, encouraging an active, healthy lifestyle. The programme employs sports ‘connectors’ and supports activity through grant funding for neighbourhood activity targeting the specific sedentary groups, overweight children and adolescents in low-income neighbourhoods.

In Sweden the county of Östergötland, implemented physical activity prescribing. An evaluation of the initiative after 12 months found that almost 50% reported following the prescription, while an additional 21% were regularly active, leading to a considerable reduction of the proportion of the population classed as sedentary.

In Germany the German Olympic Sport Confederation (DOSB) is the umbrella organisation for German sports and health management is a particular area of expertise. They collaborated with the German Medical Association to create the ‘Sports for Health’ initiative which ensures nationwide, standardised programmes which receive a “seal of quality”. All programmes must be designed to: Working with Inactive People | Manual | Version 1 © YMCA Awards 2021

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specific target groups

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be led by qualified exercise instructors

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have no more than 15 participants in sessions

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include a health check-up

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undergo quality control measures

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be part of a local network of sports clubs.

More information on other nation’s initiatives and approaches can be found here: www.who.int/publications/i/item/9789240015128.

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Mini project Exercise instructors must stay up to date with guidelines, research and the benefits of having a culture of people involved in physical activity.

Use the information contained in the physical activity factsheets found here tinyurl.com/y6p4dzue to complete the following table.

Country and/or region

Name and focus of the campaign or programme

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Notes on your findings

Working with Inactive People (M/618/6440)

Section 2: Working with inactive people Building relationships with inactive people In addition to supporting people to reach their fitness goals, professional exercise instructors should also take time to build relationships and connect directly with their patients. Building trust and establishing a positive and motivating environment will prepare the exercise instructor to guide the individual on their journey to a healthier and more active lifestyle. It is therefore important to understand the value and impact of effective communication, empathy, active listening skills, setting achievable goals and being a positive role model since these are key tools for an exercise instructor to positively influence participants’ behaviour and support long term change and retention.

Adapting communication methods An exercise instructor may well work with a range of participants from different cultures, beliefs, backgrounds, ages, abilities and levels of motivation, and some people may need more support than others at the early stages of relationship building.

Therefore, they may need to adapt their communication methods to meet the needs of people. Some examples include: •

Using a translator if necessary.

•

Using sign language.

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Using visual aids such as pictures, images or flash cards.

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Slowing your speech as appropriate.

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Speaking very clearly, maintaining eye contact and using positive open body language.

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Taking a supportive but persuasive approach.

Establishing rapport A useful consultation framework to use with new individuals is taken from Changing Eating and Exercise Behaviour, Hunt and Hilsdon, (1996), they suggest these questions are asked to create a ‘change plan’, for example: •

The main reasons I want to change are ….

•

The changes I am prepared to make are….

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The steps I will take are….

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People who may support me are….

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Things that may make change difficult are….

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My plans for coping with difficult situations are….

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I will know when I’ve been successful when….

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I will reward myself for being successful with….

Activities for inactive people Setting goals Once a positive relationship on an individual level with participants has been established, their barriers, enablers, and motivations for becoming more physically active will become easier to understand. This will help and support setting clear and achievable goals, examples of which could be: •

Improving general health and fitness for someone who is inactive but has no major health considerations.

•

Increasing socialisation and making new friends for someone who is suffering from mental health issues including depression.

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Improving appearance and confidence for someone who lacks motivation or energy.

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Weight loss or weight management for an individual who has weight concerns.

Once all the relevant information has been obtained, then the most appropriate activities for each participant can be recommended, for example: •

A younger inactive, overweight individual increasing cardiovascular fitness by walking for 20 minutes most days.

•

An older inactive individual with bone disease beginning gentle weight bearing exercise such as a gentle Yoga or Pilates class.

•

A middle-aged individual with mental health concerns, beginning with a group exercise activity with a friend and including a social activity after the class.

The exercise instructor must always work within their scope of practice and consider what activities and exercises that they can safely and effectively deliver. Along with the physical activities they are qualified to offer, such as group exercise, beginner's circuits, or gym-based activity etc, they may also consider encouraging other types of physical activity, that may motivate participation in any programme.

Examples of moderate physical activity can be seen on the image below:

Figure 3: Moderate activity image taken form Health matters: getting every adult active every day - GOV.UK (www.gov.uk)

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Adapting activities to appeal to inactive people There will be times when exercise programs need to be modified to maintain participants' interest and motivation; these activities should always be tailored to the individual or group's particular interests, preferences, and readiness for change.

However, whenever considering making any changes, it is important to remain aware that too much, too quickly can be demotivating and reinforce the perception that physical activity is too difficult.

The table below gives some ideas.

Adapting activities to appeal to inactive participants Designing appropriate sessions

How this can be achieved • Understanding individuals’ motivations and interests, music preferences, monitoring intensity, activity likes and dislikes etc.

Encourage participants to include some activities into daily routines

• Dancing to music on the radio • Taking the stairs instead of a lift • Walk to the furthest toilet facilities at work or shopping.

Building support for new behaviours

• Creating social support networks • Using existing support groups • Working with a buddy.

Reinforcing and rewarding positive behaviour

• Self-reward approaches • Positive affirmations • Giving points for participation, effort etc.

Maintaining behaviours and preventing relapse to inactivity

• Offer problem solving advice and guidance • Recognising progress • Coaching and support.

Reducing sedentary time Besides encouraging people to be physically active, exercise instructors should also encourage them to spend less time sitting for extended periods of time, since even those who are active at recommended levels can spend up to 7 hours sitting each day (and this is shown to increase with age).

Some ways by which participants could be encouraged to lessen this include suggestions to: •

Swap a long bus or car journey for walking part of the way.

•

Reduce time spent watching TV, using a computer or playing video games.

•

Take regular time not sitting during work or in meetings.

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Figure 4: Image taken from Health matters: getting every adult active every day - GOV.UK (www.gov.uk)

Influencing behaviour change The role of the sport and leisure sector ukactive and the Sport and Recreation Alliance have outlined the important role that the sport and leisure sector can play in influencing behaviour change.

The exercise instructor should therefore consider: •

How their programming targets and engages inactive people. As this is a potential new market for members or /participants, how their services are marketed and promoted will be key to popularity and uptake.

•

How they will engage with the local population.

Providing targeted events for different communities alongside inclusive activities. The use of an equality impact tool will help determine if the offer really is accessible to all. An equality impact assessment (EIA) is an evidence-based approach designed to help organisations ensure that their policies, practices, events and decision-making processes are fair and do not present barriers to participation or disadvantage any protected groups from participation. Individual’s motivation for wanting to become more physically active If an exercise instructor can identify the motivating factors that drive an inactive person to become physically active, then they will be in a better position to support them through the cycle of change and towards more positive behaviour.

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Some of the most common motivators include: •

to manage a health or medical condition

•

to meet new people

•

to feel better about themselves eg, increase confidence

•

feel more energised

•

improve overall appearance

•

be able to withstand stress

•

decrease risk of illness

•

speed up recovery from injury or surgery.

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Knowledge Check 1. What types of activities could be used when planning physical activity sessions for inactive people?

2. Give an example of an appropriate activity linked to a person’s goals.

3. Describe how you could adapt an activity or session to appeal more to an inactive person or group.

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Section 3: Planning and delivering inclusive, safe and fun physical activity sessions for inactive people This section focuses upon the importance of the relationship between programme design and activity delivery to maximise engagement with inactive people and ensuring it is inclusive, safe, effective and fun. To create the best chance of motivating and influencing participants to achieve their goals, careful and thorough planning is needed.

As with any other health-related exercise session, the objectives of the session must be clearly defined.

Session design If a session is to be effective, it must be planned to have a structure that not only targets the participants’ goals but also includes plenty of opportunities for fun and enjoyment.

Exercise programming Programming Mobility

Pulse raising

Flexibility

Cardiovascular

Strengthen big muscle groups

Considerations •

Gradual increase in range of movement in session and over time.

•

Promote good posture and abdominal engagement throughout.

•

Offer support or seated options if balance is an issue.

•

Side effects from any medication, level of pain or discomfort.

•

Extended pulse raiser to gently prepare for main activity.

•

Be sensitive to individuals’ emotions.

•

May have more muscle stiffness in the mornings.

•

Can combine with mobility.

•

Avoid excessive reps- stress on joints, functional limitations.

•

Limit high impact and work at moderate intensity.

•

Slow transitions- bulk, size or coordination may impact ability.

•

Consider chair-based options.

•

Consider functional movement.

•

Focus on body weight exercises – gradually increase lever length and reps over time.

Cool-down

•

Switch between upper and lower body exercise and include active rest.

•

Promote good techniques and offer options/adaptations.

•

Extended cool-down, gradual decrease in intensity.

•

Seated or lying stretches to avoid balance issues if tired.

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Ways to make the session more enjoyable Although once the exercise instructor gets to know their participants, they will be able to develop a rapport and find individual ways to make their sessions fun and friendly, the following examples are often good ways to start: •

Encouraging fun imagery.

•

Asking individuals to share any funny anecdotes or success stories from their week.

•

Relating activities to everyday tasks.

•

Counting reps together, possibly in time to beat of music.

•

Considering using alternative exercises and equipment to those associated with gyms.

•

Encouraging partner or small group work to promote the social aspect.

•

Giving plenty of positive feedback and encouragement.

Session plan Once the exercise instructor has determined the content of their intended session then they should record them in either a written or electronic format. Although this will often be far less “formal” than mainstream ones such as circuits, exercise to music etc., the format should still follow the same structure of warm-up, main session, cool-down.

Also, as with any planned fitness sessions, this content should include (as a minimum) all activities, together with timings, alternatives and teaching points, as well as any equipment or facilities required.

However, as inactive participants will often have a different level of motivation than mainstream participants, then making a note of possible motivating “triggers” alongside the more general teaching points, would be a useful addition.

Session delivery Delivering an inclusive, safe, effective and fun session for inactive people is the key to success with this target group of participants. Working with inactive people is, in many ways, exactly the same as mainstream sessions since it follows a standard session structure Overview of session delivery Introduction • Welcome participants from the outset using effective communication to help them feel comfortable and at ease. Perhaps introducing them to others is appropriate.

• Perform a verbal health check prior to starting the session as it may be several days or weeks since you completed the PAR-Q. • Check how they have got on since last contact. Confirm or revise plans with participants as appropriate.

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Session content • Establish and maintain appropriate exercise intensity for each component.

• Monitor and improve the performance of participants where appropriate.

•

Implement adaptations to maximise engagement and motivation.

•

Use appropriate methods to correct and reinforce technique for safety and effectiveness.

•

Use motivational styles appropriate to the participants and the exercise format.

•

Use effective communication with participants throughout and make sure they can see you clearly during the session.

Conclusion • Give participants feedback at the end to support and motivate them and gather their feedback so you can effectively evaluate the session.

Alternatives Pre-planning alternative activities or exercises will help ensure that the session/activity runs smoothly and effectively by helping ensure that: •

All participants are engaged and motivated

•

The ‘fun’ element is maintained

•

Every activity is pitched at the appropriate level each participant

•

The needs of each participant are met.

A flexible approach gives the greatest chance of retaining participants and supporting their behaviour change process.

Importance of feedback Effective feedback is key to promoting retention and changes in behaviour.

Giving participants feedback is an effective way to help them understand where their strengths and areas for development are. It’s also a good chance to give praise for their performance during the session and positive reinforcement related to their goals.

Asking for feedback from participants can be a useful tool in determining their current goals and motivators (as they may change from time to time), how successful they feel about their progress toward them and their overall enjoyment levels.

This could be done verbally at the end of each session or written in the form of notes about things like: •

What they liked

•

What they found difficult

•

How many reps and sets they achieved?

•

How long they were able to work at a certain level before taking active rest.

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•

This can be empowering for individuals to understand how they are moving towards achieving their aims.

Self-evaluation Ultimately, the goal of the exercise instructor is to enable and encourage participants to continue being physically active in the future without direct supervision.

By analysing and reflecting on conversations, approach and progress of the participants in their activity programmes; together with the popularity and retention levels will give valuable feedback on how successful they are in achieving this

Summary •

Key things to remember are:

•

That you need to agree and set achievable goals.

•

Actively listen to your participants.

•

Have empathy, plan and deliver achievable sessions and be a positive role model.

•

You can also call on the support of others to help motivate individuals to make progress and stay on programme.

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Knowledge Check 1. Outline the importance of the relationship between programme design and activity delivery to maximise engagement with inactive people.

2. Identify ways you will make your sessions inclusive, safe and fun for inactive people.

3. Describe ways you could gather feedback from participants about their session to enhance their motivation.

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Mini project Review the Chief Medical Officer guidelines for physical activity on the infographics below. These relate to the target groups for inactive people that an exercise instructor is likely to be in contact with. Use the notes box below to summarise the key points for each target group or record anything you find particularly interesting.

The Chief Medical Officer guidelines for physical activity (2019) outline the benefits of a range of activities (see images below or view online: tinyurl.com/2baybdms.).

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Notes Write notes about the section here:

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Create your own glossary Throughout this manual, you will come across words and terms that you may have never heard before.

As you read the manual, pick the key terms that you want to remember and record them here with their definition.

Term

Definition

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References Active Partnership, (2021). Engaging communities, transforming lives. (Accessed: 1 July 21). Available at: www.activepartnerships.org/.

Be Mindful, (2021). Understanding your level of stress is the first step in taking control. (Accessed:1 July 21). Available at: www.bemindfulonline.com/test-your-stress.

GetBUCSActive, (2021). Supporting you to stay active at home. (Accessed: 1 July 21). Available at: www.bucs.org.uk/get-involved/getbucsactive.html.

Moore, H. (1999). Changing eating and exercise behaviour: a handbook for professionals. Family Practice, Volume 16, Issue 4, August 1999, Pages 447–448. Available at: academic.oup.com/fampra/article/16/4/447/428790.

MacDougall, C. (2000). Crime prevention through sport and physical activity. (Accessed:1 July 2021).

Available at: www.academia.edu/16971066/Crime_prevention_through_sport_and_physical_activity.

NHS, (2019). Exercise. (Accessed: 1 July 2021). Available at: www.nhs.uk/live-well/exercise/.

NHS, (2011). Let’s get moving. (Accessed: 1 July 21). Available at: tinyurl.com/79kt34en.

NHS, (2019). Walking for heath. (Accessed: 1 July 21). Available at: www.nhs.uk/livewell/exercise/walking-for-health/.

Scholes, S. (2016). Health Survey for England 2016 Physical activity in adults. (Accessed: 1 July 2021).

Available at: tinyurl.com/9x8jc6ta.

Sport England, (2021). Active lives online. (Accessed: 1 July 2021). Available at: activelives.sportengland.org/.

Public Health England (2020). Health matters: physical activity- prevention and management of longterm conditions. (Accessed: 1 July 21). Available at: tinyurl.com/xv37v9jp.

Perks, C. (2018). Towards an active nation. (Accessed: 1 July 21). Available at: tinyurl.com/3ju8wu7b.

Public Health England, (2016). Guidance Health Matters: getting every adult active every day. (Accessed: 1 July 2021). Available at: www.gov.uk/government/publications/health-matters-getting-every-adultactive-every-day.

Sagoe, G. (2018). The Impact of physical activity on crime and anti-social behaviour. (Accessed: 1 July 2021). Available at: www.ukactive.com/blog/the-impact-of-physical-activity-on-crime-and-anti-socialbehaviour/.

Sport England, (2021). We are undefeatable. (Accessed: 1 July 21). Available at: https://tinyurl.com/nxvftcvu.

This Girl Can, (2021). This Girl Can. (Accessed: 1 July 21). Available at: www.thisgirlcan.co.uk/. ukactive, (2021). (Accessed: 1 July 21). Available at: www.ukactive.com.

UK Chief Medical Officer, (2019). UK Chief Medical Officers' Physical Activity Guidelines (2019) (Accessed: 1 July 21). Available at: https://tinyurl.com/47d6hjpe.

World Health Organization, (2018). Physical activity fact sheets for the 28 European union member states of the WHO European region 2018. (Accessed: 1 July 2021). Available at: tinyurl.com/2t2td3e4.

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World Health Organisation (2020). WHO guidelines on physical activity and sedentary behaviour.

(Accessed: 1 July 21). Available at: www.who.int/publications/i/item/9789240015128.

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