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.

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

• Slowing your speech as appropriate.

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

• 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….

• The steps I will take are….

• People who may support me are….

• Things that may make change difficult are….

• My plans for coping with difficult situations are….

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

• 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.

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

• 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)

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 How this can be achieved

Designing appropriate sessions • 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

Maintaining behaviours and preventing relapse to inactivity • Self-reward approaches • Positive affirmations • Giving points for participation, effort etc.

• 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.

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.

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.