1. How can we deliver better PA programmes? Jim McKenna Professor of Physical Activity and Health Leeds Metropolitan University Active Lifestyles research centre j.mckenna@leedsmet.ac.uk

3. Successful: healthy people, superior care and fair Sustainable: affordable, acceptable and adaptable

4. Better ways to promote PA so fewer people remain inactive

5. Eight constructs account for most variation in health-related behaviour Intentions Environmental barriers Emotions Self standards Skills Outcome expectancies Social norms Self efficacy

6. Shift from motivation to motivators

7. Time Money Physical effort Brain cycles Social deviance Non-routine Pleasure/pain Hope/fear Acceptance/rejection Signal Facilitator Spark

9. Why do we need new approaches?

11. So, what works best then?

12. Positive effects Negative effects

13. Potent PA programmes 358 studies, 99K participants (median; 74% F); moderate mean effect size (d=0.19, <500 steps/day) for studies with healthy adults* result from... Project staff delivering standardised interventions using b ehavioural techniques (exercise prescription, goal-setting, self-monitoring, PA feedback/consequences), direct to participants * Health education did not increase effect size Conn et al. (2011) Am J Pub H. 101(4), 751-8.

14. ‘New’ ways to promote things

15. ‘New’ ways to promote things? ‘ Persuasion infrastructure’ ‘Attention-omics’ Nudge

16. Time trigger + One-off behaviour

17. Time trigger + Repeated behaviour

18. Time trigger + short-term stopping

19. Time trigger + short- term behaviour

20. Time trigger + short-term behaviour + one-off behaviour

21. ‘New’ messages for promoting PA

22. Avoid threat + Seek reward

23. Personal brain management YOU facilitate the growth of YOUR brain

24. Exercise Mental stimulation Stress managing/sleep Diet

25. Some key brain rules 1. Exercise boosts brain power Our mental health is as important as our physical health

27. Some key brain rules Exercise boosts brain power Human brains evolve We ignore boring things

28. Normal lessons decrease time on task MOST for overweight children (n=97)* Normal (inactive) lessons Normal O’wt Grieco et al. (2009). MSSE 41, 1921-26. *Mean age 8.9 years; 54% female.

29. Overweight/obesity in Leeds Years 7, 9 and 11 (Griffiths et al., 2012) Fatter earlier Stay fatter for longer Fat children are fatter

30. The cognitive value of exercise Older adults Highest functioning Lowest functioning

31. After Before During

33. Gender-specific interventions

34. What’s your score? A graded and progressive relationship between these behaviours and both morbidity and mortality

35. Not smoking + Regular PA + 5+/day f/veg + Mod alcohol + BMI

36. Behavioural clusters Poortinga (2007) Prev Med 44, 124-8. A majority of UK males have two+ behavioural risks: 4 risks – 5.5% 3 risks – 23.6% 2 risks – 39.9% 1 risk - 25.3% 0 risks – 5.7% From smoking, 6+units alcohol once per week, less than 5 fruit/veg portions yesterday and <5+ days 30mins continuous MPA in last 4 weeks. 28% smoked, 23% drank heavily, 76% ate too few fruits/veg and 66% lacked MPA ‘…people who are physically active are more likely to smoke and drink heavily…’ p127