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Division of Information Services ASSIGNMENT
Nathan Campus COVER SHEET
GRIFFITH UNIVERSITY QLD 4111

Please complete all sections below DATE RECEIVED:

Course Code: 2010PSY

Course Name: Health Psychology
Due Date: Assessment Item #: 1
Enrolment: Off Campus On Campus
Campus (Enrolled) Nathan GC Logan Mt G SB

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Course Convenor: Professor Kyra Hamilton
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Please complete and check relevant boxes (double click on box and select “checked” then
click OK).

Note: Word limit is 2500 words. Words beyond this point will not be marked.

Word count:
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Abstract (120-200 words)

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[Insert Title]

Introduction/Background (700 words)

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Physical inactivity is strongly linked to several negative health outcomes and is the 4th

highest mortality risk factor worldwide (https://www.who.int/data/gho/indicator-metadata-

registry/imr-details/3416). Being physically inactive places individuals at much greater risk

of hypertension, coronary heart disease, stroke, diabetes, cancer and depression

(https://www.who.int/news-room/fact-sheets/detail/physical-activity) and accounts for 2.5%

of Australia’s total disease burden (https://www.aihw.gov.au/reports/burden-of-disease/abds-

2018-interactive-data-risk-factors/contents/physical-inactivity). Physical activity is widely

considered “the most important intervention to improve health in populations” (Paterson D,

Jones G, Rice C. Ageing and physical activity: evidence to develop exercise recommendations

for older adults. Appl Physiol Nutr Metab 2007;32(Suppl 2E):S69–108.) Despite this, Australian

adults do not meet Australia’s physical activity guidelines of 150 to 300 minutes of moderate-

intensity physical activity or 75-150 minutes of vigorous-intensity physical activity per week

(https://www.health.gov.au/topics/physical-activity-and-exercise/about-physical-activity-and-

exercise). Furthermore, adults aged 65 and over (elderly) were the least physically active

group with 87% falling short of the recommended activity levels

(https://www.aihw.gov.au/reports/physical-activity/physical-activity), despite being the

population most at risk of the negative health effects of physical inactivity (ref this). Of those

elderly who were not meeting the physical activity guidelines, 35.3% do not participate in

any physical activity at all (https://www.aihw.gov.au/reports/physical-activity/physical-

activity). With over 1/3 of Australia’s elderly population leading a completely sedentary

lifestyle, an intervention is necessary to target an increase in physical activity amongst the

elderly Australians in order to reduce the associated negative health outcomes.

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Unlike other risk factors for negative health outcomes, physical activity levels are

modifiable, meaning it is vital that an intervention to incresae the physical activty levels is

intoduced to Australia’s elderly population. Research conducted in New Zealand by ref found

that interventions faciliated my general practitioners (GPs) and nurses are effective in

increasing the physical activity levels of inactive patients aged 40 to 80

(https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/j.1532-5415.2005.00466.x?

casa_token=dbw79IW_4AYAAAAA%3AA1xUakEt5x2zN0eWb2S0uydAdIX1E7Kh-

vJVgqyf1N1z5uZYDrfVuVNPWs5bNmlWxIWouttL66Upzaho). This study involved the use

of motivational interviewing techniques delivered via brief activity counselling to provide

individualised advice and deliver the Green Prescription (written advice to be physically

active). Patients then had three telephone support calls from trained exercise specialists over a

3 month period and were also provided with newsletters and written material quarterly. The

results indicated that the proportion of the intervention group reaching the physical activtiy

recommendation of 2.5 hours of physical actvity increased from 14% to 31%, which was a

significantly larger increase than the control group. The study also revealed a 7% decrease in

hospitilisations in the year following the intevention, further reinforcing the positive health

outcomes associated with exercise.

Ref (E McAuley, K.S Courneya, D.L Rudolph, C.L Lox Enhancing exercise

adherence in middle-aged males and females Prev Med, 23 (1994), pp. 498-506) conduced a

clinical trial in the United States to investigate the impact 15-minute biweekly information

sessions prior to exercise has on exercise volume, in comparison to a control group. The

information sessions involved education on the health benefits of exercise, the formation of

‘buddy groups’ to promote self-efficacy and modelling of individuals with similar

characteristics to the participants engaging in exercise. It was found that those who received
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the intervention exercised for 29.43% longer than the control group in the 4 months following

the initial intervention.

Put another intervention study here – do it on motivation and barriers

Despite numerous overseas studies, litte research has been conducted to investigate

interventions to improve physical activity in elderly Australians. To effectively address

elderly phyical inactivity in Australia, the Health Belief Model (HBM) may be useful. The

HBM is a theoretical framework that suggests that health behaviour is influenced by

perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to

action and self-efficacy (Becker MH. The Health Belief Model and personal health

behaviour. Health Education Monographs. 1974;2:324–508.). In the context of physical

inactivity, individuals must perceive that they are susceptible to the associated negative

health risks, recognise the severity of these risks, believe that increasing their physical

activity will lead to positive health outcomes and overcome any perceived barriers to their

participation in physical activity. These factors must also align with their cues to action and

self-efficacy to provide them with motivation them to participate in physical activity. Key

aspects of the HBM have been applied to a range of effective health behaviour interventions,

including those aimed at promoting physical activity

(https://www.tandfonline.com/doi/full/10.1080/17437199.2013.802623?

casa_token=xqMOdyYTFBsAAAAA%3Am6BSJGhBwxTqW3hElu8b-

mG1Bp697NU3FGCmKIVy_B5JP0POqXriVoZF0L66TtdtMysBUp6He65f_jM). A study

conducted by (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843841/) investigated “the

effect of education based in the HBM on the physical activity” of university staff aged 25-50.

The experimental group received three sessions on the health belief model. Participants

answered a Health Belief Model Questionnaire before and after the information sessions and

it was found that participant’s perceived susceptibility, perceived severity, perceived benefits
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and cues to action significantly increased (average of 16% increase) following the

intervention, with there being no statistically significant change to these criteria in the control

group. Furthermore, the implementation of HBM education not only altered participants

beliefs towards physical inactivity, the results suggest that it also prompted them to increase

their physical activity results indicating a 47% increase in physical activity levels. Whilst this

did not investigate an elderly population, it is expected that the success of this intervention

would be transferrable across all populations. Therefore, it was concluded that the HBM

would be an effective framework for an intervention to reduce physical inactivity in elderly

Australians.

The results revealed

The results found

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Aims and Hypotheses (100 words)

The aim of this study is to apply the HBM to design an intervention to reduce physical

inactivity among Australians aged over 65. It is anticipated that following the intervention,

participants will exhibit an increase in perceived susceptibility and perceived severity of the

negative health impacts of physical inactivity and greater perceived benefits, self-efficacy and

cues to action related to exercise. As a result, it is hypothesised that these outcomes will

result in a significant reduction in physical inactivity among those exposed to the

intervention.
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Method

Participants (50-100 words)

This study will involve a sample of 200 male and female Australian adults aged over 65 years

old, as previous successful interventions had group sizes ranging from 100-300 participants

(ref the three studies I talked about in background). Participants who are currently meeting

the physical activity guidelines of 150 minutes per week or individuals who are physically or

medically unable to exercise will be excluded from the study. The participants will be

randomly divided into even intervention and control groups. Individuals will be invited to

participate by their GP and will receive $150 if they complete all intervention sessions

required questionnaires.
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Procedure (350-400 words)

Invitations to participate in the intervention will be extended to GPs from two medical centres

in Brisbane. Those willing to be involved will be trained to facilitate all three sessions that

make up the intervention. The participating medical centres will be asked to contact all

regular patients over 65 with an invitation to join the study and those interested will complete

a brief screen to check that they meet the requirements of the study. The first suitable

participants (100 male and 100 female) will then be evenly split into the experimental group

and the control group. One month prior to the intervention, all participants will be given a

smart watch that measures heart rate (HR) and will be required to wear it for the entire

duration of the trial. Leading up to the intervention, the watch will record the amount of time

participant’s spend above 64% of their maximum HR, which indicates the time spent

exercising at a moderate intensity or higher

(https://health.gov/sites/default/files/2019-10/CommitteeReport_7.pdf). Participants will also

be required to complete a Health Belief Model questionnaire developed by

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843841/) to determine participant’s initial

attitudes towards physical inactivity before any intervention sessions. Participants will be

informed that their HR data and questionnaire responses are anonymous and will be

encouraged to provide honest answers. Following the initial 4 weeks of both groups wearing

their smart watch, those in the experimental group will attend one fifteen-minute session per

month with their GP over the next three months. Session one will focus on educating

participants about the health risks associated with physical inactivity and well as the benefits

of being physically active, ultimately targeting the HBM aspects of perceived susceptibility,

perceived severity and perceived benefits. Participants will also be educated on the Australian

recommendations for amount of physical activity per week. Session 2 will build on the first
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session with GPs discussing the participant’s cues to action by linking this with the patient’s

susceptibility to and severity of the negative health outcomes associated with physical

inactivity. The final session will focus on identifying participants’ perceived barriers to

physical activity and collaboratively devising strategies to overcome these challenges in order

to improve their self-efficacy. One month after the final session is completed, all participants

will re-take the HBM questionnaire (ref) and all physical activity data will be collected from

the watches for the three-month period. The average scores for each aspect of the

questionnaire and average weekly physical activity (at a moderate intensity or higher) will be

calculated, to allow for comparison between the intervention and control groups before and

after the intervention.

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Measures/Materials/Apparatus (150-200 words)

Participants will be required to fill out a questionnaire based one the HBM

questionnaire that was developed by (ref). This questionnaire consists of 47 questions with

six questions on perceived susceptibility (e.g. if I don’t exercise I will die sooner), six

questions on perceived severity (e.g. the health impacts of physical inactivity are very

serious), eleven questions on perceived benefits (e.g. physical activity can improve my

overall health and wellbeing), eight questions on perceived barriers (e.g. I don’t have time to

exercise), six questions on perceived self-efficacy (e.g. I can consistently incorporate physical

activity into my daily routine) and six questions on cues to action (e.g. someone in my life

often suggests I exercise with them). Participants will answer each question using a five-point

scale ranging from strongly agree to strongly disagree (with strongly agree being a score of

five except perceived barriers where strongly agree was given a score of one). Participants

will re-take this questionnaire after undergoing the intervention.

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Participants will also be given a smart watch that they must wear at all times they are

awake from the moment they are given it (one month before the first intervention) until the

completion of the study (one month after the final intervention. The watch will measure

wrist-based HR and record the amount of time an individual spends above 64% of their

maximum HR. This data will be used to compare the amount of physical activity both the

control and intervention participants do throughout the study to determine whether the

intervention was effective in increasing physical activity.

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Expected Outcomes and Implications (550-600 words)

The results from previous similar studies suggest that participants who were exposed

to the intervention will exhibit significant improvements in their physical activity levels (ref

the three studies that I talked about in the background). This expected outcome aligns with

the aim to decrease physical inactivity among elderly Australians in order to address the

associated health risks. It is also expected that there will be no change in the physical activity

levels of those in the control group throughout the trial.

These results are expected to be achieved by educating the participants on physical

inactivity and the associated negative health outcomes using the HBM. As the intervention

aims to improve participant’s awareness of their susceptibility to the negative health

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outcomes caused by physical inactivity, it is expected that participants will perceive

themselves as more susceptible to these risks, thus, motivating behaviour change. Similarly,

by highlighting the severity of these health outcomes as well as the benefits of physical

activity, it is expected this will contribute to participant’s motivation to be physically active.

It is also projected that addressing participants perceived barriers to exercise and identifying

their cues to action will enhance their self-efficacy and prompt them to be more physically

active. These expectations are reinforced by

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843841/) who found that promoting

increases in physical activity via the HBM was highly successful.

The implications of decreasing physical inactivity in the Australian elderly would

include decreased risk of the associated health problems including diabetes, stroke,

hypertension, coronary heart disease, cancer and depression (ref). This may result in

increased quality of life and life expectancy among elderly Australians as well as decrease the

associated burden on Australia’s health-care system.

There are several potential weaknesses of this study including the presence of

sampling and selection bias. As participants are only being selected from two medical centres

in Brisbane, it is likely that this is not a true representation of Australia’s elderly population

which may skew the results in terms of socio-economic status, location, and ethnicity, which

would decrease the reliability of the findings. Selection bias may also be present as

participants are selected based on their willingness to participate which may result in a

sample that is healthier or more motivated than the general population, which could also

influence the results.

Another potential weakness is the use of GPs to implement the intervention. Whilst

the sessions are indicated to be 15-minutes in duration, it is plausible that GPs may rush these

sessions if they are running behind schedule. This would limit the effectiveness of the
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intervention as it may prevent in-depth conversations relating the HBM to physical inactivity

and the associated risks.

In the future, this study could be extended to include a wider range of participants

from different socio-economic statuses, locations, and ethnicities to account for the

limitations in diversity of the initial sample. This intervention could also be applied to

different groups, such as university students or high-school age females, to promote physical

activity and reduce the associated negative health outcomes in these populations. Finally, the

intervention could be altered to assess the mental health outcomes of physical activity in

addition to the physical health benefits.

Overall, an intervention involving the HBM to increase physical activity may be an

effective in decreasing the health risks of physical inactivity in elderly Australians. I feel like

I need another sentence here but idk what else to say. I feel like I cant just end it so

abruptly…
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References
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Notes:

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