Physical inactivity, which is highly attributable to risk factors such as obesity, cardiovascular diseases, and joint problems, is a significant health issue among young adults in the United States and worldwide. Notably, this issue is noticeable among college students, and it has a higher prevalence in older adults due to a lack of early adoption of healthy patterns of physical activity. Prior studies reveal that less than 40% of college students in the United States participate in vigorous exercise at least three times a week (Schaben & Furness, 2018). Although such a population is relatively moderate, it fails to meet the Department of Health and Human Services’ recommended pattern–a minimum of 30 minutes a day of moderate physical activity, five days a week (Schaben & Furness, 2018). Despite the prevalence of minimum physical activity among college students, there is limited literature on the most effective program and intervention to mitigate the healthcare problem.
Therefore, this research will build on the existing niche in literature by delving into the issue and exploring interventions used in the past to fix the health problem. The study will cover the details of the priority population, the health problem, significance, and prevalence of the problem, and results of past programs and interventions that have been tested for physical activity among college students. Ultimately, the paper will also examine some of the recommendations that experts have made regarding the health problem.
Priority Population
The priority population for this study is college students in Lucas, Ohio, United States. Statistics from the National Center for Education Statistics indicate that the United States has approximately 19.7million college students in 2020 (“Digest of Education Statistics,” n.d). Based on previous statistics, it is evident that this figure is a slight decline from 2011 and 2012, as shown in figure 1. The population of college students in the country is also highly diverse, comprising students of different genders. For example, a report by the United States census reveals that approximately 54.9 percent of undergraduate and 59.8 percent of graduate students enrolled in college in 2017 were females (Velez, 2018). Besides gender, college students in the United students are also of different races, including whites, African Americans, and Hispanics.
Figure 1
Unlike the national level population, the number of college students at the state and local level is slightly lower and varies across various regions. For example, statistics reveal that 27.8% of Ohio’s population, between 2014-2018, comprised college students aged 25 and above (“Quickfacts,” n.d.). This population varied significantly from other states such as Oklahoma, which had a slightly lower college student population during the same period. At the county level- Lucas County- 26.3% of the population consists of college students aged 25 and above (“Quickfacts,” n.d.). Overall, a significant fraction of the population at the national, state, and local levels in the United States constitutes college students, making them an ideal population of study for the health problem. Besides, as observed by Barnett, college years are critical for developing positive and negative behaviors that persist into later life (as cited by Eichorn et al., 2018). This argument makes college students an ideal group for studying the selected health problem because it is at this stage that healthy behavioral modification can occur before individuals transition into adulthood.
The Health Problem
The selected problem for this study is the lack of and inadequate physical activity among college students. According to the literature, physical activity is “anybody movement generated by the contraction of skeletal muscles that raises energy expenditure above resting metabolic rate, and is characterized by its modality, frequency, intensity, duration, and context of practice” (Thivel et al., 2018, p. 2). Physical activity is linked with multiple benefits, such as reducing cardiovascular diseases and sedentary lifestyle diseases such as obesity. However, a significant number of studies reveal that most college students indulge in insufficient physical activity, thus exposing themselves to lifestyle diseases and premature deaths.
Rationale
Lack of physical activity among college students is associated with an early onset of lifestyle diseases such as obesity and cardiovascular diseases, which is a significant health issue. Therefore, this early exposure calls for attention to identify strategies that can be used to increase physical activity in the population. Besides, physical activity is selected for intervention because it is modifiable at the individual level (Gray et al., 2018). Modification can be done at the young adult level to encourage healthy patterns during adulthood.
Significance of the Problem
Lack of or inadequate physical activity among college students is a paramount health concern because of its close association with early onset of lifestyle disorders, morbidity, and mortality. For example, previous studies show that inactive students are at risk of developing high blood pressure and elevated serum cholesterol (Alkhateeb et al., 2019). Such findings may explain the prevalence of obesity among young youth, which constitute most college students in the United States, as shown in figure 2. Furthermore, the economic and social costs associated with physical inactivity are a burden to students and the economy. For example, it is estimated that the global economic impact of obesity in 2014 was US $2.0 trillion or 2.8% of the global gross domestic product (GDP) (Tremmel et al., 2017). Besides, the costs to individuals can be high in terms of lower productivity in class and even permanent disability in the absence of intervention. Overall, the health problem imposes financial and social burdens on governments, families, and individuals.
Figure 2
Prevalence of the Problem
Overall, physical inactivity has been on the rise in the United States over the past few decades, but it varies across different states. Although there is scant data on the prevalence of the condition among college students in Ohio and Lucas County, the available data suggests that states such as Ohio have seen an increase in leisure-time physical inactivity over the last few decades compared to other states in the country (An et al., 2016). Arguably, the surge among the priority population could result from greater autonomy granted in college life relative to the middle and high school life, course workload, and social life.
Studies also suggest a significant variation in physical activity based on demographic factors. For example, past research in America conducted among college students between 18-24 years showed that only 35% of females and 39% of males indulged in physical activities that met the CDC-ACSM guidelines (Mohammed et al., 2014). Based on these past statistics, it is evident that physical inactivity is positively associated with the gender of the students. While there is limited literature on the reason behind this phenomenon, cultural expectations might be a hindrance to females’ involvement in some physical activities.
Results of Past Programs and Interventions
The prevalence of physical inactivity among college students has attracted scholarly research to test interventions and programs that can help eliminate the health problem and its associated risk factors for the past few years. Among the recently tested strategies are conceptually-based interventions, which involve lectures to enlighten students about the benefits of regular physical activity (Mosher, 2018). For example, a randomized-controlled trial was conducted by Miragall et al. (2018) to test the effectiveness of an internet-based motivational intervention (IMI) supported by pedometers (PED), in comparison with IMI alone and non-intervention, on changing constructs related to physical activity and increasing daily steps in a sample of passive students. The study was conducted over three weeks and was coupled with a three-weeks follow-up on the students.
Stages of Change
The program activities in the study followed the various stages of change model proposed by Prochaska and colleagues. The five steps involved are precontemplation, contemplation, preparation, action, and maintenance, which represent incremental increases in preparedness to change (Lacey & Street, 2017). Some of the program activities in the pre-contemplation stage involved identifying participants that initially lacked the willingness to indulge in physical activities. The researchers undertook this step using a blinded pedometer that helped establish students that walked less than an average of 7500 steps per day (Miragall et al. 2018). The participants then moved to the contemplation phase, whereby they expressed their intentions to increase their physical activity by signing informed consent.
The third stage of change in the transtheoretical model, preparation, was substantiated by the participants’ step to eliminate their physical inactivity. At this stage, the participants received information about physical activity, made a decisional balance between the benefits and cons of practicing physical activity, and set their objectives in terms of the number of steps required per day (Miragall et al. 2018). Eventually, the participants moved to the action and maintenance phase by enhancing their physical activity in terms of their daily average steps during the intervention and the follow-up study.
The study’s findings confirmed the effectiveness of the conceptually-based intervention in increasing physical activity, notably among a sample that utilized a pedometer. The researchers discovered that the intervention increased motivation for physical activity in the sample group (Miragall et al. 2018). Most notably, physical activity on the IMI + PED condition increased by an average of 2069 steps at post-intervention and 2227 steps at follow up (Miragall et al. 2018). However, the use of IMI only did not show a significant improvement in the average number of daily steps taken by the study group. Most notably, the IMI condition increased by an average of 1050 and 1493 steps in post-intervention and follow-up, respectively (Miragall et al. 2018). The scholars argued that the variation in outcomes might have resulted from the use of pedometers, which facilitated self-monitoring and self-regulation of physical activity (Miragall et al. 2018). Arguably, students who had access to the tool could easily set and meet the number of steps they wished to take daily compared to their counterparts.
Similarly, other studies have been conducted to test the effectiveness of activity-based interventions in increasing physical activity among college students. Unlike conceptually-based interventions, mainly based on verbal motivation, activity-based interventions revolve around activities aimed at increasing physical activities performed by individuals (Mosher, 2018). One such study was conducted by Ickes et al. (2016) to test the impact of a university-based program on obese college students.
The study by Ickes et al. (2016) involved a 15-weeks campus-based modification program among a sample of eighteen college students. The intervention involved a 2-60 min small group training sessions per week with a professional trainer and optional weekly 60-min group fitness classes (Ickes et al., 2016). Also, the physical activities implemented in the program were tailored to fit the participants’ varying needs (Ickes et al., 2016). Findings from the study revealed a significant increase in physical activity levels post-intervention. Most notably, students involved in the program showed the willingness to indulge in moderate-intensity physical activity for at least 30 minutes at the end of the program (Ickes et al., 2016). However, this study’s results may not have been adequate because a follow-up study was not done to examine the prevalence of physical activity post-intervention.
Stages of Change
Similarly to the IMI, the activity-based intervention conducted by Ickes et al. followed the different stages of the transtheoretical model. However, as noted in the study, the precontemplation stage was not targeted during the study, as students were expected to be at least in the contemplation phase to participate in programming (Ickes et al. 2016). Therefore, the process of change began in the contemplation stage, which involved self-reevaluation. The program activities undertaken at this stage involved regular meetings with role models such as personal trainers (Ickes et al. 2016). The primary aim of this stage was to help students re-evaluate their physical activity habits.
After the contemplation stage, the participants moved to the preparation, action, and maintenance phase. Activities undertaken in the preparation phase included establishing community norms through personal training sessions and monitoring the participant’s progress by the coaches and personal trainers(Ickes et al. 2016). At this stage, the primary change process was self-liberation, whereby students could undertake activities that suited their individual needs. The subsequent stage involved a change in behaviors whereby the students indulged in weekly group fitness activities. Eventually, the students maintained the move towards enhanced physical activity through regular discussions with health coaches (Ickes et al. 2016). Notably, the meetings were held regularly to support the students overcome barriers that would trigger unhealthy behaviors post-intervention.
Recommendations of Experts
Previous scholars have made several recommendations to improve some of the interventions used in increasing physical activity among college students. Among these recommendations is the need to use smaller groups in the intervention programs (Mosher, 2018). Overall, it is argued that the activity-based interventions that involve physical activity sessions with students should be decreased in size to create cohesion in the group and ensure that each participant receives support from the facilitator.
Additionally, it is recommended that researchers should tailor the interventions based on the needs of the participants of the program. For example, scholars should customize activity-based interventions based on the participant’s gender. Hence, such customization would encourage students to undertake activities that suit their preferences, cultural orientations, and skill levels.
According to experts, and based on past programs, the best practice for college students concerning physical activity is a combination of conceptually-based intervention and activity-based intervention. Although this approach is yet to generate sufficient evidence, the community guide suggests that two studies qualified for review showed positive results upon implementing college-based physical education and health education interventions (“Physical Activity,” n.d.). According to the guide, the program should involve course work and behavioral efforts to encourage physical activity.
Summary and Conclusions
Overall, this project has provided a more in-depth insight into the pattern of physical activity among college students, the risk factors and costs of inactivity, and suggestions of some of the interventions that have successfully mitigated the health problem. However, it is surprising that despite the availability of intervention programs, some states such as Ohio continue to experience a significant rise in the incidence of physical inactivity among college students. This trend may probably result from the implementation of programs that fail to suit the diversity and needs of the state’s population. Therefore, this research will form the basis for implementing an intervention for physical activity among college students in Lucas county, Ohio. Some of the research ideas that will be borrowed and incorporated in my planned program include customizing physical activities to suit the varying preferences and skills of the target population. I will also adopt the concept of coupling conceptually-based interventions with activity-based interventions and ensuring that the conceptually-based program is reinforced with tools that can help students to set their physical activity goals.
Furthermore, the five stages of the change model will also be incorporated in the proposed program to help the college students undergo an incremental preparedness phase. Arguably, implementing an intervention in stages will ensure that the study participants are well-prepared and willing to undertake the proposed physical activities and prevent them from dropping out of the program before completion. Among the ways that will be used to put the college students in the four stages of change are reward and recognition. The rewards will either be issued as material things such as training suits and cash rewards for full participation in the program. Notably, this strategy will be utilized in the action phase to encourage the students to continue undertaking the recommended average physical activity. Also, reward and recognition will be used to counter the chances of relapse to unhealthy physical habits, notably when faced with fatigue.
References
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“Quickfacts” (n.d). United States Census Bureau. https://www.census.gov/quickfacts/fact/table/lucascountyohio,texascountyoklahoma,OH/PST045219
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