UNDERSTANDING EFFECTIVE UNIVERSITY PROGRAMS ON PHYSICAL ACTIVITY: A REALIST REVIEW GUIDED BY THE HEALTH BELIEF MODEL

M.-G. Kang¹, F.R. Lunar¹, R.M. Ruiz¹, C.D. Olegario¹, K. Mendoza¹, M.L. Ignacio¹, P.C. Reyes¹, T.N. Santos², M. Valdez³, M.M. Tutor⁴, M.E. Aguila¹

¹University of the Philippines Manila, Department of Physical Therapy, Manila, Philippines, ²University of the Philippines Manila, Department of Occupational Therapy, Manila, Philippines, ³University of the Philippines Manila, Department of Speech Pathology, Manila, Philippines, ⁴University of the Philippines Manila, College of Allied Medical Professions Library, Manila, Philippines

Background: Wellness is a multidimensional construct that refers to the optimal state of health of an individual. Guided by theories such as the Health Belief Model, wellness programs may be implemented in the university setting and include elements that target physical activity outcomes. To date, there is limited information that highlights and synthesizes the contexts, mechanisms, and outcomes (CMO) of university-based physical activity programs. Understanding the circumstances, processes, and specific approaches that lead to their success is vital in developing and strengthening programs and policies that address physical activity as an area of university wellness.

Purpose: The study aimed to understand why and how effective university programs on physical activity work.

Methods: Guided by the Health Belief Model in the context of a realist review design, the researchers conducted a search among seven peer-reviewed electronic databases in the health and education fields using a predetermined set of eligibility criteria. Two reviewers independently conducted title, abstract, and full-text screening. Disagreements in the screening and study selection phases were resolved through consensus. Data pertaining to the CMOs of university-based physical activity programs were extracted and analyzed using descriptive statistics. Content analysis based on the elements of the Health Belief Model was also conducted to inform the CMO configurations.

Results: The search identified a total of 6219 records, of which 16 programs contributed to data synthesis. Eight CMO statements were created with the following key themes:
1) tailored and individualized interventions,
2) medium-term incentivization scheme,
3) lifestyle education programs utilizing information and communications technology,
4) interdisciplinary multi-component programs,
5) use of self-monitoring strategies,
6) social support,
7) shared experiences among employees and students, and
8) theory-based physical activity programs.
Analysis of the mechanisms of these effective university-based physical activity programs revealed processes and structures that were consistent with the elements of the Health Belief Model. Specifically, the programs utilized cues to action, self-efficacy, and perceptions of risk, barriers, and benefits to effect positive changes in physical activity behavior among university employees and students.

Conclusions: The results of this realist review demonstrate that effective university wellness programs on physical activity are those that address elements of behavior change. Future work can focus on identifying emerging developments and gaps in practice and theory utilization in university-based physical activity to further test the applicability of the CMOs.

Implications: Findings of this study can guide the development of programs and policies targeting physical activity in the university setting. Physical therapists working in and with universities can further advocate for physical activity engagement among university constituents through their involvement in program and policy creation, implementation, and evaluation.

Funding acknowledgements: This work did not receive any specific grant from public or private funding agencies.

Keywords:
Health promotion
Wellness
Movement

Topics:
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? No

Reason: The study did not involve human participants or any identifiable data.