Achieving positive physical activity behaviour change among women: does the couch to five k have a contribution to make?
Thomson, Linda Anne
Despite evidence supporting the wide-ranging benefits of regular physical activity, participation among women could be better. In addition to existing formal interventions, a number of current less formal recreational running initiatives have proved increasingly popular as points of access to and engagement in physical activity across the population. These attract large numbers of participants, particularly among women. The development of a deeper and more detailed understanding of these initiatives presents an opportunity to influence physical activity behaviours and reduce inequalities in health. This thesis was based on two studies focused on one such initiative - the jogscotland couch to five k. The jogscotland couch to five k demonstrates significant recruitment and participation numbers. However, there is no single clear overview or set of information relating to this initiative. Information is dispersed and disparate and is spread across a range of digital and paper-based sources. The purpose of the first of the two studies carried out in this research was to develop a clear description of the couch to five k, to identify its core elements and to map the behaviour change techniques evident in the programme. The results from study 1 were generated by assembling and employing the deconstruction analysis model (DAM). DAM provided a method of organising and analysing the data gathered into a coherent and detailed description of the couch to five k. The positive characteristics of the programme were highlighted as its structure; participant and organiser information resources; and underpinning activities. The study also considered the potential of the programme to effect behaviour change, and behaviour change maintenance across different stages of physical activity participation. An impressive range of BCTs was identified, including several known to be effective in changing and maintaining physical activity behaviour were identified. Study 2 built on and extended the findings of study 1. Firstly, it employed a qualitative approach to explore the initiative in operation as described by women participants in their own words in a series of one-to-one interviews. Secondly, it provided further insights into the BCTs located in the programme. The experiences of 23 women participants taking part in one of three couch to five k groups in Fife prior to January 2020 were the focus of this work. The direct testimony of participants highlights the influences framing their experience. The findings point towards women maintaining physical activity participation when they are intrinsically motivated by factors such as satisfaction of their basic psychological needs at personal and group level. Participant experiences are influenced by a range of motivating factors (including physical and mental health), social support (from programme leaders and peers), and aspects of the initiative environment (such as the clear programme structure, positive ambience, and personal safety). Several of the influences identified shift in importance as participants progress through the stages of participation with, for example, achieving physical health most obvious as a motivating factor in the early stages. Social support and aspects of the environment are also more influential at the initiation stage of participation, becoming less important as the participation progresses. Several influences such as the overall supportive environment provided remain important throughout. This is characterised by factors such as a sense of mental well-being, feelings of safety, clarity of the organisation of the programme and a non-judgemental group ambience. Analysis of the direct accounts of the women involved allowed further mapping of the BCTs evidenced in the programme by study 1. These included a significant range of BCTs identified as effective in achieving behaviour change and behaviour change maintenance including action planning, instruction on how to perform behaviour, social support, and graded tasks. These were evident throughout the women’s experiences of the couch to five k. Study 2 also illustrated that maintenance of physical activity was influenced significantly by legacy factors from the couch to five k, such as a developed identity as a runner, running safely with good technique and identifying routes and challenges. A small number of those interviewed had ceased activity. The three participants who did not complete the couch to five k expressed feelings of amotivation towards their skills and abilities and their feelings toward the group. A further two women did not maintain participation in physical activity at post six months the couch to five k relating their late departure to Covid-19 illness and issues. The couch to five k has considerable potential as an informal physical activity initiative. It attracts significant numbers of women. This research highlights that it is based on effective component parts likely to achieve positive behaviour change and behaviour change maintenance. The programme is supportive and motivates, supports, and encourages those taking part.