Physical Activity: Supportive Relationships

Background on Supportive Relationships

guy running

expandWhat are supportive relationship strategies?

collapseWhat are supportive relationship strategies?

  • Supportive relationship interventions are programs or activities designed to increase social support for physical activity through involvement from families, organizations and communities.
  • These interventions may focus on increasing the information individuals have about physical activity (informational support), the skills and abilities they have to be physically active (tangible support), or a sense of acceptance and belonging as they make choices to be more physically active (emotional and appraisal support). 
  • In addition, such interventions provide opportunities to identify and address challenges collectively rather than individually (e.g., collective problem solving or advocacy). This support may be provided through involvement from a variety of individuals or individuals as part of groups, organizations, or communities.
  • Supportive relationships interventions may help to change behaviors in order to increase physical activity (primary prevention) or work with those who have already had an injury (secondary prevention). In some cases, individuals may be asked to wear protective equipment to prevent serious injuries when falls occur (e.g., hip protectors for older adults, personal protective equipment for employees).

expandHow do supportive relationships impact physical activity related behaviors?

collapseHow do supportive relationships impact physical activity related behaviors?

  • Supportive relationship interventions are successful for many reasons: individuals can ask questions or clarify what they have been told, those providing support can also provide referrals and resources to assist the individual, and longer-term relationships can help to sustain behavior change over time, among others.

expandHow can I use supportive relationship strategies in a physical activity intervention?

collapseHow can I use supportive relationship strategies in a physical activity intervention?

  • Supportive relationship intervention strategies may be designed to discuss challenges, benefits and advice for increasing physical activity.  Supportive relationships may be provided in the form of face-to-face interactions, telephone calls, or through interactive web-based systems. These interventions may include specific information as part of each call or face-to-face session, or may be more open ended and responsive to the specific needs of the individual.

expandWhy is it important to considering tailoring in supportive relationship strategies?

collapseWhy is it important to considering tailoring in supportive relationship strategies?

  • These interventions can be very successful when the support is tailored to the individual’s needs.
  • In order to provide tailored advice to the individual, the person providing the support has to determine the specific challenges the individual is facing. Supportive relationships interventions may include an assessment of existing behaviors (e.g., physical activity), readiness to change, and as well as a discussion of challenges, benefits and advice for creating and maintaining change over time.
  • Supportive relationship interventions work best when the advice also takes into account the person’s gender, age, language, race or ethnicity, and other cultural factors.

expandWhat is “readiness to change” and how does it relate to supportive relationships?

collapseWhat is “readiness to change” and how does it relate to supportive relationships?

  • The concept of readiness to change (drawn from the Transtheoretical Model or Stages of Change)  suggests that individuals may need different kinds of interventions to help them increase or maintain physical activity depending on how ready they are to change their behaviors. Supportive relationships may be particularly important when people become ready to change their behaviors (i.e., supportive relationships can help to reinforce these decisions).

expandHow do supportive relationship strategies deal with relapse?

collapseHow do supportive relationship strategies deal with relapse?

  • Often, individuals change their behaviors and then relapse, or go back to previous behaviors. Supportive relationships, therefore, include information to help individuals to recognize that this is not unusual and to work with individuals to develop strategies to help prevent relapse in the future. (See Relapse Prevention Theory.
  • It can be helpful to recognize that changes in behaviors may happen in small steps. Every individual will have preferences for what steps may be the easiest to take first, and these preferences may depend to a large extent on the support of others for these changes (e.g., family, roommate, friends, co-workers).

expandHow have supportive relationships been used in past physical activity interventions?

collapseHow have supportive relationships been used in past physical activity interventions?

  • With respect to families, most supportive relationship interventions have utilized support as a means of increasing parental support for children’s behavioral changes. Therefore, many of these interventions involve schools or other community-based organizations providing children with packets, newsletters, workbooks, or assignments to take home and read with their families to create joint learning about the benefits of an active lifestyle. In addition, they may also provide family incentives such as certificates, opportunities to win prizes, or score cards to document family time spent being active or TV time manager forms to assist families in reducing TV time. In some cases, family counseling or parent training may be offered to teach modeling and social reinforcement skills to enhance physical activity of their children. Family support groups can help to address challenges of increasing physical activity given family dynamics or conflicts. Other examples may include presentations to parents regarding the importance of physical activity, cultural differences in body image or physical activity preferences, how physical activity can minimize risk for health conditions inherited from family members, and other relevant information.
  • There have been some worksite programs that provide social support to increase physical activity for employees and their families. Worksites can be considered a mini-community with interventions that provide tangible support through improvements in the built environment (e.g., walking trails, fitness facilities, point-of-decision prompts) and policies (e.g., flexible work hours); informational support through exercise classes, group lectures, and distribution of pamphlets, newsletters, posters and other media at the worksite; and emotional and appraisal support through buddy systems, lay health advisors, or team contests. Some worksite interventions have been offered by management, while others have been developed jointly through labor/management negotiations to encourage physical activity at the workplace.
  • Faith-based organizations have attempted to help people recognize that physical activity is part of the faith message. Through health ministry and being part of the faith community, these organizations have provided support by increasing knowledge and skills around physical activity and providing facilities, equipment or other resources that enable people to be physically active (e.g., development of community walking trails). Ministers, faith community nurses and members have prayed with fellow members, found resources for them, comforted them, and helped to nurture them.
  • Communities have provided support in many different ways. Other intervention strategies summarize informational support (mass media campaigns, group education sessions, point-of-decision prompts) and tangible support (urban planning and transportation, enhanced access) interventions; however, emotional and appraisal support interventions are highlighted in this section. For example, neighborhood walking clubs, sports leagues or recreational events (e.g., a parade, a field day, a festival) engage people in physical activity in a social context that provides encouragement and reinforcement. Likewise, community role models can talk to community members about the importance of physical activity (i.e., Olympic champions, sports players, and local heroes).

Often, individuals change their behaviors and then relapse, or go back to previous behaviors. Likewise, they may change certain parts of the environment (e.g., handrail on the stairs) and don’t recognize the need to regularly assess and change other parts of the environment as needed (e.g., handrail in the shower). Supportive relationships interventions, therefore, include information to help individuals increase their awareness, work with individuals to develop strategies to help prevent relapse in the future, and encourage individuals to regularly reassess their behaviors and environments. (See Relapse Prevention Theory)

It can be helpful to recognize that changes in behaviors and environments may happen in small steps. For example, efforts to increase physical activity may happen first in response to certain events.  Every individual will have preferences for what steps make be the easiest to take first, and these preferences may depend to a large extent on the support of others for these changes (e.g., family, co-workers, roommates, friends). 

Supportive relationships interventions are successful for many reasons: individuals can ask questions or clarify what they have been told, those providing support can also provide referrals and resources to assist the individual, and longer-term relationships can help to sustain behavior change over time, among others.

There are many different ways supportive relationships interventions have been used to help people increase or maintain their level of physical activity.

  1. Increase family support for physical activity. Many supportive relationship interventions aim to increase parental support for children’s behavioral changes. This type of intervention often uses schools or other community-based organizations to provide children with packets, newsletters, workbooks, or assignments to take home and read with their families to promote joint learning about the benefits of an active lifestyle. In addition, they may also provide family incentives such as certificates, opportunities to win prizes, or score cards to document family time spent being active or TV time manager forms to assist families in reducing TV time. In some cases, family counseling or parent training may be offered to teach modeling and social reinforcement skills to enhance physical activity of their children. Family support groups can help to address challenges of increasing physical activity given family dynamics or conflicts. Other examples may include presentations to parents regarding the importance of physical activity, cultural differences in body image or physical activity preferences, how physical activity can minimize risk for health conditions inherited from family members, and other relevant information.
  2. Increase worksite support for physical activity. Some worksite programs that provide social support to increase physical activity for employees and their families. Worksites can be considered a mini-community with interventions that provide tangible support through improvements in the built environment (e.g., walking trails, fitness facilities, point-of-decision prompts) and policies (e.g., flexible work hours); informational support through exercise classes, group lectures, and distribution of pamphlets, newsletters, posters and other media at the worksite; and emotional and appraisal support through buddy systems, lay health advisors, or team contests. Some worksite interventions have been offered by management, while others have been developed jointly through labor/management negotiations to encourage physical activity at the workplace.
  3. Increase support from faith-based organizations for physical activity. Faith-based organizations have attempted to help people recognize that physical activity is part of the faith message. Through health ministry and being part of the faith community, these organizations have provided support by increasing knowledge and skills around physical activity and providing facilities, equipment or other resources that enable people to be physically active (e.g., development of community walking trails). Ministers, faith community nurses and members have prayed with fellow members, found resources for them, comforted them, and helped to nurture them.
  4. Increase community support for physical activity. Communities have provided support in many different ways. Other intervention strategies summarize informational support (mass media campaigns, group education sessions, point-of-decision prompts) and tangible support (urban planning and transportation, enhanced access) interventions; however, emotional and appraisal support interventions are highlighted in this section. For example, neighborhood walking clubs, sports leagues or recreational events (e.g., a parade, a field day, a festival) engage people in physical activity in a social context that provides encouragement and reinforcement. Likewise, community role models can talk to community members about the importance of physical activity (i.e., Olympic champions, sports players, and local heroes).

Supportive relationship interventions can also reinforce other intervention strategies (e.g., campaigns and promotions, provider education, environments and policies, individual education, and group education) in order to help individuals address physical activity.


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