PSYCHOLOGY OF PHYSICAL ACTIVITY: DETERMINANTS, WELL-BEING AND INTERVENTIONS Stuart J. H. Biddle Nanette Mutrie Trish Gorely 3rd Edition Online learning activities These tasks are designed to engage learners with the materials from each chapter. We have created two main sets of tasks: ‘in class’ and ‘out of class’. For the ‘in class’ tasks, the lecturer must decide if the tasks are best completed after hearing the relevant lecture, before the lecture or during the lecture. That decision depends on individual teaching styles. The answers to most questions will be in the relevant chapter, but some are a matter of debate that will need input from the lecturer. The ‘out of class’ tasks are meant as follow-up assignments that should enhance learning. Chapter 1: Introduction and rationale: Why you should take your dog for a walk even if you don’t have one! In class 1. Discuss with a friend in your class what you understand to be the current recommendations for the amount and type of physical activity people need to do in order to gain health benefits. 2. There are different recommendations (in the UK for example) for preschool children, children/adolescents, adults or older adults. Specify why this is the case and what the main differences are. Out of class In Chapter 1 we have defined many key terms. Three important ones are PHYSICAL ACTIVITY, EXERCISE, and SPORT. You may also want to refer to the March 2000 document here: www.fitness.gov/pcpfs_research_digs.htm 1. Read the text, and then write down a definition of each in your own words. 2. Why is it important to distinguish between physical activity, exercise, and sport in health contexts? Chapter 2. Physical activity and psychological well-being: Does physical activity make us feel good? In class We have provided here three psychological assessment scales that might be used to assess how people feel after exercise: 1. The Positive and Negative Affect Schedule (PANAS) 2. The Feeling Scale (FS) 3. The Felt Arousal Scale (FAS). Read all scales carefully, including the instructions. Describe each scale. How and when might you use each of the scales? List the key pros and cons of each scale, looking at both content and format. Here are the three scales: Positive and Negative Affect Schedule (PANAS) This scale consists of a number of words that describe different feelings and emotions. Read each item and then mark the appropriate answer in the space next to that word. Indicate to what extent you have felt like this in the past few hours. Use the following scale to record your answers. Very slightly or not at all A little Moderately 1 2 3 Interested Distressed Excited Upset Strong Guilty Scared Hostile Enthusiastic Proud _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ Quite a bit Extremely 4 Irritable Alert Ashamed Inspired Nervous Determined Attentive Jittery Active Afraid 5 _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ To score this scale, first have a look yourself and see if you can decide which of the 20 words are positive and which are negative. Check your own judgement with the list below. Then add your scores for the ten positive words and separately for the ten negative words. Now you have your positive and negative scores. The scores generated will vary along the scale of 10–50, with lower scores indicating low (positive or negative) affect and higher scores indicating high (positive or negative) affect. Watson, Clark and Tellegen (1988) suggest that the normal population will have a mean positive affective score of 29.7 (SD = 7.9) and a mean negative affective score of 14.8 (SD = 5.4). The ten items for POSITIVE affect (PA) are: attentive, interested, alert, excited, enthusiastic, inspired, proud, determined, strong and active. The ten items for NEGATIVE affect (NA) are: distressed, upset, hostile, irritable, scared, afraid, ashamed, guilty, nervous and jittery. Feeling Scale (FS) (Hardy and Rejeski, 1989) While participating in exercise, it is common to experience changes in mood. Some individuals find exercise pleasurable, whereas others find it to be unpleasant. Additionally, feeling may fluctuate across time. That is, one might feel good and bad a number of times during exercise. Scientists have developed this scale to measure such responses. +5 Very good +4 +3 Good +2 +1 Fairly good 0 Neutral –1 Fairly bad –2 –3 Bad –4 –5 Very bad FELT AROUSAL SCALE (FAS) (Svebak and Murgatroyd, 1985) Estimate here how aroused you actually feel. Do this by circling the appropriate number. By ‘arousal’ we mean how ‘worked-up’ you feel. You might experience high arousal in one of a variety of ways: for example, as excitement or anxiety or anger. Low arousal might also be experienced in one of a number of different ways: for example, as relaxation or boredom or calmness. 1 LOW AROUSAL 2 3 4 5 6 HIGH AROUSAL Out of class We have provided two psychological assessment scales, as used in the inclass activity: 1. The Feeling Scale (FS) 2. The Felt Arousal Scale (FAS). The FS and FAS are used to provide assessments that can be superimposed on the Affect Circumplex. Plot your scores on each scale using the Affect Circumplex provided (see slide of ‘Affect Circumplex’ in the chapter) before, during and after an exercise bout as follows: 1. 2. 3. 4. 5. 15 mins before starting 5 mins before starting halfway through the exercise session immediately on completion of the session 15 mins after finishing the exercise. You will therefore need five versions of each scale, with some small enough to carry and respond to while exercising. Describe the trend that you see. Does it conform to Ekkekakis’ ‘dual mode model’? If not, what might explain your results? Chapter 3. Physical activity and depression: Can physical activity beat the blues? In class These tasks are designed for small discussion groups of two or three people with larger group feedback/discussion of the various answers. 1. Who is healthy? Describe a famous person (that everyone in the class would know) who you consider to be ‘healthy’ in the broadest definition of that term (e.g. mental and physical health). Be ready to say why you have selected this person. What makes you think that this person is mentally healthy? 2. Can you provide a lay person’s definition of good mental health? 3. In what ways could regular physical activity promote good mental health? 4. List three mental illnesses that you know of. 5. What would you say were the key symptoms of someone with depression? 6. In what ways could physical activity help someone who is depressed? 7. Critique the evidence for physical activity as a treatment for depression. Provide a list of pros and cons for using exercise as a treatment for depression that GPs might need to consider for their own practice. Out of class This activity is designed to help you think about the nature and context of exercise in the treatment of depression. The following paper is a research report of data on individuals interviewed over several time periods: Faulkner, G. and Biddle, S. J. H. (2004). Exercise and depression: Considering variability and contextuality. Journal of Sport and Exercise Psychology, 26, 3–18. If you cannot access this paper, here is the abstract and a brief synopsis of two case studies extracted from the paper. Abstract: Research continues to support the consideration of exercise as an adjunctive treatment for depression. Adopting a qualitative approach, the aim of this study was to extend our understanding of the motives and barriers to exercise faced by this clinical population, and to explore the role of physical activity in promoting psychological well-being, in a way that encompasses the variability and contextuality of the lives of individuals. Marking a departure from standard content analyses reported in the literature, instrumental case studies are developed that offer a different format for representing qualitative data. Given its longitudinal nature, this study demonstrates the fundamental importance of considering the wider context of participants’ lives in order to understand the relationship between physical activity and psychological wellbeing. This association is likely to be complex and highly idiosyncratic. Such an understanding may inform a more critical insight into the potential of exercise as an antidepressant in terms of process and effectiveness. Case 1: Initial enthusiast – Terry Being confronted by a lack of functional fitness originally motivated Terry to start the scheme. The provision of distraction, improving his body image and improving his health were important goals. The referral scheme was initially an enjoyable experience for Terry. After eight weeks he had stopped and did not return to the leisure centre. Boredom was a primary reason because the programme was seen to lack variety. Little support from leisure centre staff in monitoring his programme was also influential. Both factors acted to turn participation into a stressful experience that he would rather avoid. However, Terry had returned to an earlier leisure pursuit that was enjoyable and had increased activity levels over the year. A new job was a significant cause of this increase. Despite exhibiting ambivalence toward physical activity, Terry is probably the most habitually active of the participants. Case 2: The slow starter – Laura The referral scheme was seen as an opportunity for normalisation by promoting social interaction and daily structure. It took 12 weeks before Laura visited the leisure centre. While attendance was sporadic, it still remained a welcome leisure alternative one year later. She found the support of staff at the leisure centre appropriate and individualised. Laura’s social worker expressed an interest in the programme throughout the year and offered encouragement. While attendance provided a sense of achievement for Laura, any benefit appeared relatively transient, although more subtle changes concerning body image emerged over the year. However, social anxiety was always limiting for Laura. Social support from her daughter was critical but it was also problematic in the sense that it implied that support was necessary which was at odds with Laura’s initial ‘normalising’ motives for attending the leisure centre. Conversely, levels of habitual physical activity had increased over the year. Case 3: The regular – Dave As a regular attendee, Dave was self-motivated and did not require or seek support from others in attending. He saw the exercise referral scheme as an important part of his rehabilitation in providing structure to the day. Regular attendance was itself an important outcome rather than any discernible improvement in psychological well-being. Dave did not derive any great pleasure from his sustained participation, which might be indicative of low selfesteem where the experience of self-enhancement may be less likely. However, he did maintain regular attendance at the leisure centre for nearly a year. This may have contributed to greater confidence in tackling other challenges. Perceptions of external events (accommodation rejection and misreading Laura’s motives) affected his psychological well-being and lead to a withdrawal from exercise. He struggled at times to overcome periods of depression and often expressed feelings of guilt that he could not exercise at these times. Activity In reading the case studies: 1. What are the key ‘take home messages’ for you? 2. How does the information from this study add to what we understand about exercise and depression? Chapter 4. Physical activity and other mental health challenges: Schizophrenia, anxiety and dependencies In class These tasks are designed for small discussion groups of two or three people with larger group feedback/discussion of the various answers. 1. Early in Chapter 4, we presented the defining features of schizophrenia. Given this information, and your knowledge of the effects of physical activity, how (by what mechanisms) can physical activity play a beneficial role for this patient group? 2. In this chapter we said that it was difficult to draw clear conclusions about the protective role of physical activity on anxiety and that more longitudinal population studies are required. From your reading, note three reasons why you believe we came to this viewpoint. 3. For what aspects of tobacco dependency could physical activity provide some help for those trying to quit? Out of class These activities are designed to help you think about the nature and context of exercise in relation to schizophrenia, anxiety and dependencies. 1. We made the key point that: Schizophrenic patients report benefit from physical activity, and further research on this patient group should explore what kind of physical activity and dose is best. Activity: Consider a research design that would help provide further information on what kind of physical activity and what dose of physical activity is best for this patient group. 2. We identified three substances (tobacco, alcohol and drugs) that could lead to someone being classified as dependent (see Table 4.2 for classification). Activity: Consider one of these three potential dependencies. Write a one-page summary to professionals who may be involved in helping people overcome the dependency about the role of physical activity and why they should consider its use in their work. Chapter 5. Physical activity and cognitive functioning: Can physical activity help the brain function better? In class Have an in-class debate centred on the motion that ‘children who are physically active do better in academic studies’. Out of class Write a review as if you are reviewing a paper for a journal. Select an existing published paper that tests whether an association exists between either physical activity or physical fitness and some measure of cognitive functioning. In your review (which should be about two pages), write three to four general comments followed by seven to eight specific comments where you make reference to actual page numbers and paragraphs. In your general comments, say if and how the paper contributes to current knowledge, but also draw out some limitations. Chapter 6. Physical activity and self-esteem: Does physical activity make you feel better about yourself? In class This task shows each person how the Physical Self-Perception Profile is constructed and scored. It is a set of examples and not the complete profile. First decide which one of the two statements best describes you – for example: – some people are not very confident about their level of physical conditioning and fitness – others always feel confident that they maintain excellent conditioning and fitness Then for the statement you have chosen, decide if it is ‘really true for me’ or ‘sort of true for me’. Choices are scored 1 to 4. If you have chosen the most positive statement (others always feel confident that they maintain excellent conditioning and fitness) and say that it is really true for you, then you would score 4. If you say that it is only sort of true for you, then you score 3. In contrast, if you select the more negative option (some people are not very confident about their level of physical conditioning and fitness) and say it is really true for you, then you would score only 1; but if you say that it is sort of true for you, then you score 2. In the full version, there are 6 items for each sub-component as well as for the higher-order construct of Physical Self-Worth (PSW), giving 30 items in total. However, we provide two example statements from each of the four subdomain sub-scales. The higher the score the more you perceive that you have (endorse) that aspect of physical self-perception. Work through each of the following items from the PSPP and score them for yourself. Physical condition – some people are not very confident about their level of physical conditioning and fitness – others always feel confident that they maintain excellent conditioning and fitness score = Physical strength – some people that they are physically stronger than most people of their sex – others feel that they lack physical strength compared to most people of their sex score = Sports competence – some people feel that they are not very good when it comes to playing sports – others feel that they are very good at just about every sport score = Attractive body – some people feel that compared to most they have an attractive body – others feel that compared to most their body is not quite so attractive score= From these short examples, do you have an area of your physical selfperception in which you have a more positive score or a more negative score? Do you consider these areas to be important aspects of your self-perception? What might change your scores over time? Out of class In the introduction to this chapter, we mention that in her 2012 annual report, the Chief Medical Officer (CMO) for England stated that ‘physical activity … can enable children and adolescents to … help to build positive personal attributes such as self-esteem and self-confidence’ (https://www.gov.uk/government/organisations/department-of-health). Critique this statement and then describe the circumstances in which physical activity could lead to self-esteem development. Chapter 7. Physical activity correlates and barriers: Factors related to being active In class 1. With your neighbour, discuss and agree on what you consider to be three things that might motivate people to become more active. 2. Working individually, each person might write down what they think are the four most important barriers to physical activity. Then discuss your list with one other person and agree the two most important barriers (you must reach agreement). Then merge with another pair to create a group of four. Your group must now agree on the one most important barrier and say why and how this barrier might be overcome or reduced. Out of class Find a feature in local or national media (website, newspaper, magazine, TV, radio) that is centred on physical activity. 1. What can you glean from this feature on a) motives for being physically active and b) barriers to being physically active? 2. How consistent are these ‘lay’ views with data reported in Chapter 7? Chapter 8. Physical activity and attitude: Active people have attitude! In class 1. You have just got a job as a walking leader in a local community. How might the Theory of Planned Behaviour be used to help you in your work? Also, what might be some limitations of the theory in relation to your walk leader job? Out of class Go to the website for guidance on the Theory of Planned Behaviour: www-unix.oit.umass.edu/~aizen/index.html Go to the link on ‘TPB/constructing a TPB questionnaire’. 1. Using the document provided, construct a questionnaire for testing the TPB for a physical activity behaviour of your choice (e.g. walking to work, gym-based exercise, etc.). 2. Administer the questionnaire to one person and summarise the results in a short report of about 500 words. 3. Consider what changes you might make to your questionnaire on the experience gained with your one participant. Chapter 9. Physical activity and motivation: What it is and isn’t In class Work in groups of about five. Draw up a list of possible ‘nudge’ strategies for increasing physical activity. Compare with other groups and discuss feasibility and likely sustainability. Where appropriate, make distinctions between strategies for young people and older adults. Out of class 1. Go to BJ Fogg’s behaviour model website: www.behaviormodel.org/ 2. Write a one-page summary of the key points of his model. 3. Provide two examples of promoting physical activity where the emphasis is on making the activity easier rather than expecting higher levels of motivation from the individual. 4. Write a paragraph on what you think are the key strengths and limitations of this model. Chapter 10. Physical activity and confidence: I think I can, I think I can, I know I can! In class Draw up a list of strategies that might boost self-efficacy to be physically active for: 1. adolescent girls 2. middle-aged men who have had a heart attack. Think of the sources of self-efficacy. Discuss your findings in the light of the population sample studied and whether you think there are other ‘sources’ of self-efficacy. Out of class Interview one person who you know does not take regular ‘exercise’, play sport or be physically active most days. Interview them for about 30 minutes and seek out reasons why they are not physically active. The key issues you are seeking are around prior experiences of physical activity (e.g. school PE, sport, etc.) and self-confidence to be active. Are these issues there or are other issues important? Chapter 11. Physical activity and stage-based approaches: Let’s do it in stages In class 1. Stages of behaviour change for physical activity With reference to recommendations for physical activity for health (at least 30 minutes moderate-to-vigorous activity, like walking, accumulated on most days of the week), read through the following categories. Then decide which category best describes how physically active you have been over the last six months. The categories refer to the stages of physical activity behaviour change. I am not physically active and do not intend to be so in the next six months 1 I am not regularly active but am thinking about starting to be so in the next six months 2 I do some physical activity but not enough to meet the description of regular activity 3 I am regularly physically active but only began in the last six months 4 I am regularly physically active and have been for longer than 6 months 5 2. Decisional balance Now complete the ‘Decisional Balance’ scale (Marcus and Owen, 1992) with respect to physical activity and exercise: I would be healthier if I exercised regularly. I would feel better about myself if I exercised regularly. Other people would respect me more if I exercised regularly. My family and friends would get to spend less time with me if I exercised regularly. I would feel that I was wasting my time if I exercised regularly. I would probably be sore and uncomfortable if I exercised regularly. A five-point Likert scale is used to rate each item, ranging from Not at all important = 1 to Extremely important = 5. Score your own decisional balance. Do your pros outweigh cons? Thinking in a more qualitative way, write down what you consider the three most important pros and cons for being regularly physically active from your own perspective. Out of class You will find this website very useful concerning the Transtheoretical Model (TTM) across different health domains and behaviours: www.uri.edu/research/cprc/transtheoretical.htm Your task is to: 1. Go to the ‘Transtheoretical Model’ web link given above. 2. Go to the link ‘Detailed overview of the Transtheoretical Model’. 3. Summarise this text in 500 words and make application to physical activity. 4. Write a further 200 words of critique of the TTM as it applies to physical activity. For example, you may wish to consider measurement, logical nature of the constructs, overlap between stages, changes to consider in applying the TTM to physical activity, etc. You can be speculative and can risk making mistakes! We just want you to think about these issues rather than be definitive based on a thorough understanding of the literature. The latter will be unlikely at this stage of your work. 5. Chapter 12. Physical activity interventions: Planning and design In class You are considering developing an intervention to increase walking among older adults in your local community. In small groups, discuss: 1. how and when you would engage this group during the intervention development 2. what information you would seek from the potential participants 3. what other stakeholders you might want to engage with during the intervention development. Out of class Go to the website for guidance on the RE-AIM framework: www.re-aim.hnfe.vt.edu/index.html Go to the link ‘What is RE-AIM?’ 1. Read the information provided. 2. In your own words, define each dimension of RE-AIM and outline why it is important. 3. Some people argue that Reach is the most important criteria – after all you want to reach as many people as possible. In 500 words, explain why you either agree or disagree with this statement. Chapter 13. Physical activity interventions for young people: Get ’em young! In class Debate the following: that population gains in physical activity will be achieved better by focussing on young people rather than older adults. Out of class Research the content of the VERB mass media campaign in the US. What can be learned from this campaign that could easily be implemented in a local school or area near you? Chapter 14. Physical activity interventions for adults and older adults: You are never too old! In class Worksite physical activity programmes can lead to increases in physical activity and fitness. However, participation rates are often low, particularly among men. In small groups, discuss (1) why this might be so and (2) strategies to increase participation. Out of class Go to a local GP practice and see if there are any opportunities advertised or available from the reception staff about how you might consider doing more physical activity. This might be in the form of a leaflet, a chance to have an ‘exercise referral’, a class to join, a walking group, a set of maps for cycle or walking trails, etc. In 500 words, write a critique of how well the practice is doing in terms of promoting physical activity to the patients. Chapter 15. Physical activity interventions for clinical populations and conditions In class or out of class: the 24/7 exercise in research communication This is a task that requires some time and effort on behalf of the lecturer to provide access to at least two relevant research papers. We thought that many of the papers in Chapter 15 would be readily available and so we have put this task in here, but it could equally be used for any chapter. The aims of this task are to: give learners experience of reading research papers and coming to brief conclusions about what they mean provide experience of communicating the main research ideas from scientific papers to peers. Background We know you will have heard of the Nobel prizes in which people who have made great contributions to our lives and well-being are rewarded. For example, there is a Nobel Peace Prize and also Nobel prizes for science. The 24/7 challenge is based on the Ig Nobel awards for science, which attempts to first make people laugh and then make them think. See www.improbable.com/ig/ for further background and detail. Often the research is trivial but can play important roles in later research. Contestants in the Ig Nobel awards have to summarise their work in 60 seconds. In the past, the 60 seconds had to encapsulate a maximum 24second summary and then a statement of seven words that summarise what the summary means to Joe or Josephine Bloggs. We like the 24/7 idea and have carried it forward here. We have found this procedure very useful for engaging our students with complex research papers and communicating the findings in an amusing way. It certainly beats writing a summary of a paper for an exam! We have found the following procedure to work well with upper-level undergraduates and postgraduates. Procedure Working in groups of three or four, spend some time reading the research paper you have been provided with. (Note: this could be a pre-class requirement or time can be provided in class for this.) Make brief notes from the paper to aid your understanding. With the others in your group, prepare and rehearse a 24-second presentation about this paper and identify a clear summary – that anyone can understand – in seven words. Remember the goal ‘first make the audience laugh and then make them think’. Many creative ideas flow from this. Nominate one member of your group to present this summary. Each group will then present in the 24/7 format the main themes arising from their paper to the rest of the class. Your group will be scored by the rest of the class on completion of your presentation. You can use the marking sheet provided below. Please assess each group on the following aspects of their presentation by writing the most appropriate rating for each assessed component. Marking key: 5 = excellent 4 = good 3 = satisfactory 2 = poor 1 = not included/not done Group 1 2 3 4 5 6 7 8 9 10 Precision of timing Clarity of How good was the presentation 24/7 at first making you laugh and then making you think? Were the main research themes easy to understand from the presentation? How well do chosen sev convey the ideas in lay language? Chapter 16. Psychology of sitting: New kid on the block In class In small groups, discuss which of the following is more important: increasing physical activity or decreasing sedentary behaviour. Out of class In Chapter 16 we make the point that sedentary behaviour may have a strong habitual component. In this task, we explore this idea. One way of measuring habit strength is to use the Self-Report Habit Index (SRHI; Verplanken, B and Orbell, S. 2003. Reflections on past behavior: A self-report index of habit strength. Journal of Applied Social Psychology, 33, 1313–30). This 12-item questionnaire assesses the key features of habitual behaviour: automaticity, repetition and sense of identity. To score the SRHI, add up all the responses (possible range 7–60). Higher totals indicate that a person has stronger habitual screen-viewing behaviour. Measuring screen-viewing behaviour is challenging. One self-report method is the Adolescent Sedentary Activity Questionnaire (ASAQ; Hardy, L. L., Booth, M. L. and Okely, A. D. 2007. The reliability of the adolescent sedentary activity questionnaire (ASAQ). Preventive Medicine, 45, 71–4). Participants report, in hours and minutes, how long they usually spend doing sedentary activities outside of school time for each weekday and also weekend days. For this activity, we have adapted this measure to assess only screen viewing and for use with adults. To score the adapted ASAQ, do the following: 1. For each day, add up the total screen time in minutes. 2. Calculate the average daily screen time by doing the following: a) calculate screen_viewing_total = Monday_total + Tuesday_total + Wednesday_total + Thursday_total + Friday_total + Saturday_total + Sunday_total b) calculate average_daily_screen_time = screen_ viewing_total / 7 Self-Report Habit Index for screen viewing Watching TV and DVDs, using a computer, playing video games, reading an e-book and texting/playing on a mobile phone are all screen-viewing behaviours. Please tick the box which best describes how you feel about each of the following statements regarding your own screen-viewing behaviour. Screen viewing behaviour is something… Strongly disagree Disagree Neither agree/disag ree 1. …I do frequently. 1 2 3 2. …I do automatically. 1 2 3 3. …I do without having to consciously remember. 1 2 3 4. …that makes me feel weird if I do not do it. 1 2 3 5. …I do without thinking. 1 2 3 6. …that would require effort not to do it. 1 2 3 7. …that belongs to my normal routine. 1 2 3 8. …something I start doing before I realise I am doing 1 2 3 9. …I would find hard not to do. 1 2 3 10. …I have no need to think about doing. 1 2 3 11. …that is typically ‘me’. 1 2 3 12. …I have been doing for a long time. 1 2 3 it. Adapted ASAQ In a normal week, outside of work hours, how long do you spend doing each of the listed activities within the table? (Record the time you spend doing each activity in hours and minutes for each day. If you do not participate in certain activities please make this clear by writing zeroes in the appropriate boxes.) Think about your leisure time in a normal week Activity Example day Hours Mins Watching TV 1 20 Watching DVDs or online films/videos Using a computer/laptop/tablet (e.g. gaming, social media, work) Sitting playing/texting on your phone Reading an e-book (e.g. Kindle) 1 0 2 15 0 45 0 0 Monday Hours Mins Tuesday Hours Wednesday Mins Hours Mins Task: 1. Complete the SHRI and the adapted ASAQ for yourself. 2. Have 5–10 other people complete the SHRI and adapted ASAQ. 3. Score both questionnaires for each person and plot your results on the following graph: 50 SHRI score 40 30 20 10 0 0 50 100 150 200 250 300 350 400 Average screen viewing in minutes 450 500 550 600 Thursday Hours Mins 4. What do you notice about the relationship between habit and screenviewing behaviour? Is it as you expected? 5. Come up with three intervention strategies to break screen-viewing habits. Chapter 17. Summary, conclusions and recommendations: All’s well that ends! In class Discuss in class which parts of the book seem a) most interesting and b) most useful. Justify your choices. Out of class Write a review of this book! Check some journals (e.g. Medicine and Science in Sports and Exercise) and follow that format. Write a maximum of 500 words. Highlight what you see as strengths and limitations or content that you would like to see added or expanded.