A scoping review of interventions to improve strength training participation

Abstract

Background Low participation rates (1–31%) and unique barriers to strength training (e.g., specialized knowledge, equipment, perceived complexity) suggest effective strength training interventions may differ from effective aerobic or general physical activity interventions. The purpose of this scoping review was to examine interventions used to improve strength training participation through mapping theory, intervention characteristics, prescription parameters, and behaviour change techniques. Methods Recommendations by Levac et al. (2010) and PRISMA-ScR were followed in the conduct and reporting of this review, respectively. Patients and exercise professionals participated in developing the research question and data extraction form, interpreting the findings, and drafting the manuscript. Medline, Embase, PsycINFO, CINAHL, SPORTDiscus, and PubMed databases (inception–December 2020) were searched. The inclusion criteria were (a) original peer-reviewed articles and grey literature, (b) intervention study design, and (c) behavioural interventions targeted towards improving strength training participation. Two reviewers performed data screening, extraction, and coding. The interventions were coded using the Behaviour Change Technique Taxonomy version 1. Data were synthesized using descriptive and frequency reporting. Results Twenty-seven unique interventions met the inclusion criteria. Social cognitive theory (n = 9), the transtheoretical model (n = 4), and self-determination theory (n = 2) were the only behaviour change theories used. Almost all the interventions were delivered face-to-face (n = 25), with the majority delivered by an exercise specialist (n = 23) in community or home settings (n = 24), with high variability in exercise prescription parameters. Instructions on how to perform the behaviour, behavioural practice, graded tasks, goal setting, adding objects to the environment (e.g., providing equipment), and using a credible source (e.g., exercise specialist delivery) comprised the most common behaviour change techniques. Conclusions Our results highlight gaps in theory, intervention delivery, exercise prescription parameters, and behaviour change techniques for future interventions to examine and improve our understanding of how to most effectively influence strength training participation.

‘A Lot of People Just Go for Walks, and Don’t Do Anything Else’: Older Adults in the UK Are Not Aware of the Strength Component Embedded in the Chief Medical Officers’ Physical Activity Guidelines—A Qualitative Study

“…Previous physical activity can be directly related to self-efficacy and positive outcome expectations, demonstrated in psychological theories such as the Theory of Planned Behavior to influence exercise intention [ 67 , 68 ]. Since societal norms and stigma are also important determinants of physical activity, it would seem logical to ensure strength training becomes a normal and enjoyable occurrence in the lives of adults early in the life course [ 18 , 28 , 38 , 66 , 69 ].…”

“…Older adults in a high intensity of effort, ability-appropriate strength class, have greater adherence when compared to those in a lower intensity class [ 51 , 52 ]. This does, however, require expert supervision by appropriately-trained exercise specialists, who need to ensure older adults are adhering to proper exercise technique [ 18 , 52 , 71 ]. Older adults who feel safe, self-efficacious, and motivated, are more likely to challenge their self-limiting beliefs [ 35 , 38 , 52 , 71 ].…”

“…It has been reported that 42% of 50–74-year-olds are meeting the strength recommendations (Active Lives Survey November 2020–2021, Sport England). In the United States and Australia, the numbers of older adults participating in recommended resistance training levels are reported in the 1–16% range [ 15 , 16 , 17 , 18 , 19 , 20 ]. As these figures are self-reported via a questionnaire, the number of people meeting the strength recommendations is likely to be even lower, especially for those who may be unaware of the guidelines or unsure what activities fulfil their requirements.…”

The Coming of Age of Resistance Exercise as a Primary Form of Exercise for Health

“…However, setting the guidelines as the starting goal is likely inappropriate, given the challenges of beginning and sustaining RE participation. Discussions with clients new to RE could benefit from 1) focusing on the minimum prescription to achieve health and fitness benefits and 2) behavioral strategies to support their long-term participation (39). Notably, the 2018 U.S. PA guidelines emphasize that a single set of 8 to 12 repetitions for all major muscle groups twice weekly is a minimally effective dose of RE, particularly for those who are previously untrained.…”

“…Of those who want to undertake RE, only 42% act on their intentions (38). These findings suggest that strategies similarly used to improve AE participation, like monitoring and action planning, may be needed to address this intention–behavior gap (38,39). Rhodes and Lithopoulos (38) also highlighted RE intervention targets unique from AE promotion.…”