Over the past two decades, society has encouraged people to be more physically active. As
a result, most individuals are now aware of the positive effects of regular physical
activity and have the intention to exercise. Yet, this intention is not sufficient, as
exercise plans are often not executed. Despite gradually scaling up actions that promote
physical activity over the years, people are actually becoming less active. From 2010 to
2016, the number of inactive adults has increased by 5% worldwide, currently affecting
more than 1 in 4 adults (1.4 billion people). This gap between intention and action is a
challenge that health professionals need to address in order to counteract the pandemic
of physical inactivity.
Physical activity is one of the top contributors to health, reducing rates of
cardiovascular disease, cancer, hypertension, diabetes, obesity, and depression. This
wide spectrum of benefits is particularly important for older adults, who often suffer
structural and functional deterioration across several physiological systems. Physical
activity can reduce and delay the impact of this age-related deterioration in health and
functional independence. However, in the Americas, more than 60% of older adults are
physically inactive.
Current interventions to enhance physical activity in older adults rely mainly on
reflective processes by providing rational information about the health benefits of a
physically active lifestyle. From this perspective, changing conscious goals should lead
to substantial behavioural change. Yet, meta-analyses indicate that these interventions
are more effective in changing intentions than actual behaviour. Thus, new interventions
targeting alternative processes are necessary to explore.
Recent work highlights that engagement in physical activity is governed not only by
reflective processes, but also by automatic processes acting outside conscious awareness.
For example, in active individuals, stimuli associated with physical activity attract
attention, trigger positive affective reactions, and activate approach tendencies. These
automatic reactions are thought to facilitate the translation of intention into action.
From this perspective, physical inactivity is the result of an imbalance between strong
negative automatic reactions to stimuli associated with physical activity and a
relatively weaker intention to be physically active. This imbalance between reflective
and automatic processes can be particularly pronounced in older adults, who are more
likely to spontaneously associate physical activity with fear, pain, or discomfort felt
during physical exercise. Therefore, older adults could be particularly responsive to and
benefit the most from an intervention targeting the automatic reactions to physical
activity and sedentary stimuli.
Interventions targeting automatic reactions to health-related stimuli have already proven
to be successful in changing behaviour. For example, interventions have been used to
retrain the automatic reaction to alcohol. Using a joystick, patients were repeatedly
asked to avoid pictures on a screen that were related to alcohol and to approach pictures
unrelated to alcohol. Results showed that adding to a regular treatment an intervention
targeting cognitive bias reduced the relapse rates one year after treatment discharge by
9% to 13%. These interventions have also proven to be useful in impacting smoking, social
anxiety, and eating behaviour.