عوامل موثر بر برنامه ریزی فعالیت فیزیکی در میان کارکنان شرکت های کوچک و متوسط Factors that influence planning for physical activity among workers in small- and medium-sized enterprises

1. Introduction Evidence supporting the importance of physical activity (PA) as a form of preventive medicine is currently overwhelming. Many studies have reported lack of PA as being associated with negative health issues, such as metabolic syndrome (Kim et al., 2011), heart disease (Sieverdes et al., 2010), depression (Teychenne et al., 2010) and mortality (Stensvold et al., 2011). Conversely, performing PA results in improved pathogenesis and symptoms of specific conditions, including chronic heart failure, coronary heart disease, dyslipidemia, hypertension, obesity, type 2 diabetes, life expectancy (Lee et al., 2012) and overall quality of life (Choi et al., 2017; Vancampfort et al., 2017). Despite the known potential benefits of performing PA, the number of sedentary adult workers is increasing worldwide, including in Japan. Recommended levels of PA for adults aged 18–64 years are at least 150 min of moderately intense aerobic PA throughout the week, or at least 75 min of vigorously intense aerobic PA throughout the week, or an equivalent combination of moderate and vigorous intense activity (WHO, 2017b). However, in an investigation conducted by the Lancet Physical Activity Series Working Group, up to 31.1% (95% confidence interval 30.9–31.2) of adults (≥15 years) from 122 countries were found to be physically inactive (Hallal et al., 2012). Additionally, the World Health Organization (WHO) reported that globally, approximately one in four adults aged ≥18 years do not perform PA to recommended levels (WHO, Fact Sheet, 2017a). In Japan, 90% of the adult working population reportedly intend to perform PA; however, < 30% of people actually perform recommended levels of PA, including activities undertaken while working and during recreation (Ministry of Health, Labour and Welfare: National Health and Nutrition Survey, 2013). While most able individuals would like to perform PA to improve their health, intention to perform PA often does not always translate into actual pursuit of activities (Sheeran, 2002). This begs the question, “Why do so many people find it difficult to act on their intentions to perform PA?” One reason appears to be a lack of adequate “planning” (Cao et al., 2013; Shimizu et al., 2013; Wiedemann et al., 2009; Sutton, 2008). “Planning” is the phase that lies between intention and action, and specifies when, where, and how to carry out the intention for PA (Cao et al., 2011). The relationship between intention, planning, and action is explained by the Health Action Process Approach (HAPA), which was developed by Schwarzer (1992). The main feature of this model lies in the explicit distinction between a decisionmaking or motivation stage, including intention, and an action or maintenance stage (Schwarzer, 1992).