Exercise is Medicine! Why are People not Buying into the Prescription?

Purpose and methods: Despite decades of research documenting the numerous health benefits of exercise, most people are not buying into the “Exercise is Medicine” prescription and making the commitment to exercise regularly. The purpose of this study was to examine: 1) Participants’ perceptual association with descriptive statements and certain activities relating to exercise and physical activity (PA); 2) Participant’s attitudes towards the gym environment; and 3) The overall relationship between participants’ associations with PA and exercise, and their preferences for how they want to be physically active. Adults ages 18 years and older representing diverse groups from rural and urban communities in Guelph and Wellington County in Southwestern Ontario, Canada and groups from Cherokee County, South Carolina were participated in this mixed methodology study. Focus group facilitated discussions were conducted with 234 people from Southwestern Ontario and 175 people from South Carolina. Using the themes that emerged from the focus group interviews, a research-generated survey was created to validate the findings of the initial focus group interviews. Results: Overall, regardless of geographical region, most people felt that there was a difference between PA and exercise, and that national guidelines for activity could be met through lifestyle PA. Most respondents also felt that lifestyle PA was preferable to traditional exercise and easier to incorporate into their daily activity, particularly when goal oriented. Generally, participants associated exercise with being structured or planned. However, several inconsistencies were also evident. Adults from South Carolina indicated a greater association of exercise with being painful and boring, impractical, difficult to begin, and a chore. However, most South Carolinians, as well as Southern Ontarians, also indicated exercise as being a stress reliever, and that they felt happy and a sense of accomplishment afterwards. Not surprisingly, such activities included walking, playing with children, and other activities commonly done around the house (gardening, cleaning, carrying groceries, walking the dog) were associated with lifestyle PA. Generally, with only a few exceptions, about half the participants indicated that they had gym memberships. Interestingly, South Carolinians were more inclined to believe that going to gym was necessary to take care of themselves. Ironically, participants from South Carolina also were more likely to find getting started to be a problem, but also found typical gym exercises to be more enjoyable than those from South Ontario. Perhaps most surprising to us was that, regardless of geographic location, participants did not indicate strong feelings towards being embarrassed, intimidated, or feeling judged at the gym, or having any perception of a negative environment. However, most participants still indicated a preference towards activities which could be done outside of the gym environment. Conclusion: Most participants, despite recognizing the health benefits of traditional exercise, prefer to incorporate physical activity into everyday activities. “Exercise is Medicine”, but if the majority of adults will not partake in traditional activities, the medical community must consider what is most meaningful for their patients and the public at large instead of preaching a “one size fits all” narrative. ReseaRCh aRtiCle