Reading Into physical activity: exploring relationships between health literacy and physical activity in the community : Study 1: Health literacy, physical activity & the theory of planned behaviour ; Study 2: Creating an active community using collaborative action research methods.

The focus of this research relates to physical activity (PA) among populations at risk for inactivity. Two studies were completed. Study 1 was an exploratory study examining the relationship between health literacy (HL) and PA as they relate to the Theory of Planned Behaviour (TPB) constructs. Study 2 was an action research-based project in partnership with the staff and students of an alternative school. In Study 1 participants (N=65) completed measurements including the REALM to assess HL, and accelerometers to establish PA levels. The results of this study showed that even after controlling for covariates HL and PA are significantly linked (r = 0.37, p < 0.01), however, the TPB constructs were not found to mediate this relationship. However, Perceived Behavioural Control (r = 0.29, p < 0.05) and Intention to Exercise (r = 0.29, p < 0.05) were significantly linked to HL. Of particular interest, Difficulty Reading was cited as a significant barrier to PA for those with lower levels of HL (r = 0.37, p < 0.01). Finally, HL was found to be a significant moderator of the Education-PA relationship. Study 2 contained two components. First, focus groups with community partner organization (CPO) members to establish issues of relevance to them related to PA, to gather suggestions for incorporating PA into CPO programs, to gain an understanding of the barriers experienced by the community members, and to receive input regarding their current feelings and knowledge surrounding PA. Second, a process evaluation was conducted with administration to gauge how the CPO had progressed over the first academic year, using the TRACE process evaluation tool. The findings from the focus groups were organized by socio ecological level into PA facilitators and inhibitors, and were used to plan a new PA program for the school year. A repeated measures survey and process evaluation tool were used to assess these program objectives for the initial year. Perceived HL scores increased from baseline (M = 20.71,SD = 4.29) to follow-up (M = 22.58, SD = 5.15 ); t(-2.44), p < 0.05, as did perceived understanding of the importance of PA from September (M = 4.46 , SD = 1.60) to June (M = 5.54 , SD = 1.67); t(-3.06), p < 0.01. There was an increase in total minutes of MVPA among students as well, although this trend merely approached significance, from September (M = 526.60, SD = 557.63) to June (M=817.0, SD = 674.69), t(-1.97), p = 0.06. The evaluation tool revealed that the community was “Half Way There”, and identified areas where improvements could be made. These findings are relevant to creating equitable and comprehensive promotion and education of physical activity in the future and to understanding the mechanisms involved in PA disparities. These findings also support the need for health promoters and researchers to work with communities known to be at risk for low HL, and using action research methods to create locally relevant program development and research.

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