Panteleimon Ekkekakis: The persistent challenge of achieving disciplinary integration in exercise prescriptions and physical activity recommendations
Michigan State University, US

Over its 70-year history, the field of exercise science has been remarkably successful in producing compelling evidence on the benefits of physical activity and exercise for many facets of health and well-being. At the same time, however, it is equally remarkable that there have been no "success stories" in global efforts to encourage more individuals to be physically active. At present, the model of exercise prescriptions and physical activity recommendations exhibits at least two common elements, which will be critiqued through the prism of "normal science" and scientific "paradigms" (concepts proposed by Thomas Kuhn) and "secondary ignorance" (a concept proposed by Elliott Eisner): (a) reliance on the central argument that people should be active to reduce their long-term risk of premature death, chronic disease, and disability; and (b) the use of complex, quantitative, and frequently updated minimum targets (e.g., 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week, or an equivalent combination). This approach is based on common sense but has proven resoundingly ineffective in practice over the past 50 years. Therefore, new thinking is urgently needed. To prepare exercise science for a paradigmatic transition, limitations of the current model will be highlighted by drawing insights from behavioral sciences, including behavioral economics, social marketing, and communication. The take-home message of the lecture will be that exercise prescription guidelines and physical activity recommendations present opportunities for exercise science to increase its societal value and, in the process, move closer to the goal of achieving integration as an interdisciplinary field.

Annika Frahsa: Co-creating active communities: Insights from participatory health research on actors, approaches, and agendas
Universität Bern, Schweiz

Multifold calls for ‘a participatory turn’ in sport and health sciences (cf. Minkler & Wallerstein 2008; Rütten et al., 2019; and as an overview Smith et al. 2022) have led to participation, co-production, or co-creation becoming buzzwords in the respective relevant research fields. It has long been acknowledged that co-creation contributes to diverse actors to their respective lifeworlds, provides relays for exchange, establishes two-way bridges, and creates mutual trust for change (Bergmann et al. 2010; De Leeuw et al., 2008; Greenhalgh, 2016). Yet, the concept is still to be fully developed and acted upon in physical activity promotion research and practice.
In my talk, I will explore the continuum of co-creation to develop a heuristic of co-creating active communities: I will reflect upon diverging agendas when it comes to (co-)creating active communities. I will distinguish approaches into pre-requisites, methods, and results. I will characterize actors - from people with lived experience to professionals, policymakers, and researchers - and their roles in co-creation of active communities. 
Drawing on my own and others’ studies, I will present insights from empirical research to highlight the socio-ecological perspective that co-creation can take. Such a perspective can help us understand and explain the environmental and structural factors that influence how active or inactive specific and diverse communities might be and what might be suitable co-creation approaches within those contexts.
I will conclude with a critical discussion of conditions, challenges, and potential impacts of participatory approaches at the intersection of sport and health on which we might build in future transformative research toward active communities.

Regina Guthold: Insufficient physical activity: Global levels and trends and international response
World Health Organization, Genf

This presentation will start by briefly summarizing the global evidence on the health effects of physical activity and sedentary behaviour that formed the basis for the WHO Guidelines on these behaviours published in 2020. The main recommendations for adults and adolescents included in the Guidelines will be outlined, globally available data will be presented and data limitations and gaps will be highlighted. In the second part of the presentation, the Global Action Plan on Physical Activity 2018-2030 (GAPPA) will be introduced. The GAPPA provides a set of evidence-based policy recommendations to increase levels of physical activity participation across four strategic policy areas: active societies, active environments, active people and active systems. Several toolkits that are available to support implementation of GAPPA recommendations in countries will be presented. The presentation will then provide an overview of the global progress in implementing the GAPPA recommendations, as described in the first Global Status Report on Physical Activity to be launched in early September 2022. In light of the findings of this Status Report, the presentation will conclude by outlining a way forward towards the GAPPA vision: more active people for a healthier world.

Dominic Malcolm: Poly-pill exercise? The fallacies and limitations of physical activity health promotion
Loughborough University, UK

This presentation provides a critical sociological analysis of the poly-pill exercise movement. Drawing on the unique warrants of a critical health sociology, central thesis of the presentation is that, as part of the broader global development of physical activity health promotion and specifically Exercise is Medicine, the poly-pill exercise movement 1) has been precipitated by broader ideological shifts in the global political economy; and 2) will necessarily have limited success due to these ideological connections.
The presentation argues that this poly-pill exercise movement represents a longer-term development in the way health is understood in contemporary societies, which has been accelerated by a set of ideas commonly described as neoliberalism. Evidence for this connection can be seen in the ‘fallacies’ of physical activity health promotion, which lead to the blurring of science and politics in scientific data gathering and the subsequent public policy announcements. Moreover, the underlying principles of this political ideology – particularly ideas relating to the importance of health self-care, personal responsibility and productivity – lead to logical contradictions which distinctly limit the potential effectiveness of the poly-pill exercise movement in reality. While these principles may be persuasive in encouraging some people to be more physically active, locating exercise as a form of lifestyle and imbuing such activities with particular forms of cultural capital, lead to cross-population differences in exercise participation. Additionally, the ideologies which have led to the promotion of physical activity health promotion encourage participation in the types, intensity and meaning of exercise that are likely to lead injury and exercise cessation.
The presentation concludes by arguing that the widespread support for physical activity stems from an absence of dissenting voices which is unique within public health. It argues therefore that critical sociological evaluation has an important role to play in maximising the utility of poly-pill exercise, and minimising the unintended harms.


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