Running head: EXERCISE & PHYSICAL ACTIVITY

Sarah Hostetter, Mikala Hursh, Katie Miller, Joshua Musselman, Brooke Papciak, Janae Yellock
Dr. JoAnn Foley-DeFiore
BBH 416
5 April 2016
Exercise & Physical Activity in College Students: A Literature Review
I.

Introduction
Exercise while in college is important, but it is something that is often overlooked. The

PULSE study conducted by Student Affairs at Penn State (2015) listed many reasons that they do
not exercise, including lack of time, lack of knowledge of programs on campus, high costs of a
gym membership, or availability that does not match up with the schedule of the gyms on
campus. To go along with these issues, many students also report that they do not have friends
who exercise, which can prove to make going to the gym more difficult to do. Coupled with
exercise, physical activity is also important and yet many people neglect to perform it. With a
percentage of students who meet the daily guidelines for physical activity (75 minutes of
vigorous aerobic activity or 150 minutes of moderate intensity aerobic activity a week) under
two out of three students according to Healthy Penn State, there is still much room for
improvement.
Freshmen can have a hard time adapting to life in college, which can end up affecting how
often a college freshman can exercise. When this lack of perceived time is combined with
something such as a lack of knowledge of exercise programs that the university offers or a lack
of friends that exercise, this can make exercise and physical activity even harder. While Penn
State offers a wide variety of exercise and physical activity resources, many of which are free, it
is often hard for students to figure out how to find these resources. Women entering college often

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exercise less than men, and tend to have less knowledge of exercise programs that are offered by
the university (PULSE, 2015). It is clear that there needs to be an intervention directed at
freshmen women to increase knowledge of exercise programs offered by Penn State.
II.

Problem Statement
There are many factors that can prevent undergraduate women at Penn State from

exercising. According to the PULSE study conducted by Penn State Student Affairs (2015),
when asked about obstacles to participating in exercise, lack of knowledge of programs was
rated 2.75 out of a 4.0 scale where 1 was equal to none and 4 was equal to a lot among
undergraduate students. That number increased to 2.91 among infrequent users. The PULSE
study reported that women were also more likely than men to report a lack of knowledge of
programs being an obstacle to participation in exercise, although they did not show the data in
their report. This is problematic, as barriers to participation prevent young women from receiving
the benefits of exercise. The CDC reports benefits of exercise including weight control, reduction
of risk for cardiovascular disease, type 2 diabetes, and some cancers, strengthening of bones and
muscles, improved mental health and mood, and an overall increase in lifespan (CDC, 2015). If
an intervention can lead more people to participate in exercise, it can help lead to a decrease in
morbidity and mortality, especially because habits formed in youth tend to continue to be
performed in adulthood.
III.

Prevalence and Incidence of Weight Gain in College Students

1. Weight Gain in U.S. College Students

Before creating a health promotion strategy to increase the participation in exercise activities
on a college campus, there must be an understanding of how susceptible students are to gaining
weight and how much of the general population is affected. While the goal is not to lose a certain

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number of pounds, weight gain can be associated with unhealthy behaviors such as lack of
physical activity (Leone et al., 2015). This is shown to be true through studies that have been
completed at other universities. These factors will assist in creating a target population to focus
on.
The incidence of weight gain increases between a students high school and collegiate
years, primarily due to the environmental shift. The atmosphere of the family home versus
independent living without supervision shows relation to a change in body composition. This can
be seen in a recent study conducted in the Netherlands, where statistical analysis showed that
students living away from home gained approximately 0.5 kilograms more than students living
with parents (Vos et al., 2015). It was found the primary cause of weight gain in college
freshman was the increased consumption of alcohol and irregular eating habits. Students began
drinking alcohol for the first time or drank more than they had in the past. While this sample
does not originate from United States, it offers valuable insight on how weight gain can differ
depending on the environment. This is important to consider because even within the United
States, not all freshmen will gain weight at the same rate or be surrounded by the same
influences. School cultures vary greatly and can have an impact on the students behaviors.
Another study researched not only the risk of weight gain, but what periods of time
incidence may be the highest. It took place at a Midwestern university where freshmen living on
campus would visit a laboratory approximately every other month, where they had their weight,
waist circumference, and fat percentage measured. The results showed the most weight gain
occurred in the first and last two months of the academic year (Leone et al., 2015). Other factors
are also to be considered while assessing the patterns of weight gain, such as holidays and
studying for final exams. Alternatively, there may be other times were physical activity is

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increased, such as the weeks leading up to spring break (Leone et al., 2015). With that
information, students may benefit from an intervention program more at one time than another.
However, the larger picture should still always be considered because one of the subjects in
another collegiate study had a BMI that fell into the obese category by the end of the first
semester of testing (Vella-Zarb et al., 2010).
Although most freshman weight gain exists on a much smaller scale than what the media
portrays, even the lesser weight gain can cause considerable health consequences in the future. A
study that looked at weight changes based off of environmental and psychological predictors
resulted in a small overall mean weight gain for students, but still statistically significant.
Compared to other years, freshman year is the first time many young men and women are
left to live independently. Since it is the first time they are experiencing such responsibility, this
class is likely to be most susceptible to weight gain and not participating in regular exercise.
Statistics in the study of Dutch college students showed that 40 percent had a change in eating
patterns and 30.7 percent consumed more alcohol than previously (Vos et al., 2015). With nearly
half of the students going through this change in behavior, the prevalence in this study appears to
be fairly high. The prevalence of below-average participation in exercise is also seen in another
set of statistics from a United States study that show only 35 percent of 21-year-olds reported
engaging in vigorous physical activity on a regular basis, which is a large drop from 70 percent
of 12-year-olds that participate in vigorous physical activity regularly (Waldron et al., 2010).
While this age-range would not include the typical 18-19 year old freshmen, researchers from
this same study have found no increases in physical activity patterns in students over the 4 to 5
years of their college education (Waldron et al., 2010). Additionally, some studies have found

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that almost 70 percent of university students do not meet recommended physical activity
guidelines, which makes physical activity rates very low (Vella-Zarb et al., 2010).
While it is important to understand weight gain across the general freshman population,
gender-specific approaches may be required to prevent weight gain from occurring (Vos et al.,
2015). Females and males respond differently to health interventions so narrowing the scope is
likely to bring about the most successful results.
IV.

Summary of Previous Interventions

1. Previous Theoretical Models Used to Address Physical Activity

Of the studies conducted in the area of weight management and physical activity, several
theories have been employed in the planning of intervention strategies. One intervention strategy
of note is the use of mobile and website applications in order to produce change in individuals. In
the review by Enwald and Huotari, twenty-three intervention studies on electronic information
sources on health communication were selected for review. The Transtheoretical Model was
applied in fourteen of the twenty-three studies. Self-reporting was used in fifteen studies while
fourteen studies lacked a no-information control group. Tailoring was more effective in nutrition
interventions, but showed mixed results in physical activity. Possible biases may have resulted
from the utilization of self-reporting and on intervention design lacking a no-information control
group. However, tailored health communication is seen as more satisfying and more relevant
than traditional promotion. The outcomes of tailored communication can be assessed by
analyzing a specific intervention in which behavioral, physiological, or psychological factors are
measured both at baseline and at the end of the intervention (Enwald and Huotari, 2010).

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B. Effectiveness of Previous Interventions

Tailored feedback may be based on the Health Belief Model or the Transtheoretical Model
(TTM). In the case of most tailored health intervention strategies, the TTM is used. Studies have
shown that using the Social Cognitive Theory in tailored Internet interventions have successfully
achieved changes in areas such as nutrition practices and physical activity for up to a year.
Extensive use of the Theory of Planned Behavior has also been shown to improve effectiveness
of Internet interventions. In the use of a variety of theoretical models, demographic
characteristics such as gender, race, and age must also be considered (Enwald and Huotari,
2010).
In another study, a sample of 128 overweight volunteers were randomized to receive a weight
management intervention via smartphone app, website, or paper diary. Adherence to the program
in the smartphone group was statistically significantly higher in the smartphone group with a
mean of 92 days of dietary recording compared with 35 days in the website group and 29 days in
the diary group. An SMS text message intervention lasting sixteen weeks led to a mean weight
loss of 2.1 kilograms in a group receiving daily text messages compared to 0.4 kilograms in the
control group. However, in a larger 12-month SMS intervention in 170 overweight and obese
adults showed no statistically significant difference in weight loss compared to the control group.
Here, text messaging might be most useful in junction with a weight loss program (Carter,
Burley, Nykjaer, and Cade, 2013).
A study that integrated the study of physical activity and mental health analyzed 94 4-year
colleges in the United States. The results of this study showed that students who met the
recommendations for physical activity were less likely to report poor mental health and
perceived stress than their counterparts not meeting recommendations. The aspect of

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socialization was shown to partially resolve the relationship between physical activity, mental
health, and perceived stress. In a study among college students, approximately 60 percent of
participants reported high levels of stress. Such stress could be due to both academic and social
stress of college. Learning to cope with additional stressor of college is important for mental and
physical health (VanKim and Nelson, 2013).
In the study conducted by VanKim and Nelson, the majority of participants were female,
between 18 and 20 years of age, normal weight, Caucasian, and reported good mental health and
low perceived stress. However, compared to males, females were not as likely to meet physical
activity recommendations in college, and more likely to report poor mental health. Additionally,
the participants reported that low socialization would have lower odds of meeting physical
activity recommendations than those who reported high socialization.
Another study of importance was conducted by Naimark, where 99 people
(predominantly highly educated white females from high tech business and organizations) were
randomly assigned to either participate in an app intervention that focused on education and selfmonitoring of diet and exercise or a control group that received just a lecture on healthy
lifestyles. This population of high tech people could be useful when looking for interventions for
college students because of the high frequency of technology use in student populations.
Participants were eighteen years of age and older. The intervention lasted fourteen weeks. The
app had videos for participants to learn about their health and it had means to easily enter data
and keep track of diet and exercise. It also gave recommendations for healthy behaviors. By the
end of the fourteen weeks there was a significant difference in amount of physical activity
between the app users and the control group. The app increased duration of exercise in the users.
There were also higher success rates in females. Frequency of app use was significant to success

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of the intervention. The average use was 2.7 days a week. The typical amount of time spent on
the app was eight minutes. Naimark found that a frequency of usage of three days per week
promoted better health. There was a trend of higher use leading to better outcomes opposed to
light use. This study shows the significance of participant buy in and the possible success that
can come with high levels of participation from target populations (Safran, 2015).
Researchers at Vrije Universiteit Amsterdam identified the pervasive nature of social
networking in the lives of young adults, and aimed to investigate the willingness of university
students to share their physical activity data online. Dutch undergrad and graduate students aged
eighteen to twenty-five were evaluated based upon their adoption of an application called
Nexercise, which allows users to share their tracked activities via existing social media
platforms. Students were advised to use the mobile app for three weeks before participating in
focus group discussions. The students reactions and preferences relating to the sharing
capabilities of Nexercise were then recorded.
Parts of the intervention that were deemed successful included the competitive aspect of
the ranking feature that made getting exercise seem more like a game than an arduous task. Some
participants who did not meet activity guidelines found the ranking feature to be motivational.
One female reported that seeing a friend jogging frequently inspired her to go exercising. This
statement suggested that certain social features on an app could be appealing to females who are
not as physically active. Meanwhile, it remained notable that others with low activity in the study
perceived that feature to be confrontational and did not react positively. The applications
developers may not have taken into consideration the role of subjective norms under the Theory
of Planned Behavior. It is known that normative beliefs about an action, compounded with an
individuals motivation, influence the way a person intends to act and then eventually behaves.

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Further investigation would be needed to determine whether the inclusion of social norms of
exercising via a ranking feature is conducive to behavior change or not. If not, there may be
other ways to present norms that would not deter existing motivation.
Students in the focus groups, and especially those designated as low activity participants,
also proposed that coaching and feedback features to provide feedback would benefit them.
Certain students wanted exercise reminder notifications while others wanted more graphic
feedback. A limitation of that, though, is that it would require complex algorithms to determine
what feedback messages should be delivered based on objective measures like GPS distance
tracking and subjective measures like daily emotions.
The most markedly ineffective feature of the app was the social networking factor, which
was not seen to be effective because participants did not share many of their achievements on
Facebook. The subjects reasoning for this was that they did not feel that Facebook was the most
suitable platform to share their fitness information, and reported that a feature within the
application would provide a better forum.
C. Limitation of Previous Interventions
More data is needed to analyze the impact of physical activity on mental health and
perceived stress from high school to college. However, peer support interventions aimed at
physical activity levels could help improve mental health status as wells as physical health. For
future interventions, physical activity components with a social aspect should be incorporated
into mental health and stress management interventions (VanKim and Nelson, 2013).
In a study by Maher we see once again the potential success of a technology based
interventions. In this study 110 adults were recruited online in teams with Facebook friends.
They were given access to a 50-day intervention that included self-monitoring, pedometers, and

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also a social aspect. This intervention produced a significant increase in physical activity after
eight weeks. This is to be expected with this sort of intervention. However, at twenty weeks there
was no longer any statistically significant difference between the participants who were a part of
the intervention and those who were not (Maher, 2015). This study brings to attention the
importance of long-term behavior change. Many interventions have immediate results, but as can
be seen with this study behavior change may not be sustainable. While immediate results were
observed the intervention was essentially failing at the twenty week point. This calls for greater
focus on behavior change sustainability in future interventions.
The Nexercise app had numerous features that may have made it difficult to tell which
parts of the app kept the students logging back in and which ones discouraged their use. The
report by Middelweerd and colleagues displayed a lack of hard empirical evidence as it relied on
opinion based self-reported measures, which can be skewed. It also had a limited sample size of
thirty participants. Finally, Dutch findings may not be generalizable to students at American
universities.
V.

Conclusion
With 59 percent of Penn State Students meeting the guidelines for recommended physical

activity each week, there is room for improvement. In the PULSE student affairs survey, of the
489 undergraduate students that were surveyed, 58.1 percent of students reported using campus
recreational facilities a few times per week. In general, men reported using the facilities more
than women. Some of the obstacles to participate include costs involved, lack of time, and lack
of knowledge about programs. Of the undergraduate students, infrequent users, using the
facilities less than a few times per month, were more likely than frequent users to state that the
obstacles to participate were present (PULSE, 2015). From this data, it is clear that an

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intervention focused on these barriers to participate is necessary for freshmen women. An

additional benefit from increasing knowledge of the variety of physical activity and exercise
opportunities on campus, the freshmen women have the additional benefit of increased
socialization and ease of transition to college.

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References
Carter, M. C., Burley, V. J., Nykjaer, C., & Cade, J. E. (2013). Adherence to a Smartphone
Application for Weight Loss Compared to Website and Paper Diary: Pilot Randomized
Controlled Trial. Journal of Medical Internet Research, 15(4), e32.
CDC. (2015). Physical Activity and Health.
Enwald, H. P. K., & Huotari, M.-L. A. (2010). Preventing the Obesity Epidemic by Second
Generation Tailored Health Communication: An Interdisciplinary Review. Journal of
Medical Internet Research, 12(2), e24.
Leone, R. J., Morgan, A. L., & Ludy, M. (2015). Patterns and Composition of Weight Change in
College Freshmen. College Student Journal, 49(4), 553-564.
Maher, C., Ferguson, M., Vandelanotte, C., Plotnikoff, R., De Bourdeaudhuij, I., Thomas, S.. .
Olds, T. (2015). A web-based, social networking physical activity intervention for
insufficiently active adults delivered via facebook app: Randomized controlled trial.
Journal of Medical Internet Research, 17(7), e174.
Penn State Student Affairs. (2015). PULSE - Campus Recreation Spring 2015. In Penn State
Students Affairs.
Safran Naimark, J., Madar, Z., & Shahar, D. R. (2015). The impact of a web-based app
(eBalance) in promoting healthy lifestyles: Randomized controlled trial. Journal of
Medical Internet Research, 17(3), e56.
VanKim, N. A., & Nelson, T. F. (2013). Vigorous Physical Activity, Mental Health, Perceived
Stress, and Socializing Among College Students. American Journal of Health
Promotion: AJHP, 28(1), 715.
Vella-Zarb, R. A., & Elgar, F. J. (2010). Predicting the 'freshman 15': Environmental and

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psychological predictors of weight gain in first-year university students. Health

Education Journal, 69(3), 321-332.
Vos, P. D., Hanck, C., Neisingh, M., Prak, D., Groen, H., & Faas, M. M. (2015). Weight gain in
freshman college students and perceived health. Preventive Medicine Reports, 2,
229-234.
Waldron, J. J., & Dieser, R. B. (2010). Perspectives of Fitness and Health in College Men and
Women. Journal of College Student Development, 51, 65-78.

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Mission, Goals, and Objectives

Mission
Our mission is to pilot an application for mobile devices that serves to increase physical activity
for students at the Pennsylvania State University by increasing awareness of free fitness classes
on campus and promoting social interaction among freshman girls. Through a central database
that incorporates various modes of physical activity, overall well-being is promoted by
encouraging physical activity and socialization. The aim is to ease the transition to college while
increasing physical activity.
Goal #1
To increase awareness of fitness classes in freshman girls over the course of freshman year.
Objectives
1. Learning Objective: Increase knowledge that female freshmen have of the variety and
descriptions of fitness classes available through Penn State Fitness through the use of a
centralized database of free fitness classes available. Additionally, through the use of an
app, a calendar will list the dates of these events. RAs will also be utilized to promote the
usage of the app to the female freshmen.
2. Environmental Objective: Increase social interaction between freshman girls by
incorporating an option to invite other interested freshmen to an event. After finishing
their freshman year of classes, each participant will list up to three individuals that they
met by using the application.
3. Program Objective: Fifty percent of freshman girls will be aware of the application, thirty
percent of freshman girls will have the application downloaded on their mobile device by
the end of their freshman year of college.
Goal #2
To increase participation of fitness classes in freshman girls over the course of freshman year.
Objectives
1. Behavioral Objective: Increase participation in fitness classes. After finishing their
freshman year of classes, at least twenty-five percent of freshman girls will attend three
or more fitness classes through the use of the application.
2. Environmental Objective: Increase participation by decreasing barriers to physical
activity in freshman girls, specifically the barrier of fear. By creating an environment that
will be less threatening, participation will increase.
3. Program Objective: Twenty-five percent of freshman girls will attend classes through the
application by the end of their freshman year of college. This data will be obtained
through analyzing the number of downloads of the app.
Justification
Justification for Goal #1 Objectives
1. The introduction of a mobile database and calendar would put a fitness schedule at the
users fingertips. While paper handouts of the classes are available in fitness centers,

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some freshman girls do not visit the centers initially. Also, few students know the
complete list of benefits that a fitness membership entitles them to. The FreshFit app
would make clear the options that are available at a particular time, including the hours
for outdoor tennis courts and indoor pools. This information, paired with the instructional
component provided by Resident Assistants, would increase participants knowledge of
the physical activity options that are available in a convenient manner.
2. By creating a network of freshman girls, awareness of fitness events on and around
campus will increase. The invitation feature will promote classes and activities among the
apps users. Social networks will also expand through this feature as participants meet
each other.
3. Awareness of the application will be measured via surveys conducted by LEAP leaders
and RAs at the end of summer session and the first semester, respectively. If more
females know about the app or have the app, the greater the opportunity to see changes in
health consciousness.
Justification for Goal #2 Objectives
1. A quarter of the freshman girls are expected to use the application to attend three or more
fitness classes. This expectation suggests that the app will influence girls to alter their
fitness behaviors by trying a class not just once, but by attending a few different classes
that Penn State offers.
2. The social component of FreshFit is anticipated to make the gym and class environments
less intimidating. If a girl knows that other girls from her floor are attending a Pilates
class, for instance, she will likely be more inclined to try the class herself. Many people
within the target audience are fearful of showing up to events alone and are eager to build
friendships. Features on the app establish a buddy system, so to speak. Friends act as a
motivating factor to attend the gym more often.
3. The list of attendees for a particular fitness activity will increase. By surrounding the
freshman girls with a positive social environment, the increased social interactions will
likely lend girls motivation and support. Overall, the use of this fitness app will instill the
user with the self-efficacy to continue with these healthy behaviors.