**5. Design thinking in physical activity and exercise**

Bringing the previous notions together, it seems that physical literacy contributing to more active lifestyles is requiring a new approach able to solve more complicated problems in human decision making and actioning. New perspectives in education have the potential to provide novel methods of exercise promotion and literacy helping inactive populations to change perspectives and start their participation in exercise programs. Such a framework recently presented as a method of exploring, defining, and solving complicated problems claiming to utilise user-centred or human centred design processes [54]. Started with Brown's definitions [55, 56] Design Thinking (DT) comprises of iterative processes of three to five phases: 1. The phase of inspiration (or empathising) with an effort to explore and redefine the problem based on the clients, their perspectives and needs, 2. The phase of ideation (or definition and ideation) where the formulation of the problem and its solution is defined, and 3. The implementation (or prototyping and testing) phase where potential solutions are created and assessed [56].

DT has been proposed as one of the best approaches in health promotion as it is prioritising empathy for service users, brings together collaborative multidisciplinary teams and provides the opportunity to assess various solutions via iterative practices [57]. The potential of DT in multiple health care settings has been assessed in the past via diverse models of applications and demonstrated promising results in relation to traditional interventions [58]. Results on its potential for multiple health care domains and across diverse patient population and conditions were confirmed with authors urging for the use of DT in interventions of overlooked approaches and populations.

The application of DT in disciplines like PA and exercise literacy can be a product of related steps and procedures pertinent to the population in focus and caring for particular -amid unmet- needs. Relevant knowledge of applying DT is listed in multitude of resources highlighting the importance of the method and the application of its protocol [59]. Connecting with the requests of the real user and the population in need is the first step in the DT methodology. Claiming expertise and knowledge of the scrutinised behaviour/phenomenon when the user is not available, can possibly lead to unproperly clarified problems and quick fixes based on preconceived notions (see "empowerment model for health", [60]). Disciplines that have been scrutinising potential solutions effectively (i.e. medical treatments) supported by increased public attention and funding could generate a platform for creating diverse opinions on needs analysis [58]. The process of prototyping in a way that each potential solution is explored for its feasibility based on the elicitation of effective final results [56], is another step on the application of DT. The process of limiting solutions based on expressed ideas and their feasibility is another crucial area of DT [55]. Exchange of ideas is essential in DT and does not occur without trust, freedom of expression and undistracted collaboration among the team members [61]. Finally, having a basic appreciation of the protocol of DT and its needed steps can create a better engagement with team members ready to explore user needs, envision the ideal solution, realise its potential and endorse the answer that fits best to the initially proposed needs [55].

Testing DT protocol with the needs of the end user (i.e. unfit or obese individuals) in mind might hold the potential of more successful PA and exercise literacy helping to move way from proposals that have been shown limited success in the previous years with profound health and economic results [62]. Suggested tips that can enhance the implementation of DT for enhancing PA and exercise literacy are included in 12 tips presented by Wolcott, McLaughlin, Hubbard et al. [63]. These are separated based on the steps of DT protocol and relate to the preparation of DT (i.e. gathering resources and committing to its thinking patterns), engaging to the

#### *Design Thinking Applications in Physical Activity and Exercise Literacy DOI: http://dx.doi.org/10.5772/intechopen.97479*

discovery of users' needs (i.e. connecting to the real user and being observant of the real issues), exploring expressed ideas with a variety of means (i.e. visualisation of ideal solutions, utilising a number of mediums to scrutinise the feasibility of ideas), and encourage optimism while testing chosen solutions (i.e. flexibility when it comes to the chosen time and setting to reach a conclusion, allow space for failure and iteration of solutions).

A model of DT dealing with PA and exercise literacy can take the following form based on the suggestions of Brown [55], and colleagues [56]:

Inspiration phase; realising the needs of the individual user when it comes to human movement requires their inclusion in the process. Observation of the user or the direct involvement of users targeting the improvement of the context and needed set of skills is foundational in DT [64]. There is a need to reframe the problem and exploring it while moving away from pre-existing assumptions that lead to unsuitably specified problems and unfeasible answers [65]. The example of wearable technology as means to support increased physical activity patterns is an assumption made and failing to incorporate more active lifestyles [66]. Contrary, the idea of Augmented Reality to support PA literacy/education and more active lifestyles remains viable and untested to a large extend [67].

Equally important is the realisation of the experience of PA and exercise through the eyes of the stakeholders. Experts in academia very often assume knowledge based on prior theoretical conceptions and what has shown potential in the past [22] whereas, unique ways of thinking, personal strivings, psychological responses and thinking patterns of stakeholders cannot be predicted let alone assumed in terms of realising change [68].

During the phase of ideation, solutions to the problem start to emerge. Such process is important to continue involving both positive and negative experiences of the user while clarifying the direction of solution [55]. Testing prototype ideas through iteration and experimentation is an essential part of this process with triggered rounds of problem definition and experimental solution creation with the goal to synthesise information into illustrative models [69]. Iteration refers to testing possible solutions through trial-error procedures, mock-ups, timelines and prototype appraisals with the support of end-users and representative stakeholders [70]. Scrutinising and visualising a solution (i.e. self-caring message before putting on walking shoes) [71], and utilising previous knowledge and experience of people representing different organisations [72], is a central notion of design thinking.

Τhe implementation phase puts into final test the qualified prototype ideas through final series of iteration and experimentation aiming for synthesis [73]. Preparing a gestalt view on the proposed solution to the problem creates the opportunity for the users to be represented as a community testing assumptions and evaluating prototypes [74]. Through this process end-users have the opportunity to realise what each of the finalist proposals provides as a response to their recognised needs, offering feedback on the implementation of ideas [60]. This end result (i.e. new educational resources, holistic movement drills re-connecting mind–body) [75], provides the opportunity to move forward with new implementation of solutions and ideas around PA literacy that emanate from the users in need while implementing important theoretical positions produced via decades of systematic research and academic development [21, 22].

## **6. Conclusions**

To overcome currently overwhelming degrees of worldwide physical inactivity [76], requires looking to new definitions of the problem emanating from the actual users and their needs [55], helping us to redefine physical inactivity and our solutions to reverse this global trend. Wide examination of "prototypes" of solutions towards literacy and increased engagement with PA and exercise practices remains unexplored and profoundly based on socio-cognitive approaches (for an example see, [76]). At the same time, feasibility exploration of recently proposed PA and exercise literacy programs remains largely unknown [77]. Ideas like the application of virtual and augmented reality in the promotion of exercise [67], the role of mind–body interventions in prolonged exercise participation [78, 79], and the potential of embodied creativity activities [80] are examples of such exploration requests. There is a clear need to explore user-friendly PA and exercise literacy solutions with an unknown capability for creating active lifestyle responses for populations in need. DT methodology provides new exploration affordances towards this remit [60].

In summary, HL is believed to be one of the most promising pathways to deal with CID in modern society [45]. Even though the existing theoretical models are supporting a systematic approach towards the promotion of PA and exercise behaviours, their educational applications are limited and still underdeveloped [21, 22]. The need to overcome resistance to exercise adoption due to negative sentiments, fear and/or unconscious processes necessitates the adoption of new approaches to PA literacy. DT has been proposed as an effective approach able to provide new proposals to health promotion as it is prioritising empathy for service users, brings together collaborative multidisciplinary teams and provides the opportunity to assess various solutions via iterative practices [55, 56]. Testing proposed solutions based on the needs of various populations (i.e. clinical, older adults) is the product of further scrutiny and exploration through the applications of DT.
