**6. The way forward in addressing the pandemic of physical inactivity**

Although physical activity guidelines have evolved considerably over the las few decades, due to ever-increasing physical inactivity, many public health organisations have attempted to develop physical activity intervention programmes that are more palatable to the sedentary and have recommended the accrual of 30 minutes of only moderate-intensity exercise performed on the majority of days of the week. Problematically, an adverse result of such guidelines is that some individuals and healthcare professionals believe that vigorous physical activity is not required for optimal health or the prevention and management of disease.

Since increasing benefits occur with concomitant increasing quantity and quality of physical activity, it is essential to consider the application of one or more of this vast number of physical activity modalities and their unique design elements to ensure optimal health promotion and disease prevention [11]. Establishing the most suitable combination of these elements is key to the success of an exercise programme in terms of health promotion, disease prevention and rehabilitation. Further, both the setting (i.e., school or workplace) and population (i.e., children or elderly community-dwelling adults) additionally complicates the determination of the elements [44].

Although, physical activity prescription has become an important public health issue, at an individual, practice or organisational level, there tends to be a focus on a single type of physical activity to improve health, and prevent or manage disease [37]. This is despite overwhelming evidence demonstrating that it is essential to undertake physical activity that promotes cardiorespiratory fitness, muscular fitness (including muscular strength and endurance), body composition, flexibility, and balance, not just one of these [37]. In general, the ACSM recommends that healthy adults perform aerobic training at 60–80% heart rate maximum, for 30–60 minutes a session, 3–5 days a week and resistance training be performed at 60–80% one-repetition maximum, using eight to 10 large muscle exercises, for eight to 12 repetitions and two to three sets, 2–3 days a week. According to the ACSM, to ensure optimal health and disease prevention, flexibility training should also be performed for 10–15 minutes twice a week and neuromotor training two to three times a week [45].

However, it is essential to note that this prescription may be considered overly simplified since programme design is additionally complicated by the level of fitness

#### *Physical Activity and Health Promotion: A Public Health Imperative DOI: http://dx.doi.org/10.5772/intechopen.111927*

at the onset of the programme (i.e., beginner, intermediate or established). Further, when replicating and adapting physical activity programmes in a variety of public health settings, it is essential to consider the specific elements within an exercise programme design. When considering aerobic activities, modality (e.g., walking, running, swimming, cycling, and jumping), frequency, duration, and intensity need to be taken into consideration, while volume, intensity, tempo, rest intervals, and frequency need to be considered in resistance activities and whether muscle strength, muscle endurance, power and/or hypertrophy are the outcomes. The incorporation of flexibility activities into home, school and workplace physical activity programmes can lead to an enhanced overall health and well-being. However, the modality (e.g., static, or dynamic), stretch duration, and intensity all need to be considered. It is due to this sheer diversity of variables affecting physical activity public health programme interventions that an increased focus on training physical activity public health specialists or the development of guidelines and policies related to a formal referral scheme to qualified exercise specialists once established disease and multiple manifest risk factor for disease are present to appropriately manipulate the programme design elements to attain positive outcomes.

In this regard, although there is a need to build community- and population-wide capacity based on existing literature, there is a need to move away from a solely a behavioural science approach focusing on individuals, and rather to a systems approach that focuses on populations and the complex interactions among the correlates of physical inactivity [39, 40]. This is because the role of a variety of health professionals in prescribing appropriate physical activity or referrals to their clients, patients, children, and employees is vital to increasing global physical activity levels, which in turn, would enhance physical and mental health and well-being, and the prevention and management of key non-communicable diseases (NCDs).

The development, identification, and monitoring of approaches to promoting physical activity as a public health imperative in communities, schools, and workplaces, and at a population level need to be explored [46]. However, such approaches and recommendations need to be based on the principles of inclusive and engaged partnerships between various stakeholders such as members of community, investigators, healthcare professionals, and policy makers. More research is needed to identify factors influencing who receives physical activity interventions and how interventions are selected for communities and populations [47, 48]. Further, there is an increased need for all health professional, not just physiotherapists, Biokineticists, and exercise physiologists to (1) understand specific activities and interventions that they can incorporate as part of routine care that can prevent physical inactivity, (2) think about the resources and services available in their communities that can assist the community to become active, (3) how to measure their impact and value of their own contribution, and (4) understand and make use of physical activity referral schemes to suitably qualified health care professionals.

### **7. Conclusions**

Physical inactivity is a major global issue. The benefits of regular physical activity as a public health intervention require health professionals to become aware and competent in prescribing it to promote wellbeing and prevent ill health as part of their everyday practice. Due to the increasing global incidence of NCDs and its scientific efficacy, physical activity has increasingly been included into public health initiatives. However, there remains significant deficiencies policies, practice, and engagement as evidenced by the ever-increasing prevalence of physical inactivity. Thus, it is recommended that more emphasis be placed on the importance of physical activity on both our physical and mental health from a young age into advanced age, while considering specific and vulnerable populations to ensure equality. Political will is required to encourage health professionals and government alike to include physical activity into the fabric of public health, including schools, communities, and workplaces. This is because the prescription of physical activity by a variety of health professionals is critical to improve health, and prevent and manage chronic disease considering their trusted relationships with patients, families, and communities. Future work is needed related to the scalability of community- and population-wide physical activity intervention programmes.
