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Consequences of Indoor Tanning and Models for Behaviour Change

Info: 6816 words (27 pages) Dissertation
Published: 10th Dec 2019

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Tagged: HealthMedicine

Indoor Tanning Consequences

Indoor tanning is defined as the act of an individual using a tanning bed, booth, or a sunlamp to tan as opposed to the natural sunlight. Tanning beds, booths, and sunlamps are produced with ultraviolet (UV) rays, and the exposure to these UV rays can lead to multiple cancers. Many studies show that indoor tanning behaviors start at an early age. The American Academy of Dermatology found “that more than half of indoor tanners (52.5 percent) start tanning before age 21, while nearly one-third (32.7 percent) start tanning before age 18” (Indoor Tanning, 2015). The American Academy drew statistics from the 2013 National Youth Risk Behavior Survey in order to further explain their argument about youth’s indoor tanning behavior. The statistics in the National Youth Risk Behavior Survey found that 1.5 million female and 400,000 male high school students tan with the assistance of a tanning bed, booth, or sunlamp (Guy, et al, 2013). The aforementioned surveys, US Food and Drug Administration, Center of Disease Control, and physicians have completed multiple studies that show the negative impacts of youth using artificial UV rays such as: skin cancers, ocular cancers, and cataracts; these studies are attempting to change adolescents’ behavior by bringing awareness and presenting consequences to these behaviors.

There are potential methods for preventing and targeting indoor tanning in adolescents, such as putting in place state laws that prevent adolescents under the age of 18 to use tanning beds without their parents’ accompaniment and prohibiting the use of tanning beds until the age of 18. Physicians, US Food and Drug Administration, Center of Disease Control, American Academy of Dermatology, and the National Youth Risk Behavior Survey have enacted interventions for adolescents in order to make necessary changes to prevent lasting effects from indoor tanning. These agencies are stressing that the sun is a much more natural and healthier option to tan rather than indoor tanning. Tanning beds shine concentrated bursts of ultraviolet light, and those bursts cause fast mutations in the body which change the arrangement of human DNA. In youth, the arrangement of human DNA is significantly more important, as their bodies are still growing and shaping to support them for the rest of their lives. Robb-Nicholson (2009) found that, “Tanning beds use fluorescent bulbs that emit mostly UVA, with smaller doses of UVB. The UVA radiation is up to three times more intense than the UVA in natural sunlight, and even the UVB intensity may approach that of bright sunlight.” The dangerous amount of fluorescent lighting in tanning beds have started to mutate the DNA of over 15 percent of adolescents in grades 9 through 12 that reported using artificial sources of UV light for tanning in 2009 (Healthy People 2020). This abusive skin behavior can lead to many types of skin cancers, especially to those who are fair skinned and those who are under the age of 18, which urges their cause to create this change in adolescents. Healthy People’s (2020) goal is to reduce the percentage minimum by 14.0 percent, but their ultimate goal is to reduce the percentage down to 10 percent. Ultimately, this is one objective in their aim to increase the overall proportion of people who participate in behaviors that reduce their exposure to harmful (UV) radiation and avoid sunburn (Healthy People 2020).

Not only does indoor tanning have many negative health effects, there are also several benefits of outdoor tanning. Just being outside and catching sun rays may improve your self-esteem, enhance mood, and increase Vitamin D levels. Sivamani (2008) found that “catching some rays may lengthen your life,” and he shares how these benefits are important for adolescents under the age of 18. Self-esteem instills a sense of confidence in youth and makes them feel like a more attractive person; people, especially teenagers, believe that they look better with a tan. In addition, outdoor tanning is linked to increased energy and enhanced mood. Sivamani also determined that, “81% of individuals in 2007 felt that a tan improved appearance, whereas only 58% of individuals in 1968 held the same belief.” He explains that as years have progressed, society’s beliefs have changed to view a person as more attractive because of a tan, and from this, perceived attractiveness changes self-confidence. He also explored early studies that looked at the relationship between mood elevation and increased endorphin levels, but found no correlation. However, he found a correlation between mood elevation and increased Vitamin D levels, another benefit of outdoor tanning. In his subsequent research, he found “how sunshine decreases infection including a West African case-control study where more tuberculosis patients than controls had low levels of Vitamin D.” Tuberculosis was linked to lower levels of Vitamin D, which further illustrates the fact that Vitamin D gained from sunshine has many benefits, such as decreasing infection. The outcomes of lowered levels of Vitamin D include the increased risk for many types of cancer, heart disease, bone disease, and various autoimmune diseases.

While the health benefits that come from outdoor tanning far outweigh the consequences of indoor tanning, preventing low levels of Vitamin D in the human body is the greatest benefit. Some of the trends associated with low levels of Vitamin D include: bone pain, muscle weakness, increased risk of cardiovascular disease, cognitive impairment in older adults, severe asthma in children, and/or mortality (Vin Tangpricha, et al, 2016). Recently, a twelve-month study was completed in Finland that used Finnish adolescent girls from the ages of 14-16 with severe Vitamin D deficiency (Cashman, 2007). The Vitamin D supplementation led to bone mineral augmentation in the femur and lumbar spine in the Vitamin D deficient Finnish adolescents.

The International Agency for Research on Cancer refers to indoor tanning as a human carcinogen. A human carcinogen is defined as a cause as to why humans get cancer. The intervention that is commonly used to stop indoor tanning is done by doctors. Doctors can intervene and talk with adolescents about the long lasting effects that indoor tanning can cause. The skin cancers from indoor tanning include: melanoma, basal cell carcinoma, and squamous cell carcinoma (Centers for Disease Control and Prevention, 2017). Indoor tanning can cause ocular cancer, known as ocular melanoma, and cataracts. Elizabeth Miller (2017) at The Austin Diagnostic Clinic found that, “the risk of melanoma increases 75 percent in some who are exposed to UV radiation from tanning.” The use of tanning beds can destroy collagen and elastin fibers, superficial blood vessels, and other structures that a body needs to survive. As spring and summer approaches, many people begin to worry about showing their pale skin to the sun and to others. This mentality leads to people running to the tanning bed or any type of UV source to achieve a tan that they think is attractive. What adolescents do not realize is that a sunburn or a deep tan achieved by tanning beds will later lead to a variety of skin disorders and/or skin cancers. Indoor tanning for all, but especially in adolescents between the grades of 9 to 12, needs to cease because of the negative and dangerous outcomes caused by artificial lighting.


Colleen Scott (2014) found that only a few published studies used health behavior theories for predicting indoor tanning intentions and behavior. A lot of the research done for indoor tanning in adolescents highlights one construct, a few constructs, or multiple constructs. There are a few theories that have been used to target indoor tanning in adolescents and include the Theory of Planned Behavior and the Prototype Willingness Model. Each of these theories lists reasons why adolescents may indoor tan and helps illustrate different behavioral changes that would stop indoor tanning in adolescents.

Theory of Planned Behavior

The Theory of Planned Behavior predicts an individual’s intention to engage in a behavior during a specific time and place. It was made to explain behaviors that people do when they have the ability to show self-control. The Theory of Planned Behavior depends on the motivation (intention) and ability (behavioral control) to follow healthy behaviors (LaMorte, 2016). There are a few limitations of this theory which include that it assumes people have acquired the opportunities and resources to be successful in performing the desired behavior, it does not account for other variables, and it does not take into account other environmental factors. The Theory of Planned Behavior is suitable at predicting the attitudes of indoor tanning, but are not good at predicting the motivations of tanning. Several studies have noticed that there are many different motivations for adolescents to indoor tan all across the world. One study in the UK looked at the attitudes of indoor tanning and found that there were very significantly different adjectives to describe indoor tanning. Some adolescents said it was not harmful, good, or enjoyable, while others said it was harmful, bad, and foolish. The adolescents that said that indoor tanning was not harmful and fun had people in their social group that approved of indoor tanning while the ones that were led to say that indoor tanning was harmful, bad, and foolish explained that people in their social network would not ever approve of them using an indoor tanning device. The motivation for their attitudes came purely down to their social influences and how people in their social networks felt about indoor tanning. The attitudes of the indoor tanners are targeted for interventions. These interveners plan to point out different horrific indoor tanning statistics and provide appearance interventions to enhance the adolescents’ portrayal of themselves and share what could happen to their skin if they continued their behavior. How to conduct these interventions for adolescents is still in the planning stages, so this experiment is a work in progress. Youth especially become defensive if scare tactics are used in an intervention, so the best method is to use encouragement in an intervention or highlight the personal benefits of change. (statistics on what % population believes this) This is where limitation is key for this theory: many people think that tanning beds improve one’s overall health (Hobbs, 2013). These individuals believed this and this information was wrong and so, the Theory of Planned Behavior does not account for other variables like misconceptions about indoor tanning.

Self-Cognitive Theory

The Self Cognitive Theory (SCT) is a theory that determined that learning occurs in a social network with interactions with people, environment, and different behaviors. The feature of the Self Cognitive Theory that is important is the emphasis on social influence with different interactions in the environment and the emphasis it holds on external and internal social reinforcement. Past experiences play a role into this theory. The main goal of SCT is to look at how people regulate their behavior through control and reinforcement to achieve their goal-directed behavior that can be regulated over time (LaMorte, 2016). The biggest two limitations with this theory are that this theory just assumes that changes in the environment will lead to a change in the person and that it is loosely organized, and cannot determine if the person, behavior or environment is more influential than the other. Several studies for indoor tanning have investigated the implications of indoor tanning with the self-cognitive theory. One study was completed at the University of North Carolina at Chapel Hill, Noar (2015) investigated the lack of a theory-based understanding of indoor tanning and reasoned that more understanding will lead to more preventative behaviors and reduced indoor tanning behaviors. Noar studied sorority women at UNC what motivated them to go to tanning beds; mainly she found that appearance-oriented variables were significant and a huge reason they went. Their interactions in their different social networks with their friends, sorority groups, and/or significant others was a huge factor as to why they indoor tanned. The appearance – oriented variables were significantly associated with the outcome expectations and those were associated with the temptations to tan indoors. From this study, Noar found out that messages need to be changed that perceive women to be more beautiful with tan skin and focus more on indoor tanning and how it affects you long term. The downfall for this theory is that it is individual based, Noar’s sector was just sorority females, she did not try and investigate any other group. For her to gather more data and research, she should use the Comprehensive Indoor Tanning Expectations again, but for a larger group of college students not just on one group.

Health Belief Model

The Health Belief Model is a model that was made by social scientists in the 1950s to identify the failure of people adopting disease prevention strategies and/or screening tests for an early detection of disease (LaMorte, 2016). This theory suggests that a person’s belief in a situation with a personal threat of an illness or disease with a person’s belief of the effectiveness of a recommended health behavior or an action that they believe will predict the likelihood of the person adopting the specific health behavior (2016). Health Belief theory comes from a psychological and behavioral theory that has a foundation in two components, which are the desire to avoid the illness and/or get better and the belief that the specified action with prevent or cure the illness (2016). Specifically, there are six constructs that explain the Health Belief model and those are perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cue to action, and self-efficacy. Perceived susceptibility is the person’s personal perception of the risk of getting the illness. Perceived severity is the person’s feelings on the seriousness of getting the illness. Perceived severity deals with medical consequences, like death, and social consequences, like social relationships, when looking at the severity. Perceived benefits is the person’s perception of the effectiveness of the actions available to reduce the threat of the illness or disease, a person would accomplish the recommended health action if it was the action was perceived to be beneficial (2016). Perceived barriers is the person’s subjective feelings on the obstacles to actually performing the health behavior. People perceived different costs and benefits, so they have to weigh the effectiveness of the actions against other perceptions (2016). Cue to action are external and internal triggers that the decision-to-act process to accept the recommended health action. Self-efficacy is the belief or confidence in his or her ability to successfully be able to perform the specific health behavior. There are several limitations to the Health Belief Model and those are that it does not account for the person’s attitudes or beliefs that dictate a person’s acceptance of the health behavior and it does not take into account the environmental and economic factors that prevent or promote the health behavior.

Many studies for indoor tanning have used the Health Belief model and one in specific was conducted by the Ohio State University research group. The Ohio State University research group used an intervention that was illustrated throughout a six section long booklet that described the risks and issues that are involved with indoor tanning bed use. The research group led to a discussion of the different norms that have developed around tanning (2017). The focus of the study was to increase awareness about the risks and severity with tanning beds and to change the behaviors surrounding the activity (2017). For this study, the Ohio State University selected female university students to use in the study if they scored a score of 5 out of a 7 or higher on a test that measured their intentions to possibly tan in the next year. The ages for this study was 17-21 with a mean age of 18.6 for the female students. In the first section, the booklet discussed the history, norms, and perception of tanning in the United States culture. This specifically showed some of the perceived barriers that are included with the Health Belief Model and showed the personal perception of the indoor tanning that female students have. In the second section, the constructs of susceptibility and the perceived barriers are shown by looking at who tanning beds target and the norms and body image with media influences (2017). Section three looks at the effects of ultraviolet radiation on a person’s skin and the skin damage that occurs. Section four specifically focuses on the severity of indoor tanning and the audience who have perceived susceptibility to skin damage/cancer. Section five informed readers how to reduce the harm of indoor tanning, which is the construct of the perceived benefit. Researchers believe that adolescents should be abstinent to indoor tanning. Lastly, section 6 emphasizes how a person’s self-efficacy can change by suggesting other ways to reach the appearance that she want to achieve while avoiding tanning bed use (2017). The effect of the intervention showed that the intervention group significantly decreased in their indoor tanning behaviors than the control group. The intervention group also decreased the intention to use different indoor tanning facilities (2017). The limitation for this study is that it does not share the statistics after the study was conducted. It shows the averages, but never the amount of female students that were involved in the study. It also does not show the environmental and economic factors that were involved throughout the study. The next study should include more of the factors that influence the female college students to tan and what exactly the interventions consisted of.

Intrapersonal Factors

Intrapersonal factors are variables that are just within a person, such as beliefs, attitudes, values, knowledge, and personality. These intrapersonal factors help the individual analyze different situations, reflect on what is happening around them, and clarifying concepts around them with their beliefs and attitudes. It helps researchers predict if an individual will want to be apt to perform a health behavior or not and how the individual will consider the behavior. Indoor tanning is a factor that intermingles with extrinsic and intrinsic motivation, so fully understanding the intrapersonal factors are important in how to understand and help others indoor tanning behaviors.

One concept that is mentioned frequently in literature is an individual’s attitude about indoor tanning. Chaiklin describes attitudes as the, “set of emotions, beliefs, and behaviors toward a particular object, person, thing, or event… they are often the result of experience or upbringing, and they can have a powerful influence over behavior. While attitudes are enduring, they can also change“ (2011). Attitudes directly tie into an individual’s self-efficacy and beliefs. Since they believe that they are capable to do the behavior and believe that it is true, then they are very likely to do the behavior.

For almost all college students, the beliefs of indoor tanning and the skin damage that comes with indoor tanning are commonly known facts. There could be some individuals who were not necessarily taught that indoor tanning is a carcinogen, but generally the act of indoor tanning is known as a negative behavior. But knowing that indoor tanning is bad does not mean that the individual will stop participating in the behavior because of the perceived benefits or attitude that the individual has about indoor tanning. Most individual are motivated to tan because they believe they benefit for appearance – enhancement reasons (Heckman, 2011). This perceived benefit leads to the individual’s beliefs about how beneficial indoor tanning is for appearance. This is where the biggest disconnects occurs within the minds of adolescents. Many adolescents believe that their self-appearance affects their life significantly and rely on indoor tanning to achieve the self-appearance of their liking. One study looked at many adolescents’ behavior toward indoor tanning and saw that these female students were addicted to way that tanning made them feel and the way they perceived themselves. Researchers call this attitude “tanorexia” (2011). Many of these female students relied on tanning to make themselves look beautiful and if they did not perform in this behavior in a span of time they felt withdrawl symptoms internally. This is very important for future intervention and prevention programs that wish to intervene on adolescents who indoor tan to realize that it turns into more than a simple indoor tanning problem, it turns into an addictive process that relies on tanning for self-acceptance and a self-appearance of their liking.

Interpersonal Factors

Interpersonal factors are socially influence by friends, family, and norms within their social networks. Interpersonal factors are also influenced on their health behaviors such as meeting with a healthcare physician and having cancer screenings (Pasick et al., 2009).  One key interpersonal factor that is commonly associated with other literature reviews is social networks with friends.  A social network with friends and social acceptance are two major components of whether or not an adolescent will perform in the health behavior in order to please his/her social network (Heckman, 2011). Heckman discusses how “community norms and other factors may be more important influencing indoor tanning behavior” (2011). A relationship that was not mentioned within Heckman’s study was between the adolescent and his/her parent, he only included social networks of friends. Heckman held a study where he recruited female psychology students at an unspecified northeastern university by email. He chose Psychology 2010 because it is a general education requirement and he wanted to see all different individuals view on skin cancer with indoor tanning behaviors. This study based its results off of self-dependence of social norms for the college females, parental relationships were never mentioned (Heckman, 2011).

Interpersonal factors could be altered when being compared to adolescents younger than college aged. Middle and high school children have a more concrete parental relationship because they are around them more so than college students. Another study was conducted and the factors were different, but showed the same result; parental relationships were not addressed as well. This study was conducted to see if the role of media had any effect on the incidence rates of indoor tanning (Myrick, et al. 2017). The relationship that obviously has the biggest interpersonal effect for this study was the norms of media use. In the survey, they found “significant correlations between media use and indoor tanning outcome expectations were found. Use of interpersonal and social media (i.e., talking on the phone, texting, and online social media) were positively associated with positive outcome expectations about indoor tanning and negatively associated with indoor outcome expectations” (2017). This data describes how adolescents will more likely engage in indoor tanning if they see people on social media engaging in indoor tanning. Lastly, the study found that there was not much correlation between news media consumption and the intention between indoor tanning. The correlation was just mainly with the interpersonal factors of social norms and social networks to achieve self-acceptance.

Organizational, Community, Environment and Policy factors

When looking at indoor tanning in regard to policy, organizational, community, and environment factors, a huge factor for environment are the different seasons where an individual is most likely to have fair skin. Many studies have identified that the environment, like the fall/winter reported to tan frequently (Heckman, 2011). Heckman discusses how more individuals who tan in the fall/winter live in the Northeast rather than the spring/summer because the weather permits outdoor tanning during the spring/summer. City 100 points out that in a large environment in which adolescents live in like New York City, there are now more indoor tanning salons than Starbucks and McDonalds in the same city (2006). A negative effect of the easy accessibility for indoor tanning salons is that adolescents are able to go there more frequently. Having an indoor tanning salon at every street corner looks very beneficial for adolescents to go and get the tan appearance that they desire. In a city, the city and state government has complete control over the factors that allow tanning salons to be there. Tanning salons see adolescents who want to fit in with the appearance that they think they need, and the tanning salons take advantage of their weakness.

While these part of the physical environment might not need a physical adjustment, there might be some benefit in encouraging the use of these factors and helping educate the students. One of the biggest misconceptions that is now coming to light is that there is a positive correlation between the total amount of green space in an environment and the amount of physical exercise done by those in the surrounding area. In a literature review that looked at over 50 different article on this topic, only 20 studies found a positive relationship between the total amount of green space and physical activity/health (McCrorie, et al. 2014). The better understanding of this relationship is due to more advance technology such as Global Positioning Systems (GPS) and Geographic Information Systems (GIS) (McCrorie, et al. 2014). With this newer technology, there will likely be many more advancements in the understanding of the relationships between the environment and physical health in the years to come. he two most significant environmental factors that were commonly seen to have a very significant positive effect on the physical activity of students in the area were access to recreational facilities and the proximity of the facilities. In one study, individuals of lower and higher SES were interviewed to determine the needs of the individuals to participate in physical activity, it was found that lower SES individuals sought access to quality facilities (Humbert, et al. 2008). In addition to this one of the concerns with the facilities was that they would be safe (Humbert, et al. 2008). While these were concerns of the lower SES, they are very legitimate factors that must be addressed when looking at college aged exercise such as running. In addition to these factors, a concern that was seen in both groups was the proximity of the facility (Humbert, et al. 2008). If a facility is near by, it is much easier for students to access the facility. This is an important thing to note for colleges that have multiple campuses that might not have a facility readily available to everyone. It has been determined that the greater the access a student has to exercise and recreational facilities, the higher their self reported health (Poortinga, 2006). Going one step further, the most important part of the facility other than overall access are the programs and safety (Brownson, et al. 2009).

Predisposing, Enabling and Reinforcing Determinants

Predisposing variable are determinants that the individual brings with them when they are trying to take on a new behavior. They can be either beneficial or detrimental to the behavior and include things such as beliefs, knowledge, attitudes and genetics predispositions. When looking at beliefs, the vast majority of college students know that running and aerobic physical activity is beneficial to their health. However, their attitudes toward the behavior can be very different. Many of the target students who are not getting the proper amount of physical activity have a fear of judgment. Psychologists have termed this “social phobia” where individuals are scared to be watched running or at the gym because they fear that others will think that they look fat, weak, dumb or even clumsy (Latimer, 1990). Some gyms like Planet Fitness are currently taking approaches to promoting environments where people can feel more at ease. Their current slogan is “We strive to create a workout environment where you can relax and go at your own pace without ever being judged” (Planet Fitness, 2016). However, with this problem, many students have negative attitudes about going to gyms which can be very supportive environments for running and physical activity. Knowledge of what to do and developing a plan for these individuals can help improve this fear. In addition to this “social phobia”, there are difficulties with predispositions of genetic problems and injuries. Some individuals are genetically predisposed to obesity and sedentary behavior. One study looked at certain single nucleotide polymorphisms (SNPs), which are DNA segments and found 6 specific SNPs that are linked to an increase in sedentary behaviors and obesity (Xi, 2011). While there are a lot of negative predispositions and injuries that can make it hard to pick up running and physical activity, there are some factors that can greatly impact overall attitudes about physical activity. One of these factors is the people that a student associates with. If they are a part of a group that is physically active, they are more likely to have a positive attitude about exercising and are thus more likely to participate themselves (Beiswenger, et al. 2010). Enabling factors are environmental factors that can be beneficial or detrimental to students who are trying to take up running or some other kind of aerobic exercise. These factors can be anything from resources, services, and organizations. One enabling factor that was mentioned above and seems to have a very strong effect on students perceived ability to be physically active, is access to a safe facility or recreational organization. Many of these facilities have programs and memberships that can help provide a more supportive environment for college aged students to participate in physical activity and so the easier it is to access these facilities, the higher the rates of physical activity of students (Brownson, et al. 2009). However, there can be difficulty with getting students involved with health promoting organizations because of the “social phobia” mentioned above. In that same article, it was mentioned that many men and women work out for months before feeling confident enough to join a health club (Latimer, 1990). This can be a problem because with less support, a student will be more likely to quit a healthy behavior. Friend groups can also fall under the category of an enabling factor as they can function much like an organization that encourages healthy behaviors. The reinforcing factors can also be beneficial or detrimental to an individual’s health behavior. These are factors that can help a behavior become long term and include things such as praise, support, benefits and consequences. All of the health benefits that result from running and aerobic exercise fall under this category. These benefits include weight loss, a reduced risk for diabetes, improvements of cardiovascular health, more energy throughout the day, healthier immune systems, and lower mortality rates (Biolo, et al. 2005). The benefits that will have the greatest reinforcing effects will be the benefits that are easy to see in the short term such as the weight loss, energy and immune health. In addition to this, all forms of appraisal and support from the organizations and people around the student will help reinforce these behaviors. One difficulty is that many of the consequences like exhaustion, time commitments and sore muscles are very visible when initially starting aerobic exercise and this can be discouraging.

Suggestions for Interventions

How to approach an intervention is largely dependent on who is being targeted. Because Public Health Science generally looks at the health of larger populations, these suggestions will be aimed at targeting groups of inactive students in an attempt to change their behaviors. With all of the different theories and determinants that go into influencing college students and running/aerobic exercise, there are a lot of factors to target in an attempt to increase this behavior for students. One thing that must be considered while looking at all of the determinants is their importance and changeability. If a determinant is important and changeable, it should definitely be targeted, but if it is important and not very changeable, resources might be better used in a situation where change is more likely. In general, things that are not very changeable should be avoided. One of the biggest obstacles to getting individuals to exercise is changing student’s attitudes towards running and aerobic exercise. A theory that would be particularly good for targeting a large population of students with different views and perceptions is the Theory of Planned Behavior. This model is an expectancy value theory meaning that it targets the attitudes and beliefs of the individuals and attempts to change them and thus encourage the behavior. Through proper promotion of education and programs, a university could target the beliefs and attitudes of large populations. This would be much easier and have a greater impact on the masses than the other more individualized theories shown above (Self Determination Theory and Transtheoretical Model). This theory has shown great success in previous applications. In one study where exercise was promoted through the use of positive messages, attitudes of large groups were changed and physical activity greatly increased (Parrott, et al. 2008). It is also important to note that one of the intrapersonal factors that had the greatest impact on attitudes was that the activities should be fun. Promoting organized fun activities might provide even better success than motivational messages.  With the Ecological model, the factors that would be the most changeable and important would be the environmental factors. The interpersonal and intrapersonal factors are much harder to target because they are so individualized. The determinant that seems to have the greatest impact is the proximity of a safe and accessible facility for physical activity (Humbert, et al. 2008). Many college campuses have these facilities, but the struggle with “social phobia” which was mentioned above is still a deterrent. One potential way to help encourage these individuals is through beginners classes that can help provide knowledge and confidence without the fear of judgment from gym regulars.

With any kind of intervention, there needs to be some way to monitor the success. This could be done using some kind of sign in program or email survey to measure how much students are exercising and to determine if the current approach is working. From these results, programs can be better tailored to fit the needs of the school.


There are many benefits to promoting more running and aerobic exercise in college aged students and it is becoming even more important to establish these healthy behaviors in the younger populations as obesity rates are approaching 35% of the entire population (Adult Obesity Facts, 2015). It has been shown that physical activity decreases from adolescence into adulthood. As colleges are often the first place students experience relative independence, there is a lot of potential for targeting the students’ changing behaviors. Through environmental approaches that target the attitudes of the students and provide the knowledge and skill needed to exercise, aerobic exercising and running can be promoted and increased in the college environment.

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The area of Medicine focuses on the healing of patients, including diagnosing and treating them, as well as the prevention of disease. Medicine is an essential science, looking to combat health issues and improve overall well-being.

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