The purpose of this study was to characterize health behaviors and related characteristics among YMCA members as part of examining the need for an intervention focused on weight control and associated behaviors and to provide data to help inform the development of an intervention tailored to this community-focused wellness organization. We surveyed randomly selected members to assess self-reported physical activity, dietary behaviors, and rates of overweight and obesity.
The majority of respondents reported meeting current physical activity recommendations (i.e., 150 minutes per week or more of moderate or vigorous physical activity). The high percentage of respondents meeting this physical activity recommendation is in notable contrast to national studies conducted in the general population, which have shown lower adherence rates [14–16]. This result might be expected given that the respondents were members of a fitness facility at the time of completing the survey. However, there may also have been issues with the self reports of physical activity; we did not have observational or objective data with which to corroborate the self-reported physical activity data. One possibility is that individuals were reporting time spent at the facility, rather than time spent in moderate or vigorous physical activity. The lack of an observed relationship between self-reported physical activity and YMCA usage during the previous three months also suggests that a better measure of time actually spent in moderate or vigorous physical activity at the facility is needed.
Despite the physical activity level reported by respondents, more than half were overweight or obese. The 19% rate of obesity observed among respondents is slightly lower, although consistent with, the 20–24% rate from recent statewide data in Massachusetts . The relatively high prevalence of obesity observed, even among long-term members, suggests that dietary change and higher levels of physical activity might be needed for significant weight loss and control in this population. Few members reported consuming five or more servings of fruits and vegetables per day, which further indicates the need for dietary change interventions. We did not observe the hypothesized relationships between physical activity, dietary behaviors, and weight status and length of membership. These data suggest that membership in a community wellness and fitness facility might not be sufficient to help members control their weight and meet dietary recommendations, and that targeted weight control interventions may be needed. However, as mentioned above, more careful measurement of physical activity within and outside of the fitness facility is necessary to understand the observed results more completely, as is a more detailed and complete assessment of energy intake. In addition, recent data from the trial of an eight-week culturally targeted nutrition and physical activity intervention conducted in a black-owned commercial gym with healthy, obese African-American women indicated that not even free gym memberships and successful nutrition programs were enough for longer-term fitness enhancement [18, 19]. These data indicated that multi-level interventions targeting physical or social/environmental contributors might be necessary for improving weight control over the long term .
In addition to indicating fairly high rates of overweight and obesity in this population, the survey findings suggested that respondents would be receptive to and ready for a weight control intervention. Survey respondents were generally quite interested in changing their physical activity and dietary behaviors and in losing weight. Most respondents were in the preparation stage of change with respect to physical activity and dietary behaviors and had high levels of self-efficacy to change these behaviors, suggesting that they were motivated and felt confident in their ability to change multiple risk behaviors.
The results of the survey also suggested that targeting short-term or newer members of community fitness and wellness organizations such as YMCAs might be an effective channel for reaching underserved populations. Short-term members had lower levels of education and annual household income than did longer-term members, and were also significantly less likely to self identify as white. The potential of community-based organizations such as YMCAs for effectively reaching these underserved audiences with weight control interventions should be explored with additional research.
Interestingly, although these data did indicate some significant associations between sociodemographic characteristics and health behaviors, the directions of the associations were not always consistent with what has been observed in previous research. For example, we did not observe significant associations of education, income, gender or age with fruit and vegetable consumption, as has been found in previous studies [6, 20–24]. Nor did we observe associations between BMI and race/ethnicity, whereas previous studies have indicated that race/ethnicity is an important correlate of overweight and obesity in the general population [14–16]. Further study of these relationships in a larger population of members of community-focused wellness organizations is warranted. Community-based fitness facilities might be particularly successful in encouraging physical activity among individuals of color by providing safe and adequate facilities, for example, an important area for future research.
The limitations of this study are important to consider in interpreting our results. There might be important differences between respondents and non-respondents, as indicated by the less than optimal response rate, which could affect perceived need for and receptivity to a weight control intervention in this population. Less physically active individuals might have refused to participate, for example, as might those who were less motivated or who had less self efficacy to change behaviors. Physical activity, dietary behaviors, and BMI were based on self-report, although we used previously validated measures where possible. We measured physical activity with the short form of the IPAQ, which was created for national and regional surveillance systems and might not be appropriate for a small sample. In addition, social desirability bias might affect reporting of physical activity or weight, because respondents were members of a fitness facility. The motivation to change measure did not exclude individuals already meeting recommendations from the precontemplation group, as it assessed motivation for further behavior change. We did not collect data on previous fitness facility memberships or participation, so it is possible, for example, that short-term members were previously members of different health/fitness facilities or regularly exercised prior to joining this YMCA facility. The survey design was cross-sectional, so the data do not indicate whether respondents were able to maintain recommended levels of health behaviors (e.g., physical activity) consistently over time. We surveyed members of only one YMCA facility, so the results might not be generalizable to other community fitness settings. We did not assess more structural-level correlates, such as location of home or work and whether participants received free/reduced price memberships, meaning that we could not examine possible associations between these variables and individual-level correlates.