Dietary Habits of African Canadian Women: A Sampled Survey

### Abstract

The countless health benefits of adopting healthy eating habits have been well documented. It is troubling then that studies examining dietary behaviors among minority women find that compared with European American women, African American women practice poorer dietary habits. Given this reality, and the knowledge that poor nutrition is a contributing risk factor for chronic, cardiovascular and metabolic diseases, better understandings of minority women and their relationships with food are needed. This study aimed to contribute to this effort by surveying African Canadian women to explore both their eating habits and their perceptions of nutrition. Participants in this study were Canadian women of African ancestry who were 25 years old or older. Fifty of these women chose to participate and did so by completing a brief written survey and answering one open-ended question. Survey results revealed that the respondents rated their present eating habits as “excellent” (6%), “very good” (36%), “good” (40%), or “fair” (17%). Top dietary changes made by participants included reducing salt, fat and/or sugar intake, and/or increasing fruit and vegetable consumption. The open-ended question asked what supports could be put in place to encourage healthy eating and many of the respondents noted that nutritional classes/workshops for black women that could be offered through the community or the church would be beneficial. This study suggests increased efforts are required to further educate African Canadian women about healthy eating as poor nutrition is a significant risk factor for many of the diseases prevalent in black communities. It is imperative that any initiated nutritional education programmes be tailored to meet the cultural and linguistic background of the targeted group in question. Further research is warranted to expand our understandings of African Canadian women’s eating habits and how their food choices affect their overall health.

**Key Words:** minority women, nutrition, health status, diet-related illnesses

### Introduction

Many health professionals agree that the most significant and controllable risk factor affecting long-term health and well-being is diet. Indeed, the first steps commonly suggested for improving health and longevity are lifestyle changes like lowering salt intake, reducing total fat/saturated fat in our diets, increasing fibre intake and fruit and vegetable consumption, and integrating regular exercise into our daily routine. Without a doubt, there are countless benefits to adopting healthy eating habits. It is troubling then that studies in the United States examining dietary behaviors among minority women find that compared with European American women, African American women practice poorer dietary habits. In a number of recent studies for example, African American women were shown to consume less fruits and vegetables, and to eat more foods that were high in sodium and/or fat (1-3). The American Heart Association’s 2009 Heart Disease and Stroke Statistical Update (4) reported that on average, only three to five percent of adult African Americans consumed the recommended three or more daily servings of whole grains, only six to nine percent consumed four or more daily servings of fruit and only five to ten percent consumed five or more daily servings of vegetables.

Research also suggests that poor eating habits are a significant risk factor in the development of chronic illnesses (5) and are known to act as precursors for other risk factors, especially being overweight or obese (4). Not surprisingly then, poor nutrition among African American women is believed to contribute to the higher incidences of diabetes, hypertension and cardiovascular diseases they experience in comparison to White American women. Until minority women’s dietary habits are improved they will continue to be plagued by nutrition related illnesses.

Current literature provides limited explanation as to why African American women have poor dietary practices. What is known from the research is that health disparities, such as lack of access to proper preventative care, stressful lifestyles, lack of education about nutrition, inadequate housing, lower income and the lack of health insurance in the United States, are all believed to be factors in poor health outcomes among African Americans (6). The ongoing disparity in well-being between African Americans and their fellow citizens suggests further efforts are required to identify and implement appropriate strategies to improve this group’s nutritional and overall health status. This study aimed to contribute to this effort by surveying African Canadian women to explore both their eating habits and their perceptions of nutrition. The results of this study provide useful information for health care practitioners and educators seeking to improve health among minority populations.

### Methods

#### Participant Recruitment

The targeted participant group for this study were Canadian women of African ancestry who were 25 years of age or older. The recruitment process involved approaching African Canadian women in shopping malls, medical centers, universities/colleges and churches, providing them with a brief overview of the survey, and inviting them to participate. Those women who agreed to participate were given a consent form to read and sign. Recruitment was not stratified by socioeconomic status as many participants refused to fill out the survey or answer the open-ended question if their income, marital status or educational background was required. After one month of recruitment, 50 African Canadian women agreed to participate in the study.

#### Survey implementation

Each participant was given a written questionnaire to complete. On average, the questionnaire took participants approximately two minutes to finish. Participants were then asked an open-ended question and a digital recorder was employed to record their responses. This oral portion of the survey took approximately one and a half minutes to complete. For the purposes of confidentiality, all the respondents were assigned a file number.

#### Primary outcome measures

The primary outcome measures for the study were to provide some useful insights into African Canadian women’s dietary habits and their awareness of nutrition. It is hoped that these findings lead to open dialogues among health practitioners and educators on how best to promote healthier lifestyles among women of African descent in North America and beyond.

#### Procedures

The survey questionnaire used a likert scale to assess participant’s top dietary approaches to good nutrition; barriers to healthy eating; familiarity with Canada’s Food Guide and its recommendations; motivators in changing dietary habits; sources for nutrition information; nutrition concerns; importance of nutrition to improving Black women’s health and ratings of dietary habits. The open-ended question asked participants to indentify strategies they believed would be useful in promoting healthy eating habits among African Canadian women. With the exception of questions focusing on the link between nutrition and Black women’s health, the survey questions were adapted from the Canadian National Institute of Nutrition: Tracking Nutrition Trends series of surveys (7).

#### Statistical analysis

Analyses of the data were performed using the Statistical Package for the Social Sciences (SPSS) software version 13.0. Responses to the survey questions were coded, allowing the data to be converted into numbers. This descriptive data was then calculated and expressed as means, standard deviations, and percentage except where otherwise noted.

### Results

A total of 50 African Canadian women, ranging in age from 31 to 78 years, took part in the study. All 50 participants completed the survey questionnaire and answered the open-ended question. Based on analysis of survey results only 6% (n=3/50) of the respondents rated their present eating habits as “excellent”, whilst 36% (n=18/50) rated them as “very good”, 40% (n=20/50) as “good”, and 18% (n=9/50) as “fair.” (Table 1). Top dietary changes adopted by participants to improve their nutrition included reducing salt, fat and/or sugar intake, and/or increasing fruit and vegetable consumption.

When asked to identify barriers to adopting good eating habits the participants gave a variety of responses; 52% (n=26/50) of the women cited lack of time to prepare healthy meals, 26% (n=13/50) selected taste as an impediment and 22% (n=11/50) cited lack of desire as an obstacle. Affordability of healthy foods was not selected as a barrier to healthy eating, which may suggest that costs associated with buying healthy foods is not a concern for these women. Interestingly, only 38% (n=19/50) of the sampled women were aware of Canada’s Food Guide, whereas 62% (n=31/50) of the women were not familiar with the guide. Most women who knew of the guide also cited that they were familiar with some of its recommendations regarding daily nutritional needs. 52% (n=26/50) of the women also said that they considered themselves “somewhat knowledgeable” about nutrition, while 22% (n=11/50) reported they were “very knowledgeable”, 18% (n=9/50) “extremely knowledgeable” and 8% (n=4/50) “quite knowledgeable.”

On the topic of how important participants believed good nutrition was in maintaining or improving Black women’s health, 52% (n=26/50) of the respondents answered “extremely important,” 42% (n=21/50) said “very important” and 6% (n=3/50) recorded “somewhat important.” The top three nutritional concerns for participants were consuming too much fried foods (70%, n=35/50), consuming too much sodium (68%, n=34/50) and the presence of trans fat in foods (62%, n=31/50) (Figure 1). In terms of where they typically obtained nutritional information, 56% (n=28/50) of the women reported turning to standard nutrition leaflets/booklets, whereas 28% (n=14/50) consulted with their physician for dietary advice (Figure 2). Participants identified a number of key motivators to improving dietary habits, “having a health condition” (46%, n=23) and “to maintain health” (28% (n=14) were the top two motivators (Table 2).

#### Analysis of Open-ended Question

When asked what strategies could be employed to encourage African Canadian women to adopt healthy eating habits, a number of answers were given. Introducing nutritional workshops/classes through community-based (i.e. church) programs was a suggestion offered by many of the women. For example, one woman conveyed “if there were nutrition classes available in my church I would definitely go,” while another said “I think having some workshops to teach Black people more about good eating is a very good idea…I would go to the classes.” Still another woman echoed the idea of the church as an ideal place to deliver meaningful and effective health promotional messages within the Black community, explaining that “since a lot of black people do go to church, it would be a good thing to have nutrition classes there to learn more about nutrition.” One woman noted that she had heard of Black churches in the United States offering nutrition and exercise programs for their congregations and said “we need something like that in Canada…if we had our own nutrition or even fitness programs available in our community, a lot of us wouldn’t have all this sickness.”

Many of the participants also noted that any educational offerings about nutrition should be made culturally relevant for the African community. For instance, one woman stated, “if they have nutrition classes available for Black people, it should be cultural and to our needs…we eat different from White Canadians and we have different needs,” and another explained “we need our own diet classes to teach us [Black people] how to cook our own foods more healthy……. black people don’t realize that foods from our country are very healthy….we think that we have to eat Canadian foods to eat good.”

### Discussion

Findings from the survey and an open-ended question indicate that African Canadian women hold a variety of opinions about nutrition, and similarly, practice a variety of eating behaviors. A number of the women had made efforts to modify their current diets by either reducing salt and/or sugar intake or by choosing to consume more fruits and vegetables. Time constraints, lack of taste, and lack of desire were all noted as major barriers that prevented some of the women from adopting healthier diets.

One assumption that can be drawn from the survey findings is that reliance on physician advice about diet may not be sufficient (on its own) to produce desired and sustainable behavioral changes in food habits among African Canadian women. Indeed, many of the women in the survey had not sought or been offered advice on proper nutrition from their physicians. In their research, Podl et al. (8) assert that physicians often do not spend the extra time necessary to help their patients make lifestyle changes that could be beneficial to their health. In particular, physicians often do not give thorough advice or provide specific information on proper eating habits either because they have doubts in their ability to deliver this type of information, and/or doubts about its efficacy in leading to lifestyle change (8). A lack of training in or education about, behavioral counselling on healthy dietary practices among healthcare professionals is a major contributing factor to the reluctance in offering lifestyle advice to patients. Unfortunately, medical schools in and outside the United States only briefly cover nutrition in their curriculum, leaving medical doctors insufficient knowledge to provide assistance to patients with dietary and nutritional needs.

In spite of these challenges, it is essential for healthcare practitioners to provide counselling to their patients on preventative health measures (i.e. nutritional counselling) as health tracking studies continue to show a significant rise in nutrition-related illnesses like cardiovascular disease and diabetes in Canada (9).

The survey outcomes also suggest that more attention should be given to educating African Canadian and other minority women about Canada’s Food Guide. Many of the women in the study were unfamiliar with the guide and did not know the daily recommendations for a healthy diet. It is important that dieticians, nutrition educators and health agencies become more proactive in their attempts to promote Canada’s Food Guide in minority communities. Public service announcements from health agencies via local ethnic community newspapers, for example, could help to increase public exposure to Canada’s Food Guide among African Canadians and other minority populations who are thus far unfamiliar with it. More broadly, efforts should be made among healthcare professionals to identify and implement targeted strategies for improving dietary behaviors, and well-being in general, among minority populations in Canada.

It is important to note that there were a number of limitations and challenges with the present study. During the recruitment phase it became clear that participants were not willing to take part in the study if it required revealing their household income, educational or employment background, or marital status. Without this data, it is difficult to determine whether the sample participants were a representative reflection of the wider African Canadian community and to unravel in what ways the outcomes may have been tied to social class. A second challenge was that it was difficult to persuade participants to complete the survey. Concerns about a lack of cultural sensitivity in research studies and distrust of healthcare professionals (especially worries about being misrepresented or used for the benefit of researchers or for-profit companies) were reasons expressed by many of the women who chose not to complete the survey. These sentiments are in line with American studies that have investigated barriers that impede African American participation in clinical research (10). However, this challenge was somewhat overcome since the lead researcher is a members of the African Canadian community, and was able to connect with many of the women and convince them to participate. Nonetheless, the relatively small size of the sample population (50 women) is a limitation. Recruitment of a larger sample of participants, and a greater effort to include social class indicators, would be useful in further studies on this topic.

Finally, the methodology employed in this study did not include focus groups or detailed interviews. Focus groups are a common and useful method for understanding the perspectives of women of African descent as they allow participants to verbalize and express their opinions on selected subjects. In research undertaken by El-Kebbi et al. (11), for example, a focus group structure was employed to identify barriers to dietary self-management among a group of African Americans with type 2 diabetes (11). The resulting data yielded a wide range of identified barriers including the cost of special foods, poor taste of low fat foods, lack of family support, difficulty using the exchange system and reading food labels, and problems changing habitual patterns of behavior. A focus group or in-depth interviews would have been preferable for this study as it would likely have allowed for better insights into the participant’s dietary practices and nutritional beliefs. Thus it is suggested that future research on this topic use focus groups or detailed interviews in order to gain a deeper understanding of African Canadian women and diet.

### Conclusion

Despite the limitations discussed above, the survey did produce significant findings. For one, while African Canadian women are aware that healthy nutrition practices promote good health, it is also clear that more informed awareness, specific information and education would be beneficial. For instance, African Canadian women would benefit from information about how to be aware of portion size, how to read food labels and how to incorporate the Canada’s Food Guide recommendations into their daily meal plans. As the women identified themselves, introducing more community-based nutritional education programmes would be a good starting point for this kind of learning.

The study also reveals that if African Canadian women are to respond positively to any such nutritional education programs, these programs must be tailored to meet the cultural and linguistic background of these women. Initiating community-based dietary education programmes that are specifically for African Canadian women, for example, ought to include educational materials and resources that reflect this population’s cultural background. For instance, since taste was identified as a potential barrier to healthy eating by many of the women in the survey, the programs would need to encourage a consideration of healthier cooking methods, while at the same time, still allowing for the use and enjoyment of traditional foods and ingredients (12). The programs may also need to take into account economic factors affecting this group such as lack of time resulting from under-employment and low wage employment leading to the need to hold two or more jobs; indeed quite a few of the women cited time constraints as a major barrier to adopting healthy dietary practices. This factor would need to be taken into account in the scheduling of the program as well.

It is also suggested that any nutritional education programs be delivered by trained peer educators or volunteers from the African Canadian community. Given a history of past slavery and present racism, many African Canadian women are understandably distrustful and/or uncomfortable with mainstream institutions and experts, particularly when talking of topics as intimate as food and health. In addition, having trainers of African descent helps to ensure the validity of cultural elements and values in the program material/content and allows the trainers to serve as role models. Additionally, it would be helpful for any initiating nutritional programs to teach more African Canadian women about their African ancestors and how they ate, since they ate much more differently than African Canadians do today. With this knowledge, African Canadian women would not have to feel like they were giving up their traditional food. All of these measures increase the probability that African Canadian women would participate in, and be motivated to learn from, any community-based nutritional educational program offerings.

The higher prevalence and increasing rates of diet-related disease among women of African descent suggest that the need for this population to modify their diets is critical. Canada’s health care infrastructure can afford to, and should, expand health promotion programs encouraging healthy lifestyles among Africans Canadians. Designing and implementing culturally sensitive, community-based nutritional education programs would be a positive step in helping women of African descent and other minority communities in Canada adopt healthy diets, while still enjoying their traditional foods. Furthermore, it should be noted that the findings of this study provide some important, initial insights about African Canadian women and their dietary perceptions and practices, and these insights can be extended to women of African descent in North America and beyond. Further research is warranted to better understand African Canadian women’s eating habits and how these relate to their health and well-being. Equally, because physical activity and exercise are associated with dietary behavior, investigating African Canadian women physical activity level is also encouraged.

### Applications In Sport

Poor lifestyle choices increase the risk of developing a number of disease and health complications. However, a combination of regular exercise and/or physical activity along with good eating habits will significantly decrease the risk and is a primary defence for prevention. Very little information is available on African Canadian women as it relates to dietary habits and their exercise behavior. Further research is needed in this area to find effective intervention strategies and to understand African Canadian women lifestyle practices.

### Acknowledgements

The author would like to thank the subjects for their time and co-operation.

There were no specific funding sources for this research survey.

The author has no conflicts of interest to disclose.

### Tables

#### Table 1
Rating healthy habits

Rate Healthy Habits valid % N=50
Excellent 6% 3
Very good 36% 18
Good 40% 20
Fair 18% 9
Total 100% 50

#### Table 2
Key motivators to change / improve diet

key motivators valid % N=50
having a health condition 46% 23
to maintain health 28% 14
to prevent other diseases 12% 6
weight loss 8% 4
look better 6% 3
Total 100% 50

### Figures

#### Figure 1
Top Nutrition Concerns
![Figure 1](//thesportjournal-org-dev.mystagingwebsite.com/files/volume-15/460/figure-1.png “Top Nutrition Concerns”)

#### Figure 2
Source of Nutrition Information
![Figure 1](//thesportjournal-org-dev.mystagingwebsite.com/files/volume-15/460/figure-1.png “Source of Nutrition Information”)

### References

1. Harris, E., & Bonner, Y. (2001). Food counts in the African American community: Chartbook 2001. Baltimore, MD: Morgan State University.
2. Shikany, J.M., & White, G.L. (Dec 2000). Dietary guidelines for chronic disease prevention. Southern Medical Journal. 93: 1138-1151.
3. Bowen, D.J., & ¬Beresford, S.A. (May 2002). Dietary intervention to prevent disease. Annual Review Public Health. 23: 255-286.
4. American Heart Association. (2009). Heart disease and stroke statistical update 2009. Dallas, Texas: American Heart Association. Available at www.americanheart.org/downloadable/heart/1240250946756LS-1982%20Heart%20and%20Stroke%20Update.042009.pdf
5. Hargreaves, M.K., & Schlundt, D.G., & Buchowski, M.S. (Aug 2002). Contextual factors influencing the eating behaviors of African American women: A focus group investigation. Ethnic Health. 7(3): 133-147.
6. Drayton-Brooks, S., & White, N. (Sep-Oct 2004). Health promoting behaviors among African American women with faith-based support. The Association of Black Nursing Faculty Journal (ABNFJ). 15(5): 84-90.
7. Tracking Nutrition Trends VII: The Canadian Council of Food and Nutrition. August 2008. http://www.ccfn.ca/membership/membersonly/content/Tracking%20Nutrition%20Trends/TNT_VII_FINAL_REPORT_full_report_Sept.pdf
8. Podl, T.R., & Goodwin, M.A., & Kikano, G.E., & Stange, K.C. (Oct 1999). Direct observation of exercise counseling in community family practice. American Journal of Preventive Medicine. 17(3): 207-210.
9. A Perfect Storm of Heart Disease Looming on our Horizon: The Heart and Stroke Foundation’s 2010 Annual Report on Canadians’ Health. Available at http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.5761931/k.8118/2010_R….
10. Corbie-Smith, G., & Thomas, S.B., & Williams, M.V., & Moody-Ayers, S. (Sept 1999). Attitudes and beliefs of African Americans toward participation in medical research. Journal of General Internal Medicine. 14(9): 537-546.
11. El-Kebbi, I.M., & Bacha, G.A., & Ziemer, D.C., Musey, V.C., & Gallina, D.L., & Dunbar, V., & Phillips, L.S. (Sept-Oct 1996). Diabetes in urban African Americans. V. Use of discussion groups to identify barriers to dietary therapy among low-income individuals with non-insulin-dependent diabetes mellitus. Diabetes Education. 22(5): 488-492.
12. Mondelus C.V. (2003). Assessing the perceptions of Black American women within Virginia’s faith community regarding health and nutrition practices and their concerns [masters’ thesis]. Virginia: Virginia Polytechnic Institute and State University.

### Corresponding Author

Sherldine Tomlinson, M.Sc
2-440 Silverstone Drive
Toronto, Ont. M9V 3K8
<[email protected]>
1+ (416) 749-7723

Sherldine Tomlinson is the proprietor and a clinical exercise physiologist at the Centre of Chronic Disease & Health Inc. She is also a graduate student at the United States Sports Academy.

2016-10-12T15:02:32-05:00April 9th, 2012|Contemporary Sports Issues, Sports Exercise Science, Sports Studies and Sports Psychology, Women and Sports|Comments Off on Dietary Habits of African Canadian Women: A Sampled Survey

The Lifestyle and Sport Activity of Secretaries

### Abstract

#### Purpose
The aim of the study was to analyse the sports activity and lifestyle of secretaries in Slovenia.

#### Methods
A questionnaire with 37 variables was completed by 104 secretaries from different places within Slovenia. We calculated the frequencies and contingency tables, whereas the statistical characteristics were determined on the basis of a 5% risk level.

#### Results
We established that 26% of the secretaries were obese; most of the time secretaries are sitting down, working with their fingers, and are in forced positions. 56% of the secretaries occasionally take medicines; most of their pain occurs in the neck region, of the back, the shoulder region and in the loins; other common problems include insomnia, emotional exhaustion, and headache. The majority of secretaries engage in sporting activities on the weekend and 2 – 3 times weekly; most of them practiced sport in an unorganized way, with their family or by themselves. A good 20% engaged in an organized sport in a sport club or society, where fitness can also be classified. A good 20% practiced sport in an unorganized way, with their friends. It was established that those secretaries who engaged in an unorganized sport activity were accompanied by their friends or family. Those practicing an organized sport were mainly alone.

#### Conslusion
Secretaries who are frequently active often have a lower Body Mass Index (BMI), take painkillers less often or never, and believe that sport has a great impact on their health.

#### Applications in Sports
Sports clubs and associations should prepare appropriate activities for secretaries which will fullfil their interest, health, and wellbeing.

**Key words:** working conditions, wellbeing, health.

### Introduction

Modern professions are completely different from those undertaken in the past. Cutting-edge technology, robotics, and computer science have disburdened the human labour force and thus caused an increase in the demand and supply of office workers (secretaries, administrators, clerks etc.) whose sedentary jobs are characterized by long hours in forced postures. It is clear to see that the working conditions have drastically changed. Besides that, the leisure time and leisure activity preferences have also changed. According to the results of the latest studies, sport and recreation activities are being promoted and are increasingly gaining ground (13). The effects were first seen with highly educated people as they are aware of the potential negative consequences of a sedentary lifestyle, which is why they include a suitable sport activity in their everyday life (7, 9, 10). The fact that Slovenia is among the top European Union (EU) member states in terms of the physical activity of the population is more than encouraging. However, the latest studies show that 37.91% of adult residents of Slovenia are physically inactive (11). Due to the pressure to achieve higher productivity at work, the desire to be promoted and the aspirations for a higher income there is simply not enough time to engage in sport (8). People of different professions find themselves constantly pressed for time.

The work of secretaries is highly specific. Secretaries spend most of their working time in forced postures, sitting in unventilated offices, looking at a computer monitor most of the time, memorising huge amounts of information, and this all burdens them psychically and physically. Due to the many positive impacts of sport on physical, emotional and mental well-being (the condition of being contented, healthy, or successful) and given the nature of their work, it is highly recommended that secretaries engage in a sport activity (12). Long hours of sitting in front of a computer in a bent posture are detrimental to the human body. An appropriate sport activity can alleviate or even eliminate problems caused by a sedentary job (6). What is meant by appropriate sport activity is a recreational physical activity which positively affects both health and well-being (mood, sleep and self-confidence) (1).

This study aimed to establish the correlation between the sport activity of secretaries and some selected healthy lifestyle factors. For this purpose, a sample of secretaries was surveyed to establish the correlation between secretaries’ sport activity and the characteristics of their living environment as well as between the state of their nutrition and the type of their sport activity. We also established the frequency of health problems which precondition secretaries’ active engagement in sport activities.

### Methods

#### Sample of subjects

The sample included 104 randomly selected secretaries from different parts of Slovenia. The sample was selected at the congress of secretaries. The subjects were aged 23 to 61 years, while their average age was 41. Their jobs included personal assistant, business secretary and administrator.

#### Sample of variables

The study was based on a survey questionnaire consisting of 37 questions which enquired about social, environmental and work factors, the frequency and type of sport activity, nutrition, health condition, and psychical well-being (14). The data acquisition process was carried out in compliance with the Personal Data Protection Act. Subject gave informed consent for this study. The study was approved from the Etics Commission.

#### Data-processing methods

The data were processed using the SPSS-15.0 statistical program at the Computer Data Processing Department at the Faculty of Sport in Ljubljana. The basic statistical parameters and contingency tables were calculated. The subprograms FREQUENCIES and CROSSTABS were used for the calculation. The probability of a correlation between the variables was tested by a contingency coefficient. The statistical significance of the differences was accepted at a two-way 5% alpha error level.

### Results

#### Body characteristics

Body weight and height were self-reported. BMI was calculated from those data. Average BMI for secretaries was 23.7, indicating that the secretaries participating in the study had a normal body weight.

#### Working conditions

The secretaries’ working conditions varied (Table 1): sitting, standing – straight, standing – bending, lots of walking, working with fingers, working with hands, frequent forced posture (head and neck, turn of the torso, deep bending posture). Most secretaries spend almost all day sitting on a chair, working with their fingers and are in a forced postures. 10% of them stated these three combinations and 10% the combination of sitting and working with fingers

#### Taking work home

Secretaries often take work home with them. Sometimes they have to finish assignments at home, at other times they bring home their stress, problems, and burdens. Nearly 70% of the secretaries confirmed they sometimes feel the pressures of their work when at home (Figure 1).

#### Secretaries’ current health condition and their taking of painkillers

Most secretaries (57.7%) assessed their health condition as good. As many as 56% of them occasionally take medicines. It is statistically characteristic that those secretaries who take medicines more frequently less frequently engage in a sport activity. We established that nearly 40% of the surveyed secretaries never take any painkillers. Occasional use was reported by 56% and frequent use by 5%.

#### Secretaries’ injuries in the past three months and health problems

91.3% of the secretaries reported no injuries had been sustained in the past three months. The most frequent pains occurred in the neck, shoulder girdle, and the lumbar part of the spine. Also frequently reported were insomnia, emotional exhaustion, and headache. Other pains occur less frequently.

#### Secretaries’ absences from work

We established that 75.5% of the secretaries had not been absent on sick leave in the past six months. In the same period, 17.6% of the secretaries were on sick leave for less than 14 days. The reasons for their sick leave mainly included respiratory diseases (53.3%), care for other family members (16.7%), and injury at work or outside work (6.7%).

#### Secretaries’ assessment of the impact of sport on their health

It was established that the secretaries were aware of the importance of sport activity for their health, as nearly one-half (45.6%) of them assessed the positive impacts of sport on their health as strong, whereas the rest (53.4%) assessed them as very strong.

#### Frequency of engaging in sport

Most of the secretaries engaged in sport on weekends and 2-3 times a week. Only 4.9% of them stated they never engaged in sport (Figure 2). The time most of the secretaries dedicate to sport ranges from 35 minutes to 2 hours.

#### Types of sport activities

It was established that the secretaries engaged in several different sports at a time. The most practiced sports include cycling, fast walking, mountaineering, and swimming; skiing is also popular. One-quarter of the secretaries practice racquet sports. These sports constitute a type of physical activity which one may adapt to one’s momentary well-being and general physical fitness and, what is more, they enable the venting of psychical tensions typical of a secretary’s work. Degenerative changes in the body are not an obstacle to practicing racquet sports.

#### Method of practicing sport

Most of the secretaries practice sport in an unorganized way, with their family or by themselves. A good 20% of them engage in an organized sport in a sport club or society and the same percentage practice sport with their friends in an unorganized way. Racquet sports are undoubtedly among those activities which require only a small financial input and can be practiced nearly everywhere due to the availability of sport facilities and grounds and the fact that they can be modified to suit individual needs. It was established that those secretaries who engaged in a sport in an unorganized way were accompanied by their friends or family. Those who practiced an organized sport were mainly doing it by themselves.

#### Sport inactivity and motives for sport activity and against it

The reasons for sport inactivity lie primarily in the lack of time, fatigue, and lack of motivation, as well as inadequate organization. The motives for sport activity relate to different reasons: practice sport means to relax, maintain and improve one’s health, maintain and improve one’s physical fitness, and have a good feeling from doing something for oneself.

#### Impact of sport activity on well-being

Most of the secretaries who practice sport are more self-confident and efficient in their work. A good mood and relaxation are typical indicators of well-being and the secretaries reported being full of vitality and energy. They also enjoy better sleep after a sport activity. They reported that their tenacity, strength, flexibility, and adroitness have improved. Most of them claimed they were able to better withstand psychological pressures. All but one agreed they were not tired more than usual after engaging in a sport activity. The same was true for pain in the legs. Only three of them thought that pain in their legs was due to sport activity.

#### Employers’ role in the secretaries’ sport activity

Most of the secretaries believed that sport and recreation belonged to the private sphere of each individual. 20% of them thought that their employer should support their sport activity at least morally. The same percentage of secretaries said their employer sponsored sports events and employees’ sport clubs. Only three secretaries wished for sport activities to be included in the work process (exercises in the workplace, recreational facilities in the company). The employers did not award their employees for sport achievements (Figure 3).

The selected variables (14) were cross-checked using contingency tables in the CROSSTABS subprogram of the SPSS statistical package and the results showed a statistically significant correlation between the BMI and frequency of engaging in sport (k = 0.644, p = 0.001). A more frequent engagement in sport conditioned a lower BMI. The differences between taking medication and a frequent engagement in sport were also statistically significant (k = 0.444, p = 0.034). The more physically active secretaries only rarely took painkillers or never. The assessed health condition and frequency of engaging in sport were also statistically significantly correlated (k = 0.490, p = 0.004). A more frequent engagement in sport preconditioned a good health condition. The secretaries’ opinion on the impact of sport on their health and the frequency of engaging in sport were also statistically significantly correlated (k = 0.593, p = 0.002). The physically active secretaries believed that sport had a strong impact on their health.

### Discussion

The World Health Organization (WHO) defines obesity as excessive fat accumulation that presents a risk to health (1977). Women generally have more body fat than men. Men and women whose fat exceeds 25% and 30%, respectively, are obese. The results of our study showed that 26% of the secretaries were obese. In an extensive study involving the adult population of Slovenia, Zaletel Kragelj and Fras (15) established that as many as 40.1% of the individuals surveyed were obese and 38.5% had a normal weight. This leads us to conclude that the surveyed secretaries had a lower BMI than the Slovenian average. With reference to the above, in the future it would be reasonable to establish the ratio between the muscle mass and fat mass.

Good working conditions are certainly an essential element of the better performance of an employee, which is why good employers always strive for a better working environment for their employees (12). It was established in our research that the secretaries mainly work in the following working conditions: sitting, standing – straight or bending, and lots of walking. The study results showed that the secretaries most frequently sit, work with fingers and in forced postures. Due to such working conditions they should do specific gymnastic exercises several times a day to compensate for their long maintained sedentary positions.

Another important finding of our study was the frequency of taking medication. It these research was established that as many as 56% of the secretaries occasionally take medicines. Other researchers have found similar findings (14). In their research was namely established that the majority of people (even 70%) suffer from various intestinal difficulties for several years as a result of taking painkillers such as ibuprofen. They reported taking painkillers all too often.

Our findings about the secretaries’ injuries in the previous three months are encouraging because as many as 91.3% of the secretaries had sustained no injuries in the said period. We established that 75.5% of the secretaries had not been absent on sick leave in the past six months. In the same period, 17.6% of the secretaries were on sick leave for less than 14 days. The reasons for their sick leave mainly include respiratory diseases (53.3%), looking after other family members (16.7%) and injury at work or outside work (6.7%). The predominant diseases in terms of the percentage of absences on sick leave were diseases of the skeleton and bone system and connective tissues, followed by injuries and infections outside work, with injuries and infections at work occupying third place. In women, frequent reasons for an absence include pregnancy and diseases in the prenatal and postnatal periods (2). This is also comparable with the findings of our research.

As regards the secretaries’ current health conditions, it can be concluded that they correspond with the Slovenian average; however, the latter is considerably higher than that in the EU. A comparison with a relevant EU study reveals that Slovenians are more burdened by health problems caused by work. Nearly every second employee reports pain in the back (45.9%), one-quarter (25.7%) complain about frequent headaches and four employees out of ten (38.2%) suffer from muscle pain. The EU averages are considerably lower (3, 5).

The analysis of the secretaries’ opinions about the importance of sport, frequency, type and method of engaging in sport yielded the results presented in the continuation. We assess the secretaries’ opinion about the importance of sport activity as good. An opinion as such is not enough, but the findings show that the secretaries corroborate their views with concrete activities. Namely, 55.7% of them practice a sport between 35 minutes and two hours mainly two to three times a week. In view of the Slovenian average established by Doupona Topič and Sila (4), namely that the Slovenian active population engages in sport 3.25 hours a week on average, we realised that the secretaries can be classified among the physically active population of Slovenia. In terms of the chosen type of sport activity, with the most popular being cycling, fast walking, mountaineering and swimming, this can be compared to the Slovenian average, for women, where high percentages also represented morning gymnastics, equestrian sports and martial arts (4). Most of the secretaries practiced sport in an unorganized way, with their family or by themselves. A good 20% engaged in an organized sport in a sport club or society, where fitness can also be classified. A good 20% practiced sport in an unorganized way, with their friends. It was established that those secretaries who engaged in an unorganized sport activity were accompanied by their friends or family. Those practicing an organized sport were mainly alone. The results of the Slovenian average show that unorganized sport activities are still predominant in Slovenia as 40.2% of people practice sport in this way. Less than 25% of the population practice organized sports (4). We believe that an employee’s opinion about sport and their method of engaging in sport (unorganized) is also influenced by their employer. Most secretaries (59.3%) answered the question about their employer’s support of their sport activity by saying that the employer considered sport activity as a private sphere of life. 25.3% of employers support sport activity at least morally.

### Conclusion

It has been established that sport activity plays an increasingly important role in the everyday life of the secretaries. Due to specificity of their work which exerts psychical and physical pressure on them secretaries are engaging in sport more frequently. This positively affects their well-being, health, general fitness, and lifestyle. In our sample, the frequency of practicing a sport and the time of practice were comparable to and higher than the Slovenian average for adults of the same age. The type of sport activity was also comparable. In our opinion, more attention should be paid to the organization of sport activities as the majority of secretaries engage in an unorganized physical activity. It was also established that the secretaries hoped for some organized types of sport that would be provided by their employers. The latter insufficiently support their secretaries’ sport activity. Most of them believe that sport is a private sphere of life, not part of work. They support sport activity only morally as they mainly fail to award sport achievements, sponsor sport events or include sport activities in the work process.

### Applications In Sport

The secretaries are aware of their work, presumptions, and life. They proved this with their low rate of absences on sick leave. They should be offered more possibilities for engaging in organized sport activities and be supported by their employers financially, not only morally. Consequently, they will reduce their excessive use of painkillers and alleviate the pain in their neck, lumbar part of the spine and shoulder girdle, which are consequences of the frequent forced postures they must adopt. At the same time, they will also improve their psychical, physical, and social life.

### Acknowledgments

Authors agree that this research has non-financial conflicts or interest. This includes all monetary reimbursement, salary, stocks, or shares in any company.

### References

1. Backović Juričan, A., Kranjc Kušlan M., & Mlakar Novak, D. (2002). Slovenia on the move project – move to health. International conference: Promoting health through physical activity and nutrition. Radenci: 68-70.
2. Bolniški staž. [Sickness absence of the job]. Retrieved August 5, 2010, from Institute of Public Health of the Republic of Slovenia, Web site: <http://www.ivz.si/Mp.aspx?ni=78&pi=6&_6_id=52&_6_PageIndex=0&_6_groupId=2&_6_newsCategory=IVZ+kategorija&_6_action=ShowNewsFull&pl=78-6.0>
3. Dobre delovne razmere v Sloveniji ogrožata visoka stopnja delovne intenzivnosti in zdravstvene težave, ki jih povzroča delo. [Good working conditions in Slovenia threatens a high degree of labor intensity and health problems caused by work]. Retrieved May 17, 2009, from Eurofound, Web site: <http://www.eurofound.europa.eu/press/releases/2007/070917_sl.htm>.
4. Doupona Topič, M., & Sila, B. (2007). Oblike in načini športne aktivnosti v povezavi s socialno stratifikacijo [Types and methods of sport activity in relation to social stratification]. Šport, 3: 12-16.
5. Gibson, S., Lambert, J., & Neate, D. (2004). Associations between weight status, physical activity, and consumption of biscuits, cakes and confectionery among young people in Britain. Nutrition Bulletin, 4: 301.
6. Görner, K., Boraczyński, T., & Štihec, J. (2009). Physical activity, body mass, body composition and the level of aerobic capacity among young, adult women and men. Sport scientific and practical aspects, 2: 5-12.ž
7. Meško, M., Videmšek, M., Štihec, J., Meško Štok, Z., & Karpljuk, D. (2010). Razlike med spoloma pri nekaterih simptomih stresa ter intenzivnost doživljanja stresnih simptomov. [Gender differences in some symptoms of stress and intensity of experiencing stress symptoms] Management, 2: 149-161.
8. Mlinar, S., Štihec, J., Karpljuk, D., & Videmšek, M. (2009). Sports activity and state of health at the casino employees. Zdravstveno varstvo, 3: 122-130.
9. Mlinar, S., Videmšek, M., Štihec, J., & Karpljuk, D. (2009). Physical activity and lifestyles of Hit casino employees. Raziskave in razprave, 3: 63-88.
10. Morabia, A., & Costanza, M.C. (2004). Does walking 15 minutes per day keep the obesity epidemic away? American Journal of Public Health, 3: 437-440.
11. Sila, B. (2007). Leto 2006 in 16. študija o športnorekreativni dejavnosti Slovencev [Year 2006 and the 16th study on sport-recreational activity of Slovenians]. Šport, 3: 3-11.
12. Videmšek, M., Karpljuk, D., Meško, M., & Štihec, J. (2009). Športna dejavnost in življenjski slog oseb nekaterih poklicev v Sloveniji. [Sports activities and lifestyle of some employers in Slovenia]. Ljubljana: Faculty of sport, Institute for kineziology.
13. Videmšek, M., Štihec, J., Karpljuk, D. & Starman, A. (2008). Sport activity and eating habits of people who were attending special obesity treatment program. Collegium antropologicum, 3: 813-819.
14. Zajec, J. (2006). Povezanost športne dejavnosti tajnic z izbranimi dejavniki zdravega načina življenja. (Unpublished bachelor’s thesis). Ljubljana: Faculty of sport.
15. Zaletel-Kragelj, L., & Fras, Z. (2005). Stanje gibanja za zdravje pri odraslih prebivalcih v Sloveniji [The status of the exercise for health of adult population of Slovenia]. In: Expert conference ‘Exercise for Adults’ Health – status, problems, supportive environments. Ljubljana: Institute of Public Health of the Republic of Slovenia, 23-26.

### Tables

#### Table 1
Secretaries’ working conditions

Working conditions Frequency Percentage
Sitting 101 97.1
Standing – straight 11 10.6
Standing – bending 4 3.8
Lots of walking 28 26.9
Working with fingers 54 51.9
Working with hands 35 33.7
Frequent forced posture (head and neck, turn of the torso, deep bending posture) 40 38.5

#### Table 2
Types of sport activities

Sport Frequency Percentage
Cycling 53 57
Fast walking 47 50.5
Swimming 32 34.4
Mountaineering 32 34.4
Skiing 28 30.1
Racquet sports 25 26.9
Dancing 22 23.7
Rollerblading 18 19.4
Aerobics 17 18.3
Morning gymnastics 13 14
Yoga 8 8.6
Volleyball 7 7.5
Pilates 4 4.3

### Figures

#### Figure 1
Percentage of feeling the pressures of work at home

![Figure 1](/files/volume-15/452/figure-1.jpg)

#### Figure 2
Percentage of engaging in sport

![Figure 2](/files/volume-15/452/figure-2.jpg)

### Corresponding Author

assist. Jera Zajec, Ph.D.
University of Ljubljana
Faculty of Education
Kardeljeva ploščad 16, 1000 Ljubljana, Slovenia, Europa
<[email protected]>
gsm: 0038640757335

Jera Zajec, Ph.D. is the assistant professor in Faculty of Education in Ljubljana. She is a member of sport cathedra. Her bibliography contains article all over the word. Her interests in researching are wilde and contains development in motopedagogic for preschool children to adults.

2013-11-22T22:54:24-06:00January 5th, 2012|Contemporary Sports Issues, Sports Exercise Science, Sports Studies and Sports Psychology, Women and Sports|Comments Off on The Lifestyle and Sport Activity of Secretaries

Black Women “DO” Workout!

### Abstract

Many studies cite that women of African descent have lower physical activity levels and/or are more sedentary, than White counterparts. The lack of exercise among Black women results in them experiencing compromised life quality and reduced life expectancy. To combat the striking rates of cardiovascular-related diseases and to increase habitual exercise, health promotion interventions have been initiated designed for Black populations. Female participants in Project Joy, a church-based cardiovascular education programme, reported weight loss and lower blood pressure. This paper reviews a similar initiative; Black Women “DO” Workout! (BWDW), which makes innovative use of social media to encourage physical activity (PA) among Black women.

**Key Words:** women of African descent; exercise; social media

### Introduction

Numerous studies indicate that women of African descent have lower physical activity levels, and/or are more sedentary, than their White counterparts. A 2006 national health survey on physical activity levels in Canada found that when compared to Caucasian Canadian females, both African Canadian and South Asian Canadian women less moderately active (Bryan, Tremblay, Pérez, Ardern & Katzmarzyk, 2004). In a similar American study looking at Black, White, Hispanic and Asian women, the data revealed that only 8.4% of African American women completed the recommended level of regular physical activity (Eyler, Matson-Koffman, Young, Wilcox, Wilbur, Thompson, Sanderson & Evenson, 2003). Unfortunately, this lack of exercise participation among Black women contributes to a significantly increased health risk of cardiovascular-related complications such as hypertension, type 2 diabetes and obesity (Flegal, Carroll, Ogden & Curtin, 2010). A lack of active activities also results in Black women experiencing compromised life quality and reduced life expectancy.

In an effort to combat these striking rates of cardiovascular-related diseases and complications among women of African descent, and to increase their habitual exercise involvement, a number of health promotion interventions have been initiated across North America. These include offerings of free exercise sessions especially designed for Black populations. Evaluative studies of these types of exercise programmes suggest they produce appreciably positive outcomes. The female participants in Project Joy, for instance, an African American church-based cardiovascular education programme, reported weight loss and improvement in blood pressure after participating in the included exercise sessions (Jakicic, Lang & Wing, 2010). This paper reviews a similar programme, Black Women “DO” Workout! (BWDW), which makes innovative use of social media to encourage exercise among women of African descent.

The BWDW initiative was created and founded by Crystal Adell, a fitness enthusiast and personal trainer. Adell uses Facebook as a tool to encourage regular exercise participation among African American women. She describes BWDW as a grassroots movement for championing weight loss and healthy living, a crusade she says is much needed to address the sobering statistics that show 49% of African American women are obese, while approximately 66% are overweight (US Dept of Health and Human Services 2000). Adell notes that using Facebook, which allows her to facilitate communication between Black women, is her “personal attempt to work with a collective who are more than willing to share their fitness goals, services and lifestyle changes towards healthier living”(personal communication, 2010). Information included on the site covers topics from exercising, body image, healthy eating habits and eating disorders to the importance of fitness and nutrition during pregnancy. Adell suggests that the success of BWDW is based on “information sharing and by showing praise, encouragement, inspiration and support in the way of sisterhood and by championing individuals for their fitness goals, which ultimately keep others motivated in to want to do the same”(C. Adell, personal communication, 2010).

There is little doubt that BWDW is a success. Thus far the site boasts more than 85,000 members, mainly women of African descent, many of whom regularly visit and post to the site. While African American women make up the largest block of BWDW users, the site also attracts international members from Canada, England, African and the Caribbean. Launching an online social media page as a means to promote exercise adherence and encourage healthy lifestyles among Black women is clearly a new, unique and successful approach. In addition to being innovative, the strategy is also in accordance with the American Healthy People 2010 mandate to (1) increase quality and years of healthy life and (2) eliminate health disparities that are associated with race, ethnicity and social economic status (US Dept of Health and Human Services 2000). One of Healthy 2010 physical activity and fitness objectives is to increase physical activity levels among Africa Americans as disparities in exercise and/or physical activity levels continue to exist with this group and other populations including Hispanics, the elders and people with disabilities (US Dept of Health and Human Services 2000). Indeed, the Black Women “Do” Workout social media campaign offers the opportunity for women of African descent to make regular exercise and a healthy lifestyle a part of their daily routine.

The BWDW web page is attractive, functional, and perhaps most importantly, interactive. Members are encouraged to participate through such means as submitting healthy recipes to the ‘Chef de Cuisine’ e-cookbook and posting images to the photo album which showcases before and after pictures. There are also announcements about the monthly BWDW ‘meet-ups’ held in locations across the United States for women who want to connect in person, as well as a service that informs members about personal trainers available in their area of the country. And the site has become a space of promotion for several members who now compete in fitness and body building competitions after experiencing significant body transformations via exercise and through healthy eating. In addition, a range of BWDW merchandise are available for sale on the site.

Health policy makers and promoters across North America have acknowledged the need for a better understanding of Black women’s exercise behaviour as a basis for improving their traditionally low physical activity rates. The BWDW programme offers an opportunity for those in the health field to learn from, and about, Black women and provides a potential avenue for the dissemination of health information. Adell herself notes these opportunities, commenting that she would like to see collaboration between BWDW and “organisations like the American Heart Association, Go Red For Women, the African American churches and corporate organisations” (C. Adell, personal communication, 2010). She believes these kinds of partnerships “will allow for an enhancement of services to local African American areas and communities that statistically have a high demand for wellness, health and fitness related support” (C. Adell, personal communication, 2010).

The BWDW programme presents a best practises model for building supportive and effective health networks within communities of African descent. The site has proven to be a powerful tool for increasing exercise rates and thus helping to address the troubling prevalence of cardiovascular-related and other diseases that continue to plague women of African descent. It is hoped the BWDW programme will inspire ongoing dialogue about finding other effective means of supporting Black women to become active, whether via other social media software, or in more traditional in-person venues.

### References

1. Adell, C. (November 2010). Telephone interview with author.
2. Bryan, S.N., Tremblay, M.S., Pérez ,C.E,, Ardern, C.I., Katzmarzyk, P.T. (2006, Jul/Aug). Physical Activity and Ethnicity: Evidence from the Canadian Community Health Survey. Can J Public Health. 2006 Jul-Aug; 97(4):271-6.
3. Eyler, A.A., Matson-Koffman, D., Young, D.R., Wilcox, S., Wilbur, J., Thompson, J.L., Sanderson, B., Evenson, K.R. Quantitative study of correlates of physical activity in women from diverse racial/ethnic groups: The Women’s Cardiovascular Health Network Project–summary and conclusions Am J Prev Med. 2003 Oct;25(3 Suppl 1):93-103.
4. Flegal, K.M., Carroll, M.D., Ogden, C.L., Curtin, L.R. Prevalence and Trends in Obesity Among US Adults, 1999–2008. JAMA. 2010 Jan 20; 303(3):235-41.
5. Jakicic, J.M., Lang, W., Wing, R.R. Do African-American and Caucasian overweight women differ in oxygen consumption during fixed periods of exercise? Int J Obes Relat Metab Disord. 2001 Jul; 25(7):949-53.
6. US Dept of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2000 Washington, DC: Government Printing Office.

### Corresponding Author

Sherldine Tomlinson, MSc.
2-440 Silverstone Drive,
Toronto, Ontario,
M9V 3K8,
<[email protected]>
416 749-7723

2013-11-22T22:58:08-06:00January 3rd, 2012|Contemporary Sports Issues, Sports Exercise Science, Sports Studies and Sports Psychology, Women and Sports|Comments Off on Black Women “DO” Workout!

Body Image Disturbances in NCAA Division I and III Female Athletes

### Abstract

The purpose of this study was to examine and compare eating characteristics and body image disturbances in female NCAA Division I and III athletes in the mainstream sports of basketball, softball, track/cross country, volleyball, soccer, tennis, swimming/diving, and ice hockey. Female collegiate athletes (N = 118) from Division I and III universities completed the EAT-26 and MBSRQ. Personal demographics and anthropometric data including height, weight, BMI and Body Fat estimates were also assessed. The study found that 49.2% (Division I) and 40.4% (Division III) of female athletes were in the subclinical eating disorder range. Results assessing body satisfaction, reported that 24.2% of Division I female athletes and 30.7 % of Division III female athletes were either very dissatisfied or mostly dissatisfied with their overall appearance. Results also showed that Division I female athletes were less satisfied with their appearance evaluation (body areas satisfaction, and lower torso). Division III female athletes reported higher levels of bulimic behaviors and weight preoccupation. The results indicate that athletes in refereed female sports are at risk for eating disorders, and that body image risk factors vary between NCAA competition divisions. This research provides sport professionals with a better understanding of risk factors influencing the prevalence of eating disorders between female athletes’ divisional competition levels.

**Key words:** body dissatisfaction, eating disorders, NCAA division, collegiate female athletes, eating disorder risk factors

### Introduction

Eating disorders are among the four leading causes of disease that may lead to disability or death (2). Eating disorders have the highest mortality rate of any mental health illness (41). Approximately nine million Americans suffer from an eating disorder with a lifetime prevalence rate of 0.9% – 4.5% and approximately 10% of college women suffer from a clinical or near clinical eating disorder (19,22).

Body image refers to the self-perception and attitudes an individual holds with respect to his or her body and physical appearance. Body image is a complex synthesis of psychophysical elements that are perpetual, emotional, cognitive, and kinesthetic. Cash and Fleming (10) defined body image as “one’s perceptions and attitudes in relation to one’s own physical characteristics” (p. 455). Body dissatisfaction focuses on body build and is often operationalized as the difference between ideal and current self selected figures (7).

Body dissatisfaction is a significant source of distress for many females. Gender is reported to be a convincing risk factor for disordered eating since females are 10 times more likely to develop an eating disorder compared to males (14). Research shows that the size of the “ideal” woman is far smaller than the size of the average woman (25). “The overwhelming evidence of female gender as a risk factor for the development of an eating disorder highlights the importance of determining the factors that put women at risk, particularly the sociocultural context in which these disorders develop” (31, p. 766).

Risk factors that accompany eating disorders are multi-factorial in nature. Research has revealed that sociocultural, developmental, personality, athletic, trauma, familial, and biological factors are critical identifiable areas that house potential eating disorder risk factors (31). Within these specific areas, body image dissatisfaction and low self-esteem are two situational aspects typically associated with individuals who are at risk for developing an eating disorder. In an early study on body dissatisfaction (5), 23% of the women expressed dissatisfaction with various parts of their body. The particular areas problematic for women were the abdomen, hips, thighs, and overall weight. When the study was replicated in the mid-1980s (11), the percentage of females dissatisfied with their body increased to 38%, with the same general body areas being defined by the participants. These same general body areas were also identified in a more recent study (16) in 56% of women.

Considerable scientific attention has been directed toward the potential role that sport involvement play in an athletes’ development of attitudes and behaviors about disordered eating. Female athletes experience a higher rate of eating disorders than non-athletes (4,24,43). Female athletes have an eating disorder prevalence of 15% to 62% compared to 0.5% to 3% in late adolescent and young adult female non-athletes (21). Researchers (33) assessed disordered eating in female collegiate athletes (N = 204) from three NCAA universities. The responses to the Questionnaire for Eating Disorder Diagnoses (Q-EDD) found 72.5% (n = 148) of the female athletes were asymptomatic, 25.5% (n = 52) symptomatic, and 2.0% (n = 4) eating disorder (29). Compared to recent research (8,39), this research study found a higher percentage of female athletes who were symptomatic. Athlete’s prevalence rate is an important factor, but understanding variables associated with increasing or decreasing risk factors for disordered eating is significant etiological information that should be evaluated (32).

Athletic factors promoting eating disorder development were first identified through research that began in the 1980s, which found particular sports induced higher rates of disordered eating behaviors (1,17). Even though physical activity may develop self-esteem and encourage physical and emotional well-being, there is verification that female athletes are at greater risk for developing disordered eating than their peers who are non-athletes (6). Female athletes encounter the same sociocultural pressures that of non – athletes, however the increased demand of sport – related pressures may independently or dependently increase their risk of eating disordered attitudes and behaviors (40). Coaches, sponsors, and families may all play a role in influencing an athlete’s weight and shape. Negative comments from those that surround and evaluate the athlete may trigger the onset of abnormal eating behaviors leading to an eating disorder (12,28).

The type of sport may also play a role in predisposing an individual to eating disorders based on struggles with body performance satisfaction. Specific sports where performance is judged on body leanness, shape and movement such as ballet, gymnastics, figure skating, diving, and cheerleading have a higher incidence of eating disorders (1,42,47). Shape judged sports such as gymnastics, diving, cheerleading, and dance place more importance on the individual’s body appearance, which may lead to body shape discontent among competitors (47). Researchers also report that 15% to 65% of women in “thin build” sports such as gymnastics or ballet have pathogenic eating patterns known to influence or manipulate the history and development of the eating disorder (27,44). Participation in competitive “thin build” sports in conjunction with personality traits associated with disordered eating could put these individuals at an even greater risk for developing an eating disorder (15, 44). The personality trait of many perfectionist increase disordered eating behaviors for female athletes (20). Researchers (26) compared athletes and non-athletes and reported perfectionism was the only factor that significantly distinguished the groups. In addition, Wilmore (46) reported that athletes high in perfectionism had an increased drive for thinness than athletes low in perfectionism. Refereed sports such as basketball place a stronger emphasis on training and do not rely as much on body appearance; therefore athletes participating in these sports may be less likely to be associated with disordered eating patterns (47).

Most research to date focuses on Division I female athlete’s prevalence rates, while female athletes regardless of NCAA division, experience similar sport specific pressures associated with body image disturbances. Limited research has compared prevalence between NCAA divisions, eating attitudes, and body image disturbances in female athletes. Research has reported that the prevalence of disordered eating, unhealthy dieting, and distorted body image in the athletic population ranges from 12% to 57% (30). Elite female athletes who suffer from eating disorders put themselves at greater risk for serious illnesses and/or death (38). Research has shown that more than one-third of female Division I NCAA athletes report attitudes and symptoms placing them at risk for an eating disorder (2). The National Collegiate Athletic Association study that surveyed student athletes from 11 Division I schools (N = 1,445) reported 1.1% of the female athletes met DSM-IV criteria for bulimia nervosa while 9.2% of female athletes had clinically significant symptoms of bulimia nervosa. This study also reported 0% female athletes met the DSM-IV criteria for anorexia nervosa while 2.85% of the female athletes had clinically significant symptoms of anorexia nervosa (24). Researchers believed the results suggest that Division I female athletes are at significant risk for the progression of eating disorder thoughts and behaviors. The study also stressed the need for future research to examine non-elite Division I, II and III schools since eating disorder risk factors may be higher among lower tier schools. Comparing divisional levels of competition in NCAA athletics could be an important aspect to understanding risk factors involved in the developmental process of an eating disorder.

The purpose of this study was to examine and compare eating characteristics and body image disturbances in female NCAA Division I and III athletes in mainstream sports of basketball, softball, track/cross country, volleyball, soccer, tennis, swimming/diving, and ice hockey. This study also examined female body part dissatisfaction and eating attitudes utilizing the Multidimensional Body Self-Relations Questionnaire (MBSRQ) and Eating Attitudes Test (EAT-26). These findings may assist coaches, strength and conditioning coaches, and athletic trainers in understanding disordered eating and body image disturbances across various female sports in different competition divisions.

### Methods

#### Participants

Participants (N = 118) included Division I (n = 41) and Division III (n = 87) female athletes from National Collegiate Athletic Association (NCAA) member institutes of the following sports: basketball, softball, track/cross country, volleyball, soccer, tennis, swimming/diving, and ice hockey. The convenient sample participants were voluntary, anonymous, and in accordance with university and federal guidelines for human subjects.

#### Instruments

Each athlete completed questionnaires assessing participant demographics and athletic involvement (sport, division). Eating behavior patterns were assessed utilizing the Eating Attitudes Test (EAT-26) and attitudes concerning body image were assessed with the Multidimensional Body-Self Relations Questionnaire (MBSRQ). Anthropometric measurements (height and weight) and body fat measurements were taken on each athlete. (Omron Fat Loss Monitor, Model HBF-306C). The Fat Loss Monitor (Omron Fat Loss Monitor, Model HBF-306C) displays the estimated value of body fat percentage by bioelectrical impedance method and indicates the Body Mass Index (BMI). The bioelectrical impedance, skinfold, and hydrostatic weighing methods have all been shown to be reliable measures of body composition (r = .957 – .987) (23).

##### Eating Attitudes Test (EAT-26)

Eating Attitudes Test (EAT-26) was used to differentiate participants with anorexia nervosa, bulimia nervosa, binge-eating, and those without disordered eating characteristics. It is a 26-item measurement consisting of three subscales: 1) dieting, 2) bulimia and food perception, and 3) oral control. Scoring for this instrument was a Likert scale of six possible answers (always, usually, often, sometimes, rarely, never). Scores ranged from zero to three for each question and a total score greater than 20 indicates excessive body image concern that may identify an eating disorder (Garner et al., 1982; Williamson et al., 1987). EAT-26 has been proven to be a reliable measurement (r = .88) (17). The total score of the EAT-26 and the Drive for Thinness scale of the Eating Disorder Inventory (EDI) have reports of a 90% agreement (37).

##### Multidimensional Body-Self Relations Questionnaire

The Multidimensional Body-Self Relations Questionnaire: The Multidimensional Body-Self Relations Questionnaire (MBSRQ) is a 69 item self-report inventory for the assessment of self-attitudinal aspects of the body image construct. The MBSRQ measures satisfaction and orientation with body appearance, fitness, and health. In addition to seven subscales (Appearance Evaluation and Orientation, Fitness Evaluation and Orientation, Health Evaluation and Orientation, and Illness Orientation), the MBSRQ has three special multi-item subscales: (1) The Body Areas Satisfaction Scale (BASS) approaches body image evaluation as dissatisfaction-satisfaction with body areas and attributes; 2) The Overweight Preoccupation Scale assesses fat anxiety, weight vigilance, dieting, and eating restraint; and 3) The Self-Classified Weight Scale assesses self-appraisals of weight from “very underweight” to “very overweight.” Internal consistency for MBSRQ subscales range from .74 – .91. This questionnaire has been studied and used extensively in the college population. Internal consistency for the subscales of the MBSRQ ranged from .67 to .85 for males and .71 to .86 for females (9).

### Results

#### Descriptive statistics

Participants in the study included 118 female athletes from NCAA Division I (34.7%) and Division III (73.7%) universities. Participants reported their ethnicity as 80.5% White (n =95), 16.1% Black (n =19), .02% Hispanic (n =2), .01% Asian (n =1), and .01% as other (n = 1). The female athletes had a mean age of 19.81 years + 1.29 and a mean body fat percentage of 21.17% + 5.07 (Table 1). There was no significant difference between the divisions in regards to body fat percentage F (1,117) = .727, p = .395.

#### Test for Significance

A multiple analysis of variance (MANOVA) was conducted to determine the effect of NCAA Divisional Status (I or III) on eating characteristics and body image (Table 2). Significant differences were found between Division I and III, Wilks’s Lambda = .664, F(17, 114), p<.0001.

##### Disordered Eating Behaviors

Base frequency scores indicated that 49.2% of Division I female athletes and 40.4% of Division III female athletes scored a 20 or higher on the EAT-26. A follow – up ANOVA reported no significant differences between 20 or higher EAT-26 scores and NCAA Division, F (1, 117) = 1.732, p = .190. A significant difference was found between divisions on the bulimia subscale of the EAT-26, F (1, 117) = 9.107, p = 003. No significant differences were found between division for the EAT-26 dieting subscale, F (1, 117) = .125, p = .724 and oral control subscale F (1, 117) = 2.123, p = .148.

##### Body Disturbance

The results of the MANOVA indicated a significant difference between divisions on the MBSRQ, F(17,114 ) = 3.391, p = .000. The results of the MBSRQ, which assessed body satisfaction, found that 24.2 % of Division I female athletes and 30.7 % of Division III female athletes were either very dissatisfied or mostly dissatisfied with their overall appearance. In addition, a difference was found between Division I and III athletes for appearance evaluation, F (1, 3) = 10.525, p = .001, body areas satisfaction F (1, 3) = 8.36, p = .004, lower torso F (1, 3) = 5.975, p = .016, and overweight preoccupation F (1, 3) = 17.895, p = .000. Division I female athletes were less satisfied with their appearance evaluation, body areas satisfaction, and lower torso than Division III female athletes. Division III female athletes were more weight preoccupied than Division I female athletes.

### Discussion

The main purpose of this study was to examine and compare the eating attitudes and body image satisfaction in female NCAA Division I and III athletes in mainstream sports of basketball, softball, track/cross country, volleyball, soccer, tennis, swimming/diving, and ice hockey. Limited research is available comparing eating disturbances between NCAA divisions so the information acquired may help explain the prevalence of body image disturbances and eating disorder among college female athletes at different levels of competition.

The results of this study indicated that 49.2% (Division I) and 40.4% (Division III) of the female athletes scored 20 or higher on the EAT-26, putting them in a subclinical eating disorder range (18). Comparative research studies using the EAT-26 reported percent subclinical populations of females athletes to be 15.2%, N = 425 (3); 5.8%, N = 190 (13); and 10.2%, N = 59 (36). The current research study did not find a significant difference between subclinical population scores and division, however both Division I and Division III female athletes had a considerably higher subclinical eating disorder female athletic population compared to these previous studies. This finding may be an important implication because the desire to be thin does not always result in clinically diagnosed signs and symptoms of anorexia or bulimia. If left undetected, subclinical eating disorders may result in dysfunctional social interaction, decreased physical performance reduced physical health, and an increase in the propensity for athletic injury.

Between divisions, a significant difference was found on the bulimia subscale of the EAT-26. Division III female athletes struggled more with bulimic behaviors compared to the Division I female athletes. This finding agrees with previous research suggesting that disturbed eating behavior may be higher among lower tiered athletes (35). Bulimic behaviors may be viewed as more destructive to athletic performance so the elite competitive athletes (Division I) may be deterred from participating in such behaviors. Bulimic behaviors may also require a greater level of secrecy, so elite competitive female athletes competing may avoid such behaviors due to increased time commitment, travel requirements, and contact they experience with their coaches and athletic trainers.

It has been reported that female athletes participating in judged sports such as gymnastics, cheerleading, and dance are more prone to eating disorders compared to those who participate in referred sports such as basketball, swimming, and softball (26,34,47). The assessment of body satisfaction through the MBSRQ found that 24.2 % of Division I female athletes and 30.7 % of Division III female athletes were either very dissatisfied or mostly dissatisfied with their overall appearance. We believe that our findings warrant further investigation into the relationship of female athlete’s body dissatisfaction and those participating in referred sports.

A significant difference was also reported on the MBSRQ subscales between Division I and III athletes for appearance evaluation, F (1, 3) = 10.525, p = .001, body areas satisfaction F (1, 3) = 8.36, p = .004, lower torso F (1, 3) = 5.975, p = .016, and overweight preoccupation F (1, 3) = 17.895, p = .000. Division I female athletes were less satisfied with their appearance evaluation, body areas satisfaction, and lower torso than Division III female athletes. Division III female athletes were more weight preoccupied than Division I female athletes. A performance-related drive for thinness through appearance evaluation, body areas satisfaction and lower torso may have a greater impact on female athletes that compete in higher level divisions such as Division I. Being weight preoccupied may not be as closely associated with physical performance measures as compared to general body dissatisfaction.

Even though this was a well-designed study and used a diverse sample of female athletes, it is not without limitations. The participant sample was limited in racial/ethnic minorities, therefore future research should examine female athletic samples with greater racial/ethnic diversity. This research also compared Division I female athletes to Division III female athletes. Increasing the number of institutes and divisions would greatly benefit the findings of this study. Lastly, although a diverse group of female athletic teams was represented in this study, equal number of female athletes from each team was not available due to the sports each institution offered, scholarships, and general participation. For example, ice hockey could only be evaluated at the Division III level. It is possible that the results would have varied if there were equal participant representation. Future research should examine a greater number of institutions at varied divisions to increase participant representations among each sport.

### Conclusion

Our results indicate that refereed female sports are at risk for eating disorders and body image risk factors vary between NCAA competition divisions of female sports. Body dissatisfaction factors that may lead to serious eating disorders will continue to impact the female athletic audience due to added pressures innate to sport performance. Female athletes, regardless of sport, show evidence of risk for developing an eating disorder. Understanding what motivates the developmental process to accelerate in sport may vary depending on level of competition. The educational and scholarly implications of this research project include contributing to the body of literature in the area of body image and eating attitudes of female athletes and providing professionals with a better understanding of the risk factors that influence the prevalence of eating disorders at varied levels of competition.

### Applications in Sport

These findings may assist coaches, strength and conditioning coaches, and athletic trainers in understanding disordered eating and body image disturbances across various female sports in different competition divisions. Professionals that work with female athletes understand the sensitive nature of optimizing performance without compromising overall health. Recognizing and identifying prevention indicators for body image disturbances that lead to disordered eating will assist professionals when dealing with at risk female athletes in varied levels of competition of referred sports. This information will also greatly benefit programs aimed at ceasing the progression of disordered eating

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### Corresponding Author

Kim Kato, Ed.D.
PO Box 13015, SFA Station
Nacogdoches, TX 75962-3015
<[email protected]>
936-468-1610

Dr. Kim Kato is an Assistant Professor in Health Science in the Department of Kinesiology and Health Science at Stephen F. Austin State University in Nacogdoches, Texas.

### Authors

**Kim Kato**, EdD, NSCA-CPT
Stephen F. Austin State University

**Stephanie Jevas**, PhD, ATC, LAT
Stephen F. Austin State University

**Dean Culpepper**, PhD, CC-AASP
Lubbock Christian University

2016-04-01T09:52:41-05:00September 30th, 2011|Contemporary Sports Issues, Sports Coaching, Sports Management, Sports Studies and Sports Psychology, Women and Sports|Comments Off on Body Image Disturbances in NCAA Division I and III Female Athletes

Women’s Perspectives of Personal Trainers: A Qualitative Study

### Abstract

Personal trainers play an integral role in the day-to-day operation of the facilities in which they work. Research has identified a number of qualities and competencies necessary to be an effective exercise leader, but there is little scholarly work addressing clients’ attitudes related to the performance of personal trainers. Utilizing focus group methodology, female clients of personal trainers were recruited to provide viewpoints related to the desirable qualities of personal trainers, as well as opinions regarding trainer certification and academic preparation. Responses of the participants were transcribed, coded, and analyzed for themes. Four global themes emerged: Selection Rationale, Personal Trainer Rationale, Loyalty Rationale and Negative Characteristics. Selection Rationale consisted of qualities that influence a client’s decision to hire a particular trainer (e.g., physique, results observed in other clients, social skills). Personal Trainer Rationale referred to the clients’ reasons (e.g., frustration with current fitness level) for hiring a specific trainer. Loyalty Rationale referred to the credentials of a personal trainer that solidify the client/trainer relationship and Negative Characteristics referred to qualities considered unethical or unprofessional. The results suggest that undergraduate exercise science programs should devote additional time toward the development of future fitness trainers’ affective qualities and that clients would benefit from information about the credentials of personal trainers.

**Key words:** qualifications, certifications, credentials, licensure, attitudes, dispositions

### Introduction

Low levels of physical activity, like many other lifestyles activities (e.g., smoking), are strongly correlated with coronary heart disease, the leading cause of death in the United States (4). Lack of physical activity is also associated with asthma, type 2 diabetes, some cancers, impaired psychological status, bone and muscle problems, and decreased life expectancy (5). Despite this well-documented relationship, 37.1 % of adults have insufficient physical activity (6). Of those who do adopt an exercise program, it is estimated that 50% will discontinue it within the first six months (10), making exercise adherence a critical issue. Factors affecting adherence are complex, but an important one is a client’s perception of support from their personal trainer (28).

The significance of personal trainers has been demonstrated in several studies. Ratamass et al. (23) compared individuals trained by personal trainers to individuals working out on their own. Results showed that both1 Repetition Maximum and Ratings of Perceived Exertion scores were significantly higher in individuals who worked under the supervision of a personal trainer. Similar results were noted in studies by Maloof et al. (17) and Mazetti et al. (18). Quinn (23) suggests that part of the advantage of working with trainers relates to motivation, and that, “certified personal trainers can provide structure and accountability, and [can] help … develop a lifestyle that encourages health.”

Personal trainers, as well as club managers, believe that clients are more likely to stay with a program if the trainers exhibit the attributes of empathy, listening skills, and motivation skills (21). In addition, McGuire, Anderson, and Trail (19) report that important components of clients’ satisfaction with their fitness clubs relate to the leaders’ social support skills and instructional competency. Despite these findings, little is known about how a trainer’s qualities, including training and certification, are viewed from the client’s perspective. Several theoretical models explain the adoption and maintenance of exercise behavior (14), but little research has examined these factors in an applied exercise setting.

Finally, women are a growing majority of all health club members, accounting for 57 percent of the grand total in 2005 (13). Within the commercial club category, women constitute 60% of the national membership. In addition, studies have shown that the majority of those clients who hire trainers are female (25). Because these statistics indicate that women are primary consumers of health club memberships and training sessions, this study focused on female clients. The purpose of this study therefore, is to use an applied setting in which to systematically investigate attitudes of female clients toward the dispositions, certification, and education of personal trainers. To the authors’ knowledge, this study is the first scholarly examination of the current state of personal training from this perspective.

### Methods

#### Experimental Approach to the Problem

The data collection was qualitative and interpretive in nature. The study used the three key assumptions of the qualitative research paradigm: 1) there are no “wrong” answers; only diverse opinions, 2) there is a potential influence of the inquirer (see Limitations section of this paper) and respondent relationship, and 3) the goal is to describe findings within a particular situation (29). This interpretive perspective used grounded theory, or theory that emerges from the data (9). Therefore, this type of inquiry is not a critical or empirical comparison to existing theory.

The investigation used a focus group to examine the overarching question, “What qualities are important to be a successful personal trainer?” The focus group interview offered compatibility with the qualitative research paradigm, opportunity for direct contact with subjects, and the advantages of group format (29). This research was conducted with clients of personal trainers. Global themes, major themes, and sub-themes were selected from the transcriptions. Evidence of credibility, reliability, and trustworthiness was provided in several ways. First, three different readers were used, bringing their varying perspectives to the group. Second, the data presented represents consensus reached via thorough discussions among individuals (readers) with expertise in personal training, exercise physiology, health behavior, and qualitative research methods. Finally, the investigators sent a one-page summary (a member check) to the participants and asked for feedback and clarifications and/or additions they would like to make. The study design was identical to that used in two previous studies which examined the current state of personal training from a personal trainer point of view (20) as well as from a manager point of view (21).

#### Role of the Investigators

The primary investigator was a personal trainer for 10 years before devoting her time to teaching exercise science classes at the university level. She is a certified Health Fitness Specialist with the American College of Sports Medicine, and a Certified Strength and Conditioning Specialist with the National Strength and Conditioning Association. She is also a certified group exercise instructor with the Aerobics and Fitness Association of America (AFAA), as well as a certification examiner for their organization. She has developed and maintained close relationships with both clients and personal trainers and is very familiar with the issues surrounding this profession.

#### Subjects

Subjects included 5 female clients of personal trainers (M age= 36.2 years, with a range of 24-50 years). Detailed demographic information for the subjects is represented in Table 1.

#### Procedures

##### Surveys

Volunteers were randomly solicited from four health clubs in a small southeast community. This selection process involved recruitment through posted flyers as well as by word-of-mouth contacts. Subjects were either personally provided with or mailed a packet including: 1) a demographic/survey sheet, including name, address, age, occupation and education; 2) questions related to certification of trainers; 3) an informed consent form approved by the university Internal Review Board committee, explaining that the participants would be video- and audio-taped during the focus groups; and 4) a list of the questions that would be probed so that the participant could reflect on these prior to the meeting. Finally, in addition to the focus group interview and audiotapes, the surveys were used as a third method for triangulation of the data. After collecting all the demographic/survey sheets, participants were contacted via telephone and asked to participate in the focus groups.

##### Focus Groups

Subjects who agreed to participate were given a list of the questions that would be discussed prior to the focus group meeting. These questions were:

1. Why did you decide to hire a personal trainer?
2. What attracted you to a particular trainer?
3. What characteristics kept you coming back to the same trainer?
4. Do you know the qualifications of your trainer?

a. If you do not know, how do you know that you are getting what you paid for?
b. Does it matter if they have certifications?
c. Do you know which certifications are the most respected?
d. If you knew that not all trainers had a nationally recognized certification, how would you feel about that?
5. Have you experienced any unethical behavior with a trainer?

a. If yes, what was the nature of this behavior?
b. Even if you have not experienced it, what do you consider to be unethical?

The focus group comments were recorded using a Marantz audio-recording system and videography (60 Hz). In addition to the informed consent, participants also signed a confidentiality agreement within the group. The confidentiality statement included the investigator’s agreement not to disclose names, as well as the participants’ agreement not to disclose or discuss what was said in the interviews with other participants or individuals outside the designated focus group time. Furthermore, anonymity was assured by removing participants’ names on the final transcripts, and by replacing real names with pseudonyms (see Table 1). A moderator’s guide, (29) was used in each of the focus groups. The focus groups lasted approximately 2 hours with an emphasis on each participant getting equal amounts of speaking time (29).

#### Statistical Analyses

The focus group audio tapes were transcribed verbatim. The three investigators read and re-read each of the three transcripts and searched for key phrases emerging from the data. Key phrases were defined as those that occurred at least five times within the transcript, as the three investigators concurred that this arbitrary number was sufficient to denote a key phrase. The investigators converted the key phrases into codes and then examined the transcripts line by line, inserting the codes where appropriate. After consensus was reached concerning the coding of each line of transcript, the codes were entered into Ethnograph©, a computer program used for qualitative data analysis. In order to determine credibility and reliability, three different readers were used, bringing their varying perspectives to the group. All three read the transcripts, as well as reviewed the audio- and videotapes. This lessened the risk of allowing the primary investigator’s biases to strongly affect emergent themes. A bracketing interview was also completed to lessen this risk. In a bracketing interview, the primary investigator was asked the same questions her participants would be asked, and she answered them from her own perspective and in as much detail as possible. This was in order for her biases as a former personal trainer to be made clear to her and to the other investigators. Throughout data collection and analysis, the interview was referred to, so that her biases would not override the actual perceptions of the participants. Additionally, a member check was employed; the investigator sent a one-page summary to the participants and asked for feedback and any clarifications and/or additions they would like to make. Trustworthiness of data was established through two methods of triangulation: three data collection methods, and three different perspectives concerning the research question. The data collection methods were the focus group interview, the videotape, and the survey.

### Results

The results are reported by themes that emerged from each research question. Figure 1 depicts the hierarchical organization of the clients’ responses into global, major, and sub, and mini-themes. The global themes and their sub-factors are described therein.

#### Personal Trainer Rationale

The first global theme that emerged from the client focus group was Personal Trainer (PT) Rationale which refers to the clients’ reasons or motivations for hiring a personal trainer. Participants in the focus group provided a rich and detailed account of their motives for hiring a personal trainer. The discussion of PT Rationale produced two major themes, including Frustration and Motivation. The clients expressed frustration over their inability to achieve fitness and/or physical appearance goals, such as weight loss, muscular strength, or just the ability to fit into certain clothes. Lorraine stated,

> I just got sick of the way I looked in the mirror naked. I didn’t like the way clothes fit; I didn’t like becoming a plus-size girl at 21 years of age. And, once at the gym, I asked to use the body fat percentage machine. [As the trainer] gave it to me, I was voicing my frustration and he said something about, ‘Oh, you need to lift’ and I [said], ‘Great, I’ll be here in the morning’. And that’s how I got started.

The clients also reported a desire to work with someone who could help them sustain motivation. Clients felt they could not generate the motivation necessary to adhere to regular exercise, and wanted a trainer to motivate them to work harder during a workout session. To illustrate, Carla said that her biggest problem was just getting herself to the gym: “Motivation for me, and for probably most of the population that’s overweight, [is] what they need”.

In summary, it appears that the clients’ incentives for seeking a personal trainer originated from the negative effect or frustration associated with their failure to achieve fitness/physical appearance goals. Additionally, they sought personal trainers to maintain their motivation once in an exercise program. These major themes led to a sub-theme, Body. Clients were frustrated with their physical appearance, and they expressed the need to hire a personal trainer who would help to create the motivation required to change their bodies and to achieve results (e.g., lose weight, gain muscle tone). Once the decision to hire a personal trainer was made, the clients used certain criteria to evaluate potential trainers in order to select someone who most suited them. These criteria are considered next.

#### Selection Rationale

A second global theme for the clients of personal trainers was labeled Selection Rationale (see Figure 1). While PT Rationale examines the reasons clients sought a personal trainer, Selection Rationale refers to the attributes the client considered when evaluating a particular personal trainer. This theme includes first impressions and characteristics that clients would be able to readily observe prior to hiring the trainer. The major themes associated with Selection Rationale are Gender, Empathy, Physique Appearance, and Results of Others. Interestingly, four of the women preferred a female trainer because they felt a woman would be better suited to understand their struggles and comfort levels. Specifically, these women chose a female trainer because they felt that they would not be as self-conscious about their bodies as they might be while working with a male trainer. They also indicated that a female trainer would be prepared to understand their gender-role concerns (e.g., balancing a toned body with a feminine image). Cassie believed that a female trainer would not make her feel self-conscious in the beginning, while she was still at a body size that was undesirable to her. Alicia associated high volume weight lifting with male trainers and that this would “make her own body get too big”. [Both clients later hired male trainers and found that this was not the case]. Lorraine preferred a male trainer because she felt that she would feel the need to compete with a female trainer, though this individual did not elaborate on the meaning of “compete.” In light of the importance of physical appearance relative to reasons for hiring a trainer, it is plausible to suggest that Lorraine felt like she would compete with the trainer in terms of physical appearance. In summary, it appears that gender may play a major role when clients select a particular trainer. Female clients expressed a preference for female trainers because they believed female trainers would empathize with them more than a male trainer could. In fact, the clients discussed empathy to such an extent that it was designated as a major theme.

Empathy refers to the trainer’s understanding of the client’s experience and her skill in effectively listening to their difficulties. Several clients preferred trainers who have personally experienced the challenges associated with weight loss and adhering to an exercise program. Alicia commented, “I knew I wanted someone who had lost the weight, who knew what it felt like to struggle…I wanted someone who felt that [way] to train me”. Whitney commented,

> “I chose the person that I was with because of her [the trainer’s] own personal body change. I was watching her modify her diet and … all the training that she did and just seeing the difference in her own body… I just felt like she could achieve that with anyone who wanted to.”

These clients believed that if a trainer could feel what the client was going through (emotionally and physically), it would not only make the client feel more comfortable during the training session, but would also give the client confidence that they could achieve their own goals.

In addition to empathy and gender, the clients evaluated potential trainers based on the trainer’s physique. Physique Appearance, a third major theme, was discussed at great length and in much detail among all of the clients. The clients believed that a trainer who has a “good body” gave them confidence that the trainer “knew their stuff”. Furthermore, the clients believed that a trainer with an attractive physique must be motivated to be healthy, so they must possess the skill to motivate others. Whitney commented, “… how they look is important to me because I have to be able to put my faith in them and know that they know what they’re doing. . .”

The clients equated having a sculpted physique with competence. At the same time, several clients did recognize that mere physical appearance was not sufficient to indicate knowledge of personal training. Interestingly, the clients clearly identified empathy as a critical factor in selecting a trainer (i.e., the trainer feels or has felt the frustration associated with maintaining an exercise program), yet they also identified the appearance of the trainer’s physique as an important factor. After probing this issue, the clients concluded that for a first impression, the appearance of the trainer’s physique is important, but other factors may overcome this first impression. Clients felt that as long as they saw results with their own bodies, their trainer’s physique would become much less of a factor. Alicia commented,

> “I think that in the beginning, I would be apprehensive [with an overweight trainer]. But I wait and see what kind of change I get after working out with that person for, say, 3 months. In the long run, it’s the changes that I make and the goals that I reach …that’s going to keep me coming back- not their credentials, not what they wear, not what they look like”.

The interviews also revealed that the results that other clients achieved with a personal trainer were more important than the trainer’s physique. The major theme, Results of Others, refers to the results (e.g., successfully achieving changes in physical appearance or fitness) that other clients have achieved while working with a particular trainer. Three of the clients explained that this was one of the major reasons they chose their trainers. Carla commented, “I think that seeing the results that they’ve accomplished with someone else is as important to me as their credentials.”

#### Loyalty Rationale

Another global theme that emerged during the client focus group was Loyalty Rationale (see Figure 1), which refers to the credentials of a personal trainer that solidify the client/trainer relationship. These qualifications were not necessarily known before the client started working with her particular trainer, but they were the reasons the client stayed with the trainer. This global theme included the following major themes: Social Skills; Individuality; Education; Passion; and Results. Social Skills refers to the interpersonal and communication skills of the trainer, as well as the friendships that sometimes result with the one-on-one training. Effective interpersonal skills (e.g., charisma, sincerity) can lead to deeper, satisfying relationships (e.g., friendship) in one-on-one training. The clients noted that they like a trainer who could give them a good workout, yet who made it fun. They enjoy the camaraderie they have with their trainer, and it gives them the motivation to come every session. Carla commented,

> “…I think they should be enthusiastic, I think they should be fun. I mean, that hour is torture sometimes. And I think they have to encourage you…talking to him [trainer] and hanging out while we’re working out, is just as important probably- actually more- important than working out!”

Individuality was another major theme that emerged. It consists of two sub-themes: Full Attention and Documentation. Full Attention refers to the clients’ desire for the trainer’s complete focus and attention during their training session. Cassie commented, “I just think it’s very important to not only [oversee] training [for] the individual, but to make them feel special, make them feel that you want to be there”. Although the clients realize that their trainer has other people that she or he trains, during their hour they want to feel that they are the only client the personal trainer has.

The clients also preferred trainers who could listen closely to their concerns and make notes (e.g., programmatic changes) of what was accomplished during the session. Documentation was a sub-theme of Individuality. The clients felt very strongly that the trainers should keep formal records of what happened during each training session in order to keep track of the workouts so that they can differentiate among all of their clients. This theme also included effective listening skills, since it was believed that this would help avoid injuries. Avoiding Injury is a mini-theme that emerged from Documentation and Full Attention. These clients believed that it is important for trainers to listen to the client and document any injuries that occur so that the trainer remembers not to do that exercise again with that particular client. In addition, clients expected trainers to ask them for an update of the injured area at a later session. Some of the clients had encountered trainers who did not seem to listen when a particular exercise resulted in pain or injury, and some suggested that this was because the trainer had taken on too many other clients.

As one might expect, the clients valued the trainer’s knowledge of anatomy, physiology, and exercise program design, which was reflected in the major theme labeled Education. This theme was discussed in terms of college and certifications. College refers to any formal training at the collegiate level that clients felt should be required of trainers. Most of the clients believed that a trainer with a college degree has a broader understanding of the body than someone without a degree. Cassie, the client who had worked with six different trainers commented,

> “I find that if I have trained with people who had a B.S., the title [in] sports medicine or a related field, [instead of] a weekend course…they have a broader, general understanding of the body besides just, ‘this is the exercise, this is how you do this’. They can give you much more advice about your nutritional needs, you know, some lifestyle changes…”

It was clear that most of the clients were more comfortable with a trainer who earned a college degree, and that most assumed that their trainers had a degree since they were seeing results.

In regard to certifications (the other sub-theme associated with Education), the clients were asked whether they knew the names of any of the certifying organizations. No clients answered affirmatively. In fact, four had not known any of the qualifications of their trainers before they hired them. The exceptions to this were cases in which the trainer had won a bodybuilding or fitness show. Lorraine commented, “In the beginning, I didn’t know [what the qualifications of my trainer were]. I just assumed that everyone was certified”. When clients were informed about the fact that trainers at some locations are not required to possess a degree or have any formal training before they take many of the certification exams, they were surprised. Alicia remarked, “I didn’t ask for their qualifications. It was through our interactions that I found out what the qualifications were. I’m sitting here thinking…when I go to a doctor, I certainly want to see their qualifications.”

Another client had also been disappointed when she discovered how “easy” it can be to acquire some of the certifications. Carla noted, “I think that a lot of these groups that certify people, it’s become more of a money game than making certain people know what they’re doing. To me, it trivializes it somewhat.” Several of the clients also recognized that some trainers elected a quick certification and were training simply to make extra money. Whitney commented, “I think somebody…who’s spent the better part of her adult life working on this kind of stuff is preferable to someone who just got certified in a weekend class.”

The discussion regarding education prompted a wide variety of comments. In the absence of any probe directly concerning college, the clients noted that a degree must be an important quality for a trainer. Although the clients were disturbed by the notion of a trainer without a degree or certification, the clients seemed to quickly dismiss this opinion in situations where the trainer is clearly dedicated to the field and loves what she or he does, regardless of degree or certification. The clients called this passion.

Passion is a major theme that refers to the trainer having a love for what he or she does, including a dedication to the profession. In fact, some of the clients decided that since having a passion for your job will probably motivate a person to become better, the passion of a trainer may be more important to the clients than their education. Carla commented, “If you have a passion for it, you’re going to have a desire to learn more, read more, and to enrich your client’s life with that.”

Although social skills, individuality, education, and passion were clearly important to these clients, detectable changes in their bodies (e.g., weight loss, improved muscle tone), or results, appeared to be the most powerful factor influencing continued work with that trainer. Results refer to the changes that the clients saw in their bodies, which is consistent with their rationale for hiring a trainer in the first place (i.e., clients hired trainers in part because of the frustration that resulted from inability to achieve significant body change). According to these clients, the results that they get from working with a particular trainer may be more important than any other qualification or characteristic a trainer may possess. Alicia reported that her trainer never told her what his credentials were and that it bothered her at first, but since she was seeing results, it seemed to matter less over time.

Negative Characteristics
Finally, the clients discussed and identified a number of negative characteristics or behaviors that might impair the personal training experience. The last global theme that emerged from the client focus group was Negative Characteristics, which consisted of the sub-themes, Unethical and Unprofessional. Negative Characteristics are characteristics that clients felt were inappropriate for trainers. These characteristics might cause a client to terminate her relationship with a trainer. In this study, Unethical refers to behavior that is sexual in nature, such as flirting and sexual comments directed at the client or any other members in the gym.
Unprofessional behavior includes canceling appointments frequently, not calling to cancel appointments, cursing, and telling clients about problems with management. In addition, these clients considered inappropriate attire worn by the trainer as unprofessional. The clients expressed discomfort with female trainers who wear sport tops and bike shorts, since it seemed to make them feel self-conscious about their own bodies. Interestingly, the clients did not discuss male trainer’s dress at length, and when it was mentioned, clients suggested that the male attire should be “tasteful” and “clean”. Cassie felt that female trainers are more likely to wear inappropriate clothing. The female clients seemed to take it as a personal affront when their female trainers dressed in revealing clothing because it made the clients feel self-conscious about their own bodies. In other words, they want their trainer to have a great body, but they also want it covered. Additionally, the clients do not want to hear sexual comments made by their trainers, specifically male trainers. As Table 2 demonstrates, these clients were very clear regarding gender roles in the workplace; females should not show off their bodies, and males should not make sexual innuendos.

### Discussion

The purpose of the present study was to examine clients’ perceptions regarding the qualities of successful personal trainers. Using focus group methodology, four global themes emerged: Personal Trainer Rationale, Selection Rationale, Loyalty Rationale, and Negative Characteristics. Table 2 summarizes these results.

The clients in the present study identified several factors they considered when selecting a personal trainer. The clients preferred a trainer who could empathize with their struggles to adhere to an exercise program, help them lose weight, and improve their bodies. In addition, the trainer’s physique was important when selecting a particular trainer. These findings are in line with self-presentation theory (16), a process by which one monitors and controls how one is perceived by others. Research examining self-presentational processes in physical activity has typically focused on social physique anxiety, a perception that others are negatively evaluating one’s physique (12). The findings of the present study seem to indicate that self-presentational processes may influence the selection of a personal trainer. That is, clients’ perceptions of their own physical appearance in relation to that of a potential personal trainer may influence the selection of that trainer.

The finding that physical appearance was a major factor regarding the selection and hiring of personal trainers, as well as why people decide to exercise in the first place, mirrors contemporary society’s emphasis on the “body beautiful”. People want their bodies to emulate those seen on magazine covers and on television, and therefore seek out trainers who also have these sculpted bodies to train them. Additionally, because attractiveness is more central to women’s identity (11), women are more dissatisfied with their bodies than are men (26).

Although a trainer’s physique was an important factor in the selection of a personal trainer, the clients agreed that other factors may become more relevant (e.g., detectable changes in fitness level and physique) as they progress with their exercise program. The participants indicated that perhaps the most powerful factor when selecting a trainer is that of observing the results a trainer has accomplished with other clients. This is a factor that may lead to or be associated with false assumptions. First, it is possible that a trainer with a lean, athletic, muscular, and sculpted body has never had to worry about his/her weight. In light of the importance of genetics in determining body type, the trainer with the most attractive body may have always had a fit body, and never had to work to maintain or improve it. Thus, this type of trainer may not be necessarily empathetic to a client’s struggles with appearance. Moreover, a trainer may know how to train herself, but there is no guarantee that she can transform another person’s body. This may lead to unrealistic expectations for clients which may result in discontinuation of an exercise program.

Also, while people may see results from exercising (e.g., losing weight, toning muscles), there are incorrect ways to achieve these results. It is possible, for example, to severely dehydrate oneself in order to see more muscular definition, as some bodybuilders do prior to competition. Therefore, clients may obtain results, but they may not be using safe training methods. Finally, while factors such as noticeable results were important in the initial phases of evaluating potential trainers, they were not the factors that ultimately affected whether or not the client stayed with the trainer.

In regard to trainer characteristics, clients suggested that trainers should: 1) be educated; 2) recognize the individuality of each client; and 3) be able to help clients accomplish detectable body changes. In addition, they should have a passion for personal training, and make the workout enjoyable through the use of effective social skills. The importance of “fun” during a workout session corroborates Wankel’s findings (30) that the activity itself and the characteristics of the leader are significant factors that affect enjoyment and adherence to a program. One client mentioned that exercising is difficult, and that it is important for the trainer have the social skills to communicate as a friend and make the session as enjoyable as possible. Exercise is inherently a physically challenging activity. Therefore a trainer’s ability to use his or her social skills to make the training session comfortable is an important one. Clients are more inclined to continue with that particular trainer.

Thus, the clients want to work out in a socially friendly environment in order to sustain motivation. The importance of fitness professionals’ dispositions is critical. Studies examining the influence of disposition in service work (e.g., hospitality, retail) show that personality and social skills often outweigh a person’s technical ability (14,22). Collishaw et al. (7) also reported that an instructor’s genuine enthusiasm for teaching group fitness classes was perceived and appreciated by clients. Finally, clients report more positive affect and loyalty to a trainer as a result of positive body language. “Trainers should listen to [clients] and learn about who they are, what their lifestyle is like and what motivates them. This process will become easier with time and the personal trainers will develop a polished bedside manner.” (2). Clients also want to feel special during workouts and believe that the trainer has her full attention on the client, listening to them and documenting what worked and what did not in order to avoid potential injuries. This expectation for being treated as an individual (Individuality) is an example of the customer service that Americans demand from all businesses.

A trainer’s knowledge was important to the client. It did not necessarily have to be from a college degree or certification, however. As long as the trainer shows a passion for her occupation, and the client sees results with her own body, the need for other credentials may be minimized. If the clients recognize that a trainer is genuinely enthusiastic and shares continued education (e.g., reading) with her client, this may preclude the need for higher education. However, since the majority of the clients did not truly know what the qualifications of their trainers were, or any of the certification programs available, it is plausible to suggest that they also would not be certain that the information their trainer is seeking and distributing is from reputable sources.

While credentials are critical in the selection of a trainer and/or a facility, a trainer’s credentials (e.g., certification, college degree) may mean less to a client than the belief that the trainer can help the client achieve the desired results (8). Of course, this perception is based only upon what they observe (the body change of another). Clients may not recognize that people’s bodies change at different rates and in different ways due to genetic differences, time available for training, diet, and internal motivation.

The clients identified characteristics of personal trainers that they considered unprofessional and unethical. These negative characteristics may influence clients’ decisions to stay with a trainer. In some instances, this unprofessional behavior may result in a discontinuation of exercise altogether. As was previously noted, exercise adherence is quite low in the United States; unprofessional or unethical personal trainers only exacerbate this situation. While personal trainers who have sound knowledge and strong motivational skills inspire clients, those who do not possess these skills may be the reason why a person stops exercising. That is, if the client was frustrated before working with a trainer because she could not obtain desired results, or could not motivate herself to exercise, working with a trainer who displays negative characteristics may cause her to abandon exercise altogether.

Incompetent personal trainers may also hurt those trainers who are qualified and knowledgeable. Personal trainers who are not dedicated to the personal training industry or concerned with improving their skills severely damage the reputations of the qualified trainers who do an excellent job of caring for their clients and who make personal training a respected profession.

#### Limitations

Several limitations should be acknowledged. First, qualitative methods were used and therefore, the results cannot be generalized to other populations. Second, this study used only females and attitudes toward trainers may be gender specific. Third, focus group participants volunteered to be a part of the sessions, and this might have created a potential bias since these individuals may not necessarily represent all clients of personal trainers. Finally, all qualitative research is dependent on the biases of the authors that analyze the data. Although measures were taken to eliminate bias (the lead author completed a bracketing interview and three authors analyzed the data through consensus agreement), it is possible that preconceived beliefs may have influenced the analysis. Despite these limitations however, the authors believe that the results of the present study contribute to scholarly inquiry and offer some important practical applications for the fitness industry.

### Application in Sport

The findings of the present study have several implications relative to the personal training industry, including a discussion of the skills and/or qualifications necessary for successful personal training. First, if personal trainers are to meet the priorities of their clients, they must learn communication skills, motivation techniques, how to treat the client as an individual, and how to design various weight training programs according to the goals of the client. They must also recognize the importance of their clients’ perceptions of training results. Also, while students who do not necessarily have an ‘ideal’ physique should not be discouraged from pursuing this career, they should be cognizant that a trainer’s physique may be a deciding factor in the hiring process.

Second, the public needs to be better informed about exercise and nutrition. Clients would also benefit from information regarding the certifications associated with personal trainers. The majority of the clients in this study had not known the qualifications of their trainer when they hired them, assuming all were degreed and certified by reputable organizations. If fitness professionals can find effective ways to inform the public regarding the selection of a qualified personal trainer, clients may be less likely to have unrealistic expectations when hiring a trainer. In addition, they may be more wary of the trainers who proclaim to be able to change their entire appearance by in a short time.

Third, the authors believe that undergraduate and certification programs should include training in the development of interpersonal skills such as active listening, empathetic communication, and strategies to enhance motivation. The findings of the present study are consistent with research showing that these techniques will positively influence exercise adherence (3). Clients in the current study sought and stayed with trainers who exhibit these skills. The authors therefore, support formal incorporation of best practices into undergraduate programs. Research has shown that using such techniques will positively influence exercise adherence (3,27,28). Additionally, the findings of the present study suggest that personal trainers need to take a more client-focused approach, treating their clients as individuals and not simply as dollar signs.

A final suggestion to strengthen the current state of personal training is to move toward state licensure. The participants in the present study were largely unaware of certification procedures and the multiple licensing agencies. Currently, there are at least 19 different personal trainer certification organizations (1), and approximately 90 organizations offering fitness certifications (31). With so many organizations having their own criteria for membership and certification as a personal trainer, there has been little regulation or assurance that personal trainers working in the field are qualified. It is critical that present and future club members improve their knowledge of how professional personal trainers are educated and certified. Given the poor exercise adherence and high level of dropout rates in the United States, qualified personal trainers are in a position to help change these rates.

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### Corresponding Author

**Deana I. Melton, Ed.D., CSCS, HFS**
Human Performance and Leisure Studies Department
North Carolina A&T State University
203 Corbett Center
Greensboro, NC 27411
Phone: (336) 334-7712
Fax: 336) 334-7258
<[email protected]>

2016-04-01T09:36:46-05:00January 4th, 2011|Contemporary Sports Issues, Sports Exercise Science, Sports Studies and Sports Psychology, Women and Sports|Comments Off on Women’s Perspectives of Personal Trainers: A Qualitative Study
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