Exercise Intervention in Ban Non Muang Moo 3 1

Exercise Intervention in Ban Non Muang Moo 3

Theresa Chockbengboun, Shanice Harris, Bao Nhia Khang, Celia Lenarz, Lea Lipowcan, Eve Maxson, Kelvin Oppong, Lena Stashko

Khon Kaen University

Exercise Intervention in Ban Non Muang Moo 3 2

Abstract

From the results from the community-based research, an exercise intervention was implemented in

Ban Non Muang Moo 3 to address barriers to exercise. Surveys and interviews suggest that barriers to

exercise include inadequate resources, lack of time, and negative perceptions on exercise. Researchers

implemented an exercise intervention to target exercise barriers using existing and sustainable resources in

the community. The purpose of the intervention is to provide information on sustainable indoor and outdoor

exercise resources to increase exercise around the lake and at home. The intervention took place around the

lake and consisted of five bodyweight activities (push-ups, squats, bird dogs, lunges, and single-leg balance

touch). To measure the success of the intervention, pre and post surveys were given out to participants

before and after completing intervention activities. Results indicated that half of survey participants did not

use the lake as an exercise resource prior to intervention; however, after the activities around the lake, all of

the participants reported they would use the lake in the future, exercise was fun, knowledge on exercise

increased, and they had enough time to exercise. Results from the intervention showed that there were not

only limitations in the research design, but also in the intervention process such as social desirability.

Recommendations for future exercise intervention should include focusing on the community perceptions

and customs in order to successfully implement the intervention.

Keywords: Ban Non Muang Moo 3, exercise, resources, intervention, lake, surveys, limitations

Exercise Intervention in Ban Non Muang Moo 3 3

Introduction

Exercise is a major component to an individual’s overall health, fitness, and quality of life (CDC,

2014). According to the Center for Disease Control (CDC), exercise is a subcategory of physical activity

that is planned, structured, repetitive, and purposive. The CDC states that regular physical activity which

includes exercise can “help control weight, reduce the risk of certain chronic diseases including type 2

diabetes and various cancers, strengthen bones and muscles, improve mental health and mood, and increase

the longevity of one’s life (CDC, 2014). Despite its positive effects, “the 2007 survey conducted by the

National Statistical Office revealed that approximately 29.6% of Thai people regularly exercised” (Thai

Health Promotion Foundation). This national statistic highlights one of the many public health topics in

Thailand that students would research in their community field visits. Bahn Non Muang Moo 3, a village

located near the largest university in the northeastern region of Thailand, is one of the three communities

that the Fall 2014 CIEE students had the opportunity to visit during the Community Public Health Course in

Thailand.

During students’ community visit in Ban Non Muang Moo 3, a needs assessment was performed to

identify the needs of the community and available resources in the community. In particular, students

conducted World Health Quality of Life surveys and calculated the physical health score of a sample

population of 90 community members to be 24.89. This score falls under the category of Mid-level quality

of life as stated by WHO. In addition, several villagers were interviewed and expressed the notion that

community members have the desire to exercise, but are constrained by motivation, time, and a poor

relationship with the Village Health Volunteers.

After student’s initial visit, further research was implemented to investigate, in more detail, the

existing exercise behavior within the community. Specifically, the goal for this research is to determine the

existing exercise patterns, community resources available to support exercise, and perceptions about

exercise in Ban Non Muang Moo 3. In addition, objectives for this research focused on measuring and

determining the three main components in the goal mentioned above, exercise patterns, available resources

Exercise Intervention in Ban Non Muang Moo 3 4

that encourage exercise in the community, as well as perceptions of exercise in Ban Non Muang Moo 3.

Objectives for this research include:

● Measure baseline indicators of exercise and healthiness

○ Measure frequency of exercise (i.e of average number of hours exercised/week)

○ Measure accessibility to exercise locations

○ Calculate BMI (as an indicator of healthiness)

● Compare villagers’ average number of hours exercised/week to CDC recommended exercise

guidelines

● Compare villagers’ average BMI to WHO International Classification of Adult Underweight,

Overweight and Obesity according to BMI

● Determine villagers’ experiences, perceptions and knowledge about exercise through personal

testimonies

From the results of the initial research, students planned an intervention that incorporated home-

based exercises and natural resources. Students noticed the community had a lake, a perceived underused

natural resource, which could be a location for exercise; based on this observation, students wanted to

promote outdoor exercise around the lake. After reviewing interview responses, students wanted to address

barriers to exercise (i.e. lack of resources and time) by creating methods for villagers to exercise at home.

Focusing on home-based exercises shows villagers that they can exercise in a short amount of time and do

not need a lot of equipment and materials to do so. Lastly, understanding if villagers perceive exercise as

“fun” plays an important role in promoting outdoor and indoor exercise. By performing the intervention

with a group, villagers are encouraged to participate in group indoor and outdoor exercises which can

ultimately lead to more positive perceptions on exercising. In this intervention, students will promote

outdoor, indoor, group, and timely exercise in Ban Non Muang Moo 3.

Literature Review

Outdoor exercise in the natural environment has been suggested to be beneficial for self-reported

health and well-being (Coon, 2011). Kaplan’s attention restoration theory and the psycho-evolutionary

Exercise Intervention in Ban Non Muang Moo 3 5

theory support the positive impact of the natural environment on health and well-being. Kaplan’s attention

restoration theory proposes, “nature provides the particular environmental stimuli to allow restoration from

attention fatigue, which occurs during the performance of cognitive tasks that require prolonged

maintenance of directed attention.” In essence, this theory postulates the environment promotes feelings of

‘being away’ from routine activities and thoughts, while also nurturing ‘moderate fascinations’ with

features in the environment that attract attention without requiring effort. The psycho-evolutionary theory

proposes that nature allows psychophysiological recovery through innate responses to the natural

environment by spatial openness and the presence of structure. This theory suggest the perception of the

natural environment triggers positive emotional reactions related to safety and survival (Bowler, 2010). Hug

and associates surveyed participants about their preference for outdoor and indoors exercise settings; an

outdoor setting was rated as more restorative, suggesting more positive reviews on the effects of the

outdoors on their wellbeing (2009). The potential role for the outdoor exercise on human health and well-

being has shown positive impact, however, further investigation is needed to understand the significance

between health and the natural environment (Bowler, 2010).

Home-based exercise can show significant improvements in fitness and weight loss for individuals

who do not have enough time or resources to exercise. Participants were assigned home exercises where

they were instructed to complete a walking program (30 minutes per day, 5 days per week). After 12

months, the home-based exercise program showed increased improvements in weight loss (Perri, 1997). In

elderly women who were at risk for falling, home-based, specifically tailored programs were implemented

to improve physical function in women 80 years and older. After six months of home-based exercise,

balance in elderly women improved and the rate of falling decreased substantially within the year

(Campbell, 1997).The effects of home-based exercise on a Chinese population at risk for type 2 diabetes

displayed significant improvements in exercise behavior and certain metabolic risk factors for 9-months

(Wu, 2011). Home-based exercise have been shown to have significant improvements in fitness and weight

loss through the input of the participant and the exercise program provided.

Exercise Intervention in Ban Non Muang Moo 3 6

Group exercises is a potential model for people to engage in physical activity. Group exercise is

described as exercise performed by a group of individuals led by an instructor. The benefits of group

exercise include exposure to social and fun environment, a safe and effectively designed workout, and a

workout that requires no prior exercise knowledge or experience. An exercise class structured with a

purpose can be beneficial for people with limited knowledge about exercise (Dolan, 2012). Group based

exercise using low-cost equipment and existing resources are more practical and effective for long-term

care (Lazowski, et al., 1999). According to Lazowski and associates’ study on group exercise programs in

long-term care, seniors can respond positively to challenging group exercise program with minimal training

and resources (1999). In an intervention that supervised a 12-week group exercise program between 203

women, researchers found this group exercise provided functional and psychological benefits, such as

greater mobility and positive moods (Mutrie, 2007). Group exercise, as opposed to individual exercise, can

be an advantageous resource for people who want to exercise, but do not know where to begin.

Designating time for exercise becomes difficult for individuals with familial and personal

responsibilities. Commonly reported barriers to exercise are a ‘lack of time’ and ‘work demands’ (Burton &

Turrell, 2000). People quit an exercise program because of time constraints, and to overcome this obstacle

30 to 45 minute workouts can be carried out for people with limited time to exercise (Dolan, 2012). Eight

patients underwent a 6-minutes walking test (6MWT) intervention to assess if patient self-paced walking

speed can achieve “maximal” sustainable critical power and speed. Results show the 6MWT indicates

maximum sustainable exercise regardless of the short time span allotted for exercise (Casas, 2005). In a

study investigating barriers to exercise among patients who did and did not suffer from a stroke found that a

‘lack of time’ to exercise was the highest ranked barrier among non-disabled adults; however, this was not

the case in patients who had a stroke. Perhaps non-disabled patients were employed and had more

responsibilities than patients who experienced a stroke (Rhimmer, 2008). Working adults rate ‘lack of time’

as a major barrier to exercise, thus stressing the importance of timely exercises to encourage any form of

physical activity.

Exercise Intervention in Ban Non Muang Moo 3 7

The purpose of this intervention is to provide villagers in Ban Non Muang Moo 3 with information

on sustainable indoor and outdoor exercise resources to increase exercise around the lake and at home. The

objectives for this intervention were established in order to address four topics: the promotion of exercise

by making good use of the outdoors; promotion of exercise with home-based exercises; promoting exercise

as fun through group exercises; understanding the timing of workouts may affects exercise initiative of

individuals. Objectives for this intervention implementation include:

● 100% of participants will report that they will intend to use the lake as an exercise resource after

completing the intervention activities at the lake.

● At least 50% of the villagers that participate in the intervention will report that they intend to use

the bodyweight exercise pamphlet after participating in the five bodyweight exercise stations.

● At least 50% of the participants will believe that exercise is fun after completing one lap around the

lake.

● At least 50% of the participants will believe that they have time to exercise after completing one lap

around the lake.

Methods and Material

Research: Survey

Initial data was collected over the span of two days through surveys. A survey was expressly

created for this study in order to assess reasons for exercising or not exercising, the average hours of

exercise, the type of exercise, and to calculate BMIs. Survey participants were identified using convenience

sampling to answer 18-multiple choice questions on the survey. Prior to starting the survey, participants

read and signed a consent form, which included information on surveyors’ purpose, the topics covered by

the survey questions, informed participants how their information will only be shared with the public health

students, and their participation is voluntary. The survey was based on the International Physical Activity

Questionnaire, which measures frequency, intensity of exercise, and means of transportation. The

questionnaire focuses on the type of exercise performed, the number of hours each week participants

Exercise Intervention in Ban Non Muang Moo 3 8

exercise, and self-reported intensity of exercise through heart rate detection. Overall 62 surveys were

collected, but only 55 were used in data analysis due to survey incompletion.

The survey used the Body Mass Index (BMI) and the Center for Disease Control (CDC)

recommended exercise guidelines as a standard for comparison. The BMI is a baseline indicator for both

men and women to assess total body fat, and this was used to determine healthiness of survey participants.

Height and weight were used to calculate the participants’ BMI by using the formula given by the CDC:

[weight (kg)] / [height2 (cm)] x 10,000. The BMI was then compared to the following American standard

categories: underweight (below 18.5), normal (18.6-24.9), overweight (25-29.9), and obese (30 and above)

(CDC). The CDC’s standard for exercise is four hours per week (CDC). Official recommendations for

exercise from the CDC was compared against the exercise patterns revealed in the surveys to identify if the

population was at risk of insufficient physical activity. A one-way ANOVA test was used to determine if

there is a significant difference in hours of exercise per week between the different BMI categories.

Research: Interviews

Two in-person interviews were conducted with a community member who exercises routinely and

one who does not exercise. These interviews consisted of ten question concerning perceptions of exercise

and exercise resources within the community. Follow-up questions were improvised based on the

interviewee’s responses. During each hour-long interview, one student would ask questions, while another

student would transcribe the responses; a translator would be present to ask questions and translate

responses in Thai for the interviewee. The first interview was with a 66-year-old woman who engages in an

hour of aerobic exercise daily because she wants to stay healthy and fears getting sick. The second

interview was with a 48-year-old man who was physically active two years ago because it helped him feel

“active and fresh.” He regularly engaged in tennis, takor, and other strength training exercises such as pull-

ups; however, injuries from his previous occupation as a sheet metal worker and his current health condition

prevents him from working out. The process of collecting interview responses used a conceptualization

method where observations were interpreted directly, “pulled apart,” and reassembled more meaningfully;

the purpose of using conceptualization is to provide a detailed description of observations and provide a

Exercise Intervention in Ban Non Muang Moo 3 9

sense of what is important (Qualitative Data Analysis, 2010). The interviews were not recorded, therefore,

the data were exclusively from the transcriptions at the time of the interviews.

Intervention: Planning and Preparation

Based on the data collected from the surveys and interviews, students devised an exercise

intervention plan focusing on sustainable outdoor and indoor exercise resources within the community. The

exercise intervention included activities around the lake for outdoor workouts and bodyweight pamphlets

for indoor workouts. Participants will perform bodyweight exercises, which can be found on the pamphlet,

at designated stations scattered around the community lake. Participants will receive a straw for making an

effort at each bodyweight station, which can be redeemed for a free meal at the end of the intervention.

After the lake intervention, participants and other community members will be encouraged to take part in

relay activities held at the Health Promoting Hospital (HPH). At the end of the intervention day,

participants and their families will be encourage to eat dinner at the HPH as an incentive for participating in

the intervention.

Outreach about the intervention was promoted using announcements and flyers. Permission to use

the lake as a location for the intervention was granted a week in advance by the village Headman. The

Headman agreed to make two announcements; one announcement was three days prior to the event and the

other was made at 7:00 am the morning of the event. Another announcement was made at the primary

school three days prior to the event. One hundred fliers were handed to villagers or placed in mailboxes

three days prior to the event indicating the place, time, date, and description of the event. Each

announcement and flier included mention of a free dinner to all those who participate.

Five signs displaying bodyweight exercises were assembled to provide a pictorial example and

written description as a bodyweight station around the lake. The photos and translations of the descriptions

were printed on waterproof vinyl, glued on a sign frame, then glued to PVC pipes (see Appendix A). These

bodyweight exercises were taken from the exercises on the bodyweight pamphlet. Two students were

photographed performing these five exercises; these exercises were:

● Push-ups - From a plank position body is lowered near to the ground and raised via arms.

Exercise Intervention in Ban Non Muang Moo 3 10

● Squats - From a standing position with feet placed hip-width distance apart, hips are moved

back and knees are bent until knees are at a 90 degree angle. Participant then returns to

upright position.

● Bird dogs - Beginning on all fours with knees at hip width distance the right arm and left

leg are extended out horizontally and lowered back to the initial position. Then the left arm

and right leg are extended and returned to initial position.

● Lunges - From a standing position one foot steps forward and is placed flat on the ground.

Both knees bend until both reach 90 degree angles and the participant returns to starting

position.

● Single-leg balance touch - From a standing position right leg is lifted backwards to a

horizontal position while torso leans forward to a horizontal position and right hand touches

the ground. After returning to standing position the exercise is repeated on the left side.

The bodyweight pamphlets, in which the signs were based off of, contain information on a total of

seven exercises. In addition to the five bodyweight exercises displayed on the signs, side lunges (feet are

placed three feet apart, butt is lowered to the right side such that the right knee makes a 90 degree angle,

return to initial position, repeats on the left side) and leg lifts (from a laying position, the straightened legs

are lifted such that legs are at a 60 degree angle from the ground) were also on the pamphlets, but not used

as a part of the signs. Each exercise had a photographic example performed by a student and a translated

description of the exercise (see Appendix for example of pamphlets). One hundred pamphlets were handed

out to intervention participants at the last bodyweight station; leftover pamphlets and the electronic version

were given to the HPH as a resources to use in the future.

Before and after the activities around the lake, participants were asked to do a pre- and post-survey

to assess the objectives for the intervention. The pre-survey consists of four questions, while the post-survey

consists of five questions. These questions attempt to address whether or not participants will intend to use

the lake in the future, use the bodyweight pamphlet in the future, if they believe exercise is fun, and if they

believe they have enough time to exercise. The pre-survey asks:

Exercise Intervention in Ban Non Muang Moo 3 11

● Have you ever exercised at the lake before?

● Do you plan on using the lake as an exercise location in the future?

● Do you think you have enough time to exercise?

● Do you think exercise is fun?

The post-survey makes an effort to be consistent with the pre-survey to determine if perceptions have

changed due to the intervention. The post-survey asks:

● After participating in this activity, do you plan on using the lake as an exercise location in

the future?

● After participating in this activity, do you plan on using the bodyweight exercise pamphlet

in the future?

● Do you think this activity has increased your knowledge on how to exercise?

● After participating in this activity, do you think you will have enough of time to exercise?

● After participating in this activity, do you think exercise is fun?

All questions in the survey were either “yes” or “no” responses, and the length of the survey was purposely

kept short as to not distract from the intervention. Success of the intervention is measured by the amount of

participants and the results of pre-intervention and post-intervention surveys.

The last part of the intervention was relay activities and dinner at the HPH. The purpose of relay

activities were to address the “fun” aspect of the objectives, by making exercise a form of entertainment.

The five relay activities consisted of an egg-and-spoon race, a potato sack race, a water bucket competition,

a three-legged race, and a ball toss competition. Although materials were purchased for these activities, they

were never performed because of a lack of attendance. Dinner would be served to intervention participant at

5:30pm and was open to all community members until 7:00pm.

Intervention: Implementation Day

The exercise event took place on Saturday, December 6 from 3:30-4:30. The pre-survey was

handed out to the participant at the first bodyweight station; translators were present to translate consent

form and surveys for participants who could not read. During the event, participants walked or jogged

Exercise Intervention in Ban Non Muang Moo 3 12

around the lake and stopped at the various bodyweight stations. Each station had one student to demonstrate

proper form of the exercise, encourage participants, and hand out straws to those who tried the exercise.

Straws were rewarded based on effort, not completion. If a community member came to the sign and tried

the exercise he or she was given a straw. Additionally, take-home exercise pamphlets were handed out to

each participant at the last bodyweight station, along with a post-survey. The extra pamphlets and an

electronic version of the pamphlets were given to the HPH to supply community members with the take-

home exercises. All 15 participants left the event by 4:30pm. The bodyweight exercise signs were left

around the lake for future use. Students moved to the HPH in order to start relay activities, however, no

community members showed up for the relay activities. After the allotted time for relay activities, dinner

was served for intervention participants; however, due to excessive amounts of Pad Thai, fruit, and water,

dinner was opened up to the entire community. The dinner attracted no participants from the intervention;

only 5-10 community members showed up to dinner.

Results Research: Survey

Baseline Indicators of Exercise

As shown in Table 1 of Appendix C, 55.6% of the community members surveyed had a normal

weight, 27.8% were overweight, 11.1% were underweight, and 5.6% were obese. An analysis of variance

was conducted and it showed that there’s no significant difference in hours of exercise per week between

the different BMI categories, F(3,27) = .568, p = .583. Approximately 73.7% of community members

reported that the primary reason for not exercising is lack of time. Over half of the community members

surveyed reported that the primary reason for exercising was either to prevent health problems (38.46%) or

to manage existing health problems (30.77%), which suggests that community members had adequate

knowledge about the health benefits of exercise.

Exercise Accessibility

The majority of community members surveyed reported that their exercise locations were two

kilometers or less from where they live; 44.7% of the community members surveyed indicated that they

Exercise Intervention in Ban Non Muang Moo 3 13

lived less than a kilometer from their exercise location, 36.8% lived 1-2 kilometers away, 10.5% lived 2-4

kilometers away, and 7.9% indicated they lived over 5 kilometers from their exercise location. When asked

to report the level of difficulty in getting to their exercise locations, 61.5% of the community members

surveyed reported that it was easy and 38.7% reported that it was of mid-level difficulty to get to their

exercise locations. The results from these two questions suggest that neither distance or level of difficulty

traveling to an exercise location acted as barriers to exercise. (equipment/exercise location)

Comparing Hours of Exercise and BMI

Table 2 of Appendix C shows that the CDC’s standard for exercise falls within the 95% CI (3.30 –

4.87) for the average hours of exercise per week. Therefore, the average hours of exercise per week

reported in the surveys is not statistically different than what the CDC recommends as the standard. The

average BMI score (23.73) corresponds with the normal BMI category (18.6 – 24.9). These two statements

suggest that community members are healthy and are exercising enough.

Research: Interviews

Lack of Resources

In the interview conducted with the elderly lady, she suggested that villagers are not exercising

because community members believe they do not have the resources available to incorporate exercise into

their daily lives. For instance, the elderly lady interviewed stated “The only exercise facility in the

community is located at the Health Promoting Hospital. The exercise equipment at the hospital was

provided ten years ago as part of an exercise intervention, but is very outdated and worn down. In addition,

she said, “People do not like to exercise on the equipment at the Health Promoting Hospital because the

location is very loud due to the main road nearby.”

Lack of Time

During both interviews, interviewees expressed that villagers may not exercise due to a lack of

time. This notion expressed in interviews also corresponds with survey results when 73.7% of the villagers

surveyed reported that the primary reason for not exercising is lack of time. For instance, the middle-aged

man stated, “My first priority is to find a steady income to support my family before I begin a consistent

Exercise Intervention in Ban Non Muang Moo 3 14

workout routine.” In addition, the elderly lady stated, “The community does not get exercise enough

because have not been educated or informed on how they can fit exercise routines into their lives.”

Perceptions

Another concern revealed in one of the interviews was the perception that local leaders and health

providers do not support exercise in the community. In her interview, the elderly lady stated that, “During a

previous intervention, the Village Health Volunteers (VHVs) at the Health Promoting Hospital were not

exercising alongside villagers despite the fact that they were hosting the event.” In addition, she also said

that, “Because the VHVs were not actively involved in the intervention, community members were

discouraged from listening to their suggestions.” This suggests that community members may feel that the

leaders of the community do not support exercise due to a lack of interest or involvement in health

promotion.

Intervention: Results

The target number of community members participating in the intervention was 40 people, but 15

community members came to the intervention, including six children and nine adults. The pre- and post-

intervention surveys were collected from the nine adults. Before the intervention, 55.6% (n = 9) of

participants had not used the lake as an exercise location; however, after participating in the intervention,

100% (n = 9) of participants indicated that they planned on exercising around the lake in the future. Before

and after the intervention, 100% (n = 9) of participants believed that they had enough of time to exercise

and that exercise was fun. After the intervention, 88.9% (n = 9) of participants indicated that they would use

the bodyweight exercise pamphlet as a guide to exercise and 100% (n = 9) of participants indicated that this

intervention increased their knowledge on how to exercise.

Discussion

According to the villagers’ average BMI (23.73) as shown in Table 2 of Appendix C, surveyed

community members in Ban Non Muang Moo 3 were considered healthy because the majority of villagers

had a normal BMI. The BMI was used to determine healthiness of participants, however, this may not be a

clear representation of how healthy the community actually is. Existing literature supports the BMI may not

Exercise Intervention in Ban Non Muang Moo 3 15

be the best indicator for healthiness without being supplemented with other standards. The BMI was created

to quickly assess the amount of body fat in large populations, which provides health professionals and

researchers with an easy standard of measurement (Lewis, 2013). Although the standard is easy to use, it

does not take into account other factors that determine healthiness. The BMI does not distinguish between

race, gender, and age, thus using an American BMI standard to assess Thai villagers could have resulted in

misrepresented data. Also the BMI does not take into consideration muscle, location of fat deposits, or

whether individuals have low or high BMIs due to current health ailments or non-harmful excess fat

(Weisell, 2003). Low attendance in the intervention could be contributed to the BMI being an unreliable

indicator of healthiness during data collection, therefore, villagers who may have needed assistance would

have been overlooked. Using the BMI as a sole indicator of healthiness was a limitation in this research

design and to assess healthiness in the future, the BMI should be supplemented with other standards to

account for the factors not representing the population.

As shown in the results above, attendance for the exercise intervention was relatively low (i.e. 15

participants) when compared to the target number (i.e. 40) of participants expected to attend the event.

Villagers’ perceptions about the lake can account for low attendance at the event. For instance, if the

villagers do not perceive or view the lake in a positive way, they may have decided not to come to the

intervention. In addition, 55.6% of the participants had not used the lake as an exercise location which may

be because they do not view the lake as a reliable resource for exercise. If villagers do not view the lake as a

reliable resource for exercise, this view could have ultimately influenced their decision to attend and

participate in the intervention. Not measuring or determining villagers perceptions or usage of the lake was

a limitation in this research design and may have influenced the success of the intervention. A

recommendation for the future would be to include questions regarding villagers’ perceptions and usage of

the lake in surveys and interviews conducted during the research process.

According to the results of the pre-intervention survey, 100% of participants reported that they

planned on using the lake as an exercise location in the future.This extremely high percentage could have

been due to desirability bias. Desirability bias occurs when research subjects give socially desirable

Exercise Intervention in Ban Non Muang Moo 3 16

responses instead of choosing responses that correspond with their own true feelings (Chung & Monroe,

2003). Furthermore, it is unclear if the villagers will actually use the lake as a resource to exercise in the

future or if they reported that they would in order to please those implementing the intervention. In addition,

students were unable to identify whether or not villagers marked yes to the second question (i.e. Do you

plan on using the lake as an exercise location in the future?) because they had already planned on using the

lake as an exercise location prior to knowledge about the implementation of the exercise intervention.

Because of the reasons mentioned above, the results for the second question on the pre-intervention survey

was omitted from further analysis.

Conclusion

From the results of the intervention, conclusions can be drawn to further improve the

implementation of the intervention. In order to implement a successful exercise intervention, incorporating

Thai culture and Thai exercises would increase interest, participation, and engagement. The bodyweight

exercises consisted of exercises that are familiar in western cultures; however, these unfamiliar exercises

can deter villagers from becoming fully interested in using the workouts in the future. To better engage

villagers, researchers need to investigate how Thai villagers exercise and refrain from promoting western

ideas when implementing an exercise intervention in Thailand. Another conclusion that can be drawn from

the results is that in order to improve villagers’ usage of outdoor exercise resources in the community,

health providers must be aware of villagers’ perceptions of existing resources. The location of the

intervention (i.e. the lake) was determined by students in hope that villagers would attend, participate, and

continue to use the lake as an exercise location in the future; however, existent perceptions of the lake may

have discouraged villagers from using it to exercise. In conclusion, in order to help villagers, students

should ask them: 1) about their perceptions regarding certain resources and 2) how students can help change

and/or improve villagers’ perceptions and usage of resources in the community. Moving forward in

improving future exercise interventions, researchers must be aware of how culture and insights into

villagers’ perspectives will contribute to the investment and engagement of community members.

Exercise Intervention in Ban Non Muang Moo 3 17

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Appendix AExample of the signs placed around the lake. Push-ups are displayed on the left. Single-leg balance touch

on the right

Appendix B

Example of bodyweight exercise pamphlet. Lunges on the left. Side-lunges on the right.

Exercise Intervention in Ban Non Muang Moo 3 20

Appendix C

Baseline Indicators of Exercise. Table 1 displays BMI categories. Table 2 displays range, average, and CI of the hours per week and BMI. Figure 1 displays reasons for not exercising. Figure 2 displays reasons for

exercising.

Table 1. Body Mass Index (BMI) frequency by Category

Table 2. Summary Table

Figure 1. Primary reasons for not exercising Figure 2. Primary reasons for exercising