It Is Time for the Fitness & Wellness Industry to Lead the Agenda against Physical Inactivity

Physical inactivity challenge has been addressed from different approaches in recent years due to the negative effects of its consequences at public health level. However, the number of people who do not perform sufficient physical activity on a daily basis is not decreasing. Surprisingly, it is not common to involve the fitness & wellness industry in interventions to address inactivity in leisure time despite the industry aim to promote a healthy lifestyle through physical exercise and its resources. Whilst the industry seems not to be interested in collaborating with public bodies and research centres. In this manuscript, we discuss the reasons why this industry should get involved in the effort for addressing physical inactivity using community-based intervention.

The health-related benefits of doing 150 minutes of moderate to vigorous physical activity and two days of strength exercise per week are well known: i.e. better quality of life, lower mortality risk, lower risk to suffer non-communicable diseases [1][2][3][4]. However, rates of inactivity are not decreasing worldwide [5] even though several countries have designed schemes to promote physical activity; Change for Life in the UK, or Exercise is Medicine® in the USA [6,7]. In this regard, one in four adults is inactive worldwide [4], and this rate increases in most developed countries up to exceeding 60% of adults in some European countries [8]. The impact of physical inactivity in modern societies has been widely studied being responsible for more than 9.4% of total deaths and causing a cost over $ (INT$) 53•8 billion per year to health-care systems [9,10]; evidencing that addressing physical inactivity is a priority matter in public health.
A number of studies have tested interventions to increase physical activity levels of some particular populations with promising results [11,12]; providing the literature with some important tips and approaches to deal with this problem. However, most of them targeted such a limited number of people that were unable to provoke a declining in the inactive levels of the community where the interventions were conducted [13,14], or the methodology applied couldn't be converted into a large-scale intervention that could make a real impact on public health [15]. Furthermore, many of these trials have been criticized because participants do not have a clear exit pathway to keep doing regular physical activity in a familiar environment when the study ends [16]. Thus, the challenge remains in translating the evidencebased research findings into a real-world environment that targets enough people to reduce the physical inactivity levels of the entire population long-term [13,14,17].
Community-based public health oriented interventions may be a suitable approach for this purpose as they target thousands of people at the same time within real environments [18,19]. Unfortunately, there are not many community-based public health oriented interventions published and most of them have an elevated risk of bias [18,19]; not demonstrating a significant improvement in the physical activity levels of the whole community [14,18,20]. To increase the effectiveness of these interventions, it is required to test the reliability of the methodology applied in these trials, but on a smaller scale. Thus, using pilot communitybased intervention trials for addressing physical inactivity could provide a greater control than general public health interventions, whilst it is maintained the real-world approaches; providing the required base for developing effective public health interventions contributing afterwards [21].

Research & Investigations in
Sports Medicine

C CRIMSON PUBLISHERS
Wings to the Research

Why the Fitness & Wellness Industry Should Lead Community-Based Interventions to Address Physical Inactivity
The main objective of the fitness & wellness industry (composed by a great diversity of all sports centres, fitness centres, wellness centres, studios, boutiques, etc. offering one or more programs of physical activity and exercise to their customers; from now on fitness centres) is to promote a healthy lifestyle based on physical exercise [22]. So, this objective should involve all adults in the community where this industry is located regardless if they are customers or not of fitness services. Furthermore, this industry already owns the resources required for providing different sorts of physical activities and exercise programs to thousands of people at the same time [17,23]; being considered fitness centres as "community hubs for physical activity promotion and exercise" [17].
At present, just a few interventions have focused on increasing physical activity rates through these centres [17,24]. Being more focused on studying the attendance rates of fitness centres' customers and implementing plans for addressing customer dropouts [25][26][27]. From these studies, it is acknowledged that although most people who enrol and exercise in fitness centres are due to fitness and health reasons [28] the average attendance rate per month in fitness centres is low; being around 1.1 sessions a month [25]. Moreover, within the first 6 months, only 10% of members regularly attend to these centres and just a few of them (up to 2.3%) never relapse in two years [29]. To address the dropout issue, most approaches have focused on customer retention [26,27,30], because of the higher value for money or perceived quality the greater repurchase intention [23,31]. However, despite these approaches, customer retention does not increase [32][33][34], probably because most of the customers fail to acquire an active lifestyle [35]. Therefore, although around 151 million of individuals exercise in the 187,000 fitness centres worldwide [36] most of the fitness centres are under their maximum capacity.
As a result, we consider that retention rates in fitness centres would increase if they integrate intervention programs to help and support inactive adults (those who do not meet the international guidelines for physical activity, [4]) to modify their current inactive behaviour. These interventions should aim to build a new personal commitment in individuals to integrate an active lifestyle regardless if they are fitness centres members or not [17]. Indeed, this approach would generate a double return: first, lower dropout rates, and second, a higher number of people committing personal financial resources to cover a membership fee; supporting a sustainable growth of the industry in developed countries. Likewise, most of the countries and international bodies have developed and implemented local, regional or national plans for addressing physical inactivity (e.g. Global Action Plan for the Prevention and Control of NCDs 2013-2020; [4]). What fitness centres could provide to support and expand the impact of these plans is its current capacity (an established investment in resources, staff, facilities and programs) to develop and deliver interventions for inactive populations. For those reasons, the fitness and wellness industry not only shares the challenge of increasing physical activity levels of the communities where they are located, but also should lead a disruptive movement engaging inactive people.