Determinants of physical activity habit formation: a theory-based qualitative study among young adults

ABSTRACT

Purpose

Engagement in physical activity significantly contributes to reducing the onset and severity of chronic diseases. Nonetheless, establishing habits around this behaviour remains a persistent challenge. This research endeavours to discern the determinants influencing the formation of physical activity habit among young adults in Israel, drawing upon a socio-ecological model.

Methods

A qualitative approach with phenomenological-hermeneutical method was used. In-depth interviews were carried to cover four levels of the socio-ecological model.

Results

Interviewees were categorized into three subgroups according to their physical activity habit strength: Habitually physically active (n = 8), Variably physically active (n = 11), and physically inactive (n = 6). The content analysis yielded four overarching themes associated with physical activity habit formation. Intrapersonal determinants encompassed personal traits, perceptions and attitudes, perceived benefits, and emotional responses related to physical activity. Interpersonal determinants encompassed social support, modelling support, and peer pressure. Community determinants pertained to social norms, resource availability, and accessibility. Finally, public policy considerations encompassed educational policies as well as workplace policies and cultural influences.

Conclusions

This study highlights the unique determinants contributing to the formation of physical activity habit. As intrapersonal and interpersonal factors are significant determinants, interventions should focus on these elements in order to promote this behaviour among young adults.

KEYWORDS:

• Habit formation
• Israel
• physical activity
• socio-ecological model
• qualitative research
• young adults

Introduction

Physical inactivity is one of the leading risk factors for death and non-communicable diseases (NCDs) such as cardiovascular diseases, diabetes, and cancer worldwide. Regular physical activity significantly contributes to prevent NCDs, providing a non-invasive means for prevention and treatment (Anderson & Durstine, 2019). Yet, about 30% of the adult population and more than 80% of the world’s adolescent population are insufficiently physically active (World Health Organization, 2017). Physical activity habits during the young adult years are likely to be important influences on habitual physical activity during overall adult life (Huotari et al., 2011). Moreover, during their transition from secondary school to university, students are required to adapt to a new environment, usually far from home, where they become independent, work for their living, and need to contend with a load of educational tasks. All of these tasks may be barriers for engaging in regular physical activity. Indeed, studies among university students found a high prevalence of physical inactivity (Haase et al., 2004; Irwin, 2004; Weinstock, 2010), all of which make them to a target sub-population in the efforts to promote physical activity habits (Leslie et al., 2001).

Behaviour is viewed as being affected by and affecting multiple levels. Ecological models identified influential factors categorized in three major groups: intrapersonal factors (e.g., intrinsic motivation), interpersonal factors (e.g., social support), and environmental factors (organizations, community, and policy) (Sallis et al., 2015). At the individual level, studies have shown that personal characteristic such as positive attitudes and beliefs (Graham et al., 2011), knowledge and awareness of the benefits of physical activity and the risks of physical inactivity (Xu et al., 2017), and high self-efficacy (the confidence of being able to perform the behaviour; Hong & Chung, 2022) predict higher engagement in regular physical activity. Another important intrapersonal factor that influence physical activity adoption is motivation. In line with the self-determination theory (Deci & Ryan, 2011), people with high intrinsic self-determined motivation (rather than extrinsic control motivation) tend to have higher intention, performance and maintenance of long-term physical activity (Kalajas-Tilga et al., 2020; Nogg et al., 2021). A preliminary study suggested that intrinsic, integrated and identified forms of motivation are associated with stronger habit strength of physical activity (Hopkins et al., 2022). At the interpersonal level, the support of family members and friends is a significant predictor of one’s physical activity performance (Brownson et al., 2001; Van Luchene & Delens, 2021). In a study that investigated the motives behind engaging in physical activity during the transition from high school to university, it was discovered that active students placed a significantly greater emphasis on meeting new people or forming new friendships compared to their less active counterparts (Wilson et al., 2022). There are also environmental factors associated with the behaviour. For example, among adults living in the US, neighbourhood characteristics, including the presence of sidewalks, enjoyable scenery, heavy traffic, and hills, were positively associated with physical activity performance (Brownson et al., 2001).

In this study, we lean on an ecological framework in order to understand the factors that influence young adults with strong versus weak physical activity habit. Many studies have investigated the determinants of physical activity, but less focused specifically on the cognitive mechanism that lead to adopt this behaviour. While a behaviour can be mediated by several conscious mechanisms such as intention, planning, and monitoring (Schwarzer, 2008), it may also be mediated by non-conscious mechanisms for example habit. Habit is a mechanism of action, characterized by a repetition that occurs automatically without thinking as a response to a cue in the same context, and resulting in reward (Lally & Gardner, 2013). There is strong evidence that habit strength is a strong predictor of healthy lifestyle behaviours (Fleig et al., 2014; Norman, 2011; Sniehotta et al., 2014). Turning a healthy behaviour into a habit is a strong aspiration of clinicians, as it holds the potential for consistent and sustained performance. Although some studies investigated determinants of physical activity among undergraduate students, these studies did not distinguish between conscious and non-conscious processes (Deliens et al., 2015; LaCaille et al., 2011). Thus, there is a need to identify the determinants of habit formation that lead to physical activity among students. Identifying the determinants of habit formation may be the first step in the development of effective tailor-made interventions to promote such physical activity habit among university students. The research question of the current study was what are the determinants that influence university students in the formation a physical activity habit. The objective of this study is to understand what are the hinders and facilitators of physical activity habit formation of university students, according to the socio-ecological model levels.

Materials and method

Design

A qualitative approach with phenomenological-hermeneutical method (Lindseth & Norberg, 2004) was used. This method is a way to get a good understanding of a phenomena’s meaning by investigating lived experience (Lindseth & Norberg, 2022).

Participants

Graduate and undergraduate students at a public university in South Israel were recruited. To increase credibility, participants were purposively selected using the criteria of academic level (undergraduate students vs. graduate students), discipline, and gender (Graneheim & Lundman, 2004; LaCaille et al., 2011).

Recruitment strategies

Participants were asked to voluntarily participate in a one-hour long interview through an ad posted on the Student Union website (a free website open to all students at the university). The ad informed participants of the study’s focus on healthy lifestyle, with no mention that it focused on exercise or physical activity, in order to prevent selection bias and to recruit participants with heterogeneous levels of actual physical activity. Students interested in participating in the study contacted the researcher via email. A meeting was set for the interview at the participant’s convenience and was held in an office at the Faculty of Health Sciences by the principal investigator. Participation in the interview earned the participant a restaurant voucher of 50 NIS (approximately US$15). Participants were recruited and interviewed between December 2015 and March 2016.

Data collection

Face-to-face interviews were used to collect data. We selected a face-to-face interview design rather than using focus groups in order to avoid peer pressure, facilitate genuine participation, and efficiently utilize participants’ time. After participants received an explanation about the purpose of the interview, and the option to avoid answering questions or to stop it at any point in time, they gave verbal consent, and we audiotaped each interview. The participants were instructed that there are no right answers to the questions, and questions included probes to reach deep understanding. Reflections were made by the interviewer after each question to obtain a true understanding of the meaning. We conducted interviews until data saturation was reached, namely until no further new information was obtained, after 25 interviews (Gentles et al., 2015). A semi-structured question guide was developed following an accepted approach and consultation with experts in qualitative research design in order to identify the participants’ attitude towards habitual physical activity and the factors influencing habitual behaviour. The question guide used open-ended questions and included two sections. The first section consisted of general questions about the participants’ perception of physical activity (e.g., ” how do you perceive the significance of physical activity?”), and the participant’s actual physical activity routines (e.g., “please tell me about your physical activity habits”). The second section referred to the promoting and hindering factors that affect these habits (e.g., “what or who encourages you to exercise?”). Interviews were held for 45–60 minutes. A pilot study was conducted among three interviewees in order to assure that the questions were clear, and the interview flow coherent. Two questions that were not completely understood were rephrased. However, since there was no significant change in the meaning of these two questions, the participants who were interviewed during the pilot were included in our final analyses.

Data analysis

We used a theory-driven qualitative analysis (‏Epel-‏baron et al., 2016), which is valuable when researchers aim to explore how a specific theoretical framework applies to a particular context such as habit formation. The data from the audiotaped interviews was verbatim transcribed using Express Scribe Transcription Software (Version 5.84, NCH Software, Greenwood Village CO, USA). The transcripts were read through several times by the three authors (one with experience in qualitative analysis, another with expertise in motivational processes, and the third with expertise in behavioural economics) to obtain a good sense of the whole. We used a phenomenological-hermeneutical method (Lindseth & Norberg, 2004, 2022) to understand the meaning of the experience of habit formation. This method comprises three steps: a first interpretation, a structural analysis and a comprehensive understanding. Meaning units were extracted from the text and labelled with codes independently by the three authors. Thematic content analysis with an integrated approach that employed both inductive (ground-up) and deductive (framework-based) approaches was used to develop code structure (Bradley et al., 2007; Braun & Clarke, 2006; Hsieh & Shannon, 2005; Lindseth & Norberg, 2022). This method is acceptable when the analysis is theory-based, and the analysed phenomenon (physical activity habit formation) was not previously examined within this framework (i.e., the ecological model). The code structure was finalized at the point of theoretical saturation. The various codes were compared against each other and stored into categories. The categories were further discussed by our study group and compared with the original text to reach agreement with regard to the way the data were labelled and sorted under categories and themes (Graneheim & Lundman, 2004). By doing analyst triangulation, we ensured confirmability of the research findings (Amankwaa, 2016). IBM SPSS Statistics for Windows (Version 24.0, Armonk, NY: IBM Corp.) was used for descriptive analyses of interviewees’ characteristics.

Ethical approval

The study protocol was approved by the Ethic Committee of the Faculty of Health Sciences at Ben-Gurion University of the Negev (#312015). Participants gave verbal consent to participate in the study.

Results

Saturation was reached following completion of 25 interviews. Participants were categorized into three subgroups according to the extent of their physical activity habit strength. Habitually physically active participants were categorized as such if they had engaged in at least one major type of exercise for a long time, usually at the same time each day; this activity was seldom cancelled, took place even when the routine changed and did not require special equipment and/or prerequisites. Variably physically active participants were categorized as such if they were alternately engaged in different types of exercise; the exercise took place at different points in time each day/week dependent on other competing tasks; the activity was periodical and sometimes cancelled or stopped for a while, but usually took place again. If the participants were not engaged in any exercise (or rarely were), then they were categorized as physically inactive. Table I presents the sample characteristics according to these categories.

Table I. Characteristics of participants [n (%)]–.

PA group	Habitually physically active participants n = 8	Variably physically active participants n = 11	Physically inactive participants n = 6
Age M (SD)	26.0 (4.3)	25.7 (1.3)	26.0 (3.2)
Gender (female)	3 (37.5)	8 (72.7)	2 (33.3)
Family status (single)	7 (87.5)	11 (100.0)	4 (66.7)
Origin (Israel)	7 (87.5)	10 (90.9)	5 (83.3)
Education (undergraduate)	5 (62.5)	10 (90.9)	4 (66.6)
Faculty
Health Sciences	3 (37.5)	1 (9.09)	1 (16.7)
Engineering Sciences	2 (25.0)	1 (9.09)	–
Humanities and Social Sciences	2 (25.0)	8 (72.7)	2 (33.3)
Business & Management	1 (12.5)	–	2 (33.3)
Natural Sciences	–	–	1 (16.7)
NA	–	1 (9.09)	–
Self-reported health status (% reporting very good or excellent)	8 (100.0)	9 (81.8)	5 (83.3)
Type of exercise*
Running	2 (25.0)	6 (54.5)	–
Group activities (Zumba, Spinning, Pilates, Yoga)	1 (12.5)	5 (45.5)	–
Gym	2 (25.0)	3 (27.3)	–
Ball games	2 (25.0)	2 (18.2)	–
Walking	2 (25.0)	–	–
Swimming	1 (12.5)	–	–
Engage in more than one type of exercise	2 (25.0)	6 (54.5)	–

Note: Each participant might engage in more than one type of exercise; thus, percentages do not add up to 100%.

Participants were mostly undergraduate students (various faculties), single, and born in Israel. Most of the habitually physically active or inactive were men, whereas most of the variably physically active participants were female. There was a variety in the discipline distribution among physical activity categories. The habitually physically active participants generally reported participation in one activity such as running, walking, working out at the gym, or playing ball games. However, half of the variably physically active participants reported participation in more than one activity, and the frequent activities in this group were running, group activities, and gym workouts. None of the variably physically active participants reported engaging in walking.

Socio-ecological models help experts to recognize and understand the factors that affect an individual’s health behaviour, and to plan interventions that improve public health (Golden & Earp, 2012). Because these models include not only the social environment, but also the physical environment of the individual, they are suitable to explain health-promoting behaviours. The determinants that emerged from the interviews were analysed using the four themes of the socio-ecological model (‏Epel-‏baron et al., 2016): Intrapersonal, interpersonal, community, and public policy factors. Table II summarizes the themes and categories of the research question.

Table II. Themes and categories of the determinants of habitual physical activity.

Themes	Categories
Intrapersonal factors	Perceptions and attitudes towards physical activity
	Perceived benefits of physical activity
	Personal traits
	Feeling associated with physical activity
Interpersonal factors	Social support
	Modeling support
	Peer pressure
Community factors	Social norms
	Availability and accessibility
Public policy factors	Educational policy
	Workplace policy/culture

Intrapersonal factors

The individual’s perceptions and attitudes towards physical activity were found to be different between habitually physically active participants and variably physically active participants or inactive participants. The former saw physical activity as a way of life, something they do as a routine. One male participant (#20) said: “That’s how I used to live, I mean … if I have the option of taking a bus for 5–7 stations or walk, I prefer to walk….” Another male participant (#10) said: “If one day I do not run and had planned to, then all day I have the feeling that ‘I missed something’ and it affects me all day,”. A female participant (#19) said:

There is no external factor that drives me to do this (PA)… It just became a routine, as if I know that on this day, at that time, I do it! It became a routine of something that I’m used to doing … I know it’s important for my health and for my mind. It’s a part of lifestyle … it’s totally a part of my life.

In addition, since the habitually physically active participants take this activity as part of everyday life, they precisely schedule their physical activity, as a male participant (#10) said: “Usually I run at the same time in the morning … on the same days of the week … It is seldom canceled … I have been running like that for 15 years … .” Another male participant (#20) said: “Regularly, I organize all my activities in a diary, and that’s how I take care not to set busy things on too many evenings,” and a female participant (#4) said: “When I have something defined, ordered, known. it just becomes part of who I am.”

Habitually physically active participants saw the long-term benefits of being active (rath-er than the immediate benefits of weight loss and better shape). A female participant (#19) said: “I know how important it is, and that it’s good for health and good for the soul, and I think if I’ll stop, I would feel worse … .” Another male participant (#20) said:

Yes, [physical activity has] mental benefits, yes, benefits in ordering my daily thoughts, all kinds of things … I heard about studies that found it improves things … helps … prevents aging memory and all kinds of things like that.

From that point of view, they choose to engage in physical activities that can take place everywhere and anytime (such as walking or running), activities that do not require special equipment or other prerequisites. One male participant (#10) said:

I am a practical person, and running is a very practical thing, and it seems to me that helped me decide … that it does not depend on anything, not on other people, not on special accessories, it does not take up extra time beside the running itself. I can do it whenever I want more or less … .

Another participant (#20) said: “Last year, I signed up for a gym, and I saw that I was not really utilizing it … because you have to get special clothes and shoes, and then to arrive and so on … .”

Personal traits also emerged as an intrapersonal determinant of habitual physical activity. Participants felt that maintaining a physical activity habit depends very much on personal characteristics. Strong willpower was addressed as an important trait that help prevent relapses (#19): “Those who have willpower will be able to maintain it to a certain extent, but it is very difficult.” A female participant (#4) stated: “I … I have a lot of willpower. I tell myself something, and I do it.”

Lastly, habitually physically active participants mentioned enjoyment as an important factor to adhere to a long-term physical activity. They thought that if physical activity is a behaviour that one enjoys, it will finally become a habit: “It’s fun, the most important is the pleasure. The girls’ company is very nice, it is fun. The group game … and moving myself sometimes … I just do not know to be without it” (female participant, #14). “The best way to really persevere and succeed and maintain it over time is if you are doing something that is fun for you” (#19). An inactive female participant (#2) referred to enjoyment as the reason for not being active. She said:

It just feels like suffering, I cannot even describe it to you. I just cannot wait until the end of it, I don’t enjoy it! … and when it is finally finished, I just go out and say: “It’s over!”

Self-confidence and self-efficacy in the ability to exercise were enhanced upon completion of the exercise. These feelings were reported as pleasant, and as those respondents want to feel again. For example, female participant (#4) stated: “I experienced the success, I saw that when I exercised it really leads me to outcomes, and feeling good, and relaxed… It adds to my sense of confidence.‘ A male participant (#23) described the influence that physical activity has on him: ’ … such a balance, that is when you are alone with yourself, adrenaline rises, you feel good after that. Yes, that is important. Perhaps contributing to self-confidence. Definitely for health … .”

Interpersonal factors

Social support that comes from close people such as family members, friends, or colleagues was identified as a strong determinant of long-term physical activity habit. A female participant (#4) said:

My boyfriend … he also wants to exercise, he likes it and enjoys it, so it’s something that we do together. My mother also likes to exercise sometimes, so it’s an incentive to do it together … .I would have given myself some chance … because some sports, in my opinion, are also a social thing, so I say to myself, come on … it will be fun.

A female participant (#17), who used to walk with her mother every day, said that her mother encourages her to keep walking and to never give up: “My mother … if I give up to myself or something, then she says ‘Come on, let’s do it …’ So it’s also mom … .” An ultra-marathoner (#13) described the motivation he gets from his partners in a race:

… First of all the people around me. I’m talking about the other runners, not necessarily around me every day … Because it’s a sport you can’t do if you don’t like it … everyone comes along with his desire, with his drive, it creates a feedback loop for each other.

A male participant (#24) said: “As far as my friends exercise, then it motivates me more. I would have someone to exercise with… when a lot of people exercise, they invite other people to come in.”

In addition, some participants referred to a peer pressure $-$ the social need to be like everyone else. The response of participants to the question: What is the influence of knowing that most of your friends are regularly active? was: “I think it’s a bit of an influence because it’s part of a social circle … maybe it would have influenced me to try to synchronize with them and do sports together” (female participant, #16). A female participant (#9) said: “I’m pretty sure yes, I can say it about anything else that other people close to me do, so I’ll immediately feel the need to do it too.” Participants also referred to the modelling support that comes from the people around them as a motivating factor. A female participant (#18) said when she was asked for the reason she had started to exercise regularly: “It was something from our house, something from my parents … it was something I had been raised on since I was young.” A male participant (#10) also stated: “A personal modeling, I think this is something very important. Such a personal story, a life story of someone who made the change.” In addition, participants stated that group activities create commitment, and thus enhance habit: “When a lot of people do exercise, they invite other people to come in. Especially if it’s a more social exercise” (#24), or “When you are with someone else, it gives you some kind of commitment” (#4).

Community factors

Two facets of the community level were identified as determinants of habitual physical activity. The first facet is the attitude towards physical activity and related social norms in one’s community. Group activities in one environment increase the opportunity to participate and to find a favourite kind of activity. A male participant (#25) said: ” … exercise with people … It makes me less give up on myself, so yes, if people around me exercise a lot, I will also exercise a lot.” Another male participant (#23) said: ‘The fact that you are turning something into a norm. For example, in the neighborhood, at the workplace, at school, it’s already part of your life.’ A male participant (#13) said: ‘For me, the greatest impact is … when you go back from the university and you see someone doing a run, or a walk … .’ Secondly, participants referred to environmental factors such as availability and accessibility that facilitate performance of physical activity. When we asked what factors can increase habitual physical activity in the overall population, a female participant (#4) said: ‘More accessible, I mean, more places to exercise in. If I had a gym close to my home, for example, I wouldn’t have to come especially. Really, I’m sure I would exercise more.’ Another female participant (#3) said: ” I think proximity is a significant way to encourage people to exercise. When the activity is very close to home or work…Maybe it should be institutional. I see at the university, there is yoga in the morning ….” Another female participant (#12) thought that each organization should promote physical activity of its members: “I think it should be something more general… to advertise more or to do more things that are outside of teaching hours. It is something that the organization you’re in has to push … .” A male participant (#15) thought that institutional organized groups are good because they increase access to physical activity: “All the organized groups, running groups, or gyms … for the person who is part of a group, it will be much easier to maintain.”

Public policy factors

Participants stated that educational policies, specifically at a young age, and workplace culture can influence individuals to change their behaviour and adopt a healthy lifestyle automatically, without the need to explicitly encourage them. One male participant (#8) said that when the education system emphasizes the importance of being physically active to very young students, it more likely becomes a habit:

It seems to me that this is something that might need to come from education at the early age. Making it a norm, a major part of everyday life, and then you don’t have to convince people to do it.

One female participant (#18) thought that education should focus on the value of physical activity: “I’ve met people who do not think it’s (physical activity) very important; they do not see it as valuable. It seems to me that when we see something as valuable—we do it.” She also said that workplaces should adopt physical activity as one of the company’s values: “There are places, I have heard, that dedicate two hours in the morning to physical activity of their employees … this is such an agenda, in workplaces, really putting it as a value of the organization.”

Discussion

The aim of this study was to identify determinants of habitual physical activity among university students in Israel. In line with the socio-ecological model levels (McLeroy et al., 1988), the analysis revealed four major themes: The first level of intrapersonal factors revealed perceptions and attitudes towards physical activity, perceived benefits of physical activity, personal traits, and feeling associated with physical activity. The second level of interpersonal determinants revealed social support, modelling support, and peer pressure. The third level of community factors revealed social norms, availability and accessibility. The fourth level of public policy factors revealed education and workplace policy and culture. In the following chapter, we will discuss our results in light of the extant literature.

Different from others, habitually physically active participants referred to physical activity as a way of life (rather than as a way to achieve immediate goals). A systematic review found that integrating physical activity into one’s lifestyle routine is a facilitator of uptake and maintenance of the behaviour (Kelly et al., 2016). It looks like this notion affects not only the adoption, but also the habit formation of physical activity. Additional literature review of barriers and enabling factors in workplaces revealed that blending strategies into daily work structures may be more effective (Dabkowski et al., 2023. According to the integrated behaviour change model for physical activity (Hagger & Chatzisarantis, 2014), implicit motivation—a non-conscious process from the self-determination theory (Deci & Ryan, 2011)—has direct impact on the adoption of physical activity, in parallel to the conscious process. It means that although physical activity is a complex behaviour (compared to putting on a seat belt, or brushing one’s teeth), the non-conscious process leads to this behaviour beyond the known role of the conscious process (i.e., awareness and intention). A qualitative study examined positive emotions of leisure-time exercise among maintainers. The researchers found that more than 50% of the participants, mostly the younger group (18–34 years of age) attributed the positive emotions to an inner drive that pushes them to move (in addition to other motives such as social interaction, perceived competence, and novelty of experience, that may be relevant to non-habitual exercisers too) (Wienke & Jekauc, 2016). It appears that habitual physical activity associated with the perception of physical activity as a lifestyle habit rather than as a temporary goal that needs to be achieved (e.g., striving to lose weight or completing a marathon). These kinds of goals are derived from a conscious process of constantly being aware of achievements. When the goal is achieved, the activity may stop; thus, habit formation will not materialize. However, when physical activity is perceived as a way of life, it unconsciously becomes a part of everyday routine—an activity that is done without prior thought and planning. Hence, influencing people’s perspective regarding physical activity may be effective in promoting habit formation.

In addition, we found the habitually physically active participants tend to be driven by long-term benefits rather than by short-term ones. They think about their health and functioning in the far future. They characterized themselves as people with a high level of willpower. In contrast, inactive or variably physically active participants were more likely to think about their feelings during the activity and their body image following it, and they characterized themselves as those with less ability to suffer during exercise. Kelly et al. (2016) in their systematic review found psychosocial factors such as lack of motivation and low self-efficacy as barriers of uptake and maintenance of physical activity, and Amireault et al. found that maintainers had higher baseline self-efficacy compared with those who relapsed (Amireault et al., 2013). However, studies have shown an association between habit formation and self-control in the domain of health behaviour (e.g., Adriaanse et al., 2014). Donovan and Francas (1990) found differences between benefits that drive people to start physical activity and benefits that drive them to maintain it. They found that more than 60% of those who started an exercise programme did so for aesthetic reasons such as to lose weight, look good, or shape up, while those who continued exercise (for more than three months) did so for psychological reasons, that is, because it feels good mentally. A systematic review study also demonstrated the difference between factors that explain initiation of behaviour change and factors that explain maintenance of the behaviour change (Kwasnicka et al., 2016). The researchers suggest that, since different motives exist, interventions targeted to the specific factors that enhance maintenance of physical activity should be developed and evaluated.

Interpersonal determinants, namely, social support, modelling support, and peer pressure, were found in our study to strongly affect formation of habitual physical activity. This finding provides additional evidence of the fact that social support encourages initiation of behavioural change (‏Epel-‏baron et al., 2016). A systematic review among adults revealed that social support was not significantly different among individuals who did and did not maintain physical activity participation over time (Amireault et al., 2013). However, another systematic review among adults found inconsistency across studies with regard to the strength and direction of the association between social support and physical activity (Scarapicchia et al., 2017). Our study was conducted among young adults. Similar to our results, peer pressure was also recognized as a facilitator in a study among undergraduate students (Deliens et al., 2015). The fact that modelling support was found in our study to be an influential determinant of habitual physical activity is consistent with two studies that found that a higher level of parents’ physical activity was associated with significant higher physical activity of their 5–6-years-old child (Sebire et al., 2016) and among adolescents (Biddle et al., 2011). In addition. It was found that students with greater increase in peer support over time experienced greater increase in physical activity from adolescence to young adulthood (Cao et al., 2023). The most frequently reported role model for physical activity among young adults were friends, professional athletes and parents (in descending order), yet no significant difference were observed in the level of physical activity by the different role models (Ingersoll et al., 2022). It may be that, in our study, social support referred to the direct mechanism of support one gets to actually adopt habitual physical activity (e.g., keep walking with a partner every day or playing soccer with the same team every week), whereas the literature refers to social support as an umbrella term that refers to all types and sources of support (Amireault et al., 2013; Scarapicchia et al., 2017). It could be that more indirect types of social support (e.g., instrumental support, appraisal support) influence initiation and maintenance differently. Also, it could be that both cultural and individual differences affect the extent to which social and interpersonal factors determine habitual physical activity.

The physical environment that enhances availability and accessibility to exercise was one of the community determinants that students perceived as promoting habitual physical activity. A cross-sectional study (Brownson et al., 2001) and a longitudinal one (Brinthaupt et al., 2010), support the association between access to facilities and adoption of physical activity. However, there is evidence that providing free access to fitness accessories does not itself increase the extent of physical activity (Sforzo et al., 2012). In addition, the impact of community-based physical activity promoting interventions is limited (Baker et al., 2015; Kipping et al., 2014). In addition, we found that students who engage in habitual physical activity usually tend to choose an activity that do not require special equipment, and that can be performed anywhere and anytime. Thus, it seems that while environmental factors may enhance students’ desire to initiate physical activity, these factors are less influential in maintaining physical activity in a routine manner.

Public policy factors, such as education policy, workplace culture, and regulations (‏Epel-‏baron et al., 2016) did not frequently emerge during the interviews. Although participants recognized early education in elementary school as an important driver of habit formation among children, other aspects of public policy were not mentioned. It is possible that habit, a non-conscious process is perceived as endogenous; therefore, it is influenced mainly by intrapersonal determinants. Another explanation could be that public policies are usually not in one’s control, and therefore may not be perceived as a strategy. When public policy is implemented, people usually do not have to endeavour to achieve the change because they do not have another opportunity (e.g., in the case of regulations). It was argued that when developing theoretically-based intervention strategies based on ecological models, a more behaviour-specific approach that extracts different levels of the models should be adopted (Sallis et al., 2015). Corresponding with this notion, our results suggest that if the aim is to encourage habit formation, public policies that are based on regulations may be less influential. Nevertheless, those policies that are targeted at health promotion strategies that address intrapersonal and interpersonal determinants have the potential to be effective.

Limitations

This study has some limitations. First, the voluntary recruitment may led to selection bias. We tried to minimize this limitation by purposively selecting participants by academic level, faculties, and gender. In addition, the recruitment advertisement did not specify that the study would focus on physical activity. The fact that we eventually interviewed a heterogeneous group in terms of the predefined characteristics and the actual engagement in physical activity may imply that this strategy indeed minimized this limitation. However, it may be that a more selective sample strategy would have raised more factors associated with habitual physical activity. Second, participants in our study were all students from the same academic institution, and this might influence their point of view especially about community and public policy factors, as they all referred to the same organization. Finally, the interviews were all conducted in a relatively short period during the winter. This could have affected the results since people tend to be less physically active during challenging weather conditions. However, winter in Israel (specifically in the south of the country) is usually not so extreme. In addition, collecting data in the winter may better emphasize the differences between habitually physically active participants and variably physically active or inactive participants, since habitual physical activity should be continuous and consistent regardless of season.

Conclusions

Our study aimed to shed light on the determinants of habitual physical activity. Intrapersonal and interpersonal factors are significant determinants in individual’s decision to initiate and maintain physical activity, and therefore are the key for physical activity-enhancing interventions. Specifically, strategies to promote habitual physical activity should be target at physical activity as an integral part of daily life, shaping participants’ perspective on physical activity, emphasizing its long-term benefits, and strengthening self-control. In addition, interventions that consider the potential influence of social support and peer pressure such as a group-based exercise programme may be effective in habit formation. Further research may apply our results, while designing interventions to promote physical activity habit, and evaluate them in a quantitative longitudinal design. This evaluation may articulate the relative effectiveness of different strategies to promote habitual physical activity. In addition, applying qualitative method inquiry among a more heterogeneous population (for example, a working age population) is recommended.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Notes on contributors

Rinat Avraham

Rinat Avraham is a Post-doctoral fellow at the Drexel Food Lab, Drexel University, Philadelphia & at the Negev Food Lab at the School of Public Health, Ben-Gurion University of the Negev, Israel. She is a teacher at the Department of Nursing, the Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel. Dr. Avraham research focuses on promoting healthy lifestyle by focusing on intrapersonal determinants of behavioural change. In the Negev Food Lab, she works on the design, development, and evaluation of projects that aim to encourage healthy food choices and eating experiences.

Tzahit Simon-Tuval

Tzahit Simon-Tuval is an Associate Professor of Health Economics at the Department of Health Policy and Management, the Guilford Glazer Faculty of Business and Management and the Faculty of Health Sciences at Ben-Gurion University of the Negev in Israel. Prof. Simon-Tuval research focuses on health services research, adherence of chronic patients to self-care behaviours, medical decision-making, and outcomes research. I am primarily engaged in research collaboration with HMOs in Israel aiming at analysing health services utilization patterns, and leading research projects that examine predictors of patients’ adherence to prescribed therapy and self-care behaviours.

Dina Van Dijk

Dina Van Dijk is an associate professor of Organizational Behavior (OB) at the Department of Health Policy and Management, at the Ben-Gurion University of the Negev. She obtained her Ph.D. from the Hebrew University. Prof. Van Dijk’s research primarily focuses on work motivation and leadership dynamics. She particularly explores the interplay between leaders’ and followers’ self-regulatory focus and its impact on diverse organizational facets, such as health behaviours, well-being, performance, and turnover. Prof. Van Dijk serves on the editorial board of the Leadership Quarterly and is an Associate Editor at Frontiers in Organizational Psychology.