Public health communication and education to promote more physical activity and less sedentary behaviour: Development and formative evaluation of the 'physical activity triangle'

Objective: Communication and education about health behaviours to the general population is essential in public health promotion. This paper describes the process and outcome of developing a new health education model (infographic) for physical activity (PA) and sedentary behaviour used in Flanders (Belgium). Methods: The Flanders Institute for Healthy Living, expertise centre for public health, coordinated a process, including the evaluation of its previous education model among citizens; reviewing existing models from other countries; expert panel meetings (n = 3); and a formative evaluation (34 focus groups) among citizen with various profiles. Results: The previous model was difficult to understand and not motivating. Foreign models (n = 18) were mostly expert-based (72 %), but not evaluated among citizens. Based on expert meetings, the new model includes a daily and weekly variety of activities at different volumes and intensities, sitting (interruptions), and physical and mental health benefits of PA. Based on the focus groups, no quantitative PA recommendations were integrated, and specific symbols, colours, and heart icons were crucial to illustrate different PA behaviours, volumes and intensities. Practice Implications: Involving several key stakeholders, especially sedentary/inactive and vulnerable citizens, is suggested when developing a health model. Citizens preferred non-quantitative PA messages and quantitative messages around sitting interruptions. (C) 2020 Elsevier B.V. All rights reserved.