Chronic disease prevention is a leading global public health issue . There is strong evidence that a lack of sufficient physical activity is independently associated with an increased risk of several major chronic diseases including coronary heart disease, type 2 diabetes, colon and breast cancer, depression, and Alzheimer’s disease as well as all-cause mortality [1, 2]. For the prevention of chronic diseases, The World Health Organization (WHO) recommends that adults participate in (i) at least 150 min/week of moderate (e.g. walking) or 75 min/week of vigorous-intensity aerobic physical activity (e.g. jogging), or an equivalent combination of both, and (ii) 2 or more days per week of muscle strengthening activity involving major muscle groups . In addition, other health organisations, such as the American College of Sports Medicine, recommend that adults should engage in specialised exercises to enhance neuromotor fitness, (e.g. coordination, agility and balance) by doing exercises on unstable surfaces, such as balance beams or wobble boards and flexibility-related activities (e.g. passive and active stretching, tai chi, yoga) . While the current evidence base is limited to support the health benefits of these activity modes among apparently healthy adults, engagement in neuromotor fitness and flexibility training are likely to be beneficial for older adults at risk of falling.
Despite of the promotion of existing physical activity recommendations, population adherence remains low. Recent estimates based on self-reported data suggest that globally between 40 and 60 % of adults meet the moderate to vigorous-intensity aerobic physical activity guidelines , 15–30 % meet the strength training guidelines [6–10], whilst only 10–20 % meet the combined moderate to vigorous-intensity aerobic physical activity-strength training guidelines [6, 11, 12]. Given these low levels, physical activity adherence is considered one of the biggest challenges in health promotion .
It has been recently proposed that fitness trainers, such as personal trainers, gym or group instructors, have a potentially important and underutilised role in promoting and supporting physical activity and exercise [14, 15]. Qualified fitness trainers should be trained in the principles of exercise prescription, such as pre-screening, goal setting, assessment and monitoring and program design . Moreover, fitness trainers have access to exercise equipment to deliver a wide range of exercise modalities (e.g. stationary bikes, strength training equipment, stability balls). However, the effectiveness of fitness trainers in reaching the most inactive populations remains unknown. Research into factors associated with physical activity shows that those who experience socioeconomic disadvantage are consistently among the most inactive population subgroups . Encouragement to engage in physical activity may be more limited amongst socioeconomically disadvantaged individuals since the engagement of a fitness trainer is contingent upon the ability to afford this service.
Another potential factor limiting engagement with fitness trainers may be a lack of availability of professionals within an individual’s immediate environment, such as a neighbourhood. This is consistent with the emerging research describing the role of area-level disadvantage on physical activity levels . In brief, after controlling for individual factors (e.g. age, gender, health-status), low physical activity levels observed among disadvantaged populations are partly explained by several area-level factors including real and perceived access to recreation facilities [18, 19].
Fitness trainers work in a variety of indoor settings (e.g. large fitness centres, health clubs, small studios) and outdoor settings (e.g. local parks, recreation reserves) . At present, research on access to exercise facilities have mostly examined structured (e.g. gyms, health clubs, outdoor exercise stations) [21, 22] and unstructured exercise facilities (e.g. parks) . Studies have shown that fitness centre density are distributed by area-level disadvantage, with more advantaged areas having more facilities . While these studies provide insights into the distribution of exercise facilities, little is known on where the services provided by fitness trainers are currently distributed within the community.
In 2011, it was estimated that ~30,000 adults in Australia were employed full-time, part-time or casually as fitness trainers , highlighting a great potential for a wide reach of fitness service provision. Fitness trainers are simply a service provided for community members to help them engage in correctly monitored physical activities. Whilst individuals can maintain fitness simply through the presence of a path (which they can walk or jog on) there are many other facets of the environment that can lead to greater participation in physical activity. Local provision of fitness trainers may be one such factor that to date has not been explored with regards to location.
Using a large sample of Australian fitness trainers, the primary aim of this study was to examine if training locations (e.g. large fitness centres, small studios, local parks) are distributed by area-level disadvantage. A secondary aim was to examine whether characteristics of trainers (e.g. qualifications, years of experience) were associated with area-level disadvantage.