FUTURE SPORT, EXERCISE AND PHYSICAL EDUCATION PROFESSIONALS' PERCEPTIONS OF THE PHYSICAL SELF OF OBESE CHILDREN
By Derek M. Peters, and Ruan J.A. Jones

Kinesiology: International Journal of Fundamental and Applied Kinesiology (2010) 42(1): 36-43. The journal abstract and full length article can be downloaded at: Hrcak Portal of scientific journals of Croatia.

Introduction
The World Health Organization has described the increasing prevalence of obesity across all age groups in the world as a ‘global epidemic’ (WHO, 2006). In the UK alone, there are estimated to be around 1 million obese children under the age of 16 with the prevalence of ‘at least overweight’ in boys and girls aged 2-15 in 2002 reported as 22 and 28%, respectively (National Office for Statistics, 2002). The trend in childhood obesity and the identification of the potential importance of sport and physical activity participation in reducing the problem has stimulated a range of cooperative multi-agency initiatives in England. These have involved sports coaches, exercise specialists and physical educators as the frontline physical activity promoters to maximize sport, exercise and physical activity participation throughout childhood and youth (The Audit Commission, 2006; Department of Health, 2008).

Previous research has, however, identified anti-fat bias amongst such practitioners and indicated that negative implicit and explicit attitudes and perceptions can predict prejudiced behaviour towards the target groups (McConnell & Leibold, 2001; Rudman & Glick, 2001). Indeed, in the broadest context, Davison and Birch (2004) conclude that "discriminatory practices emanating from fat stereotypes have broad-reaching negative implications on the accessibility of health care, educational opportunities, employment opportunities, and the social treatment of overweight individuals."

It is therefore essential to identify if such negative perceptions of overweight and obese children exist in those undergoing training to become the physical activity professionals of the future. If such perceptions are manifest, the findings from this research would add further support to calls for the development of awareness raising interventions in the training of these populations (Gately, 2007). Anti-fat bias has been observed in the most knowledgeable obesity health professionals in the USA, with stereotypes of 'lazy,' 'stupid,' and 'worthless' associated with obese people (Schwartz, Chambliss, Brownell, Blair, & Billington, 2003). There is some evidence to suggest that this bias is stronger amongst females, in younger respondents and those who had higher body mass index (BMI).

The outcomes of the study clearly support findings from previous research which identified that overweight women perceived that their health professional did not understand how difficult it was to be overweight (Wadden, et al., 2000). As such, those with a professional role in supporting patients and reducing levels of overweight and obesity were found to possess prejudice that was explicitly evident to their patients. It was purported, therefore, that if patients felt uncomfortable in such healthcare settings as a result of practitioner bias, "it would not be surprising if they avoided care" and that interventions which enhanced "appreciation of the experiences of obese individuals may be useful in changing attitudes" (Schwartz, et al., 2003).

A large online sample of the general population representing weight category ranges from underweight to extremely obese has also demonstrated that whilst all weight status groups exhibited significant anti-fat bias, there was an inverse relationship between weight status of the participant and the level of observed bias, with weight bias decreased with increased weight category (Schwartz, Vartanian, Nosek, & Brownell, 2006).

Chambliss, Finley, & Blair (2004) found a strong anti-fat bias in the 'good' vs 'bad' and 'motivated' vs 'lazy' implicit stereotype measures, with having an obese friend, having a family history of obesity and lower belief in the level of personal responsibility for the condition associated with less anti-fat bias. As such, their research was congruent with the seemingly global anti-fat bias, but also acknowledged that having a direct familial or social relationship with an obese person, and holding the belief that the condition is not purely the individual;s fault mediated the strength of the anti-fat bias. This would appear congruent with the previously cited appreciation of the experiences of obese individuals being key to changing anti-fat attitudes (Schwartz, et al., 2003) and again, highlights the potential negative impact that failure to appreciate obesity issues may have upon the likelihood of positive interaction between obese people and the health, fitness and physical education professionals of tomorrow.

Anti-fat attitudes and negative obesity bias have also been identified specifically in future physical education, exercise and fitness professionals through research involving physical education undergraduates in New Zealand (O’Brien, Hunter, & Banks, 2007) and undergraduate and graduate students studying exercise sciences in the USA (Chambliss, et al., 2004). Research with first year and third year PE students, and a control sample of psychology students from the University of Otago in New Zealand, demonstrated several significant differences between the PE and control sample and between different year groups of PE students (O’Brien, et al., 2007).

Whilst all student groups demonstrated significant anti-fat bias in three attributes of the Implicit Association Test in relation to attitudes of 'good' vs 'bad,' 'motivated' vs 'lazy,' and 'smart' vs 'fat,' main effects were found for both the student group (PE group greater anti-fat bias) and the year group (year three greater anti-fat bias), and a significant interaction effect revealed that the year three PE sample had significantly greater anti-fat bias than all other groups of students.

Whilst the remainder of the instruments used by O’Brien et al. (2007) related to the students’ explicit attitudes towards measures of physical self-identify and ideological beliefs rather than directly to student perceptions of fatness in children, the authors concluded that small attitudinal differences between student groups in the first year of their course increase greatly over time. This was suggested as "indicating the socialization of prejudice" (O’Brien, et al., 2007) which would appear to be heightened in physical education programmes. Although without the benefit of data gathered in specific relation to physical education delivery, as negative attitudes have previously been identified as leading to prejudiced behaviours (McConnell & Leibold, 2001), O’Brien et al. (2007) also concluded that the training of physical educators needs to include programmes to reduce implicit and explicit anti-fat prejudice. This would appear congruent with the contention of Martinek (1997) who found that lower expectations of individuals have also been shown to influence the quality and quantity of feedback and instruction in physical activity and sport-related educational settings.

Surprisingly, however, only one published study has examined the perceptions of youth 'obesity' among practising PE teachers (Greenleaf & Weiller, 2005). In their sample of 105 practising PE teachers, Greenleaf and Weiller (2005) measured global anti-fat attitudes towards fat 'people' using the Anti-fat Attitudes Scale (Morrison & O’Connor, 1999); performance expectations for 'overweight' and 'normal weight' youth using selected strength, flexibility, endurance/fitness, coordination and sport competence scale items from Marsh’s Physical Self-Description Questionnaire; and overall expectations for 'normal weight' and 'overweight' youth in relation to physical skill, reasoning, cooperation and social interaction.

As such, though only representing approximately half of the data collection instruments used in the research, these aspects of their investigation related to 'overweight' rather than obesity issues in youth, and in relation to global rather than youth-related anti-fat attitudes. Despite potential misinterpretation of the focus of the study upon 'overweight' as opposed to over 'fatness,' all expectation and ability scores were significantly worse for 'overweight' compared with 'normal-weight' youth.

The items exhibiting the most equivocal status between 'overweight' and 'normal-weight' youth were strength expectation, sport competence expectation and reasoning ability, whilst the greatest differentials were found in the items representing endurance expectation and physical ability. It was concluded that holding lower expectations of, and anticipating decreased physical ability in, ;over-weight' youth could be problematic for the provision of effective physical education programmes.

Thus, research has shown that current and future health and PE professionals at the forefront of obesity prevention and physical activity promotion show socialized anti-fat bias that is similar to the population and control samples. It is also suggested that the explicit awareness of this by patients/clients/ students may well reduce the positive experience and likelihood of participation in health care, physical activity promotion and indeed physical education settings.

Despite this, no published work has explored future sport, exercise, and physical education professionals’ perceptions of the physical self of the 'obese child' in comparison with their perception of the physical self of the 'normal weight' child. Hence, the present research is novel in its attempt to quantify the perceptions of the physical self of obese children held by future sport, exercise, and physical education professionals. This research also provides the first empirically supported discussion of the ramifications of the presence of explicit, anti-fat perceptions potentially resulting in prejudice, non-inclusive behaviours, and reduced likelihood of participation in organized sport, exercise and physical education opportunities.

The aim of the research was to investigate the perceptions held by future sport, exercise and physical education professionals of the physical self of 'fat' children compared with their perceptions of 'normal-weight' children.

METHODS

Participants
One hundred and sixty-seven students (mean age 20.9±2.9 yrs; mean height 1.75±.11 m; mean mass 72.4±12.7 kg; mean BMI 23.7±3.4 kg .m2) who were studying sport, exercise, and physical education-related courses in higher education in England completed a questionnaire consisting of demographic information and an adapted version of the Children and Youth Physical Self Perception Profile (Whitehead, 1995).

Instruments
The first section of the survey contained informed consent information including an explanation of the study, including the nature of the subsequent questions. Participation was entirely voluntary with completed and returned questionnaires accepted as informed consent to participate.

The second section of the survey consisted of questions which gathered demographic data about the respondent. These included questions to obtain data for the following variables: sex, age in years, self-reported height (m) and weight (kg), course of study and current year of study (ranging from first to fourth year). This was followed by an adapted version of the CY-PSPP. The CY-PSPP is a 36-item questionnaire that has been commonly used to measure the physical self-perceptions of children and adolescents (Jones, Polman & Peters, 2009; Whitehead, 1995). The instrument is headed by the title What am I like? and requires the participant to determine which of two opposing statements is most like them, and then to select one option to indicate whether the statement they have selected is really true or sort of true for them (see Figure 1).

Within the questionnaire, there are six subscales that measure self-perceptions of sports competence (SPORT), physical condition (CONDITION), body image (BODY), physical strength (STRENGTH), physical self-worth (PSW) and global self-esteem (GSE). The subscale mean was calculated as the mean of the responses to the six individual component items that make up the subscale, with a higher score representing a higher self-perception.

The adapted CY-PSPP used in the present study was revised so that each item had the prefix Compared to normal weight kids… and had some kids or other kids replaced with fat kids in every item (see Figure 2). This approach permitted respondents to determine their own perception of normal-weight kids against which to compare their perception of fat kids and as such permitted the comparison with a self-referenced peer control group 'norm.' The participants were required to decide which statement was true for their perception of fat kids compared to normal-weight kids, and then indicate whether the statement was sort of true or really true. One example of the adaptation of an original item for each subscale follows:

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