Explaining physical activity behavior among university students in Fiji Islands using the multi-theory model of health behavior change: A cross-sectional study

Introduction: The Fiji Non–Communicable Disease National Strategic Plan embraces physical activity (PA) as an important component of its strategic directions. Therefore, it is critical to assess the correlates of PA behavior with the help of a robust theoretical framework. This study aims to examine the testing of the fourth-generation multi-theory model (MTM) of health behavior change in predicting the initiation and sustenance of PA behavior among university students in Fiji. Methods: This cross-sectional study was conducted from 29 July 2021 to 1 September 2021 using a non-probability sample of 334 students enrolled at a Fiji national university. Of 334 participants, 15.6% reported not being engaged in any sort of PA. The sample was predominately females (65.9%), undergraduates (93.7%), and Indo-Fijians (68.0%). The physically active participants had higher mean scores of “perceived advantages,” “behavioral confidence, “changes in the physical environment,” “emotional transformation,” “practice for change,” and “changes in a social environment,” as opposed to their physically inactive counterparts. Gender, age, race/ethnicity and MTM constructs significantly predicted initiation (R2 = .525, F (5, 46) = 8.293, p<0.001; adjusted R2 = .462) and sustenance (R2 = 0.460, F (6, 46) = 6.391, p<0.001; adjusted R2 = 0.388). Discussion: This study demonstrates the importance of developing PA promotion strategies for university students in Fiji. MTM can play a role in delineating such strategies through the implementation of educational and promotional interventions. Motivational interviewing along with structural development, including improvement of the facilities of running track, gym, swimming pool, etc. is required to influence changes in the physical environment.