Outdoor Gymnasiums and Physical Activity in a University Setting: A Mixed-Methods Study

Context of Physical Inactivity and Global Health

• Physical activity is essential for positive health outcomes, basic functioning, and overall well-being. It is specifically associated with a reduced risk of hypertension, diabetes, heart disease, and specific cancers (including colon and breast cancer). Mental health benefits include the reduction of anxiety, stress, and depression, along with weight maintenance and protection against the onset of dementia.

• The prevalence of physical inactivity in India is estimated at $34\%$, which represents the highest rate among South Asian countries. This level of inactivity poses a significant threat to public health and the economic productivity of the nation.

• Data from India’s largest study on physical activity reveals that $54.4\%$ ($n=14,277$) of a sample aged $\ge 20$ years were found to be inactive. Inactivity remains more prevalent in urban participants ($65\%$) compared to their rural counterparts ($50\%$).

• Traditional physical activity interventions focus on individual factors (habit strength, self-efficacy, sense of well-being) and social factors (peer and spousal support). However, the social ecological approach suggests that physical activity behaviors result from the interaction between individuals and their physical and social environments.

• Built environment interventions serve as promising public health initiatives. Outdoor Gymnasiums (OGs) are a primary example. These consist of physical activity infrastructures built in natural landscapes, such as public parks, containing weather-resistant exercise machines designed for the general public.

• The "Healthy University" concept has gained prominent status over the last decade, aiming to cultivate well-being through environment-level interventions. University gyms help staff and students remain active while minimizing feelings of isolation. These installations contribute to Corporate Social Responsibility (CSR) by promoting environmental commitment for sustainable development.

Study Framework: Sequential Mixed-Methods Research

• A sequential mixed-methods design was employed to generate numerical data (Phase I: Quantitative) and non-numerical data (Phase II: Qualitative). Ethical approval for the study was granted by the Institutional Ethical Committee of the Institute of Medical Sciences, Banaras Hindu University (Dean/EC/7201).

• Phase I involved the observation of four specific OGs between 6:00 am and 8:00 pm for one week per month from December 2022 to March 2023. This period covers the winter and spring seasons in Varanasi, India.

• Phase II involved face-to-face, semi-structured in-depth interviews (66 total) conducted in Hindi between August and October 2023. Purposive sampling was used to recruit participants over the age of $18$ who were residents of Varanasi and regular users of the OGs. Individuals under $18$ or those with a history of injuries were excluded.

• All interviews were recorded with consent, transcribed verbatim, and translated into English. Data saturation was achieved by the $66$th interview. The inductive thematic analysis followed the six-step method established by Braun and Clarke, utilizing NVivo 14.0 software for coding.

Detailed Profile of Outdoor Gymnasiums (OGs)

• The study was conducted at Banaras Hindu University (BHU) in Varanasi, India, which is the largest residential public university in Asia. The campus hosts $66$ hostels ($41$ for boys, $21$ for girls, and $4$ for international students) and approximately $1,500$ residential quarters. The campus recorded an average daily footfall of $55,000$ people in 2023.

• The four OGs analyzed were provided by the brand Grand Slam and included the following specifications:

• OG-A: Located within Mahila Mahavidyalaya (MMV), a gated campus exclusive to female students and staff. It contains $10$ machines that can accommodate $17$ users simultaneously. Machine types include:

  • Aerobics: Air walker, Double cross walker, Elliptical machine, Triple twister ($1$ each).

  • Muscular: Horse rider/Air swing ($1$).

  • Stretching: Leg press, Rowing machine, Shoulder wheel, Push chair/Chest press, Pull chair/Shoulder press ($1$ each).

• OG-B: Located adjacent to the International Hostels and accommodates $16$ simultaneous users on $9$ machines:

  • Aerobics: Air walker, Double cross walker, Scaling ladder ($1$ each).

  • Muscular: Weight assisted chest press, Weight assisted shoulder press ($1$ each).

  • Stretching: Sit-up-station, Leg press, Push chair, Pull chair ($1$ each).

• OG-C: Located at the intersection of two Men’s Hostels and accommodates $18$ simultaneous users on $10$ machines:

  • Aerobics: Air walker, Double cross walker, Triple twister ($1$ each).

  • Muscular: Horse rider/Air swing, Aero rider ($1$ each).

  • Stretching: Sit-up-station, Leg press, Shoulder wheel, Push chair, Pull chair ($1$ each).

• OG-D: Adjacent to the University Student Health Centre, accommodating $19$ simultaneous users on $9$ machines:

  • Aerobics: Double cross walker, Triple twister ($1$ each).

  • Muscular: Weight assisted chest press, Strength training (Smith Machine), Seated arm machine, Back shoulder press ($1$ each).

  • Stretching: Leg press, Leg rise tower, Monkey bar equipment ($1$ each).

Statistical Analysis of OG Usage Patterns

• Data collection occurred in four specific time slots: Slot 1 (6:30 am – 8:30 am), Slot 2 (11:00 am – 1:00 pm), Slot 3 (3:00 pm – 5:00 pm), and Slot 4 (6:30 pm – 8:30 pm).

• Climatic Context: Winter (December/January) temperatures in Varanasi range from a low of $10\,^\circ\text{C}$ to a high of $22\,^\circ\text{C}$. Spring (March) temperatures rise to a low of $15\,^\circ\text{C}$ and a high of $31\,^\circ\text{C}$.

• Total users recorded over the four-month period:

  • OG-C: $3,384$ users (Most popular).

  • OG-D: $2,380$ users.

  • OG-B: $2,004$ users.

  • OG-A: $792$ users (Lowest popularity, particularly in December).

• Frequency Trends:

  • Usage was higher in Spring compared to Winter.

  • Males used the OGs more frequently than females. For example, OG-B had only $16\%$ female users on weekdays and $12\%$ on weekends.

  • Weekends exhibited higher occupancy than weekdays for both genders.

  • Peak usage for OGs B, C, and D occurred in Slot 1 (6:30–8:30 am) during March. OG-A peaked at Slot 2 (11:00 am – 1:00 pm) due to its proximity to the student canteen during lunch breaks.

Qualitative Insights: Perceived Benefits of OGs

• Physical and Mental Health Benefits ($95\%$ coverage, 63/66 participants): Users reported feeling invigorated, more productive, and experiencing weight loss, controlled blood sugar, and relief from chronic issues like bone pain, flatulence, and constipation. One participant noted, "If the stamina of the body increases then the confidence automatically increases."

• Proximity to Nature ($82\%$ coverage, 54/66 participants): Participants preferred the open environment, fresh air, and trees over closed gym settings. It was described as a medium to connect with nature that is often missing from modern indoor-centric lifestyles.

• Opportunity to Socialize ($71\%$ coverage, 47/66 participants): OGs provided a family-friendly atmosphere where users could meet friends and children could interact. It was described as a venue for both health maintenance and recreation.

• Safe Environment ($70\%$ coverage, 46/66 participants): The location within a university campus provided a sense of security. However, some female students expressed safety concerns regarding early morning or late evening usage due to the presence of males or the fear of harassment.

• Economical ($64\%$ coverage, 42/66 participants): Because the gyms are free, they attract students and individuals from low and middle socio-economic backgrounds who cannot afford private gym fees.

• Ease of Access for Everyone ($58\%$ coverage, 38/66 participants): The lack of scheduling restrictions or rules allowed users to exercise according to their personal schedules. The facilities are open to university staff, students, and the general public (except for the female-only OG-A).

Qualitative Insights: Challenges and Barriers to Usage

• Lack of Time ($92\%$ coverage, 61/66 participants): This was the primary barrier. For students, the hurdle was a hectic academic schedule. For outsiders and staff, it was the burden of office workload and household chores.

• Overcrowding ($52\%$ coverage, 34/66 participants): Heavy traffic during peak evening hours made equipment unavailable, forcing users to wait or skip exercises.

• Damaged Equipment ($45\%$ coverage, 30/66 participants): Users lamented that several machines were non-functional or broken, which hindered their training routines.

• Laziness ($42\%$ coverage, 28/66 participants): Intrapersonal barriers included a lack of motivation to maintain a regular routine, with users noting that gaps of $2$ to $3$ days would often break their physical activity habits.

User Recommendations for Infrastructure Improvement

• Regular Maintenance ($38\%$ coverage, 25/66 participants): Users emphasized the need for lubrication (greasing) and rust prevention, especially after rain, to ensure machines move smoothly.

• Installation of More Equipment ($36\%$ coverage, 24/66 participants): To combat overcrowding, participants suggested increasing the number of machines and potentially adding heavier resistance options or dumbbells.

• Installation of Amenities ($33\%$ coverage, 22/66 participants): Many users highlighted a specific need for drinking water stations and restroom (sanitary) facilities on the OG premises.

Comparative Discussion and Global Benchmarking

• Gender and Seasonal Variations: The observation that males used OGs more than females aligns with previous leisure-time studies in Spain and elsewhere. Low occupancy in winter matches a Chile-based study where unfavorable weather reduced participation. Higher weekend occupancy mirrors findings from Xihu Park in China.

• Environment and Socialization: The preference for green environments over indoor exercise is supported by urban green space literature suggesting increased psychological benefits. Social connectedness is a recurring theme found in systematic reviews of OGs in Canada and Australia.

• Access Models: While the BHU OGs are free, comparisons to China show a different model where university stadiums may provide either free services (like basketball courts) or paid services (like tennis courts) to the public.

• Security Concerns: Security issues identified by female users at BHU are consistent with international systematic reviews on outdoor gym utilization patterns. Recommendations include placing female security guards at OGs to encourage higher female participation in the evenings.

Study Strengths, Limitations, and Conclusions

• Strengths: The study employs a rigorous mixed-methods design and explores how university-based OGs contribute to public health promotion in the Global South.

• Limitations: The findings are specific to urban India and may not generalize to rural populations. The observations were limited to Winter and Spring, excluding Summer and Monsoon seasons. There is a potential for observer bias, which was mitigated by using multiple observers and cross-referencing with interviews.

• Conclusion: OGs are recognized as viable built environment interventions that revitalize open green spaces and facilitate the fulfillment of social responsibilities for educational institutions. They offer a feasible strategy to combat the rising burden of non-communicable diseases by encouraging sedentary populations to embrace physical activity.