Abstract
Physical activity participation has historically been conceptualized at the individual level with a strong emphasis on apparently healthy people. However, in the latter part of the 20th century and early part of the 21st century, a paradigm shift emerged whereby physical activity participation increasingly was acknowledged to be dependent on factors residing beyond an individual's control, with programming and intervention efforts necessary across the lifespan, in multiple settings, and under various life circumstances. This shifting emphasis has created opportunities and challenges for those involved in physical activity program delivery and research. In this presentation, physical activity behavior change, promotion, and retention efforts will be reviewed and critiqued. Emerging from this critical analysis is an understanding of the syndemic nature of hypokinetic diseases (i.e., the diseases associated with disuse and physical inactivity). The term syndemics is used to account for the interplay and synergistic nature of person, place, and timing in the development of disease. Not only are individual lifestyle behaviors and social factors considered in syndemics, but so too are the forces that link those causes together. To genuinely affect change among the masses, those involved in delivering physical activity interventions and programming must not only address each lifestyle behavior and social affliction that contributes to hypokinetic diseases, but also to the social and environmental forces that link those causes together (e.g., stigma, unequal access to resources).