Be Active Your Way Blog - Active Advice

Communities + Employers = Increased Physical Activity

sFranklin — Wed, 15 Jun 2011 09:25:00 -0400

Everyone knows that physical activity is good for us... right? Okay, maybe not everyone, but certainly the vast majority of adults and many, many children, as do policymakers, healthcare professionals, etc. Yet so few of us regularly attain the daily recommendations in the National Physical Activity Guidelines. The million dollar question is: WHY?

The most popular reason listed is time, or lack thereof. For many adults, the amount of time they spend at work and commuting to/from work is in excess of 10 hours a day. Add in other responsibilities - such as children, or perhaps, classes - and there is not much left of their waking hours. While a federal mandate reducing work hours for all would be great, it is clearly not realistic. But, what can be done is to look at how physical activity can be incorporated into the commute and/or the work day, and what role a community plays in helping to make this happen.

Take the commute. There are a variety of ways that physical activity can be integrated into commuting. The National Physical Activity Plan's Transportation and Active Living sector has identified several immediate priorities dedicated to active transportation. Employers, federal and state legislators, as well as communities and individuals themselves must work together if policy change that will encourage active commuting is going to happen.

Communities can insure that bike racks are installed at transit stations and that commuter parking lots are safe, well lit, and in inclement weather, provide clear sidewalks. Communities could work with employers to institute a bicycle sharing program with locations at local transit stations as well as in areas conducive to places of employment. Such programs allow individuals to "borrow a bike" for a very nominal fee and are increasing in popularity.

And now for the workday... when thinking of communities, we often silo them as their own entities, with their own activities and priorities for serving their residents. We don't often think of them working in partnership with the companies, etc. that may be in their boundaries. Working together with employers, communities can make great strides in helping more people log increased physical activity during the workday. Perhaps a brochure could be developed for those working in the community, highlighting facilities, parks, etc. that are available for physical activity. Another thought is using the employees as focus groups to help determine development and expansion of things like walking trails. Is there a lovely corporate campus headquarter that might be the perfect setting for construction of a non-motorized trail that could serve the needs of both the employees and community residents? Can special rates be offered for a community fitness facility to those that are working in the community but might not be residents? Employees might be new recruiting ground for volunteer youth sport coaches or additional teams for existing or new adult sports leagues.

What ideas do you have for how communities can work together with companies, etc. to make it easier for employees and residents to engage in fitness activities?

Engaging Communities in Fitness: A Range of Options

JPivarnik — Wed, 01 Jun 2011 09:30:00 -0400

One measure of the richness of any community is its diversity. Variety of geography, age, ethnicity, culture and other traits is at the heart of American life and values.

As diverse as we are, though, and as differently as we choose to live, we have much in common. Deeply rooted in our shared, human physiology, for example, is the need to move. We all benefit from physical activity and exercise. Whether in a schoolyard or a nursing home, condo or campground, in the pink of health or post-chemo, the power of exercise can help us keep healthy or recover. The research is unmistakable, but more compelling for most people is the empirical evidence - how good they feel when they get regular exercise for recreation and as part of daily living.

But, how to get everyone to understand the need to be physically active? How to ensure they have ample opportunities to exercise, and how to motivate them to do it? The answers, fortunately, are as diverse as our communities themselves. I was reminded of this on May 31, when we kicked off the second World Congress on Exercise is Medicine with a community walk in Denver. Everyone - from schoolkids to the Senator to the "Biggest Loser" star - had a great time, and finished the walk just a bit healthier than before.

Just move!

At heart, physical activity is about movement. As two-legged creatures, we are made to walk. The setting may be a mall, trail, sidewalk or office park. No gym membership or special equipment needed; shoes are optional but recommended. The pace may be slower in the retirement home than the high school, but the benefits are just as real. Accumulating daily steps toward the Federal Physical Activity Guidelines is a big contribution toward better health for all. We should share the Guidelines widely and help people find ways to meet them.

But, walking isn't everyone's cup of tea, and it isn't enough for some. Communities with plenty of parks and playgrounds, sports leagues for all and safe, walkable neighborhoods have a leg up and tend to measure better on the ACSM American Fitness Index.

The "Law and Order" Principle

Crime shows tell us the perpetrator needs motive, means and opportunity. Same for exercise: We need to tell our diverse communities why they should be physically active; provide a variety of ways for them to enjoy activity, and help them fit it into daily life. If a personal trainer is too costly, let's offer free or low-cost classes at community centers. When it's too cold to jog, open a skating rink. Those who aren't up to running the mini-marathon can do the 5K family walk.

When the community's health is a priority, people find ways to encourage healthy lifestyles. The challenge is for each of us - government, businesses, nonprofits and community groups of every stripe - to find what works for us and then make it happen.

What can you do to foster active lifestyles in your community?

Want to Get More Active? Walk Your Dog!

BOwens — Wed, 18 May 2011 01:00:00 -0400

Contributed by Dr. David Geier

May is National Physical Activity Month and what better way to celebrate being active than to walk your dog. He'll appreciate it just as much as you will. Obviously strenuous exercise, such as running and other forms of cardiovascular exercise, and sports are are excellent ways to achieve health and meet the activity standards established by the Department of Health and Human Services. But finding simple ways for children and adults to integrate activity into their normal activities might be the best way to get people moving.

A new study published in the March issue of the Journal of Physical Activity and Health suggests a potentially great idea for all Americans to become more active. The study, presented by Matthew J. Reeves et al., looks at whether owning a dog and walking the dog are associated with increased physical activity. They gathered data from the 2005 Michigan Behavioral Risk Factor Survey to try to determine if a relationship existed between owning a dog and physical activity.

The authors found that people who own a dog are more active overall and walk more. Dog owners who take their dogs for walks on average walk about one hour more per week than the one-third of dog owners who don't walk their dogs. Interestingly they also found that younger Americans and the elderly walked their dogs the most and that people with large dogs (weighing over 45 pounds) walked longer than owners of smaller dogs. Finally the study seems to suggest that the benefits of owning a dog, as it pertains to physical activity, may actually be more than just the actual walking, as dog owners seem to be more physically active than non-dog owners in general.

When I heard about this study, I was not terribly surprised. I always like to find easy ideas to stimulate physical activity. For instance, I think it is helpful to take the stairs instead of an elevator when possible. Also, parking at the end of the parking lot away from stores and businesses forces people to walk a little bit more with their normal activities. Owning a dog and walking it are more examples of easy changes to implement.

What this study does not address, but most dog owners will tell you, is that the benefits of having a dog are not just seen with physical activity. Most of my friends who have a dog point out the happiness that comes when their dogs greet them when they get home from work or school. They also love taking their dogs to the park and the beach. So to everyone out there who owns a dog - get outside and walk with your four-legged friend. It just might improve your health too.

What are some other ways to get more active with your four-legged friend?

Program Spotlight

SLier — Mon, 22 Nov 2010 10:30:00 -0400

This week we would like to spotlight the Fit for the Masters Use module of ProjectPower and how it was implemented by a Houston-based program.

Program Basics

The American Diabetes Association (ADA) has created a year-round diabetes awareness program called ProjectPower, which is specifically designed for implementation in African American churches. In this program, the church can promote awareness messages and healthy family living by participating in one of the modules called Fit for the Masters Use (Physical Activity). In this module, participants learn the definitions of diabetes and pre-diabetes. This module increases awareness of why physical activity is important, introduces different forms of exercise, provides suggestions for getting started, discusses the recommended amounts of exercise for adults, and increases awareness of the healthcare provider’s role. According to Sherry Grover, her program tailored the module by offering some give-a-ways such as the ProjectPower pedometer and using line dancing, which has become increasingly popular in the African American community, as exercise.

Measuring Success

Grover says that they measure program success through knowledge and program assessments. Knowledge is measured in the form of pre/post quantitative test. The questions are focused on information presented in the Fit for the Master’s Use module. Participants are asked to not include a name on questionnaires and consent for participation is constituted by completing the forms which are optional.

The program’s success is measured by the qualitative and quantitative measures. Qualitative measures are obtained by the Ambassador Evaluation. Ambassadors are church representative trained by the ADA to conduct the year-round modules. Questions measured address the presentation of the workshop and the materials used in the program.

Challenges

Challenges faced in implementation include recruitment and funding. The pastors of the churches are asked to recommend ambassadors’ or representatives from the church that can recruit church member participation. Past participation has been low. Some of the reasons given include: time constraints and not wanting to know about a potential illness. “In addition,” Grover states, “funding for giveaways, materials and snacks is often a problem.”

Implementing a Similar Program in Your Community

Those interested in implementing similar programs can contact the ADA for market area, ambassador training and program materials. The ambassador training is normally conducted at the ADA offices but can be conducted at individual churches. After participants complete training, they are given ambassador materials for the program. They are also given timelines. The ADA will conduct follow-up on each participant’s progress.

How could you use this program in your community?

Program Spotlight

SLier — Mon, 01 Nov 2010 12:23:00 -0400

This week we would like to spotlight Healthy & Fit on the Go, a program designed to inspire behavior change by providing tips and tools for self-care, healthy eating and physical activity for University of Minnesota Extension staff.

The Program Basics

Healthy & Fit on the Go is a program designed to inspire behavior change by providing tips and tools for self-care, healthy eating and physical activity for Extension staff who spend a great deal of their work day in the car. The Physical Activity Guidelines are used as the basis for materials development. A review of the research in behavior change, nutrition and physical activity resulted in this series of 10 how-to tip cards packaged in a take-along kit with a lunch bag, water bottle and exercise band.

This program is designed as a worksite wellness initiative; a pilot was conducted with staff that included an education session featuring the materials in the kit: an insulated lunch bag with re-freezable ice pack, a medium-resistance exercise band, a BPA-free water bottle and 4 how-to tip cards for healthy eating choices and physical activity ideas.

Components of the kit were distributed and demonstrated at the Annual Conference of Extension Educators during October 2010.

Measuring Success

Betsy Johnson and her colleagues conduct end-of-conference surveys at the close of each annual conference where distribution, education and demonstration occur. In addition, kit-specific online surveys are sent at 3-month and 6-month intervals following the conferences. Online surveys include a request for input regarding the usefulness of the kit contents as well as suggestions for tip card topics.

Initial results indicated a strong motivation for changing behavior upon receipt of the portable kit with actual changes exceeding 40 percent for recipients after the first year.

Challenges

Johnson mentioned three main challenges for the program:

Institutionalization: “It was relatively easy the first year to ensure all staff received the kit and participated in the education/demonstration. In years 2 and 3 we are experiencing some issues around distribution and education to new staff as well as distributing and educating staff about new tip cards.”

Individual motivation: “Kit recipients are motivated to use the materials immediately following the conference as evidenced in post-conference surveys. But motivation decreases as time passes. The 3-month and 6-month surveys indicate less actual use/behavior change the further away from the conference. But, each survey does serve as a reminder about the kit and some become motivated by that reminder.”

Cost: “As we expand to the staff in more program areas within Extension (and are faced with state budget crises) we are testing components of the kit for usefulness and cost-effectiveness as a way to motivate behavior change at a lower cost.”

Implementing a Similar Program in Your Community

Try using the following suggestions when implementing a program like this in your community:

As we’ve heard with other programs, get leadership buy-in. With upper management support for the effort, it will more likely be integrated into the planning for a conference or program; without that support, all expense and effort could be wasted.

Develop a systematic reminder system to maintain the motivation for behavior change that follows the education sessions.

Respond to suggestions for improvements, changes or additional tips and materials; it must be relevant to the user or it won’t be used.

If materials and education are distributed once a year at a conference, plan for 3-5 years worth of new materials to keep it fresh and to create the expectation that this wellness program is part of the conference culture.

Program Spotlight

SLier — Tue, 12 Oct 2010 16:13:00 -0400

This week we spotlight Cincinnati Veterans Affairs (VA) Management of Overweight/Obesity for Veterans Everywhere Program (MOVE!), an evidence-based lifestyle program for veterans.

The Program Basics

According to Stephanie Ciccarella, Cincinnati VA utilizes a 2-step process to promote readiness to change. The first step offers education on nutrition, behavioral habits, and physical activity. The second step emphasizes action, like journaling, physical activity, and problem-solving personal habits. Training is offered twice a week under the supervision of a physical therapist with cardiovascular, strength training, and education during 2-hour classes. Personal accountability is the cornerstone of the program.

Veterans begin the second step with education on the importance of regular daily activity. Each person is issued a pedometer and instructed to track their daily steps. Veterans are able to see changes in their activity levels reflected in their journals and set goals. By the end of the program, veterans take lead roles by leading exercise and supporting each other through problem solving and motivation.

Measuring Success

"Emphasis on performance and outcome measures are keys to determining effectiveness of the program,” says Ciccarella. “They help guide program development.”

The Cincinnati MOVE! Phase II program utilizes additional evidence-based outcome measures to help guide the development of physical activity training and education during meetings. These outcome measures (listed below) help indicate ability to successfully participate in semi-intensive exercise, degree of health risk, and improvement in function. By reviewing pre- and post assessment measures, each group member is able to see his or her specific improvement.

Challenges and Program Shortcomings

“One of the primary shortcomings of this program is its length,” says Ciccarella. A longer program would ensure a more thorough change in behavior and demonstrate greater physical progress. Another drawback to the program is geographic availability. Evidence demonstrates that people are more likely to maintain a physical activity schedule when resources are available within 10 miles of their homes. Some veterans must travel significant distances to participate. Veterans are also required to commit a significant amount of time over a 6-week period. This poses a problem for those who work, have children, or go to school. Given the nature of weight loss, the benefits of participation may not be dramatic enough to maintain motivation. Some of the proposed answers to these problems include lengthening the program to 9 or 12 weeks, expanding Physical Therapy Clinics in all outpatient settings, and introducing more flexible scheduling.

Outcome Measures

Berg balance scale	Perceived wellness survey
Montreal cognitive assessment	Gait speed
Weight/BMI	6- minute walk test
Rate of perceived exertion	Vital signs
Readiness to change

Implementing a Similar Program in Your Community

Cincinatti VA tailored the national MOVE! Program to fit their specific needs. To implement the program in your area, check out the original MOVE! Program at: http://www.move.va.gov/ and see how it can work for you.

How could you tailor the MOVE! program for your area?

Are you interested in having your program spotlighted? Leave a comment below and we will contact you with more information.

Program Spotlight

SLier — Mon, 04 Oct 2010 10:24:00 -0400

This week we would like to spotlight Alive!, an email-delivered intervention to help people increase their physical activity and improve their diets.

The Program Basics

The core of the Alive! program, is individualized weekly goal-setting, according to Dr. Gladys Block. Alive! is intended for adults with access to email and the web. Currently its focus is on working adults, although it is adaptable to older persons and college students. Alive! was developed by NutritionQuest in collaboration with physical activity, nutrition and behavioral experts Barbara Sternfeld (Kaiser Permanente), Gladys Block (UC Berkeley), Abby King (Stanford), Kim Gans (Brown) and Cliff Block (NutritionQuest).

The first step in the Alive! program is to complete a detailed online physical activity and dietary practices assessment. Results are provided to participants instantly. For physical activity, the participant's minutes of moderate or vigorous activity, as well as strengthening activities, are compared with the Physical Activity Guidelines for Americans.

That feedback serves to motivate individuals to make changes and to participate in Alive!. Feedback is provided to everyone, whether or not they decide to enroll. If they do enroll, they choose a "Path" to work on for the next 12 weeks, either improving physical activity, increasing fruits and vegetables, or decreasing saturated and trans fats and added sugars. At the end of each 12-week intervention period, participants may choose one of the other two Paths or continue further in the same Path.

In weekly emails, the participant is offered a choice among four small-step goals, individually tailored, to work on during the coming week. Each weekly goal is a small achievable step that will move the participant closer to the Path's behavioral target, such as increasing physical activity to national standards. Goals are tailored to the participants' baseline activity level and to their personal characteristics and preferences. Tips for overcoming barriers and motivational support are also individualized, as is optional automated algorithm-driven phone and print support. In addition to weekly goal-setting, the Alive! program also provides weekly health information and many other resources.

Measuring Success

The developers of Alive! used a randomized controlled trial among almost 800 employees of a large firm to measure their success. Articles reporting the results of these studies can be found here and here. The evaluations showed statistically significant improvements in physical activity and dietary intake during the intervention. However, even more exciting is the fact that that those changes were sustained four months after completion of the intervention.

Challenges

According to Dr. Block, “the computer programming challenges have been enormous, because of the high degree of individual tailoring at the heart of the program. Apart from that, our biggest challenge has been to interest companies or organizations in using a low-cost, successful intervention that only improves physical activity and diet.”

Implementing a Similar Program in Your Community

If you are thinking of creating a computer based intervention for your community, Dr. Block offers the following advice:

Algorithm-driven individualizing of most elements of such electronically delivered programs is essential.
Developing such a tailored program is likely to require far more expert input and costly programming than anticipated.
Be aware that today’s ever-changing web and email standards require the use of high-level programming expertise in presentation methods.
Contact NutritionQuest to discuss tailoring the Alive! program for your community.

If you don’t feel tech savvy enough to create your own algorithm-driven, individualized e-mail- based physical activity promotion program, what are ways you could individualize programs in your community to increase program success?

Program Spotlight

SLier — Mon, 27 Sep 2010 16:26:00 -0400

This week we would like to spotlight Family Fitness Days (FFD), a successful, community-based physical activity program in Southern California.

The Program Basics

Network for a Healthy California – San Diego & Imperial Region works with low-income Californians, increasing their physical activity and teaching them the importance of living a healthy life. Their FFD are monthly events that take place at the City Heights Farmers’ Market. The program highlights physical activity opportunities and classes taking place in the community that are either free or low cost. According to Larissa Johnson, Physical Activity and Community Youth Organization Coordinator, "The goal is to get people to realize that all they need to do is pick an activity that’s easy to fit into their lives and then do it."

FFD are multifaceted, providing interactive physical active events and a booth with physical activity information such as the Be Active Your Way fact sheets. Different physical activities are highlighted every month, alternating between aerobic activities and strengthening activities. Videos of past activities on posted on the ICanSanDiego YouTube page at: http://www.youtube.com/user/ICANSANDIEGO#g/a

Measuring Success

The success of the program is measured by how many people are reached. Network for a Healthy California has established partnerships with local recreation centers and agencies that provide physical activity demonstrations to see if enrollment increases as a result of the FFD.

Challenges

Ms. Johnson feels fortunate that the challenges have been minimal. Both the community and the Farmers’ Market have been receptive to incorporating the physical activity program. However, one of the challenges faced by FFD is lack of personnel to staff the events. Though the events only occur once a month, it is difficult to secure volunteers for the four hour time commitment. To overcome the challenge, FFD connected with professor Ellen Turkel from San Diego City College, a local community college, where students from her health class receive school credit for service learning. They have found the student volunteers to be a great addition to the project, because they want to play a positive role in the community.

Implementing a Similar Program in Your Community

Ms Johnson feels it would be quite easy to create programs similar to FFD in any community. She suggests that others should:

Connect with local resources. For a Farmers’ Market, there are always organizations, businesses, etc surrounding the market. Utilize them as a resource!
Take a look at events that are going on in your community and try to see ways that physical activity can be integrated into that event. For example, if your community has an annual pumpkin festival, that festival is a great opportunity to include physical activity. Think about using the pumpkins as makeshift cones for a relay course or a soccer dribbling challenge.

Do you have suggestions that FFD could use to build their program’s success?

How might this program be adapted for success in your community?

Using the P.A. Guidelines with Cancer Survivors: LIVESTRONG at the Y

JKauffman — Wed, 25 Aug 2010 11:22:00 -0400

What do you think of when you hear the word “cancer”? Like me, you probably don’t think of “working out”, or “increased levels of physical activity”. You might think of hair loss, painful treatments, feeling sick, and having no energy, among other things. But for some folks, exercise and physical activity is just what their doctor orders, even if they haven’t been active in the past. In most cases, the physical activity guidelines can be followed by (or modified for) cancer survivors, especially while under the care of an oncologist or other physician. Physical activity not only helps improve their physical health, but can also be instrumental in improving their overall well-being.

The Y started actively working with cancer survivors in organized programs more than three years ago, and has been instrumental in helping cancer survivors understand the role of physical activity in their life, and increasing their levels of physical activity during all phases of their life as a cancer survivor. (For most, the definition of a cancer survivor is anyone who has been diagnosed with cancer, from the minute of their diagnosis).

How did the Y become more effective in increasing activity levels with cancer survivors? Select Ys participated in the LIVESTRONG at the YMCA collaborative, in partnership with the Lance Armstrong Foundation. First, they oriented and trained their staff. Second, they engaged multiple cancer experts and organizations, locally and nationally. Third, they did everything they could to ease cancer survivors into evidence based programs, lead by caring, empathic staff, in safe comfortable surroundings, with other cancer survivors. And fourth, they shared what they learned along with the way.

Staff throughout these Ys were oriented and trained on how to respond appropriately when someone identifies themselves as a cancer survivor. We also learned basic, factual information about cancer, treatments, and ways to successfully engage cancer survivors in safe levels of physical activity. We involved local and national cancer experts during meetings, webinars, and conference calls, to glean more information about safe physical activities for cancer survivors, like weight training, aerobic activity, and flexibility exercises. This was critical to the creditability of the LiveStrong at the Y program, as was the empathic staff who led group physical activities or one-on-one training with cancer survivors.

One of the more creative and helpful aspects of the LiveStrong at the Y program was helping cancer survivors feel in control of their lives, through physical activity. Instead of feeling like their cancer diagnosis was a signal to do nothing (which can lead to a feeling like cancer is controlling your life), participants were encouraged to and participated in physical activities that showed they could indeed increase their physical conditioning, become stronger, more flexible, which overall showed them their cancer was something they could deal with. Working out with other cancer survivors, and even participating in activities that benefited others (park clean ups, food drives, etc.), only enhanced this feeling of being back and being in control of one’s life.

The physical activity guidelines are important for all people, abilities, and mindsets.

How are you using the guidelines in new programs or in programs with new populations?

News & Reports 7/26/10

SLier — Fri, 23 Jul 2010 09:30:00 -0400

This week we highlight some current news articles regarding physical activity as a family event.

Family Workouts Establish Bonds (source: Wisconsin Rapids Tribune) Article discusses the added benefit of relationship building that can come from participating in physical activity as a family.

Family Fitness Challenge: How to have a fun, active summer (source: USA Today) Article discusses ways for families to be active together this summer with six weekly activities.

What are some other ways for families to become involved in physical activity together?