Be Active Your Way Blog - Tools

Program Spotlight

SLier — Tue, 09 Nov 2010 13:55:00 -0400

This week we would like to spotlight the Hip Hop Healthy Heart Program for Children™ (Hip Hop), a comprehensive wellness program bringing together physical education, music, and arts in grade K-6th.

The Program Basics

Hip Hop works through wellness education that flows from teacher, to student, to family and the community at large. It requires parents/guardian/mentors to be involved in training on a daily basis, not only helping to reinforce the lessons at home, but also by personally participating in the President’s Active Lifestyle Award Program (PALA). It has 8 multidiciplinary modules and inspires kids to participate by recognizing their achievements with:

Award certificates for completion of each module
Certificate of Completion for the entire program.

In order to receive their final program certificate, students and an adult partner are required to register for the PALA when they start Module 1.

Measuring Success

Jyl Steinback, co-creator of the program and Executive Director of Shape Up US mentioned two ways in which Hip Hop is evaluated:

Educational Assessment: Students are required to complete a written test to assess their comprehension of the topic. Upon passing each module test, students will receive a module certificate of completion and will be eligible for additional awards and prizes.

Health Assessment: To make sure that the positive lifestyle lessons taught in Hip Hop are truly making a difference, Shape Up US has partnered with HeartSmartKids to track each student’s health progress. Anthropometric data, lifestyle factors, and family history are assessed and tracked using this system.

Challenges

Steinbeck states that, “in some cases, students may not have a parent, guardian or partner/mentor available, or able to participate.” In such cases, she suggests that instructors help students partner with another role model so that they can participate in the program: older siblings; grandparents; recent retiree volunteer - Check www.AARP.org ; student mentor from a local high school as part of the high school’s community service curriculum.

Implementing a Similar Program in Your Community

Use existing infrastructure- The Hip Hop model relies on training educators, healthcare professionals and others who work with groups of children. This creates a program with controlled costs because it builds on existing infrastructure. In your community, try building upon existing infrastructures to implement your program.

Engage parents and guardians- To help engage partners to get the maximum benefit of Hip Hop:

Letters to send home to parents that provides parents with information about the curriculum prior to starting it
Parent, guardian or partner/mentor contracts for each module

Reach out to encourage participation-

Scheduling a group meeting to discuss the curriculum
Send home personal invitations to the group meeting and ask parent/guardians to RSVP by a specific date.
Telephone parents who do not respond and encourage them to participate

Don’t forget potential resources in your community- Hip Hop is designed to be taught many different types of teachers. Programs like this can be taught by:

Public/Private School Teachers as part of their regular curriculum
Home School Instructors
PE Instructors
Fitness Instructors at Health Clubs, After School Programs, YMCA, etc.
Park and Recreation Instructors

Have you used existing infrastructure to implement a physical activity program? How?

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, 26 Oct 2010 09:35:00 -0400

This week we would like to spotlight the "Physical Activity. The Arthritis Pain Reliever" campaign which aims to increase physical activity among men and women with arthritis.

The Program Basics

"Physical Activity. The Arthritis Pain Reliever" is designed to:

• Raise awareness of physical activity as a way to manage arthritis pain and increase function

• Increase understanding of how to use physical activity (types and duration) to ease arthritis symptoms and prevent further disability

• Enhance the confidence of persons with arthritis so that they can be physically active

• Increase trial of physical activity behaviors

Messages are added or edited based on research including making sure that it is congruent with the Physical Activity Guidelines for Americans. In Wisconsin, implementation includes the health communication campaign with targeted print and community event outreach including health fairs, bus stop posters, and billboards.

Measuring Success

The Wisconsin Arthritis Program measures program success by impressions or the number of people that have been exposed to the campaign message. Radio spots, billboards, bus benches, posters, print ads and bookmarks are all utilized to communicate the campaign message to as many individuals as possible.

In May 2010, the Wisconsin Arthritis Program conducted the health communication campaign, including statewide radio advertising with targeted print and community event outreach in several select counties; Milwaukee, Marathon, and Wood.　 The Program was highly successful in delivering over 35 million impressions of the message to adults over the age of 40 living in Wisconsin.

Challenges

As Julie Dotson mentioned, "It can be time consuming to establish partnerships within a particular community prior to beginning a campaign." The Wisconsin Arthritis Program invested 6 months prior to campaign implementation into making contacts and establishing partnerships within the community. Dotson also mentioned that it was a challenge to make sure that the program aligned with prominent community leaders that were identified by members of the community. The Program learned that selecting the right individuals to serve on a planning committee or spearhead an effort is crucial to the campaigns ultimate success.

Implementing a Similar Program in Your Community

Partnering with community based organizations that frequently serve the population that you are trying to reach is essential. The Wisconsin Arthritis Program found that building rapport with the community through trusted partners was a very strong foundation on which to implement the campaign and spread the message regarding the importance of physical activity for persons with arthritis. The Program also found tremendous success in participating in community sponsored events like health fairs.

Program Spotlight 10-18-10

SLier — Tue, 19 Oct 2010 09:51:00 -0400

This week we would like to spotlight the Arkansas State University – Beebe Wellness Program, a recently developed wellness program struggling through the difficulties associated with building a successful program with limited resources.

The Program Basics

The Arkansas State University – Beebe Wellness Program (ASUB Wellness) is entering its second year of existence. Upon initiation of the program, they received a copy of the Physical Activity Guidelines for Americans Toolkit. Since then, they have followed many of the guidelines in their programs and especially in wellness coaching sessions with individual employees. They have established an incentive program entitled “Step by Step” focusing on walking and “Walking Wednesdays” to promote physical activity. Be Active Your Way materials are freely distributed to the employees who show interest in physical activity.

Measuring Success

According to Joseph Scott, “Our program success has exclusively been measured by employee participation.” In their inaugural year, ASUB Wellness ongoing events and programs were deemed successful if they could increase participation from start to finish. Evaluation sheets were sent out post participation asking for input on how the employees were affected and what they would change. Most responses were positive. Scott says, “They have already been asking when the incentive program will be back.”

Challenges

The wellness program is financed by the college with a small, $5,000 budget for programming exclusively for college employees. This poses all kinds of challenges when trying to run a wellness program for an entire semester. Joseph Scott mentioned that they have overcome some of the financial burden by:

Asking local vendors to donate prizes and incentives
Holding events/programs that do not take a major toll on the budget
Getting brochures and handouts from major organizations like ADA or AHA as well as government agencies
Partnering with their health insurance provider to procure speakers, handouts, and information

The program is run by a part-time wellness coordinator which limits the time available to set up events and run the program. Another challenge to consider is that, as a state institution, ASUB Wellness encounters many restrictions on implementing incentive programs. It restricts buying the employees basic instruments like pedometers and wellness materials. The last challenge faced is getting the campus interested in wellness. No previous programs were in place to consistently focus on wellness at the college until the ASUB Wellness Program. The wellness coordinator has routinely been asked what the program is and does.

Implementing a Similar Program in Your Community

ASUB Wellness has many tips to offer minimally funded smaller wellness programs. They have discovered that when minimally funded and understaffed you have to:

Reach out for help from larger groups and organizations. This might include getting wellness materials for discounted rates or even free.
Ask local organizations to participate in events. This helps use manpower from the community.
Reach out to individuals specifically in different areas to get more departments involved in activities.
Find ways to incorporate giving incentives for physical activity. This has been very successful and popular among ASUB employees.

Do you have suggestions for this budding wellness program? How could they strengthen their program?

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?

Tools You Can Use

JWargo — Fri, 16 Apr 2010 15:38:00 -0400

Image courtesy of the President’s Challenge

Providing low cost, readily accessible tools that organizations and individuals can use to help children increase their levels of physical activity can be a challenge, but it’s one the President’s Council on Physical Fitness and Sports’ (PCPFS) President’s Challenge program is ready to meet. Thanks to one of the goals identified in First Lady Michelle Obama’s “Let’s Move” initiative--to increase youth physical activity as measured through participation in the President’s Challenge Presidential Active Lifestyle Award (PALA) , the Council hopes more physical activity practitioners, parents, caregivers, and teachers will know about the tools at their disposal.

In addition to the PALA, the physical activity and fitness awards programs that make up the President’s Challenge offer a low or no cost and easy way to help children and adults stay on track with their physical activity and fitness. While tracking physical activity isn’t for everyone, it can help some realize a goal, such as those outlined in the Physical Activity Guidelines for Americans, and help them work towards improved health.

As the Guidelines for children and adolescents state, young people should engage in a variety of activities that they enjoy. There are over 100 different activities that count towards earning the PALA including skateboarding, soccer, baseball, rock climbing, canoeing, and the increasingly popular video-based physical activity or exer-games. This variety exemplifies the breadth of physical activities, including sports and recreational activities, in which individuals of all ages and abilities can participate to maintain or improve their health.

People need to start someplace and by doing the amount of activity required to earn the PALA, youth and adults are well on their way to realizing the health benefits of physical activity. If you have the capacity to influence a child’s life, take a moment to consider challenging them to earn the PALA. The program is for individuals ages 6 and older, therefore, adults (e.g., parents, grandparents, big brothers or sisters, coaches) have the opportunity to set an example for the children they influence by earning their own PALA, too.

What kinds of tools are you using to increase levels of physical activity among the children you serve? Do you believe that adults can serve as physical activity role-models for youth? Have you had success using awards programs to encourage youth or adult physical activity?