Be Active Your Way Blog - SLier

Physical Activity in Healthy People 2020

SLier — Mon, 11 Apr 2011 11:58:00 -0400

Written by Janet Fulton, Centers for Disease Control and Prevention

How were the physical activity objectives developed?

The Centers for Disease Control and Prevention in partnership with the President's Council on Fitness, Sports and Nutrition worked with a team of federal agency representatives to formulate the objectives for the physical activity topic area. The availability of recent and ongoing nationally-representative data were a necessary requirement for inclusion of an objective; public comments provided further guidance for the final objectives. The Healthy People 2020 default method (10% relative beneficial change) was most commonly used to set the target for each objective.

What's new for Healthy People 2020?

The 2008 Physical Activity Guidelines for Americans provided an evidence-based framework by which the Healthy People 2020 physical activity behavioral objectives were revised. For adults and youth, objectives PA-2 and PA-3 are now consistent with the Guidelines. Because aerobic and muscle-strengthening activities are BOTH required to fully meet the Guidelines, sub-objectives for youth and adults that combine aerobic and muscle-strenghtening activities are now included.

School-based physical activity is reflected in modified objectives for physical education (PA-4 and PA-5) and in two new objectives for elementary school recess (PA-6 and PA-7). More than 60% of pre-school

children attend child care. Therefore, enacting policies that require physical activity in the child care setting (PA-9) is a strategy to modify the physical activity environment for children. Given the ubiquitous role screen time plays in society, the modified objective for youth to reduce screen time through telelvision viewing and computer use (PA-8) is an increasingly important goal.

A new objective for Healthy People 2020 (PA-11) will monitor physician counseling about exercise. Given the recent emphasis on physician counseling about physical activity by the American College of Sports Medicine's Exercise is Medicine program, it is timely that physical activity guidance in the health care setting is tracked at the national level.

Where do we go from here?

With less than 20% of adults meeting the Guidelines for aerobic and muscle strengthening activities and a similarly low percentage of youth meeting the Guidelines for aerobic physical activities, a multidisciplinary approach is needed to facilitate improvements in recommended levels of physical activity.

The importance of having reliable, nationally-representative data sources to track the metrics associated with physical activity cannot be overstated. Important and novel topics were discussed by the Work Group, only to learn that a suitable data source was unavailable. For example, improving the environment for physical activity is a recommended strategy, although there is no acceptable national data source that tracks individual access to green spaces or parks. The same is true for physical activity in the work place. It is imperative to continue support of current Healthy People 2020 data sources and to support future collection of strategic priority topic areas for physical activity promotion.

It is our hope that as these Healthy People objectives disseminate across states and into the schools, businesses, and organizations that make up our communities, there will be an interest in working across sectors to affect real change in physical activity behaviors. The National Physical Activity Plan provides an excellent multi-sectoral framework along with strategies and specific tactics for action. Time and again the health benefits of physical activity have been well documented. Let's work together to move the dial on physical activity this decade!

Can Physical Activity Help Children with ADHD?

SLier — Tue, 01 Mar 2011 13:46:00 -0400

Inattentiveness, procrastination, fidgetiness, and disorganized work habits are just a few of the symptoms of ADHD. For a child with ADHD, such behaviors impair functioning at school, home, and their ability to maintain relationships with peers. The cause of ADHD is largely unknown and likely to be a multi-factorial interplay between genetic and environmental influences. Current strategies for management include medications and intensive behavioral therapy which are not optimal for long term management of the disorder.

Can physical activity help symptoms of ADHD? There is burgeoning research in this area that suggests this may be the case. A recent review paper published by Jeffery M. Halperin and colleagues from Queens College of the City University of New York, in Neuroscience and Behavioral Reviews, January 2011, suggests ADHD in children should be viewed within the context of a “developmental trajectory” rather than a fixed medical condition. As such, ADHD can be modified by environmental influences, including exercise. Individuals with ADHD are never cured, but they can compensate. Environmental influences, including exercise, may affect the degree of later brain development and hence determine the extent to which an individual can compensate.

Functional magnetic resonance imaging (fMRI) scans of the brains of children show that exercise increases activity in the frontal lobes, which are responsible for executive function (see USA Today article). The executive functions consist of processes responsible for planning, rule acquisition, initiating appropriate actions/inhibiting inappropriate actions, and selecting relevant sensory information. ADHD is a disorder of executive function. In an NIH funded study performed by Catherine Davis and colleagues at the Medical College of Georgia, on 94 sedentary children randomized to a high dose exercise intervention group, found improvement in planning scores (i.e., executive function) in the high dose group compared to controls.

Studies are underway to determine the optimal frequency and amount of physical activity appropriate for children with ADHD. There is some consensus however, that certain types of physical activities may be more beneficial in children with ADHD (see article). Activities that require memorization and sequencing of behaviors help focus attention and repeat learned movement patterns, e.g., yoga, martial arts, dance/ballet, gymnastics, swimming and team sports. One study of the brains of judo players (adults) by Jacini and colleagues found significantly higher volume of gray matter in the frontal, parietal, occipital, temporal, and cerebellar regions of the brains of judo players versus controls. Interestingly, neuroimaging studies have shown reduced volume of the frontal, posterior, and cerebellar areas of brains of children with ADHD.

There is also evidence that physical activity outdoors may be more beneficial for children with ADHD. Dr. Frances Kuo from the University of Illinois found that green outdoor settings (green backyard, park, or neighborhood space) appeared to reduce the symptoms of ADHD in children compared to the same activities performed in indoor settings AND built outdoor settings (concrete areas, not much green). Lastly, in July 2010, Yale Researcher, Dr. David Katz published preliminary results of the ABC Fitness Program (Activity Bursts in the Classroom) which focuses on physical activity during the school day. The study compared an intervention group (schools that incorporated bursts of physical activity throughout the day) versus a control group. Preliminary results indicated that medication use for ADHD decreased in the intervention group. Green settings for playgrounds at schools, physical activity in the morning before class (tai chi on the lawn anyone?), and incorporating physical activity during the day in the classroom, may be just the prescription needed to help children overcome the hurdles of ADHD.

Thanks to Farzana L. Walcott, MD, MPH, for submission of this post.

Commemorating the First Anniversary of Let’s Move

SLier — Wed, 09 Feb 2011 11:00:00 -0400

As we celebrate the first anniversary of First Lady Michelle Obama’s Let’s Move initiative, we want to convey to you how thrilled we are that Let’s Move is relying on the 2008 Physical Activity Guidelines for Americans. We are especially pleased that the guidelines are incorporated as the Get Active pillar of Let’s Move. During its first year, this initiative to end childhood obesity within a generation, has built tremendous momentum and has come alive in hundreds of communities across the nation.

Everyone can get involved in Let’s Move. Parents, community leaders, chefs or kids, all have a role in fighting childhood obesity. Get involved: http://www.letsmove.gov/action.php #letsmove”

The President’s Council of Fitness, Sports, and Nutrition is setting the pace for Let’s Move with the Million PALA challenge. All it takes to win The Presidential Active Lifestyle Award or PALA is 60 minutes of physical activity for kids and 30 minutes for adults, five days a week for six weeks. We are supporters of the President’s Council in this challenge and encourage everyone to participate. The First Lady has earned her PALA award, and if she can do it as one of the busiest ladies in our country, so can the rest of us.

Congratulations to Let’s Move! What are you doing to get your community moving?

New Dietary Guidelines Include Need to Increase Physical Activity

SLier — Mon, 31 Jan 2011 16:57:00 -0400

On January 31, Agriculture Secretary Tom Vilsack and Secretary of the Department of Health and Human Services Kathleen Sebelius announced the release of the Dietary Guidelines for Americans, 2010. We are pleased to share these evidence-based guidelines with the physical activity community. The guidelines offer nutrition guidance to promote health and reduce the risk of chronic diseases and reduce overweight and obesity through improved nutrition and physical activity.

This new version of the Dietary Guidelines for Americans, 2010 places stronger emphasis on reducing calorie consumption and increasing physical activity to help with confronting the obesity epidemic.

The new Dietary Guidelines for Americans focus on balancing calories with physical activity, and encourage Americans to consume more nutrient dense foods like vegetables, fruits, whole grains, fat-free and low-fat dairy products, and seafood, and to consume less sodium, saturated and trans fats, added sugars, and refined grains. These guidelines continue to advise the public to consume alcohol in moderation, if at all. The Dietary Guidelines physical activity recommendations are from the 2008 Physical Activity Guidelines for Americans.

The new guidelines also include a call to action for helping Americans make healthy choices for lifelong healthy eating, physical activity, and weight management. We encourage physical activity organizations and practitioners to take an active role in the movement to make American healthy by using these new guidelines in your communities and by helping Americans bring the key recommendations into their lives.

To learn more about the guidelines visit: www.dietaryguidelines.gov.

Please join us as we ensure that all Americans have access to actionable information about how to incorporate the guidelines into their lives, nutritious foods, and opportunities for physical activity.

How does your organization envision using the new Dietary Guidelines for Americans?

Program Spotlight 1-11-11

SLier — Tue, 11 Jan 2011 12:50:00 -0400

This week’s spotlight shines on the Kids Take Heart program offered by The Hope Heart Institute, an organization in Bellevue, Washington that focuses on cardiovascular disease prevention.

Program Basics
Kids Take Heart (KTH) is a health and fitness curriculum that includes anatomy, fitness, nutrition, stress and goal-setting. It was developed and piloted by certified teachers in nearly 20 districts and over 60 schools and 650 classrooms. KTH was designed as a tool to equip children in third, fourth and fifth grades to make lifestyle choices that promote fitness, health and wellness and lessen the likelihood of cardiovascular disease.

An online training component provides graduate continuing education credits or clock hours for teachers, and allows teachers to schedule a curriculum kit (including all lesson materials) for two months. After the program is completed, students will be able to:
     • Identify components, functions, and diseases of the cardiovascular system.
     • Recognize and evaluate risk factors, warning signs, and prevention strategies (i.e. healthy eating and active living) for cardiovascular disease.
     • Create and implement a personal wellness plan targeting nutrition and physical activity.
Kids Take Heart also involves student health ambassadors promoting heart health information among families and the greater community.

In addition to emphasizing 60 minutes or more of physical activity daily, the KTH fitness unit helps students integrate active lifestyles, the FITT (frequency, intensity, time and type) principle and components of health-related fitness (i.e. flexibility, muscular strength, muscular endurance and cardiorespiratory endurance). Throughout the unit, students participate in a series of physical activities and calculate their median pulse. This helps them determine which physical activity level they fall within most days of the week so they can determine individual daily amounts. In the end, students communicate the concept of energy balance – the intake of quality foods in the right quantity expended by physical activity.

Teachers can implement the program during PE classes, in various grade level classrooms, or some combination of the two. KTH could also be used in an after-school program, through the local Parks & Recreation Department or Boys & Girls Clubs. The program incurs little to no cost for school districts (or other venues).

Measuring Success
Teacher evaluations and student health logs determine the impact of the program. The evaluations provide information on the structure and content of training, appropriateness of curriculum, ease of use with kit materials as well as the total number of students reached. Student health logs show nutrition and physical activity goals that students set, as well as their progress in reaching their goals over a two week period.

Challenges
Carly Meiser, CHES, serves as the Education and Community Outreach Assistant for The Hope Heart Project. When asked about program challenges, she said, “With school budget cuts, the pressure of standardized tests, and so many programs competing for time within the school day, health and physical education programs are either being pushed to the back burner or off the burner entirely even as the number of children who are overweight or obese rises.” This is likely a challenge that is echoed among school-based programs nationwide.

Lessons Learned
Ms. Meiser shared that flexibility has been the program’s key to success, “We piloted the original program several years ago, and continue to modify it for improvement based on feedback and changing needs of diverse populations. One tip would be to create a program that can be altered to meet different needs. Having a “menu” of items for folks to select from helps us piece together what a group needs most.”

According to Ms. Meiser, KTH can be used to support health and physical activity in the community by allowing kids to be health ambassadors promoting what they learned throughout your program while developing advocacy skills (perhaps at a community health event). The program can equip families with sound information and spur healthy changes within households.

What are some other creative ways that student ambassadors could be used to affect change in their communities? Share your thoughts & experiences by submitting a comment, below.

Program Spotlight- Call for Submissions

SLier — Thu, 30 Dec 2010 10:53:00 -0400

We hope you've enjoyed our Monday program spotlights the past couple months. Do you enjoy reading about all these fantastic physical activity promotion programs? Would you like your program to be spotlighted? Do you know a program you would like to nominate to be spotlighted? We would love to hear from you! Just answer the six questions below in 750 words or fewer and e-mail them, along with a photo from your program, to rachel.hayes@hhs.gov.

Submitting information about your program does not guarantee that your program will be featured. “Programs” may include specialized organizations, ongoing efforts by broader organizations, temporarily-funded interventions, and/or periodic events. Programs must not conflict with the Physical Activity Guidelines for Americans. Evidence-based programs or programs including an evaluation component will be given preference. If your program is chosen, an ODPHP representative will e-mail you before posting to confirm accuracy of the blog post.

Questions

1. Describe your program and the population it serves.

2. How are the Physical Activity Guidelines for Americans incorporated into the program?

3. How is the success of your program measured?

4. What are some challenges you faced in implementation?

5. Please give tips for others to implement programs similar to yours.

Exergaming and Physical Activity

SLier — Wed, 22 Dec 2010 10:54:00 -0400

Video games, along with television and computers, are often maligned as a major culprit in the obesity epidemic in America. Given the coincidence between the obesity epidemic and the onslaught of media (a study from the Kaiser Family Foundation found that one in five 8 to 18 year olds are exposed to at least 16 hours of media a day!), it’s really not a stretch to see that this is the case.

However, recently, home gaming platforms, particularly Nintendo’s Wii, have received considerable attention and research funding to explore their potential in increasing physical activity. For example, some schools in New York City have developed pilot programs to have kids satisfy their gym requirement by playing Wii Fit 4 hours per week. The new term to describe this practice is “exergaming.”

One of the benefits of exergaming is its inherent entertainment factor. Kids (and adults) love games because they’re fun, social, and captivating. While exercising with the general goal of long-term health in mind is noble, it is difficult to remain motivated when there are more immediate needs to attend to, and you can always put your exercise off “until tomorrow”. Video games provide an engaging, immediate goal to attain, which coupled with a required physical activity can be a far less painful way to burn calories than logging endless hours on a treadmill. Video games have actually been shown to distract from physically painful stimuli, allowing people to tolerate pain longer. As with any other exercise regimen, exergaming is only useful if people stick to it and really exert themselves. Once the initial novelty wears off, these games can be just as tedious as trudging to the gym.

Is exergaming a sufficient way to get the recommended physical activity into our busy schedules? Compared to sedentary video games, active games are beyond a doubt a better choice. On average, kids expend only about 107 calories per hour playing sedentary games, which have also been shown to increase snacking behavior while playing: a double whammy for developing an obesogenic culture. In comparison, an hour of Wii boxing burns an average of about 174 calories. This is a definite improvement on sedentary gaming, however, keep in mind that one study showed that in doing an hour of real boxing, a kid expends 382 calories.

Does the hour of Wii boxing constitute the hour of physical activity suggested by the guidelines for children and adults?

According to the American College of Sports Medicine the answer is yes- so long as the activity gets the heart rate up sufficiently. This level of exertion varies with age and physical fitness level. For the physically fit gamer, home gaming systems don’t provide enough intensity for the games to be counted towards the daily physical activity recommendations, though games are certainly a good way to get together with friends and family or relax after a long day.

But for older adults who need get back into exercise, people who are undergoing rehab, or those who have limited mobility in general, exergaming is an engaging and comfortable way of getting exercise, which can very well serve as your physical activity for the day. You might be surprised to think of introducing older generations to video games, but according to a recent study by the Pew Research Center, over half of adults regularly play video games already, making exergaming an obvious option for people who are already familiar with the systems.

How do you think exergaming can be incorporated into the physical activity recommendations?

Sanna Ronkainen B.A.
Guest blogger

Program Spotlight 12/21/10

SLier — Tue, 21 Dec 2010 11:42:00 -0400

This week’s spotlight shines on the Spring Training program offered by Girls in the Game, a Chicago-area organization dedicated to improving girls’ health and fitness.

Program Basics

Girls in the Game was founded 15 years ago by a group of women who recognized that their participation in sports as girls helped them develop the strength, voice and confidence they needed to succeed as adults. Since 1995, Girls in the Game has emerged as a leader in girls’ health and fitness, serving 2,500 girls in Chicagoland each year. Girls in the Game's comprehensive, evidence-based programs address the health needs of girls ages 6 to 18, and equip girls with the skills and confidence they need to become healthy, successful young women. Girls in the Game’s After School programs use sports and fitness, health and nutrition education, and leadership development activities to help girls form healthy habits to benefit them now and in the future. Girls meet after school, once a week, and are engaged in sports, health and leadership programming tailored to the specific needs of elementary and middle-school girls.

Spring Training is Girls in the Game's train-the-trainer program that gives qualified youth service professionals the tools and training they need to run a Girls in the Game program at their school, park or youth center. With Spring Training certification, youth service sites and their representatives are certified to run a designated Girls in the Game program for either elementary, middle or high school girls. Created specifically for girls ages 8-14, the program is currently implemented in 30 different schools and sites around the Chicagoland area.

Measuring Success

Kristi Skala is the Training and Evaluation Manager for Girls in the Game. She reports that the success of the Spring Training program is evaluated in a number of ways. Youth service providers who participate in Spring Training evaluate the quality and content of the training itself. They are also provided with three months of follow up support so that potential problems can be addressed and questions answered. Additionally, outcome evaluations will be performed on participants of programs implemented by the first five pilot sites to ensure program fidelity and monitor progress.

Challenges

Research demonstrates the importance of both gender specific and sports programming, and many underestimate the need for structured sports and fitness programs for girls. As Skala points out, girls today still do not have as many sports and fitness opportunities as boys have. This lack of understanding or awareness of the need for gender-specific healthy lifestyle programs for girls often leads to challenges in finding staff and resources to implement Girls in the Game’s programs.

Implementation in Your Community

Skala believes that the Girls in the Game model is highly transferable. In fact, Spring Training exists to give youth service providers the tools to implement Girls in the Game programming in their own communities. Sites that aren’t ready for the full Spring Training program can benefit from one day workshops on a variety of topics. These trainings can help youth service providers run their own programs more effectively and efficiently, while ensuring that youth have a positive and healthy experience.

How are the health and fitness needs of school-aged girls addressed in your community? Share your comments!

Program Spotlight

SLier — Mon, 13 Dec 2010 13:16:00 -0400

This week we would like to spotlight the West Virginia Physical Activity Symposium: A First Step in the Development of a WV Physical Activity Plan.

Program Basics

The West Virginia Physical Activity Symposium was organized to draw the attention of statewide media, state government officials, and sector and regional representation from organizational leaders and other individuals throughout the state, to focus on the West Virginia Physical Activity Plan (WV PAP) and was held in June 1010. As part of the Symposium, working groups were formed to look at the National Physical Activity Plan (NPAP) strategies, and within each sector, select and refine strategies that are appropriate for WV. Groups were asked to begin to formulate action steps that could be incorporated into an effective plan to meet the needs of the state. Results of these meetings were used to begin writing a statewide PAP appropriate to meet the context of WV, with final release of the statewide Plan slated for May 2011. As with the NPAP, the WV PAP is based on the 2008 Physical Activity Guidelines for Americans, using the Guidelines as a foundation for plan development, policy recommendations, and advocacy.

Measuring Success

Success was evaluated by looking at process indicators. The PA Symposium included 250 attendees, 7 nationally recognized speakers who shared a global perspective on physical activity and the sector-specific connection, 43 WV programs and research projects presenting posters, 18 WV professionals making oral presentations, and 3 nationally recognized celebrities (Shannon Miller, Olympic Gymnast; Jared Fogle, Subway Spokesman; Phil Psister, World’s Stongest Man) who promoted the message for increased physical activity. In addition, Governor Joe Manchin and the First Lady Gayle Manchin participated throughout, including hosting a reception for guests and the All-Conference Picnic at the Governor’s Mansion. Process indicators for success were accomplished, and in most cases, exceeded.

Challenges

While Eloise Elliott, the chair of the WV PA Plan, did not mention facing any challenges, coordinating a statewide symposium is no simple feat. It can be difficult to reach all of the target populations or create enthusiasm for the event.

Implementing a Similar Program in Your Community

Elliott gave the following suggestions to consider when trying to develop a PAP plan or hold a symposium:

· Development begins with at least one key stakeholder who can provide statewide leadership and a team of dedicated individuals who can serve on a working coordinating committee.

· Key players include state policymakers and government agencies, state and local organizational partners that can provide input and leadership, and many interested individuals and groups who can foster implementation of the strategies and give grassroots input.

· Representation from all societal sectors and from all regions of the state is imperative. The call for action is for EVERYONE who can impact PA participation and/or opportunities to get involved, provide input, take ownership, and make it happen!

· A statewide initiative, such as a PA Symposium as an initial “first step” helps to facilitate interest and support, educates the state about the NPAP, and gives sectors and regional representatives throughout the state a venue to share best practices, and provide initial input into state needs, barriers and successes.

How has your community worked toward implementing the National Physical Activity Plan? Share your challenges and successes by commenting, below!

Launch of Healthy People 2020

SLier — Tue, 23 Nov 2010 13:31:00 -0400

Dear Physical Activity Colleagues,

For thirty years, the Healthy People initiative has put forth a comprehensive set of health promotion and disease prevention objectives to track, monitor, and motivate action to improve the health of all people in the United States. As we prepare for the next decade, the Healthy People 2020 initiative aims to unify the national dialogue about health, motivate actions, and encourage new directions in health promotion, providing a public health roadmap and compass for the country. More than ever, the Healthy People vision of a society in which all people live long, healthy lives speaks to the challenges and opportunities we face each day, calling on us to improve population health by developing collaborative solutions that reach beyond health care.

It is with great excitement that the U.S. Department of Health and Human Services invites you to be a part of the launch of Healthy People 2020. The event will take place on December 2, 2010, from 11:00 AM to 1:00 PM EST at the Jack Morton Auditorium of The George Washington University, 805 21st Street NW, Washington, DC 20052.

This event will mark the beginning of Healthy People 2020 and the official release of the next decade’s national health promotion and disease prevention objectives. The program will include remarks from the HHS Assistant Secretary for Health Dr. Howard K. Koh and members of the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020. There will be an introduction and orientation to the Healthy People 2020 Web site and objectives, followed by a panel discussion about the uses of Healthy People 2020. You can ask live questions via Webcast and Twitter.

You have played an important role in developing Healthy People 2020. Now the real work begins! Similar to the past two decades, Healthy People 2020 will include Physical Activity as a topic area. As a key stakeholder, your work to implement Healthy People 2020 Physical Activity objectives throughout the decade will be critical to improving the health of the nation. Please consider following Healthy People on Twitter at: www.twitter.com/gohealthypeople. Registration for the event is strongly encouraged. Live Web streaming will also be available. Any questions regarding the event can be sent to healthypeople2020@air.org. To attend the launch or participate via Web streaming, register by visiting www.healthypeople.gov/2020_reg/register.aspx

Please join us and be part of making Healthy People come alive for all Americans.

Sincerely,

RADM Penelope Slade-Sawyer, P.T., M.S.W.

Deputy Assistant Secretary for Health

(Disease Prevention and Health Promotion)

U.S. Department of Health and Human Services