Physical Activity Interventions at Worksite, School and Community Levels How to Have the Greatest Reach and Sustainability May 19, 2015 Deanna Askew, MPA, RD, LRD, daskew@nd.gov North Dakota Department of Health Deanna Askew, MPA This presenter has indicated that she does not have a commercial support relationship to disclose. Her presentation will not include discussion of any commercial product or service. The presentation will not include discussion of off label and/or investigational use of products or services. This presenter will not use trade names in her presentation. The providing units (UND SMHS, ND Department of Health and the Cancer Coalition) will not discuss commercial products or services. The sponsoring units will not include or discuss off label and/or investigational use of any products or services. Nor will trade names be used. The Planning Committee Members have indicated that they do not have a commercial support relationship to disclose. (Katelyn Anderson, Shannon Bacon, Diana Greff, Janna Pastir, Joyce Sayler, Mary Sahl, Jesse Tran, Mary Johnson) 1
Policy can be rules, mandates, laws, ordinances, regulation, or resolutions. Formal or informal Governmental or non governmental What is Policy? What are Environmental Changes? Involves physical or material changes to the environment. Architectural and landscape changes to the built environment Examples include stairwells, walking trails, bike paths Policy and Environmental Indicators 1. Create or Enhance Access to Safe Places to Physical Activity 2. Enhance Physical Education and Physical Activity in Schools and Child Care Settings 3. Street Scale and Community Scale Design Policy 2
Successful Policy Changes That Have Impacted Health: Organizational worksite wellness policies Allowance of work time to walk or exercise School/community joint use policies Allowing general public to use school grounds after hours for walking or playing Successful Environmental Changes: 15 minute walking path Walk the stairs campaign and stairwell placement Bike paths and bike racks (including on buses) Shower facilities at work Sidewalks and countdown cross signals in neighborhoods. Examples of Policies and Environmental Change Strategies that support healthy lifestyles and healthy communities: Attractive and safe locations for physical activity. Adequate physical education for all students. Opportunities for physical activity before, during, and afterschool for physical activity. Safe Routes to Schools and Complete Streets strategies 3
Improving Policies and Environments to Increase Physical Activity Strategy 1: Create or Enhance Access to Safe Places for Physical Activity Strategy 2: Enhance PE and PA in Schools and Child Care Settings Strategy 3: Support Street Scale and Community Scale Design Policy WORKSITES START AT THE ORGANIZATIONAL LEVEL, rather than the individual level. Think about how the jobs are designed what is the nature of the work? Need to look beyond the walls of work. Do workers have a voice in the program? Don t think about adding to their health until you take away what is harming them. CDC Worksite Health Scorecard 4
Worksite Physical Activity Interventions On site exercise facilities Subsidize or discount the cost of offsite exercise facilities Provide environmental supports for PA Provide organized individual or group physical activity programs Provide brochures, videos, posters, pamphlets, newsletters, or other information Worksite Physical Activity Interventions Provide a series of educational seminars, workshops, or classes on PA Provide or subsidize physical fitness assessments, follow up counseling, and PA recommendations either on site or through a community facility Provide free or subsidized self management programs for PA Point of decision prompts to encourage use of stairs Walkability Checklist How Walkable is Your Community? 5
Community Physical Activity Interventions Community wide campaigns Point of decision prompts to encourage use of stairs Individually adapted health behavior change programs Social support interventions in community settings Community Physical Activity Interventions Creation of enhanced access to places for PA combined with informational outreach Street and community scale urban design and land use policies Active transport to school Transportation and travel policies and practices Community Design & the Built Environment Environmental factors beyond the control of individuals contribute to increased obesity rates by reducing the likelihood of healthy eating and active living behaviors. Environmental factors that influence physical activity behavior: Lack of infrastructure supporting active modes of transportation, i.e. sidewalks & bike facilities Access to safe places to play and be active Access to public transit Mixed use & Transit Oriented Developments 6
School Health Index Elementary Middle and High Schools School Physical Activity Interventions Enhanced school based physical education Integrate physical activity in the classroom Recess policies Before and after school access to PA opportunities Staff wellness CDC s Recommended Strategies for Obesity Prevention PA in Schools Require physical education in schools Increase the amount of physical activity in physical education programs in schools Increase opportunities for extracurricular physical activity Support locating schools within easy walking distance of residential areas 7
Physical activity environments in child care settings Movement Break Examples of Interventions that Are Low hanging fruit 8
Designation Programs Worksites Schools Community You can t make healthy choices if there s aren t healthy choices to make. Institute of Medicine Quote It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environmental conspire against such change. Smedly and Syme (2000) 9
Why focus on policy? Why not just start new programs? Private and Public Effect Sustainability Population wide impact Little amount of money goes a long way! Upstream thinking (prevention) creates a healthy environment But, I like doing programs! Programs are: What we are good at. Easy for people to understand. What public health has always done. Easily accepted by the community. Tangible Short term (8 week course) Not typically sustainable Policies are: Newer focus, new skills Harder to gain acceptance by others. New to public health in chronic disease (tobacco has been a leader) Harder to convince others Usually intangible Long term Sustainable Providing programs and environmental change strategies get sites READY for policy change; can be modeling a policy before it s ever implemented. 10
Differences Between Programs and PSE Change Setting Programs/Events PSE Change School Celebrate national Apply for Safe Routes to School funding Walk to School Day Community Host a community bike ride and parade Implement a Complete Streets policy to ensure community roads are constructed for safe biking, walking and driving Worksite Educational session about the value of physical activity; walking challenge Install bike racks at a community center Develop policy where 2 breaks can be combined and added to lunch hour for added PA time; implement walking meetings; improve stairwells We are most likely to make the healthy choice when...... it s the easy choice! 11