Promoting Physical Activity to REAL People: Practical Considerations and Concerns

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Promoting Physical Activity to REAL People
Practical Considerations and Concerns

• T.K. Behrens Ph.D., CHES, FACSM
• Health Promotion Laboratory, University of
  Colorado at Colorado Springs

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Good Morning!
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What is Physical Activity?

• Physical Activity
• any bodily movement that results in energy
  expenditure
• Occupation
• Transportation
• Leisure-time
• Activities of daily living (i.e., housework,
  etc.)
• Exercise
• Physical activity using large muscle groups that
  is planned, structured, repetitive, and purposive

Casperson, 1985
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Current PA Recommendation

• Adults should do at least 150 minutes (2 hours
  and 30 minutes) a week of moderate-intensity, or
  75 minutes (1 hour and 15 minutes) a week of
  vigorous-intensity aerobic physical activity, or
  an equivalent combination of moderate- and
  vigorous-intensity aerobic activity.
• For additional and more extensive health
  benefits increase aerobic physical activity to
  300 minutes (5 hours) a week of
  moderate-intensity, or 150 minutes a week of
  vigorous-intensity aerobic physical activity
  Additional health benefits are gained by engaging
  in physical activity beyond this amount.

http//www.health.gov/paguidelines/guidelines/chap
ter4.aspx
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Are we Doing it?
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Physical Activity in U.S. Adults
CDC, 2007
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County-level Estimates of Leisure-time Physical
Inactivity among Adults aged 20 years

United States 2006
Age-adjusted percent
www.cdc.gov/diabetes
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County-level Estimates of Leisure-time Physical
Inactivity among Adults aged 20 years

United States 2007
Age-adjusted percent
www.cdc.gov/diabetes
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County-level Estimates of Leisure-time Physical
Inactivity among Adults aged 20 years

United States 2008
County-level Estimates of Leisure-time Physical
Inactivity among Adults aged 20 years

United States 2008
Age-adjusted percent
www.cdc.gov/diabetes
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2006 Age-Adjusted Estimates of the Percentage of
Adults Who Are Physically Inactive in New
Hampshire
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2007 Age-Adjusted Estimates of the Percentage of
Adults Who Are Physically Inactive in New
Hampshire
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2008 Age-Adjusted Estimates of the Percentage of
Adults Who Are Physically Inactive in New
Hampshire
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The Burden of Physical Inactivity

• The Outcome
• Obesity, CVD, cancer, diabetes
• Physical inactivity is a primary factor in over
  200,000 deaths annually
• 2 million deaths worldwide
• Small increases could affect 30K to 35K deaths/yr
• Medical costs exceed 76 billion annually
• Comparable to tobacco costs

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Why Arent We Doing It?
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Which  one is better for my unborn  child?
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Cultural Values?
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Technology?
NY Times, 2008
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Environmental Design?
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No Time?
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Current Time Trends
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What Can WE Do to Encourage Physical Activity?
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Be Grounded in Behavior Change Theory !
Transtheoretical Model
Social Ecological Model
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Be Knowledgeable of Best Practices!

• The Guide to Community Preventive Services(the
  Community Guide)www.thecommunityguide.org

• Recommended
• Individually-adapted health behavior change
  programs
• Social support interventions in community
  settings
• Enhanced school-based physical education
• Community-wide campaigns
• Community-scale urban design and land use
  policies
• Creation of or enhanced access to places for
  physical activity combined with informational
  outreach activities
• Street-scale urban design and land use policies
• Point-of-decision prompts to encourage use of
  stairs

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Translation
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Incentives

• Behavioral economics?
• Typically results in higher HRA participation
  rates for worksites if 100 is offered
• Careful of behavior tied to incentive
• May not translate to long-term behavior change

Goetzel Ozminkowski, 2008
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Technology
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Technology

• Has been demonstrated to increase EE over
  sedentary activities in children
• Insufficient evidence otherwise
• Promising avenue?

Lanningham-Foster, 2009
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Transportation
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Transit Ridership and Percent Active Walkers
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Active Transportation and Obesity Rates
Bassett et al., 2010
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Negative Impacts of Suburbia
Less Walking
Less exercise
More driving
More energy consumption
Worse health
Suburbs
More pollution
More pavement
Less green space
More built space
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Poorly Designed Street Networks
Most transportation experts agree this road is
poorly designed
Completestreets.org
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Designed for Multiple Uses
Most transportation experts agree this road is
better designed
Completestreets.org
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Sport
Americans Use of Time Project
Godbey Robinson, 1999
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Guerilla Marketing
Corn Maze
Fitness First Bus Scale
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(No Transcript)
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Take a Walk in Zion Preliminary Results
Media message content
Environmental/ climate factors
Community involvement
Trail access
Suggestions for improvement
Resistance to protocol
Trail specific features
Non-pedestrian factors
Bus specific differences
Target audience
Behrens et al., APHA 2008
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Sedentary to Active Time

• Park far away
• Take stair instead of elevators
• Skip the stop
• Stepping commercials
• Play with children
• More?

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A N.E.A.T. Idea
Dr. James Levine Mayo Clinic Rochester, MN
Speed 0. 7 mph
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Your Ideas?

• Does it address multiple levels of influence?
• Does it address readiness to
• change?
• Does it hold a relative advantage
• over its predecessors?
• What is the complexity level?
• Is the program trialable?
• Is it convenient?
• Are the results observable?
• What is the time investment?

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Theres nothing new under the
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Physical Activity Recommendation, 1786

• A horse gives but a kind of half exercise, and a
  carriage is no better than a cradle. I sometimes
  wonder whether we have not lost more than we
  gained by the use of this animal. No one has
  occasioned so much the degeneracy of the human
  body.
• Not less than two hours a day should be devoted
  to exercise, and the weather should be little
  regarded.

-Thomas Jefferson
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Henry David Thoreau, 1862

• I think that I cannot preserve my health and
  spirits unless I spend 4 hours a day sauntering
  through the woods and over the hills and fields,
  absolutely free from all worldly engagements.
• I confess that I am astonished at the
  endurance, to say nothing of the moral
  sensibility of my neighbors who confine
  themselves to offices the whole day for weeks and
  months, aye, and years almost together. I know
  not what stuff they are made of.

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Take Home Message (What to tell your family and
friends)

• Some Physical Activity Is Better Than None
• Additional Health Benefits With More Physical
  Activity
• Additional Benefits With Vigorous Physical
  Activity
• Accumulation of Physical Activity

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Tips for Being More Active

• There are 1440 minutes in every day... Schedule
  30 of them for PA
• Walk, cycle, jog, skate, etc., to work, school,
  the store, or place of worship.
• Park the car farther away from your destination,
  or get on or off the bus several blocks away.
• Take the stairs instead of the elevator or
  escalator.
• Play with children or pets.
• Perform gardening or home repair activities.
• Avoid labor-saving devices-turn off the
  self-propel option on your lawn mower or vacuum
  cleaner.
• Use leg power-take small trips on foot to get
  your body moving.
• Exercise while watching TV (for example, use hand
  weights, stationary bicycle/treadmill/stairclimber
  , or stretch).
• Dance to music.
• Keep a pair of comfortable walking or running
  shoes in your car and office. You'll be ready for
  activity wherever you go!  

www.cdc.gov
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Tips for People Who Have Been Inactive for a While

• Use a sensible approach by starting out slowly.
• Begin by choosing moderate-intensity activities
  you enjoy the most. By choosing activities you
  enjoy, you'll be more likely to stick with them.
• Gradually build up the time spent doing the
  activity by adding a few minutes every few days
  or so until you can comfortably perform a minimum
  recommended amount of activity (30 minutes per
  day).
• As the minimum amount becomes easier, gradually
  increase either the length of time performing an
  activity or increase the intensity of the
  activity, or both.
• Vary your activities, both for interest and to
  broaden the range of benefits.
• Explore new physical activities.
• Reward and acknowledge your efforts.

www.cdc.gov
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Questions?For more information please
contactTim Behrens tbehrens_at_uccs.edu