National Center on Physical Activity and Disability

1
National Center on Physical Activity and
Disability

• James H. Rimmer, Ph.D., Professor
• University of Illinois at Chicago
• Director, National Center on Physical
• Activity and Disability
• IFC Executive Committee Co-Chair
• September 13, 2007

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Presentation Outline

• Health Disparities in Adults and Youth with
  Disabilities
• NCPADs
• Central Mission
• Resources
• Future

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Health Disparities In Adults with Disabilities
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Without Disabilities
Health Disparities - Adults
With Disabilities
5
Health Disparities - Adults
Risk Factor
Percent
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Health Disparities In Youth with Disabilities
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Disparity in physical activity participation
among youth with disabilities

• Youth with disabilities are 4.5 times more likely
  to be physically inactive compared to
  non-disabled youth.
• Youth with disabilities are twice as likely as
  non-disabled youth to report watching TV for more
  than 4 hours per day.
• 26.6 of youth with disabilities report 3 hours
  /school day of sedentary activities vs. 20.4 of
  youth without disabilities.

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Youth with Disabilities are Vulnerable to
Overweight and Obesity

• Researchers have reported a higher prevalence of
  overweight among children and adolescents with
• Spina bifida
• Prader-Willi syndrome
• Down syndrome
• Muscular dystrophy
• Brain Injury
• Visual impairments
• Learning Disabilities
• ADHD and autism spectrum disorders

• Rimmer et al. Obesity Levels Among Youth with
  Disabilities, J Adoles Health, 2007.

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Prevalence of Overweight (BMI 95th) among
Youth (ages 617) by Disability and Sex.
Percentage
Source 1999-2002 National Health and Nutrition
Examination Survey reported by Bandini et al.
(2005).
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Overweight and Obese Youth are at Increased Risk
of Serious Health Issues

• Chronic Conditions
• High blood pressure
• Hyperlipidemia
• Insulin resistance
• Secondary Conditions
• Mobility limitations
• Extreme deconditioning
• Fatigue
• Pain
• Depression
• Social isolation

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Adolescents with and without disabilities who
exercise lt once per week
Percent Exercising 1 / week
Steele et al., 2004 Data from the Canadian WHO
Cross-National Survey of Health Behaviors in
School-Aged Children (HBSC).
(OR 4.50 95 CI 3.55-5.72)
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The Challenge Before Us

• Physical activity is significantly lower and
  obesity significantly higher in youth and adults
  with disabilities.
• The problem is exacerbated by
• Children and adults with disabilities have less
  access to physical activity.
• Technology and convenience items reduce energy
  expenditure in IADL and ADL.
• Unemployment rate for working age people with
  disabilities is more than three times that for
  non-disabled people.

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Cycle of Physical Inactivity and Onset of
Secondary Conditions
Development of secondary conditions
Physical inactivity
Onset or increase of functional limitations
Decreased capacity to engage in physical activity
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NCPADs Three Central Features

• A resource and information center on physical
  activity and disability, with thousands of
  references on the subject.
• A health promotion center encouraging and
  supporting healthy lifestyles for people with
  disabilities.
• A research and training center promoting further
  research on the benefits of physical activity and
  guiding best practice in the field.

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What We Do

• Identify, collect, synthesize, and organize
  materials on physical activity and disability.
• Create useful resources for consumers,
  professionals, and researchers.
• Increase public awareness of the importance of
  physical activity for people with disabilities.

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More of What We Do

• Promote increased participation in physical
  activity by people with disabilities.
• Educate consumers and professionals about best
  practices and safe methods of exercise.
• Identify important research issues and stimulate
  further research on physical activity and
  disability.

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Pathways to Inclusion in Disability and Health
Healthy, Active Lifestyles FOR ALL
Barriers to Physical Activity Make it More
Difficult for People with Disabilities to Reach
the Goal
Empower the Person
Enable the Environment
Improve Physiological and Psychological Health
Promote Adherence
Increase Participation
Provide Access
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How Do We Get There?

• Better surveillance systems to track and monitor
  obesity and PA levels in Youth and Adults with
  disabilities
• Evidence-based practices in physical activity and
  health promotion for youth and adults with
  disabilities
• Inclusive (livable) communities for youth and
  adults with disabilities

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How Do We Get There?

• Health marketing campaigns aimed at increasing
  awareness and knowledge of major health
  disparities
• Education and Training Programs that increase
  knowledge and awareness
• Capacity Building (i.e., training students in
  public health, continuing education)

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NCPAD Today
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Website Enhancements
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Interactive Features
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Directories

• The following searchable directories are
  available online at www.ncpad.org
• NCPAD Programs Database http//www.ncpad.org/progr
  ams
• NCPAD Personal Trainers Database
  http//www.ncpad.org/trainers
• NCPAD Parks Database http//www.ncpad.org/parks
• NCPAD Suppliers Database http//www.ncpad.org/supp
  liers

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Technical Assistance
The NCPAD Contact Us Form
NCPAD Consumer Request Service System Form
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Partnership with the Presidents Council on
Physical Fitness and Sports (PCPFS)

• The initial focus of the partnership is on the
  development of a series of fact sheets.
• Identified topics
• International Classification of Functioning,
  Disability, and Health
• Pedometers for people with disabilities
• Resources to assist in locating accessible
  recreation programs and facilities
• Including people with disabilities in media
  messaging (via pictures, placards, training
  toolkitsany special considerations for talking
  or working with people who have disabilities)

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2007 Featured Products

• A complete list of NCPAD-developed resources is
  available at www.ncpad.org/shop.

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NCPADs Next Steps Connecting to State Public
Health Departments
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Supporting State Implementation Projects in
Physical Activity
MT
ND
OR
NY
MI
IA
IL
CA
VA
KS
NC
NCPAD provides information resources and
technical assistance to the 16 State
Implementation Projects in the area of physical
activity for people with disabilities
Validated evidence based practice and effective
health promotion strategies for increasing
physical activity are fed back to NCPAD
AR
SC
NCPAD actively promotes adoption of evidence
based physical activity programs for people with
disabilities to all States
FL
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Working at the Intersection of Disability and
Health

• Establish framework for collecting, aggregating
  and synthesizing data from various State
  Disability and Health modules.
• Build a longitudinal database that qualifies
  the health behaviors (i.e., physical activity,
  nutrition) of people with disabilities.
• Track benefits of each program longitudinally
  (i.e., post-implementation).

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Future Directions

1. Customize (tailor) materials and content for
   specific target audiences.
2. Establish a National Health Marketing Campaign
   targeted to specific audiences (e.g., public
   health professionals, providers, consumers,
   etc.).
3. Develop safe, effective and innovative ways for
   online exergaming for people with disabilities.

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Future Directions

• Employ new and emerging technologies that
  encourage/motivate people with disabilities to
  live healthier, active lifestyles.
• Online community of exercisers using sport, dance
  and general exercise.
• Become an interactive Evidence-Based Center that
  connects ongoing DH projects with each funded
  State and rest of nation.

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Technology and Innovation Resources

• Accessible programs
• Personal trainers
• Exercise buddies

• PEP
• PEP for youth
• Cooperative or competitive play

• Full programs on DVD
• Downloadable clips
• Demonstrations of sport and recreation activities

User Supported Communities
Video Library
Interactive Online
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Livable Communities/Universal Design
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HEZ Toolkit

• Toolkit to build Health Empowerment Zones (HEZ)
  for People with Disabilities
• Accessible sidewalks and paths
• Healthy food choices
• Accessible recreation and exercise facilities
• Transportation choices
• Improving social networks

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HEZ Toolkit

• Toolkit content
• Accessibility and Participation
• Community Accessibility Survey
• Facilities
• AIMFREE (fitness facilities, parks, trails)
• Grocery Store Assessment Instrument (physical
  availability and freshness/quality)
• Built Environment
• Health Empowerment Zone Environmental Assessment
  Tool (pathways, curb cuts)

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HEZ Toolkit

• Toolkit content (cont).
• Health Behavior (exercise and nutrition)
• PADS
• B-PADS
• Fat Fiber Questionnaire
• Health Outcomes
• Secondary Conditions Instrument

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Training Professionals and Paraprofessionals
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ACSM Distance Learning Initiative
Bridging the Gap
World of Disability
World of Fitness
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Inclusive Fitness Trainer Certification Program

• Health professionals gain entry-level knowledge
  specific to physical activity and disability

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Capacity Building
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IFC Call to Action

• Work with the U.S. Surgeon General and the Office
  on Disability
• Create partnerships to expand accessibility
• Work with health care providers and organizations
  to increase physical activity for people with
  disabilities
• Advocate for research and technologies
• Recognize those who support the cause

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• http//www.incfit.org

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Technology Innovation (PEPONLINE)

• Tailor to personal needs and environmental
  factors.
• Eliminate any and all barriers.
• Make it easy to implement.
• Keep it fluid - changing as the person changes.
• Provide some type of feedback mechanism on a
  regular basis (i.e., monthly).
• Account for seasonal changes (i.e. winter vs.
  summer).

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PEPonline Coach Summary Screen
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PEPonline Participant Screen
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Personalized Attention

• Friendly, highly trained people available by a
  toll-free telephone, TTY, e-mail, or fax to
  provide personalized responses to yourquestions.
• Toll-free phone [phone] (v or tty)
• E-mail to ncpad_at_uic.edu
• Fax questions to 1-312-355-4058