What Would You Do with $5,000

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What Would You Do with 5,000?

• Promoting Real Change on a Real Budget

Heather Chambliss, PhD, FACSM Collaborating
Scientist, The Cooper Institute Behavioral
Scientist/Consultant, Health Behavior Research
and Programs 662-404-1414 dhchambliss_at_gmail.com
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What Would You Do with 5,000?

• A question worth asking?

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health educator
community member
behavioral scientist
wife/mom
health council volunteer
consultant
From Go, Dog. Go! by PD Eastman
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RE-AIM A framework for decision making

• Reach
• Effectiveness
• Adoption
• Implementation
• Maintenance

www.re-aim.org Download the RE-AIM Planning Tool
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RE-AIM Framework

• Reach the target population
• Efficacy or Effectiveness
• Adoption by target settings
• Implementation - consistency of program delivery
  
• Maintenance of intervention effects over time
• www.re-aim.org

• Is it a good fit?
• Does it work?
• If we build it, will they come?
• Is it doable?
• Is it a flash in the pan?

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Be a Critical Consumer

• 2008 Physical Activity Guidelines for Americans
  http//www.health.gov/PAGuidelines/
• Youth (ages 6-17) 1 hour daily
  strength 3 days per week
• Adults (ages 18-64) 150 minutes moderate
  or 75 minutes vigorous per week strength 2 days
  per week
• Older Adults (ages 65) follow adult recs as
  health allows include balance

• Know the key recommendations.
• Stay aware of research and current guidelines.
• Be involved in national groups and organizations.

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Be a Critical Consumer of Information

• View health information through the lens of
  accepted guidelines
• 140 bpm example
• Seek training from professional organizations and
  read current research
• Be wary of information
• Examine sources
• Check credentials
• Follow the links

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Selecting a Physical Activity Focus Practical
Programming

• Implementing evidence-based programs and resources

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Physical Activity Pyramid

• Sedentary Activities
• Flexibility and Balance Activities
• Strength Activities
• Aerobic Activities
• Lifestyle Activity

HEALTH Handbook
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Selecting a Program Question 1 Is It
Evidence-Based?

• Follows current guidelines and best practices
• Developed by credible experts and organizations
• Based on principles of behavior change
• Demonstrated efficacy/effectiveness
• Research
• Practice
• See the Center of Excellence for Training and
  Research Translation http//www.center-trt.org

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Selecting a Program Additional
Questions

• Available?
• Affordable?
• Appropriate?
• Accessible?
• Acceptable?

• Adaptable?
• Accountable?
• Achievable?
• Applicable?
• Attractive?

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Focus Your Program Remember to RE-AIM

• What resources are available?
• What are your strengths?
• What are your limits?
• Expertise
• Time Frame
• Budget
• Setting
• Manpower

• What is your target?
• Environment
• System / Organization
• Individual Behavior
• What are your objectives?
• How will you define and measure success?
• Who are the willing participants?

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Elements of a Physical Activity Program

• Administrator Materials
• Detailed procedures from start to finish
  (recruitment through evaluation)
• Clear physical activity objectives
• Allows tailoring and flexibility
• Leader Materials
• Clear, detailed, efficient
• Staff burden time, labor, expertise
• Participant Materials
• Attractiveness, readability, accessibility
• Participant burden time, cost, behavior

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Physical Activity Programs

• Elements in Action

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Active Living Every Day

• www.activeliving.info
• Key Elements
• Evidence-based (research)
• Training and Resources for Facilitators
• Participant materials can stand alone
• Adaptable for various populations and settings

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Diabetes Prevention Program

• www.bsc.gwu.edu/dpp/lifestyle/dpp_dcor.html
• Key Elements
• Evidence-based (efficacy research)
• Resources for facilitators and participant
  materials can stand alone
• Includes behavioral skills and health education
  for specific target (diabetes)

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Choose to Move Start!

• www.heart.org/
• Key Elements
• Evidence-based
• Resources for worksite leaders (Start!)
• Self-directed programs with participant materials
  
• Adaptable for various populations and settings
• Other health information readily available
• Accessible (online, free)

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Healthy Monday

• www.healthymonday.org/
• Monday Mile http//www.healthymonday.org/wp-conten
  t/uploads/media/pdf/hm_miles_20080312.pdf
• Key Elements
• Adaptable for various populations and settings
• Accessible (online, free)
• Good network of organizations and partnerships
• Attractive and Marketable

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America on the Move

• www.americaonthemove.org
• Key Elements
• Evidence-based
• Focused campaign with consistent messaging
• Variety of resources for group leaders, schools,
  organizations, and participants
• Self-directed program
• Adaptable for various populations and settings
• Accessible (online, free)

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StairWELL to Better Health (CDC)

• Improvements (full cost was 16,000)
• Paint
• Carpet
• Rubber stair treads
• Framed Artwork
• Motivational Signs
• Music
• Stairwell Use Tracking system (infrared sensors)

• Motivational Signs
• www.cdc.gov/nccdphp/Dnpa/hwi/toolkits/stairwell/mo
  tivational_signs.htmMessage20Ideas
• www.eatsmartmovemorenc.com/StairwellGuide/Stairwel
  lGuide.html

Kerr, N.A., Yore, M.M., Ham, S.A., Dietz, W.H.
(2004). Increasing Stair Use in a Worksite
Through Environmental Changes. American Journal
of Health Promotion, 18 (4) 312315.
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Real World Examples from DeSoto County
Mississippi

• Health Promotion in Anytown, USA

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Real World Examples from DeSoto County
Mississippi

• Local Community Health Council
• Monthly Health Champions
• Monthly Health Campaigns
• Developing Athletic Children Program

www.kidsgetalife.org
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DeSoto County Community Health Council

• Greenways Committee Member
• School Principal
• Youth Representative
• MSU Extension Service Health Agent
• Church Pastor
• Hospital CEO
• Head Start Director
• Grant Writer

• Exercise Scientist/Researcher
• YMCA Director
• Athletic Club Owner
• Parks Recreation Department Representative
• Community Foundation Staff
• Family Physician
• Public Library Staff
• Business representative

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Monthly Health Campaigns

• Brief health activities designed to be
  implemented across schools, worksites, and
  community organizations based on health
  observances calendar
• e.g., http//prevention.sph.sc.edu/palinks/observa
  nces2009.htm
• Cost/Ideas
• Free if distributed by email
• Print and distribute to key organizations
• Post on website
• Publish a health calendar
• Ask local businesses to donate prizes
• Create version for churches/businesses

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Monthly Health Champion

• Established as a way to recognize local people
  and organizations who are promoting healthy
  lifestyles in DeSoto County (media support)
• Cost/Ideas
• 10 for plaques
• Create press release template see
  www.cfnm.org/press_releases.htm

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Monthly Health Champion

• Hernando Parks Department was recognized as the
  Health Champion for December 2007 by the DeSoto
  County Community Health Council.   Hernando Parks
  Department was chosen as the first recipient
  for their work in providing avenues for healthier
  lifestyles and promoting group sports such as
  Ultimate Frisbee.   

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Monthly Health Champion

• The DeSoto County Community Health Council, a
  component of Get A Life! My Life, My Health, My
  Choice, a childhood obesity prevention initiative
  of the Community Foundation of Northwest
  Mississippi, has recognized Southaven Coach Bam
  Bryant as the January Health Champion!  For
  voluntarily leading exercise classes for the
  staff and teachers and for advocating for healthy
  lifestyles in DeSoto County, Coach Bryant
  received this recognition. 

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Monthly Health Champion

• Oak Hill Baptist Church takes physical health
  seriously and offers many opportunities for its
  members to participate in physical and
  nutritional activities.  The church has a
  community recreational area and walking track
  along with a community garden.  Road Warriors
  are Oak Hill ushers who visit other churches
  sharing faith-based health opportunities. 

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Learning Points from DeSoto County

• Community Health Council Keep to a workable
  number of contributing and energetic local
  members
• Community Areas Rely on the star schools and
  churches Partner with civic organizations
• Physical Activity Consultants Use expert
  consultants (contact ACSM) or university
  researchers key personnel for program efficiency
  and effectiveness
• Communication Strategies Maximize communication
  through various avenues media, email database,
  community organizations and local government,
  social marketing

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So, Heather, What Would You Do with 5,000?
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What Can You Really Do on a Real Budget?

• 100 or less
• Start a local Health Council
• Recognize Health Champions
• Promote monthly health observances
• Use downloadable materials or online resources to
  conduct a small program or health campaign
• Use social marketing resources to get the word out

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What Can You Really Do on a Real Budget?

• 500 or less
• Expand monthly health observances with broader
  distribution and incentives
• Compile a health toolkit
• Invest in a fee-based program or expand a health
  promotion program using participation incentives
• Spruce up a stairwell or indoor walking trail
• Promote a specific health event (e.g., National
  Wear Red Day Diabetes Day)
• Host an active family night

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What Can You Really Do on a Real Budget?

• 5000 or less
• Purchase ongoing advertising (newspaper,
  billboard)
• Build/expand a website
• Invest in community parks, playgrounds, trails
  (keep the project focused)
• Implement a small program with added features
  (paid facilitator or exercise leader, childcare,
  participant materials, exercise equipment)
• Provide small grants to schools or organizations
  (maintain oversight and accountability)
• Host a community event (fun run, health fair)

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Build Excitement, Not Frustration Smart
Strategies for Common Pitfalls

• Be OK with what you have to work with.
• Overestimate costs and stay on budget.
• Use volunteers and donations.
• Relax, you cant change the world.
• Understand the viewpoints and weigh opinions
  accordingly.

• Think Small
• Be Smart
• Keep It Local
• Enjoy the Process
• Maximize your Expertise and Passions

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Why Do Programs Get Lost in Translation?
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Why Do Programs Get Lost in Translation?

• Objectives that are not Accurate
• Ideals that are not Realistic
• Messages that are not Consistent
• Goals that are not Appropriate
• Plans that are not Guided
• Programs that are not Attractive

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Keep In Mind When you throw money at something,
dont expect change.

• Thank You
• ACSM, Behavioral Strategies Committee
• DeSoto County Community Health Council
• Dr. Carl Caspersen and Ms. Darlene Thomas (CDC)

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Professional Physical Activity Resources

• 2008 Physical Activity Guidelines for Americans
  www.health.gov/PAGuidelines/
• ACSM Resource Manual/Guidelines for Exercise
  Testing and Prescription Exercise Is Medicine
  http//exerciseismedicine.org/
• The Guide to Community Preventive Services
  Physical Activity www.thecommunityguide.org/pa/
• Physical Activity Evaluation Handbook.
  www.cdc.gov/nccdphp/dnpa/physical/handbook/pdf/han
  dbook.pdf
• USC Prevention Research Center http//prevention.s
  ph.sc.edu/PAlinks/
• PCPFS Research Digests http//fitness.gov/publicat
  ions/
• Eat Smart, Move More NC www.eatsmartmovemorenc.com
  /

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Participant Materials Brochures

• Centers for Disease Control (CDC)
  www.cdc.gov/Publications/
• National Institutes of Health (NIH/NIDDK)
  www2.niddk.nih.gov/
• National Diabetes Education Program (NDEP)
  www.ndep.nih.gov/diabetes/pubs/catalog.htmndep-91
  a
• American Heart Association (AHA)
  http//heart.org/
• Commercial Vendors e.g., NCES, Nasco, Positive
  Promotions, PBH

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Reference Guide of PA Programs for Older Adults
A Resource for Planning Interventions

• The guide is a tool that organizations can use to
  help select the right physical activity program
  for older adults they must serve.
• Programs demonstrating efficacy and effectiveness
  were initially sought. Also included are
  programs that may not yet have been thoroughly
  researched.
• The guide included programs developed by
  non-governmental organizations, government
  agencies, universities, and commercial entities.
• 17 physical activity programs can be applied to
  older adults with diabetes with complications or
  who are homebound, frail, physically impaired,
  have comorbid conditions, or are without any
  complications and otherwise healthy.

Moran SA, Caspersen CJ, Thomas GD, Brown DR and
The Diabetes and Aging Work Group (DAWG). USDHHS
Centers for Disease Control and Prevention.
Division of Diabetes Translation and Division of
Nutrition and Physical Activity,
2007. http//www.cdc.gov/diabetes/pubs/pdf/RefGuid
eofActivity.pdf
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D diabetes, PD prediabetes, HB homebound, F
frail, C chronic condition, H healthy
(i.e., basically without complications or
impairments)
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Remember The unit of change is always people

• The common element of systems, environments,
  communities, organizations, and programs is
  people

Social-Ecological Model http//www.cdc.gov/NCCDPHP
/dnpa/obesity/state_programs/se_model.htm
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Tensions
Science
Public Health
Practice
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Developing Athletic Children A Pilot Physical
Activity Program for Kids

• 10,000 budget CATCH materials, basic exercise
  equipment, health models, fitness coach
• 50 children ages 10-12 with access to Desoto
  Athletic Club for 6 months, group fitness coach,
  participation in the Presidents Physical Fitness
  Challenge
• 24 kids completed the program group lost 300
  inches participants maintained/lost weight
• Pros/cons/benefits