The Value of Policy and Environmental Changes to Support Physical Activity

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Texas Department of State Health
Services Nutrition, Physical Activity Obesity
Prevention Program
The Value of Policy and Environmental Changes to
Support Physical Activity Natalie Clifton,
M.Ed., CHES 2010 State Agency Wellness
Conference September 22, 2010
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Evidence
Policy and environmental change initiatives that
make healthy choices in nutrition and physical
activity Available, Affordable, Easy
Will likely prove most effective in combating
obesity.
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Obesity Target Areas
Sugar-Sweetened Beverages
Physical Activity
Fruits Vegetables
High- Energy- Dense Foods
TV Viewing
Breastfeeding
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Basic Public Health Question
Will the publics health improve primarily as a
result of Individuals getting more and better
knowledge about personal risk factors that
increase the likelihood of obesity OR Individual
s and groups getting more skills and
opportunities to participate in changing public
policy and environments?
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Socio-ecological Model
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(No Transcript)
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Policy Environmental ChangeMore than telling
people what to eat and how to exercise

• Shift the focus from individual behavioral level
• Advance solutions that improve health on a
  population level

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So What is PE Change?

• Policy laws, regulations, formal and informal
  rules and understandings that are adopted on a
  collective basis to guide individual and
  collective behavior
• Environmental change things that alter or
  control the legal, social, economic, and physical
  environment affecting health

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What PE Change is Not

• Health fairs
• Education
• Events
• Brochures
• Classes
• Other

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Balancing Values
Social Accountability
Personal Responsibility
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Growing Community Video Series
www.dshs.state.tx.us/obesity/GrowingCommunity.shtm
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Texas! Bringing Healthy Back The DVD

• Six short videos (5-8 minutes each) featuring
  inspiring community programs
• CDC Evidence Based Strategies

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Texas! Bringing Healthy Back

• Initiative with a pioneering approach Community
  vs. Individual
• Examples of changing our environment to make
  healthy living the easy choice in Texas.
• Goal To Make Healthy Eating and Active Living
  the Easy Choice for All Texans.

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Your Role Catalyst for Change

• Help Bring Healthy Back to Texas by
• Watching the six videos
• Sharing the videos with others
• Encouraging a discussion
• Logging your Screenings at the Bringing Healthy
  Back Web site
• www.texasbringinghealthyback.org

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1. Watch the Six Videos on the DVD
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2. Share the videos with others by
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3. Share the Message

• Encourage a discussion

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4. Share the results with DSHS
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CDC Community GuideEnvironmental and Policy
Approaches to Increase Physical Activity

• Community-Scale Urban Design Land Use Policies
• Creation of or Enhanced Access to Places for
  Physical Activity Combined with Informational
  Outreach Activities
• Street-Scale Urban Design Land Use Policies
• Point-of-Decision Prompts to Encourage Use of
  Stairs

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Create or enhance access to places to be
physically active

• Building walking trails
• Providing public access to school gymnasiums,
  playgrounds, or community centers.
• Worksite activity programs that provide access to
  onsite or offsite fitness rooms, walking breaks,
  or other opportunities to engage in physical
  activity.
• Interventions to improve access should also
  include outreach that increases awareness of the
  opportunity to be active

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Worksite Physical Activity Strategies

• 1. Allow maximum access to recreation facilities.
• 2. Provide cash incentives or reduced insurance
  costs for participation in physical activity
  and/or weight management or maintenance
  activities
• 3. Institute environmental changes to increase
  activity.

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Worksite Physical Activity Strategies

• 4. Set up programs that have strong social
  support systems and incentives.
• 5. Encourage scheduling that allows for more
  activity.
• 6. Promote opportunities.
• 7. Provide on-site child care facilities to
  facilitate physical activity

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Improving Worksite Stairwells

• Stairwell Basics
• The stairwells need to be safe, with controlled
  access from the outside.
• Stairwells should be well-lit with good
  visibility (including mirrors and video cameras
  if needed).
• Stairwells should be well constructed and
  maintained, equipped with non-slip or non-skid
  treads, and cleaned regularly.
• Creating Attractive and Inviting Stairwells
• Post motivational signs and prompts at
  elevators that encourage employees to take the
  stairs.

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Alternative Transportation

• "Alternative transportation" modes are
  telecommuting, carpools, vanpools, public
  transportation, bicycling, walking, and running.
• These commute methods are relevant to employee
  health in two ways
• A reduction in the use of single-occupancy
  vehicles helps reduce environmental fuel
  emissions.
• Employees who use "active transport" (public
  transportation, bicycling, and walking) to
  commute to work may increase their daily physical
  activity.

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Federal Agency Policy Examples

• 5 U.S.C. 7901 Federal agency heads may
  establish health service programs to promote and
  maintain the physical and mental fitness of their
  employees. Authorizes agencies to establish and
  operate physical fitness programs and facilities
  designed to promote and maintain employee health,
  such as occupational safety and health. 41 CFR
  102-79.30 States that federal agencies can allot
  space in federal buildings for fitness
  programs.5 U.S.C. 7905 States that federal
  agency heads may develop programs to encourage
  commuting by means other than single-occupancy
  motor vehicles. Includes transit passes and
  furnishing space, facilities, and services to
  bicyclists.5 U.S.C. 5946 Sets limits on
  paying membership fees or dues of federal
  employees in societies or associations. However,
  Comptroller General Decision B-240371 (Jan 18,
  1991) allows agencies to pay for access to
  private fitness facilities for its employees as
  part of its health service program.

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Resources

• 2008 Physical Activity Guidelines for Americans
• http//www.health.gov/paguidelines/
• Guide to Community Preventive Services
• Worksite Health Promotion http//www.thecommunity
  guide.org/worksite/index.html
• Recommended Community Strategies and Measurements
  to Prevent Obesity in the United States
  http//www.cdc.gov/obesity/downloads/community_str
  ategies_guide.pdf
• Healthier Worksite Initiative, CDC
  http//www.cdc.gov/nccdphp/dnpa/hwi/index.htm
• Indicators of Activity-Friendly Communities
  http//www.nspapph.org/index.php?optioncom_docman
  taskdoc_downloadgid26Itemid83
• Visit www.cdc.gov/nccdphp/dnpa/stairwell/motivatio
  nal_signs.htm
• to obtain sample stairwell signs that have
  been tested and found to be effective.

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For further information resources

• www.texasbringinghealthyback.org

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Texas Department of State Health
Services Nutrition, Physical Activity Obesity
Prevention Program

Natalie Clifton Texas Department of State Health
Services Nutrition, Physical Activity Obesity
Prevention  Tower Building 406 / Mail Code
1944 PO Box 149347  Austin, Texas 78714 P
512-458-7111 ext. 3447 F 512-458-7618 E-Mail
Natalie.Clifton_at_dshs.state.tx.us