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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. Good Morning!. What is Physical Activity?. Physical Activity
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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
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
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/chapter4.aspx
Physical Activity in U.S. Adults CDC, 2007
County-level Estimates of Leisure-time Physical Inactivity among Adults aged ≥ 20 years: United States 2006 Age-adjusted percent www.cdc.gov/diabetes
County-level Estimates of Leisure-time Physical Inactivity among Adults aged ≥ 20 years: United States 2007 Age-adjusted percent www.cdc.gov/diabetes
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
2006 Age-Adjusted Estimates of the Percentage of Adults† Who Are Physically Inactive in New Hampshire
2007 Age-Adjusted Estimates of the Percentage of Adults† Who Are Physically Inactive in New Hampshire
2008 Age-Adjusted Estimates of the Percentage of Adults† Who Are Physically Inactive in New Hampshire
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
Technology? NY Times, 2008
Be Grounded in Behavior Change Theory ! Transtheoretical Model Social Ecological Model
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
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
Technology • Has been demonstrated to increase EE over sedentary activities in children • Insufficient evidence otherwise • Promising avenue? Lanningham-Foster, 2009
Active Transportation and Obesity Rates Bassett et al., 2010
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
Poorly Designed Street Networks Most transportation experts agree this road is poorly designed Completestreets.org
Designed for Multiple Uses Most transportation experts agree this road is better designed Completestreets.org
Sport Americans’ Use of Time Project Godbey& Robinson, 1999
Guerilla Marketing “Corn Maze” Fitness First Bus Scale
Take a Walk in Zion: Preliminary Results Media message content Environmental/ climatefactors Trailaccess Community involvement Suggestions for improvement Resistance to protocol Trail specific features Non-pedestrian factors Targetaudience Bus specific differences Behrens et al., APHA 2008
Sedentary to Active Time • Park far away • Take stair instead of elevators • Skip the stop • Stepping commercials • Play with children • More?
A N.E.A.T. Idea Dr. James Levine Mayo Clinic Rochester, MN Speed = 0. 7 mph
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?
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
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.”
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
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
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
Questions?For more information please contactTim Behrens tbehrens@uccs.edu