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DNPAO Message Information Session

DNPAO Message Information Session. Increasing Physical Activity: Guidance Document Strategies State Nutrition, Physical Activity And Obesity Program Annual Training Meeting March 18, 2010. Guidance Document Background. Purpose:

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DNPAO Message Information Session

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  1. DNPAO Message Information Session Increasing Physical Activity: Guidance Document Strategies State Nutrition, Physical Activity And Obesity Program Annual Training Meeting March 18, 2010

  2. Guidance DocumentBackground • Purpose: To help guide the selection of intervention strategies from among the many available • What the document is not: It is not meant to be prescriptive. It is not all-inclusive, and the levels of evidence vary. • How were the strategies selected? Each guidance document used the highest level of evidence available for the recommended strategies.

  3. Physical Activity Guidance Document • How were the physical activity strategies selected? Eight strategies are recommendations of the U.S. Task Force on Community Preventive Services. Two additional evidence-based strategies were selected on the basis of scientific evidence or expert panel recommendations.

  4. So………why is it important to promote physical activity? • Health benefits • Physical activity guidelines • Physical activity prevalence

  5. Physical Activity Health Benefits 30% risk reduction in all cause mortality 20-35% lower risk for CVD, CHD, Stroke 30-40% lower risk of type 2 diabetes 30% lower risk of colon cancer, 20% lower for breast cancer 20-30% lower risk for depression, distress and dementia 36-68% lower hip fracture risk

  6. Weight-related Benefits ofPhysical Activity • Weight Stability • Regular PA provides benefits for weight stability • Weight Regain • More PA is better to help prevent regain of lost weight • Weight Loss • More than 5% of body weight difficult without reduced calorie intake

  7. PA Recommendations: Adults • All adults should avoid inactivity, adults who participate in any activity gain some health benefits • 150 minutes of moderate-intensity activity or 75 minutes of vigorous, or a combination of both, per week. • For additional and more extensive benefits, do 300 minutes of moderate or 150 minutes of vigorous per week

  8. Children and Adolescents Children and adolescents should do 60 minutes (1 hour) or more of physical activity daily. • Aerobic: Most of the 60 or more minutes a day should be either moderate- or vigorous-intensity aerobic physical activity, and should include vigorous-intensity physical activity at least 3 days a week. • Muscle-strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include muscle-strengthening physical activity on at least 3 days of the week. • Bone-strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include bone-strengthening physical activity on at least 3 days of the week.

  9. Reported Total Weekly Aerobic Physical Activity – BRFSS, 2007

  10. Recommended Physical Activity Intervention Strategies • Three broad domains align with levels of behavioral influence: • Informational • Social and Behavioral • Environmental and Policy • Top three – potential reach and impact

  11. Strategy 1: *Community-wide Campaigns Strong evidence • Large scale, high visibility campaigns • Mass media messages • Support through various sectors in the targeted community • Emphasis on policy and environmental change *One of the top three recommended strategies

  12. Strategy 2: *Create or Enhance Access to Places for PA Combined with Informational Outreach Strong evidence • Long-term efforts in worksites and/or communities to improve PA opportunities • Environmental changes: • Create walking trails • Create exercise facilities • Better access to nearby facilities *One of the top three recommended strategies

  13. Kona, HI ogging Path

  14. Strategy 3: *Enhanced Physical Education in Schools Strong evidence • Increase length of time that youth are active in PE classes • Can be applied in various youth-oriented settings, such as community recreation centers and after-school programs *One of the top three recommended strategies

  15. CATCH PE • Increase MVPA to 40% • Teacher training and on-site TA • Policy – PE 90 minutes/3x wk • Curriculum – activity selection & modification • Teaching and class management strategies

  16. Strategy 4: Point of Decision Prompts for Promoting PA Strong evidence • Signage placed at the point where decisions are made: • Stairwells • Escalators

  17. CDC’s StairWELL to Better Health

  18. Strategy 5: Social Support Interventions in Community Settings Strong evidence • Build, strengthen and maintain social networks • Buddy systems • Walking clubs • Contracts

  19. Strategy 6: Individually Adapted Health Behavior Change Strong evidence • Tailored based on readiness for change • Target daily routines • Build social support • Prevent relapse into inactivity

  20. Personal Empowerment Plan • 12 week self-directed worksite program • Targets stages of change • Coordinator kit & promo materials • Worksites can add activities • revised/expanded • Cooper Institute

  21. Strategy 7: Street Scale Urban Design and Land Use to Promote PA Sufficient evidence • Local changes to support PA within a few blocks • Policies to improve lighting, traffic calming, etc.

  22. Strategy 8: Community-Scale Urban Design, Land Use Policies & Practices Sufficient evidence • Target geographic areas to support PA • Policies and practices to develop/improve: • Streets • Sidewalks and bike lanes

  23. Community Design

  24. Strategy 9: Active Transport to School National Safe Routes to School Task Force found that SRTS interventions can be effective in increasing physical activity and creating infrastructure to support physical activity. • Supports youth in walking, bicycling, or skating to school • May involve urban design, land use policies, and community • Includes neighborhood efforts (e.g. walking school bus) • 100’s of millions of dollars available!

  25. Strategy 10: Transportation and Travel Policies and Practices NICE (UK) review examined 26 studies and found that: • Traffic calming • Introduction or expansion of multi-use trails • Closing or restricting use of road by motorized traffic • Road user charges • Improved cycling infrastructure • Safe routes to school Resulted in increases in walking, cycling, and outdoor play

  26. Intervention Characteristics • Policy measures, e.g. roadway design standards • Expanding public transportation services • Subsidizing public transportation • Providing bicycle lanes and racks • Increasing the cost of parking

  27. Key considerations for intervention selection • Reach • Acceptability • Feasibility • Sustainability • Adaptability

  28. Local adaptation • Consider Social Ecological Model • Realize that ALL interventions need some level of adaptation • Seek out other forms of evidence (e.g., political will, stakeholder interests, evidence-based practice) • Evaluate

  29. Thank you The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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