The Value of Policy and Environmental Changes to Support Physical Activity

1. 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

2. 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.”

3. Obesity Target Areas Sugar-Sweetened Beverages Physical Activity Fruits & Vegetables High- Energy- Dense Foods TV Viewing Breastfeeding

4. Basic Public Health Question Will the public’s health improve primarily as a result of: Individuals getting more and better knowledge about personal risk factors that increase the likelihood of obesity OR Individuals and groups getting more skills and opportunities to participate in changing public policy and environments?

5. Socio-ecological Model

7. Policy & Environmental Change:More 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

8. So What is P&E 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

9. What P&E Change is Not Health fairs Education Events Brochures Classes Other

10. Balancing Values Social Accountability Personal Responsibility

11. Growing Community Video Series www.dshs.state.tx.us/obesity/GrowingCommunity.shtm

12. Texas! Bringing Healthy Back: The DVD Six short videos (5-8 minutes each) featuring inspiring community programs CDC Evidence Based Strategies

13. 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.

14. 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

15. 1. Watch the Six Videos on the DVD

16. 2. Share the videos with others by:

17. 3. Share the Message Encourage a discussion

18. 4. Share the results with DSHS

19. CDC Community Guide:Environmental 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

20. 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

21. 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. Worksite Physical Activity Strategies

22. 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

23. 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. Improving Worksite Stairwells

24. "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. Alternative Transportation

25. 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.

26. Resources • 2008 Physical Activity Guidelines for Americans: http://www.health.gov/paguidelines/ • Guide to Community Preventive Services: Worksite Health Promotionhttp://www.thecommunityguide.org/worksite/index.html • Recommended Community Strategies and Measurements to Prevent Obesity in the United States: http://www.cdc.gov/obesity/downloads/community_strategies_guide.pdf • Healthier Worksite Initiative, CDChttp://www.cdc.gov/nccdphp/dnpa/hwi/index.htm • Indicators of Activity-Friendly Communitieshttp://www.nspapph.org/index.php?option=com_docman&task=doc_download&gid=26&Itemid=83 • Visit www.cdc.gov/nccdphp/dnpa/stairwell/motivational_signs.htm to obtain sample stairwell signs that have been tested and found to be effective.

27. For further information & resources: www.texasbringinghealthyback.org

28. 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@dshs.state.tx.us