Increasing Exercise Adherence through Environmental Interventions

1. Increasing Exercise Adherence through Environmental Interventions

2. Environmental Interventions Refers to the people’s transactions with their physical and socio cultural environments (Sallis, et. al.,1996). Major strategy (intervention) used by the government, cities, states, and nations to promote and increase physical activity in it’s citizens. But personal trainer can use environmental interventions to promote higher levels of exercise adherence. Most if not all the environmental interventions designed, developed, and delivered is based on the social ecological model.

3. Social-Ecological Model

4. Environments & PA Behavior Environments effect PA behavior in several ways: a) promoting, or demanding action, e.g., these environments are designed for activity such as, sports fields, gyms, health clubs, & YMCAs. b) discouraging or prohibiting. e.g., these environments are designed to restrict or prohibit activity such as classrooms, workplaces, theaters, offices, highways, and living rooms. ** The assumption is PA takes place in specific physical environments influences the amount and type of the activity.

5. Environment Interventions & Creating Supportive Environments All environmental interventions are directed toward creating supportive environments. -The more supportive environments that can be designed, developed, and delivered results in a higher physical activity and exercise in the population. - A supportive environments include settings, facilities, and programs. - Setting are neighborhoods, schools, and worksites. -Facilities are health clubs, cycling paths, parks, etc. -Programs are aerobic classes, sport teams, supervised recreation, walking clubs or unsupervised activities they can do on their own.

6. Supportive Environments • Design building to promote PA such as provide showers for employees to walk or ride their bike to work, make stair walking fun or place copy machine at the end of the hall not in one’s office. • Cities build walking and bicycling for commuting to work, shopping, and for routine activities. • Offer privileges to employees, who demonstrate their involvement in PA activities. • Employers in Palo Alto reimburse employees who walk or bicycle to work. • Health insurance provides discounts based on fitness levels. • Government removes subsidies for companies who rely on sedentary behaviors (e.g. car and oil companies) • Government increases subsidies for industries that promote PA (e.g. sporting goods.) • Schools should provide daily PA for their students • Have wide walking places, trials, offices that promote more activity, etc.

7. Environmental Interventions Environmental interventions should be put in place before educational interventions are attempted. - Media campaign to promote walking is irrelevant to people in cities where the side walks are not required and poorly maintained. -Duluth major encouraging people to ride to work is irrelevant to the citizensifthe highways and roads do not have bike lanes and trails. -UMD encourages the students to walk to school is irrelevant to the studentsif no oneremoves snow from their sidewalks in a timely manner.

8. Facts • CDC determined that improving places to be active can result: • in a 25% increase in the percentage of people who exercise. • 43% of people with safe places to walk within 10 minutes of home met recommended activity levels. • 37% of people living in walkable neighborhoods met PA recommendation compared to 18% of those in low walkable neighborhoods. • Other studies have proven that if one develops just one new trial it resulted in a higher walking percentage. • People who live in neighborhoods with a mix shop of businesses with a easy walking distance have a 35% lower risk of obesity.

9. Typical Environmental Interventions • Signage & Stairwell Interventions • Neighborhood • Trials & Parks • Land use

10. Use the stairwell not escalator • http://www.biertijd.com/mediaplayer/?itemid=16297/ • Make your stairwell fun!

11. Point-of-Decision Prompts • Can you think of a time when you were prompted to exercise, and you did?

12. Stairwell Interventions • Signage • StairWELL intervention is a point-of-decision prompt to motivate people to use the stairs rather than an elevator • Design of signage includes 4 major things • Message relates to target audience • Needs to a outcome (e.g. you will burn a extra 100 Kcal if you take the stairs) • Information must be accurate • Pilot test to see if the sign works • Hallways and stairwells • Wide • Carpeted and rubber treaded stairs • Well lighted • Include art or paintings on the wall and music

13. Neighborhood • Trail usage is directly correlated to the neighborhood characteristic (Lindsey, et at., 2006). • Lindsey and her collegues monitored trial use 24 hours per day 7 days per week at 30 location in Indianapolis from May of 2004 to July 2005. Cycling was the predominant activity observed on each of the trials then walkers the then skaters. Females used the trial more than males. 93% of users were white. • Low income people are highly concerned with safety, lack of sidewalks, and cost of using recreational facilities. • Moderate income families are highly concerned with location of the recreational facilities and safety but not the cost of using recreational facilities. • Families from lower SES perceive their neighborhoods having more hazards. This perception of their neighborhood affects children’s PA level (Romero et al., 2001)

14. Neighborhood • Perceived aesthetics, convenience, access to service, and traffic associated with one neighborhood impacts physical activity (Humpel et al, 2004) • People are more active in neighborhoods with “traditional designs” (Orleans et al, 2003) • Traditional design is densely populated, compact neighborhoods with housing, work, and shopping in close proximity • Density is defined as # of single family detached house. • high connectivity neighborhoods with well built and safe network of sidewalks and bike paths (e.g., few cul-de-sacs) promotes physical activity • High walkability neighborhoods produces more people who meet daily PA recommended levels • Speed traffic at 30 mph; separate from the streets, well-maintained, crosswalks signals for walkers. • People are more active in neighborhoods that has greater land use mix, higher residential density and high street connectivity (Atkinson, et al, 2005)

15. Environmental Variables Related to trial & parks • Parks that are esthetically pleasing and have tree-lined walking paths increases PA use. • Parks need to be close to shops • Reduce the use of organized sport team usage of parks. • Provide walking and bike paths across the entire city connecting the various parks. • Paths and sidewalks needs to be maintained • Separate paths and sidewalks for bikers and walkers.

16. Designing for Active Recreation • Better access to facilities, parks, and trails. • Neighborhoods are linked to PA levels • Safe places encourages activity • Lower the crime rate in neighborhoods and cities resulted in higher physical activity in the citizens • Living in traditional, walkable, and mixed use neighborhoods are associated with increased PA levels. • Supportive environments that promote more outdoor recreations increase PA levels.

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