Just the Facts Leveraging Research to Promote Active Living in Army Communities

1. �Just the Facts��Leveraging Research to Promote Active Living in Army Communities James Sallis, PhD San Diego State University www.drjamessallis.sdsu.edu For Army MWR Conference Louisville, KY 1/26/10

2. Goals for this Talk You leave with new ideas, based on research, to promote physical activity on your base to enhance MWR. You are prepared to identify new partners to help you achieve your mission. Take lots of notes.

3. 3Four50.com Oxford Health Alliance's key message: 3 risk factors � tobacco use, poor diet, lack of physical activity Contribute to Four chronic diseases � heart disease, type 2 diabetes, lung disease and some cancers Which, in turn, contribute to more than 50 per cent of deaths in the world

4. Deaths (thousands) attributable to individual risk factors in both sexes

6. What is being done to improve PA? Minor investment in programs Guided by theories that emphasize psychological & social influences Primary goals are education and behavior change skills training targeting individuals Fragmented, poorly coordinated, poorly funded approaches

7. Psychosocial Models of Health Behavior

8. How is it working?

9. Will individual interventions ever be sufficient? Interventions based on psychosocial theories can be effective But not sufficient Reach is limited Effects are modest Maintenance is rare Programs are not designed to change the root causes of current behavioral patterns

10. Physical Activity Transition

13. An Ecological Model of Health Behavior

14. Key Points from Ecological Models Interventions that work at all levels likely to be most effective Individual interventions will not work well when environments are not supportive Environment and policy changes likely to have most widespread and longest-lasting impacts First, create activity-friendly environments. Then motivate & educate people to be active

16. Physical Activity Settings & Experts Neighborhood Transportation facilities Recreation facilities Schools & workplaces Planners Transport engineers & planners Park & rec, landscape architects Educators, architects

17. Elements of An Active Living Community

20. The Neighborhood Quality of Life (NQLS) Study: The Link Between Neighborhood Design and Physical Activity

21. NQLS Neighborhood Categories

22. Accelerometer-based MVPA Min/day in Walkability-by-Income Quadrants

23. Percent Overweight or Obese (BMI>25) in Walkability-by-Income Quadrants

25. Walkable neighborhoods encourage more walking in older adults Older women who live within walking distance of trails, parks or stores recorded significantly higher pedometer readings than women who did not. The more destinations that were close by, the more they walked.

26. Elements of An Active Living Community

28. A national study of US adolescents (N=20,745)* found a greater number of physical activity facilities is directly related to physical activity and inversely related to risk of overweight

29. People are Most Active on Tracks and Walking Paths Observation Results: Outdoor tracks support the most walking and moderate-to-vigorous activity, when adjusting for the number of facilities and the average number of users. Walking paths and tracks are features that support physical activity in which most people are likely to engage. In the 10 parks without an accessible track or walking path, the average percentage of park users observed walking was 11 percent compared to 23 percent in the parks with accessible facilities for walking. The average percentage of adults walking was 16 percent in parks with walking paths versus 6 percent in parks without paths Sidewalks are second in importance for facilitating walking and moderate-to-vigorous physical activity, but we also noted that many people on the sidewalk were sedentary, since they were usually watching instead of engaging in activities that took place in contiguous activity areas. Playground areas generated as much moderate-to-vigorous physical activity as that in gymnasiums and multi-purpose fields. Baseball/softball fields generated the greatest amount of sedentary activity, because of the large number of spectators they draw and because the game itself is largely sedentary.Observation Results: Outdoor tracks support the most walking and moderate-to-vigorous activity, when adjusting for the number of facilities and the average number of users. Walking paths and tracks are features that support physical activity in which most people are likely to engage. In the 10 parks without an accessible track or walking path, the average percentage of park users observed walking was 11 percent compared to 23 percent in the parks with accessible facilities for walking. The average percentage of adults walking was 16 percent in parks with walking paths versus 6 percent in parks without paths Sidewalks are second in importance for facilitating walking and moderate-to-vigorous physical activity, but we also noted that many people on the sidewalk were sedentary, since they were usually watching instead of engaging in activities that took place in contiguous activity areas. Playground areas generated as much moderate-to-vigorous physical activity as that in gymnasiums and multi-purpose fields. Baseball/softball fields generated the greatest amount of sedentary activity, because of the large number of spectators they draw and because the game itself is largely sedentary.

32. Number of Organized Activities Declined Observation Results: NUMBER OF ORGANIZED TARGET AREAS IN 10 PARKS. Observation Results: NUMBER OF ORGANIZED TARGET AREAS IN 10 PARKS.

33. Lessons from Park Renovation Studies Improving physical structures alone may not be enough to change physical activity Programs and events may be needed to help park users make use of physical changes Probably need more attention to outreach

34. Percent of 8-14 year-olds meeting 60 min/day of MVPA during sports practice

35. Elements of An Active Living Community

38. PE classes in lower income schools spend less time being active. Yancey. www.calendow.org

40. Evidence-based PE is Available Early Childhood/preschool Elementary schools Middle schools High schools SPARK SPARK CATCH M-SPAN (SPARK) TAAG LEAP SPARK

42. SPARK Outcomes PE specialists>trained classroom teachers> controls Improved quality of PE instruction Increased physical activity in PE Improved cardiorespiratory & muscle fitness Improved sports skills Positive impact on academic achievement Students enjoyed SPARK lessons 1.3 million kids a day getting active with SPARK

44. School Environment Interventions Stratton et al. from the UK conducted several studies showing simple markings on elementary playgrounds increases PA about 18 min/day Verstraete from Belgium showed Equipment at Recess increased PA

45. After School Programs Primary time for youth to be active Key issues Transportation access Cost Quality of program & leadership Amount of activity provided SPARK Active Recreation Program

47. Elements of An Active Living Community

48. Designed for active travel

51. Walking to School as Percent of School Trips (Children 5-15)

53. Adolescents in Melbourne, Australia (N=188) are more likely to increase active commuting (walking and biking) to school if their parents are satisfied with the number of traffic lights and pedestrian crossings in their neighborhood

54. Funding Active Living Research program of the Robert Wood Johnson Foundation Oregon Transportation Research & Education Consortium (OTREC) Phases Random phone survey of Portland, OR region adults GPS Funding Active Living Research program of the Robert Wood Johnson Foundation Oregon Transportation Research & Education Consortium (OTREC) Phases Random phone survey of Portland, OR region adults GPS

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59. A model for military bases Linenger. Am J Prev Med. 1991 Environmental changes on a Naval base Bike paths along roadways Extend hours for rec facilities Regular athletic & PA events on base Running & biking clubs organized Women�s fitness center opened Healthy foods more visible Recognition for improved fitness Newspaper listed top performers Fitness testing with feedback Significant fitness improvements in 1 year

60. Resources at www.activelivingresearch.org

61. Next Steps Assess conditions on your base Places Policies Programs What interventions could have the biggest and longest-lasting impact? What interventions could serve both military and civilian residents & workers? Gather the right partners & resources Develop & implement a plan Evaluate it!