P ROMOTING PA One-third of KY adults have not participated in any - - PowerPoint PPT Presentation

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P ROMOTING PA One-third of KY adults have not participated in any - - PowerPoint PPT Presentation

Oct 30, 2022 144 likes •679 views

C OLLABORATIVE E FFORTS TO P ROMOTE P HYSICAL A CTIVITY IN K ENTUCKY February 9, 2017 Melinda J. Ickes, Ph.D. Associate Professor Department of Kinesiology and Health Promotion BREATHE Faculty Associate University of Kentucky An Equal

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An Equal Opportunity University

COLLABORATIVE EFFORTS

TO PROMOTE PHYSICAL

ACTIVITY IN KENTUCKY

February 9, 2017 Melinda J. Ickes, Ph.D. Associate Professor Department of Kinesiology and Health Promotion BREATHE Faculty Associate University of Kentucky

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An Equal Opportunity University

OBJECTIVES

  • Describe the use of point-of-decision prompts to

encourage physical activity.

  • Describe the benefits of assessing community

readiness for physical activity policy.

  • Identify stage-based strategies to increase

readiness for physical activity policy.

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PROMOTING PA

  • One-third of KY adults have not participated in any PA during the

past month, and only 2.3% bike or walk to work.1

  • The built environment has potential to affect long-term health of

individuals by increasing daily PA they experience through independent transport, activities, and play.2,3

  • Efforts to promote active living have the potential to increase
  • verall PA and improve related health consequences.4
  • An active city can be a low-cost, high-return investment that

impacts more than just health.4

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SOCIO-ECOLOGICAL MODEL

ORGANIZATIONAL – Changing the policies, practices, and physical environment of an

  • rganization (e.g., a

workplace) to support behavior change. COMMUNITY – Coordinating the efforts of all members of a community (organizations, community leaders, and citizens) to bring about change. PUBLIC POLICY - Developing and enforcing state & local policies that can increase beneficial health behaviors.

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WALK UK

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POINT-OF-DECISION PROMPTS PROMOTING PA

  • Point-of-decision prompts are motivational signs to encourage

individuals to participate in a healthy behavior.5

  • Focus on health benefits or opportunities to promote PA; reach wide

segment of population in various settings.5

  • Although the use of point-of-decision prompts is well supported,6,7

past research has focused on using signage to solely promote stair use.

  • Integrating effective health communication strategies as part of

point-of-decision prompts or signage can promote behavior change and has the potential to reach a diverse audience.8

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WALK UK PLANNING

  • Walk Your City (WYC) is a national initiative to promote walking for

transportation and leisure to local area attractions and/or services through the use of point-of-decision prompts placed strategically in

  • communities. Rather than distance, the signs include total minutes
  • f walking to the destination (https://walkyourcity.org/).
  • We collaborated with the WYC team to develop a tailored, campus-

based initiative, Walk UK, using point-of-decision prompt signs on campus and in surrounding community area.

  • Planning occurred with the assistance of graduate students in

health promotion, university stakeholders, downtown tourism and planning committee, and WYC personnel.

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WALK UK PLANNING

Step 1

  • Determine campaign goals
  • Form campaign planning team; contact necessary stakeholders

Step 2

  • Walkability Assessments
  • Assess pedestrian route info.
  • Brainstorm origins & destinations

Step 3

  • Develop wording for signs
  • Develop campaign with web-based tool
  • Order signs

Step 4

  • Intersection Guides to assist with implementation
  • Press release/communication strategies
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WALK UK PLANNING

  • 80 signs were placed on campus and in one surrounding

neighborhood corridor frequently traveled by university staff and students during October 2015; another 40 signs were placed May 2016.

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WALK UK EVALUATION

  • Quasi-experimental pre- and post-design.
  • Random sample of 2,000 faculty and 3,000 staff (provided by

Human Resources) recruited via email.

  • Online surveys administered through Qualtrics software at baseline

(Sept. 2015) and 6-months post-campaign #1 (April 2016).

  • Items included: 1) behaviors related to walking for transportation &

leisure; 2) attitudes toward walking for transportation & leisure; 3) subjective norms toward walking for transportation & leisure; 4) perceived behavioral control toward walking for transportation & leisure; and 5) demographics.

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Pre- % (N) Post- % (N) p-value Sex 0.16 Male 29.73% (330) 26.46% (142) Female 70.81% (779) 73.23% (476) Other 0.09% (1) 0.31% (2) Race/Ethnicity 0.65 White 89.46% (951) 89.72% (567) Non-White 10.52% (211) 10.28% (65) Marital Status 0.98 Married 68.95% (746) 68.05% (443) Relationship, but not married 9.98% (108) 10.75% (70) Never Married/Single 10.81% (117) 10.75% (70) Divorced/Separated/Widowed 9.89% (107) 10.14% (66) Sexual Orientation 0.85 Heterosexual 93.85% (992) 94.01% (596) Homosexual 3.31% (35) 2.68% (17) Bi-sexual 1.61% (17) 1.89% (12) Other 1.23% (13 1.42% (9) Work Status 0.36 Part-Time 1.75% (19) 2.13% (14) Full-Time 98.07% (1065) 97.72% (1707) Work Description 0.41 Mostly Sitting 78.71% (854) 81.37% (533) Mostly Standing 10.32% (112) 7.94% (52) Mostly Walking 8.94% (97) 8.70% (57) Mostly Heavy Labor or Physically Demanding Work 2.03% (22) 1.98% (13)

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RESULTS

  • Any past 30-day PA was reported by 83.7% (pre-) and 87.1% (post-),

p=0.36.

  • Past 7-day moderate PA significantly increase from pre- (M=3.83, SD=2.29)

to post- (M=4.09, SD=2.32), p=.03.

  • 7-day walk for transportation significantly increase from pre- (M=2.81,

SD=2.35) to post- (M=3.05, SD=2.38), p=.04.

  • Destinations walked to for transportation in past 7 days increased

significantly across 20 locations.

  • Days walked to work increased significantly from pre- (M=0.87, SD=1.92)

to post- (M=2.90, SD=1.94), p<.0001.

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OBSERVED POINT-OF-DECISION PROMPTS

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LESSONS LEARNED

  • Walk UK resulted in significant improvements in PA outcomes and

promoted walking for transportation to multiple destinations targeted by the campaign.

  • There is a need to further emphasize how walking for

transportation can be incorporated into the work day.

  • Collaborative efforts, strategic planning, and attention to

detail/organization necessary for successful campaign.

  • Low-cost and potential for high reach across college campus

populations; may need broader campaign over a large geographically widespread campus.

  • Combining with additional health communication strategies such

as social media would be beneficial; future research needed to determine what is most effective.

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CELEBRATE SUCCESS!

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SOCIO-ECOLOGICAL MODEL

COMMUNITY – Coordinating the efforts of all members of a community (organizations, community leaders, and citizens) to bring about change. PUBLIC POLICY - Developing and enforcing state & local policies that can increase beneficial health behaviors.

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PHYSICAL ACTIVITY POLICY READINESS SURVEY

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WHY POLICY?

  • Make the healthy choice the easy choice
  • Impact entire populations
  • Change the social norm
  • Increase perceived health risks
  • The ultimate form of public education!
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EVIDENCE-BASED PHYSICAL ACTIVITY POLICIES

Physical Activity Policy Brief Description Community design policies strive to create more active living communities These policies target zoning regulations related to land use, including proximity between commercial and residential destinations; building codes; and additional environmental changes encouraging transit-oriented development to support PA. Street design policies ensure that streets and roadways are user-friendly and safe for all including bicyclists, pedestrians, and motorists of all ages and abilities. These policies may require reduced building setbacks, transit shelters, or street furniture such as benches and traffic barriers. Communities that adopt Complete Streets policy create the infrastructure to support bicycling (e.g., bike paths) and walking (e.g., adequately lit and safe sidewalks), and improve personal and traffic safety in areas where persons are or could be physically active. Neighborhood availability involves increased access to facilities that support play, sports, or recreation such as parks, playgrounds, trails, and recreations centers. Providing access to outdoor active living opportunities influences PA in the surrounding

  • community. For example, increased availability of outdoor trails greatly enhanced PA

levels among those who were not regularly physically active. In addition, reducing barriers to access of PA opportunities can be targeted by decreasing fees and/or expanding

  • peration hours. Shared-use is another way to increase opportunities for PA without

building new facilities, allowing agencies to share costs and resources. Point-of-decision prompts involve increased signage for information, navigation, and motivation in schools or communities to encourage active choices for PA. According to a recent systematic review, there is strong evidence that these prompts are effective in increasing the use of stairs. However, these efforts can be expanded to promote physical activity throughout the community.

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Changing health policy relies on a community’s readiness to change.

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THEORETICAL FRAMEWORK

Community Readiness Model

(a) communities are at different stages of readiness for dealing with problems; (b) stage of readiness can be accurately assessed; (c) communities can be moved through stages of readiness; and (d) interventions used to advance a community through change are stage-specific.

(Jumper-Thurman & Plested, 2000)

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BENEFITS OF COMMUNITY READINESS MODEL

  • Help to identify community’s weaknesses and strengths, and

the obstacles likely to be met moving forward.

  • Integrate appropriate actions that match community’s

readiness levels.

  • Work within the community’s culture to come up with actions

that are right for the community.

  • Aid in securing funding, cooperating with other
  • rganizations, working with leadership.
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STAGES OF COMMUNITY READINESS

Unawareness Vague Awareness Pre- planning Preparation Initiation Endorseme nt

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DIMENSIONS OF COMMUNITY READINESS

Community Knowledge Existing Voluntary Policies Community Leadership Community Resources Community Climate Community Political Climate

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  • 18-month community-based feasibility study with two

rural Kentucky counties to: (1) Assess readiness for selected evidence-based physical activity policies, and (2) Adapt appropriate stage-specific strategies relevant to community readiness for physical activity policy.

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COMMUNITY READINESS ASSESSMENT PROCESS

Build Rapport and Engage Stakeholders

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COMMUNITY READINESS ASSESSMENT PROCESS

Windshield Survey

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COMMUNITY READINESS ASSESSMENT PROCESS

Recruitment

  • Community members

– 5-8 key informants per county

  • Policymakers from each study county

– 3-4 per county

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COMMUNITY READINESS ASSESSMENT PROCESS

Measures: Pre-survey

  • Which PA policy is the community most likely to

pursue during the year? – Rank policies from 1 (most ready) to 4 (least ready). – Respond to each of the policies on a 3-point scale from very ready (2) to not ready at all (0). – How frequently they have worked on each policy in the past year from very often (2) to not at all (0).

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MEASURE: FULL READINESS ASSESSMENT

Dimension Items Brief Description Resources 68-items Includes the people, coalition cohesiveness, ability to organize the grassroots, money, time, equipment, and space dedicated to the issue including those willing and able to lobby. Existing PA Policies 9-items Policies mandated by law or regulation or voluntarily adopted by organizations or businesses such as government buildings, schools, faith-based organizations, and healthcare facilities. Knowledge 11-items Activities and approaches to educate the community about the negative effects of physical inactivity including media advocacy and public education campaigns, training, petition and resolution drives, collecting local data, and holding community events. Leadership 5-items Encompasses support for PA policy provided by elected and appointed officials including the Board of Health Community Climate 14-items Involves social norms that influence PA policy development including media attention, signage, public attitudes, and opposition. Political Climate 7-items Influence of the political process and politics on PA policy development including the positions of the Mayor, City Planner, County Judge Executive School Superintendent, etc.

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SAMPLE RESULTS

1) County #1

a) Pre-survey b) Full readiness assessment c) Policymaker assessment d) Development of stage-based strategies specific to PA policy

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Neighborhood Availability

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Point-of-decision Prompts

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POLICYMAKER ASSESSMENT

This is a crucial issue. We have allowed children to sit around and be inactive and promote unhealthy behavior. Blood pressure for children is at an all-time high. Children do not go outside to play anymore and parents allow it. Parents often blame schools, but schools are, in some ways, healthier than ever in promoting PA and offering healthier food choices. Parents are the ones who need to be better about making sure their kid go

  • utside and play. Children spend far too

much time on their phones and computers.

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STAGE-BASED STRATEGIES

Build Capacity Build Demand Stage Progression Translate & Disseminate Science

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PREPARATION STAGE

  • Goal: To enact a ‘best practice’ physical activity
  • rdinance or regulation.
  • Recommendations for Low Leadership:

– Review and revise strategic, including political lobbying activities

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LESSONS LEARNED

  • Assessing community readiness for physical activity is

beneficial in: – Promoting discussion related to the issue – Convening existing groups – Understanding policymakers’ views – Learning about barriers to address when advocating for or implementing policy

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LESSONS LEARNED

  • Barriers to assessing community readiness for physical

activity: – Competing interests within health groups/advocates – Not all health groups meet regularly; need a champion – Resources are needed to support such policy movement – Transition of policymakers

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CELEBRATE SUCCESS!

  • Community #1

– Used readiness results and language from stage-based strategies to secure Foundation funding.

  • Community #2

– Integrated PA theme into annual health fair. – Received Trail Town designation. – Continued interest in promoting PA opportunities within the community.

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THANK YOU TO OTHERS IN KY WORKING TO PROMOTE PA…

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http://www.fitky.org/our-efforts/physical-activity/step-it-up-kentucky/

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SOCIO-ECOLOGICAL MODEL

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CONTACT INFORMATION

Melinda Ickes, Ph.D. Associate Professor Department of Kinesiology and Health Promotion University of Kentucky Email: melinda.ickes@uky.edu Phone: 859-257-1625