Promoting partnerships for physical activity.Despite the clear importance of regular physical activity to health and well-being, we remain a nation of largely inactive people. Fewer than 10% of the American adult population is estimated to participate in sustained large-muscle activities at least three times per week at an intensity sufficient to improve or maintain cardiorespiratory fitness Cardiorespiratory fitness refers to the ability of the circulatory and respiratory systems to supply oxygen to skeletal muscles during sustained physical activity. Regular exercise makes these systems more efficient by enlarging the heart muscle, enabling more blood to be pumped . Nearly 60% of adults engage either in no leisure-time physical activity or activity that is so irregular that it confers little or no health benefits. Physical inactivity physical inactivity A sedentary state. Cf Physical activity. tends to be higher among women, minority populations, the elderly, and those with less income or formal education. The amount of inactivity inactivity Sedentary activity Internal medicine An absence of physical activity and/or exercise, a predictor of obesity. See Couch potato. Physical activity, Vigorous exercise among our nation's children equally is alarming, with over one-third of children aged 10 through 17 reportedly not engaging in activity that is vigorous enough to enhance and maintain cardiorespiratory fitness. With such high levels of inactivity in our population, those in the fitness, recreation and health promotion fields must examine our efforts more closely. Clearly, if we are to get our nation moving, it will take a combined effort of many different organizations. The power of partnerships comes from different groups working together to accomplish a common vision or goal. Partnerships allow us to reach more people and have more impact. They also eliminate duplication of effort, broaden community support, strengthen community trust in recreation and fitness programs, and combine forces of community leaders, agencies, "gatekeepers," and influential people. Although successful collaborative relationships require communication and endorsement of all parties involved, very often partners can be instrumental in assisting an organization reach its target audience and goals, since they have wider access to staff, volunteers, resources, and expertise. Developing broad-based partnerships to tackle health issues at a national, local, or regional level can effectively heighten height·en v. height·ened, height·en·ing, height·ens v.tr. 1. To raise or increase the quantity or degree of; intensify. 2. To make high or higher; raise. v.intr. initial awareness of a health concern. Additionally, these coalitions provide a level of involvement and support across diverse segments of a community that will make the successful program or strategy implementation more likely. Such coalition-building has been successful for a variety of other health, environmental, and sociopolitical so·ci·o·po·li·ti·cal adj. Involving both social and political factors. sociopolitical Adjective of or involving political and social factors issues but, to date, has been used less formally in the physical activity arena. To increase effectiveness, "community partners" need to include a variety of groups and agencies who represent a diverse constituency and a range of interests but who have a common interest or potential for common interest in health and/or the means to reach populations that could benefit particularly from increases in physical activity. Potential local coalition members include schools (representing primary, secondary, and college levels), parks and recreation departments, local public health departments, community service clubs (e.g., Lions, Rotary), organizations representing senior citizens, sports organizations, local chapters of nonprofit A corporation or an association that conducts business for the benefit of the general public without shareholders and without a profit motive. Nonprofits are also called not-for-profit corporations. Nonprofit corporations are created according to state law. agencies whose focus includes health and/or physical activity (such as the American Heart Association American Heart Association (AHA), n.pr a national voluntary health agency that has the goal of increasing public and medical awareness of cardiovascular diseases and stroke, and thereby reducing the number of associated deaths and disabilities. ), and religious organizations. Other potential partners include representatives of the medical/health community (physician, nursing, public health, and psychological groups; hospital auxiliaries, and clinics), civic and business leaders (including community Chambers of Commerce and owners of exercise clubs and facilities), media services, tourism bureaus, mall organizations, homeowners associations, realtors, neighborhood groups, sports associations, and foundations. Including merchants or organizations that represent ethnic, racial, or gender groups is important if the coalition is to reach all community members effectively, particularly those at greatest risk for underactivity. In the past, insurance groups, particularly those involved with life insurance, have expressed interest in physical activity as a means for diminishing illness and also should be included in coalition-building efforts. Successful State Partnerships Do such partnerships work? There are many successful examples. In Colorado, for instance, a cooperative project was implemented that included a coalition of schools, recreation agencies, and a local health department to target youth fitness as part of the school curriculum and non-school hours participation. The "Well-Kids" program is a school- and community-based initiative for heart disease risk reduction and includes a strong emphasis on physical activity among urban, low income, and ethnically-mixed groups. So far, the program is demonstrating cost-effectiveness and the utility of multiple agency collaboration. South Carolina South Carolina, state of the SE United States. It is bordered by North Carolina (N), the Atlantic Ocean (SE), and Georgia (SW). Facts and Figures Area, 31,055 sq mi (80,432 sq km). Pop. (2000) 4,012,012, a 15. boasts another successful partnership. The Department of Health and Environmental Control there has developed 13 health promotion teams throughout the state (one located in each of the public health districts) whose responsibility is to work with the communities in its district to develop an environment which will support healthy lifestyles. Currently, 12 of the 13 teams are addressing physical activity as part of their community efforts. The teams use different intervention strategies, ranging from coalition building to media and policy advocacy in a number of different settings (i.e., work sites, schools, health care system, community organizations, and community environments). Their efforts have included developing walking trails, promoting organizational policies which support positive physical behaviors, assisting with the implementation of school physical activity programs, and support of local coalition efforts to promote physical activity as a healthy behavior. The state Governor's Council on Physical Fitness, with financial support from the state health department, has awarded mini-grants to communities in South Carolina to develop local councils on physical fitness. Each of these communities is working to establish community support for existing or new physical activity programs in their local areas. The membership of these groups includes representatives from recreation departments, local government, public education, YMCA/YWCA, fitness centers, sporting goods Noun 1. sporting goods - sports equipment sold as a commodity commodity, trade good, good - articles of commerce sports equipment - equipment needed to participate in a particular sport stores, local colleges, Chambers of Commerce, and other local groups and active citizens. Because physical inactivity is such a public health problem, other state health departments and the Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. (CDC See Control Data, century date change and Back Orifice. CDC - Control Data Corporation ) are focusing more resources toward physical activity programming efforts. And, increasingly, states are directing federal prevention block grant and other monies to physical activity programming initiatives. Federal and state efforts have focused on several areas. First, CDC has helped to develop and interpret physical activity and surveillance data and has conducted epidemiological epidemiological emanating from or pertaining to epidemiology. epidemiological associations the associative relationships between the frequency of occurrence of a disease and its determinants, its predisposing and precipitating research concerning the determinants and health effects of an active lifestyle. This information is used to develop and track progress towards the Healthy People 2000 National Health Promotion and Disease Prevention Objectives relating to relating to relate prep → concernant relating to relate prep → bezüglich +gen, mit Bezug auf +acc Physical Activity and Fitness. In conjunction with this, the Behavioral Risk Factor Surveillance System The Behavioral Risk Factor Surveillance System (BRFSS) is a United States national health survey that looks at behavioral risk factors. It is run by Centers for Disease Control and Prevention and conducted by the individual states. (BRFSS BRFSS Behavioral Risk Factor Surveillance System ) was begun in 1984 in conjunction with state health departments and has employed a telephone survey that monitors health behaviors, including physical activity, that relate to the leading causes of death among adults in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. . By providing physical inactivity risk factor estimates over a state and even countywide coun·ty·wide adv. & adj. Throughout a whole county: found at locations countywide; a countywide search. Adj. 1. area, the BRFSS can help recreation professionals in program planning and evaluation. (For a more detailed description of the BRFSS physical activity survey items, contact the state BRFSS coordinator in your state health department.) A second area for potential partnering is the CDC State Physical Activity Contact Network. Each state and U.S. territory health department has identified a physical activity, exercise, and fitness liaison to CDC to foster effective communication and networking among key individuals in state health departments and major national and federal organizations/agencies committed to the promotion of health and physical activity among all or specialized segments of the population. CDC also assists the state contact with his or her efforts to promote physical activity policies and programs at the local level. Many of the state contacts are on WONDER/PC, a computer link that enables public health professionals to communicate electronically with one another and provides data bases, public health reports, and guidelines guidelines, n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks. that can be accessed. CDC Efforts A key function of the CDC network has been to disseminate dis·sem·i·nate v. dis·sem·i·nat·ed, dis·sem·i·nat·ing, dis·sem·i·nates v.tr. 1. To scatter widely, as in sowing seed. 2. updated information that the states and other organizations can use in their programming efforts. Previous dissemination dissemination Medtalk The spread of a pernicious process–eg, CA, acute infection Oncology Metastasis, see there has included a media package containing the new CDC/American College of Sports Medicine sports medicine, branch of medicine concerned with physical fitness and with the treatment and prevention of injuries and other disorders related to sports. Knee, leg, back, and shoulder injuries; stiffness and pain in joints; tendinitis; "tennis elbow"; and (ACSM ACSM American College of Sports Medicine. ) physical activity recommendation (which promotes moderate-intensity activity), summaries of CDC reports, and professional journal articles highlighting important epidemiological findings concerning the relationship between physical activity, physical fitness, all-cause mortality, coronary heart disease coronary heart disease: see coronary artery disease. coronary heart disease or ischemic heart disease Progressive reduction of blood supply to the heart muscle due to narrowing or blocking of a coronary artery (see atherosclerosis). , and longevity longevity (lŏnjĕv`ĭtē), term denoting the length or duration of the life of an animal or plant, often used to indicate an unusually long life. . The materials are presented so that they can be readily usable by network members. (To access the physical activity network liaison in your state, contact the health education/promotion or chronic disease unit in your state health department.) CDC and state health departments are focusing their physical activity programming efforts is in instituting model community-based public health intervention health intervention Health care An activity undertaken to prevent, improve, or stabilize a medical condition approaches. To complement individual change strategies, today's health promotion planner needs to incorporate a variety of comprehensive approaches which strive to reach larger groups of people, even entire communities. The public health approach combines a multi-site (work, health care, school, and community) and multi-strategy intervention matrix to modify group/ individual behavior change Behavior change refers to any transformation or modification of human behavior. Such changes can occur intentionally, through behavior modification, without intention, or change rapidly in situations of mental illness. . These strategies range from educational and promotional methods that address awareness, knowledge, and attitudinal issues regarding exercise to interventions that teach necessary activity skills. They also address legislation, regulations, and policies that promote leisure-time and occupation-and transportation-related physical activity and establish a supportive social, emotional, and physical environment in which desired lifestyle changes can flourish. Figure 1 shows the framework of the comprehensive public health intervention approach and examples that relate to physical activity programming. Public Health Approach The public health approach to promoting physical activity especially is relevant given current evidence that even moderate-intensity activity can confer substantial health benefits. In 1993 CDC and ACSM issued a joint recommendation concerning appropriate levels of physical activity to prevent and/or control cardiovascular and other chronic diseases. The recommendation states that every American adult should accumulate 30 minutes or more of moderate intensity physical activity on most, preferably all, days of the week. Because most adult Americans currently do not meet this standard, almost everyone should strive to increase their participation in moderate or vigorous physical activity. Activities that can contribute to the 30-minute total include gardening, walking the dog, walking up and down stairs, raking raking of an elephant—see back raking. leaves, and walking short distances instead of driving. Other acceptable activities include brisk walking, jogging jogging Aerobic exercise involving running at an easy pace. Jogging (1967) by Bill Bowerman and W.E. Harris boosted jogging's popularity for fitness, weight loss, and stress relief. , playing tennis, swimming, and cycling. All in all, persons who do not engage in any regular physical activity should begin by incorporating a few minutes of increased activity into their day, building up gradually to 30 minutes. Those who are active on an irregular basis Adv. 1. on an irregular basis - in an irregular manner; "her letters arrived irregularly" irregularly should strive to adopt a more consistent level of activity. FIGURE 1. PUBLIC HEALTH APPROACH TO SITE-BASED INTERVENTIONS FOR PHYSICAL ACTIVITY PROMOTION Site Strategy EDUCATION/INFORMATION Worksite * Printed material (pamphlets, desk signs, interoffice in·ter·of·fice adj. Transmitted or taking place between offices, especially those of a single organization: an interoffice memo; interoffice conferences. memos, self-help and program kits & videos) * Special events (e.g., National Employee Health & Fitness Day) * Fitness expert lectures Health Care * Printed material (pamphlets, desk signs, interoffice memos, self-help and program kits & videos) * Physician counseling & exercise prescription * Waiting rm. cable TV School * Printed material (pamphlets, desk signs, interoffice memos, report card/newsletter inserts, self-help and program kits & videos) * Special events (e.g., play day * Correspondence courses Community * Screening (step test, VO2 max : VO2 max is the maximum capacity to transport and utilize oxygen during incremental exercise. (The derivation is V̇ - volume per time, O2 - oxygen, max - maximum). ) * Special events (ex. community fairs) * "Team" neighborhood or association competitions * Family/sig. other inclusion Strategy LEGISLATIVE/REGULATORY (Governmental) POLICY (Organizational) Worksite * Develop consortia of companies to share facilities * Zoning for walking/jogging/biking in industrial parks * Flexible work scheduling to accommodate exercise * Liability legislation for fitness facilities Health Care * Coalitions/task forces of state medical associations/other medical organizations * Insurance reimbursement Reimbursement Payment made to someone for out-of-pocket expenses has incurred. for patient physical activity counseling * Medical school curriculum training in exercise science, public health, & counseling School * Funding physical activity facilities for new school facility sites; renovating older schools * Activity incorporated throughout school curriculum * Increased summer playground supervision Community * Zoning railway tracks for walking/biking paths * Zoning walking, biking, or jogging paths in new planned residential areas; includes public housing * Authorize To empower another with the legal right to perform an action. The Constitution authorizes Congress to regulate interstate commerce. authorize v. to officially empower someone to act. (See: authority) public transfer of land for park/recreation purposes (e.g., closed military bases) * Coalitions/task forces, including local councils on physical fitness & sports Strategy ENVIRONMENT Worksite * On-site exercise facilities with shower & locker rooms * Walking, jogging, or biking paths on company grounds * Businesses next to residential areas connected by walking, bike paths Health Care * Walking, jogging, or biking paths on site (e.g., on top of bldgs. for urban health care centers * Specialized equipment and programs for special populations (e.g., persons with disabilities, diabetics, pregnant women, etc.) School * Walking, jogging, and biking paths on school grounds * Schools built next to residential areas connected by walking, jogging, or biking paths * Secure areas for bicycles * "Off-hour" community use of school facility Community * Conversion of railroad railroad or railway, form of transportation most commonly consisting of steel rails, called tracks, on which freight cars, passenger cars, and other rolling stock are drawn by one locomotive or more. right-of-ways to walking, running paths * Walking, biking paths safe distance from roads * Bldg. design for stairway stairway or staircase Series or flight of steps that provides a means of moving from one level to another. The earliest stairways seem to have been built with walls on both sides, as in Egyptian pylons dating from the 2nd millennium BC. usage accessibility * Indoor shopping malls for walking clubs Focus on Moderate Exercise Obviously, it's going to take involvement from everyone in the community to promote physical activity and provide a supportive community environment. Recreation and park professionals play a major role in this scheme, particularly since an emphasis on public policy and environmental approaches to health and physical activity promotion is consistent not only with promoting regular activity but with the tenants of the recreation field. Federal, state, and local initiatives to convert abandoned railway tracks, unused factories and businesses, and closed military installations for public recreational use point toward recreation and park personnel as key partners in community-based physical activity promotion. References Bouchard, C, Shephard RJ, Stephens T, Sutton JR, & McPherson BD (1990). |
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