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

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 Opportunity University

O BJECTIVES • 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. An Equal Opportunity University

P ROMOTING 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 overall 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 An Equal Opportunity University

S OCIO -E COLOGICAL M ODEL PUBLIC POLICY - Developing and enforcing state & local policies that can COMMUNITY – increase beneficial Coordinating the efforts of all health behaviors. members of a community (organizations, community leaders, and citizens) to bring about change. ORGANIZATIONAL – Changing the policies, practices, and physical environment of an organization (e.g., a workplace) to support behavior change.

W ALK UK An Equal Opportunity University

P OINT - OF -D ECISION P ROMPTS P ROMOTING 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 An Equal Opportunity University

W ALK UK P LANNING • 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 of 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. An Equal Opportunity University

W ALK UK P LANNING • Determine campaign goals • Form campaign planning team; contact necessary stakeholders Step 1 • Walkability Assessments • Assess pedestrian route info. Step 2 • Brainstorm origins & destinations • Develop wording for signs • Develop campaign with web-based tool Step 3 • Order signs • Intersection Guides to assist with implementation • Press release/communication strategies Step 4 An Equal Opportunity University

W ALK UK P LANNING • 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. An Equal Opportunity University

An Equal Opportunity University

W ALK UK E VALUATION • 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. An Equal Opportunity University

Pre- Post- p-value % (N) % (N) 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)

R ESULTS • 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. An Equal Opportunity University

O BSERVED P OINT - OF -D ECISION P ROMPTS An Equal Opportunity University

L ESSONS L EARNED • 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. An Equal Opportunity University

C ELEBRATE S UCCESS ! An Equal Opportunity University

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

PHYSICAL ACTIVITY POLICY READINESS SURVEY An Equal Opportunity University

W HY P OLICY ? • Make the healthy choice the easy choice • Impact entire populations • Change the social norm • Increase perceived health risks • The ultimate form of public education! An Equal Opportunity University

E VIDENCE - BASED P HYSICAL A CTIVITY P OLICIES Physical Activity Policy Brief Description Community design policies strive to These policies target zoning regulations related to land use, including proximity between create more active living communities commercial and residential destinations; building codes; and additional environmental changes encouraging transit-oriented development to support PA. Street design policies ensure that These policies may require reduced building setbacks, transit shelters, or street furniture streets and roadways are user-friendly such as benches and traffic barriers. Communities that adopt Complete Streets policy and safe for all including bicyclists, create the infrastructure to support bicycling (e.g., bike paths) and walking (e.g., pedestrians, and motorists of all ages adequately lit and safe sidewalks), and improve personal and traffic safety in areas where and abilities. persons are or could be physically active. Neighborhood availability involves Providing access to outdoor active living opportunities influences PA in the surrounding increased access to facilities that community. For example, increased availability of outdoor trails greatly enhanced PA support play, sports, or recreation such levels among those who were not regularly physically active. In addition, reducing barriers as parks, playgrounds, trails, and to access of PA opportunities can be targeted by decreasing fees and/or expanding recreations centers. operation 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 According to a recent systematic review, there is strong evidence that these prompts are increased signage for information, effective in increasing the use of stairs. However, these efforts can be expanded to navigation, and motivation in schools or promote physical activity throughout the community. communities to encourage active choices for PA. An Equal Opportunity University