The Value of Policy and Environmental Changes
to Support Physical Activity
Natalie Clifton, M.Ed., CHES2010 State Agency Wellness Conference
September 22, 2010
Texas Department of State Health ServicesNutrition, Physical Activity & Obesity
Prevention Program
Evidence
“Policy and environmental change initiatives that make healthy choices in nutrition and physical activity
Available, Affordable, & Easy
Will likely prove most effective in combating obesity.”
Fruits & Vegetables
Physical Activity
Breastfeeding
Sugar-Sweetened BeveragesHigh- Energy- Dense FoodsTV Viewing
Obesity Target Areas
Basic Public Health Question
Will the public’s health improve primarily as a result of:
Individuals getting more and better knowledge about personal risk factors that increase the likelihood of obesity
OR
Individuals and groups getting more skills and opportunities to participate in changing public policy and environments?
Socio-ecological Model
Policy & Environmental Change:More than telling people what to eat and
how to exercise
• Shift the focus from individual behavioral level
• Advance solutions that improve health on a population level
So What is P&E Change?
• Policy – laws, regulations, formal and informal rules and understandings that are adopted on a collective basis to guide individual and collective behavior
• Environmental change – things that alter or control the legal, social, economic, and physical environment affecting health
What P&E Change is Not
• Health fairs
• Education
• Events
• Brochures
• Classes
• Other
Balancing Values
Social Accountability
Personal Responsibility
Growing Community Video Series
www.dshs.state.tx.us/obesity/GrowingCommunity.shtm
Texas! Bringing Healthy Back: The DVD
• Six short videos (5-8 minutes each) featuring inspiring community programs
• CDC Evidence Based Strategies
Texas! Bringing Healthy Back
• Initiative with a pioneering approach: Community vs. Individual
• Examples of changing our environment to make healthy living the easy choice in Texas.
• Goal: To Make Healthy Eating and Active Living the Easy Choice for All Texans.
Your Role: Catalyst for Change
Help Bring Healthy Back to Texas by:1 Watching the six videos
2 Sharing the videos with others:
3 Encouraging a discussion
4 Logging your Screenings at the Bringing Healthy Back Web site:
www.texasbringinghealthyback.org
1.
Watch the
Six
Videos
on the
DVD
2.
Share the
videos
with
others
by:
3. Share the Message
Encourage a discussion
4. Share the results with DSHS
CDC Community Guide:Environmental and Policy Approaches to
Increase Physical Activity
• Community-Scale Urban Design Land Use Policies
• Creation of or Enhanced Access to Places for Physical Activity Combined with Informational Outreach Activities
• Street-Scale Urban Design Land Use Policies • Point-of-Decision Prompts to Encourage Use of
Stairs
Create or enhance access to places to be physically active…
• Building walking trails • Providing public access to school gymnasiums,
playgrounds, or community centers. • Worksite activity programs that provide access
to onsite or offsite fitness rooms, walking breaks, or other opportunities to engage in physical activity.
• Interventions to improve access should also include outreach that increases awareness of the opportunity to be active
Worksite Physical Activity Strategies
1. Allow maximum access to recreation facilities.
2. Provide cash incentives or reduced insurance costs for participation in physical activity and/or weight management or maintenance activities
3. Institute environmental changes to increase activity.
Worksite Physical Activity Strategies
4. Set up programs that have strong social support systems and incentives.
5. Encourage scheduling that allows for more activity.
6. Promote opportunities.
7. Provide on-site child care facilities to facilitate physical activity
Improving Worksite Stairwells
Stairwell Basics• The stairwells need to be safe, with
controlled access from the outside.• Stairwells should be well-lit with good
visibility (including mirrors and video cameras if needed).
• Stairwells should be well constructed and maintained, equipped with non-slip or non-skid treads, and cleaned regularly.
Creating Attractive and Inviting Stairwells
• Post motivational signs and prompts at elevators that encourage employees to take the stairs.
Alternative Transportation"Alternative transportation" modes
are telecommuting, carpools, vanpools, public transportation, bicycling, walking, and running.
These commute methods are relevant to employee health in two ways:
• A reduction in the use of single-occupancy vehicles helps reduce environmental fuel emissions.
• Employees who use "active transport" (public transportation, bicycling, and walking) to commute to work may increase their daily physical activity.
Federal Agency Policy Examples
5 U.S.C. § 7901 Federal agency heads may establish health service programs to promote and maintain the physical and mental fitness of their employees. Authorizes agencies to establish and operate physical fitness programs and facilities designed to promote and maintain employee health, such as occupational safety and health. 41 CFR 102-79.30 States that federal agencies can allot space in federal buildings for fitness programs.
5 U.S.C. § 7905 States that federal agency heads may develop programs to encourage commuting by means other than single-occupancy motor vehicles. Includes transit passes and furnishing space, facilities, and services to bicyclists.
5 U.S.C. § 5946 Sets limits on paying membership fees or dues of federal employees in societies or associations. However, Comptroller General Decision B-240371 (Jan 18, 1991) allows agencies to pay for access to private fitness facilities for its employees as part of its health service program.
Resources• 2008 Physical Activity Guidelines for Americans: http://www.health.gov/paguidelines/• Guide to Community Preventive Services:
Worksite Health Promotion http://www.thecommunityguide.org/worksite/index.html
• Recommended Community Strategies and Measurements to Prevent Obesity in the United States: http://www.cdc.gov/obesity/downloads/community_strategies_guide.pdf
• Healthier Worksite Initiative, CDC http://www.cdc.gov/nccdphp/dnpa/hwi/index.htm
• Indicators of Activity-Friendly Communities http://www.nspapph.org/index.php?option=com_docman&task=doc_download&gid=26&Itemid=83
• Visit www.cdc.gov/nccdphp/dnpa/stairwell/motivational_signs.htm to obtain sample stairwell signs that have been tested and found to
be effective.
For further information & resources:
www.texasbringinghealthyback.org
Texas Department of State Health ServicesNutrition, Physical Activity & Obesity
Prevention Program
Natalie Clifton
Texas Department of State Health ServicesNutrition, Physical Activity & Obesity
Prevention Tower Building 406 / Mail Code 1944
PO Box 149347 Austin, Texas 78714
P 512-458-7111 ext. 3447F 512-458-7618
E-Mail: [email protected]