Physical Activity Around the World

1
Physical Activity Around the World

• February 8, 2005
• Nancy Dubois
• n.dubois_at_utoronto.ca519.446.3636

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OVERVIEW

• Levels
• International
• National
• Other Provinces

• Types
• Research
• Resources
• Programs

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INTERNATIONAL
4
USA
5
CDC Resources
6
CDCs Physical Activity Evaluation Handbook
7
CDCs Inventory of Qualitative Research

• http//www.cdc.gov/nccdphp/dnpa/qualitative_resear
  ch/index.htm

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CDCs Inventory of Qualitative Research

• Provides basic information about qualitative
  studies that have been conducted in nutrition,
  physical activity, and other related fields.
• The qualitative research presented includes
• formative research to study target audiences
  while developing intervention strategies
• research to pretest intervention activities
  and/or materials, and
• monitoring evaluation research to find out how
  projects are doing so they can be fine-tuned to
  improve efficiency and effectiveness.

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CDCs Inventory of Qualitative Research

• The purpose of the inventory is to provide a
  brief overview of qualitative research conducted
  on the topics of nutrition, physical activity,
  and other related fields. For each study,
  information is included about the topic, target
  audience, purpose, sample population, data
  collection date, methods, available documents,
  and contact person. Ideally, the level of
  detail included in the inventory and the
  categories of information for each study allow
  you decide if you want to contact an organization
  or person for more information about a particular
  study.

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Inclusion Criteria

• The research must be qualitative in nature and
  must include the topics of physical activity,
  nutrition or related fields, such as obesity and
  inactivity or TV watching.
• The data must have been collected in the year
  1997 or later.
• The data must have been collected in a systematic
  way, using standard qualitative methods of data
  collection (e.g., focus group discussions,
  in-depth interviews, ethnography, etc.)

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ACES Active Community Environments Initiative
(CDC)

• promotes walking, bicycling, and the development
  of accessible recreation facilities.
• developed in response to data from a variety of
  disciplines, including public health, urban
  design, and transportation planning.
• These data suggest characteristics of our
  communities such as
• proximity of facilities
• street design
• density of housing
• availability of public transit and of pedestrian
  and bicycle facilities
• play a significant role in promoting or
  discouraging physical activity.

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Current Activities

• promoting physical activity through trails and
  partnerships
• development of the KidsWalk-to-School program to
  promote walking and bicycling to school
• collaboration with public private agencies to
  promote National and International Walk-to-School
  Day
• development of the Active Community Environments
  guidebook for public health practitioners to use
  to partner with transportation and city planning
  organizations to promote walking, bicycling, and
  close to home recreation facilities
• a partnership with the National Park Services
  Rivers, Trails, and Conservation Assistance
  Program to promote the development and use of
  close-to-home parks and recreational facilities
• collaboration on an Atlanta-based study to review
  the relationships of land use, transportation,
  air quality, and physical activity
• collaboration with the Environmental Protection
  Agency on a national survey to study attitudes of
  the American public toward the environment,
  walking, and bicycling.

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Active Community Environment Working Papers

• How Land Use and Transportation Systems Impact
  Public Health(PDF - 845K)This paper is a
  synthesis of the literature on the relationship
  between physical activity and community
  design.(updated 12/26/2000)
• How Land Use and Transportation Systems Impact
  Public Health An Annotated bibliography (PDF -
  635K)(updated 12/26/2000)

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Healthy Weights / Addressing Obesity
Physical activity and good nutrition essential
elements to prevent chronic diseases and
obesity 2004 - CDC
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State Programs in Action
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Bone Health Osteoporosis A Report of the
Surgeon General (2004)

• US Department of Health Human Services
• www.surgeongeneral.gov/library/bonehealth/content.
  html
• Chapter 12 Population-Based Approaches to
  Promote Bone Health
• 7 case studies
• Powerful Bones, Powerful Girls
• Strength Training for Older Adults
• Take Our Trail

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Powerful Bones, Powerful Girls

• http//www.cdc.gov/powerfulbones/index2.html

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Growing Stronger Strength Training for Older
Adults

• www.cdc.gov/nccdphp/dnpa/physical/growing_stronger
  

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Take Our Trail

• http//www.cdc.gov/nccdphp/dnpa/physical/handbook/
  appendix6.htmfigureC

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Background

• In 1997, data from the state BRFSS indicated that
  60 of the states population was overweight and
  65 were not sufficiently active to meet public
  health recommendations. To address this health
  problem, state officialswith help from a
  community Heart Health coalitionfunded
  construction of walking trails in two communities
  in 2000 through the state DOT. Community members,
  businesses, and city government donated
  additional funds.

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• Although no formal evaluation was initially
  conducted, DOT staff members heard that the
  trails were underused because of safety concerns
  and lack of certain amenities (e.g., playground
  equipment or well-maintained restrooms).
• When other communities began requesting funds to
  build trails, state officials needed to know if
  the investment was worthwhile. To promote use of
  existing trails, state officials funded the local
  health department in one of the communities with
  a newly constructed trail to conduct an awareness
  campaign and trail enhancement activities.
• If community members were not more physically
  active after having both access to a walking
  trail and information about the trail and the
  benefits of regular physical activity, then state
  officials would probably not fund additional
  trails.

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Take Our Trail
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Results

• The 1-year follow-up phone survey indicated a 5
  increase in the number of persons meeting the
  physical activity recommendations in the Take Our
  Trail community, a 2 increase in the other
  community with a trail, and a 1 decrease in the
  community without a trail. Although these numbers
  are small, they could result in larger changes if
  the trends continue. For example, in 3 years, the
  community without a trail could have a 3 total
  decrease in the number of persons meeting the
  physical activity recommendations, whereas the
  Take Our Trail community could have a 15
  increasea substantial improvement over the
  current rate.

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WHO
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Move For Health Day May 10

• Core message
• At least 30 minutes of cumulative moderate
  physical activity every day (walking/brisk
  walking as well as other appropriate, healthy and
  enjoyable physical activities and sport for all
  actions). Additional health gains can be obtained
  by relevant daily moderate to vigorous physical
  activities of longer duration e.g.
• children and young people need an additional 20
  minutes' vigorous physical activity 3 times a
  week.
• - weight control would require at least 60
  minutes every day of moderate/vigorous physical
  activity).

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WHOs Health Development through PA Sport
http//www.who.int/hpr/physactiv/docs/health_and_d
evelopment.pdf
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United Nations 2005

• International Year for Sport and Physical
  Education
• On 3 November 2003, the United Nations General
  Assembly adopted resolution 58/5, Sport as a
  means to promote education, health, development
  and peace. It proclaimed 2005 as the
  International Year for Sport and Physical
  Education and invited Governments, the United
  Nations and its funds and programmes, the
  specialized agencies, where appropriate, and
  sport-related institutions to promote the role of
  sport and physical education for all when
  furthering their development programmes and
  policies, to advance health awareness, the spirit
  of achievement and the bridging of cultures and
  to entrench collective values.

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International Physical Activity Questionnaire
(IPAQ)

• an internationally agreed upon set of measures of
  physical activity participation.

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www.pushplay.org/
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NATIONAL
31
www.hc-sc.gc.ca/english/lifestyles/healthylivingin
dex.html
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2004 CIHI Report Raines
Overweight and obesity in Canada A population
health perspective CPH/CIHP
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The ANGELO framework (Analysis Grid for
Environments Linked to Obesity)

• a conceptual model for dissecting the rather
  nebulous concept of environment into
• concrete elements which are amenable to
  measurement and intervention.The
• framework is a 2 x 4 grid that dissects the
  environment into size (micro and macro) by
• type (physical, economic, political, and
  sociocultural).
• Micro-environments are relatively small
  potentially influenced by individuals. Some
  examples of micro-environments are
  homes/families, workplaces, schools, food
  retailers, food service outlets, recreation
  facilities.
• Macro-environments influence micro-environments
  include media, technology, food marketing, urban
  planning, and transportation systems.
• Both micro- and macro-environments can be further
  typed into
• physical environment (availability of healthy
  foods, opportunities for physical activity),
  economic (costs and income),
• political (rules governing behaviour, such as
  family rules for food consumption or national
  food policies)
• sociocultural (community or societal beliefs and
  values related to food and physical activity).
• The ANGELO framework helps analyze the
  environmental elements that influence food
  intake, physical activity, and their interaction.
  Those promoting over-consumption and inactivity
  are characterized as obesogenic (promoting
  obesity). The framework may be helpful in
  prioritizing environmental interventions.

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Authors Conclusions, Knowledge Gaps Policy
Options

• Policy Option No. 1 Develop a comprehensive,
  coordinated surveillance system to monitor
  ongoing rates of obesity, the costs of obesity,
  and impacts of interventions.
• Policy Option No. 2 Build upon current
  commitments to food and nutrition surveillance,
  including eating patterns and nutrient intake
  physical measures, through the CCHS, Cycle 2.2,
  planned to begin in 2004. Commit further
  resources to exploit opportunities for ongoing
  surveillance, data analysis, interpretation, and
  reporting so that the contributions of food
  intake and physical activity to obesity can be
  understood and acted upon.

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Authors Conclusions, Knowledge Gaps Policy
Options (2)

• Policy Option No. 3 Develop a comprehensive,
  coordinated surveillance system to monitor
  physical activity among Canadians.
• Policy Option No. 4 Exploit opportunities for
  analysis of currently available surveys and
  develop surveillance mechanisms to fill current
  gaps in data gathering in order to monitor social
  trends such as recreation patterns, television
  viewing, food purchasing patterns, food supply,
  and marketing strategies related to food and
  physical activity that contribute to the
  understanding of environmental determinants of
  obesity.

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Authors Conclusions, Knowledge Gaps Policy
Options (3)

• Policy Option No. 5 Conduct health impact
  analyses of social policies influencing income
  equity/financial security to assist in developing
  an understanding of socioeconomic determinants of
  obesity.
• Policy Option No. 6 Develop policies supportive
  of weight management for individuals at risk for
  health problems due to obesity.
• Policy Option No. 7 Work with education
  ministries and school boards to promote healthy
  weights through schools.

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Authors Conclusions, Knowledge Gaps Policy
Options (4)

• Policy Option No. 8 Work with private- and
  public-sector employers to develop a workplace
  environment that promotes healthy weights.
• Policy Option No. 9 Based upon extensive
  evidence generated from knowledge and experience
  with other health issues in Canada (such as
  tobacco) and from other countries, apply
  promising practices for population-based policy
  change to promote healthy weights.
• Policy Option No. 10 Evaluate and measure
  outcomes of programs and interventions using
  common indicators of success to increase the
  evidence base for future public-health
  initiatives.

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CDPAC Obesity Initiative

• Expert Advisory Committee met in Vancouver in
  January
• Creating a Community of Practice on obesity

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www.cflri.ca
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PACE Canadawww.pace-canada.org

• PACE Canada is a comprehensive guide to
  counseling for healthy active living designed to
  assist physicians in effectively increasing their
  patients physical activity levels and improving
  their eating habits.
• Research has demonstrated that the PACE
  intervention is effective in helping patients
  move towards more healthy active living, and that
  the program is acceptable to health care
  providers, office staff and patients.
• The program does not require staff to have
  special medical training and can be used
  effectively by a wide range of primary care
  providers.

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PACE Canadawww.pace-canada.org

• PACE Canada includes both a Tool Kit and
  Counseling Guide.
• PACE Canada addresses major barriers to physician
  counseling in that it requires only 2-5 minutes
  of physicians time to administer and focuses on
  moderate intensity activities that are safe,
  effective, familiar to the patient.

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Go For Green
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Go For Green

• Business Case for Active Transportation
• http//www.goforgreen.ca/at/Eng/resources/busines
  s_case.aro

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Canadian Sports Policy (2002)

• The Vision of the Canadian Sport Policy is to
  have, by 2012, a dynamic and leading-edge sport
  environment that enables all Canadians to
  experience and enjoy involvement in sport to the
  extent of their abilities and interests and, for
  increasing numbers, to perform consistently and
  successfully at the highest competitive levels.
• http//www.canadianheritage.gc.ca/
• progs/sc/pol/pcs-csp/2003/polsport_e.pdf

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Coalition for Active Living

• Three priority recommendations for Government
  action to reduce Canadas physical inactivity
  epidemic.
• The Government of Canada, through key Ministries,
  makes a strategic investment of 500 million
  dollars over 5 years, similar to the investment
  to reduce Tobacco consumption, to undertake an
  aggressive strategy to address the physical
  inactivity epidemic in Canada.
•  

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Coalition for Active Living

• The Government of Canada creates tax incentives
  to encourage physical activity among Canadians.
• The Government of Canada targets new investments
  and incentives (recommendations 1 and 2 above) in
  areas of strategic emphasis. The Coalition for
  Active Living has identified 5 strategic areas
  for investment, which will be needed in order to
  achieve the pan-Canadian goal, agreed to by all
  14 Ministers responsible for Physical Activity,
  of increasing physical activity by 10 percentage
  points in every province and territory.
•  

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Coalition for Active Living Strategic Areas for
Investment

• Healthy Public Policy
• Community Physical Environments
• Supportive Social Environments
• Public Education
• Research and Knowledge Exchange
•  

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OTHER PROVINCES
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BC
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BC Action Schools Focus Areas

• Healthy Heart cardiovascular fitness
• Healthy Bones bone health
• Healthy Self muscle fitness, positive
  self-esteem, tobacco use prevention and
  cessation, healthy weight, nutrition and academic
  performance
• Healthy School inclusive, safe healthy school
  communities

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Alberta Centre for Active Living

• Workplace Physical Activity Framework
• a Program Standard (a guide to the elements
  needed to implement and/or sustain a workplace
  physical activity program)
• an Audit Tool (a way to measure your
  organization's program against the standard so
  that the program can improve).
• http//www.centre4activeliving.ca/Research/2003Wor
  kplace/Audit.htm

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http//www.saskatchewaninmotion.ca
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Physical Activity Coalition of Manitoba

• Web site (www.winnipeg.cbc.ca)
• CBC radio TV info campaign
• Province-wide physical activity events Jan. 7
  8
• Encourages people to make a pledge create a plan

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http//www.doitforyou.gouv.qc.ca/
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Kino-Quebec

• is a government program in existence since
  1978. It is managed by three partners
• the Secrétariat au loisir et au sport of the
  Ministère des Affaires municipales, du Sport et
  du Loisir
• the Ministère de la Santé et des Services sociaux
  
• regional health and social services boards.
• Its mission is to promote a physically active
  lifestyle in order to contribute to the
  well-being of the population of Québec.
  Kino-Québecs implementation is based on a novel
  approach that calls on local organizations to
  play a leadership role, while providing them with
  support.
• http//www.kino-quebec.qc.ca/

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Nova Scotia
http//www.gov.ns/ohp/srd/
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http//www.snbs.gnb.ca/
New Brunswick
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Newfoundlandhttp//www.unb.ca/spans/en/home.htm
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Goal of community sport and recreation intiiatives
Increased participation among physically
inactive New initiatives and training of staff
and volunteers Recreation, sport and fitness
sectors at community level
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(No Transcript)
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http//www.active2010.ca/
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Components of Each Tool

• What is it?
• How will this help me get people active?
• When can I use it?
• For example
• Other helpful Toolkit Tools
• Suggested format
• Source
• Tool

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Closing Remarks

• Never a time where there is so much collective
  activity exciting
• stars are aligned
• A lot of data has been gathered to assist in
  making the case
• Many programs resources already available