How to promote HEPA?

Sylvia Titze

Master of Public Health courseSchlosshofen, 12 Jänner 2008

Outline

Promotion of physical activity: individual approachTranstheoretical model

Promotion of physical activity: setting approachExample: Bewegtes Amt (Office in Motion)

Promotion of physical activity: community approachSocial marketing theory

Example: Bewegte Steiermark

Verhaltensänderung

Das transtheoretische Modell

Pro

gram

m

Absichtslosigkeit

Absichtsbildung

Vorbereitung

Handlung

Aufrechterhaltung

- Str

ateg

ien

der

Ver

halt

ensä

nder

ung

- Ent

sche

idun

gsba

lanc

e- S

elbs

twir

ksam

keit

Zun

ahm

e ge

sund

heit

swir

ksam

er

Bew

egun

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Individual Factors

Social Environmental Factors

Physical Environment Factors

Social ecological model

Based on Giles-Corti, B. et al., Exerc. Sport Sci. Rev. 2005

Self-efficacy for cycling for transport; perceived benefits and barriers to cycling for transport

Social norms for cycling for transportation, social support for cycling for transport

Connectivity of neighborhood street network; Traffic Safety; Land use-mix access, Living density

Physical Activity

Office in Motion A Lifestyle Activity Intervention in

a Worksite Setting

S. Titze1, B.W. Martin2, R. Seiler2 & B. Marti2

1 Institute of Sport Sciences, University of Graz, AUT2 Institute of Sport Sciences, Federal Office of Sports Magglingen, CH

Titze, S., Martin, B. W., Seiler, R. & Marti, B. (2001). A worksite intervention module encouraging the use of stairs: results and evaluation issues. Sozial und Präventivmedizin, 46, 13-19.

Titze, S., Martin, B. W., Seiler, R., Stronegger, W. & Marti, B. (2001). Effects of a lifestyle physical activity intervention on stages of change and energy expenditure in sedentary employees. Psychology of Sport and Exercise, 2, 103-116

OBJECTIVE OF THE STUDY

to assess the effects of a physical activity intervention in a worksite setting on changes in physical activity

OUTCOME MEASUREMENTS OF PHYSICAL ACTIVITY

Stages of change (Transtheoretical Model)Stages of change (Transtheoretical Model) Progression within the stages: precontemplation, Progression within the stages: precontemplation, contemplation, preparation, action and maintenancecontemplation, preparation, action and maintenance

Energy expenditureEnergy expenditure Total weekly energy requirements of all activies withTotal weekly energy requirements of all activies with an intensity an intensity than 4.5 METs than 4.5 METs

INTERVENTIONS (1)

• Information- Leaflet about the intervention programme - Brochures on recent recommendations of HEPA - Lectures: nutrition, stress, fitness - Demonstrations of bicycles and bike equipments- Personal counselling

• Action services – lifestyle activities• Action services – exercise and sport

INTERVENTIONS (2)• Information

• Action services – lifestyle activities- Action days: climbing stairs - Action day: closed lifts - Lunch time walk - Five-minutes activity breaks

• Action services – exercise and sport

INTERVENTIONS (3)• Information

• Action services – lifestyle activities

• Action services – exercise and sport- Fitness lessons during lunch break - Afternoon jogging- Fitness test - Hiking day

QUALITY CONTROL OF INTERVENTIONS

Process assessmentProcess assessment- Date of the event- Date of the event- Number of participants- Number of participants- Gender distribution- Gender distribution- Method of announcements - Method of announcements - Acceptance of the events- Acceptance of the events

FeedbackFeedback - - Meetings: Project manager, evaluator, and Meetings: Project manager, evaluator, and exercise professionalsexercise professionals - Informal consultation- Informal consultation

TOTAL ENERGY EXPENDITURE Percent > 1000 kcal/week

0

10

20

30

40

50

60

70

80

4 Intervention offices 2 Controll offices

Baseline

Follow-up

%

21% 8%

STAGES OF CHANGEPercentage of changes

0

10

20

30

40

50

60

Relapsers Stables Adopters

4 Intervention offices2 Control offices

%

CONCLUSIONS

• Intervention increased the number of people sufficiently active for health (baseline!)

• Energy expenditure in lifestyle activities increased • More adopters and • Less relapsers in the intervention group.

Lifestyle activity programmes are fisible and effective to promote HEPA in worksite settings

Social Marketing Theory

A process that attempts to create voluntary exchange between a marketing organization and members of a target market based on mutual fulfillment of self-interest. The marketing organization uses its resources to understand the perceived interests of target marketmembers, to enhance and deliver the package of benefits associated with a product, service, or idea, and to reduce barriers that interfere with its adoption or maintenance. Target market members, in turn, expend their resources (e.g., money, time, effort) in exchange for the offer when it provides clear advantages over alternative behaviors.

Maibach, E. W. (2002). Recreating communities to support active living: A new role for social marketing. American Journal of Health Promotion, 18, 114-119.

Recommended literature Hardman, A. E. & Stensel, D. J. (2003). Physical Activity

and health. The Evidence Explained. London: Routledge. Bouchard, C., Blair, S. N., & Haskell, W. L. (2007).

Physical Activity and Health. Champaign, IL: HumanKinetics.

Marcus, B. H. & Forsythe, LA. H. (2003). Motivating people to be physically active. Champaign, IL: HumanKinetics.

Oja, P. & Borms, J. (2004). Health enhancing Physical Activity. Oxford: Meyer & Meyer Sport.

U.S. Department of Health and Human Services (Hrsg.) (1999). Promoting Physical Activity. A Guide for Community Action.

www.hepa.ch (Gesundheitswirksame Bewegung. Grundlagendokument)