HLPE2542: School Health Promotion: Physical Activity and Nutrition

Research Project: Case Study (Written)

Pilates Plus: Improving Rural Community Health

Sarah Mutch (2153178)

Flinders University

mutc0009@flinders.edu.au, Hall Terrace, Bedford Park, South Australia, Australia, 5042

Word Count: 2,013

Health Promotion Program Case Study

‘Pilates Plus: Improving Rural Community Health.’

Introduction:

Pilates Plus is a recently developed community program that encourages rural populations to

engage in physical activity. Pilates instructor Lisa Lowe works collaboratively with the

Harrington Bush Nursing Centre to provide the program which offers low impact physical

activity for community members. The program targets individuals that prefer low impact

physical activity that improves flexibility, prevents injuries and enhances core strength. Over

the past twelve months, Pilates Plus has improved the health and well-being of rural women

by providing a social environment where members can remain active and able.

The Harrington Bush Nursing Centre, a partner organisation, assists with the planning,

development, advertising, finances and implementation of Pilates Plus. The centre advertises

Pilates Plus in their newsletter and promotes the program on social media and their website

(refer to Figure 2, Figure 3 and Figure 4). Additionally, the Centre has assisted Lowe by

providing the location and the equipment for Pilates Plus.

Participants indicated that the program had assisted them in developing their core strength,

flexibility and improving their knowledge of the body. The community members felt that the

program improved their mental, social, emotional and physical health. Additionally, the

Harrington Bush Nursing Centre suggested that Pilates Plus has provided the community with

another form of physical activity that has brought more community members into the centre.

Background

Physical activity is essential in maintaining an individual’s health and wellbeing. The

National Physical Activity Guidelines recommends that adults participate in a minimum of 30

minutes of moderate to vigorous physical activity on most, preferably all, days (National

Rural Health Alliance Inc., 2011). It is estimated that only 30 percent of Australians meet

these guidelines (National Rural Health Alliance Inc., 2011). Physical inactivity is a

substantial health issue that affects individuals worldwide (Nazaruk et al., 2017). Low levels

of physical activity are particularly evident in rural and remote locations. Australian Institute

of Health and Welfare statistics suggest that rural populations are 1.16 times more likely to

engage in sedentary behaviours than individuals in metropolitan areas (National Rural Health

Alliance Inc., 2011). In particular, women living in rural locations have significantly lower

levels of physical activity.

Females have low levels of physical activity in comparison to males. Rural women that

experience low levels of physical activity are susceptible too poor physical and mental health

(American College of Obstetricians and Gynecologists, 2014). Women in rural areas have

reduced access to health facilities and programs that assist in improving their physical

activity levels (Germov, 2014). Such health disparities have led to higher rates of obesity in

rural women that progress to increased incidences of diabetes and other health conditions

(National Rural Health Alliance Inc., 2012). Health promotion programs can assist rural

women in improving their physical activity levels, health and well-being by addressing the

current barriers and challenges that rural women face.

Harrington is a rural town in western Victoria that has a population of 315 people (refer to

Figure 1) (Victoria Places, 2015). The Harrington Bush Nursing Centre offers various health

programs for community members. However, it was evident that the currently available

physical activity programs neglected older men and women. Lisa Lowe, a Harrington

community member, recognised the lack of activities available for older women and

approached the Centre to develop a health program that could assist rural women in

improving their physical activity levels.

Pilates Plus is a 50-minute mat work Pilates class ran by Lowe that is designed to provide

low impact physical activity for rural women. The program, suited for beginners to advanced,

offers a full body work out that engages and strengths muscle to achieve muscular balance.

The Pilates classes provide a series of safe and effective exercises inspired by callisthenics,

yoga and ballet (Better Health Channel, 2017). Pilates was established in the 1920’s as a form

of physical therapy for athletes (Better Health Channel, 2017). Since then, Pilates has been

adapted to improve individual’s flexibility, strength, balance and body awareness.

Figure 1. Map displaying the travel distance from Adelaide, South Australia to Harrington, Victoria. (Google Maps, 2017)

Over the past 12 months, Pilates Plus has assisted rural women in developing their physical

activity levels. Participation levels have increased throughout the year, and there has been an

increase in the number of rural women visiting the local health clinic, Harrington Bush

Nursing Centre.

Aims and objectives

Pilates Plus aims to provide an enjoyable exercise class that improves the health and

wellbeing of rural community members by keeping them active, social and able. The program

offers the Harrington community an alternative low impact group exercise for all abilities.

The Pilates Plus, short-term goal, is to provide the community with challenging exercises that

are great for injury prevention and improving core strength. The programs long-term goals

include enhancing the community’s commitment to physical activity as well as developing

individual’s mindfulness, flexibility, functional strength, mobility, longevity and decrease the

risk of cardiovascular disease.

The success of the program will be determined by the attendance numbers, participant beliefs

about their progress and the ongoing assessments made during class by Lowe. Participant

surveys and feedback are vital ways to measure the success of the Pilates Plus Program.

Participants

The program targets rural women between the age of 30 to 60 years that are looking to

participate in a challenging program that involves low impact physical activity. Pilates Plus is

offered to individuals with various abilities and physical activity levels. The program is

available to both males and females. However, there has currently been no male participants.

Methodology

Over the past 12 months, Pilates Plus has provided challenging and low impact exercises as

an alternative physical activity program for Harrington community members. The Pilates Plus

program aligns with the Victorian school terms. Participants that pay upfront for a school

term pay $5.50 per session, whereas casual participants pay $8 per session. The program runs

two 50 minute sessions every Wednesday at the Harrington Bush Nursing Centre starting at

6:10 am and 8:40 am. The costs have been subsidised by the Harrington Bush Nursing

Centre. Each participant is required to fill out a consent form indicating their details, health

status and abilities.

Lowe recognised that the community lacked appropriate physical activity programs for rural

women who prefer low impact exercise. Lowe, a qualified Personal Trainer for CrossFit,

Bootcamp, Children’s exercise and Older Population physical activity, completed a mat work

Pilates Certificate to build on her current degree, a Bachelor of Applied Sciences. After

discussing the gap in physical activity access for rural women with the Harrington Bush

Nursing Centre, Lowe developed the Pilates Plus program. The program consists of a variety

of Pilate exercises that aim to improve the health and wellbeing of Harrington community

members. The workouts cater for a range of abilities and Lowe provides individual exercises

for women with health issues or illnesses.

Figure 2. Harrington Bush Nursing Centre Facebook Page utilised for advertising the Pilates Plus program (Harrington Bush Nursing Centre, 2017b).

The Harrington Bush Nursing Centre assisted in the planning, development, finances and

implementation of Pilates Plus. The Centre encourages health promotion and offers various

health programs to the Harrington community, including Bootcamp, Cooking Classes and Art

classes. Working closely with Lowe, the Centre provides the location and equipment for the

program and subsidises the session costs. Additionally, the Centre advertises Pilates Plus on

their website, Facebook page and in their weekly newsletter (refer to Figure 2, Figure 3 and

Figure 4).

Figure 3. Harrington Bush Nursig Centre Newsletter advertising the Pilates Plus program (Harrington Bush Nursing Centre, 2017a).

Figure 4. Harrington Bush Nursing Centre Website (Harrington Bush Nursing Centre. 2017c

The program has assisted in developing positive relationships between the Harrington Bush

Nursing Centre and community members. The participants that are members of the centre

receive health support services and additional programs. The average number of participants

per session is 6-7 people and has increased over the past 12 months. The quality of Pilates

Plus will be determined by participant feedback, attendance numbers and instructor

observations. The feedback will be used to make appropriate alterations to the program.

Challenges

The Pilates Plus program has overcome various developmental and organisational challenges

including session times, establishing a cost, payment process and participation numbers. The

scheduling times of the program had to be negotiated between the instructor and the

Harrington Bush Nursing Centre, to finalise a time that would suit community members. This

took several weeks of communication to determine the day and times that the program would

run. Additionally, the establishment of a cost for the program required effective

communication between the two organisations. The cost of each session needed to cover the

instructor's wage and the hire of the facility for the program. The Centre assisted in

establishing a subsidised cost for the program that would be affordable for community

members. Participation payments are processed through the Harrington Bush Nursing Centre

directly instead of through the instructor. Furthermore, participation numbers were a

significant challenge faced by the program.

Harrington is a small rural town in Victoria that is geographically isolated from major cities.

The low population of the town makes it difficult to encourage community members to

participate in new physical activity programs. Advertising by the Harrington Bush Nursing

Centre assisted in promoting the program and increased the community awareness and

involvement in the Pilates Plus sessions. Lowe suggested that the challenges faced by the

program were overcome efficiently (Lowe, 2017). The use of effective communication,

planning and advertising assisted the success of the program. In future, Lowe recommends

that when establishing a physical activity program in a rural location, it may be useful to

communicate with the community to determine their availabilities and interests before

implementing the program (Lowe, 2017).

Successes

Pilates Plus has encouraged the Harrington community to engage in physical activity. The

program has successfully overcome various developmental and organisational difficulties.

This success was achieved by the effective communication and organisation of the Pilates

Plus instructor, Lisa Lowe and partner organisation, Harrington Bush Nursing Centre. The

program has provided community members with alternative low impact physical activity and

has improved the health and well-being of rural women. Participation in the program has

grown over the past 12 months which has led to an increased number of people visiting the

Harrington Bush Nursing Centre (Lowe, 2017). Participant surveys, feedback and instructor

assessment suggests that the program has resulted in various health benefits. According to the

Participant surveys conducted by S. Mutch (Participant Survey, 20th September 2017)

improved fitness, flexibility, coordination and core strength are just some of the physical

benefits of the Pilates sessions. Additionally, participants indicated that the exercise made

them ‘feel good’ and provided an opportunity to make new friends, which reinforces that the

program has the potential to provide mental health benefits. Deslandes et al. supports this

concept of physical activity improving mental health (Deslandes et al., 2009). Furthermore, it

was suggested that the program includes education about the body and the importance of

exercise.

Participation feedback indicated that Pilates Plus is an affordable and effective physical

activity program that caters for all individual needs and abilities. The instructor’s positive

attitude and effective communication creates an inclusive environment that all community

members are welcome to join. Although the program has only had female clients aged 30-60

years, the class is accessible for all wider community members.

Conclusion

In conclusion, the Pilates Plus program has assisted the Harrington community in improving

individual’s health, well-being and awareness. The program targets rural health and aims to

improve participant’s flexibility, core strength and fitness. The instructor has assisted clients

in developing their knowledge of the body and understanding of the importance of health.

Rural women have been provided with challenging low impact Pilates exercises that improve

participant’s mindfulness, mobility, longevity and can potentially reduce the risk of

cardiovascular disease. The Pilates Plus program has been effectively implemented by Lowe

and the Harrington Bush Nursing Centre through their use of effective communication.

Moving forward, Pilates Plus aims to continue to run in 2018 and encourage greater

participation from a wider variety of community members and may potentially expand by

being accessible on another day.

References:

American College of Obstetricians and Gynecologists, 2014, Health disparities in rural

women, Obstetrics and Gynecology, 123(2 Pt 1), pp.384-8.

Better Health Channel, 2017, Pilates and Yoga: Health Benefits, viewed 20 September 2017,

< https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pilates-and-yoga-

health-benefits>

Deslandes, A., Moraes, H., Ferreira, C., Veiga, H., Silveira, H., Mouta, R., Pompeu, F.A.,

Coutinho, E.S.F. and Laks, J., 2009, Exercise and mental health: many reasons to

move. Neuropsychobiology, 59(4), pp.191-198.

Germov, J., 2014, ‘Rural Health’, in Second Opinion: An introduction to Health Sociology,

5th edn, Oxford University Press, South Melbourne Australia, pp.184-197

Google Maps, 2017, Map of directions from Adelaide, South Australia to Harrington,

Victoria [online], Google, viewed 19 September, <

https://www.google.com.au/maps/dir/Adelaide+SA/Harrow+VIC+3317/@-

36.0384496,138.9896025,8z/data=!3m1!4b1!4m13!4m12!1m5!1m1!

1s0x6ab0ced7a303a4e7:0xb38d70584e1c3e53!2m2!1d138.6007456!2d-34.9284989!

1m5!1m1!1s0x6acc1403f60f1f6d:0x40579a430a0ae10!2m2!1d141.6208782!2d-

37.1634902>

Harrington Bush Nursing Centre, 2017a, Bay Riders Community Centre: Harrington

Neighbourhood House Newsletter [Internet], viewed 1 October 2017, <

http://www.hbnc.org.au/reports-publications/documents-notices/>

Harrington Bush Nursing Centre, 2017b, Harrington Bush Nursing Centre [Facebook],

viewed 28 September, < https://www.facebook.com/HarringtonBushNurse>

Harrington Bush Nursing Centre. 2017c. Harrington Bush Nursing Centre. [ONLINE]

Available at http://www.hbnc.org.au/. [Accessed 2 October 2017].

Lowe, L., Pilates Plus Instructor (Personal communication, 20th September 2017)

National Rural Health Alliance Inc, 2011, Physical Activity in Rural Australia, viewed 28

September, < http://ruralhealth.org.au/sites/default/files/fact-sheets/Fact-Sheet-26-

physical%20activity%20in%20rural%20australia_0.pdf>

National Rural Health Alliance Inc., 2012, Women’s health in rural Australian, viewed 8

September 2017, <http://ruralhealth.org.au/sites/default/files/publications/fact-sheet-31-

womens-health-rural-australia.pdf>

Nazaruk, D., Tedders, S.H., Alfonso, M.L. and Vogel, R.L., 2017, The determinants of

physical activity in rural women, aged 20 to 44 years, in Georgia. Family & community

health, 40(1), pp.11-17.

Victoria Places, 2015, Harrow, viewed 1 October 2017,

<http://www.victorianplaces.com.au/harrow>