Healthy People 2020's Physical Activity Objectives completes a trifecta of physical activity publications for physical activity professionals, advocates and enthusiasts. The first ever publication of a set of science based, government issued Physical Activity Guidelines were released in October of 2008 and May 2010 brought the launch of the nation's first health plan for physical activity, the National Physical Activity Plan.

The National Coalition for Promoting Physical Activity is providing the leadership for implementation of the Physical Activity Plan. NCPPA recognized the importance of working to insure that the objectives listed in HP2020 be complementary to those included in the NPAP. Many NCPPA member organizations offered comments on the proposed HP2020 physical activity objectives as did the Coalition itself.

NCPPA recently published our first implementation report; Make The Move, 2010-2011 Implementation of the National Physical Activity Plan. Make the Move details the priorities identified in each of the sectors, states their goals and objectives and how they plan to achieve them and lists a variety of success stores as well.

Many of the physical activity objectives included in HP2020 physical parallel those identified as priorities by the NPAP sector implementation teams. A few examples are included below:

NPAP: Ensure that early childhood education settings for children ages 0 to 5 years promote and facilitate physical activity.

HP2020: Increase the number of States with licensing regulations for physical activity provided in child care.

NPAP: Encourage business and industry to interact with all other sectors to identify opportunities to promote physical activity within the workplace and throughout society

HP2020: Increase the proportion of employed adults who have access to and participate in employer-based exercise facilities and exercise programs.

NPAP: Prioritize resources and provide incentives to increase active transportation and other physical activity through community design, infrastructure projects, systems, policies, and initiatives.

HP2020: Increase legislative policies for the built environment that enhance access to and availability of physical activity opportunities.

The examples listed above are great ideas…but now the time has come to walk the walk rather than simply talk the talk…in other words, work together to make these things happen! Please visit the NCPPA website to sign your organization up to get involved with the implementation of the Nation's first Physical Activity Plan.

What is your organization doing in the areas listed above to increase the number of Americans achieving the PAG?

This week’s spotlight shines on the Kids Take Heart program offered by The Hope Heart Institute, an organization in Bellevue, Washington that focuses on cardiovascular disease prevention.

Program Basics
Kids Take Heart (KTH) is a health and fitness curriculum that includes anatomy, fitness, nutrition, stress and goal-setting.  It was developed and piloted by certified teachers in nearly 20 districts and over 60 schools and 650 classrooms.  KTH was designed as a tool to equip children in third, fourth and fifth grades to make lifestyle choices that promote fitness, health and wellness and lessen the likelihood of cardiovascular disease. 

An online training component provides graduate continuing education credits or clock hours for teachers, and allows teachers to schedule a curriculum kit (including all lesson materials) for two months.  After the program is completed, students will be able to:
     • Identify components, functions, and diseases of the cardiovascular system.
     • Recognize and evaluate risk factors, warning signs, and prevention strategies (i.e. healthy eating and active living) for cardiovascular disease.
     • Create and implement a personal wellness plan targeting nutrition and physical activity.
Kids Take Heart also involves student health ambassadors promoting heart health information among families and the greater community. 

In addition to emphasizing 60 minutes or more of physical activity daily, the KTH fitness unit helps students integrate active lifestyles, the FITT (frequency, intensity, time and type) principle and components of health-related fitness (i.e. flexibility, muscular strength, muscular endurance and cardiorespiratory endurance).  Throughout the unit, students participate in a series of physical activities and calculate their median pulse.  This helps them determine which physical activity level they fall within most days of the week so they can determine individual daily amounts.   In the end, students communicate the concept of energy balance – the intake of quality foods in the right quantity expended by physical activity.

Teachers can implement the program during PE classes, in various grade level classrooms, or some combination of the two.  KTH could also be used in an after-school program, through the local Parks & Recreation Department or Boys & Girls Clubs.  The program incurs little to no cost for school districts (or other venues).

Measuring Success
Teacher evaluations and student health logs determine the impact of the program.  The evaluations provide information on the structure and content of training, appropriateness of curriculum, ease of use with kit materials as well as the total number of students reached.  Student health logs show nutrition and physical activity goals that students set, as well as their progress in reaching their goals over a two week period.

Challenges
Carly Meiser, CHES, serves as the Education and Community Outreach Assistant for The Hope Heart Project.  When asked about program challenges, she said, “With school budget cuts, the pressure of standardized tests, and so many programs competing for time within the school day, health and physical education programs are either being pushed to the back burner or off the burner entirely even as the number of children who are overweight or obese rises.”  This is likely a challenge that is echoed among school-based programs nationwide.

Lessons Learned
Ms. Meiser shared that flexibility has been the program’s key to success, “We piloted the original program several years ago, and continue to modify it for improvement based on feedback and changing needs of diverse populations.  One tip would be to create a program that can be altered to meet different needs.  Having a “menu” of items for folks to select from helps us piece together what a group needs most.”

What are some other creative ways that student ambassadors could be used to affect change in their communities?  Share your thoughts & experiences by submitting a comment, below.

Dec. 21 marked the winter solstice (Northern Hemisphere), signaling the long-awaited return of longer days and the warmth of spring. The solstice, coinciding with traditional holiday celebrations, has always given hope to people struggling with the challenges of cold weather and long, dark nights.

The month of January offers more reason for hope in the form of Healthy People 2020, a collaborative process by which the CDC provides science-based, 10-year national objectives for improving the health of all Americans. The proposed objectives for physical activity and fitness show the influence of ACSM and its members, including in-person testimony by Past President Angela Smith, M.D., FACSM and online comments by numerous members/experts.

ACSM was not a lone voice crying in the wilderness, however. Many experts, speaking alone or on behalf of professional societies and other organizations, cited the demonstrated importance of physical activity for health. Their consensus informs the plan, which includes baseline measures, 10-year targets and data sources.

A few observations:

• Healthy People 2020 will serve as a companion to the National Physical Activity Plan (a frequent topic on this blog). The Plan provides a roadmap for achieving the changes needed to reach the targets spelled out in HP2020. Taken together—and taken seriously—the two can be transformative.
• The baseline measures document the need. For example, 36.2 percent of adults engaged in no leisure-time physical activity in 2008, according to the CDC’s National Health Interview Survey.
• The targets are modest, calling for a 10-percent improvement across the board. Surely, our nation can move the needle in 10 years so that, for instance, 8.7 percent of physician office visits include counseling about exercise.

The latter (part of Objective 11) was proposed by ACSM, expanding the original objective which called for counseling about exercise for patients with chronic diseases. Both embody the essence of Exercise is Medicine®. Acting on them would profoundly affect the well-being of millions of people and vastly reduce health care costs.

As we prepare for the chills of January, physical activity advocates will be warmed by the prospect of other objectives we have long supported. HP2020 also calls for the following, to choose a few:

• Increasing the proportion of adults and adolescents who meet physical activity guidelines (Objectives 2 and 3, respectively).
• More trips by walking (13) and bicycling (14).
• Changes to the built environment to expand opportunities for physical activity (15). Sound familiar? This is a bedrock principle of the National Physical Activity Plan.
• More physical education (4, 5) and recess (6, 7) in schools; less screen time for kids (8).
• Opening public and private school facilities outside of school hours to provide opportunities for physical activity for the community (10).

Healthy People 2020 is comprehensive, measurable and laden with the potential for positive change—the fruit of a well-managed public/private collaboration. Implementing it falls to all of us: states, cities, communities, organizations of all types, and individuals. I propose we each seek our role, using the MAP-IT framework familiar to those involved with implementing public health interventions. Let’s insist on success and get to work on a decade of change.

Which objectives of Healthy People 2020 relate most directly to your work?
Which could have the greatest impact on your community?