Steps Toward Wellness

Communities & Facilities Take Action to Improve Health

By Dawn Klingensmith

All but the smallest communities are home to various organizations whose goal is to promote wellness. The local hospital may offer free blood pressure readings and nutrition classes. Area employers host health fairs for workers. Parks and recreation departments offer fitness classes and afterschool programs centered on nutrition.

That was the scenario in Fulton County, N.Y., before Mayor Timothy Hughes of Gloversville asked a local physical therapy center to spearhead a communitywide fitness initiative. "The challenge is to round up and bring together" the various program providers and work collaboratively to reach more people, said Matthew Goodemote, owner of Community Physical Therapy & Wellness. On board so far for the Get Fit Fulton County initiative are the local YMCA, a fitness center, a hospital, grocers and restaurants.

The county's budget constraints are such that the parks and recreation department can't even come close to offering comprehensive wellness programs on its own. "Basically, all the department can afford to do right now is keep the grass mowed," Goodemote said.

But there's a silver lining. Not just in Fulton County but all across the United States, recessionary budget cuts coupled with rising concerns about obesity rates and chronic health problems such as diabetes and heart disease are ushering in a spirit of cooperation among community organizations whose shared mission is health promotion. Public health issues are being jointly addressed by parks and recreation departments and organizations in the public and private sectors. Such partnerships enable each entity to broaden its reach while leveraging shared resources, including funding, personnel, equipment, facilities and publicity.

And tough economic circumstances have given rise to creative solutions, as organizations set out to tackle growing public health problems on shoestring budgets, resulting in programs that are effective yet inexpensive. A handful of these exemplary programs are featured in this article.

But first, let's make a case for a cooperative model of wellness promotion.

Strength in Numbers

The Columbus (Ind.) Parks and Recreation Department has a longstanding partnership with Columbus Regional Hospital to provide personal training and a host of fitness classes, including aerobics, yoga, Pilates, strength training, fall prevention for seniors and aqua fitness. "The partnership began after we realized we were offering some of the same services," so logistics were put in place to offer them synergistically instead of redundantly, said Katia Hatter, marketing and public relations coordinator, Columbus Parks and Rec.

The hospital provides certified fitness instructors, while the recreation department provides facilities and administrative support. Other costs are shared.

Building on the success of that partnership, the department is always looking to form new synergistic alliances.

"We've been proactive in looking at our programs and asking, 'Are there other agencies doing this and doing it well?' Rather than reinventing the wheel, we try to work with them and bring them under our umbrella," in part by listing complementary programs in the department's brochure, Hatter said.

"In some communities, you may have parks and rec doing exercise programs and the hospital doing exercise programs, and they're competing with each other," Hatter continued. "There's no point in competing, especially if one entity does something better."

Ask the Experts

Besides eliminating redundancies and defraying program costs by pooling resources and sharing expenses, partnerships with hospitals, health-related nonprofits and other organizations ensure program instruction and information is safe, accurate and effective.

When the Westerville (Ohio) Parks and Recreation Department deemed it critical to address the childhood obesity epidemic, it partnered with Columbus, Ohio-based Nationwide Children's Hospital to develop a fun but effective program without breaking the bank. With regard to weight management and nutrition, "We don't always have answers for everything, so it behooves us to find experts on these subjects and develop partnerships," said Mike Herron, the recreation department's fitness manager.

Westerville's FitQuest Kids' Club aims to educate children and their parents about the importance of healthy eating habits and daily physical activity. More specifically, the program encourages kids to increase their fruit, veggie and water intake while decreasing the amount of time spent in front of TV, computer and videogame screens.

The hospital's Center for Healthy Weight and Nutrition provided nutrition guidance for a refrigerator chart that children can use to help them make healthy eating and leisure decisions. For each fruit, vegetable and water serving consumed, kids get to color in pictures of representative icons, such as an apple, a carrot or a drinking glass. For every 15 minutes of physical activity, they get to color in an athletic shoe, and then redeem their filled-out charts for sports equipment provided by sponsors.

Nationwide Children's Hospital made for an ideal and easily forged partnership because "hospitals have an interest in nutrition from the preventive side," Herron said.

Goodemote agrees that for any wellness program, it's a "huge advantage" to get hospitals involved. They bring resources and expertise to the table; add instant credibility and increased visibility; and have access to, and influence over, community members who are most in need of wellness interventions.

Public agencies, health departments, school districts, sports organizations, police and fire departments, and affiliates of national organizations such as the American Heart Association are all prospective partners for parks and rec initiatives aimed at promoting wellness.

As for attracting private-sector sponsors, "Businesses offering goods, services and facility space basically get free publicity," which is a compelling reason to participate in communitywide health initiatives, said Goodemote, who is putting together a 90-day wellness program for Fulton County that will receive newspaper and radio coverage free of charge.

Taking the long view, helping to develop preventive health programs can lead to a workforce that's less stressed out and prone to illness, and ultimately more productive, which translates to increased revenues for local businesses.

Anticipate–and Eliminate–Excuses

"People look for all sorts of excuses not to exercise," Goodemote asserted. (He seeks to eliminate them all: As a side project, he started a nonprofit organization that fixes cracked sidewalks, which discourage walkers and joggers.) Therefore, community wellness programs need to be inclusive and accessible, and yet target certain subgroups' specific issues at the same time. They should also be affordable or—ideally—free.

Get Fit Fulton County is a 90-day program with beginning, intermediate and advanced tracks, as well as a track designed specifically for seniors. In addition, participants may choose from among several supplemental, or "a la carte," classes and events. One option is a field trip to the grocery store, where a nutritionist-cum-tour guide helps people identify healthier foods, evaluate health claims and compare nutrition labels. All program offerings are free "so that cost does not become an obstacle or excuse," Goodemote said.

Measurable results are another hallmark of a good wellness program. Get Fit Fulton County will gauge the success of the program with before-and-after screenings of participants, which will include body fat analysis, blood pressure readings, range-of-motion evaluations and the like.

Patti Harper, co-chair of Weatherford, Oklahoma's low-budget, volunteer-driven Walking for Wellness program, shares Goodemote's mindset about perceived barriers: There's no charge to participate "because we did not want anyone to have an excuse not to walk," she said. She also applies the KISS principle—Keep It Simple, Sweetie—to recruit the greatest number of participants. "Walking is the easiest form of exercise," she said. Plus, the way the program is set up, residents can participate as much or as little as possible, subscribing to the theory that some degree of physical activity is better than none. However, the program is also set up to spark a desire to be a team player and help the community as a whole rack up as many miles as possible. "We wanted to show as a community how much we could walk together," Harper said.

Material incentives and spirited competition also factor into the program's success. All participants receive free pedometers to monitor their mileage, which Walking for Wellness procures through grant support.

One Foot in Front of the Other

Participants track their mileage and submit monthly tallies at drop-off sites or online. Participants are eligible for random monthly drawings for gift cards and other incentives donated by local businesses.

Competition comes into play with the annual Mayor's Challenge, which in 2007 entailed walking 100 miles within a certain time frame to celebrate Oklahoma's centennial. More recently, the Mayor's Challenge has involved friendly rivalries with neighboring towns to see which municipality can log the most miles.

But, foremost, the Walking for Wellness program is designed to be flexible and fun. Participants can walk on their own or in groups, and once a month there's a group "fun walk" highlighting different places in Weatherford. The rotation includes the outdoor track at the local university, the YMCA's indoor track, woodsy walking trails and scenic neighborhood sidewalk treks.

"We try to do different things," Harper said, "to show that you don't just have to walk on a treadmill. There are so many ways to change up a walking routine."

Past events include walking along the golf cart tracks at the local golf course, a harvest-time corn maze challenge, strolling a museum campus and, afterward, being rewarded with free admission, water walking in the municipal pool, and bundling up for a foot tour of residential holiday lights displays.

Each of the monthly fun walks includes an educational program. For example, prior to circling the high school track, participants meet in the cafeteria to discuss running basics, such as how to select appropriate shoes.

Walking for Wellness is administered through Weatherford's parks and recreation department, but volunteers actually conceived and developed the program, and a volunteer committee essentially runs it. T-shirt sales help defray costs; however, a local Walmart, hospital, university, YMCA and bank keep the program afloat through grant support, donations and incentives, publicity, a Web-based platform through which participants track miles and facility space.

Launched in September 2007, Walking for Wellness in its first year drew 327 adult participants and 1,090 public school students, collectively logging a total of 61,631 miles.

For Health's Sake

Tangible incentives are fun and effective, but the true, lasting benefits of exercise are improved physical and mental health. Aside from building endurance and strengthening the heart and muscles, exercise can:

  • Lower the risk of stroke (aerobic exercise)
  • Lower the risk of heart disease (aerobic)
  • Maintain or improve bone health by increasing density and preventing fractures (weight-bearing aerobic and strength training)
  • Lower the risk of diabetes (moderately active vs. sedentary)
  • Alleviate symptoms of depression
  • Lower blood pressure (aerobic)
  • Reduce pain caused by arthritis (low-impact aerobic and strength training)
  • Improve balance and lower the risk of falls for seniors
  • Lower the risk of cancer (moderately active vs. sedentary)

Offer Incentives

Simplicity and incentives were also core components of two programs launched in the Western region. In Boulder, Colo., the Freiker Program—short for frequent biker—began at an elementary school after founder Rob Nagler could not persuade his kids to ride their bikes to school, less than 1 mile from home. However, when offered small prizes, the kids started pedaling to school and gradually found cycling to be rewarding in its own right. Initially, bike trips were tracked using a punch card system, and then a barcode system. Now, as students pedal up to the bike rack, a solar-powered "Freikometer" (a radio frequency ID tag reader) reads tags placed on their safety helmets. Each bike trip earns points toward a prize. During the 2007-08 academic year, kids at five Boulder schools logged 54,000 rides. In 2008-09, the program rolled out nationally.

In Utah, a nonprofit system of health services providers called Intermountain Healthcare last year partnered with the mayor's office and local businesses to launch the Park Farther program in the Salt Lake City area. The objective is to motivate people to increase their activity level by parking farther away from their destinations. Participating businesses and organizations agree to allow a professional crew paid by Intermountain Healthcare to paint a couple of remote stalls in their parking lots. The painted stalls have the program logo and the message, "Park here to walk farther and be healthier." Aside from improved health, participants could receive rewards from a prize patrol that randomly visits Park Farther locations to hand out iPods, gift cards and other donated items.

Tap Existing Resources

Although a tailored, targeted approach to health promotion is critical among certain demographics, when it comes to wellness programming, there are strong national kids' programs that can be implemented at the local level. Likewise, programs that are already being administered by various organizations in a community can be brought together to build robust adult and senior wellness programs.

One such national model is Sajai Foundation's Wise Kids program, which encourages kids to make healthy food choices and stay active. A sister program, Wise Kids Outdoors, shares those objectives and also fosters an appreciation for nature. Wise Kids kits are available to parks and recreation departments and other organizations, and are intended to enhance existing summer camp and after-school programs. The kits include everything needed to successfully implement the program: student workbooks, games, pedometers and learning aids, plus a training DVD and manual for leaders.

The program teaches children nutritional basics such as the food pyramid, reading food labels and portion control. It also teaches how exercise benefits the body. The physical activities tend to reinforce the lessons. For example, if students are learning about the heart, the physical activity might be an obstacle course modeled on the circulatory system. Children moving balls through the course gain an understanding of how the heart pumps blood and nutrients throughout the body. "We make the activities fun and noncompetitive so all kids can play, not just the athletic ones," said Melissa Hanson, president and CEO.

Wise Kids Outdoors adds an environmental component. For example, kids might get exercise by creating and caring for vegetable gardens or collecting litter along a nature trail and then sorting the trash from the recyclables. Learning aids provided in the kit include backpacks for collecting treasures like leaves and pinecones, a magnifying glass, and seed packets.

Grants from the National Recreation and Park Association (NRPA) enabled 49 community organizations (YMCAs, parks and recreation departments, school systems) to implement the program in 2009, bringing the total number of participating communities to 80 across 32 states. (The Sajai Foundation's Web site lists the top 10 grant providers by state for this type of programming.)

Realizing that Sacramento, Calif., had a range of wellness programs for seniors, but that they were scattered, the city's parks and recreation department helped knit them together as part of its 50+ Wellness program. Biannually, the department sends out a 16-page newsletter that lists not only its own programming but also resources and events available to seniors through various other organizations—anything from lectures to salsa lessons. The newsletter also includes articles about health and is mailed to 6,000 individuals as well as area agencies serving the senior population, for a total press run of 10,000.

Parks and recreation departments exist in just about every municipality in the United States, and they can provide wellness programs for people from all walks of life—that is, if they foster relationships with hospitals, nonprofits and other organizations to expand their resources and broaden their reach.

What Spurs People to Action?

Incentives. Offering small rewards when people reach certain milestones keeps them on track through positive reinforcement. Incentives are effective for adults and children alike.

Competition. "Biggest Loser" type of weight-loss and wellness programs have proved to enhance motivation and foster social support, resulting in lower attrition rates and significantly more pounds shed, especially when participants compete as teams instead of individuals, according to a study conducted by the University of Delaware's psychology department, the University of Pennsylvania School of Medicine and the County Health Improvement Program in Williamsport, Pa.

Social networking. Social media can be utilized as part of a wellness program to drive behavior change. Shape Up The Nation is an online exercise and weight loss program with tools allowing users to share their goals and successes and spur one another on. For example, participants can give each other virtual high fives.

Feedback. "People are motivated by immediate, objective feedback," which is why pedometers are so effective, said Fitness by Phone coach Tiffany Crate, TLC Fitness, Chicago. For a fee, the Belton (Mo.) Parks and Recreation Department provides "Smartkeys" for fitness center users. The device is a key-shaped microchip that inserts into consoles attached to exercise equipment and collects workout data, so users receive immediate feedback and can also track their progress over time.

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