Evidence-Based Preventin Strategies: Increasing Physical Activity thrugh Scial Supprt in African-Americans within Ck Cunty Kim Kwasny, Jacqueline Lagman, Airin Lam, Amanda LaMnica-Weier, Alyssa Lapin
Ppulatin: Residents f Ck Cunty, IL Ppulatin size: 5,240,700 Age Under 18 years : 24.4% 1,272,007 18 t 65: 63.7% 3,342,931 Male 47.7% Female 52.3% 65 & lder: 11.9% 625,762 Male 40.8% Female 58.2% Gender Females: 51.5% Males: 48.5% Race/Ethnicity White: 56.5% African American: 24.7% American Indian: 0.2% Asian: 6.3% Other: 10.4% Tw r mre: 1.9% Hispanic r Latin 24% Nt Hispanic r Latin 76% ("Ck Cunty QuickFacts frm the US Census Bureau," 2014) ("American FactFinder - Results," 2012)
Ppulatin cnt d Sciecnmic Status: 50% f pverty level 6.7 % 125% f pverty level 20.1% 150% f pverty level 25.5% 200% f pverty level 34.4% Persns belw pverty level: 16.4% White 10.6% African American 28.5% American Indian 20.5% Asian 12.8% Native Hawaiian r Pacific Islander 7.2% Other 21.4% Educatinal Achievement: high schl graduate: 24.2% bachelr degree: 20.7% graduate r prfessinal degree: 13.6% Other statistics: unemplyment: 7.7% with health insurance: 83.4% withut health insurance: 16.6% ("American FactFinder - Results," 2012)
Health Assessment: Mrbidity Diabetes 9.2% Hypertensin 28.4% Smke 21.6% Asthma 7.5% Overweight 37.1% Obese 27.7% High Chlesterl 37.3% Cmmunicable Diseases: (2006-08 Incidence) Gnrrhea: ttal 7,872 Primary and Secndary Syphilis: ttal 153 Chlamydia: ttal 23,903 Tuberculsis: ttal 356 HIV: ttal 866 Health Statistics: Binge drink 20.4% Eat few fruits & vegetables 76.8% N leisure physical activity 28.8% Limited activities because f physical, mental, r emtinal prblems 16.4% ("Mrbidity and Mrtality Weekly Reprt," 2010) ("Cmmunicable Diseases," 2010)
Health Assessment: Mrtality Leading Causes f Death 2005-2007 Number f Deaths (ttal=62,521) Heart Disease 27.3% (17,053) Cancer 24.3% Strke 5.8% Chrnic Lwer Resp Dis 4.1% Pneumnia/Flu 2.7% Diabetes 2.7% Alzheimers Disease 2.7% Kidney Disease 2.6% Unintentinal Injury (nn-mva) 2.2% Septicemia 2.1% Mrtality by Age 1-14: Unintentinal injury (nn-mva) 15.3% (222) 15-24: Hmicide 25% (691) 25-44: Heart disease 16.1% (2492) 45-64 Cancer 35.7% (10,260) 65& lder: Heart disease 29.2% (48,157) By Sex Males Number f Deaths (ttal=29,219) Heart Disease 28% (8,176) Females Number f Deaths (ttal=33,297) Heart Disease 26.7% (8,876) By Race African American (ttal 7,955) Heart Disease 25.6% (2,033) Asian (ttal 1,149) Cancer 27.6% (317) Hispanics (ttal 2182) Cancer 22.3% (487) White (ttal 50,804) Heart Disease 28% (14,245) Assessment," 2010) ("Cmmunity Health Status
Health Assessment African Americans in Ck Cunty, IL Number f Deaths (ttal=7,955) Heart Disease 25.6% (2033) Cancer 23.9% Strke 5.5% Kidney Disease 3.9% Diabetes 3.6% In the U.S African American Males Hypertensin 26.5% Overweight r bese 63% Diabetes 9.9% High Chlesterl 25.4% African American Females Hypertensin 23.9% Overweight r bese 77% Diabetes 9.0% High Chlesterl 25.6% ("Cmmunity Health Status Assessment," 2010) ("A Clser Lk at African American Men and High Bld Pressure Cntrl," 2010) ("Diabetes and African Americans - The Office f Minrity Health - OMH," 2014) ("African-Americans and Heart Disease, Strke," 2014)
Risk Factrs f Cardivascular Disease High bld chlesterl and triglyceride levels High bld pressure Risk Factrs Diabetes and prediabetes Overweight and besity Smking Lack f physical activity Unhealthy diet Stress (Natinal Institutes f Health, 2011)
Selected Risk Factr Lack f Physical Activity The American Heart Assciatin recmmends that individuals get at least: 30 minutes f mderate activity 5 days a week (150 minutes) OR 25 minutes f vigrus activity 3 days a week (75 minutes) AND Muscle strengthening activity at least 2 days per week. (American Heart Assciatin, 2013)
Ppulatin Characteristics Strengths: Envirnment Densely ppulated area Numerus park districts Cmmunity Strng family ties Racial and cultural pride Strng sense f cmmunity Challenges: Envirnment Weather cnstraints Vilence in the neighbrhd Distance frm wrk, schl, r shpping Cmmunity Pverty level Educatinal level Cultural cnsideratins ("Ck Cunty QuickFacts frm the US Census Bureau," 2014) (Ck Cunty Clerk, n.d.) (Management Sciences fr Health, 2014) (United States Census Bureau, 2012) ("American FactFinder - Results," 2012) (Flwers, 2004) (Natinal Institute fr Health Statistics, 2008)
Ppulatin Characteristics: The Eclgical Mdel Intrapersnal: i. Insufficient knwledge abut health risks assciated with lack f physical activity ii. Self efficacy iii. Mental Health Hme and Family Envirnment: i. Weather cnstraints ii. Cultural nrms: family and friends wh aren t physically active, persnal aesthetics Lcal Cmmunity Factrs: i. Lack f access/prximity t safe utdr facilities (playgrunds/fields/curts) ii. Lack f finances (pverty) Larger Scietal Factrs: i. Feelings f inequality within ne s scial envirnment ii. Lack f insurance cverage iii. Advance in use f technlgy can encurage a mre sedentary lifestyle. (America's Health Literacy: Why We Need Accessible Health Infrmatin, 2008) (Flwers, 2004) (United States Census Bureau, 2012) ( American Fact Finder - Results, 2012)
Interventin Physical activity thrugh scial supprt: The Cmmunity Preventive Services Task Frce recmmends implementing effrts made in cmmunity settings t prvide scial supprt fr increasing physical activity. (Cmmunity Preventive Services Task Frce, 2014).
Purpse f the Interventin Prvide supprtive relatinships fr changing physical activity behavir thrugh building, strengthening, and maintaining scial netwrks (Cmmunity Preventive Services Task Frce, 2014). Emtinal supprt such as encuragement and acceptance Instrumental supprt such as getting a ride t aerbic/fitness class tgether Infrmatin supprt such as learn mre abut hw t ptimize yur physical activity by getting suggestin r infrmal advice Prvide a rle-mdel in psitively changing the physical activity behavir Create a new scial netwrk r increase participants existing netwrks
Details f the Interventin Fcus African Americans living in Ck Cunty. Lcatin One high schl f each f the High Schl Districts f Ck Cunty Jacksn Park and Garfield Park Time Perid Begins January 2015 Cntinues fr ne year If successful, will cntinue and expand. Resurces: Funding (prvided by the state) Safe space: Partnership with high schls Transprtatin: Partnership with the public schl bus system Exercise instructrs Exercise equipment Administrative cmmittee: Recruitment: Survey cmmunity needs/ preferences Scheduling and advertising Paper and printing surces fr fliers Newspaper advertisements Radi annuncements
Ratinale The leading cause f death fr African Americans in Ck Cunty is heart disease ("Cmmunity Health Status Assessment," 2010) Lack f physical activity is a mdifiable risk factr fr heart disease (Natinal Institutes f Health, 2011) The Cmmunity Preventive Services Task Frce fund that time and frequency f physical activity increased by 44% and 19%, respectively, when utilizing scial netwrks in the cmmunity (Cmmunity Preventive Services Task Frce, 2014)
Methds f Delivery Our first interventin is ne we plan t implement within the chsen ppulatin: 1. Fitness activities ffered thrugh lcal schl gymnasiums (Eng, 2010) Offered primarily n weekday evenings, which accmmdates 8 a.m. -5 p.m. wrk schedules Prvides a safe, indr space Classes and fitness activities will be available fr children and adults Offered within each high schl district in Ck Cunty fr ease f access Fr all three methds f delivery, flyers including dates/times will be psted in schl hallways, sent hme t parents, psted in lcal grcery stres, and nline t prvide easy access fr all. Flyers will include infrmatin n lcatin and time f the classes and events, as well as a brief explanatin f the imprtance f physical activity and the benefits f exercise.
Methds f Delivery cnt d The fllwing are established interventins where we plan t increase participatin: 2. Fitness classes ffered thrugh the Chicag Park District There are 102 Park Districts within Ck Cunty, making this apprach accessible fr everyne. Prvides a safe, indr space Offers a variety f daytime and weekend classes fr children and adults Classes include: a variety f sprts, zumba, yga, and dance. Opprtunities t get active and invlved with the cmmunity with mre than 330 Family Fun Events Family Fun Events ffer yga, dancing, and activities fr tddlers. The events als prvide pprtunities t watch Midnight Circus in the Parks with an ensemble f acrbats, aerialists, dancers, cntrtinists and pets. Fllwing the perfrmance, the crwd can get invlved! (Chicag Park District, 2014) (Ck Cunty Clerk, n.d.)
Methds f Delivery cnt d 3. PlayStreets Day (Adams, 2014) What is it?? Designed by the Chicag Department f Public Health, this event is used t increase access fr children t have safe places t play while prmting healthy activities with the aim f reducing childhd besity. At a PlayStreets event, streets are clsed ff t traffic fr three r mre hurs and transfrmed int an urban asis. Runs June thrugh Octber (ver 100 classes ffered, multiple times a week at varying times f day) Offered in bth the Nrth and Suth side f Chicag, in a variety f different neighbrhds Prvides a safe, utdr space fr children and families t be active Offers sprts, games, bunce huses, dancing, fitness classes, and mre. Aids in maintaining scial netwrks during the summer mnths when schl isn t in sessin Can advertise high schl gymnasium and park district exercise classes
Adaptatins Health Literacy Adaptatins Use health literacy strategies t effectively advertise classes The mst imprtant infrmatin will be first. Fr example, where the classes are being held, what time, fr whm, and why Each f the sectins will have a clearly labeled subheading and infrmatin belw will be bulleted Questins like D yu want t get healthy while having fun with friends? will be used t engage the audience The majrity f the wrds used will be ne r tw syllables Readability will be tested t ensure the flyer is at a 5th grade reading level The fnt will be black and the backgrund will be white (Centers fr Disease Cntrl and Preventin, 2009)
Adaptatins Cultural Cmpetency Adaptatins Cnduct surveys f different neighbrhds determining prefered times, dates, lcatins and type f classes (Anthny et al., 2009) Offer classes in different languages (Centers fr Disease Cntrl and Preventin, 2009) Establish strng relatinships with cmmunity partners such as park district emplyees, principals, plice, and public schl bus system (Anthny et al., 2009)
Objectives Prcess Objectives (PO) 1. One fitness class per week will be held in high schl gymnasiums f each High Schl District f Ck Cunty during 2015. 2. There will be a 15% increase in African American attendance rates at the Chicag Park District grup exercise classes by the end f 2015. 3. There will be a 30% increase in African American attendance rates at the PlayStreets Day events frm June-Octber f 2015. Outcme Objectives (OO) 1. There will be a 10% increase in the number f African Americans engaging in physical activity in Ck Cunty by the end f 2015. 2. By the end f 2016, African Americans in Ck Cunty will shw a 1% decrease in rates f besity, a significant risk factr f heart disease.
Prcess and Outcme Evaluatin Fitness class Pre/Pst Survey: Demgraphics Physical exercise frequency Level f exercise cnfidence Self-rated health level Level f interest in exercise Level f satisfactin in exercise Hw participants heard abut the prgram Prgram likes/dislikes Administratin cmmittee will mnitr: Number f participants signing up and cmpleting the prgram Percentage f sessins attended Attendance at each sessin Number f weekly classes held Survey participants at PlayStreets Day events while signing up fr raffle Frequency Survey cnducted at: First visit Quarterly End f the prgram
Prcess and Outcme Evaluatin Cmpare the 2015 and 2016 U.S. Census data fr African Americans in Ck Cunty, IL, fcusing n results fr Prevalence f cardivascular disease Mrtality rates f cardivascular disease Number f peple reprted engaging in physical activity Risk factr statistics Obesity Hypertensin Diabetes
Resurces A Clser Lk at African American Men and High Bld Pressure Cntrl. (2010). Retrieved frm Centers fr Disease Cntrl and Preventin website: http://www.cdc.gv/bldpressure/dcs/african_american_executive_summary.pdf Adams, Q. (2014, July 24). Chicag Department f Public Health Celebrates PlayStreets Day, Encurages Kids t Get, Stay Active. Retrieved August 5, 2014, frm City f Chicag: http://www.cityfchicag.rg/city/en/depts/cdph/prvdrs/healthychicag/news/2014/jul/chicag-department-f-public-healthcelebrates-playstreets-day--.html African-Americans and Heart Disease, Strke. (2014). Retrieved frm http://www.heart.rg/heartorg/cnditins/mre/ MyHeartandStrkeNews/African-Americans-and-Heart-Disease-Strke_UCM_444863_Article.jsp America's Health Literacy: Why We Need Accessible Health Infrmatin. (2008). Retrieved July 6, 2014, frm U.S. Department f Health & Human Services: http://www.health.gv/cmmunicatin/literacy/issuebrief/health Literacy - Fact Sheet: Health Literacy Basics. (n.d.). Retrieved frm http://www.health.gv/cmmunicatin/literacy/quickguide/factsbasic.htm American FactFinder - Results. (2012). Retrieved frm http://factfinder2.census.gv/faces/tableservices/jsf/pages/prductview.xhtml?pid=acs_12_5yr_dp05 American Heart Assciatin. (2013). American heart assciatin recmmendatins fr physical activity in adults. Retrieved 8/5, 2014, frm http://www.heart.rg/heartorg/gettinghealthy/physicalactivity/fitnessbasics/american-heart-assciatin-recmmendatinsfr-physical-activity-in-adults_ucm_307976_article.jsp Anthny, J., Cardna, J., Córdva, D., Dates, B., Escbar-Chew, A., Fitzgerald, H., Villarruel, F.(2009). "Querems Aprender': Latin immigrants' call t integrate cultural adaptatin with best practice knwledge in a parenting interventin. Family Prcess, 48(2), 211-231.
Resurces Byingtn, J. E., Carter-Edwards, L., Piehl, M., Hutsn, J., Langdn, D., & McManus, S. (2000). Cultural Attitudes Tward Weight, Diet, and Physical Activity Amng Overweight African American Girls. Preventing Chrnic Disease. Retrieved frm http:// www.ncbi.nlm.nih.gv/pmc/articles/pmc2396970/ Centers fr Disease Cntrl and Preventin. (2009). Simply put. Retrieved 7/14, 2014, frm http://www.cdc.gv/healthliteracy/pdf/simply_put.pdf Chicag Park District. (n.d.). 330+ Family Fun Events. Retrieved August 5, 2014, frm Chciag Park District: http:// www.chicagparkdistrict.cm/ntp/family-fun/ Cmmunicable Diseases. (2010). Retrieved frm Ck Cunty Department f Public Health website: http:// www.ckcuntypublichealth.rg/files/data-and-reprts/chsa/chsa%20sectin%206.pdf Cmmunity Health Status Assessment. (2010). Retrieved frm Ck Cunty Department f Public Health website: http:// www.ckcuntypublichealth.rg/files/pdf/weplan/appendix%20c_4_29_2011.pdf Cmmunity Preventive Services Task Frce. (2014). Behaviral and scial appraches t increase physical activity: Scial supprt interventins in cmmunity settings. Retrieved 6/9, 2014, frm http://www.thecmmunityguide.rg/pa/behaviral-scial/cmmunity.html Ck Cunty Clerk. (n.d.). Park Districts. Retrieved August 5, 2014, frm Ck Cunty Clerk, David Orr: http:// www.ckcuntyclerk.cm/abutus/map_rm/dcuments/cuntywide/parkdistricts.pdf Ck Cunty QuickFacts frm the US Census Bureau. (2014, July 8). Retrieved frm http://quickfacts.census.gv/qfd/states/17/17031.html Diabetes and African Americans - The Office f Minrity Health - OMH. (2012, April 24). Retrieved frm http:// minrityhealth.hhs.gv/templates/cntent.aspx?lvl=2&lvlid=51&id=3017
Resurces Eng, M. (2010, February 26). Schls find ways t fit in fitness. Retrieved August 5, 2014, frm Chicag Tribune: http:// articles.chicagtribune.cm/2010-02-26/health/ct-x-c-schl-exercise-0227-20100226_1_after-schl-prgrams-chicag-publicschls-schl-day Flwers, A. (2004, June 1). Obesity. Retrieved August 5, 2014, frm Chicag Life Magazine: http://www.chicaglife.net/cntent/ health/obesity Mrbidity and Mrtality Weekly Reprt (Vl 59, SS-10). (2010). Retrieved frm Centers fr Disease Cntrl and Preventin website: http://www.cdc.gv/mmwr/pdf/ss/ss5910.pdf Natinal Center fr Health Statistics. (2014). Exercise Rates by Age and Educatin Level, 2008 Trends in Higher Educatin. Retrieved frm https://trends.cllegebard.rg/educatin-pays/figures-tables/exercise-rates-age-and-educatin-level-2008 Natinal Institutes f Health. (2011). What are crnary heart disease risk factrs?. Retrieved 8/6, 2014, frm http://www.nhlbi.nih.gv/health/health-tpics/tpics/hd/ United States Census Bureau. (2012). Highlights. Retrieved August 5, 2014, frm United States Census Bureau: https:// www.census.gv/hhes/www/pverty/abut/verview/