Bill Reger-Nash, Ed.D. WVU Community Medicine CDC —April 13, 2006 Beyond Wheeling Walks: Enhanced planning, environment, and policy components Bill Reger-Nash, EdD, WVU Prevention Research Center Linda Cooper, MSW, LCSW Adrian Bauman, MD, PhD Kenneth J Simon, EdD Kevin M. Leyden, PhD
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Beyond Wheeling Walks : Enhanced planning, environment, and policy components
Beyond Wheeling Walks : Enhanced planning, environment, and policy components. Bill Reger-Nash, EdD, WVU Prevention Research Center Linda Cooper, MSW, LCSW Adrian Bauman, MD, PhD Kenneth J Simon, EdD Kevin M. Leyden, PhD. PRESENTATION OUTLINE. Background - PowerPoint PPT Presentation
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Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Beyond Wheeling Walks:Enhanced planning, environment, and policy components
Bill Reger-Nash, EdD, WVU Prevention Research Center Linda Cooper, MSW, LCSW Adrian Bauman, MD, PhDKenneth J Simon, EdD Kevin M. Leyden, PhD
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
PRESENTATION OUTLINE
Background Community capacity building Formative research and message development Pilot testing of the targeted ads Program implementation and evaluation Results Policy and environment change
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
RESULTS –EARNED MEDIA
76 -- TV news stories
48 -- Radio news stories
49 -- Newspaper articles (23--Front Page)
107 -- TV / Radio interviews / promotions
2 -- USA Today article w/ pix
Wheeling Walks
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Wheeling Walks
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
RESULTS—TELEPHONE QUESTIONNAIRESSELF-REPORT --Baseline to Immediate-post
Percent Increase
32%
14% difference
Wheeling Walks
18%
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
RESULTS—POSITIVE STAGE CHANGES
From Baseline precontemplation, contemplation, and preparation
62%*
50%
* p< .001)
12% difference
Wheeling Walks
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Treatment
Attitude
Control
IntentionWalking Status
.13
.11
.33
.42
.31 .15
All paths with coefficients are significant at .01 or better
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Best “Predicted” Model, Chi-square[3] = 39.73; p < .00001
Treatment
Control Beliefs
IntentionWalking Status
.18 .57
.15
All paths with coefficients are significant at .01 or better
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
4-week Media BOOSTER --11th month
--334 TV ads (30-second)
--95 Radio ads (60-second)
--6 1/8-page Newspaper ads
--Public Relations events
-Kick-Off Press Conference
-Celebrity visitor (Adrian Bauman)
-2nd Annual Mayor’s Fitness Cup
-Closing celebration
--Weekly columns by PI (BRN)
Wheeling Walks
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
RESULTS—TELEPHONE QUESTIONNAIRES
Immediate 12-mos Post Post
Knew about campaign------------ 90% 89%Saw TV ads--------------------------- 77% 93%Heard Radio ads-------------------- 33% 36%Saw or heard news stories------ 81% 83%Heard about campaign: at worksite------------------------ 5% 5% via faith-based programs----- 4% 4% via speakers--------------------- 4% 5%
Wheeling Walks
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Group A= Baseline daily walking minutes <=10 minutes
0
10
20
30
40
50
60
70
80
90
100
0 3 6 9 12
Months from baseline
Wee
kly
wal
kin
g ti
me-
in m
edia
n m
inu
tes Least Active at Baseline
Wheeling Walks
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
PHASE IV – POLICY and ENVIRONMENT
Process Outcomes:
• Mayor designated Walkable Wheeling Task Force, Monthly meetings since 2001, Trails Master Plan now approved by City Council 03/06
• Develop walking opportunities in the community
o Upgrade and connect trails (DOT added trails , city exercised eminent domain in December 2005)
o Adding rest rooms and telephones
o Improve overall safety & aesthetics
o Plan for an urban state park
• Engaged city, county, and state agencies: streets, highways,
recreation department, schools, parks, planning
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
0%
10%
20%
30%
40%
North-Central WV Comparison
WV WALKS
RESULTS—TELEPHONE QUESTIONNAIRESBaseline to Immediate-post
Percent Increase
27%
15%
12% difference
WV WALKS
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
RESULTS –EARNED MEDIA
Wheeling WV
Walks WALKS
76 77 -- TV news stories
48 27 -- Radio news stories
49 40 -- Newspaper articles (23--Front Page)
107 1,241 -- TV / Radio interviews / promotions
2 -- USA Today article w/ pix
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Annual cost Per month per per Intervention changed changed
person person
Project Active Lifestyle change $205.80 $17.50 Structured exercise $591.72 $49.31
Wheeling Walks Wheeling only $38.47 $3.20 TV media market $19.00 $1.58
WV WALKS $18.27 $1.52
Cost comparison of Wheeling Walks, WV WALKS, and Project Active
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Wheeling Walks
a. Total campaign cost $120,000
b. Total media area population 418,000
c. Total ages 50-65 (18.6%) / 40-65 (27%) 77,748
d. Target Population (insufficiently active) (58% / 60% )* 45,094
e. Exposed to campaign message (target population) (92% / 82%)* 41,486
f. Cost per individual exposed to message (a/e) $ 2.89
Cost per month (f/12) $ .24
g. Individuals self-report changed (14% / 12% of d.)* 6,313
h. Cost per changed person (a/g) $ 19.00
i. Cost per month ( h/12) $ 1.58
*Percent derived from intervention surveys.
Basis of calculations
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
POLICY and ENVIRONMENTProcess Outcomes in Morgantown:
• Work in concert with City and University via WV WALKS Community Advisory Board
• Diverting large industrial truck traffic from downtown
• Develop walking opportunities in the community
- Upgrade and connect trails
- Adding new and paving sidewalks ($150k per year)
- Developing community walking league
• Coordinated study (Zande Engineering) to make WVU-HSC campus more walkable
• Physicians writing “prescriptions for walking”
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Assessment of Policymakers• Mail survey to assess whether WV Walks intervention focused on changing
the attitudes and behavior of the public can also affect policymakers
• Survey mailed to all municipal elected officials, appointed heads of departments, and all individuals appointed to serve on government boards/commissions (133 in Morgantown and 120 in Huntington )
• Response rates
PRE POST
Morgantown n=76 57.1% n=58 43.4%
Huntington n-38 31.7% n=34 29.3%
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Walking Issues
• Morgantown– Baseline: Ranked 4th– Post Campaign: Ranked 1st
– P < 0.05 (t-test for differences in proportion means)
• Huntington– Not mentioned
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Community Problem IssuesMorgantown – Lack of Pedestrian Walkways, Crosswalks and
Sidewalks – Poorly Planned Development and Sprawl– Traffic Congestion
Huntington– Underage Drinking– Drug and Alcohol Abuse– Crime
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
Environment and policy changes have great potential to influence human behavior. They can impact and sustain change in entire populations for a small financial investment.
O’Donnell MP. Am J Health Promot. 1989;2(2):5.
BUT HOW DO WE DO THIS?
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
WORLD HEALTH ORGANIZATION1st International Conference on Health Promotion
November 21, 1986Ottawa, CANADA
OTTAWA CHARTER FOR HEALTH PROMOTION“Health promotion is the process of enabling
people to increase control over, and to improve, their health…People cannot achieve their fullest health potential unless they are able to take control of those things which determine their health.”
Bill Reger-Nash, Ed.D. WVU Community MedicineCDC —April 13, 2006
• Health / other sectors participating together in PA campaigns