National Center on Physical Activity and Disability James H. Rimmer, Ph.D., Professor University of Illinois at Chicago Director, National Center on Physical.

National Center on Physical Activity and Disability

James H. Rimmer, Ph.D., ProfessorUniversity of Illinois at Chicago

Director, National Center on PhysicalActivity and Disability

IFC Executive Committee Co-Chair

September 13, 2007

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Presentation Outline

Health Disparities in Adults and Youth with Disabilities

NCPAD’s Central Mission Resources Future

Health Disparities In Adults with Disabilities

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Health Disparities - Adults

With Disabilities

Without Disabilities

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Health Disparities - AdultsR

isk

Fac

tor

Percent

Health Disparities In Youth with Disabilities

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Disparity in physical activity participation among youth with disabilities

Youth with disabilities are 4.5 times more likely to be physically inactive compared to non-disabled youth.

Youth with disabilities are twice as likely as non-disabled youth to report watching TV for more than 4 hours per day.

26.6% of youth with disabilities report 3+ hours /school day of sedentary activities vs. 20.4% of youth without disabilities.

Youth with Disabilities are Vulnerable to Overweight and Obesity

Researchers have reported a higher prevalence of overweight among children and adolescents with: Spina bifida Prader-Willi syndrome Down syndrome Muscular dystrophy Brain Injury Visual impairments Learning Disabilities ADHD and autism spectrum disorders

Rimmer et al. Obesity Levels Among Youth with Disabilities, J Adoles Health, 2007.

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Prevalence of Overweight (BMI ≥ 95th%) among Youth (ages 6–17) by Disability and Sex.

0

5

10

15

20

25

30

35

All Girls Boys

Adolescents withPhysicalDisabilityAdolescentswithout PhysicalDisability

Source: 1999-2002 National Health and

Nutrition Examination Survey reported by

Bandini et al. (2005).

Percentage

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Overweight and Obese Youth are at Increased Risk of Serious Health Issues

Chronic Conditions High blood pressure Hyperlipidemia Insulin resistance

Secondary Conditions Mobility limitations Extreme deconditioning Fatigue Pain Depression Social isolation

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Adolescents with and without disabilities who exercise < once per week

0

10

20

30

40

50

60

70

11-12 13-14 15-16Age (in years)

Adolescentswithdisabilities

Adolescentswithoutdisabilities

Percent Exercising ≤ 1 / week

Steele et al., 2004 Data from the Canadian WHO Cross-National Survey of Health

Behaviors in School-Aged Children (HBSC).(OR: 4.50; 95% CI [3.55-5.72])

The Challenge Before Us

Physical activity is significantly lower and obesity significantly higher in youth and adults with disabilities.

The problem is exacerbated by: Children and adults with disabilities have less

access to physical activity. Technology and “convenience” items reduce

energy expenditure in IADL and ADL. Unemployment rate for working age people with

disabilities is more than three times that for non-disabled people.

Cycle of Physical Inactivity and Onset of Secondary Conditions

Physical inactivity

Decreased capacity to engage in physical activity

Onset or increase of functional limitations

Development of secondary

conditions

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NCPAD’s Three Central Features

A resource and information center on physical activity and disability, with thousands of references on the subject.

A health promotion center encouraging and supporting healthy lifestyles for people with disabilities.

A research and training center promoting further research on the benefits of physical activity and guiding best practice in the field.

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What We Do

Identify, collect, synthesize, and organize materials on physical activity and disability.

Create useful resources for consumers, professionals, and researchers.

Increase public awareness of the importance of physical activity for people with disabilities.

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More of What We Do

Promote increased participation in physical activity by people with disabilities.

Educate consumers and professionals about best practices and safe methods of exercise.

Identify important research issues and stimulate further research on physical activity and disability.

Pathways to Inclusion in Disability and Health

Empower the Person

Enable the Environment

Healthy, Active

Lifestyles

FOR ALL

Provide Access

Increase Participation

Promote Adherence

Improve Physiological and Psychological Health

Barriers to Physical Activity Make it More Difficult for

People with Disabilities to Reach the Goal

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How Do We Get There? Better surveillance systems to track

and monitor obesity and PA levels in Youth and Adults with disabilities

Evidence-based practices in physical activity and health promotion for youth and adults with disabilities

Inclusive (livable) communities for youth and adults with disabilities

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How Do We Get There? Health marketing campaigns aimed at

increasing awareness and knowledge of major health disparities

Education and Training Programs that increase knowledge and awareness

Capacity Building (i.e., training students in public health, continuing education)

NCPAD Today

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Website Enhancements

The NCPAD Accessible Video Viewer

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Interactive Features

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Directories

The following searchable directories are available online at www.ncpad.org:

NCPAD Programs Database http://www.ncpad.org/programs NCPAD Personal Trainers Database

http://www.ncpad.org/trainers NCPAD Parks Database http://www.ncpad.org/parks NCPAD Suppliers Database http://www.ncpad.org/suppliers

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Technical Assistance

NCPAD Consumer Request Service System Form

The NCPAD Contact Us Form

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Partnership with the President’s Council on Physical Fitness and Sports (PCPFS)

The initial focus of the partnership is on the development of a series of fact sheets.

Identified topics: International Classification of Functioning, Disability, and

Health Pedometers for people with disabilities Resources to assist in locating accessible recreation

programs and facilities Including people with disabilities in media messaging (via

pictures, placards, training toolkits—any special considerations for talking or working with people who have disabilities)

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2007 Featured Products

A complete list of NCPAD-developed resources is available at www.ncpad.org/shop.

NCPAD’s Next Steps: Connecting to State Public Health Departments

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Supporting State Implementation Projects in Physical Activity

AR

CA DE

FL

IL

IA

KS

MA

MI

MT

NY

NC

NDOR

SC

VA

NCPAD provides information resources and technical assistance to the 16 State Implementation Projects in the area of physical activity for people with disabilities

Validated evidence based practice and effective health promotion strategies for increasing physical activity are fed back to NCPAD

NCPAD actively promotes adoption of evidence based physical activity programs for people with disabilities to all States

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Working at the Intersection of Disability and Health

Establish framework for collecting, aggregating and synthesizing data from various State Disability and Health modules.

Build a longitudinal database that ‘qualifies’ the health behaviors (i.e., physical activity, nutrition) of people with disabilities.

Track benefits of each program longitudinally (i.e., post-implementation).

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Future Directions

1. Customize (tailor) materials and content for specific target audiences.

2. Establish a National Health Marketing Campaign targeted to specific audiences (e.g., public health professionals, providers, consumers, etc.).

3.Develop safe, effective and innovative ways for online exergaming for people with disabilities.

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Future Directions

4. Employ new and emerging technologies that encourage/motivate people with disabilities to live healthier, active lifestyles.

• Online community of exercisers using sport, dance and general exercise.

5. Become an interactive Evidence-Based Center that connects ongoing D&H projects with each funded State and rest of nation.

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Technology and Innovation Resources

User Supported Communities

Interactive Online

• Accessible programs

• Personal trainers

• Exercise “buddies”

• PEP

• PEP for youth

• Cooperative or competitive play

Video Library

• Full programs on DVD

• Downloadable clips

• Demonstrations of sport and recreation activities

Livable Communities/Universal Design

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HEZ Toolkit

Toolkit to build Health Empowerment Zones (HEZ) for People with Disabilities Accessible sidewalks and paths Healthy food choices Accessible recreation and exercise

facilities Transportation choices Improving social networks

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HEZ Toolkit

Toolkit content: Accessibility and Participation

Community Accessibility Survey Facilities

AIMFREE (fitness facilities, parks, trails) Grocery Store Assessment Instrument

(physical availability and freshness/quality) Built Environment

Health Empowerment Zone Environmental Assessment Tool (pathways, curb cuts)

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HEZ Toolkit

Toolkit content (cont).

Health Behavior (exercise and nutrition) PADS B-PADS Fat & Fiber Questionnaire

Health Outcomes Secondary Conditions Instrument

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Training Professionals and Paraprofessionals

ACSM Distance Learning Initiative

World of Disability World of Fitness

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Inclusive Fitness Trainer Certification Program

Health professionals gain entry-level knowledge specific to

physical activity and disability

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Capacity Building

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IFC Call to Action

Work with the U.S. Surgeon General and the Office on Disability

Create partnerships to expand accessibility

Work with health care providers and organizations to increase physical activity for people with disabilities

Advocate for research and technologies Recognize those who support the cause

http://www.incfit.org

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Technology & Innovation (PEPONLINE)

Tailor to personal needs and environmental factors.

Eliminate any and all barriers. Make it easy to implement. Keep it ‘fluid’ - changing as the person

changes. Provide some type of feedback mechanism

on a regular basis (i.e., monthly). Account for seasonal changes (i.e. winter

vs. summer).

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PEPonline Coach Summary Screen

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PEPonline Participant Screen

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Personalized Attention

Friendly, highly trained people available by a toll-free telephone, TTY, e-mail, or fax to provide personalized responses to yourquestions.

Toll-free phone: 1-800-900-8086 (v or tty)

E-mail to [email protected] Fax questions to 1-312-355-4058