This page intentionally left blank. Promoting Physical Activity A Guide for Community Action Second Edition David R. Brown, Gregory W. Heath, and Sarah Levin Martin Editors Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Nutrition, Physical Activity and Obesity Human Kinetics Library of Congress Cataloging-in-Publication Data Promoting physical activity : a guide for community action / Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity and Obesity ; edited by David R. Brown, Gregory W. Heath, and Sarah Levin Martin. -- 2nd ed. p. ; cm. Includes bibliographical references and index. ISBN-13: 978-0-7360-6208-4 (soft cover) ISBN-10: 0-7360-6208-4 (soft cover) 1. Health promotion--Social aspects--United States. 2. Physical ftness--Social aspects--United States. 3. Medicine, Preventive- -Social aspects--United States. I. Brown, David R., Ph. D. II. Heath, Gregory. III. Martin, Sarah Levin. IV. Coordinating Center for Health Promotion (U.S.) V. National Center for Chronic Disease Prevention and Health Promotion (U.S.). Division of Nutrition, Physical Activity and Obesity. [DNLM: 1. Health Promotion--United States. 2. Physical Fitness--United States. 3. Preventive Medicine--United States. 4. Sociology, Medical--United States. QT 255 P9653 2010] RA427.8.P767 2010 362.1--dc22 2009047443 ISBN-10: 0-7360-6208-4 (print) ISBN-13: 978-0-7360-6208-4 (print) This book is published for the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity and Obesity by Human Kinetics, Inc. This book is a work of the United States Government. All material appearing in this book, except where otherwise noted, is in the public domain and may be used and reprinted without permission. Citation of the source, however, is appreci- ated. We also request that you notify us as a courtesy when reprinting or adapting excerpts of 500 or more words. When reprinting or adapting excerpts from Promoting Physical Activity: A Guide for Community Action, Second Edition, please contact the Division of Nutrition, Physical Activity and Obesity, Mail Stop K-46, 4770 Buford Highway, NE, Atlanta, GA 30341-3724; phone: 770-488-5820. The Web addresses cited in this text were current as of October 2009, unless otherwise noted. Acquisitions Editor: Michael S. Bahrke, PhD; Managing Editor: Melissa J. Zavala; Assistant Editor: Casey A. Gentis; Copy- editor: Julie Anderson; Indexer: Nan Badgett; Permission Manager: Dalene Reeder; Graphic Designer: Angela K. Snyder; Graphic Artist: Angela K. Snyder; Cover Designer: Keith Blomberg; Photographer (cover): © Human Kinetics; Photographer (interior): © Human Kinetics, unless otherwise noted; Photo Asset Manager: Laura Fitch; Photo Production Manager: Jason Allen; Art Manager: Kelly Hendren; Associate Art Manager: Alan L. Wilborn; Illustrator: Tammy Page; Printer: Versa Press Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 The paper in this book is certifed under a sustainable forestry program. Human Kinetics Web site: www.HumanKinetics.com United States: Human Kinetics Australia: Human Kinetics P.O. Box 5076 57A Price Avenue Champaign, IL 61825-5076 Lower Mitcham, South Australia 5062 800-747-4457 08 8372 0999 e-mail: contents Contributors  vii Preface  xi Introduction  xv Part I  Foundations for Physical Activity Promotion  1 Chapter 1  Health Benefts of Physical Activity  3 David M. Buchner What Is Physical Activity?  3 What Is Physical Fitness?  4 Physical Activity and Energy Expenditure  4 Determinants of the Health Benefts of Physical Activity  5 Types of Physical Activity  7 Other Attributes of Physical Activity  7 Preventive Health Benefts of Physical Activity  7 Health Benefts of Physical Activity in Children  16 Prevention of Functional Limitations and Disability  17 Therapeutic Exercise  19 Perspective on Physical Activity Risks  19 Conclusion  20 Resources  20 Chapter 2   Physical Activity Recommendations  21 Janet E. Fulton and Harold W. Kohl III Healthy People 2010: National Health Promotion and  21 Disease Prevention Objectives Related to  Physical Activity and Physical Fitness Physical Activity Recommendations for Adults—  22  Historical Considerations Overview of Current Physical Activity Guidelines for Adults  24 Current Physical Activity Guidelines for Adults  24 What’s New About the 2008 Physical Activity Guidelines  26 for Americans? Physical Activity Recommendations for Older Adults—  29  Historical Considerations Current Physical Activity Guidelines for Older Adults  30 Physical Activity Recommendations for Children  32  and Adolescents—Historical Considerations Current Physical Activity Guidelines for Children  37  and Adolescents Summary  39 Suggested Readings  39 iii iv Contents Part II  A  pproaches and Interventions for Changing  41 Physical Activity Behavior Chapter 3   Informational Approaches to Promoting Physical Activity  47 Community-Wide Campaigns  47 Sara Wilcox and Dennis Shepard Point-of-Decision Prompts  57 Sarah Levin Martin, Leigh Ramsey Buchanan, and Robin E. Soler Chapter 4  Behavioral and Social Approaches  63 to Promoting Physical Activity  Enhanced School-Based Physical Education  63 Jacqueline N. Epping and Sarah M. Lee Individually-Adapted Health Behavior Change Interventions  75 David R. Brown and Tina J. Lankford Social Support Interventions in Community Settings  86 Rebeka Cook and Ross C. Brownson Chapter 5  Environmental and Policy Approaches  93 to Promoting Physical Activity Creation of or Enhanced Access to Places for  93  Physical Activity Combined With Informational  Outreach Activities James F. Sallis and Gregory W. Heath Community-Scale and Street-Scale Urban Design and  102  Land Use Policies and Practices to Promote  Physical Activity Thomas L. Schmid and Candace Rutt Part III  P  lanning, Implementing, and Evaluating  117 Your Intervention or Program Chapter 6  Partnerships  119 Tamara Vehige Calise, Reflwe Moeti, and Jacqueline N. Epping Key Steps to an Effective Partnership  120 Step 1: Determine Whether a Partnership Is Necessary  122 Step 2: Determine Whether Potential Partners Have the  123  Capacity and Interest to Support the Partnership Step 3: Recruit Partners  128 Step 4: Establish Leadership  130 Step 5: Determine One or More Common Goals  130 Step 6: Determine the Partner’s Level of Involvement  132  and Cooperation in the Partnership Step 7: Defne the Partnership’s Operational Structure  132 Step 8: Keep the Long-Term Goal in View  134 Step 9: Start With Reasonable Short-Term Objectives  134 Step 10: Evaluate the Partnership  135 Conclusion  135 Recommended Readings  135 Contents   v Chapter 7  Program Planning and Evaluation  137 Sarah Levin Martin and Lauren M. Workman Program Planning  137 Program Evaluation  144 Conclusion  151 Suggested Readings  152 Part IV  R  esources for Action  153 Appendix A  Physical Activity and Disability  155   by James H. Rimmer Appendix B  Physical Activity Surveillance by Sandra A. Ham  165 Appendix C  Physical Activity and Fitness (HP 2010 Progress Review)  171 Appendix D  Physical Activity and Health: A Report of the  197 Surgeon General (Executive Summary) Appendix E  Resources  215 Glossary  225 References  233 Index  255 About the Organization  261 About the Editors  262 This page intentionally left blank. contributors Editors David R. Brown, PhD, FACSM Research Behavioral Scientist Physical Activity and Health Branch Division of Nutrition, Physical Activity and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Gregory W. Heath, DHSc, MPH, FACSM, FAHA* Guerry Professor and Head Department of Health and Human Performance Director of Research, College of Medicine University of Tennessee Chattanooga Sarah Levin Martin, PhD* Healthy Maine Partnerships Evaluation Team Leader Maine Center for Public Health Contributing Authors Ross C. Brownson, PhD Professor and Codirector Prevention Research Center in St. Louis Schools of Medicine and Social Work Washington University in St. Louis Leigh Ramsey Buchanan, PhD Epidemiologist Division of Nutrition, Physical Activity and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention David M. Buchner, MD, MPH* Shahid and Ann Carlson Khan Professor in Applied Health Sciences Department of Kinesiology and Community Health University of Illinois at Urbana-Champaign Tamara Vehige Calise, MEd* DrPH Candidate Boston University School of Public Health Rebeka Cook, MPH Commission on Ministerial Health Texas District Lutheran Church-Missouri Synod Austin, TX vii viii Contributors Jacqueline N. Epping, MEd Team Leader, Guidelines and Recommendations Development Team Physical Activity and Health Branch Division of Nutrition, Physical Activity and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Janet E. Fulton, PhD Team Leader, Epidemiology and Surveillance Team Physical Activity and Health Branch Division of Nutrition, Physical Activity and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention * Sandra A. Ham, MS Divinity School University of Illinois at Chicago 1 Harold W. Kohl, III, PhD, MSPH Professor of Epidemiology and Kinesiology University of Texas School of Public Health, Division of Epidemiology and Dis- ease Control and College of Education, Department of Kinesiology and Health University of Texas at Austin Tina J. Lankford, MPH Public Health Analyst Physical Activity and Health Branch Division of Nutrition, Physical Activity and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Sarah M. Lee, PhD Health Scientist Division of Adolescent and School Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention * Reflwe Moeti, MA Public Health Educator Division of Oral Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention James H. Rimmer, PhD Professor Director, National Center on Physical Activity and Disability Department of Disability and Human Development University of Illinois at Chicago Candace Rutt, PhD Senior Service Fellow Physical Activity and Health Branch Division of Nutrition, Physical Activity and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention