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Strategies to Increase Physical Activity
Leading a sedentary lifestyle has been one of the major contributing factors of obesity, and overall the increase of NCDs. Tackling obesity and NCDs is so complex that it requires a multi-sectoral approach at different levels. This is due to the complexity of its contributing factors.
Strategy 1: Community-wide campaigns
Description
Like a media campaign, the community-wide campaigns use different forms of media like the radio, television, newspaper and even trailers in movie theatres to promote their messages; which in this case is physical activity. The extra punch that community-wide campaigns offer is the on-the-ground element which features a multitude of components that help drive home the message of promoting physical activity. These can include support and self-help groups; counselling services for those in need; public screening to help identify potential risk factors in individuals; education and information sessions at workplaces, at schools, and even at community or public events. The inclusion of policies and environmental changes are part of the promotion scheme. For example, opening school facilities for public use to help enhance physical activity. The campaign messages that are carried across can be generalized to the public or tailored to suit a targeted audience; both of which are achievable due to the diverse modes of media and communication that are available. To ensure that these campaigns are sustained and ongoing, it requires a multi-sectorial approach with different stakeholders partnering to ensure it success and longevity.
Rationale and Evidence
The rationale behind this strategy is addressing the community at different levels using different approaches of education and motivation. This provides a diverse field to help individuals welcome and grasp the message and concepts behind physical activity. It works in a marvellous way that not only provides inspiration and influence at the individual level, but also provides an interpersonal, institutional, as well as a communal approach that both promote and eliminate barriers to physical activity. CDC supports this strategy based on a review of 10 studies presented by the Task Force on Community Preventive Services’ Guide to Community Preventive Services (the Community Guide) which has found a success rate of about a 4 percent median increase in the percentage of people who have become more physically active and a 16 percent increase in energy expenditure. However, this is not the only advantage community-wide campaigns have to offer because they are effective in diverse populations and work well in different settings. These campaigns bring about a unity amongst the people and they enrich the people with a feeling of accomplishment by working together to bring about a positive healthy change.
Action Steps

Strategy 2: Individually adapted health behaviour change programs
Description
This strategy is individually tailored depending on the person’s readiness to change, their interests and preferences concerning physically activity. Individuals can be empowered by being taught behavioural skills that can help boost their daily activity levels. An ideal approach is teaching individuals ways of incorporating physical activity in their daily routines, for example, enhancing household chores to include some form of moderate intensity activity for half an hour for at least five days in a week. Other ways to help boost positive behaviour changes for a more active lifestyle is by building support through social support networks, for example, exercising with a training buddy or involving a group in your exercise routine. This reinforces the positive behaviour change towards being more active as it makes exercise more interactive and fun as a shared activity. Self-reward and positive self-talk are other booster techniques that can be utilized to help prevent relapses into sedentary behaviours. The beauty of this strategy is its effectiveness and diversity in its application to different population types and in different settings. Race, ethnic minority, and socioeconomic status have no limitations to its application; and success is witnessed in the community, at work sites, in schools and even fitness and health care settings.
Rationale and Evidence
People cope in different ways and function at different rates; that is the focus of this strategy. It plays to the individual’s strength and is based on the stage of change they are in. This allows for a broad scope across the socioecological framework and helps identify and address the different barriers. This community-level effort can both complement and enhance policies and environmental interventions. The sustainability of this strategy is based on the how well both the community and a supportive environment meld together. Key factors that enhance the success of an individualized program is how to caters to the individual’s readiness for change, his or her special needs, as well as the desired outcomes. CDC has reviewed the effectiveness and success of this strategy to be strong in its strategy interventions that promote individual behaviour change. This is based on eighteen studies reviewed by the Community Guide to have a 35 percent median increase in the time spent on physical activity and a 64 percent increase in the level of energy expended. Its effectiveness is evident in diverse populations in a variety of settings.
Action Steps

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Strategy 3: Enhanced school-based physical education
Description
These interventions are designed to encourage moderate to vigorous physical activity among youths with the intention of making it more enjoyable. This can be applied both in and outside of the classroom. There is not limitation to its incorporation into physical education (PE) lessons alone and can be used in after school programs in the community or in youth-oriented settings. CDC has highlighted that the criteria for enhanced PE interventions set by the Community Guide must include at least one of the three elements in its program: (1) increased percentage of time during PE class that engages students in moderate to vigorous activity, (2) additional PE sessions within the school schedule, or (3) longer PE sessions. Other components which can be included in this strategy is a change to PE policies, curricula, or teaching practices.
Rationale and Evidence
This strategy allows students to achieve standard PE requirements. It also provides a platform for increased physical activity among students, who away from school, have little to no opportunity to be physically active. It aims to improve overall physical fitness by enhancing flexibility, muscular endurance, and physical activity knowledge. And contrary to the common thought that expanding time on physical activity takes valuable learning time from students, it contributes to improved academic outcomes. Other self-improvement skills which are relayed through enhanced PE include self-assessment, self-management and goal setting for physical activity which builds a physically active lifestyle. The review offered by the Community Guide that is identified by CDC found that a review which included fourteen studies showed a median increase of 10 percent in the time that was dedicated to PE and 50 percent in the time spent in moderate to vigorous physical activity during PE. Its success rates are not affected by diverse populations nor settings.
Action Steps

Strategy 4: Social support interventions in community
Description
According to the Community Guide that is highlighted by CDC, the basis of this strategy focuses on both existing as well as new social support networks that help build interactive and supportive ways for individuals to maintain physically active lifestyles. These networks can be set up outside the family such as in the workplace or community. Important elements which define this system include a “buddy” system, establishing work out “contracts” with others to complete specific levels of physical activity or setting up work out groups that provide both companionship and support. Creating supportive social environments such as these increases the compliance rate of individuals to maintaining an active lifestyle by connecting with others to help monitor their progress while making exercise more enjoyable as a shared activity that everyone participates in. This interactive form of support also allows for group discussions to address and overcome barriers to maintaining active lifestyles.
Rationale and Evidence
Social support interventions can both act as a precursor or a component of physical activity interventions. They help participants identify barriers to being physically active and provide solutions to reduce or overcome these obstacles. Working with others for a common cause – in this case being physically active, provides participants with the companionship and support they need. Interpersonal levels of interaction are just as important as policies that enforce and nurture physical activity due the high behavioural influence of physical activity. CDC has identified strong evidence presented by the Community Guide based on a review of nine studies which shows a 44 percent median increase in the time spent being physically active and a 20 percent increase in energy expenditure.
Action Steps

Strategy 5: Creation of or enhanced access to places for physical activity combined with informational outreach activities
Description
These interventions focus on two major components, the individual and the environment, and are usually long-term interventions. The individual component includes behaviour change education for participants, educating and training individuals on how to use exercise equipment, screening sessions for risk factor identification with appropriate referrals when required, health and fitness programs, and having a support or buddy system. The environmental component looks at enhancing the environment to create a favourable atmosphere that encourages physical activity. This may include building walking trails, exercise facilities, or improving access to existing facilities.
Rationale and Evidence
Equipping people with the knowledge, skills, attitudes, and motivation to be physical active only accomplishes half of the work towards encouraging and enhancing physical activity in the community. Overlooking the availability and accessibility to the facilities and equipment which help build and enhance physical activity grossly condones the aim of such interventions because this can either limit or prohibit individuals from being active. Another crucial element is creating awareness in the community so that individuals are aware of the opportunities which exist and accessible to them. Both components thrive well among diverse populations and settings which is a great advantage in terms of application. In the presence of community support and overall involvement, this guarantees increased efforts of physical activity in the community. This is another strong strategy that is highlighted by CDC from evidence presented by the Community Guide based on a review of ten studies which showed an increase of 25 percent in the proportion of the population who are physically active at least three times per week. Most of these studies also reported weight loss or a decrease in body fat among the participants.
Action Steps

Strategy 6: Street-scale urban design and land-use policies
Description
This strategy uses street-scale urban design and land-use policies in small geographical areas which is only limited to a few blocks. Some of its policies and practices include improving street lights, increasing ease and safety of street crossings, introducing or enhancing traffic calming, enhancing the aesthetics of the streetscape and ensuring sidewalk continuity.
Rationale and Evidence
Studies have found that people are more likely to walk more if the neighbourhood is safe, walkable and aesthetically pleasing. As one of the most frequently cited barriers is safety, improving the pedestrian and cycling infrastructure will make walking and cycling more alluring to individuals. So key factors to this strategy is establishing safety, walkability, improved sense of community, decreased isolation as well as crime and stress in the community. The advantage these interventions hold is it permanence in the community therefore influencing, if not all, most of the community members to being more active. Once these enhancements are established they exist for the life of the structure and do not require sustained promotional efforts. According to CDC, the Community Guide rates this strategy as a sufficient one which, based on six review studies, has a median increase of 35 percent physical activity.
Action Steps

Strategy 7: Community-scale urban design and land-use policies
Description
This strategy uses community-scale urban design and land-use policies and practices to support physical activity on a larger scale involving several square kilometres. These interventions develop and implement infrastructure projects using policies and practices that help improve the continuity and connectivity of streets, sidewalks and bicycle lanes with the purpose of promoting physical activity in the community. Some characteristics of this intervention include zoning regulations and roadway design standards that promote physical activity by creating a layout where destinations are within a reasonable walking distance. Mixed zoning creates the co-location of residential, commercial and school properties in relatively close distance to each other; thus, encouraging people to be more active by walking to their desired destinations.
Rationale and Evidence
The physical design and layout of a community is very important because it is permanent and when well planned provides a sustainable environment that promotes and support physical activity. An important feature is having everything in walking distance, for example, the presence of commonly frequented places near residential areas like work, schools, shopping or entertainment centres. People are more likely to walk or cycle to their desired destinations rather than using automobiles. This is achievable by engaging key stakeholders like community residents, city or town planners, and developers in creating the layout of the community; keeping in mind that both the business and residential community needs are met. CDC identifies this strategy is sufficient in its effectiveness based on evidence presented by the Community Guide which found in a review based on twelve studies that improving physical aspects in the community resulted in an overall increase in walkers and bicyclists. Improving the built environment not only influences the level of physical activity in the community but also the quality of life.
Action Steps

Strategy 8: Active transport to school
Description
Active transport to school is designed to support and encourage children and youths to engage in walking, bicycling or even skating to school. They can also involve urban-design elements and practices that ensure that the built environment provides safe conditions for active transportation to ensure that this intervention is easily implemented by different levels of the school system, primary and high school.
Rationale and Evidence
Children are more likely to walk to school in a safe, pedestrian-friendly setting such as the presence of safe sidewalks. These interventions have the potential to build a sustainable environment that supports physical activity in the long term for both students and the community. Developing programs that promote active transport to school often use principles applied in urban design and land-use policies and practices to help mould the physical environment in a positive way that supports this intervention. The key factor that promotes the success of this intervention is road safety for the students. CDC gives a collection of studies that were included in the 2008 report of the National Safe Routes to School Task Force for the United States that showed that these interventions were effective in increasing physical activity, improving safety, and creating sustainable infrastructure that supported physical activity.
Action Steps

Strategy 9: Transportation and travel policies and practices
Description
This strategy looks to promote other forms of transportation like bicycling, public transportation and even walking by undertaking transportation and travel policies and practices to increase the safety of walking and bicycling; reducing the use of cars which overall improves the quality the air. Several approaches can be utilized such as altering roadway design standards; the inclusion and enhancement of bicycle lanes; increasing the availability and accessibility of public transportation; providing safe bicycle storage racks on buses; providing incentives for car or can pooling; and raising the cost of parking.
Rationale and Evidence
The way forward with these interventions is creating and enhancing healthier alternative forms of transportation other than automobile use such as walking and bicycling. This has the potential to increase physical activity among a substantial portion of the population. Alternative transportation like public transport use instead of private automobiles is another aim of these interventions because there is some form of physical activity involved like having to walk to and from the bus stop to your destination. Other forms of encouraging alternative transport use other than private automobiles is the use of disincentives such as increasing parking costs. These interventions not only promote more physically active forms of transportation but also gives back to the environment by potentially improving air quality, commerce, aesthetics through increase of green space, and helps decrease stress.
Action Steps

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