1. How to promote HEPA? Sylvia Titze Master of Public Health course Schlosshofen, 12 Jänner 2008

2. Outline  Promotion of physical activity: individual approach Transtheoretical model  Promotion of physical activity: setting approach Example: Bewegtes Amt (Office in Motion)  Promotion of physical activity: community approach Social marketing theory Example: Bewegte Steiermark

3. Verhaltensänderung Das transtheoretische Modell Programm Absichtslosigkeit Absichtsbildung Vorbereitung Handlung Aufrechterhaltung -Strategien der Verhaltensänderung -Entscheidungsbalance -Selbstwirksamkeit Zunahme gesundheitswirksamer Bewegung

4. Individual Factors Social Environmental Factors Physical Environment Factors Social ecological model Based on Giles-Corti, B. et al., Exerc. Sport Sci. Rev. 2005 Self-efficacy for cycling for transport; perceived benefits and barriers to cycling for transport Social norms for cycling for transportation, social support for cycling for transport Connectivity of neighborhood street network; Traffic Safety; Land use-mix access, Living density Physical Activity

5. Office in Motion A Lifestyle Activity Intervention in a Worksite Setting S. Titze 1, B.W. Martin 2, R. Seiler 2 & B. Marti 2 1 Institute of Sport Sciences, University of Graz, AUT 2 Institute of Sport Sciences, Federal Office of Sports Magglingen, CH Titze, S., Martin, B. W., Seiler, R. & Marti, B. (2001). A worksite intervention module encouraging the use of stairs: results and evaluation issues. Sozial und Präventivmedizin, 46, 13-19. Titze, S., Martin, B. W., Seiler, R., Stronegger, W. & Marti, B. (2001). Effects of a lifestyle physical activity intervention on stages of change and energy expenditure in sedentary employees. Psychology of Sport and Exercise, 2, 103-116

6. OBJECTIVE OF THE STUDY to assess the effects of a physical activity intervention in a worksite setting on changes in physical activity

7. OUTCOME MEASUREMENTS OF PHYSICAL ACTIVITY Stages of change (Transtheoretical Model) Stages of change (Transtheoretical Model) Progression within the stages: precontemplation, Progression within the stages: precontemplation, contemplation, preparation, action and maintenance contemplation, preparation, action and maintenance Energy expenditure Energy expenditure Total weekly energy requirements of all activies with Total weekly energy requirements of all activies with an intensity  than 4.5 METs an intensity  than 4.5 METs

8. INTERVENTIONS (1) Information - Leaflet about the intervention programme - Brochures on recent recommendations of HEPA - Lectures: nutrition, stress, fitness - Demonstrations of bicycles and bike equipments - Personal counselling Action services – lifestyle activities Action services – exercise and sport

9. INTERVENTIONS (2) Information Action services – lifestyle activities - Action days: climbing stairs - Action day: closed lifts - Lunch time walk - Five-minutes activity breaks Action services – exercise and sport

10. INTERVENTIONS (3) Information Action services – lifestyle activities Action services – exercise and sport - Fitness lessons during lunch break - Afternoon jogging - Fitness test - Hiking day

11. QUALITY CONTROL OF INTERVENTIONS Process assessment Process assessment - Date of the event - Number of participants - Gender distribution - Method of announcements - Acceptance of the events Feedback Feedback - Meetings: Project manager, evaluator, and - Meetings: Project manager, evaluator, and exercise professionals exercise professionals - Informal consultation - Informal consultation

12. TOTAL ENERGY EXPENDITURE Percent > 1000 kcal/week 0 10 20 30 40 50 60 70 80 4 Intervention offices2 Controll offices Baseline Follow-up % 21%8%

13. STAGES OF CHANGE Percentage of changes %

14. CONCLUSIONS Intervention increased the number of people sufficiently active for health (baseline!) Energy expenditure in lifestyle activities increased More adopters and Less relapsers in the intervention group. Lifestyle activity programmes are fisible and effective to promote HEPA in worksite settings

15. Social Marketing Theory A process that attempts to create voluntary exchange between a marketing organization and members of a target market based on mutual fulfillment of self-interest. The marketing organization uses its resources to understand the perceived interests of target marketmembers, to enhance and deliver the package of benefits associated with a product, service, or idea, and to reduce barriers that interfere with its adoption or maintenance. Target market members, in turn, expend their resources (e.g., money, time, effort) in exchange for the offer when it provides clear advantages over alternative behaviors. Maibach, E. W. (2002). Recreating communities to support active living: A new role for social marketing. American Journal of Health Promotion, 18, 114-119.

16. Recommended literature  Hardman, A. E. & Stensel, D. J. (2003). Physical Activity and health. The Evidence Explained. London: Routledge.  Bouchard, C., Blair, S. N., & Haskell, W. L. (2007). Physical Activity and Health. Champaign, IL: HumanKinetics.  Marcus, B. H. & Forsythe, LA. H. (2003). Motivating people to be physically active. Champaign, IL: HumanKinetics.  Oja, P. & Borms, J. (2004). Health enhancing Physical Activity. Oxford: Meyer & Meyer Sport.  U.S. Department of Health and Human Services (Hrsg.) (1999). Promoting Physical Activity. A Guide for Community Action.  www.hepa.ch (Gesundheitswirksame Bewegung. Grundlagendokument)