1. March, 2009 1 Caribbean Workshop on Physical Activity Follow On.. March 9, 2009

2. March, 2009 2 ACTIVE CARIBBEAN 2009; ROAD TO THE WELLNESS REVOLUTION Caribbean Workshop on Physical Activity March 6-7 2009 Accra Beach Hotel & Resort Christ Church, Barbados

3. March, 2009 3 Evolution & Opportunities Promoting physical Activity:

4. March, 2009 4 OVERVIEW Burden of chronic disease and prevalence of physical inactivity in the Caribbean Evolution of physical activity promotion Opportunities for physical activity promotion initiatives in the Caribbean

5. March, 2009 5 Caribbean PA Inactivity Prevalence: One half of adults are sedentary More females More urban 17-38% engage in planned exercise

6. March, 2009 6 CARICOM Heads of Government Summit on NCD's September 15, 2007 Port of Spain, Trinidad

7. March, 2009 7 May 6, 7 2008 Port of Spain, Trinidad Promoting Physical Activity in the Caribbean in the Caribbean

8. March, 2009 8 Caribbean Regional Private Sector Meeting on NCD Prevention and Control May 8-9 2008 Port of Spain, Trinidad

9. March, 2009 9 HEALTHY CARIBBEAN 2008 First Caribbean Chronic Disease Conference: A Wellness Revolution Event October 16-19 2008 Christ Church, Barbados

10. March, 2009 10 EVOLUTION OF PROMOTING PHYSICAL ACTIVITY

11. March, 2009 11 ESTABLISH HEALTH AND OTHER BENEFITS

12. March, 2009 12 ESTABLISH IMPORTANCE AS A RISK FACTOR

13. March, 2009 13 ACHIEVABLE VIA ACTIVITIES OF DAILY LIVING ESTABLISH GUIDELINES

14. March, 2009 14 DOCUMENT PREVALENCE OF INACTIVITY (SURVEILLANCE)

15. March, 2009 15 ECONOMICS AND DEVELOPMENT RATIONALE

16. March, 2009 16 Cost Effectiveness of Community-Based Activity Interventions Am J Prev. Med 2008; 35 (4) Roux, Pratt, et al Study assessed *cost-effectiveness (CEA) of population – wide strategies to promote physical activity in adults and followed disease incidence over a lifetime. *Dollars per quality – adjusted life year (QALY) gained relative to no intervention.

17. March, 2009 17 Four Intervention Strategies Previously Recommended By the Task Force on Community Preventive Services: Community – wide Campaigns. Individually adapted health behavior change. Community social – support interventions. Creation of or enhanced access to physical activity information and opportunities.

18. March, 2009 18 Conclusions : All evaluated PA interventions reduced disease incidence. All evaluated PA interventions were cost-effective. Compared with other well accepted preventive strategies the PA interventions offered good value for the money Results support using these interventions as part of public health efforts to promote physical activity In considering PA interventions, CEA is a valuable adjunct to other factors such as program reach, feasibility, community priorities and resources.

19. March, 2009 19 DOCUMENT THE MANDATE (RESOLUTIONS, ETC.)

20. March, 2009 20 “WHO Calls For Action to Tackle Social Injustice” …..Targeted preventive campaigns, for example about the risks of inactive lifestyles, can help close the health gap.

21. March, 2009 21 AWARENESS ACTION

22. March, 2009 22 CAPACITY BUILDING

23. March, 2009 23 RESOURCES/PROGRAMS

24. March, 2009 24INTERSECTORALINNOVATIONS

25. March, 2009 25 WHO STRATEGY ANDASSISTANCE TO IMPLEMENT

26. March, 2009 26 ADVOCACY FOR DEVELOPMENT OF NATIONAL PLANS

27. March, 2009 27 PA ATTRIBUTES

28. March, 2009 28 PROMOTING PHYSICAL ACTIVITY IS EXCITING, POSITIVE, MARKETABLE AND TIMELY

29. March, 2009 29 Synergy: PA complements other important national policy issues such as nutrition, urban safety, tobacco control, environmental health, transportation and sport.

30. March, 2009 30 It encourages positive action not prohibition

31. March, 2009 31 The message is simple and consistent

32. March, 2009 32 It is relatively free from opposing lobbies, special interest groups

33. March, 2009 33 Recommendations can be achieved via enjoyable activities of daily living (walking the dog e.g.) or sport

34. March, 2009 34

35. March, 2009 35

36. March, 2009 36 Mark Cunningham

37. March, 2009 37 BENEFITS APPLY ACROSS POPULATIONS

38. March, 2009 38 Benefits extend beyond health alone to workplace issues such as productivity and absenteeism

39. March, 2009 39 for older adults especially relevant with agingpopulations Benefits to quality of life

40. March, 2009 40 Increased awareness of NCD burden and obesity prevalence provides incentive

41. March, 2009 41 Specific plans and interventions can be tailored to individual country circumstances

42. March, 2009 42 Promoting physical activity must be opportunistic according to individual country politics, culture, capacity. culture, capacity.

43. March, 2009 43 Plans/ initiatives can be broad spectrum from simple to sophisticated and can start through alternative sectors.

44. March, 2009 44 Winning sport season promotes population level interest ELEMENTARY EXAMPLE….

45. March, 2009 45 SOPHISTICATED EXAMPLE: Collect data to individualize country prevalence of inactivity, NCD rates, and demonstrate potential economic and other benefits to be gained by increasing population levels of PA.

46. March, 2009 46 COST SAVING MECHANISM: Minimize data collection by using international consensus data

47. March, 2009 47 GETTING STARTED

48. March, 2009 48 GOOD PRACTICES IN NATIONAL PUBLIC HEALTH PLANNING APPLIED TO PHYSICAL ACTIVITY Make the case (health and others) Consult with key stakeholders; identify partners Comprehensive inter-agency planning; shared responsibility of coalitions/ task forces Multiple strategies at different levels Identify "what, who, timeline, $$" Evaluation ( process and outcome)

49. March, 2009 49 HEALTH SPORT TRANSPORTATION / URBAN PLANNING EDUCATION DEVELOPMENT GOVERNMENT NGO'S PRIVATE SECTOR ENGAGING OTHERS IS ESSENTIAL WHICH SECTOR LEADS?

50. March, 2009 50 A WORD ABOUT EVALUATION

51. March, 2009 51 Strategies / Venues National plan / intersectoral committee Worksites Schools Transportation Policies Recreational Facilities Healthy spaces in urban design Training for teachers and healthcare workers

52. March, 2009 52 Summary of Fundamental PA Promotion Considerations: Physical inactivity is associated with increased risk of many chronic diseases and resultant economic consequences. Risks decrease with increases in physical activity Other benefits accrue from PA. Globally, and in the Caribbean, there are high levels of physical inactivity as well as chronic diseases. There is evidence that public health efforts can increase physical activity. PA interventions can be cost effective. PA initiatives are synergistic with other public health efforts.

53. March, 2009 53 FUNDING PROPOSAL

54. March, 2009 54 FUNDING PROPOSAL 1. Mission Statement 2. General Description of Proposed Program Purpose Benefit to the community $$$ 3. Program Detail Goals/Objectives Activities Collaboration Staffing Evaluation Start/end dates 4. Budget Summary and Narrative

55. March, 2009 55 Thank You