Inactivity: What Can Be Done?
Task Force on Community Preventive Services has reviewed interventions
to increase physical activity and identified public health interventions
that work. Their report, Increasing
Physical Activity, was published in MMWR in 2001 and is available
on the Web. The following interventions were recommended (see the report
itself for details):
- two informational
prompts to encourage using stairs;
- three behavioral
and social approaches,
- social support
interventions in community settings (e.g., setting up a buddy
system or contracting with another person to complete specified
limits of physical activity), and
adapted health behavior change; and
- one environmental
and policy approach,
of or enhanced access to places for physical activity combined
with informational outreach activities.
is socially determined. An examination of specific social determinants
might lead us to additional approaches toward the promotion of exercise.
See "upstream causes" link on the right.
interventions designed to increase levels of physical activity vary
in demonstrated effectivenss. CDC's Community
Guide to Preventive Services has summarized their systematic review
of selected population-based interventions.
are some examples of how the "spectrum of prevention" approach
might be applied to improving physical activity in San Francisco.
Level of Spectrum
Influencing Policy and Legislation
San Francisco is working for a safer pedestrian environment.
Has successfully lobbied for increased fines for parking
on sidewalks and is
very active in promoting walking as a healthy activity.
See plans for mobilizing in the
Mission during FY 2004-5, below (Level 6).
Mobilizing Neighborhoods and Communities
Up for Youth provides grants to community groups to improve and expand
out-of-school sports in low-income neighborhoods.
Parks Council is a coalition of neighborhood-based park
groups who are actively involved in improving parks. They
Recreation & Park's Department.
FY 2004-5, the San Francisco Department of Public Health
will be facilitating community
capacity in the Inner Mission to create changes that will make
this neighborhood more conducive to physical activity. The
CDC has found that there is strong evidence supporting this
Fostering Coalitions and Networks
Activity & Nutrition: The Department
of Children, Youth, and Families works with the SF Unified
School District and various City Departments (including
Public Health) to increase physical activity & improve nutrition
among SF youth.
Changing Organizational Practices
Activity & Nutrition: The
inclusion of Body Mass Index (BMI) > 25 on the problem
list of patients' charts might improve communication between
providers and patients.
Promotion of stairway use at 101
Grove Street (SF Dept of Public Health).
website -- see also the links to diet and to obesity.
Promoting Community Education
and health events work on a small scale. Media advocacy (which
requires a newsworthy story) reaches large numbers of people.
The CDC has found that there is strong evidence supporting intense,
highly-visible community-wide campaigns [The
Community Guide] when they are combined with another intervention,
such as increased access to physical activity.
Strengthening Individual Knowledge and Skills
stairway climbing: see Health Canada's interactive
offers weight and lifestyle classes to its members, Ocean Park
Health Center offers Gentle Yoga, the Neighborhood Parks Council
(see level 6) offers Tai Chi in the Parks, WalkSF organizes
interesting weekend walks (follow the "Walk with Us"
link on the left side of the WalkSF
site), and there are many groups that provide regularly scheduled
activities to help San Franciscans become more physically active:
Seniors in Motion, San Francisco Mall Walkers, the Arthritis
Self-Management Program, Newcomers Program's Russian Healthy
Living Program, and others.
has found that there is strong evidence supporting individually
adapted behavior change programs [The
Community Guide] aimed at increasing physical activity.
burden in SF
What can be done?