What does it look like for individuals - Iowa



Nutrition and Physical Activity to Prevent Obesity Symposium Results

Community

What does it look like for individuals? What are they experiencing? (Vision) (asterisks indicate duplicate entries)

Symposium Priorities

• Businesses provide incentives

• Walkable, accessible communities

• Disease not the norm

INDIVIDUAL/GROUP IDEAS

Attitudes/Perceptions

➢ Group Compilations

• Exercise and activity as a reward

• More family time

• Families are knowledgeable in nutrition and exercise

• People are vibrant, creative, empowered, informed

• Less rushed pace of life – more balance between work and life

• More family interaction

➢ Individual Compilations

• I can, would enjoy, and will safely walk, bike, or take public transit to my friends home, to my places of entertainment, to do my regular tasks such as grocery shopping, other shopping

• I will not complain as frequently about lack of parking or gas prices because I won’t be as dependant on using a car

• People have time to exercise

• People are more aware of use of fat ingredients in their traditional recipes

• Walking and biking are positive emotional experiences

• More quality family time**

• Family fun time/activity

• People learning sound health and nutrition fitness principles

• Parents encouraged to play with children

• Kinder – not so stressed out because now they walk, etc

• Not so isolated

• People are happier and there is less violence in our schools

• More family interaction

• Life is less frantically paced and balance between work and home

• Better time managements

• Better peer relationships

• It’s fun to ride a bike for short trips

• More energy and positive attitudes

• Multi generational activities/parks

• Less divorce rates

• People more aware of world around them

• Accessible – know opportunities

• Cultural

• More family interaction

• Fun/enjoyment

• Increased quality of life

• Relationships – families , neighborhoods, workplaces, schools are vibrant

• Safe

• Wellness is the norm

• A life of reward with looking forward to go for a long walk to start a day with a smile

• People encouraging each other to eat health and exercise

• X person works in office as department club manager from 8-5. However she doesn’t have time to do exercise. Her employer offered to all employees sport training and 30 minutes before leaving work for everyone to do exercise. Those who exercise 3 times a week in their log books received 5 more days vacation annually. As her children the school has 30 min morning and 2- 30min afternoon to play and at home they have computer games that require movement and school lunch meals are 50 or $1 less is students eat salad or fruit. This system worked on restaurants and becomes a policy incentive

• I am a middle aged woman with 2 teenagers who are able to got o school events with other middle ages women who have a BMI less than 25. We are able to use the school facilities between 6am and 8pm walk, run on the track. My kids have milk and healthy snacks the can purchase at school .They have nutritious lunches no open campuses. They have intramurals or encouraged non “jocks’ to stay active and physically fit.

• Size 10-12 feel good about themselves

• Capable of doing more

• Healthy people*

• People doing more for themselves

• Not afraid to get old because they’ve taken better care of bodies

• People are vibrant, empowered, creative, appreciate positive efforts, better at informed decision making

• Decreased emphasis on weight

• Families slowing down pace

• People are managing stress well

Physical Activity

➢ Group Compilations

• Increased leisure/vacation time taken

• More non-competitive group athletic activities

• Walking and biking to work/play/school

• More people active in athletics

• Physical activity opportunities for all ages

• Decrease screen time to 1 hour per day

• Waking, biking to schools

• Physical activity is a priority

• More people walking because it is safe

➢ Individual Compilations

• People are walking or biking on a daily basis for work, play, errands, school, etc

• More people are walking places – safe places to walk*

• Exercise is second nature

• People would know their opportunities for increasing physical activity

• More “fit” bodies

• Less TV and more activity

• Families outside during all seasons and enjoying fitness activities – TVs off 1 hour per day

• Older adults gather to walk, bike, etc.

• Emphasis on PA as a priority

• It will be second nature to do exercise

• Fun activity and PE every day in school for every child

• Exercise before breakfast

• Adults have choices/places to leave children while they are exercising

• Use stairs for all events

• Exercise is the norm

• Fitness and exercise – utilize 24hour fitness facilities, post work shifts to minimize stress and weight loss

• Physical activity is a priority

• Walking is not punishment/video and TV not a reward

• Sports not just for jocks

• TV come with sensor that says “Time to turn TV off and go play”

• Families participating together in physical activities outdoor

• Video games and TVs only allow children to play an allotted time per day

• Increased physical movement and people of all ages feel good about moving

• Families are working out and playing together outside and inside

• It becomes the status to walk

• It’s easy and fun to exercise and there are lots of options

Media

➢ Group Compilations

• Common health messages by all entities

➢ Individual Compilations

• Consistent messages from pediatricians to geriatric clinics

• Consistent messages begin in peds clinics, schools, elderly

• Food signs and advertisements are not in your face 24/7

• Common message on health (reduced mixed messages)

• Media, conversation, information based on health, one common message

• Messages are consistent –reinforcing

• When media reports wellness etc industry always gives consistent messages

Nutrition/Foods

➢ Group Compilations

• Water is our main beverage

• Healthy food looked at as a reward

• Fast food restaurants will have healthy menus

• Foods without chemical additives

• Healthy fast foods options that are affordable

• People eating well/size tolerance

• People like to eat vegetables/ not just have to eat them

• Utilize farmers market at WIC clinic

• Access to health foods in all settings – school, church, social, work

• Decreased fast food establishments

➢ Individual Compilations

• I know other people who cook

• Individuals can find many healthy eating restaurants free of smoke and full of healthy cooked item at a reasonable price

• Soda expensive, milk cheap

• Healthy fast food options

• Stores offering reasonably priced fresh produce

• Fast food chains offer fruits and veggies as their menus

• Restaurants offer nutritious choices for meals

• Families are enjoying fresh fruits and veggies

• Fresh fruit and veggies for all snacks

• Many options available in communities for physical =fitness for all ages

• Citizens take responsibility for eating healthy foods and exercising

• Grocery stores offer cooking classes and how to prepare certain foods

• People like and eat fruits and veggies

• Better understanding of healthy cooking

• I can buy “small” sized food and drink not just tall/med/grande/large

• All the food in Hy-Vee is in the “health market” portion of the store

• Fewer fast food restaurants and more activity and farmer’s markets and healthy eating places

• Availability of healthy food

• Decrease fast food est.

• Eat available nutritional food with less chemical induced products

• Have better choices at any time or place for physical activity and nutritional choices less processed foods

• Healthier “fast food”

• School lunches will be lower fat and good variety

• All healthy foods in vending machines at schools

• Healthier foods easily available at restaurants , stores, meetings, etc – expected not the exception

• Meals with fruits and veggies

• Employers and students look for healthy food options from worksite and school vending cafeteria food services

• Restaurants with normal portions

• Water as a main beverage*

• Spend time in family meals

• Increased price of less healthy foods, and decrease price of healthy choices

• Children and adults have access to nutritionally sounds food choices at a reasonable cost

• Access to healthy food choices in all settings ie. School ,social events, worship etc

• Decreased fast food establishments

• Snacks are chosen wisely

• Fast food is a convenience, not a treat

• Large portions are not better

• Kids receive healthy snacks in school as well as bank, grocery stores

• Fast food is no longer unhealthy food

• Access to sustainable edible landscapes

• No food insecurity

• No fast food

• Cherish home cooked meals

• Smaller portions

• Increased normal eating

• Decreased good food/bad food mentality

• Enjoy a wide variety of foods

• Increased accessibility to healthy foods

• People cooking more instead of eating out

• Restaurants have healthier choices, smaller portions

• Healthy balanced diets

• Smaller servings

• Food isn’t the cure for emotional issues for those served and those serving

• Families sharing a nutritious meal together at least once daily

• Water for breakfast, fresh fruit at meals

• McDonalds menu has changed

• Food not use for emotional issues

• Families eat together

• Fast food restaurants provide health menus that are good for you

• Its affordable to get health food

• People are creative about preparing healthy meals

• Fresh fruits and vegetable vending machines in school and worksites instead of candy and pop

• Increased priced high calorie foods and decreased low calorie foods

• Families preparing meals from fresh fruits and vegetables, whole grains

• Decreased fast food opportunities in all towns/ cities

• Foods stamps selective to raw foods with a balance of all food groups

Community

➢ Group Compilations

• Architecture of community reflects more sociability

• Communities recognized for health initiatives

• Safer communities

• Communities built to have complete streets, sidewalks, bike paths, etc

• Available and easily accessed activity centers

• Easy access to trails

• Neighborhood parks and child care in all subdivisions

• Clean, safe and handicap accessible integrated playgrounds

• People are vibrant, creative, empowered, informed

• Improved access to nutrition and activity

• Day care for walkers/exercise groups

• Business, citizens, schools, healthcare – working, coordinating, and pooling or resources to build a culture of health in their community

• Healthy communities which support activity and healthy eating at parks, schools, business, etc.

• Revitalize downtowns for walkability and community needs

• Transportation to physical activity events for special populations

• Walkable communities with access to school, groceries, church, etc.

• People experiencing a greater sense of community

➢ Individual Compilations

• Trails and natural areas are within easy access to all Iowans

• Connected trails

• Climbing walls

• Water experiences

• Increased vacations

• “Fun clubs’ for youth encourage participation in sports and activities in friendly un-competitive atmosphere

• Support for activity and play throughout neighborhoods (safe)

• Knowledge of available resources within community to address health concerns

• Autos not used to trips less than 3 miles (other than work)- disincentive for short distance auto trips

• Affordable recreation and fitness facilities for all

• People have easy access to biking/hiking trails and parks

• Bus and com organizations are working with schools and families

• Resources are pooled within constraints of funding streams

• smoke free environments

• community partners working together

• Increased community interactions

• Neighborhood is safe to play and walk in

• More seniors living at home

• Kids outside playing more riding/walking to work

• Individual only use family care to go on out of town trips

• People use public transportation that is now in most of the small towns in Iowa. People also walk and bike more. There are safe bike and walk paths in most communities.

• Fitness center/ parks are rewards

• Transportation is not a sedentary6 activity – even if you drive you own vehicle you can still get physical activity

• Many walking trails that connect the town can be found with stations to exercise strategically placed

• Increased number of community centers and trails

• Daycare at parks and pools and after school

• Opportunities for safe physical activity will be within reasonable distance of all homes

• Supportive community values

• Farmer’s market at our WIC clinics

• Bike paths to work

• Fast food = good food

• Walk/bike were going

• Fitness center more accessible

• More inclusive and respectful society

• Better community cohesion and cooperation

• Evenings you can see families and extended families in walking trails

• Easy access to facilities for physical activity – esp in winter cold and summer heat ie. Persons with disabilities

• Convenient transportation to physical activity facilities esp for those who can’t drive and esp in rural areas not funded with add’l $$ but by existing available transportation such as churches org vans, etc.

• Sidewalks – design*

• Healthier communities for all age groups

• Streets are safe and more people on them

• People are walking and biking to work and school

• People experiencing a greater sense of community

• Transportation for special population to access pa

• Safe/completed walking biking trails*

• Clean update safe playgrounds

• Cleaner environment in which to breath or observe

• Experiencing more community and people come together to get things accomplished

• Use of less pesticides

• Local availability improved – market driven access to F/V

• Safe trails for walking/jogging

• Adults and children are physically active in their communities

• More people walking because it is safe

• Revitalize downtown area for walkability and community needs

• Walkable communities design, walkable access to school, workshops, etc

• Improved social interaction

• Better use of health clubs

• Increased access to resources and facilities

• Community centers with up-to-date equipments indoor and outdoor

• New communities with planned green-space, sidewalks

• Redesign of older communities*

• Expanded mass transit linking neighborhoods to areas of recreation

• Increased access to f/v for low-income , WIC, homeless, food basket

• Wide outside lanes – bike lanes

• Bike parking at work and schools

• Easy access to bike and hike ( safe for families and children)

• It’s fun to ride a bike for transportation

• Comprehension maps

• City engineers view transportation as more than just cars

• Recognition of communities for health improvements more family time

• Community responsibility

• Citizens take responsibility for health

• Incentives for alternative transportation

• Decreased suburban sprawl

• Increased local (mom and pop) small businesses

• Increased tourism, activity, health, and decreased obesity

• Community stakeholders identify and work from a collaborative plan to monitor, evaluate, sustain programs and services (turf issues have been minimized) and supplication of services eliminated

• Community values health and wellness rather than rushed pace of life

• Trails connecting communities

• Have day cares throughout communities at various activity-promoting places (parks and pools)

• Access to low price fruits and veggies

• More activity in community

• Support in community for individuals, resources, assistance

• Families only have 1 or none TV’s, gameboys, etc. and watch/playing with it is limited to 1-2 times a week is a designated room

• Children are playing outside again, riding bike ins a safe supportive neighborhood

• Parents get involved in neighborhood, get together where activities are planned ie. Softball, etc. – neighborhood is home again

• Community promotes championships and contests involving healthy practices

• People can afford fitness machines in the market

• Communities are working together to foster healthier eating and physical activity habits versus one company doing this, another that, schools something else, others nothing

• Community members are engaged and supported one another

• All businesses provide awards for employees who practice wellness behaviors – days off, reduce insurance, recognition

• Engineers think and plan for multiple modes of transportation, design manners

• City government views health aspects of planning as important as safety and welfare

• Communities encourage socialization through common spaces

• There are recognition programs for communities that promote walkable communities

Workplace sites

➢ Group Compilations

• Business provides incentives for wellness practices

• Worksite wellness 24/7

• Incentive to live near work

➢ Individual Compilations

• Large companies promoting wellness within the company (worksite wellness) and within the community (local activities and media)

• Shorter workday to include more time for exercise and relaxation

• In workplaces start times, breaks, and flexible lunch times allow staff to make exercise part of workday.

• Office and computer work stations are more mobile and offer an opportunity to jog, ride or work out while reading e-mail

• Balance between work and home

• Exercise breaks at work

• People have found a balance between work and home – life is less frantically paced – people have time they can spend in healthy ways

• Adults in workplace have flexible schedules allowing them to be home when child comes home

• Physical activity at worksite – not necessarily job related

• Worksites with facilities to be active at work

• Parents allowed to work out at the workplace and also received healthier food in work environment

• Work out on paid time

• “workout breaks” instead of smoke breaks*

• Shower facilities at work

• Intra-agency connectedness

• Parks and rec centers are the hubs of community. they are now connected to each other and no one has to walk more than 204 blocks to get on a pedestrian friendly/priorities route

• Employees who are mentally healthy

• Incentives to living near work

• Worksite wellness center available 24/7 and promote use

• Parents working with time for personal PA built into workday

• Increased vacation time/leisure/family

• Less work time lost because of illness

• Higher salaries due to health insurance costs

• Employers offer benefit packages to employees who complete wellness activities, discount insurance

• Employers walk around community in persona rather than e-mail/call

• Support in worksite to be more active – on-site facilities flex time

• Lunch time at work means taking a break to eat a healthy lunch and take a walk or other exercise. It is part of the work culture

• Work and life are balanced

School sites

➢ Group Compilations

• Daily physical education

• Schools focused on physical activity as a priority – less on competitive sports

• Mandatory daily P.E. and healthier meals in school

• More P.E. classes in schools

• Physical education in school curriculum

➢ Individual Compilations

• There will be time set aside at all work and school sites for either opportunity for physical activity or stress reduction

• Schools increase PE time

• Schools encourage and award students for their effort to reduce weight

• Children with time for free play and PA skills built into school day

• Majority of children walk to school or ride bikes.

• Corporations give incentives for people to walk/bike or live close to work

• Education immerses kids in a “healthy rich” environment/ lesson plans

• PE offered 5 days a week and school offers only healthy snacks and beverages

• Cafeterias and work setting vending machines with healthy food and beverage choices that are cheaper than junk food

• School lunches less dependant on a-la cart and vending

• Better more important PE programs

• Mandatory PE***

• No year round school

• PE in school curriculum

• PE is not longer a taboo but focusing on a healthy lifestyle in school

• Increased education outcomes

• Schools increase PE time

• Bike racks on buses

• Better healthier foods in schools

• Sports are not so expensive that any child can join a team with the right equipment

• Schools make PE mandatory daily, for all students/faculty participates too.

• Every child has daily PE (fun and lifelong)

• Healthy meals in schools

Health Care

➢ Group Compilations

• Disease not the norm

➢ Individual Compilations

• Fewer chronic illnesses*

• Older people whoa re independent

• Well care replaces health care

• More babies are breastfed

• Focus on health not just weight

• Benefit premium discounts for maintaining health

• Emphasis on prevention

• Decreased health care cost because increased in wellness programs

• Decreased disease problems in schools, etc

• Low income hh has equal access to fresh fruits and veggies

• Low/no cost healthcare services – preventative services covered

• Improved physical and mental health

• Longer life span

• Healthier population leading to less illness and less stressful environment

• Less drug use

• Overweight and obesity rates among adults have dropped by 50% in the last 20 years and in children

• Persons with disabilities are mainstreamed into everyday life

• Participation in relaxation and meditation rooms

• Spirituality issues addressed in workplace – combat stress – increased purpose, increased fitness

• Disease is not the norm – BP, cholesterol, diabetes, are not “OK”

• Continuum of services – availability to individuals*

• Less depression and stress

• Decrease in number of depressed people

• Less ADD in children

• Lower health costs

• Obesity levels in schools and communities under 5% of population

• Increased body image

• Decreased depression, mental well-being

• Decrease eating disorders

• Less disease and chronic pain – better able to work and be productive; les burden on families to care for sick

• Less homecare services

• Public health more preventative education

• Fewer children with weight control concerns- more bike trails, soccer fields, family activities, walking trails

• WIC nutrition education conducted at age-appropriate intervals – not the way it is now, all in one setting – integrate within well child exams

Cost/Money

➢ Group Compilations

➢ Individual Compilations

• Affordable

• Monetary incentives /insurance premium price breaks for exercising

• Lower insurance costs

What partnerships and collaborations (that don’t exist today) took place to get there? (Action Steps)

Symposium Priorities

• Public policy for walkable communities

• Collaboration: insurance, employers & public health

• Community collaboration: media, schools, businesses, faith

INDIVIDUAL/GROUP IDEAS

Education

➢ Group Compilations

• Increase educational efforts and provide resources with respect to wellness (improve physical/mental health and wellness campaigns)

• Educate collaborative team in health and every size approach [4]

➢ Individual Compilations

• Men can cook and take care of children too

• Educate residents of the facilities and areas available

• Educate on need to make it a routine in people lives

• Adequate resources to educate and provide tools needed to positively reinforce what was learned, recognized and rewarded

• Educate people about health awareness

• Health educators at markets and grocery stores

• Data to support healthy eating/purchasing by consumers and drives supply of health food choices

• Educate community through increased media partnerships

• Educate/collaboration among older adults, disabled individuals, meddle aged, adolescents, children, pre-school, professionals, and representatives

• Educate youth on how to eat right and be physically actives

• Educate on ROI – exercise and fitness and what active employees means to our bottom line

• Learning supported cross departmentally

• Educate dieticians and physicians

• Educate parents on healthy choices

• Public is educated on how to take care of themselves rather than focusing on how to fix themselves

• As a community we study these communities or cultures that aren’t obese what did we do before TV and computers

• Educate families about stress reduction and give a list of interventions to do so it is a common household theme

• Educate on reduced TV time

• Educate on HAES (health at every size) approach and develop program –media, schools, worksite

• Teach classes on how to eat properly and learn more about vitamins/minerals and how to properly prepare and cook foods

• Educate – planning officials, transportation eng, city councils, planning and zoning comm., design for healthy lifestyles as planning policy

Physical Activity

➢ Group Compilations

➢ Individual Compilations

• Physical activity and community partnerships between schools, community, public, resources

• Environment created that promotes physical activity – bike trails, walking paths, community rec facilities, mandated P.E., incentive for physical activity, limited TV access

• P.E. becomes part of all curriculum, not just a separate class

• Self propulsion decrease use of fossil fuels and burns calories

• Families and neighborhoods are involved win regular physical activities including walking, biking, and organized sports

• Wellness centers in every business and main street 24/7

• Elevators are for disabled only

Nutrition

➢ Group Compilations

➢ Individual Compilations

• Formulate knowledge on food pyramid

• Lots of water available, bottled from drinking fountains, drinking fountains work consistently

• Pop sold only in 8 oz servings

• Educate on meal planning on all budgets

• More organic and less processed foods available

• Locally grown and reasonably priced produce used in schools

• What “bottom line” means for nutrition and buy in by all dept leads

• Access to healthy foods*

• Nutritional programs streamline

• Create environment that promotes good nutrition – prohibited school vending or regulate school vending options, fast/snack foods are discouraged via pricing/tax policy, social gatherings are not centered around food, healthy food options at school events

• Health food is the standard not the exception

• Head start/preschools/day cares send healthy meal home with families so they don’t go to McDonalds’

• Price decrease and increase availability for fresh fruits and veggies

• Grocers offering economic foods of high nutritional value

• Big changes in supermarket choices

• Increased greenhouses for fresh fruits and veggies – delivered daily

• Schools buy from local grocers

• Families are regularly preparing healthy nutritious foods

Media

➢ Group Compilations

• Consistent educational message will be presented from all entities [2]

➢ Individual Compilations

• All sectors promote the same message

• One message

• Community partners spreading the same messages to the community

• Social marketing campaign – one message – one voice, across all communities

• Educate via media

• Social marketing in conjunction with the media

• Media campaign

• Public health – media – globe, radio, billboards

• A consistent ongoing community messaging campaign implemented using various media/venues

• Messaging resources available to employers/families/students reinforcing messaging

• Consistent health and activity message in the media

• Consistent message form hospitals, businesses, schools, and families

• Consistent message sent from all entities

Community

➢ Group Compilations

• City planning and rural connectedness with health professionals – massive annual meeting among collaborators in the state [5]

• Linkage of resources and ownership of communities and families to common vision and single message [6]

• Community and counties will share resources [1]

• Community collaborative efforts: [23]

o Involves media, schools, businesses, faith communities

o Decrease screen time

o Build a more sound environment on all levels

• Link community resources relate to physical activity

➢ Individual Compilations

• Involve community planners

• One reference center

• Local traffic and transportation

• Environmentally sound community

• Created an environment of mutual support in reaching goals among congregants and other denominations

• Trails, greenways and open spaces are created as part of the basic infrastructure of a community, neighborhood, or subdivision

• Developers, engineers, and planners are working together to create and promote these concepts

• Develop local wellness programs

• Created livable walkable communities with a sense of community

• Neighborhoods with access to trails, activities, community gardens, and green spaces

• City sidewalk repair, adequate lighting

• Places to walk

• Paths and safer ways to walk or bike

• Permission to time out during work day

• Business/community/neighborhood collaboration encourages recreation during the workday

• Trails, structure, safe way to transport self without a care

• City planners work with grocers, educators, in the school, low-income service organization (food back, WIC, FAP)

• Communities advocate for health

• Free fitness centers

• Creation of safe walking trails – organizations would donate a block of the path and it would be named after them

• Created an environment with a universal design – designed to serve all, to be available to/used by all

• Bike paths everywhere

• Workplace and the Y/ city recreation with incentives

• Well designed safe walking community and well integrated collaborative community*

• Changed areas and trail systems

• More parks that reflect diversity – diversity awareness

• Sidewalks and city planners

• Require fitness in site designs

• Community leaders educate in social environment about food and exercise

• Networking, brainstorming among representatives throughout community

• Affordable resources

• Community wide Iowans Fit for Life partnerships – exist and meet to plan/prioritize and keep individual efforts energized – common link – ID

• Ongoing communication

• Environmental support

• Malls have check points that walkers get stamped at various stores and earn awards and prizes

• Create environments that make it safe and east to be active

• County conservation board, city parks, state parks

• Retail and restaurant support with medical

• Availability of bike paths, sidewalks, crosswalks, and accessibility and promotion – public aware

• Community design – planners, council, public, facilities planning, includes special needs, elderly

• City will collaborate with businesses to help build and market trails for families

• Linking community resources with in the community (open schools for activities)

• Communities created a health plan and health was a priority when planning new development areas

• County building permits required increased environments that supports health living, trails, sidewalks

• Create environments that promote alternative modes of transport

• Promote community wide events that promote non-auto transport

• Faith community and employers found a common vision of wanting to enhance “quality of life” for their employees (quality of life might mean having less money, but more time)

• Building an environment to nurture healthy lifestyles from prenatal to seniors

• Working collaboratively with all resources

Health Care

➢ Group Compilations

• Wellcare replaces healthcare, public knows how to take care of themselves [6]

• Implement a health system that is focused on holistic (mind, body, spirit), community-oriented, and mutually supportive living [7]

• Require health and wellness impact assessments in review of new and existing developments (as well as for whole communities) [4]

➢ Individual Compilations

• Health and wellness impact rating criteria on new subdivisions. What will it cost the community (from health perspective) to construct new subdivision

• Sharing of health facilities

• Engage insurance companies

• Incentives and reduced insurance premiums paid time to exercise

• Better incentives on insurance policies for those healthy people

• Health care organization promote benefits of p.a. and proper nutrition outside of medical/physical health

• $$ for pathways (policy changes)

• Partner with insurance industry to demonstrate carrying out our actions will lower health cost

• Visionary policy makers for improved environmental health changes

• Create a “health czar”??

• Health care not solely short term profit driven due to federal reality we all need health care

• Preventative health care – like WIC

• Institutaions more culturally competent to help diverse communities

• Focus on health, not just weight

• RD, PT, Physician, counselors, coaches, all working toward common goal for health of individual

• Health incentives linked to benefits/HC – true measures

• Insurance collaboration – incentives for employers to implement and create healthier worksites , e.g. decreased premiums coverage of preventative health

• Hospitals and Y’s work together to help rehab and educate individuals about better health

• Collaboration with insurance companies, employers, and public health

• Health organizations promote transportation issues

• Insurance companies valuing healthy habits by lowering premium for non-smokers, etc.

Worksite

➢ Group Compilations

• Corporate efforts: [10]

o Build wellness committees within institution

o Wellness coordinator

o Focus on health promotion

➢ Individual Compilations

• Places of employment will see benefits of increased productivity of staff if physical activity breaks allowed to happen

• Create environments supportive to health and work

• Workforces allow time for workout and exercise because it’s good business

• Employers more flexible with exercise, and breastfeeding

• Incentives for exercising in workplace

• Educate employers that well employees are worthy investing in (initiate employee wellness programs)

• Create work settings supportive of healthy behaviors

• Worksite decision-makers, local extension, public and private health providers have on-going relationship to design, implement, and evaluate local nutrition and physical activity projects

• Employers help with balance by offering treats to go, flexible on release time for fitness

• Incentives for companies and small businesses to protect employee time for physical activity

Schools setting

➢ Group Compilations

• Create knowledge for high schools graduates to have physical activity for life

• Headstart, preschool, and daycare provide healthy meals to take home to families

• Need changes in school system that collaborate school and family

➢ Individual Compilations

• School classes emphasize lifelong fitness

• Health department with education

• Policy for -physical activity as important as academics in schools

• Create environments that are conducive to learning healthy habits in schools

• Increase health professionals in schools system

• Create knowledge and ability for high school graduates to have a physical activity plan for life

• School policy for activity and nutrition

• Mandatory PE

• Schools will work with local food distributors for economical and nutritious foods, school will not need to rely on vending machines for revenue

• Schools will work with communities to make leisure activities life long

• Increased physical education in schools

• School personnel, IA college, public health, ISU, parents, media

• Opening gym at school for community members to use

• Schools work with depts. To improve snacks, PE

• Schools and parents

• School districts and Y’s will work together to promote and implement fun programs for youth and create family days that promote healthy activities

• Schools including pre-schools, focus on activity, nutrition, providing alternatives to screen time

• Engineering colleges educate students on different design principles that provide for bike and ped movements

• Schools (health and administration officials) have on-going relationship with local public and private health providers to design , implement, and evaluate local nutrition and physical activity projects

• Longitudinal educational efforts from prenatal to early childhood, schools, community based continuing education

• Local school policies established to ensure availability of healthy food options – local businesses capitalized upon

• Curriculum enhanced to incorporate physical activity and nutrition

• Schools offer PE classes on daily basis, not penalizing overweight children

Government/State/Business

➢ Group Compilations

• Aggressive policies that address school and work [2]

• Public and private blending [16]

o Local policy development for “built environment” – easy to walk and bike

o School policy changes for nutrition and activity

o Media campaign

• Public and organizational policy will change to reflect healthier lifestyles [1]

➢ Individual Compilations

• Business had knowledge and resources to guide employees to wellness

• Business collaborate with wellness programs, insurance companies

• Collaboration with state and local governments for reimbursement or tax write-offs

• Government and local donations

• Cities and businesses work together

• Work with lawmakers to make Iowa smoke-free

• Consumer influences/ business

• City councils have health person

• Government with consumers and business

• Implement a “fat tax” on appropriate foods, this would impact manufacturers and consumers

• We influenced public policy by exhilarating need and showing political outcomes

• Business and schools

• A state connected by an accessible trail system for all age groups

• Counties that integrate social/urban/rural/natural resource based (actuaries)

• City leaders/business meet regularly to insure community design

• Restaurant associations work together

• Low-income families have coupons/vouchers to receive the healthy foods at FF restaurants at discounted prices

• Impacted public policy involving city, county, and state input and changes regarding business, industry, education, public places, governmental assistance

• State puts together regional coalitions to take their initiative just like BT regions meet quarterly/state consultants to help facilitate

• State helped workers to take care of their children with no cost or low cost

• Training and education for government officials about health aspects and needs

• Affect policy changes

• State and federal public programs- health and social service bureau’s work with private providers to design, projects – fed and state program flexible to local needs

• Legislation around school and nutrition and PE

• Local government implement policies to include bikes/pedestrians

• Flexible credit spending to cover cost of gym memberships

• Implemented science based program and evaluation to consistently measure effectiveness – state eval specialist used, universities, etc.

• DOT funded planning and implementation of trails, value of trails is appreciated

• DOT funded planning and implement of destinations – planning involved collaboration between Main St. merchants, city planners, landscape architects

• Local businesses/ industry offer wellness programs to employees

• Organization policies

• Large grocers into smaller communities, satellite stores within walking distances

• Businesses, health care, insurance have a strong partnership

• Organizational policy allows for fitness time during working hours

Key Partnerships

➢ Group Compilations

• Collaborate between insurance companies, employers, and public health [29]

• Networking and partnerships inclusive of families, business, schools, hospitals, etc.

➢ Individual Compilations

• Deliberately include diverse groups, including those who are not at the table; those who don’t want to come to the table and why; racial, ethnic, and language diversity; age, youth as well; urban and rural suburban, other subpopulations

• Identified connections between physical and spiritual

• Highly effective leaders painted a picture of future and how we might get there

• Paint picture by management support and approval of usage of fitness, whenever they want to exercise

• Management support and utilizations by management

• We created environments that are supportive and are motivational

• Role models- gained buy-in by celebrities

• Regimalize? to prevent fragmentation, sharing resources

• Point of greatest linkage / greatest impact

• Private and public blending

• Paradigm shift in thought process of individuals and organizations

What barriers are keeping this vision from becoming a reality? (Barriers)

Symposium Priorities

• Lack of collaboration

• Lack of awareness

• Funding

INDIVIDUAL/GROUP IDEAS

Attitudes/Perceptions

➢ Group Compilations

• People experiencing a greater sense of community

• Too comfortable life style

• Society of instant gratification

• Turf issues, politics, personal agendas

• Attitudes, i.e. teachers realize physical activity as important part of learning process- beyond ‘academics’

• Traditionalists

• Partisan politics

• Opposition – special interests

• Territorialists

• What’s in it for me?

• Turf issues

• Culture – change is 5 step event

• High pace-high demand environment

➢ Individual Compilations

• Turf issues************

• Territorialism

• Silos and turf issues (this is my area, not our area to overlap, etc)

• Top dogs look at short term not long term

• Instant gratification***

• Attitudes/beliefs*******

• Short term vs long term (need supper quick, long term effects)

• Lack of visionary policy makers*

• History- way we’ve always done it

• Lack of communication between entities that play a part in making it happen

• Selfish use of resources/share resources(cafeteria/gym in schools open to all citizen)

• Societal norms

• Greed and profit*

• “not invented here” paralysis

• Philosophical difference

• Victim mentality

• Lack of “common good” notions

• People too accepting of the way life is now

• What’s in it for me

• Lack of role model

• Lack of awareness of benefits of collaboration**

• Ignorance

• Territorialism

• Bucking traditions

• Need for “quick fix”

• Lack willingness to change

• Buy-in

• “It’s mine” attitude in community

• Traditionalists

• Capitalism

• Lack of volunteers

• Visionary leaders

• Culture views

• Population doesn’t believe that lifestyles changes of necessary

• No mechanism to share ideas*

Personal barriers

➢ Group Compilations

• More family interaction

• Incentive to live near work

• Worksite wellness 24/7

• Lack of awareness

• Lack of role models

• Drugs and poverty

• Political will

• Lack of understanding of root cause of health issues (not holistic approach)

• Working in isolation

• Money/greed/profit

➢ Individual Compilations

• Personal agendas*

• Language barriers***

• Lack of motivation in people who have a hard time seeing the good in living a healthy lifestyle

• Peer pressure

• Lack of time******

• Working in isolation*

• Quality of life vs essential services

• Priorities*

• Overwhelmed with other projects

• Lack of support

• 2 parents working

• Collaboration is hard and largely goes unrewarded

• Lack of recognition (for job well done)**

• Some people require incentives to make change

• Cultural issues, can also be an asset

• High paced and high demand environment*

• Behavior changes

• Personal stages of change

• Self is low priority

• Too “busy”

• Attitudes***

Education

➢ Group Compilations

• Physical education in school curriculum

• Not just ‘thin’ people that need education

➢ Individual Compilations

• Science is boring

• Lack of education/ awareness*****

• People don’t understand the benefits of collaborating

• Inaccurate education

• Education – skills, helmets

• General knowledge and education for public

• Understanding of root causes

• Everyone wants more and more done through schools

• 5 steps of change

• School boards opening facilities to public

• Liability*

• Educators need to realize that academics isn’t only studying – physical activity is good

Nutrition/Foods

➢ Group Compilations

• Decreased fast food establishments

• Fast food

• People not cooking

➢ Individual Compilations

• Portion sizes

• Processed foods and fast food

• Fast food

• People not cooking

Physical Activity

➢ Group Compilations

• Car hours

• TV

• Physical activity is a priority

➢ Individual Compilations

• Exposure to various sports that are noncompetitive

• Wellness programs – investment into wellness by both: 15 min employer and 15 min employee

Media

➢ Group Compilations

• Media – too much information

• Advertising

• Media (can be an asset)

➢ Individual Compilations

• Advertising*

• Mixed messages*

• Media- can also be an asset

• Negative influence of media

• Marketing campaigns for other side*

Community

➢ Group Compilations

• Emphasis on new development

• Poor built environment

• Revitalize downtowns for walkability and community needs

• Access to health foods in all settings – school, church, social, work

• Transportation to physical activity events for special populations

• Walkable communities with access to school, groceries, church, etc.

• More people walking because it is safe

• Lack of resources – buy-in

• Lack of collaborations among city planning and health professionals

• Access

➢ Individual Compilations

• Community planning approach- only programs while the grant is available

• Community safety issues

• Not a community priority

• Liability issues

• Lack of community feeling/ responsibility to neighbors

• Access

• Safety issues**

• Community safety issues

• Design/infrastructure

• Lacking the “true“ community planning and stakeholder buy in

• No community planning approach, grant ends, program ends

• Liability issues with sharing transportation options

• Poverty *

• Other community priorities (roads, school)

• Drugs*

• Motivation

• City planner and health professionals don’t collaborate

• Commitment

• Opposition from special interest groups – fast food, automobiles

• Developers and engineers that are not held accountable for their unhealthy subdivision design

• Men (mainly) in the local public works and country engineering depts. That refuse to build complete and accessible streets for al modes of transportation

• Lack of communication and awareness between trail developers and health and wellness professionals, what they each do, how they can help each other, don’t know each other

• Poor built environment

• Emphasis on new development

• Car hours

Business/Government

➢ Group Compilations

• Economics

• Politics

• Management – decreased knowledge and support

• Private and public insurance policy

• Economics

• Lack of support from employers

➢ Individual Compilations

• Big business

• Lack of communication with local, state governments

• Capitalism*

• Lack of business/employers to support healthy activities

• Politics**

• Too much legislation

• Political support

• Lack of political will*

• Partisan politics*

• Economics*

• Lawmakers

• Not priority with policy makers

• Too many directions to go, we need a few statewide goals - focus

• Lack of management support and knowledge*

Health Care

➢ Group Compilations

• Insurance policies

➢ Individual Compilations

• Addictions

• Insurance premiums

• Institutions not culturally competent

• Private and public insurance companies have control

• Insurance money for prevention

• Insurance doesn’t pay for prevention

• Insurance $$ not in right place, will pay for gastric bypass surgery, but not for weight watchers

• Medical providers can’t be afraid to use “obese” diagnosis

Cost/Money

➢ Group Compilations

• Funding

• Money/resources

• Security

• Liability issues

• Finances

➢ Individual Compilations

• Money******************

• Lack of funding****

• Lack of funds in poorer communities

• Funding too competitive, makes turf issues less likely to collaborate

• Financial support

• Money to initiate new community programs

• Have not tapped full range of funding opportunities

• Competing priorities

• policies

• Liability issues related to opening school up for public access

• Insurance companies not lowering rates for physically active companies

• Cost

• Private and public insurance

• Insurance companies*

• Employers fear expense

What partnerships and collaborates need to take place to address these barriers? (Solutions)

Symposium Priorities

• Media campaign: consistent message

• Partnerships between legislators/insurance & communities

• Communities develop common visions & collaboration

• Medical & health service orgs. work together

INDIVIDUAL/GROUP IDEAS

Educational Setting

➢ Group Compilations

• School campaign for improved nutrition and activity [1]

➢ Individual Compilations

• Local education of various organizations to teach or encouragement

• Schools**

• School and community leaders

• Parents

• Schools work with departments to improve snacks, PE

• Educate parents on healthy choices

• Community health education

Government/State Level

➢ Group Compilations

• Grant writers across the state collaborate [1]

• Collaboration between corporation, government and media [1]

• Partnerships between legislators, insurance companies, and community members [25]

• Local focus – local community advisory and intervention [5]

• Long term plan + 5 years (effort) [3]

• Whole spectrum of entities need to share funding, personnel, resources [1]

➢ Individual Compilations

• Elected officials

• Local advisory boards with local/state gov’t regulatory bodies

• Chambers

• Local and state level policy makers

• Policy makers

• Community leaders in partnership with politicians and legislators

• State institutions more involved and more culturally competent

• Legislators, insurance companies, businesses, age groups across the lifespan

• Lawmakers

• Include IDPH in the great places campaign (if it’s not already)

• Work together to apply for grant money

• City councils, local chamber of medical, schools and etc, everyone should be involved

Workplace setting

➢ Group Compilations

➢ Individual Compilations

• Improve workplace flexibility

• Employers

• Commit time and resources

• Address barriers that get in the way

• Provide wellness incentive education in business major degrees as class subject

Media

➢ Group Compilations

• Media campaigns

• Media campaign [1]

• Media campaign – consistent message [32]

• Media involvement

• Everyone will change to positive social marketing in all languages

➢ Individual Compilations

• Everyone will change to positive social marketing from negative in all languages

• Grant writers across the state are unified to assist in necessary govt funding

• Partner with media to “spread the wellness gospel”

• Media should be here today

• Positive social marketing

• Media*****

• Common message/vision

• Talking and sharing

• Communication

• Open sharing

• Role models – nationally sharing the same message

Community

➢ Group Compilations

• Community organizational task force to address concerns

• Community entities have willingness to come together on a common vision and collaboration [24]

• Faith-based organizations

• Community/school/parent collaboration [1]

• Buy-in from all community partners [1]

• Developers, engineers – accountability planner [6]

• Collaboration between agencies who work with all groups

• Need to get everybody pulling the same cart [22]

o Insurance companies

o DOT

o Farm Bureau

o Motivation and communication

➢ Individual Compilations

• DOT, farm bureau

• Motivation and communication

• Faith based organization

• School and day care systems

• Community organizations participate in a task force to address the concerns

• Designers (landscape arch) need to talk to health professionals and service (YMCA) and medical need to all be on same page

• Involve ISU extension as a backbone group as they have statewide network in place to help facilitate community change

• Collaborate between agencies who aork with all age groups of individuals in the community to work together when it comes to exercise and nutrition

• Collaboration between corporation and companies and the government- incentives for the promotions of healthier foods (include media)

• Everyone needs to be involved

• Local coalitions to support healthy families – all partners, business, civic, faith-based providers

• Community network

• Community development

• Local advisory groups

• Conservationists and wellness professionals could work together to publich and distribute trail guides, host walking and biking events, etc

• Require local coalitions with recommended list of entities and required minimum – before can qualify for $$

• Businesses

• Chambers

• Association of business

• Public health providers need to include private health providers in assessment, design implement, and evaluation of programs – no one knows better the impact of poor life style choices than treatment health providers – integrate prevention with treatment in high risk families

• Organizations and businesses and community working together with a long-term vision

• Extension

• Community activities

• Community developers to build a better city

• Developers and engineers, planners, educators

• Economical developers in partnership with communities

• Buy-in by all factories, businesses, insurance companies

Health Care

➢ Group Compilations

• Medical and health service organizations

➢ Individual Compilations

• Health insurance companies to issues incentives (lower insurance rates if doing healthy workout) It has to be collaboration between workout facilities and ins companies is necessary

• Fitness facilities

• Health care facilities

• Health professionals present at engineers conference

• Spirituality

• Fast food partnership

• Health and mental health organizations and professionals

• Get city officials to promote holistic approach to health

• Exercise professionals

• Holistic collaborations

• Medical and health service organizations

Cost/Money

➢ Group Compilations

• Insurance dollars - collaborative efforts

➢ Individual Compilations

• Regional partners to share funding

• Promote healthy issues as monetary benefit, insurance, employer

• Insurance companies

• Blend public and private funds at point of consumer contact

• Insurance companies with employer to provide breaks on proof of physical activity ( also lower liability of schools insurance for opening facility to public ie weight rooms, pools, etc)

• Insurance companies

• Cost benefit of healthy society

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