STEPS TO A HEALTHIER CLARK COUNTY WASHINGTON     2003 - 2008

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Success Story - Walkability Campaign

December 2007

Disease (s): Obesity and Diabetes; physical inactivity risk factor

Sector: Access to Physical Activity/Community Walkability

Objectives:

• To design a walkability awareness campaign that reflects the Clark County community.
• To raise awareness of the principles of walkability amongst the general public and those who have influence over the lifestyle choices of other people (including elected officials and policy makers).
• To develop and provide tools to facilitate applying the principles of walkability into a lifestyle or sphere of influence.
• To support policy work that will lead to healthier residents and a healthier community.

Methodology:
This intervention is based on the socioecological model that recognizes the relationship between the individual and their environment. A community-based team was formed and a contractor was hired to research and design a multi-faceted outreach and education campaign that will launch in January 2008. Campaign tools and messages will be delivered through a variety of channels including web-based tools, print materials, mass media, and group or individual presentations.

Contact Information:
Barbe West
Executive Director, Community Choices
Project Manager, Steps to a Healthier Clark County
1101 Broadway Suite 110
Vancouver, WA 98660

Public Health Issue:

Obesity and Overweight
In 2001 the US Surgeon General reported that an estimated 300,000 preventable deaths per year may be attributable to obesity. For both children and adults, overweight and obesity contribute to greater risk of developing Type 2 diabetes, hypertension, heart disease, stroke, and other health complications.

• Between 1996 and 2005, obesity rates among Clark County adults rose from 1 out of 6 adults to 1 out of 4.
• In 1996 almost half (46%) of Clark County adults were overweight and obese. By 2005, the rate was 62%. Overweight is often a precursor to obesity.
• In both 2004 and 2006, 1 out of 4 8th, 10th and 12th grade high school students reported being overweight or at risk for overweight.

Diabetes
Diabetes is one of the most costly and burdensome chronic diseases of our time and increasing at epidemic proportions.

• Slightly more than one out of twenty adults in Clark County had diabetes in 2005.
• Slightly more than one out of twenty 12th graders reported having diabetes in 2006.

Physical Activity
Physical inactivity is associated with obesity, increased chronic diseases such as diabetes, heart disease and stroke, and increased health care costs.

• In 2003 and 2005, one out of two Clark County adults met the national recommended levels for vigorous or adequate physical activity. (self-reported assessments documented in the Clark County BRFSS)
• In 2004 and 2006, one third of youth in Clark County reported meeting the national recommended level for moderate physical activity. (self-reported assessments documented in Washington Healthy Youth Surveys)
• In 2006, one out of two Clark County sixth graders reported walking or biking near their home or school on three or more days per week. Only one out of four Clark County 12th graders reported walking or biking on three or more days per week.

Intervention:
In January 2007, the leadership within the Steps Initiative called for the creation of a Community Walkability Team. Team members represent all the Steps venues: worksites, community, schools, and health systems. Based on analysis of priorities and best practices, the team subdivided into two groups – the Walkability Awareness Team (WAT) and the Walkability Policy Team. The teams are supported by Steps staff and a contractor. This success story highlights the work of the WAT research, planning, and design of the awareness campaign: Walking – All Reasons, All Seasons .

The WAT shaped their approach to an awareness/outreach campaign by following the best practice described in the Task Force on Community Preventive Services. The Guide to Community Preventive Services: Physical Activity. The best practice calls for engaging the target audience through a multi-faceted outreach campaign that combines community education opportunities, mass media, a call-to-action, and tools to support fulfilling the call-to-action. In addition, the goals of the campaign also align with the Healthy People 2010 goals and the recommendations put forth by the Washington State Nutrition and Physical Activity Policy Leadership Group.

Between February and April 2007, the WAT developed key principles to guide the development of the campaign.

• Promote access to walking through the development of walkable communities. The focus is not on motivating individuals to begin and maintain fitness-oriented walking programs.
• Promote existing tools and education opportunities wherever possible.
• The campaign should reflect Clark County’s look (scenery, environment) and demographics.
• The campaign will align with the Steps initiative with regard to target audience, health issues, and evaluation, and focus on long term system change.

To accomplish these goals, the WAT contracted with JD White to manage the development and design of the campaign. The WAT was responsible for providing content, professional contacts, and guidance to the JD White staff. In August 2007, JD White conducted six community-leader stakeholder interviews to gather input on campaign messages, target audiences, and delivery mechanisms. That same month, JD White and the Steps contractor conducted eight focus groups representing various segments of the community including seniors, Latino, low-income, parents and employees. An interpreter was hired to provide translation for the Latino focus group.

Key findings from the focus groups revealed several differences between segments of our community, but also certain commonalities amongst all focus group participants. The findings include:

• Motivation to walk is fluid. At any one time, a person may be walking for their health, for recreation, or as a means of transportation.
• The number one barrier to walking is the perception of not being safe. Safety concerns include the poor condition of the built environment such as lack of lighting, no sidewalks or sidewalks in need of repair, and being forced to walk too close to moving cars.
• The second and third barriers are long distances between destinations (such as school, work, shopping) and lack of time.
• People generally respond favorably to positive reinforcement and respond negatively to a sense of being lectured or told to do “what is good for them.”

Based on the focus groups and stakeholder interviews, the target population was defined as the middle of a bell curve of health/wellness. Imagining a bell curve, the far left side of the curve represents the most healthy in our community and the far right represent the most unhealthy (including obesity and chronic disease). The campaign does not have the time or resources to meet the unique needs of the far left, or have a large impact on the complicated needs of those on the far right. We believe we can impact the population in the middle of the curve. The middle of the curve represents people who are typically 10-20 pounds overweight and relatively healthy otherwise. They are often employed (both blue and white collar), parents, business owners/employers, have a sense that they can impact change in their own lives, and have some degree of influence in the lives of those around them. Within the middle of the curve, we will aim our efforts at families, employers, and policy makers (including elected officials). Within these three larger but defined categories, messages and tools were tailored to reach adults, youth, schools, workplaces, Latinos, seniors, and local and regional policy or decision makers.

The campaign name Walking – All Reasons, All Seasons reflects the preference of the focus groups and captures the range of motivation and timing for including walking in their lives.

The campaign’s messages will raise awareness that citizens can achieve the characteristics of a healthy life through walking. These characteristics include safe neighborhoods, healthy youth, healthy employees, and family connections. In October 2007, Mark Fenton, a nationally known walkability expert, visited Clark County to present the keynote at the Community Choices forum, Walkable Communities: Can we get there from here? During a work session with the WAT, Mark encouraged the team to also include advocacy messages within the awareness campaign. Advocacy messages should explain how and why to make the community more walkable and include tools and a call-to-action. These messages will be targeted both to individuals and to those who influence others’ access to walking through decisions and policies.

The campaign is set to launch with a press conference on January 22, 2008. The press and community leaders will be invited to walk a four block stretch of McLoughlin in West Vancouver. This stretch features pedestrian (and bike) friendly amenities. Local dignitaries and representatives will describe the pedestrian amenities and announce the beginning of the campaign.

Currently, the WAT is approving the evaluation plan and the design of campaign tools and delivery methods.
Tools include:

• Walkability fact sheets written for specific audiences (families, schools, developers, public safety, employers, planners, elected officials, Spanish-language). Fact sheets will feature walkability information and resources that pertain to that audience.
• Posters and flyers featuring local citizens shot at locations around the county.
• The Clark County Walkaround Guide developed through the Steps Initiative in 2004.
• Tips on how to advocate for walkability within your sphere of influence.
• Paid and earned media outreach through public service announcements, web, print and radio.

Delivery methods include:

• www.walkclarkcounty.org – the official campaign website.
• Incorporating tools and materials into other organizations’ existing programs.
• Presenting the tools and materials to key groups such as employers, school administrators or neighborhood associations.
• Fulfilling individual requests for information.

Outcomes:
Our short term outcome is to successfully launch the campaign in January 2008. We anticipate a successful launch due to careful planning and community/partner support.

• The campaign is well-researched to include information and visuals that will resonate with Clark County residents.
• The campaign aligns with best practices to include mass media but not depend on it.
• The campaign includes tools to educate people on the principles of walkability and help them apply those principles to their lives.
• The campaign includes an advocacy component that encourages anyone who has the capacity to influence the lives of others to act on behalf of walkable communities.
• Partners are already committing to include the tools and messaging in their organizations’ work. These partners include Southwest Washington Medical Center, Community Choices, Leadership Clark County, City of Vancouver Transportation Department, City of Vancouver Police Department, First Friday Artwalk and Vancouver’s Downtown Business Association.

Long term Outcomes - The legacy of this campaign will be reflected in the growing priority of pedestrian-friendly policies in Clark County. We hope the campaign ignites grassroots support for walkability by increasing citizen awareness and demand. By simultaneously educating elected officials and policy makers, citizen awareness and demand will be supported by policies that facilitate a change in cultural norms.