Written by Janet Fulton, Centers for Disease Control and Prevention

How were the physical activity objectives developed?

The Centers for Disease Control and Prevention in partnership with the President's Council on Fitness, Sports and Nutrition worked with a team of federal agency representatives to formulate the objectives for the physical activity topic area. The availability of recent and ongoing nationally-representative data were a necessary requirement for inclusion of an objective; public comments provided further guidance for the final objectives. The Healthy People 2020 default method (10% relative beneficial change) was most commonly used to set the target for each objective.

What's new for Healthy People 2020?

The 2008 Physical Activity Guidelines for Americans provided an evidence-based framework by which the Healthy People 2020 physical activity behavioral objectives were revised. For adults and youth, objectives PA-2 and PA-3 are now consistent with the Guidelines. Because aerobic and muscle-strengthening activities are BOTH required to fully meet the Guidelines, sub-objectives for youth and adults that combine aerobic and muscle-strenghtening activities are now included.

School-based physical activity is reflected in modified objectives for physical education (PA-4 and PA-5) and in two new objectives for elementary school recess (PA-6 and PA-7). More than 60% of pre-school

children attend child care. Therefore, enacting policies that require physical activity in the child care setting (PA-9) is a strategy to modify the physical activity environment for children. Given the ubiquitous role screen time plays in society, the modified objective for youth to reduce screen time through telelvision viewing and computer use (PA-8) is an increasingly important goal.

A new objective for Healthy People 2020 (PA-11) will monitor physician counseling about exercise. Given the recent emphasis on physician counseling about physical activity by the American College of Sports Medicine's Exercise is Medicine program, it is timely that physical activity guidance in the health care setting is tracked at the national level.

Where do we go from here?

With less than 20% of adults meeting the Guidelines for aerobic and muscle strengthening activities and a similarly low percentage of youth meeting the Guidelines for aerobic physical activities, a multidisciplinary approach is needed to facilitate improvements in recommended levels of physical activity.

The importance of having reliable, nationally-representative data sources to track the metrics associated with physical activity cannot be overstated. Important and novel topics were discussed by the Work Group, only to learn that a suitable data source was unavailable. For example, improving the environment for physical activity is a recommended strategy, although there is no acceptable national data source that tracks individual access to green spaces or parks. The same is true for physical activity in the work place. It is imperative to continue support of current Healthy People 2020 data sources and to support future collection of strategic priority topic areas for physical activity promotion.

It is our hope that as these Healthy People objectives disseminate across states and into the schools, businesses, and organizations that make up our communities, there will be an interest in working across sectors to affect real change in physical activity behaviors. The National Physical Activity Plan provides an excellent multi-sectoral framework along with strategies and specific tactics for action. Time and again the health benefits of physical activity have been well documented. Let's work together to move the dial on physical activity this decade!

Research published in the British scientific journal Age and Ageing found that older adults are highly knowledgeable about the health benefits of physical activity, yet many remain inactive due to the many barriers to participation. This article examines these barriers and suggests ways in which you and your organization can reduce or eliminate their impact on the physical activity levels of older adults.

1. Lack of interest (by far the #1 factor)

Prior to starting a program, have your older customer examine all their options. Would they prefer taking a class or going solo? Are they a morning or night person? Does indoor fitness appeal to them, or would they prefer to play outside? Could they dedicate large blocks of time to physical activity or could they fit only shorter, more frequent intervals into their schedule? What are their real world goals?

Young or old, people tend to enjoy things that interest them, that help them reach a goal or that is fun and social. By simply asking what they like to do you can break this barrier down one program at a time.

2. Shortness of breath

Shortness of breath can be due to a variety of health issues. It can also be that they are simply out of shape. Meet with their  healthcare provider to see whether you'll need to consider any special modifications before starting an exercise program. If necessary, get clearance to begin a program. Educate members that there are ways to address issues to improve their quality of life.

3. Joint pain

According to the Arthritis Foundation, regular, moderate exercise offers a whole host of benefits to people with arthritis. By exercising, your member can reduce joint pain and stiffness, build strong muscle around the joints, and increase flexibility and endurance.

4. Perceived lack of fitness

Education is the key here. Ensure that your members know they can start slowly, i.e. with 5-10-minute walks in the morning, at lunchtime and after dinner. With their resistance training, start them with only a couple of exercises and build up. DO NOT OVERWORK them or you will never see them again. Set long-term goals and show them how they will build their fitness level or workout over time.

5. Lack of energy

In many cases, this barrier is reversible and can be due to a low fitness level. It could also be from the interaction of multiple prescription drugs. The first step to a solution is to establish why they are lacking energy, then explain how being active will actually give them more energy. For many it can even reduce the number of expensive drugs they take.

6. Doubting that exercise can lengthen life

Ask your older customers about their quality of life. Are they able to do the things they want to do? Explain how exercise can improve their quality of life, no matter how long they live. What exercise will offer them is the ability to age on their own terms.

How are you reducing barriers that limit participation levels among your older customers?