White House Honors PRC Community Partner
New Mexico PRC Partner Among 13 Physical Activity Proponents Called "Role Models"
"We want you to share your ideas—we want you to share your stories," First Lady Michelle Obama said, as she congratulated Richard Kozoll, MD, MPH, and 12 other physical activity advocates honored by the White House for their work to get the nation's young people moving.
Dr. Kozoll, a community partner of the University of New Mexico PRC, was recognized for having developed Step Into Cuba, a program to increase walking, hiking, and other physical activity in the rural community of Cuba, New Mexico. PRC Director Sally Davis, PhD, joined Dr. Kozoll at a White House event March 22, 2012, that gave the honorees an opportunity to share experiences, lessons learned, and ideas for reducing youth obesity. The PRC works with Step Into Cuba to adapt and evaluate evidence-based strategies recommended in The Guide to Community Preventive Services (The Community Guide).
The recognition was part of the two following White House initiatives: President Barack Obama's Champions of Change: Winning the Future Across America, which recognizes Americans, businesses, and organizations who help the nation innovate, educate, and build for the future; and Let's Move!, launched by Mrs. Obama to reduce childhood obesity. The honorees, selected from more than 600 nominees, included teachers, volunteer coaches, parks and recreation coordinators, and a disabled Iraqi war veteran who works with athletes with disabilities. Mrs. Obama personally thanked the guests of honor, saying she wanted to show them and other physical activity advocates across the country that they have the support of the White House.
"We are making progress and we are doing it because of the work that you do," Mrs. Obama said. (See a congratulatory letter to Dr. Kozoll from President Obama here.)
Sam Kass, a White House chef and senior policy advisor on food initiatives, introduced a panel discussion with the honorees. He explained the importance of stemming the rise in youth obesity, which now affects 17% of children and adolescents in the United States—triple the rate from just one generation ago.
"When you step back and think about the implications that obesity has on our nation, our economy, and our health care system, it's pretty significant," said Mr. Kass. "We're already spending $150 billion a year treating obesity-related conditions," said Mr. Kass. "Children don't learn well when they don't get enough physical activity. Obesity also is the number one reason young people are disqualified from military service. The stakes are really, really high".
The honorees were asked to describe their physical activity programs for the approximately 200 administration officials and invited guests, including representatives from national governmental and non-governmental offices, as well as people watching the event via a live Web stream on the White House Internet site. Dr. Kozoll, a practitioner of family and preventive medicine, described Cuba as a small, isolated community in northwest New Mexico that has limited resources and infrastructure to support physical activity.
"But one thing that we do have, and it is a significant asset, is our public lands," he said. "Our city, county, national forest, BLM [Bureau of Land Management] lands surround us, and are easily accessible. And that has been complemented by a donation of open space land."
Dr. Kozoll believes these open spaces can contribute to creating a community culture of activity. "It's difficult for children and youth to be active unless the community is active," he noted.
He organized a broad partnership to connect Cuba and the surrounding public lands. Partners include the BLM, U.S. Forest Service, National Park Service, the New Mexico departments of health and transportation, and the Robert Wood Johnson Foundation. The partners designed Step Into Cuba to facilitate residents', especially young people's, use of local public lands through trail development, community campaigns, roadway pedestrian enhancements, and other initiatives.
"We soon became aware that solid research paves the way for communities…to successfully promote active living," said Dr. Kozoll. He also wrote in a blog post for the White House Web Site. "But implementing the recommendations in a rural New Mexico community of less than 2,000 people is a challenge", said Dr. Kozoll.
The New Mexico PRC was invited into the partnership to help to meet that challenge. As part of its core research project, the PRC introduced evidence-based strategies known to increase physical activity in other settings.
"Most of the things they [the Step Into Cuba partners] wanted to do fit with…The Community Guide, which has recommendations based on evidence for getting people to be more physically active," said PRC Director Dr. Davis.
"But it soon became obvious that none of the evidence used in the recommendations for The Community Guide was rural," she said. "For example, when the guide says 'prompts and points of decision signage increase physical activity,' it suggests signs like 'take the stairs instead of the elevator or the escalator.' However, everything in Cuba is ground level and flat. We tackled how to make the recommendations appropriate for a rural community."
The PRC also adapting The Community Guide recommendations for street-scale urban design and land use policies to improve Cuba's walkability Plans, and projects are in process to create safe pedestrian and bicycle access to a major highway that runs through the town. Several walking paths have been built around the community, and a trail now extends from the village to a national forest that has hiking trails. A "Walking Champion" organizes and leads walking groups in the community, and healthcare practitioners prescribe walking to their patients.
To get young people involved in creating this "culture of activity," a local youth juvenile justice facility joined the Step Into Cuba partnership. Youth from the facility join community volunteers in constructing and maintaining trails and paths. Additionally, walkways now connect Cuba's school campus to other community sites initiated after school physical activity project and surveyed students about pedestrian enhancements needed in the community. The PRC is evaluating the signs, trail- and path-building, and other measures for effectiveness and will share results with other communities that want to increase physical activity.
The White House event ended with a roundtable discussion. "There was a lot of discussion about 'best practices,' but no recognition of how they are established," said Dr. Davis. "This was a great opportunity to share with decision makers about how the evidence underlying best practices in physical activity promotion is gathered by researchers and made available to communities in resources such as The Community Guide."