Building a Culture of Physical Activity [Podcast Series]

• [:54] Dr. Bantham introduces her guest, Dr. Howard Koh

  • Dr. Koh is the Harvey V. Fineberg Professor of the Practice of Public Health Leadership at the Harvard T. H. Chan School of Public Health and the Harvard Kennedy School.  

  • Dr. Koh was 14th Assistant Secretary for Health for the U.S. Department of Health and Human Services (HHS) in the Obama Administration and the Massachusetts Commissioner of Public Health.

• [1:19]   Incorporating physical activity into daily life

  • “There's the physical and health benefits that we can all talk about. But there are also the emotional well-being and mental health benefits too. And then of course the people you meet and the camaraderie you build when you're involved in team sports is tremendous. So it's been a lifelong love for me. And it is still part of my daily life up through today.”

• [3:34]  Prioritizing daily physical activity

  • “And then your point, which has been essential for me, personally, is to just make it part of your daily routine. People have various ways to do this. I'm an early morning guy. So my wife and I get up early in the morning and we exercise part of the Zoom class now. And that's just part of what we do. It's funny, if I don't do it, I don't feel like the day can really start. And so it becomes an absolute priority for me. And I'm very, very grateful for it because I think it keeps you as healthy as possible.”

• [5:57]  Creating community through physical activity

  • “The other thing you've alluded to is the social aspect of this is hugely important. I am so grateful for the people I've met who I would otherwise never meet. Many of them now a lot younger than I am, if I could say, and they're a lot fitter than I am too, by the way...And we encourage each other and it's a wonderful community.”

• [7:25]  Policy makers prioritizing physical activity

  • “So this is another reason why I feel so grateful.  When I became Assistant Secretary, we had an incredible First Lady, Michelle Obama, who prioritized physical activity and fitness and healthy nutrition.  It was known as the Let's Move campaign. And so she was such a force that she mobilized, first of all, the whole administration, not just HHS, but the whole administration and then the whole country to focus on this critically important theme.”  

• [11:22] Building a culture of physical activity through cross-sector collaboration

  • “That's a classic definition of leadership that I love. Bringing people together for a common mission and saying, ‘Hey, no one of us can do this by ourselves.’ We need everybody literally at the table, developing plans and then trying to implement those and measuring progress, which is also not easy.”

• [14:12]  Physical activity as a magic pill

  • “In my view, there should be so much more emphasis on [physical activity]. And we simply don't. I don't quite understand it, because it's a life saving tool. It helps everybody's emotional well-being as well as their physical well-being. And, you know, we just have not had the attention that people like you are now bringing to it. So we need to double down on this if we're going to have a healthier future.”

• [15:30] Prioritizing disease prevention

  • “But I also saw way too early in my career, death and suffering that could have and should have been prevented and quite honestly, at the beginning of all that I was really upset by it and angered by it and frustrated by it, I didn't quite know what to do with it. And it dawned on me over time, that we needed more attention to prevention and ultimately to public health.” 

• [17:37] COVID-19 and physical activity

  • “So here we are now in COVID. We know that this fast pandemic has been fueled by the slow pandemic of chronic illness, of obesity, of hypertension, of chronic lung disease, chronic heart disease, so much of it could be prevented. And this is where the physical activity theme comes in. If we could instill this, particularly in kids—because I now firmly believe as a not just as a physician and professor but as a parent—that if it's instilled in kids at an early age and becomes just part of what they do every day, they can maximize that gift.” 

• [18:33] Knocking down silos

  • “So I now feel very passionately that for public health to improve, that we have to work with all sectors of society and get out of the health silo. So working with education and transportation, faith-based organizations—it's an area that I'm very committed to—and then also business.”

• [21:58] Building collaborations with the educational sector

  • “So again, harkening back to my own life, the more the educational sector and schools can make this a vital part of what they do on behalf of kids and as part of education, I think is critically important…[T]he more it's expected for kids to be involved in some level of activity and encouraging creativity there, I think the better off we're going to be as a society.” 

• [24:23] Investing in public health

  • “You know, we have so many crises in our society now about business, about the economy, about schools, about health. But the overriding message is we can't solve any of those other crises unless we solve the health crisis first. And then so much of COVID could have been and should have been prevented. This is where the investment in public health is so important. So one silver lining, I guess—if you can call it that—is that public health, our field, which was invisible to so many is no longer invisible. Everyone sees the vital importance of public health and prevention.”

• [27:03] Public health done well

  • “I like to say now that when public health works, absolutely nothing happens and all you have is the miracle of a perfectly normal healthy day. And in a time like this through COVID, I mean we all yearn for those days and we have got to get those days back again sooner rather than later. And so that's why this work is so important.”

• [28:39] The meaning of public service

  • “So that sense of service and the role of public service is something I never dreamed I would experience when I was a younger person, but here I am, I look back on that as the most meaningful chapters of my life. And so if that was relevant to me, maybe it'll be relevant to others because you really get to sit and think about what's important for populations, what's important for communities, the nation, the world, keeps your perspective broad. It keeps you ever humble about the need to keep learning and working with people. And then try to help the next generation be even healthier than this one.”

Using Technology to Connect Healthcare and Health & Fitness [Podcast Series]

• [:54] Dr. Bantham introduces her guest, Ryan Eder

  • CEO/Founder of IncludeHealth, a digital health and wellness company leveraging design, technology and data to transform rehabilitation and wellness.

• [1:10]  Vision for IncludeHealth 

  • “It's always been purely through the lens of lowering barriers for people to stay active and healthy. And it started through the lens of physical accessibility.”

• [3:00]  Evolution of IncludeHealth

  • “Throughout your life you go in and out of the healthcare system and a lot of the health issues that people are experiencing and trying to navigate as well...it broadened our horizon to just being able to develop this technology that we can serve anyone across that spectrum and not isolate it to a certain moment in time.”

• [3:51]  Improving health through the lens of a designer

  • “I boil it all down to empathy, and trying to look at the world through someone else's eyes. And so looking at that as an individual trying to stay healthy, trying to stay active...to the trainers or practitioners delivering personal training or rehab or care...to the administrators...to the health plans, look at the entire system.”  

• [5:31] Health & fitness clubs opening their doors to people living with disability

  • “It's a mindset of everyone in there knowing that your services are for everyone. And removing the stigmas that a lot of people just inadvertently have about, like assuming based off of someone's appearance or their abilities that they are interested or can do certain things or cannot do other things, right? It simply isn't the case.”

• [7:04] Challenges and opportunities in integrating healthcare and health & fitness

  • “I think the fitness industry has always seen the potential there and wanted to be able to collaborate, but you need to have that other side willing to answer the call. So you need those incentives to get aligned.”

  • “And the opportunities are big. So when all of a sudden you have the entire world stop, and everybody is reassessing and reevaluating, then you start realizing the opportunities for the providers, like the healthcare organizations that are interested in delivering more convenient, extended care beyond their brick and mortar.” 

• [10:10] Using technology to facilitate physician exercise referral and feedback

  • “So we built the platform starting completely in the walls of healthcare, of understanding, how do you have an authoring tool to create medically driven digital protocols that can be delivered anywhere that is connected to the platform.”

• [15:46] Collaboration among professionals caring for the patient

  • “What's really exciting is this technology can really make that collaboration quite seamless.  So you are able to connect organizations that historically haven't been able to be connected.” 

• [17:52] Incorporating exercise into daily life in a community-based setting

  • “Being able to have this connected care, health and wellness at any location at any time is just really powerful.”

• [21:36] Progression from equipment to cloud to movement sensors

  • “And so that's really that insight that pushed us to develop IncludeConnect and these sensors that we can now connect any equipment. And that is what opened up when you start saying, Okay, this is a piece of equipment, this is a platform, I can connect facilities within my network, I can connect out of network facilities.”

• [25:08] Impacting population health

  • “You're right, it has to be accessible to everyone. And to do that, I mean, you need to really break the barriers of technology even further. Not requiring specific equipment, not requiring a specific device, being able to have this connected, where it goes with you, wherever you are any of your devices, where you can get this programming, you can continue your journey and it all feeds back and can then weave into the operational needs of the stakeholders involved.”

• [28:47] Impact of COVID-19 on vision 

  • “Any technology company is really trying to be an agent of change. And there is no greater agent of change than a global pandemic. Everyone's so much more aware of their personal health and wellness than they ever would have been before. I mean, I think it does create a really unique opportunity on the other side.”

A Unified Voice for Physical Activity Advocacy [Podcast Series]

• [:56] Dr. Bantham introduces her guest, Dr. Laurie Whitsel

  • Vice President of Policy Research and Translation for the American Heart Association.

  • Dr. Whitsel is also a Senior Advisor for the Physical Activity Alliance. 

• [1:22]  Translating science into policy/action

  • “We really want to take strategies, take policy that is going to, that has evidence for health impact and equity impact, and apply it to our strategic policy agenda and mission.”

• [3:32]  Challenges in translation

  • “So that is part of the work that we do in policy research, is that due diligence to put forth a policy agenda that is going to be impactful, equity-focused, strategically aligned, and that, if we accomplish it, will be transformational in terms of population health.”

• [6:14]  Making science and research relevant for policymakers

  • “[Policymakers] are also worried about how to pay for whatever they are asked to pass.  We often bring the science argument to them, but we also have to bring the economic argument to policymakers, and we also have to bring the health impact.  We speak different languages, and so doing that translation is really, really important.”  

• [8:01] Investing in resources to get people physically active

  • “I actually think we need more of that economic analysis in our work on physical activity.”

• [9:37] Reconciling timeframe for value on investment

  • “Sometimes we might have a policy priority or policy strategy that’s not going to save money in the long term or return money in the long term, but it can improve health and create value.”

• [10:55] Creation of the Physical Activity Alliance 

  • “It brings together the powerful roadmap/strategic plan of the National Physical Activity Plan Alliance, combined with the advocacy and policy work of the National Coalition for Promoting Physical Activity, with the professional education/public health education work of the National Physical Activity Society.”

• [13:52] A unified voice for physical activity advocacy

  • “I really hope that by coming together we have, as you say, created this unified voice, but I hope that will be appealing to funders.  There is so much important work for us to do, and I think it is much easier for funders to see a unified voice, and to know where to put resources into making things happen.”

• [15:11] Development of a physical activity advocacy strategy

  • “There are four pillars to successful advocacy work—policy research, government relations or educating policy makers, media advocacy, and grassroots.  Putting all four of those together, I think we have four of those elements pretty much in the new Physical Activity Alliance.”

• [17:33] Physical activity advocacy as a team effort

  • “This is what has been really wonderful about the Physical Activity Alliance is everybody that has come together to make this happen and make this work—it is a total team effort.”

• [18:35] Promising developments around worksite wellness

  • “I think one of the most exciting trends in the space right now is that we are acknowledging that we need to actually shift the environment in which people work, not just the programming, not just worksite health promotion programming, but the environment is so incredibly important.”

• [21:34] Impact of COVID-19 on agenda and priorities

  • “COVID has impacted our work across the board...where telehealth, for example, is rising and is an opportunity to deliver care to our cardiovascular disease patients...being able to modernize and update our whole public health infrastructure and surveillance infrastructure.”

• [23:21] Chronic disease as a COVID-19 risk factor

  • “We have to continue to promote nutrition and physical activity as a critical way to stay healthy, and then we have to really address the infectious disease and what this means for people with chronic health conditions.”  

• [26:30] Integrating physical activity and healthcare

  • “Focusing in on embedding physical activity across the healthcare environment is a personal passion of mine.”

Older Adults Living Healthier, Longer, More Active Lives [Podcast Series]

• [:50] Dr. Bantham introduces her guest, Colin Milner

  • Founder and CEO of the International Council on Active Aging.  

  • Colin advises organizations and governments globally, such as the National Institute on Aging, the World Economic Forum, and World Health Organization.  

• [1:13]  Founding the International Council on Active Aging

  • “The population, of course, started to really move demographically and numbers wise towards an older population, but the reality was we weren’t responding to what their needs were.”

  • “I think when you are looking at the millions and millions of people out there, they deserve a response.”

• [2:33]  Identifying and meeting needs of older adults

  • “If you don’t have your health and wellness or health and wellbeing, life can be very difficult.”

  • My goal is very simple, and that is to help people function at a higher level for longer so that they can enjoy their life the way it was meant to be.” 

• [3:30] Improving quality of life for older adults

  • “The reality is, everything we do has an impact...that’s why we focus on a wellness model as opposed to just a fitness model.”

  • “Be engaged in as many different areas of life as you can and your health will follow.”

• [5:26] Active aging and mental and physical health

  • “Active aging...is being engaged in life.  You’re actively involved in life.  Or, you’re inactively involved in life.”

  • “And that is everything from your workplace to challenging your mind to managing your mental health.”

• [6:27] Isolation among older adults

  • “The isolation factor is huge.”

  • “In today’s world, thankfully, there are many different kinds of technologies that can help minimize that.”

• [8:14] Inclusive fitness for older adults

  • “I think the first thing comes down to committing to and embracing all individuals.”

  •  “There is no reason we shouldn’t be investing in our health and well-being to get ourselves healthy.”

• [10:44] Changes in the health & fitness industry in serving older adults

  • “Many of the clubs have changed in regards to design, layouts, size, equipment, technology...the problem is the segmentation of the clubs is still relatively close to what it was.”

  • “Maybe we are about 23% off of who should be coming into the clubs. So imagine if you could almost double the number of participants just by having a focus on what their needs are...I need to remain healthy, I need to function, I need to keep my social engagement up, I need to participate in activities that bring me joy.”

• [13:26] Health & fitness centers creating community among older adults

  • “As you get older, that becomes even more important...you really have a key group of very close friends that really brings meaning to your life.”

  • “The clubs have an opportunity to have clubs within the clubs that don’t cost them anything to run....walking clubs, sewing clubs, movie clubs, whatever it may be, but it is organized by their own members, but it is situated out of the club.”  

• [15:33] Disposable income of older adults to spend on fitness services 

  • “If you are somebody that is strictly looking at the economics, there is no question that you would look at the older population because, since twenty years ago when I started, the older population had 50% of the disposable income.  Today they have over 75% of the disposable income.” 

  • “The older population now spends more on products and services to help them age well than on prescription drugs or pharmaceuticals to manage chronic diseases.”  

• [18:17] Older adults assessing risk with COVID-19

  • “I think the first thing to understand is no matter what you do, there is some risk...The issue is how to minimize that risk to almost nothing”

  • “Think about where you are going to go and what you are going to do ahead of time.”

• [22:51] Countering ageism during COVID-19

  • “Fear heightens ageism, and that is probably the greatest example of ageism out there.  So the only way you can counteract that is not to accept that.”

  • “I think what we need to realize is that everybody matters and that, as a society, for us to be holistic and not have warfare amongst the ages, we need to embrace everyone.  And everyone has value, no matter how old you are.”

• [26:30] New developments in research on aging

  • “One of the things that has really been interesting for me over the last couple years has been the shift where we have moved the definition of healthy aging...the ability to maintain our functional abilities versus the absence of disease.” 

  • “That, and of course there is a huge focus on cognitive abilities...If you can delay the onset of [Alzheimers’] by a year or two or three, that is a significant amount of time for a longer period of quality of life versus it being diminished.”

• [28:18] Adopting physical activity habits for a lifetime

  • “I think if we can make movement fun and we build it in that it becomes habit from a very, very young age.” 

  • “The ability to find a fun activity that you want to pursue throughout your life.”

Partnering to Prioritize Prevention [Podcast Series]

• [:50] Dr. Bantham introduces her guest, Katie Adamson

  • Vice President of Health Partnerships and Policy at YMCA of the USA.  

  • Katie has a background working on health advocacy in multiple sectors—nonprofit, for profit, government—particularly relevant to our topic today.

• [1:14]  Connecting the dots for policy makers between the chronic underfunding of public health and prevention and the impact of COVID

  • “COVID-19 has made known to policy makers what those of us—you and me—in public health have known for years—that there is a great disparity in health outcomes for racial and ethnic populations and low income populations in general.”  

  • “We also have to build prevention and public health into our healthcare system as a paid for service because getting funding for CDC, as important as it is and will continue to be, it can not be the only approach.  There needs to be a cultural shift of our understanding of what health means to lead with prevention and wellness and begin to pay for it.”  

• [3:24] Receptiveness to message linking COVID and chronic disease as a risk factor 

  • “It may lead to more funding to prevent the next epidemic, and I think it is going to be incumbent upon us to put the two and two together.”

  • “Even to see the loss of lives during COVID is nowhere near the loss of lives that we will see in a regular year to chronic disease.”

• [5:42] Making the health and economic case for prevention

  • “While the clinical setting is important, it will not achieve health without the partners that can change the drivers.”

  • “So, transportation needs to be there, housing, education, food systems, those voices that are trying to move the bigger systems to focus on health.”

• [7:31] Diabetes Prevention Program as a case study

  • “At its core, the Diabetes Prevention Program has been and probably still is one of the best chances we have to prove prevention’s value in both human and economic terms to any of the naysayers out there.”

  • “What could have been one of the greatest successes of public health is, in my mind, poised to collapse without major relief by the federal agency.”

• [12:17] Laying the groundwork for other interventions

  • “We have figured out how to scale it...the payment side has been challenging.  And as we look at social determinants of health or we look at the lifestyle health interventions that the Y has been doing, either one, the health system is going to have to figure out how to integrate better with community”   

  • “We need the health system to find a better way to pay community in a way that is realistic and understands that we are not the formal health system and don’t want to become the formal health system.” 

• [16:04] Community settings partnering with clinical settings to improve health outcomes

  • “We have co-built facilities with the healthcare system…After serving the community and finding out what their biggest barriers were in terms of social determinants, the Y looked to partners that could fill those gaps together, on site, collectively, in one place.” 

  • “Pushing the envelope on innovation to be the partner to the health system to collectively improve health outcomes.  Because even though they are only 20%, the healthcare system, the clinicians, are still the anchors and we need to build their strength with community partners.”

• [20:13] Community-based organizations as an innovative, integral healthcare partner

  • “We need to figure out a way to maintain the unique benefit that community partners bring without just making them part of the health system.”

  • “I really think if the community players aren’t being able to lift up their own voices to the system to tell them what they need, we are not going to make the kind of change that we need to make.”

• [23:13] Non profit advocacy during COVID 

  • “Longterm, had these major entities—and some of them will still go under—but had they gone under, I just can not imagine.  The services they provide that are the very same services that are undervalued, under resourced by the health system, they are helping the folks that have the highest risk of chronic disease, they are doing the social determinants of health work.”

  • “While we were being shut down, our YMCAs stepped up.  And they are providing 1100 sites for grab n go meals for kids and families.  We have 1100 emergency childcare sites.  We have tens of thousands of calls every week going into the homes of older adults to stave off social isolation, to see if they need medication.  I mean, you wouldn’t believe the services we are providing during this time where we have been shut down, furloughed.  And that kind of passion and mission for the health of our communities needs to be there tomorrow.”

Connecting Health Clubs to Healthcare Through Physician Exercise Referrals [Podcast Series]

• [:51] Dr. Bantham introduces her guest, Dr. Greg Degnan

  • Medical Director of Atlantic Coast Athletic Clubs and associate clinical professor of orthopedic surgery at UVA.  

  • Dr. Degnan maintains a clinical practice in orthopedic surgery. 

• [1:18] Making a physician exercise referral program successful

  • “First and foremost, these programs have to be a win-win-win: the patient has to be able to benefit from it, not just in the short term but in terms of modifying their behavior for long term change; the physician has to see that and believe that the program can effect change for their patient; but the person administering, whether you are a fitness club or a personal trainer who is an entrepreneur, you have to monetize this.”  

  • “Without that relationship with the medical community, you can have the greatest program in the world, you can have the greatest people there to administer it, but you have to recognize that this population does not come in of their own accord, that is why we are getting them through physician referred programs.  So what we have to do is convince their gatekeepers, the medical professional, that we have something to offer.  You have to have all three of those components in place to have a successful program.”  

• [6:35] Communicating wins and successes to the patient and referring physician

  • “We have those who are very interested in very specific outcomes.  They want to know metrics.  They want to know weight loss, they want to know blood pressure, they want to know how many times this individual actually showed up.  Are they actually using the program?”

  • “For those physicians who want metrics, we are collecting them and we do give them a midpoint and an endpoint letter telling them how the patient is doing in terms of number of visits, BMI, weight...A1C.”

• [10:08] Cost and return on investment of physician exercise referral programs

  • “30-35% of our membership base are current graduates of our medical programming.  And this is a population that no one else in the industry is able to get to.  This is our differentiator.  So it makes us huge money.  But we lose on every patient who walks through the door.  Where we make it back is in the memberships which, by the way, are long term memberships.”

  • “You are going to see the return on the investment.  But there is an investment.  And it is a bit of a leap of faith.  Because you have to make this affordable for the patient, or the physician will not refer.  And yet you have to make it a quality program with quality people or you won’t get results.”

• [13:55] Building relationships between healthcare and health & fitness

  • “You have to create a perception for the medical community and patient population that you are a cut above and beyond what they perceive to be the ‘normal’ fitness industry.”

  • “The key with establishing those relationships in the medical community is finding champions in the healthcare community that will be your voice.”

• [18:07] Building trust between healthcare and health & fitness

  • “Just as the healthcare world doesn’t necessarily trust the fitness world to ‘take care’ of their people, the fitness world doesn’t trust the healthcare world to recognize how important exercise is.”   

  • “Healthcare is guilty of treating with prescriptions for pharmaceuticals, treating with prescriptions for surgical procedures, rather than treating with prescriptions for lifestyle change.” 

• [20:48] Shared cooperation between healthcare and health & fitness

  • “There are two huge things that could be done to bring these two industries together.  First, on the fitness side, we really need to step up our certification game.”   

  • “On the healthcare side, we need to get a generation of physicians who, as part of their medical education, receives training in exercise, better training in nutrition, and training in behavior modification.” 

• [24:31] Barriers of time, training, tools, trust in physicians making exercise referrals

  • “The best way to bypass the ‘time issue’ of a physician having to get familiar with your facility and your people is to have one of his or her peers say…’I trust my patients to them, you can trust yours to them.’”

  • “If you really want to break into the medical community...you need one of their own on your side telling them they can trust you.”

• [27:30] COVID and health & fitness centers as essential 

  • “We know that COVID impacts people more significantly with medical comorbidities, most significantly obesity.  And yet, we have from the get go talked about health clubs being unsafe petri dishes.  But the first thing we open up are restaurants and bars where they can go eat an oversized meal that will make them more obese and worsen their hypertension.”

  • “If there was any place that should have been opened in Phase I, it should have been the place you are going to go to become healthier to eliminate some of the risk.  It shouldn’t have just been health clubs that were taking care of physician referred patients.  At the end of the day, they should have all been opened in Phase I.  Just with pretty strict requirements to which they were forced to adhere.  But they should have been opened long before restaurants, bars, salons, and beaches, none of which contribute anything to your health, all of which give you additional health and exposure risk.”

  • “Until we have a vaccine, and we are six months at best from that, COVID isn’t going away.  In six months, I can lose a fair amount of weight.  I can get my diabetes pretty well under control.  I can get my hypertension pretty well under control in six months.  If we look at this as the long game, at the end of the day, one thing COVID has demonstrated to us, no matter what comes around, it hits people with chronic disease harder.  And health clubs are the solution for chronic disease.” 

Empowering Children and Families to Lead Healthier Lifestyles [Podcast Series]

• [:53] Dr. Bantham introduces her guest, Teresa Earle

  • Teresa Earle, Co-Founder of the MEND Foundation and the Healthy Weight Partnership.  

  • Teresa is also the head of marketing and sales for the Healthy Weight Partnership. 

• [1:08] Vision for MEND and the Healthy Weight Partnership

  • “We know that there are about one-third, or 45 million, of U.S. children who currently have overweight or obesity and we know that the weight management industry is worth $59 billion give or take, but families still don’t really have solutions that are easily accessible, affordable, personalized and, most importantly, effective”

  • “It is not a diet or a weight loss program, but health and wellness, a way of life for the entire family, for life.”

• [2:58] Accessibility and affordability of programming

  • “When I say accessible, I mean, we don’t want there to be barriers because of money, time, place, socioeconomic or racial status to families joining programs like MEND.”

  • “The advent of the use of technology is definitely going to help...bring programs like this to many more kids and their families.”

• [4:45] Importance of evidence-based programming

  • “Science and facts really matter to us so that children and their families get the most effective treatment and programs that only enhance their lives and don’t do any harm or risk failure.”

  • “It is incredibly important that we deliver something proven to work...we don’t ever want to set these families up for failure, we want them to succeed or they will never do it again.”

• [6:16] Delivery in clinical and community settings 

  • “If we can’t bring all of the clinic to the community here, then working with clinics is perhaps a faster way to get these programs out to families that really need them.”

  • “Prevention and treatment need to work hand in hand in communities for those communities to succeed in their quest to help people with obesity and overweight.”

• [11:08] Framing health promotion/disease prevention with cost effectiveness

  • “I think what really helps is to frame the discussion about investments and costs around the subsequent disease state that comes from obesity and overweight.”

  • “I think we have to be more clear about linking the targeted prevention programs with the prevention they create for longer term chronic disease.”

• [12:38] Working with children versus the whole family unit

  • “We provide the children and their families with the information they need to change those behaviors that are creating the context for unhealthfulness.”

  • “We do it by helping the child or children become the agents of change in their families so that they gain the knowledge and the tools to help them live healthier forever.”

• [14:02] Empowering families to improve their health

  • “We provide them with information that is easy to understand at the level that they are at, both in terms of nutrition, exercise or physical activity, goals, rewards.”

  • “It is done in a way that the children in particular can understand the information, process it, and make decisions themselves about what they will eat, when they will exercise.”

• [16:17] Lessons learned from programming

  • “To make sure that the people leading the program have all the tools that they need when they start out.”

  • “That ability to flex and be appropriate to communities where they are at in the cycle of wanting to do this for their children and families.”

• [19:21] A-ha moments 

  • “Groups that are cohesive and supportive, I would say lovingly guided with expert information, really help people to step up and begin to share what they have been going through.”

  • “Every parent wants to do well for their child, this is a given...and to sit in a room where there are other people validating maybe for the first time ever what you are feeling, that is powerful.”

• [21:45] Social support in behavior change

  • “None of these families is having to make this journey of this depth alone.”

  • “They come, they sit down, they get practical information and a lot of support from their peers.” 

• [23:05] Role of partnerships in developing, designing, executing programs

  • “We work with a variety across the board of different entities, organizations, and people who help make these programs work in their communities.”

  • “We talk about what does it take to implement prevention programs in communities and the hub spoke and wheel models and how everyone has a part to play.”

• [24:58] Creating policy around early interventions

  • “Making in second nature that programs like this are paid for and available to everyone no matter where you come from.”

  • “They understand at a local level best what their kids need, what the rhythm of their communities are.”

• [28:54] Impact of COVID on vision and work

  • “That may make the jump to technology really being able to facilitate behavior change in groups much more easy than it might have been prior.”

  • “We could actually out of this tragedy provide programs like MEND to even more people through a variety of methods.”

Screening for Physical Activity as a Vital Sign and Social Determinants of Health [Podcast Series]

• [:54] Dr. Bantham introduces her guest, Dr. Liz Joy

  • Dr. Liz Joy,  Senior Medical Director of Wellness and Nutrition at Intermountain Healthcare. Dr. Joy is a practicing physician, an adjunct professor of medicine, and the past president of the American College of Sports Medicine.  

• [1:14] Incorporating physical activity assessment/referral into the clinical workflow

  • “Really making an effort to really use that SBIRT model.  Screening, with a physical activity vital sign, Brief Intervention at the point of care, where the physician is really personalizing information about physical activity to that individual, and then Referral to Treatment.  It’s really a referral to resources, and there are many, many resources that are available to people.”

• [3:20] The physical activity vital sign as a prompt

  • “Having a physical activity vital sign does serve as a prompt to collect information about what they are doing and then to inform a discussion and to personalize it.  ...having a conversation about how much activity someone is doing or, maybe most importantly, not doing, can really have a benefit in terms of their health outcomes.”

• [5:01] Making the time to talk about physical activity

  • “Our medical assistants actually ask the questions about the physical activity vital sign. And then based on what we are seeing in terms of total minutes per week and self-reported intensity, that creates an opportunity to contextualize the activity in the care of that patient.  What do you do if you have just one minute with that patient to talk about physical activity?  Or two? Or five? Or maybe ten?”

• [7:46] Transitioning counseling about physical activity in the clinical setting to the community setting

  • “This is where the physical activity vital sign comes into play and is so important.  Understanding how little someone is getting can help you counsel them to make small steps toward a bigger change.” 

• [11:26] Including physical activity as part of social determinants of health and social needs screening

  • “It really was my work in championing the physical activity vital sign in the electronic health record that led to my work championing screening for unmet social needs in the electronic health record...recognizing that environment plays such a critical role in people’s ability to be safe.”

• [16:45] Prioritizing physical activity in screening 

  • “Workflow is critical for the entire care team.  You have to clearly define whose job is which.  Clinical medicine is a team sport….There are lots of different strategies to give the patient the experience where we care about them as a whole person, and recognizing how their environment affects their lifestyle behaviors and how their environment and their lifestyle behaviors together influence their health. ”

• [21:14] Other members of the care team who can facilitate adoption of healthy behaviors outside the clinical setting

  • “How do we provide more education and skill to our community health worker population around healthy lifestyle behaviors?...There is definitely more that we could be doing within our communities that is around supporting healthy lifestyle in a very culturally appropriate way that I just don’t think we have really prioritized yet.”

• [24:32] Interrelationship between COVID-19 and physical inactivity

  • “I share my strategies with my patients….healthcare providers themselves who are physically active and have figured out how to integrate regular activity into their busy lives are way more likely to talk to their own patients about strategies to integrate physical activity into their lives.”

Role of Exercise Professionals in Getting People Moving [Podcast Series]

• [:55] Dr. Bantham introduces her guest, Dr. Cedric Bryant

  • Dr. Cedric Bryant, the President and Chief Science Officer at the American Council on Exercise.  With a doctorate in physiology and a master’s in exercise science, Dr. Bryant leads the development of ACE’s evidence-based programming, studies and publications on exercise science and behavior change.

• [1:20] The mission to get people moving

  • “The evidence is pretty overwhelming and clear that if we can get individuals adopting more physically active lifestyles that it can have a profound impact on many of the chronic conditions that really beset our nation...hypertension, diabetes, obesity...all have been shown to be profoundly and positively impacted if we can get individuals moving on a regular basis.”

• [5:08] Physical activity as a “best buy”

  • “It is my belief that we find the time to do those things that we value and enjoy.  We have got to shift the thinking on the part of individuals to help them to understand the real value of being physically active, but more importantly to help them to find those things that really work for them.”

• [9:22] Framing physical activity versus exercise

  • “We know that if people are having a somewhat pleasant experience associated with a given activity, the likelihood of them doing it on a sustained basis goes up exponentially….you’ve got to think of activity like loose change in your pocket.  Every little bit counts.”

• [12:05] Engineering physical activity back into our lifestyles

  • “It is going to take a systems approach to address this epidemic of physical inactivity that we face.” 

• [14:48] Removing barriers to active lifestyles

  • “I think inactivity is almost a learned behavior in a lot of respects and I think it is unfortunate that most of us forget how to play with each passing year...if we could harken back to just the days when it was natural to move, discover, and explore...let’s turn the clock back and have a more childlike approach to how we approach the day.”

• [17:20] The role of exercise professionals in getting people moving

  • “I think we need to have a shift in our thinking and really view healthcare as the ultimate team sport...where exercise professionals can have an impact, I think, is really helping address that physical inactivity related component of overall public/population health.”

• [21:37] Exercise professionals and empathy in bringing about behavior change

  • “As we have started to try to bridge the gap between physical activity, fitness and healthcare, we have gained a greater understanding of the importance of helping our professionals to develop that understanding of the need to be empathetic and the need to be effective communicators...if we are going to have a chance at being trusted and accepted by the healthcare/medical community, it is really being able to display not only the competence from a scientific perspective and knowledge-based perspective, but also being able to display that real competence as it relates to communication and interpersonal skills as well.”

• [24:44] The dual pandemics of COVID and physical inactivity/sedentary behavior

  • “I think there can be a strong and cogent argument made that physical activity should be a highly promoted weapon in the arsenal when fighting these types of pandemics and contagions.”

• [27:43] Optimistic outlook for getting people moving

  • “I have not met more passionate people than individuals in the physical activity, exercise space…[they] derive a tremendous amount of joy seeing other people move and helping other people move safely, enjoyably and effectively.”

Physical Activity As Essential [Podcast Series]

• [:40] Dr. Bantham introduces her guest, Chuck Runyon

  • Chuck Runyon is the CEO and Co-Founder at Self Esteem Brands, which is the parent company of Anytime Fitness, Basecamp Fitness, Waxing the City, and the Bar Method. Anytime Fitness operates 4,000 franchised health & fitness clubs in 50 countries and has been named the #1 franchise and the fastest growing fitness club in the world. 

• [1:10] Physical activity as essential

  • “Physical activity can empower people to new roles, new moves, new mindsets.”

  • “Health is an asset in my life that empowers everything I do.”

  • “Daily physical activity is critical to mental acuity and mindset and to unlock our potential.”

• [3:10] Fitness as one piece of mental and physical health

  • “There is so much evidence linking it to lower risk of depression and stress.”

  • “I wish we focused less on the scale and more on how it mindset and mood and how it empowers so much in your life.”

  • “We want to make sure we are reaching people where they are at..reaching them with nutrition support, physical activity support, we are moving more toward more mental support, and just more lifestyle, more holistic in the coaching we can provide.”

• [5:40] Removing barriers to active lifestyles

  • “I think we can unlock a person’s potential once they are willing to be a bit vulnerable, once they are willing to ask for help.”

  • “What I love about some of the body scanners and wearables is that it democratizes body intelligence, so now we can take biometrics that are highly personal and help someone understand them, and now set some very realistic goals to make fitness achievable.”

  • “Progress equals further engagement.”

• [8:30] Teaching kids to be physically active so they grow up to be active adults

  • “We have to reframe how we are teaching health and make sure that we value physical activity.”

  • “Physical activity and nutrition and health should be part of the core curriculum.”

  • “When people get out of school, they are not equipped to live in an unhealthy world, a world of high calorie cheap meals and sedentary activities...equipping people to be the CEO of their own health.”

• [11:40] The dual pandemics of COVID and physical inactivity/sedentary behavior

  • “The health of the country, pre-COVID, was not good, and when COVID goes away, we are going to be left with a very unhealthy country.”

  • “This thirty day pandemic has shined a spotlight on this 30 year epidemic called obesity and physical inactivity and diabetes and hypertension.”  

  • “That is what we have to fix long-term.  We need to turn the health of this country in the other direction.”

• [14:00] Exercise as better than medicine

  • “An ounce of prevention is worth a pound of cure.  We are not even putting an ounce worth of prevention”

  • “If you look at policies, and funds and incentives for individuals and corporations to be healthy, we don’t have a culture of health”

  • “Everyone is on the hook here, everyone can do a better job to help people, help communities, help our country get to a better place.”

• [17:05] The fitness industry as a partner with healthcare

  • “Doctors can trust that if they refer to a patient to someone with one of these certifications, they are going to get good care.”

  • “The technology is there now where we can start to standardize data, that can be used by the consumer and by the doctor to show that we are in fact making progress.”

  • “We are in the progress game, because if an individual is making progress, they stay engaged in their health and fitness goals.”

• [20:30] Physical activity as essential now more than ever

  • “If I were a lawmaker, I would be fighting like heck to find a way for the gym industry to reopen safely and responsibly under COVID conditions and find a way to get people stronger, get people moving.”

  • “Now more than ever people need to move.”

  • “For us to get through these very trying times, we’ve got to have the emotional strength and mindset to do that, and that starts with physical activity.”

• [22:18] Physical activity in a post-COVID world

  • The optimist in me says yes, this is going to be the perfect time to spark a new conversation to get people healthy and we are going to see a surge coming back to our facilities”

  • “I love the fact that you are trying to bring the medical community closer to the fitness space and closer to communities.  I really think this can be solved through collaboration.  We’ve got to find some adjacent industries to work together.”

  • “I love the digital muscle that this fitness industry has been building”  

• [29:50] Closing the health loop

  • “Maybe as a fitness industry we can do a better job closing the health loop with data..you referred him your him to us, and this is the progress they have made”

  • “You can’t do this alone.  We’ve got to collaborate with smart people, we’ve got to collaborate with other industries.”

  • “The only way to solve personal health, the only way to solve global health is through collaboration.”