Helping People Find Their Motivation to Start and Continue Exercising [Podcast Series]

• [:56] Dr. Bantham introduces her guest, Dr. Michelle Segar

  • Dr. Michelle Segar is Director of the Sport, Health, and Activity Research and Policy (SHARP) Center at the University of Michigan.  

  • Dr. Segar is also the author of No Sweat! How the Simple Science of Motivation Can Bring You a Lifetime of Fitness.

• [1:21]  Language and motivation for exercising

  •  “And so embedded in this language is our experiences that many of us have had that just don't feel good, are painful, are shame producing, make us feel self conscious and, more generally, create a negative feeling that make many people disdain exercise and want to avoid it at all costs.”

  • “But really, if we could reframe the term, the language ‘active living,’ to reflect how we live our lives, we look for opportunities to move. Another term we can use for exercise, take an opportunity to move. Who doesn't want an opportunity, right? Inherent in that concept is something positive.”

• [5:15]  Helping people find their motivation

  •  “And I'm asking people if being active or exercising feels like a chore from one (a chore) to a five (a gift). And through that answer, we find out whether people's reason or why for exercising is based on motives or reasons for exercising that research has found actually make it into a chore or are based on logical or should-based reasons, which we know from research and years of promoting exercise for these reasons are actually, they may get people to start exercising, but they don't get people to to continue.”

• “I think I come at it in a sideways way, and, through helping people understand that their whys have actually been getting in their way and then helping them identify what I call the right whys. And it's not that they are right because I say they are right.  The right why is inherent to the individual, which I think is what you're doing with your clients as you're helping them identify what type of why for exercise is actually going to help them both stay motivated, and want to do it but experience positive feelings, all of which the research show will promote sustainable motivation.”

• [8:50]  Moving from a chore to a gift

  • “So if we can use this explicit dichotomy, then it gives us a point of conversation, a point of entry, to convert someone from a chore to a gift.”

• [10:20] Health is not a motivator for exercise

  • “The challenge is that in theory, we care about our health, in theory, we want to exercise for health, but in reality, we have too many other more urgent compelling things to do. So that's why health as a primary motivator for exercise, whether, again, it's right now or in 20 years, may not be the greatest motivator for people who aren't super, super, super, super motivated to prioritize their health.”

• [12:42] Focusing on the short-term reasons for exercising

  • “So we need to align what we really want to achieve with the way it's going to get there. And ironically—I think there's something super ironic about this—that the way to achieve the long term benefits from exercise is actually to focus on the short term reasons for doing it.”

• [14:10] COVID-19 and exercise

  • “So anecdotally, I've heard that some people are exercising more because they have more flexibility in their lives. And on the other hand, a lot of the people who are regular, regularly active before COVID are less active because they can't do what they love doing or what their regimen, their exercise regimens were.”

• [19:16] Making lasting behavior change

  • “I believe we've got to get people focused on the experiences in the now that they are going to achieve from their quote unquote health related choices. So I believe that the beginning is what do you need? What's missing from your life? What's missing from your day? Is it energy? Is it a spark, you know, verve? What is it? And then well what could help you achieve that?”

• [23:47] The health & fitness industry communicating to reach the 80%

  • “And if, when the fitness industry understands—which I think they do—that the 80% that is not coming to their doors looks different than the 20% that is coming to their doors, has had different experiences than the 20% that is coming to their doors. And then addressing those things and showing images of people of all sizes and shapes and colors doing different types of activities and offering different types of classes.”

5 Steps to Making a Health Club an Essential Community Resource [Podcast Series]

• [:53] Dr. Bantham introduces her guest, Tom Richards

  • Tom Richards is the Founder and Managing Editor of the Activist in Motion and Principal of the Activist in Motion Advisory Services.  

  • Tom is a long time part part of the health & fitness industry through roles at IHRSA and ACE

• [1:13]  Communicating a club’s value proposition to the community

  • “The health and fitness community is really good at marketing to a certain segment of the community, who are in the right frame of mind at the right time to commit to exercise. I think most clubs struggle, however, to communicate their value to the wider community. And I'm thinking of the county council, public health officials, school boards, large employers, libraries, civic organizations, certainly the media, and really all the people who could benefit from the services provided by the club, but who don't really consider themselves to be health club type people.”

• [3:28]  COVID-19 and “essential” businesses

  • “And I think what we're seeing is that the health & fitness community is chronically undervalued, misunderstood, and really isolated from the broader community. And so now, when a crisis hits, we have public health officials and policymakers who are good people, they're not trying to do harm to any particular industry, but they are also in a crisis trying to make quick decisions based on the information that they already know.” 

• [6:17]  Moving away from “non essential” toward “essential”

  • “But I don't think that, broadly, what's happening inside the club—the professionalism and the credibility—is being communicated or translated outside the club. And that's put us in this position where we are now being ‘non essential,’ lumped together with bars and restaurants and casinos, when we should be lumped together with healthcare providers, allied health professionals, and people who are doing the best work in the community.”

• [9:40]  Understanding the needs of the community

  • “And my sense, my belief, is that many clubs are already set up to address those issues and to partner with those groups. They just haven't made the connections yet.  And they haven't made the outreach with the approach or with the language that resonates with the broader community.  And what that means for clubs is more members in the club, more guests in the club, more activities, more events, making the club more essential as part of a vibrant community.”

• [11:36] The Activist in Motion vision

  • “So I named my website and the advisory business the Activist in Motion not really in reference to me, but in honor of all the people who I've come across and who inspire me, who make a positive difference in their community by motivating others to move more and sit less.” 

• [15:58] Transforming the health & fitness industry

  • “There are so many, like you and I are sort of kindred spirits in this work. I also know that there are hundreds of thousands of exercise professionals, physiologists, PhDs, club owners, managers who feel the same way. They're just looking for a place or an idea to put their energy behind. And I think the club industry could be transformed and elevated significantly, both in stature and in revenue, if it can become that community hub that transforms communities.”

• [19:55] 5 steps to becoming an essential community resource

  • “The essential resource plan—the five components that we've discussed—starts with the essential resource scorecard or assessment. The purpose of that assessment is to establish what the club is currently doing that has great value to the community.”

  • “And then, from there, we would move into a community health needs assessment. And that's a review of what are the public health concerns or what are the health concerns in general in that location, in the club’s community. That can be a high rate of diabetes, high rate of obesity, it could be isolation, depression, a range of mental health issues, what's going on in the community that the club could address.”

  • “Clubs need to understand their stakeholders and what their needs are, what their initiatives are, what their goals are, what they hope to accomplish for the next 12 months. And then when you take those three components—the essential resource scorecard, a community health needs assessment, and a community stakeholder scan—you can start connecting those three pieces to the resources in the club and start making recommendations for how the club can better serve the community.”

  • “And then I think the fifth piece is just developing that outreach plan. So you know who your stakeholders are.  You see what, how you could add value to them in the club. How are you going to reach out to them and who is going to do it in your club. How are you going to do it effectively. How are you going to do it in a way that presents the club in the best light and brings forth the credibility of the club.  And you use the word trusted, which is probably the most important asset that a club can have in the communities, that it's trusted. And that trust leads ultimately to a feeling of indispensable, where the club is just an indispensable member of the community, valued and trusted.”

• [26:24] Connecting health clubs to healthcare

  • “And what the essential resource project can do is help clubs connect more effectively, more directly, and more quickly with health care systems and other stakeholders in their community.”

Fixing a Broken Health & Fitness Industry [Podcast Series]

• [:54] Dr. Bantham introduces her guest, Dr. Darian Parker

  • Dr. Parker is the Co-Owner of Epic Leisure Management, a longtime fitness professional and part of the health & fitness industry.

• [1:53]  Dr. D’s Social Network Podcast

  • “Yeah, so my podcast, Dr. D’s Social Network, it's all about creating my own network of very like minded people doing very different things in the world. And generally storytelling that is action based, so not only telling stories, but ways that you can get involved with those people on the podcast to make a difference and whatever topic that is for that. So I focus primarily not on one area of life that people are living, but on a wide variety of topics that there's no limitations, pretty much. I will talk about anything that is engaging and exciting.”

• [4:32]  Connection to the health & fitness industry

  • “And I remember my dad saying, make sure you do something that...make your hobby your job, do something that you just really love like that you'll actually enjoy your work as an adult. And I thought that's good, that's good advice, you know. And so, I always loved to exercise. But more than anything, I loved creating meaningful relationships with other people. And I felt that exercise was a great way to accomplish that.”

• [7:43]  Exercise and habit formation

  • “And that hopefully, that you're creating good habits and systems that help you to be accountable to those things. And if that system is a person, like myself, a trainer. Hopefully you have a good personal trainer, or someone who is an authority in that field, who is a good human being, is showing up regularly with you, bringing a positive light to the environment and cheering you on. But when it gets down to it, the actual work part is just not that fun.”

• [10:58] Accountability in exercise

  • “I think in exercise, you should have an exercise companion.  Whether they're working with you or not working out with you or not. Someone who is keeping you on the straight and narrow, being accountable.”

• [14:18]  Improving fitness performance.

  • “But if you want to get better or walk faster.  You want to actually improve your cardiovascular endurance to a higher level.  That walk has to get harder. It just has to.”

• [19:22] Goal setting

  • “A lot of clients or people, they're in it for weight loss. Like, I want to lose weight. I'm like, why do you want to lose weight? If you can't explain that to me, then you have no idea why you're doing this. And why weight loss? There's something deeper, if it's just weight loss.  There's a huge psychological component to that.”

• [22:00] Getting to the why

  • “Explain it to me, tell me why. If you can't explain your own reasoning for doing something, it's not a good reason. What's the reason if you can't define the reason why you're doing something? Why are you doing it?”

• [22:22] The benefits of online personal training

  • “So how I convey things, demonstrate them my words, my feelings, is totally accomplishable through a live online format, which is what I do for that. You're also providing a huge amount of positivity for clients, consumers, because you're taking away drive times, you're decreasing their...they don't have to get childcare generally anymore because they can be at home. Much more efficient, time wise, for the service provider, you can stack clients, one on top of each other, you don't have to drive to other places if you're not working at a facility. So time is the great equalizer...” 

• [23:58] Fitness and technology

  • “If you alleviate as many friction points for both sides of the equation, then you're going to be much happier doing those things. That's what technology does, in general, it tries to solve problems of the human condition. How can we schedule better? How could we be more efficient at work? How can we communicate quicker and all these things. And I think fitness and technology can work together to be very powerful.” 

• [25:36] Fixing a broken health & fitness industry

  • “I think the industry was broken before COVID. I think it was extremely broken. And I mean, you got to think about an industry where 15 to 18% of the population exercises regularly and that hasn't changed in 30 years. What are we doing that that hasn't changed? So to say that the fitness industry was amazing before that, is a huge lie. The industry has been broken.”

  • “But as long as the people who run our industry are not willing to consolidate and become one larger body and have more rigorous standards, the industry will continue to not provide a way that 30,40, 50% of people start becoming more active.”

• [28:53] Connecting with others

  • “Connection is what you make of it.  If your connection version is to just get your point across and try to be right and push your agenda on very controversial things, you may get a lot of attention, but you're going to feel very lonely. Question is, do you want to be famous and recognized and controversial? Or do you want to have a good life connected to a lot of people that probably will get you no viral activity online, you will not be popular, you will not be trending, but you'll be rich in quality relationships. What do you want? You make the choice.”

Moving Toward Happiness - Move Happy®[Podcast Series]

• [:54] Dr. Bantham introduces her guest, Erin Nicole

  • Erin Nicole is the CEO and Founder of Move Happy® and host of the Move Happy® Movement podcast.

• [1:07]  Helping patients improve their fitness and happiness

  • “I didn't know if it would work or not, I didn't know if it would help my patients be happier and improve their fitness or not. I believed in my capacity as a fitness educator and seeing previous experiences of people's fitness levels being improved.”

• [4:57]  Quantifying program success

  • “So I designed a one page questionnaire for their happiness, self-perceived, we did include some Likert style questions, which is like a one to five scale, one to 10. And, and then included some open ended questions to get some quality based feedback from the patients. And asked them.  How do you feel this program went?  We did a pre, mid, and post for all three rounds of the program. And I started implementing their feedback from those that felt safe enough to actually share feedback.”

• [10:09]  Naming Move Happy® 

  • “What's an inclusive word? Because my goal.  I said, Go back to your goal. Well, my goal was to get the patients interested in moving because I knew how beneficial movement and exercise is to my own mental health, to my own healing with losing my dad and just struggling with my own personal issues with depression....” 

• [15:09] Adapting programs for different settings and populations

  • “My background is in exercise and sport psychology, I know what motivates and helps to actually make someone believe that they can replicate a movement. The best form would be live version, of course. Second best would be video, but we didn't have a bunch of computers or TV screens to hit play for them to see during our station day. So I used picture.”

• [19:56]  Mental health in the workplace

  • “Businesses are starting to realize that they should care about their employees, but we've got a lot of work to do.  A lot of growth in that area, a lot of professionals needing to take responsibility for their teams. If your employee works a third of their life for your organization or work, then a lot of their time is spent there. So you should care about their mental health, their mental well being....”

• [22:00] Chief Happiness Officers

  • “If businesses could have Chief Happiness Officers or Chief Heart Officer—I've heard it termed as well—I think that that would be beneficial, but a title without implementation isn't going to do anybody any good.”

• [25:28] Creating brand ambassadors

  • “If you focus as an organization on your employees or interns—whoever works for you and adds value to your brand, whether it's sales, marketing, operations, finance, whatever departments are working for you. If you focus on making sure that they're set up for success, that you leave an open door policy so that your company feels that they can come talk to you as leaders at any point, they're going to cover your customers.  They're going to take care of your organization because they will feel valued. And they will then become ambassadors for your brand, which is essentially free marketing.”

• [27:00] Moving toward happiness

  • “Get yourself In a place of gratitude, no matter how small it can be, whether you're running a company or you're working for a company. Take responsibility for what you can, you will never know how big opportunities come your way, or how many opportunities can come through focusing on what you can control, which is being grateful, which is showing others by example that you can focus on things that are positive and going on, you know, happy in your life, and adding value.”

Community Is Medicine - Open Source Wellness [Podcast Series]

• [:54] Dr. Bantham introduces her guests, Dr. Elizabeth Markle and Dr. Ben Emmert-Aronson

  • Dr. Markle is a psychologist, speaker, writer, researcher, and Associate Professor of Community Mental Health at California Institute of Integral Studies.  

  • Dr. Emmert-Aronson is a psychologist, researcher, advocate and statistics consultant.

  • Together, they founded Open Source Wellness, a “behavioral pharmacy” operating at the intersection of healthcare and communities.

• [1:28]  Community Is Medicine

  • “So we set out to create the behavioral equivalent of a pharmacy, or an experiential delivery system for one universal prescription, which we abbreviate to be move, nourish, connect, be. So physical activity, healthy food, social connection and stress reduction.”

  • “There's nothing rocket science about physical movement, eating some vegetables, practicing some mindfulness.  Really, in our experience, the active ingredient, the thing that helps people get traction and transformation in their health, their well being, in their lives, is about community.”

• [4:57]  Creating a trusted referral pathway

  • “Providers were desperate to have some referral source. They were desperate for the resources to help their patients make these changes. And they just weren't out there. And so to be able to partner with them in this way, and really spend a little time building that initial relationship so that they could trust the referral was crucial.”

• [7:17]  Integrating programs with group medical visits

  • “What we've learned is that even when a doctor refers a patient somewhere else, about a third of them don't make it for one reason or another. They don't feel safe, they don't feel comfortable, they don't have the social capital to show up or join a new group. And really a breakthrough for us was learning to deliver our program as a group medical visit in partnership with one clinical provider who could then bill for it.”

• [8:23] Delivering programs in clinical- and community-based settings

  • “And we see almost identical outcomes, whether we're looking in the clinical setting or in the community setting. And so we know both of these programs are highly effective. And, arguably more important, both of them are a lot of fun. Both of them set up a really great system where patients don't want to leave at the end of it.”

• [11:13]  Transitioning from a clinical- to a community-based setting

  • “They complete their dose, and they graduate and they don't want to be done. And in some cases, we can offer them a transition to a community-based site, which starts to expand their comfort and their capacity to then go out into the community and get some of those needs for movement, connection, support, etc., filled.”

• [13:01] The role of health coaches in behavior change

  • “And I think really connecting with patients on a one-to-one basis, connecting with patients in a really close manner, and then finding out the goals that matter most to patients is one of those things that our doctors are just not trained to do and don't have the time for. So it's a place where our use of health coaches is vital. So our health coaches sit down with our participants. They hear from the participants what it is that matters most to them, what are the goals that they want to change?”

• [16:00] Integrating healthcare and communities

  • “I think there will be a world where there's a whole clinic community continuum and integration that that we just don't have as a system quite yet.”

• [18:31] Sustainable, scalable models

  • “Our clinical provider, on average, given no shows, was seeing around eight and a half individuals in a clinical shift. And then when we ran the Open Source Wellness program, they were seeing 16 point something on average per four hour shift. And when you look at the FQHC billing rate, what that does is it just generates a lot of extra revenue that more than covers the cost of Open Source Wellness.”

• [21:50] Evaluating program outcomes

  • “We want folks to know that this works. We've talked a little bit before about doctors not having the necessary training around behavioral prescriptions and helping folks to make these behavioral changes. I think so much of that is because the pharmaceutical lobby is much better funded than the exercise lobby or the broccoli lobby. So they're able to come in and share a lot more data. And it's incumbent on us to then gather these data and to share that in and to say, look, this really is an effective method of behavior change.  This improves patient health.”

• [24:55] Role of social support and structures

  • “And so I think we really need to have the courage to look not just at clinical structures, but also at social structures that make it possible, or really impossible, for people to do the things that our bodies and our psyches need to be happy, healthy and well. And that giving somebody a prescription that it's impossible for them to fill. They live in a food desert, the streets aren't safe, they don't have childcare, etc. It's actually not a service, right, we actually just potentiate shame and a feeling of powerlessness. So to go one step further than behavioral prescribing, I think we need to actually embed the social structures and conditions to make it possible for people to carry that forward and into their lives.”

Shifting to a Long-term, Systems Approach to Improving Community Health - Wellville [Podcast Series]

• [:56] Dr. Bantham introduces her guest, Rick Brush

  • Rick Brush is the CEO of Wellville, the national nonprofit sponsor of a 10-year initiative to improve equitable wellbeing in five U.S. communities.  

  • He is also the Founder & CEO of Collective Health, a consultancy focused on innovative health and financial models.

• [1:20]  Measuring short- and long-term success

  • “So what we're looking at is overall equitable wellbeing in five places, somewhat determined by what they think is important. And when we say equitable wellbeing, we are talking about measuring not only the overall outcomes, but also the gaps. So are people at the very highest levels achieving far greater wellbeing in measures like health outcomes, education outcomes, quality of life than people who are not experiencing as strong outcomes?”

• [3:13]  The role of community engagement and collaboration

  • “We started out with five communities, five years and five metrics, and quickly realized that five years was barely enough time to get these collaboratives working together effectively and differently, in such a way that they would produce different outcomes. So Esther, in her generosity said, ‘Well, let's extend this to 10 years.’  By 10 years, we think we can have a good base of strong collaboration, some early indicators of results, and more importantly, the kind of capacity that's going to be needed for these communities to continue the work well beyond the decade.”

• [5:39]  Collective impact 

  • “There are many, many, there are hundreds of communities that are doing this kind of work around the country, this kind of multi-sector collaborative—it's often called collective impact kind of work. And there's a reason for that. Institutions, and individuals are realizing that they can't accomplish the kind of change that they want alone.”

• [7:52] Community-led initiatives

  • “Another way of thinking about community-driven is truly driven by the individuals, the residents who live in those communities. And what we're discovering is that the priorities shift, sometimes pretty significantly, depending upon the level of involvement of individual residents in the work. So I would say across the board in all five places, there is more intention to bring community members and residents more front and center in the work, so that the work of the institutions and the funders and community members working together really makes a difference in people's lives, who live in the communities.”

• [10:51]  Having the right people at the table for collaboration

  • “There were priorities that the community identified that didn't match the interests and capacity of the people who were at the table. So a lot of this is forming, sometimes disbanding, sometimes reforming collaboratives.  And I would say, Amy, to your point, becoming more inclusive of, as you call them, the right people. It becomes evident when you're doing the work, that important people are missing.”

• [12:42] Healthcare addressing social determinants of health to improve health outcomes

  • “So you've got these social determinants of health screenings. Now, health systems are implementing these platforms to partner with and make referrals to social services organizations. So it's about food security, it's about jobs, it's about housing security, all things that healthcare systems are not equipped to deal with. But, they are actually making inroads and seeing the kind of outcomes at a population level that they wouldn't see if they were only focused on clinical.” 

• [16:34] Healthy weight initiatives

  • “...we would need a 10 year window to make a significant change in doing this. And that if we did that, then we could look upstream.  And one of the focuses is on healthy weight.  So it's not only managing weight at the point of care, or at the point of intervention, it's saying, ‘Well, what are the systems that are causing higher obesity rates, and you can start looking at food systems and incentives, and barriers to access.  So it really changes the kinds of interventions that communities can do.” 

• [19:48] Addressing health inequities

  • “So, I think, there is a commonality that has emerged in our communities, is a focus on, we can do all the health improvement and well being improvement work and shift systems. But until we get to some of these root causes that are driving inequities, we will never be successful in ensuring that every single individual has that fair and just opportunity for a life well lived, and also that every individual can contribute.”

• [23:04] Shifting from short-term to long-term thinking about investing in community health 

  • “If we know that we can make smarter investments and get better outcomes, maybe at less cost, Why aren't we doing it?...Because we're addicted to short-term thinking as a nation, as individuals, as institutions.  It's about political cycles, it's about quarterly earnings.  It's a path, what do I need to do to take care of me versus the greater good? But that's not inevitable.” 

  • “And I come out on the side that we're really at our heart as human beings about kindness and generosity and collaboration. And that we're stuck in structures that incentivize short-term thinking and self interest. So how do you break free from that? That's really what our communities are doing.”

• [28:22] Moving upstream

  • “If we want the kind of outcomes that we say we want, the only way to achieve those is to collaborate and to do it with a longer-term focus.  The short-term fix for an illness might be writing a prescription, the long-term strategy for greater wellbeing improvement is about reshaping communities. A lot of what we're doing with our collaboratives is really pointing further upstream and pointing further into the future. And having those communities come together around what they care about and what they want to achieve over the long haul.”

• [28:53] Integrating healthcare and communities

  • “Our theory of change is based on the belief that we all are built to be good collaborators. And that when given the chance to work together toward a shared goal or outcome, and given the support and the incentives to do so.  Every great thing that humankind has achieved, has resulted from that.”

Creating Community Within and Beyond a Health Club [Podcast Series]

• [:55] Dr. Bantham introduces her guest, Mike Alpert

  • Mike Alpert is the former President and CEO of the Claremont Club.

  • He is also the current COO of Smart Health Clubs.

• [1:16]  Creating community within and beyond the four walls of the club

  • “Part of your culture really should be that if we're surviving and making money, and we're profitable, some of that profit should go back into the community. And you should be welcoming to all populations. And in my opinion, especially those people that struggle with disabilities, with chronic illness, chronic injury.”

• [2:24]  Making community connection part of the culture and DNA of the club

  • “We created it by creating and maintaining meaningful purpose in the work that people did, and how did we do that? We started helping people that were desperate, that were in need of hope, acceptance and possibilities. And we focused on people that were struggling with these terrible, chronic injuries, paralysis, these chronic illnesses, long term cancer, Parkinson's, and a host of things. And we really used exercise as medicine.” 

• [4:33]  Sharing programs and best practices among clubs

  • “I had taken my wellness director to a seminar that Julie Main put on back in 2005 at an IHRSA convention, and it was on a program she had started and was running very successfully in Santa Barbara with a hospital there, called Cancer Wellfit program. And we were so impressed with her talk and what she had done that I went up after that talk and I asked her if she would share her template with me and let me develop a program like that in Claremont. And if you knew Julie, she was such an amazing human being, truly an amazing person that she said, ‘Sure.’ And we took it.”

• [9:43] Becoming totally vested in a community

  • “I'm willing to give these programs to any club that wants to implement them, complimentary. I mean, it's not about money here. It's about helping people. And building a culture around your brand that says ‘We're here to do that. And we're the club of choice and we're the employer of choice in our neighborhood. And we are totally vested in the community.’”

• [13:16]  Building relationships with physicians

  • “'So, you know, you can't go to doctors to build your bottom line.  They'll shut you down before you even get past two minutes with them. And you have to convince them that you're there to make a difference in people's lives and in their patients lives.”

• [16:27] The impact of programs on staff and member retention

  • “Let me tell you how easy it is to make money by doing the right thing for people in need. It resonates with your members, your staff, the community. I will tell you that our attrition rate dropped 8% after we started these programs a couple years after we were running them. They dropped from roughly 23 and a half percent to 15 and a half percent a year.”

• [21:17] Socialization and social support

  • “And the other thing I want to say is the social aspect of all these programs cannot be emphasized enough. I think they're as important or more important than the physical fitness part. So I use a term that I think that socialization is more important than perspiration. It's powerful, it helps with depression, anxiety, mental problems that people go through. To get them out instead of going to a clinic or a hospital, having their treatment and going home, getting them around like people in a support group setting with electric excitement going on. And then injecting the fitness part is powerful. It's powerful, powerful medicine.”

• [22:01] The role of health clubs in a post-COVID world

  • “Well, let me respond to the COVID issue. It will be over. And although virtual, live streaming, on demand, all that is not going to go away. It's going to be important. But people are going to yearn and want to get back and interact with people.”

• [24:30] The purpose of a health club

  • “I think those that focus on doing the right things and having the right blend of social activities and physical activities in their club are going to reap rewards like they never thought they would when this is over. You have to have it in your blood that your club is more than a place to just come and sweat.”

• [25:10] Integrating healthcare and health & fitness

  • “I think if ever there was a time for the experts in fitness, and the experts in health care, to come together to start working together instead of so independently, now is the time.  And especially when we know the powerful effect that exercise has on overall health.”

• [26:22] Health clubs as essential

  • “During the pandemic that we're in right now and, God forbid, if there are future pandemics, we should be an essential business. You shouldn't be able to go to Walmart, and be in with 6 million people picking up produce and putting it back on the shelf or waiting around the block at Costco to get in for 45 minutes and not be able to come to a health club, with certain restrictions, to stay healthy. It just makes no sense.”

• [26:50] First steps to connecting medical and fitness communities

  • “There's power in numbers and you've got to get all, all the barriers down and you’ve got to bring everybody in the fitness end together moving in one direction with the, towards the medical community.”

Inspiring Women to Be Active and Healthy - Black Girls RUN!

• [:56] Dr. Bantham introduces her guest, Jay Ell Alexander

  • Jay Ell Alexander is the CEO and Owner of Black Girls RUN! and a running, health & fitness enthusiast herself.   

• [1:24]  Carrying on the Black Girls RUN! legacy

  • “So the organization, we've done some beautiful things over the last two and a half years in terms of forging new partnerships out in the community, our membership base has grown about 30%, we have expanded our footprint to about seven new groups across the country.”

• [3:55]  Amplifying voices in the community with a 501(c)(3)

  • “We couldn't tangibly say over the last decade, how much we have moved the needle...So the 501(c)(3) has allowed us to put some strategy and some processes in place to really track our progress, how many members we have, what type of physical activity minutes our members are doing, how much weight is being lost, blood pressure, how much money is being—not in terms of being spent in the community, but how much—is going towards helping to support our members.”

• [5:46]  Building a supportive community

  • “We are building a community, a community that is quite supportive….[w]e make sure that if you come out to a weekly run for the first time or for the fifth time, you feel like you are a part of a group of women that are supporting you, encouraging you, and holding you accountable for your health and fitness journey.”

• [8:44]  Addressing health disparities

  • “We're showing women—I think visually it means a lot to show a woman, again, no age discrimination, no shape discrimination—showing that women can do it, and that black women are out here running and that we can we can definitely be a part of that community.”

• [9:09]  Physicians as role models and advocates for physical activity

  • “But I had a doctor, an OB, that was definitely, she was a runner as well, she was a black woman. And so she was an advocate for my health, and she was not quick to put me on medication. And she was like, you need to change your diet, you need to change your physical activity. And so that's probably one thing, is just, how do you interact with your healthcare provider, making sure, understanding that medication doesn't have to be the first resort, in terms of getting your weight down or getting your health stats in order.”

• [13:42]  Addressing barriers to physical activity

  •  “And it is conversations like this, that if people are aware that those things exist, then we can really help to find some solutions to make sure everyone feels able to just, you know, be able to hit the pavement and feel like they're absolutely welcome and able to do so.”

• [13:57] Creating an inclusive fitness movement

  • “But as long as you're a woman, and that you are in support of what we're doing on the pavement, you are absolutely 100% welcome. And so that's a part of our inclusive message that it does not matter your skin color, that you can definitely join us on the pavement.”

• [16:59] The role of social support 

  • “But that social support is definitely a component about it, that we we want you to fit again, that inclusive message we want you to feel included, we want you to feel encouraged, and those relationships are happening organically, as you start to get more involved with BGR and start getting more healthy and active. So it's definitely a sisterhood.”

• [20:25] Bringing new members into the community

  • “They see us just loud and very vibrant at races and out in events and out in the community. And they see our logo, which is very prominent, and they want to find out ‘Well, what is that all about?’ Or they see us on social media, and they see all these women just having a great time out on the pavement and they're like, ‘Hey, I just want to be a part of that.’ ”

• [23:16] The impact of COVID-19

  • “And then we offered online virtual classes for about three months, in terms of where people could log in, and attend these free classes just to stay active. And then we kind of lifted the suspension, if you will, in mid July, and probably about a third of our groups have resumed to some type of group run, small group run or something. But in terms of races and larger events that we're participating in, the rest of 2020 is completely canceled.”

• [25:27] eRACE Racism 

  • “You know, I've heard of stories of women talking, you know, white women and black women talking, some black women that may be in law enforcement, or you know, some women that may stay in a part of the nation that may be underserved. And so what are those conversations like? What can we do to kind of help, you know, bridge this gap, and create just a, just a better, a better country for us all.”

Removing Barriers to Fitness Programming, Education and Jobs For Homeless Youth - Bootcamps for Change [Podcast Series]

• [:56] Dr. Bantham introduces her guest, Katie Heggtveit

  • Katie Heggtveit is the Founder of Bootcamps for Change (#SweatierForTheBetter).

• [1:23]  Encouraging systems-wide solutions for chronic disease and physical inactivity

  • “But at Bootcamps for Change, we really do view poverty as a cause and consequence of ill health. So we address the alarming prevalence of A) ill health as well as B) unemployment within the homeless youth population.”

• [5:03]  Empowering homeless youth to become physically active

  • “So we provide critical education and employment training and opportunities, as well as accessible fitness programming helps them to develop these life skills. And this launches them on a positive path towards independence and self sufficiency as contributing members of society.”

• [6:23]  Prioritizing funding for physical activity

  • “I believe we really need to hone in on measuring the success of our programs, of these physical activity programs.  So that includes not only the health impacts for youth, but also like the return on investment from a preventative standpoint.”

• [8:11]  Meeting basic needs

  • “And you touched on something in my field or in my work that we like to call the emergency response side of homelessness.  So those are things you touched on like shelter, food and clothing. How can I think about implementing healthy dietary changes when I don't even know where my next meal is coming from?”

• [11:21] The beginning of the Bootcamps for Change journey

  • “I taught weekly for a year. And then in August of 2018 is when Bootcamps for changes was born since I couldn't continue that time commitment. So I didn't want the program to end. And then since then, we've mobilized over 250 fitness professionals to work with this population, and we've put six kids through our scholarship program.” 

• [13:12] Advice for young social entrepreneurs

  • “But then, in terms of actual advice for young social entrepreneurs, I'd say be in love with the problem. So you said that right. Identify a problem, not your solution. So I never imagined that Bootcamps for Change would be what it is today. But I was open to pivoting and changing along the way.”

• [15:05]  Physical activity as part of the social determinants of health conversation

  • “So in addition to really honing in on that return on investment, I think we really have to look at what physical activity does either than just making you feel good.  There has been a lot of really great research on drug addiction and health issues related to homeless activities. And how physical activity can actually alleviate some of these problems.” 

• [17:22] Tapping into the fitness community to make physical activity accessible

  • “And by cultivating relationships between the fitness professional and the youth experiencing homelessness, this creates, it almost ignites a passion in the fitness professionals that we work with, especially fitness professionals that have friends that have friends that have experienced homelessness or mental health issues, or maybe even they experienced some sort of poverty growing up, that really resonates with them.”

• [20:27] The importance of mentoring

  • “So mentoring, which I would characterize as sustained support, guidance, concern and encouragement of a youth also promotes that healthy relationships, resiliency and positive social development.  So self advocacy and resilience, like you mentioned, are really themes of our work.” 

• [22:04] Fitness as a stepping stone

  • “So I wouldn't say that every single youth that is going to go through our program will be a career fitness professional, remain in the fitness industry until they retire, but I really do think fitness can act as a great stepping stone. Whether It's fitness as their calling or now they have enough income that they have the ability to find their calling, or to work on gaining that skill or pursuing that education.” 

• [23:56] Stopping youth from falling through the cracks

  • “I don't have the exact stat in front of me, but Canada is higher percentage wise in terms of youth poverty compared to like 25 other developed nations, I believe we're at 13%. And to me, that's, that's unacceptable. There's always going to be inequality and inequities but to have youth fall through the cracks, is signifying that they weren't adequately supported in the beginning.”

• [25:34] Removing the stigma of homelessness

  • “If they let us and we're able to propel their stories and show that youth experiencing homelessness do want to work and they do want to overcome the challenges that they're experiencing, this will help debunk those harmful stereotypes that actually perpetrate that self stigmatization in the population that we serve.”

• [28:43] The impact of COVID-19

  • “The changes have kind of allowed us to be really creative and just take a look at our whole mentorship and employment program specifically, and accept the fact that in the future youth may only be hired by us. Who knows with the economy with the gyms, the studio gyms we are working with, they may not be able to get hired there.”

Working on the Frontlines of the Physical Inactivity Epidemic - Fitness Warriors [Podcast Series]

• [:58] Dr. Bantham introduces her guest, Jacki Quinlan

  • Jacki Quinlan is the Director of Community Outreach at Sports Backers.

  • The Sports Backers’ Fitness Warriors program serves communities with the highest rates of physical inactivity with fitness classes that are free of cost.  

• [1:46]  Report from the frontlines of the physical inactivity epidemic

  • “If you really want to talk about frontlines, that’s what it is. It’s life or death.”

  • “Our warriors that are out there recruiting folks to get moving and leading these free fitness classes. They are literally on the front lines. We have classes in Gilpin Court, where no one else is out leading classes. There's no gyms. There's no, you know, healthy place to go get food. That's where our warriors are.  We go where really no one else has gone to bring physical activity right to the communities that need them the most.”

• [4:51]  Reaching people where they are

  • “For us, we offer classes in places where people are already comfortable going in their communities. So that is churches, community centers, libraries, apartment complexes, that is where the people already frequent those places. They're centered in their communities so we're not saying, hey, come to us, we're coming to you. We're stepping onto your turf, where you're comfortable. And we're bringing what we have to offer to you.”

• [7:14]  Drawing fitness warriors from the community

  • “So we recruit folks that are from the community, average people, they're not people who have already gone through a certification. They are folks that have a passion for fitness, and have a passion for giving back to their community.”

• [10:26]  The role of social support

  • “So from our survey that we do with our warrior instructors, 75% attribute friendships and connections that they have built to our program. So it's way more than just physical activity. It's connecting them to this active living network of people who think like them, believe like them, and serve like them. And so there's this connection between the warriors that, it's deep, it's a deep connection and that filters down into their classes that they lead in the community.”

• [14:32]  Fitness warriors making a difference in the community

  • “That is what I think, to our warriors, makes it all worth it. And so it's really like knowing that they're making a difference in the community is, you know, making a difference in someone's life is what really impacts our warriors the most.”

• [16:01] Implementing the fitness warrior train-the-trainer model in other communities

  • “And so when you're going to recruit new people for the program or mentors for the program, you need someone who's well versed in the landscape of the fitness industry in your region.”. 

• [17:29]  Diversifying fitness

  • “So I think that for people to feel more comfortable and for people to feel like physical activity and fitness is for them, they need to be able to see people that look like them doing what we're asking them to do. And so I think that's another piece that, you know, as a whole, the industry has to address and has to do a better job of diversifying the face of fitness.”

• [19:56] Bringing about sustainable behavior change

  • “But when you have a warrior checking in on you, when you are, you know, starting to get to know the people in your class and they're also holding you accountable, and then they're challenging you to do the next thing.”

• [24:44] The fitness journey

  • “And so there's that progression too. And of course, as you are going through that, that's just furthering your own fitness journey. And now, it's this ripple effect. It's like you started out as a participant. Now you're going to go through the training to become a warrior, and then you're going to reach a whole other group of people that we wouldn't have reached before.”

• [26:35] Scaling up affordable programs

  • “There's lots of ways that we have gone about making this affordable and sustainable. And I think a crucial piece is being really creative, and being willing to go out and tell your story and ask people to help support in the ways that they can.”

• [29:05] Evaluating the impact of the Fitness Warriors program

  • “One of my favorite data points is that 97% of our class participants would recommend a fitness warriors class. That ripple effect that we talked about, that's crucial. That's how that happens, is people talking, that word of mouth.” 

  • “78% of our class participants are overweight or obese. And so, I am proud of that number, not because, because you might be hearing that a different way than I hear, what I hear is that we're reaching the right people. Our classes are open to anyone, anyone can come to the class, but we're really trying to reach those people who need the class the most, who are either living sedentary lifestyles, or are overweight or obese and need a place to feel comfortable coming to work out.”

Motivating Communities to Move - Walk with a Doc [Podcast Series]

• [:54] Dr. Bantham introduces her guest, Dr. David Sabgir

  • Dr. David Sabgir is a cardiologist and the CEO and Founder of Walk with a Doc.

• [1:09]  Inspiration for Walk with a Doc

  • “I started my residency and did my fellowship from 97-03 and during that time, realized how critical physical activity was. And we hear it described as the miracle drug. And I feel like every day that's hammered home more and more. So that had to be really at the forefront of our discussions.”

  • “And I thought I was doing actually a really good job until, you know, I stepped back and looked and realized that I was doing actually a very, very inadequate job. I wasn't getting my patients to be active or pursue it despite what they said in the office. So one day I really wanted this person to have to say no to my face.”

• [3:13]  Naming Walk with a Doc 

  • “I was meeting with a TV anchor in the first few weeks, very well respected in Columbus, Ohio, and she, like I'll never forget, I was walking out the door and she said, David go with Walk with a Doc that's a better name. It keeps the medical in it.” 

• [6:15]  Support for Walk with a Doc

  • “It's grown. It's been a beautiful, organic, viral, grassroots thing.”

• [6:28]  Reach of Walk with a Doc

  • “There's about 9 million doctors in the world and then obviously, so many more healthcare providers than that... nurse practitioners, nurses, etc. So we had 10,000 last year, ballpark, lead events, so that's less than 0.1%. So thanks to CDC, WHO, CNN, some others, that huge net is pulling in a very small percentage, but it's a small percentage of a big number.”

• [9:01]  Physicians as trusted providers

  • “I think when our participants and the people that come out to the walk, when they read about it in their paper, maybe the doc is, maybe they're interested in, you know, learning from the doctor, or sharing. And that's really great. But I really think the secret ingredient is...are the other walkers that are there. And it's that camaraderie, that social connectedness that you've spoken so well about in your previous podcast that really is the, those are the ties that bind.”

• [10:49] Physicians walking the walk and investing the time

  • “So you may put in an hour a week, an hour a month, an hour a year, but you get, I think about tenfold back of what you put into it.”

• [12:43]  Evaluating Walk with a Doc

  • “The coefficient is not near as high as I want and, but that is counterbalanced by the number of chapters growing and the interest and the spread. And I've been really surprised at the staying power of the docs.”

• [14:08] Focusing on social connectedness

  • “We also stumbled into the social connectedness and the importance. I just wanted people to get more active. So we got these miracle drug, you know, got it in motion, everything we could get to the 150 minutes a week and then the social connection is what our focus is going to be for 2021.” 

• [20:27] Adapting Walk with a Doc during COVID-19

  • “We have had virtual walks. Those are Saturday mornings, as well, and they allow us to feature our docs from all over the world. It's a great way to pull others in, make the family closer, even though it's on Zoom, or, you know, pre recorded.

• [21:47] Decreased physical activity during COVID-19

  • “I'm surprised how many people haven't really thought of going outside alone for a walk or with their spouse or partner. And often, you know, a little nudge from our team can make a difference.”

• [24:09] Growth of Walk with a Doc

  • “We, we’re guesstimating about 200,000 people last year, but that was up from 145,000 the year before. So we're really fortunate. We have currently 562 chapters, 451 in the US, and it needs to be so much more. And I think it will because the healthcare providers that have come to us they're so incredible. And their experience, thank goodness, has been, they feel as good about it as I do.”

Expanding Opportunities for Children and Families to Be Active Outdoors [Podcast Series]

• [:54] Dr. Bantham introduces her guest, Jackie Ostfeld

  • Jackie Ostfeld is the Director of the Sierra Club’s Outdoors for All Campaign.  She is also the Founder of the Outdoors Alliance for Kids.  

• [1:10]  Engaging children in outdoor physical activity

  • “And living through a pandemic, I have become even more acutely aware of just how important nearby nature access is for my own family's mental and physical health….And it's also really shone a spotlight on how access to parks is not a ‘nice to have’ but really an absolutely essential for all of our well being.”

  • “I've seen nature change us.  I've seen nature heal us.  And I just I believe every child deserves to benefit from the outdoors, whether that's physically, emotionally, socially or academically.”

• [3:39]  Outdoors for All Campaign vision

  • “Our work is to envision a just equitable and sustainable future where all people benefit from a healthy, thriving planet and a direct connection to nature. And so, we're striving for a world where all people can breathe fresh air, drink clean water and safely and regularly spend time outdoors.” 

• [8:18]  Addressing transportation barriers

  • “So a lot of our work has been educational. In some places, there are public transportation lines, and people just don't know about it. And all that's needed is better signage and better communication. And in some places there needs to be new bus lines created or other transportation solutions.”

• [12:00]  Addressing access and inclusivity issues

  • “And so I think understanding how people engage, how people want to engage is one part of helping to make sure that the outdoor community is more welcoming, inclusive.”

• [14:45]  Founding Outdoors Alliance for Kids 

  • “I am so grateful to have been able to co-develop with many partners the Outdoors Alliance for Kids, which we're celebrating our 10 year anniversary this year. And we have worked together, we started as seven organizations, groups like the YMCA and Sierra Club and REI. And we've expanded to over 100 organizations working to advocate for equitable access to the outdoors for children, youth and families specifically, and we've had a lot of success at the national level.” 

• [18:19] Evidence linking outdoor physical activity and mental and physical health

  • “There is evidence about the need for the nearby nature and that kids, families who have that neighborhood level access to green trees have better overall health outcomes, whether it's about obesity and mental health, but also the mortality rates are lower when you have access to nature. And then there's evidence that suggests that all you really need to gain many of those health benefits is about 120 minutes a week.” 

• [22:37]  Nature prescriptions and integration with healthcare

  • “I think it's critical that people are hearing from their doctors and trusted professionals in their lives that they should get outdoors.”

• [24:58] Making outdoor physical activity more affordable

  • “ We are working to reduce and remove fees as much as possible, working to expand transportation lines. But it's more than that. We need to have programs that invite and welcome and create opportunities for kids, for families to get outdoors.”

• [28:18] Healing through nature

  • “I am hopeful that this pandemic and also the uprising for Black Lives that we have seen all at the same time in the last couple months have woken us up as a society to the systemic racism and inequities that impact our society and our culture, including who has access to clean air, clean water, parks and play spaces, and that we move forward as a society to address through nature and all the other ways in which communities are needing to heal right now.” 

Tomorrow’s Health & Fitness Leadership Today [Podcast Series]

• [:55] Dr. Bantham introduces her guest, Lynne Brick

  • Lynne Brick is Co-owner, President, and Founder of Brick Bodies, Co-owner of Planet Fitness Growth Partners, and Co-Founder of the John W. Brick Mental Health Foundation.  

• [1:14]  Bringing the healthcare and health & fitness sectors closer together

  • “It's always been my vision, my dream, to merge the medical world with the movement world....However, we need to get more people to believe [exercise is medicine], to live it, to prescribe it, to create an organic means to help prevent disease.”

• [2:35]  Changing the perception of the health & fitness industry

  • “The first step is to change the conversation and remove the fact that the health club industry or recreation centers are considered just that, recreation. Like, just for fun. And once we change that conversation, that perception, we're able to sit at the table with docs and physical therapists and other essential industries.  The bottom-line is that we do help save people's lives and in essence help them to improve their health and well-being, help improve their longevity, help improve their resilience.” 

• [3:44]  Changing the self-perception of the health & fitness industry

  • “I think that the whole industry must unite and focus on collective intelligence of incredibly smart people in the industry and also in other industries to help collaborate on how we can help shift the conversation, shift the whole movement toward movement.”

• [4:57]  Building confidence of healthcare in the health & fitness industry

  • “If we can somehow incorporate organic movement as part of a care plan, part of protocols the medical world prescribes, then we are at the table, we can help shift the conversation there. But there has to be the confidence and the evidence-based research to back up what we say, what we believe. And again, making sure that everyone in our industry does believe that exercise is medicine.”

• [8:22]  Reaching the other 80%

  • “We have successfully as an entire company reached out to what we call the other 80%, people who have never been in a health club before, have overcome the Big Five Fears of joining a health club or being involved in a community that is surrounded by health, and the more information we can gather from those folks, the people that are changing their lives and losing not just 50 pounds, but 100 or 200 or more pounds and getting off their blood pressure medication, the data that we can gather from those folks will help shift the medical community and make them more trusting, as you mention.”  

• [11:04] Leading during a disruptive time

  • “The most important thing about being a leader in this disruptive time is that you're not alone. And I do lean on our entire team, leans on each other, to help learn more, and create these collaborative conversations so that we can learn more and how to utilize best practices.”

  • “One of the things about trying to be a better leader every day is trying to pull out the greatness in other people, and that is what we really tried to do, is to pull out the greatness in other people.”

• [14:54]  Female leaders in the health & fitness industry

  • “I think that’s one of the things women bring to the table is this concept of mutual respect, and of course, empathy. We lead a lot of times, not just from our head and our gut, but from our heart. And I think that that has been a great asset to the industry.”

• [20:04] Family leadership lessons

  • “The things I hoped that I was able to pass on to Vicki is, lead by example. And be willing to do whatever it takes to get your hands dirty too, so that you are in the trenches with your team so that they know that you're on their side.” 

• [21:37] Building evidence-based research connecting physical activity and mental health

  • “But our focus is to create a collaborative club and work with organizations and other researchers like yourself to help make people much more aware of the mental health issues.”

• [28:04] The future of the health & fitness industry

  • “How will health and fitness change for the better? It's a great way to end this incredible conversation and of course, sanitation and respect and empathy are going to be key elements to success for the future for the health & fitness industry. But what I think is also evolved out of this is the need for incredible leaders, more—much more—diversified leaders.”

  • “It's just the nature of what we are going to see, not just from our industry, but every single industry, the strong will survive.  But we need to help to cultivate the best of the best, the Top Gun of our industry. So through diversification, through education and financial backing, and the future is bright, and I think that we all need to keep our positively positive attitudes to help create the new world.”

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.”