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ENCOURAGING PHYSICAL
ACTIVITY – A KEY HEALTH
PROMOTION STRATEGY FOR
THE PREVENTION AND
CONTROL OF NCDs
Dr. Monika Arora
Director: Health Promotion &
Adjunct Associate Professor
Public Health Foundation of India
GBD 2010

Risk Factors
(Top Contributors to DALYs)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10

High Blood Pressure
Smoking (excluding SHS)
Alcohol Use
Household Air Pollution
Low Fruit
High Body Mass Index
High Fasting Plasma Glucose
Childhood Underweight
Ambient PM Pollution
Physical Inactivity

Diet & Physical Inactivity
Cluster Responsible For
Largest Global Disease

Burden

Lancet 2012
NCD Risk Factors in India:
Physical Inactivity - I
 Study conducted among adolescents across 5 districts of India
showed 25.2% boys and 24.7% girls had poor physical activity
index
Bachani et al., 2013

 Among adolescents (> 11 yrs) duration of Sedentary activity
(223 min) was more than moderate- vigorous physical activity
(60.7 min)
Swaminathan et al., 2012

 Walking and bicycling to work is associated with reduced
cardiovascular risk in the Indian population. A dose-response
relationship was observed between duration of bicycling to
work and being overweight, having hypertension or diabetes.
Millett et al., 2013)
NCD Risk Factors in India:
Physical Inactivity - II
 A hospital-based case control study with 1050 participants (350
AMI cases and 700 controls) conducted in New Delhi and
Bangalore suggested that:
 Participants with the highest level of physical activity (>145 MET minutes per day) had a RR of 0.45 (95% CI: 0.31, 0.66) for CHD
compared with non-exercisers.

 Participants with >3.6 hours of sedentary activity per day had
an increased risk (RR 1.88; 95% CI: 1.09, 3.20) of CHD
compared with participants doing <70 minutes of sedentary
activity per day.
Rastogi et al., 2004
(WHO SEARO, 2013)
Targets for NCD Prevention and Control in
India
Effectiveness of Interventions to
Promote Physical Activity
 A social marketing focused intervention to promote physical activity in rural
Tamil Nadu (India) mobilised nearly 55% of the subjects in brisk walking > 4
days a week

Subitha et al., 2013

 An intervention with 11 year olds in Norway effect on overall physical activity
at the level of p = 0.05 with a net effect of 50 cpm increase from baseline to
post intervention in favour of the intervention group (95% CI −0.4, 100)

Grydeland et al., 2013

Source: Cecchini M, Sassi F, Lauer
J et al. Tackling unhealthy diets,
physical inactivity and obesity:
health effects and costeffectiveness. Lancet 2010
An Evaluation of School Environments: Physical
Activity Audit tool
 Surrounding area
 Less than 15% had cycle lanes separated from road
 Less than 15% had pavements on both sides of road
 Less than 10% had pavements on one side of the road
 Less than 10% had marked pedestrian crossing
 Less than 30% had traffic calming measures
 No signs
 School grounds
 Generally, modal quality ‘Adequate’
 Over 90% had playground equipment
 Over 50% had courts
 Over 50% had quadrangles
 Over 50% had uncovered cycle parking while less than 10% had covered
cycle parking
Innovative Health
Promotion Campaigns
Walk for Health: Counting every
mile you walk!
Mobilizing the Ground Miles
App Download

www.groundmiles.bupa.com
Total global downloads: 21,372
Clicks from India: 3,13,884
Walk for Health – Delhi (Oct 20, 2013)
Nearly 10000 participants
Walk for Health – Mumbai (Oct 20, 2013)
Nearly 6000 participants
Walk for Health-Vizag (Nov 30, 2013)
Nearly 5000 participants
Inter-school Poster Competition- Delhi

1,200 students from nearly 40 schools in
Delhi
Inter-school Poster Competition-Vizag

Nearly 1000 students participated in the Poster making competition
Optimising Social Media
Twitter
Engaging celebrities to spread the word
Engaging like minded organisations
Promotion on Y4H
www.facebook.com/youthforhealth
The DADA Campaign
Promoting Physical Activity in Colleges
Partnering at festival of Youth
Sport, Delhi University

Organising mini-marathons
and walkathons with college
students
Eat for Goals!
Eat For Goals! is a recipe book for children
13 players
13 dishes
1 cause
1 book
Rationale:
Footballers are role models for boys and girls.
A multicultural group of 13
internationally renowned male and
female star players present their
food choices.
The recipe book highlights the
interdependency between a
balanced healthy diet and
performance.
Respect Your Health
An increase in health literacy levels
• A positive change in lifestyles
• An increase in community
involvement in social activities
• A wider range of citizens playing
sport and using local sports facilities,
thanks to a greater sense of
community ownership
http://respectyourhealth.eu
The European Healthy Stadia Network
 “Healthy Stadia are those which promote
the health of visitors, fans, players,
employees
and
the
surrounding
community... Places where people can go
to have a positive, healthy experience
playing or watching sport.”
A holistic approach to developing
stadia as ‘health promoting settings’

http://www.healthystadia.eu
Make a healthy heart your goal

www.worldheart.org/womenseuro
Make a healthy heart your goal
UEFA Multi-European City Initiative
THANK YOU!
monika.arora@phfi.org

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Next Step 2014 presentation by Dr. Monika Arora from Public Health Foundation of India (PHFI)

  • 1. ENCOURAGING PHYSICAL ACTIVITY – A KEY HEALTH PROMOTION STRATEGY FOR THE PREVENTION AND CONTROL OF NCDs Dr. Monika Arora Director: Health Promotion & Adjunct Associate Professor Public Health Foundation of India
  • 2. GBD 2010 Risk Factors (Top Contributors to DALYs) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10 High Blood Pressure Smoking (excluding SHS) Alcohol Use Household Air Pollution Low Fruit High Body Mass Index High Fasting Plasma Glucose Childhood Underweight Ambient PM Pollution Physical Inactivity Diet & Physical Inactivity Cluster Responsible For Largest Global Disease Burden Lancet 2012
  • 3. NCD Risk Factors in India: Physical Inactivity - I  Study conducted among adolescents across 5 districts of India showed 25.2% boys and 24.7% girls had poor physical activity index Bachani et al., 2013  Among adolescents (> 11 yrs) duration of Sedentary activity (223 min) was more than moderate- vigorous physical activity (60.7 min) Swaminathan et al., 2012  Walking and bicycling to work is associated with reduced cardiovascular risk in the Indian population. A dose-response relationship was observed between duration of bicycling to work and being overweight, having hypertension or diabetes. Millett et al., 2013)
  • 4. NCD Risk Factors in India: Physical Inactivity - II  A hospital-based case control study with 1050 participants (350 AMI cases and 700 controls) conducted in New Delhi and Bangalore suggested that:  Participants with the highest level of physical activity (>145 MET minutes per day) had a RR of 0.45 (95% CI: 0.31, 0.66) for CHD compared with non-exercisers.  Participants with >3.6 hours of sedentary activity per day had an increased risk (RR 1.88; 95% CI: 1.09, 3.20) of CHD compared with participants doing <70 minutes of sedentary activity per day. Rastogi et al., 2004
  • 6. Targets for NCD Prevention and Control in India
  • 7. Effectiveness of Interventions to Promote Physical Activity  A social marketing focused intervention to promote physical activity in rural Tamil Nadu (India) mobilised nearly 55% of the subjects in brisk walking > 4 days a week Subitha et al., 2013  An intervention with 11 year olds in Norway effect on overall physical activity at the level of p = 0.05 with a net effect of 50 cpm increase from baseline to post intervention in favour of the intervention group (95% CI −0.4, 100) Grydeland et al., 2013 Source: Cecchini M, Sassi F, Lauer J et al. Tackling unhealthy diets, physical inactivity and obesity: health effects and costeffectiveness. Lancet 2010
  • 8. An Evaluation of School Environments: Physical Activity Audit tool  Surrounding area  Less than 15% had cycle lanes separated from road  Less than 15% had pavements on both sides of road  Less than 10% had pavements on one side of the road  Less than 10% had marked pedestrian crossing  Less than 30% had traffic calming measures  No signs  School grounds  Generally, modal quality ‘Adequate’  Over 90% had playground equipment  Over 50% had courts  Over 50% had quadrangles  Over 50% had uncovered cycle parking while less than 10% had covered cycle parking
  • 10. Walk for Health: Counting every mile you walk!
  • 11. Mobilizing the Ground Miles App Download www.groundmiles.bupa.com Total global downloads: 21,372 Clicks from India: 3,13,884
  • 12. Walk for Health – Delhi (Oct 20, 2013) Nearly 10000 participants
  • 13. Walk for Health – Mumbai (Oct 20, 2013) Nearly 6000 participants
  • 14. Walk for Health-Vizag (Nov 30, 2013) Nearly 5000 participants
  • 15. Inter-school Poster Competition- Delhi 1,200 students from nearly 40 schools in Delhi
  • 16. Inter-school Poster Competition-Vizag Nearly 1000 students participated in the Poster making competition
  • 19. Engaging like minded organisations
  • 22. Promoting Physical Activity in Colleges Partnering at festival of Youth Sport, Delhi University Organising mini-marathons and walkathons with college students
  • 23. Eat for Goals! Eat For Goals! is a recipe book for children 13 players 13 dishes 1 cause 1 book Rationale: Footballers are role models for boys and girls. A multicultural group of 13 internationally renowned male and female star players present their food choices. The recipe book highlights the interdependency between a balanced healthy diet and performance.
  • 24. Respect Your Health An increase in health literacy levels • A positive change in lifestyles • An increase in community involvement in social activities • A wider range of citizens playing sport and using local sports facilities, thanks to a greater sense of community ownership http://respectyourhealth.eu
  • 25. The European Healthy Stadia Network  “Healthy Stadia are those which promote the health of visitors, fans, players, employees and the surrounding community... Places where people can go to have a positive, healthy experience playing or watching sport.” A holistic approach to developing stadia as ‘health promoting settings’ http://www.healthystadia.eu
  • 26. Make a healthy heart your goal www.worldheart.org/womenseuro
  • 27. Make a healthy heart your goal