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Page

Get Ready:

Introduction 3

Creating your action plan 5

Get Set: All the tools you need to get started

Getting Set implementer checklist 6

10 tips to make recess a success 7

Go! It’s recess time!

How to lead an Instant Recess 8

Safety guidelines 9

Instant Recess talking points 10

Instant Recess cheat sheet 11

Cool Down: Next steps

Tips for success and overcoming challenges 12

Evaluation tools 13

Additional Resources:

Fact sheet 15

FAQs 17

Customizable flyer 19

Other ways to fit in physical activity 20

Large front cover image: Staff and leaders of the South Bay Medical Center take part in an Instant

Recess at the farmers market for worldwide “Bring Back Recess Day."

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The problem

Let’s face it. We sit too much and don’t move enough. As Dr. Toni Yancey, creator of Instant Recess explains, less than five percent of American adults meet the recommended 30 minutes of physical activity, five days a week. Two thirds of Americans are overweight or obese. Kaiser Permanente (KP) mirrors the national average — according to aggregate health data, over 67 percent of KP employees are overweight or obese. Sedentary workers use more sick time, have less productive work days, and suffer higher rates of injury.

A sedentary lifestyle puts you at increased risk for:

Diabetes Glaucoma Osteoporosis Hypertension Chronic kidney disease

Vascular dementia Heart disease Cancer

Alzheimer’s disease

A fun and easy solution

Instant Recess is a quick, easy, and fun way to fit physical activity into your workday. Dr. Toni Yancey, author of Instant Recess: Building a Fit Nation 10 Minutes at a Time, co-director of the University of California, Los Angeles (UCLA) Kaiser Permanente Center for Health Equity, and Professor of Health Policy and Management at UCLA’s Fielding School of Public Health, created Instant Recess to add physical activity, a few minutes at a time, into our daily lives – at work, at school, and in our leisure time. Dr. Yancey’s research has shown that adding short recess breaks to the work day can help employees control their weight and decrease depression, diabetes, heart disease, and cancer.

A healthier team means employees who have better attendance, are more productive, and suffer fewer injuries. KP work units that have implemented Instant Recess are getting great results. Labs, pharmacies, call centers, and even patient care units have all lowered absentee rates and injuries while boosting teamwork and morale.

While a few minutes may not seem like a long time, research has found that any amount of physical activity, no matter how small, can have health benefits. Additionally, individuals who participate in Instant Recess have been found to increase their physical activity and other healthy behaviors outside of work.

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Productivity

Cognitive processing efficiency

Speed and accuracy of data-entry

Energy levels

Employee morale

Engagement of inactive individuals

Mood, self-efficacy; self-esteem

Fruit and vegetable consumption

Overall physical activity (outside of work)

Absenteeism

Injuries (ergonomic and accidental)

Health care costs

Urge to smoke

Stress and anxiety

Harmful effects of prolonged sitting

Weight and BMI

From Dr. Yancey’s book, Instant Recess®: Building a Fit Nation 10 Minutes at a Time

It’s really that simple. Just a few minutes a day can lead to improved health for your employees, your department, and Kaiser Permanente.

The investment to bring Instant Recess to your department is very minimal. All you need is a few minutes of time, a couple of Instant Recess leaders, some music, and a small space where employees can gather. Let’s get started!

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Creating your action plan

Departments that regularly participate in Instant Recess have significantly improved attendance, decreased injuries, and have boosted morale and performance measures. Teams look to Instant Recess to help them relieve their stress. The activity acts as a re-set button after a stressful call, time, or interaction.

Use this form below to create an action plan to get Instant Recess started in your department or facility. Make sure to use SMART goals (specific, measurable, attainable, realistic, and time-bound).

My Instant Recess Action Plan My goal is: _______________________________________________________________________________________ (SMART goal example: To start Instant Recess in my department once per day for 5 minutes by May 6, 2013.) How confident are you that you can start Instant Recess with your team?

0 1 3 4 5 6 7 8 9 10 0 = not at all confident 10 = totally confident If your confidence level is below a 7, what would need to happen to increase it to at least a 7? _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ Things that could make it difficult to start Instant Recess in your department? ______________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________

(Example: small space, hectic department, etc.)

What is your plan for overcoming these barriers? ______________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________

What support and resources will you need to bring Instant Recess to your team?

______________________________________________________________________________________________________________________________________________________________________________

What is the first step you will take and when will you take it?

______________________________________________________________________________________________________________________________________________________________________________

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Implementer checklist for Instant Recess

Once you make the decision to start Instant Recess, you need a plan. Use the checklist below to make sure you have everything you need to get started. Gain manager and leader support and participation. The teams with the most success come

from departments where leaders and managers take an active role in Instant Recess. Employees who see that their health is a priority to their manager and KP feel cared for and supported. Use the attached Fact Sheet to help engage management. Work with your labor partners to help get management support.

Engage Unit Based Teams. When unit based teams/front line teams get involved they can help brainstorm through barriers and help ensure maintenance sustainability of Instant Recess.

Recruit Instant Recess leaders. Recruit two to three Instant Recess team leaders. Leaders can be anyone who has a passion for Instant Recess— regardless of size, shape, age, or fitness level. Share with them the tip sheet and / or PowerPoint presentation on how to lead an Instant Recess as well as the safety guidelines.

Make space. Designate a space where staff can safely gather for Instant Recess. It doesn’t have to be very large — just enough room for everyone to move a little. Try break areas, conference rooms, clearings between cubicles, or going outside for fresh air. Keep in mind, though, that the farther people have to go, the easier it will be to opt out of recess.

Find time. Designate a regular time for recess that will not interfere with patient or customer care. Depending on your department, you may need to split into several teams and rotate taking Instant Recess to ensure adequate coverage.

Make some noise. No need for fancy sound systems or speakers. Just a CD player, a computer, or an iPod or Smartphone with speakers and you’re ready to go.

Rock it out. Upbeat music makes Instant Recess fun and exciting. Let team members take turns choosing the music they enjoy.

Keep it simple. You don’t have to be an aerobics instructor or professional athlete to lead an Instant Recess. Start small with simple stretches or calisthenics such as modified jumping jacks and partial squats. The benefits come from moving, so encourage everyone to do whatever they can. Use the Instant Recess Fact Sheet and / or slide deck.

Get the moves. Got the moves like Jagger? Create a fun dance routine. It can be anything from a few simple steps to line dancing. A favorite at the South Bay Medical Center in Southern California is the chicken dance! For more inspiration, check out the Instant Recess routines website.

Get everyone involved. Instant Recess is for everyone. The routines can be adapted to include people of varied fitness levels and with limited mobility. Anyone who wants to participate should be able to join in and have a good time, but never insist. Try to have a few modifications up your sleeve to make Instant Recess fun and enjoyable for everyone. Check out ideas for different moves in the Instant Recess at KP “Get Moving Library”.

Create a buzz. Get everyone excited about recess time with e-mails, flyers, or face-to-face interactions with your team. Customize the flyer for your department or facility.

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10 tips to make recess a success

Once you have everything set, and have spread the word and built up excitement, you are ready to gather the troops and get started. Here are 10 tips to make recess a success:

1. Make it known: recess is not the just the flavor of the month. Build it into your department schedule; make sure employees know that it is here to stay.

2. Build it and they will come. Participation is always voluntary. Anyone who wants to participate should be able to join in and have a good time, but never insist. Usually once people feel the immediate effects on their mood, energy, and stress level they will want to keep it up. Even reluctant employees will join in when they see what a great time everyone is having.

3. Break out of the box. Instant Recess can be done by anyone, in any location, in any attire. Allow everyone to participate at their own level and in their own way. For example, if a participant is unable to move the lower body, have a few alterations ready such as clapping or drumming to the beat. Another idea is to ask the person ahead of time if they would like to call out the exercise moves for the group. You can always check out other ideas for different moves in the Instant Recess at KP “Get Moving Library”. Remind participants that they can adjust the intensity of the movement to suit their fitness level.

4. Gather the troops. The group aspect of Instant Recess makes it more fun. Invite leadership and management to join whenever possible. It helps to build teamwork and shows staff that leadership supports recess.

5. Sell it. How you describe recess is crucial. Explain it as “playtime” and not another work task. Don’t mention weight loss — overweight employees may be turned off by another message to try to get fit. Do mention other health benefits, such as improved mood and energy.

6. Call it what it is. Everyone loves recess! Make sure you call it Instant Recess when you describe it to staff. Everyone knows that recess means fun and time away from work duty.

7. Institutionalize it. Remember elementary school? The recess bell would ring at the exact same time every day and you would rush out the door to play. Just like then, Instant Recess breaks should be designated specific times — during regular staff meetings, huddles, or a particular time of day, rather than relegated to discretionary time.

8. Make it easy. Take recess breaks as close to staff work areas as possible, so staff can see and hear it starting and can quickly step away from their work to join. This is especially helpful for patient care departments. Taking a recess break around the nurses’ station allows staff to take a break and still be in close proximity to their patients.

9. One size does not fit all. Every medical center and even every department has its own culture. One department may enjoy dance and aerobic routines, while another team likes sports drills. If a recess style doesn’t click with your team, keep trying. For example, the Oncology Department at South Bay Medical Center in Southern California tried Instant Recess for several months before they found their groove with line dancing.

10. Recess is part of who we are. Kaiser Permanente stands for Total Health. Building physical activity into the day of our employees and physicians shows that we are walking the talk. Make it feel like part of how we do things, not just one more thing we have to do.

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How to lead an Instant Recess

By now you’ve gotten leadership and management support, designated space and time during the work day, and promoted Instant Recess to your team. Now it’s recess time. Leading an Instant Recess break is easy. Anyone can do it, regardless of fitness level or expertise. The moves are simple, low-impact, and easy-to-learn. All it takes is motivation and a little sense of humor.

Recess breaks can be anything from stretching and simple movements to full-on dance routines or even flash mobs. Instant Recess is for everyone. The routines can be adapted to include people of varied fitness levels and with limited mobility. Participation is always voluntary. Anyone who wants to participate should be able to join in and have a good time, but never insist. Instant Recess breaks all consist of repetitive movements and last anywhere from three to ten minutes in length. The important thing is to get everyone moving and their heart rate up.

Need inspiration? Here are some ideas for how to lead an Instant Recess break in your department.

Plug n’ play videos. Download KP Instant Recess videos and play at your next meeting or recess break. You can even show the plug n’ play at your next online meeting. Simply save the video file to your desktop and share the file. Once you get the hang of it try making up your own routine!

Tag team. This is a fun exercise for small groups (5-20 people). Put on some upbeat music, get in a circle, and start with a march in place. Then go around the circle and each person comes up with a move that everyone follows. Start with one move, and as it goes around the circle, add on, until you have a whole routine.

Head coach. Loved playing sports in school? Relive those fond memories by doing some warm up routines or drills. Just keep in mind the fitness level of everyone in the group and keep the exercises moderate in levels of difficulty and intensity.

Dance, dance, dance. Whether you remember the Hustle or the Roger Rabbit, we all have our favorite dance moves from our youth. Bring back fun routines such as the YMCA, the Electric Slide, the Twist, or the Chicken Dance.

Stretch break. Download stretch break slides from the Healthy Workforce website. Or order a Healthy Meetings Pocket Guide that includes a stretch break how-to.

Yoga moves. Yoga calms the mind and energizes the body. It simultaneously stretches, strengthens, and offers a sense of calm.

KP’s got talent. Everyone on your team is capable of leading an Instant Recess, but you may also find some extraordinary leaders. Tap your department for hidden talent. You never know who may be an expert salsa dancer or tai chi guru.

Flash mob. Ready to make a splash? Organize a flash mob at your local KP farmers market or another Thrive event.

Meetings and conferences. Leading an Instant Recess at a large scale event or gathering? Simply download the Instant Recess PowerPoint, routine cue card, and your music onto a laptop, flash drive, or even a smart phone. If available, wear a portable microphone for leading the moves.

More videos. Download more Instant Recess videos and routines from kp.org/healthyworkforce.

And it goes without saying, always practice safety. Follow the safety guidelines below.

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Rules of thumb for good form:

Never bounce when stretching. Bouncing may cause the muscles to stretch farther than their capacity and may result in injury. All stretches should be held static while participants focus on their breathing. Remind participants that increased flexibility will come over time.

Never “lock out” a joint. Always keep a slight bend should in the elbow and knee joints to prevent injury.

Always bend from the hips, not the waist, and hold abdominal muscles tight to protect the lower back.

Breathe. Participants should never hold their breath. Instruct participants to focus on taking deep breaths throughout the break, inhaling through their nose and exhaling through their mouth. Exhale at the exertion portion of strength exercises.

Instant Recess is simple, easy, and fun. But it’s still important to be safe. Follow these safety

guidelines to make sure no one gets injured and everyone has a good time.

Comfort level. Instant Recess should always be conducted at the level at which everyone feels comfortable. Begin by demonstrating the most simplistic version of the activity. After everyone has mastered the movements, feel free to move to more advanced exercises, but let each individual participate at the level that works for them. Offer movement modifications to meet participants at their comfort level. Keep in mind that Instant Recess participation is always voluntary. Anyone who wants to participate should be able to join in and have a good time, but never insist.

Attire. Instant Recess is designed to be conducted in any sort of attire, from scrubs to business suits. However, suggest that participants wearing high-heels or uncomfortable shoes remove them. While sneakers are not necessary, this is a great opportunity to encourage everyone to keep a pair at their desk, work station, or locker — for these breaks and taking walks on their lunch hour!

Movements. Begin with just lower body movements and then add in the upper body. Combining lower and upper body movements maximizes calorie burning and improves coordination. Allow everyone to participate at their own level and in their own way. It’s important to have movements that include everyone. For example, if a participant is unable to move the lower body, have a few alterations ready such as clapping or drumming to the beat. Another idea is to ask the person ahead of time if they would like to call out the exercise moves for the group. You can always check out other ideas for different moves in the Instant Recess at KP “Get Moving Library”. Always remind participants that they can adjust the intensity of the movement to suit their fitness level. You might want to have two people leading the Instant Recess, with one modeling higher-intensity movements and the other modeling lower-intensity movements. If participants feel tired, encourage them to continue using their lower body while taking an upper body break. Those who are unable to engage in the lower body portion of activities can complete the upper body movements from a chair. The important thing is for everyone to keep moving.

No pain no gain? Be attentive to injury prevention. Exercises may produce mild discomfort but should never produce pain, make sure participants understand the difference. If an exercise is producing pain, participants should adopt a less strenuous modification or return to lower or upper body movement only until beginning the next exercise.

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Below are some talking points about Instant Recess that you can use to introduce the program. You can also download PowerPoint slides of these talking points from the Healthy Workforce website to use at your next meeting or presentation.

Introduction

Who has heard of Instant Recess? How many people have participated in an Instant Recess? Who created Instant Recess? Dr. Toni Yancey, MD, MPH, Professor in the Department of Health Services at UCLA School of Public

Health Co-Director of the UCLA Kaiser Permanente Center for Health Equity Primary research interests are in chronic disease prevention and adolescent health promotion Wrote a book titled “Instant Recess: Building a Fit Nation 10 Minutes at a Time”

What is Instant Recess? Technology has engineered activity out of our daily lives Instant Recess is Dr. Yancey’s approach to building activity back Short bouts of activity (5-10 minutes) set to music integrated into the work day Movements and routines can be modified so that everyone can have fun and get involved!

Why “recess?” It’s called “recess” because it should be fun! Building a culture and society that makes activity the easy choice This is an opportunity to have fun and interact with your coworkers Participation is encouraged, but always voluntary

Instant Recess at the South Bay Medical Center in Southern California Kaiser Permanente Healthy Workforce staff teamed up with Dr. Yancey to pilot Instant Recess in

three departments: the laboratory, the call center, and Unit 3000 inpatient care Results: both absenteeism and injury rates decreased, team morale increased Implemented in 20 departments so far, goal is to add two departments per month Lessons learned:

o Visible leadership support is key to success o Departments that roll out through UBTs are more successful in implementation and

maintenance

Instant Recess at KP Kaiser Permanente stands for Total Health, which includes the health of the workforce Part of KP’s mission is to have the healthiest employees in the health care industry KP supports a healthy work environment, where the healthy choice is the easy choice Instant Recess at KP integrates fun and healthy activity breaks into the work day

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Some routines to get you started

Below are some sample moves to start you off on the right foot. Pick and choose the moves that you feel comfortable leading and feel free to add your own. Make sure the music you pick is tailored for your audience. Use the playlist in this toolkit for song ideas. You can also download PowerPoint slides from the Healthy Workforce website to use at your next meeting or presentation.

The Instant Recess break should last somewhere between 3-10 minutes, depending on how much time you have. Each exercise can be done 10-15 times. Repeat exercises if needed. To get people in the spirit and having fun, clap your hands, do call and response, or have everyone sing or shout out parts of the song. You will be amazed at the response.

Warm Up March in place (keep marching throughout the exercises) Arm raises: inhale and exhale Shoulder rolls: forward and backward Neck rolls: clockwise and counter clockwise

Get Your Heart Pumping Step side-to-side and clap your hands Add arms: raise hands up and out Knee lifts Add arms: bicep curls (lift and lower 10-15 times) Knee curls (alternate curling your legs back) Add arms: triceps (extend back and forward 10-15 times)

Sports Moves Rowing Dragon Boat: march/stroke with arms Baseball Batter on deck: side step/arms up holding bat behind head Batter up: forward side step/swing bat Fastball: forward side step/throw ball Catch: 2 side steps/extend arm left then right to catch Football Fast feet: high step double time/turn left and right Wave: deep knee bend/arms straight up Celebration: side step/catch the ball and throw it down Basketball Defense: side step/“guard” with arms extended, turn left and right Chest pass: 2 side steps/”pass” the ball

Cool Down March in place and inhale / exhale several times, cooling down. Cross one arm over the front of your torso and hold with the other. Repeat on the other side. Stretch arms over head and reach down to touch your toes (or as far as you can go). Repeat.

Instant Recess is for everyone. The routines can be adapted to include people of varied fitness levels and with limited mobility. Participation is always voluntary. Anyone who wants to participate should be able to join in and have a good time, but never insist. And always remind participants that they can use lower or higher intensity movements to fit their fitness level. The most important part is to keep moving. For more inspiration, be sure to visit the Instant Recess at KP “Get Moving Library”.

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Tips for success and overcoming challenges

You did it! You are increasing your physical activity along with your department. Everyone is having fun and noticing the changes. Now what?

Measure your progress Track your Instant Recess participation and monitor your improvements. This will help build your business case and serve as justification for making Instant Recess a permanent part of the work day. Use your UBT documentation forms (if doing a UBT project) or the forms below to monitor your progress.

Overcome challenges All kinds of departments and teams throughout KP have successfully made Instant Recess a part of their culture. Nearly all of them have faced some challenges and struggles along the way, but creatively worked through them. You and your team can, too. If you encounter a barrier, work with your UBT and other team members to find a solution for it.

For example, when the South Bay Medical Call Center in Southern California first started Instant Recess, their hold times increased. They took this challenge to their UBT who split the department into several smaller teams, who could rotate taking breaks. The UBT also decreased the number of minutes that Instant Recess was performed. These small changes helped increase service scores and made Instant Recess a hit.

In an inpatient unit, the team opted to do recess breaks three times throughout the day, so that every shift could participate. They scheduled the breaks to be just after peak times, so that patient care was not compromised. During the day and evening breaks, available staff members gather around the nurses’ station, inform the patients and family members what they are doing, and even invite them to join in.

Keep it fresh The final step is keeping Instant Recess fresh and engaging. Even the best routines can get boring after awhile. Make sure your team has several different regular routines in their repertoire. When you run out of ideas, check out the Healthy Workforce website for more routines. Try line dancing, tai chi, hula hooping, jump roping — the possibilities are endless.

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Track your progress

Track all the days your group takes recess. A healthier and happier team is around the corner. You can also download a spreadsheet here.

Department: ____________________________________________________________________________

Leader(s): _______________________________________________________________________________

Contact Info: ____________________________________________________________________________ (Name and number for recorder) Date: Leader: What you did: For how long? # participants:

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Improvements

Adding Instant Recess to your department will make some improvements. Tracking those improvements will help keep Instant Recess going! In addition to sick leave and injuries, which you can measure below, you can also informally track stress levels and attitude changes in the workplace. You can also download a spreadsheet here.

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Instant Recess consists of short (3 - 10 minute) physical activity breaks built into the work day. The basic exercises can be performed easily by individuals of varied fitness levels at varying levels of intensity, with minimal risk of injury.

Instant Recess was designed to change work culture norms to increase moderate regular physical activity participation. Integrating brief bouts of structured exercise into the daily work routine has been shown to improve health, lessen injuries, and boost team morale.

By participating in Instant Recess you may experience the following: increased fitness, more energy, better mood, and a general sense of wellbeing. Benefits can be obtained from physical activity breaks as brief as 10 minutes at a time.

No. Instant Recess is separate from your allowed breaks. These activity breaks are being encouraged as a part of overall KP workforce wellness.

Exercises may produce mild discomfort but should never produce pain. Be sure to know the difference. If an exercise is producing pain, adopt a less strenuous modification or return to lower or upper body movement only until beginning the next exercise. However, if an injury does occur, your worker’s compensation benefits will cover you.

Exercises are designed to be conducted in any sort of attire – from scrubs to business suits. However, please remove any high-heels or uncomfortable shoes. You may want to bring in a pair of tennis shoes to keep at work just for recess breaks, and perhaps for other break time activities as well!

Instant Recess activities are designed for all fitness levels. Begin with the most simplistic version of the exercise at a moderate intensity. After you feel comfortable with the movements, you can move on to more advanced modifications. More fit participants can always increase the intensity and speed of any movement.

Being active and on your feet at work may not be intense enough for the health benefits of physical activity. The goal of Instant Recess is to get your heart rate up and your blood pumping.

Instant Recess puts play back in your day. Not only does it get you moving, it has been shown to increase mood, energy level, employee morale and decrease stress.

It seems counter-intuitive, but most people find that physical activity actually increases their energy. After the recess break, employees return to work refreshed and energized.

Health problems may make physical activity a little more difficult when you begin. But over time, these health conditions can actually improve. If you have a chronic illness or condition or are over the age of 40, be sure to check with your healthcare provider before beginning your program. Start slowly, build up, and each day it should become easier.

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Participation is always voluntary. Anyone who wants to participate should be able to join in and have a good time, but never insist. Instant Recess is for everyone. The routines can be adapted to include people of varied fitness levels and with limited mobility. For more information on how to modify or incorporate different movements, refer to the Instant Recess at KP “Get Moving Library”.

Absolutely! Just click on your favorite Instant Recess “Plug and Play” and you have an Instant Recess at your very own workstation on demand.

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Instant Recess is one component of a healthy and active lifestyle. Once you get started you’re likely to find you’re eager to incorporate even more activity into your daily routine. You don’t have to spend hours at the gym or even change clothes. Try some of these quick and easy ideas to fit in fitness into your day:

KP Walk! is a fun online program that encourages us all to “walk the talk” by walking 30 minutes a day, 5 days a week. Join KP Walk! today by visiting: http://www.kpwalk.com/. Step Up. Walk on.

Whenever possible, take the stairs instead of the elevator. Stair climbing burns more calories than jogging — 200 calories in just 20 minutes. The steps will help you feel refreshed when you arrive at your destination.

Use a regular meeting time to walk (inside or out). You’ll be surprised at how much you can get accomplished while walking and talking.

Take that spot at the back of the parking lot instead of circling around trying to find the closest one to work or the store. You’ll actually save time and get your heart rate up.

Take time before or after dinner to walk with your family or a close friend. Or use the time to call a friend. Get a group of friends together and go bowling, dancing, skating, or play active games.

Taking public transport is good for you and the planet. Try taking the bus or train to work a couple days a week. It has been found that train commuters walk an average of 30 percent more steps than car commuters.

Is most of your family time spent in front of the TV? Be a role model for them. Play catch, tag, or their favorite sport. Cold or dark outside? Turn on some music and have a dance party. And while you wait for your kids to finish practice, lessons, or games, take the time to go for a quick walk. Pack your walking shoes in advance.

Mopping, sweeping, yard work, even folding laundry burns calories and builds muscle. Turn on your favorite tunes to amp up your chores and your heart rate.

It saves you money, is great for your health, and can even be faster than driving! You can actually be twice as fast on your bike than in your car stuck in traffic. And you never have to worry about finding a parking spot.

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If you have questions, feedback, photos, or success stories that you’d like to share, please contact the Healthy Workforce team at HealthyWorkforce@kp.org. We look forward to hearing from you!

Toni Yancey, MD, MPH, Instant Recess: Building a Fit Nation 10 Minutes at a Time. (Berkeley: University of California Press, 2010).

A. K. Yancey, R. E. Sallis, & R. Bastani, “Changing Physical Activity Participation for the Medical Profession,” The Journal of the American Medical Association, January 2013, 141-142.

Tiffany Creighton, Project Manager II, Healthy Workforce / Workplace Safety, South Bay Medical Center Shira Potash, Intermediate Project Manager, National Healthy Workforce

The Healthy Workforce Instant Recess Toolkit was inspired by the KEEN Instant Recess Toolkit and developed in partnership with Dr. Toni Yancey, author of Instant Recess: Building a Fit Nation 10 minutes at a Time, co-director of the UCLA Kaiser Permanente Center for Health Equity Services, and Professor of Health Services at the UCLA’s School of Health.

Special thanks to the South Bay Medical Center leadership team for their support of Instant Recess and the many departments at South Bay that jumped on board, including the Call Center, Laboratory / Pathology, and Unit 3000.

Toolkit Advisory Board Andrew Gallardo, Director of Fitness, Southern California Monica Hahn, Marketing Consultant, Instant Recess® Heather Thompson, NW Coalition Partnership Staff Representative, Coalition of KP Unions Toni Yancey, MD, author of Instant Recess: Building a Fit Nation 10 Minutes at a Time

Medical Advisors Robert Sallis, MD, Southern California Medical Group Kate Christensen, MD, Medical Director Internet Services Group

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Executive Sponsors John August, Director of Coalition of KP Unions , Charles Columbus, SVP & CHR Officer Arthur Southam, Executive VP, HP Operations Kathy Gerwig, VP of Employee Safety, Health & Wellness, and Environmental Stewardship Office

Healthy Workforce Team Members Margaret Peisert, Coalition of KP Unions, LMP Co-Lead Carol Akiyama, Lead Project Manager Michelle Mancuso, Senior Business Consultant Shira Potash, Intermediate Project Manager Deborah Benzuly, Project Manager Contractor Jill Schlessinger, Communications Manager Sarah Pearlman, Communications Consultant Contractor