in motion in motion toto en mouvement: en mouvement:Reducing Health Inequalities with the Francophone Population Reducing Health Inequalities with the Francophone Population

Through a Physical Activity Health Promotion StrategyThrough a Physical Activity Health Promotion Strategy

CPHACPHAHalifax, Nova ScotiaHalifax, Nova Scotia

June 3, 2008June 3, 2008

Linda Martin, Saskatoon Health RegionLinda Martin, Saskatoon Health RegionDr. Anne Leis, Réseau Santé en français de la SaskatchewanDr. Anne Leis, Réseau Santé en français de la Saskatchewan

in motionin motion

In motionIn motion is a comprehensive community based is a comprehensive community based physical activity health promotion strategy.physical activity health promotion strategy.

Vision: Vision: Saskatoon Health Region will lead the collective Saskatoon Health Region will lead the collective action of community partners in making action of community partners in making

Saskatoon and Region the healthiest community in the Saskatoon and Region the healthiest community in the country through physical activity.country through physical activity.

This will serve as a model for provincial, national, and This will serve as a model for provincial, national, and international initiativesinternational initiatives

How does How does in motionin motion achieve its vision? achieve its vision?

• Building partnershipsBuilding partnerships

• Building community awarenessBuilding community awareness

• Targeted community strategiesTargeted community strategies

• Measuring our successMeasuring our success

Four Key ComponentsFour Key Components:

Founding Partners of Founding Partners of in motionin motion

Saskatoon Health RegionSaskatoon Health Region

City of SaskatoonCity of Saskatoon

University of SaskatchewanUniversity of Saskatchewan

ParticipACTION CanadaParticipACTION Canada

Over 100 organizations Over 100 organizations collaborate withcollaborate with

in motionin motion

•Physicians/Healthcare Profess.Physicians/Healthcare Profess.

•School DivisionsSchool Divisions

•Business CommunityBusiness Community

•Non-Profit OrganizationsNon-Profit Organizations

•Chronic Disease GroupsChronic Disease Groups

•Local MediaLocal Media

•Community AmbassadorsCommunity Ambassadors

Building Community AwarenessBuilding Community Awareness

• Branding - Branding - in motionin motion

• Consistent messaging:Consistent messaging:

• Regular public Regular public

awareness campaignsawareness campaigns

• Support of community Support of community

initiativesinitiatives

• Advertising and signageAdvertising and signage

• Promotional productsPromotional products

• Brochures & newslettersBrochures & newsletters

• Information lineInformation line

• WebsiteWebsite

Physical Activity…do it for life!

61% of residents recall seeing, hearing or reading about 61% of residents recall seeing, hearing or reading about in motion in motion

Targeted Community StrategiesTargeted Community Strategies

• Children & YouthChildren & Youth

• Workplace WellnessWorkplace Wellness

• Older AdultsOlder Adults

• Primary Prevention of Primary Prevention of DiabetesDiabetes

• Healthcare Professional Healthcare Professional ReferralReferral

• Inactive AdultsInactive Adults

Measuring Our SuccessMeasuring Our Success

• Evaluation of Evaluation of in motionin motion is an ongoing and critical is an ongoing and critical process to the initiative. process to the initiative.

• Of fundamental importance is the strategy's built-Of fundamental importance is the strategy's built-in program evaluation and University of in program evaluation and University of Saskatchewan led research. Saskatchewan led research.

• Results include: increased physical activity levels, Results include: increased physical activity levels, increased community capacity building, improved increased community capacity building, improved health behaviors, unintended outcomes, positive health behaviors, unintended outcomes, positive testimonialstestimonials

Why Why En mouvementEn mouvement??• Francophones living in a minority situation (outside Quebec):Francophones living in a minority situation (outside Quebec):

– rate their health lower than their Anglophone counterparts rate their health lower than their Anglophone counterparts – have less access to health services in their own languagehave less access to health services in their own language– Are less likely to visit a family physician and seek health Are less likely to visit a family physician and seek health

services services – Are less responsive to messages and campaigns geared Are less responsive to messages and campaigns geared

toward the Anglophone majoritytoward the Anglophone majority• Quality health services are based on culturally competent Quality health services are based on culturally competent

communication and interactions between the health provider communication and interactions between the health provider and the client/patientand the client/patient

• En mouvement En mouvement wantswants to be more inclusive by reaching the to be more inclusive by reaching the Francophone community living in minority situation…Francophone community living in minority situation…

Are Francophones less physically Are Francophones less physically active and therefore more at risk active and therefore more at risk

of ill health?of ill health?

En mouvementEn mouvement

Physical Activity Survey Physical Activity Survey 20072007

En mouvementEn mouvement en français- en français- MethodologyMethodology

• The initial/baseline survey in Saskatoon Health Region was The initial/baseline survey in Saskatoon Health Region was conducted in the Spring of 2000 (n=1759) before the launch conducted in the Spring of 2000 (n=1759) before the launch of of in motion in motion and the survey was repeated every two years. and the survey was repeated every two years.

• in motion in motion physical activity 2006 survey was translated in physical activity 2006 survey was translated in French and adapted (2007)French and adapted (2007)

• This initial baseline survey among the Francophone residents This initial baseline survey among the Francophone residents of the Saskatoon Health Region was conducted in the Fall of of the Saskatoon Health Region was conducted in the Fall of 2007 at the same time as 2007 at the same time as En mouvement En mouvement launch.launch.

• Targeted sample (phone lists of rural SHR Francophone Targeted sample (phone lists of rural SHR Francophone towns and Saskatoon Francophone residents as identified by towns and Saskatoon Francophone residents as identified by Francophone organisations’ lists )Francophone organisations’ lists )

En mouvementEn mouvement en français- en français- Baseline PA Survey - 2007Baseline PA Survey - 2007

• Added qualifier questions Added qualifier questions – Qualifying that the household is Francophone or has Francophone Qualifying that the household is Francophone or has Francophone

background (e.g. parents or grandparents)background (e.g. parents or grandparents)

• 7 day physical activity recall (last 5 weekdays and 2 weekend days)7 day physical activity recall (last 5 weekdays and 2 weekend days)

– Frequency, Intensity, Time and TypeFrequency, Intensity, Time and Type

– Modified from Paffenbarger et al., 1978 & 1993Modified from Paffenbarger et al., 1978 & 1993

• Additional questions regarding:Additional questions regarding:

– demographics (e.g. age, location, SES) demographics (e.g. age, location, SES)

– perceptions (e.g. activity level, behaviour change, perceptions (e.g. activity level, behaviour change, in motion in motion awareness) awareness)

– tobacco usage, fruit and vegetable consumptiontobacco usage, fruit and vegetable consumption

– health conditions health conditions

• Added preschool physical activity survey (ages 5 and under) Added preschool physical activity survey (ages 5 and under)

En mouvementEn mouvement en français- en français- MethodologyMethodology

• Interviewers began telephone survey in Interviewers began telephone survey in French (CATI System)French (CATI System)

• One adult (age 19+) was surveyed One adult (age 19+) was surveyed andand if if possible, one of each child category per possible, one of each child category per household (preschooler: 0-4; child: 5-12 ; household (preschooler: 0-4; child: 5-12 ; youth:13-19)youth:13-19)

• 225 surveys occurred in French and 26 in 225 surveys occurred in French and 26 in EnglishEnglish

• Response rate: 37% Response rate: 37%

En mouvementEn mouvement en français- en français- Analysis-Analysis-

• KKD (kilocalorie/kilogram/day) is simply a KKD (kilocalorie/kilogram/day) is simply a way of expressing energy expenditureway of expressing energy expenditure

• An energy expenditure of 3 KKD is An energy expenditure of 3 KKD is equivalent to walking one hour every dayequivalent to walking one hour every day

• Cut-offs of energy expenditure for health Cut-offs of energy expenditure for health benefits benefits – for adults: >3 kkd for adults: >3 kkd – for children: >8 kkd for children: >8 kkd

Images viewed on October 29, 2004 from Images viewed on October 29, 2004 from http://www.tourismsaskatoon.com/gallery/http://www.tourismsaskatoon.com/gallery/

Results of the Francophone surveyResults of the Francophone survey

Caractéristiques des 201 Caractéristiques des 201 répondants Adultesrépondants Adultes

• 133 femmes et 68 hommes133 femmes et 68 hommes

• Âge entre 20 ans et 100 ansÂge entre 20 ans et 100 ans• 31% provenant de localités rurales31% provenant de localités rurales• Éducation : 32% ( secondaire); 25% (diplôme Éducation : 32% ( secondaire); 25% (diplôme

collégial ou un peu d’université); 42% (diplôme collégial ou un peu d’université); 42% (diplôme universitaire) universitaire)

• 18 % à la retraite et 25% en enseignement18 % à la retraite et 25% en enseignement• 14 d’origine autochtone, 17 métis et 19 de minorités 14 d’origine autochtone, 17 métis et 19 de minorités

visiblesvisibles

Caractéristiques des répondants Caractéristiques des répondants (enfants et jeunes n= 50)(enfants et jeunes n= 50)

• 21 garçons et 29 filles21 garçons et 29 filles

• 0-4 ans = 14; 5-12= 20 ; 13-19 =16 )0-4 ans = 14; 5-12= 20 ; 13-19 =16 )

• 70% sont à l’école canadienne-française de 70% sont à l’école canadienne-française de SaskatoonSaskatoon

• 90% sont physiquement actifs90% sont physiquement actifs

Bénéfice sur la santé de l’activité Bénéfice sur la santé de l’activité physique chez les adultes se disant physique chez les adultes se disant

physiquement actifs physiquement actifs

Bénéfice sur la santé de l’activité Bénéfice sur la santé de l’activité physique chez tous les adultes ayant physique chez tous les adultes ayant

répondu au sondage répondu au sondage

Francophone Adults Francophone Adults

URBAN%

RURAL%

Do you use tobacco regularly: yes daily and occ. 10 5

Average fruit and vegetable consumption:5 and more 57 42

Strongly agree PA reduces the incidence of diabetes, cancer and CVD

83 72

Strongly agree that stopping tobacco reduces incidence of diabetes, cancer and CVD

83 90

Strongly agree that vegetable and fruit consumption reduce the incidence of diabetes, cancer and CVD

63 63

Bénéfice sur la santé de l’activité Bénéfice sur la santé de l’activité physique chez les enfants et jeunes se physique chez les enfants et jeunes se

disant physiquement actifs disant physiquement actifs

Bénéfice sur la santé de l’activité Bénéfice sur la santé de l’activité physique chez les enfants et jeunes ayant physique chez les enfants et jeunes ayant

participé au sondage participé au sondage

A few results from the A few results from the preschoolers surveypreschoolers survey

How much PA or sport do you think is How much PA or sport do you think is required on a daily basis for a child's well-required on a daily basis for a child's well-

being and health? being and health?

When your child plays actively outdoors, When your child plays actively outdoors, where does he or she do this most often?where does he or she do this most often?

On a typical week day, how much time does On a typical week day, how much time does your child spend actively playing outdoors?your child spend actively playing outdoors?

On a typical weekend day, how much time does On a typical weekend day, how much time does your child spend actively playing outdoors?your child spend actively playing outdoors?

How much time does your child spend in How much time does your child spend in organized physical activities such as organized physical activities such as gymnastics, swimming lessons, etc…gymnastics, swimming lessons, etc…

Thinking about the kinds of things you Thinking about the kinds of things you typically do with your child, how often do typically do with your child, how often do

you play active games or sportsyou play active games or sports

Influence of In motion messagesInfluence of In motion messagesPercentage of Percentage of AdultsAdults who think who think in motionin motion

Advertising messages have prompted Advertising messages have prompted them to....them to....

Anglophones Anglophones 2006 2006 (%)(%)

FrancophonesFrancophonesURBAN (%)URBAN (%)

FrancophonesFrancophonesRURAL (%)RURAL (%)

Eat a healthier dietEat a healthier diet 4545 3737 4141

Reduce inactivityReduce inactivity 4141 3535 2929

Encourage family, friends and co-workers to become Encourage family, friends and co-workers to become physically activephysically active 3737 3030 3939

Provide opportunities for family to be active togetherProvide opportunities for family to be active together 3333 2727 2727

Reduce screen time for yourself/your childrenReduce screen time for yourself/your children 3232 2424 2323

Look for information on health, recreation, nutritionLook for information on health, recreation, nutrition 3131 22223939

Visit a recreation facilityVisit a recreation facility 2626 2222 1414

Speak up for more physical activity opportunities in Speak up for more physical activity opportunities in your communityyour community 2323 2323 3030

Contact a recreation department, seniors club, Contact a recreation department, seniors club, fitness centre or other service providerfitness centre or other service provider 1717 1616 1616

Quit SmokingQuit Smoking 1212 99 77

Purchase physical activity clothing/equipmentPurchase physical activity clothing/equipment 99 1313 2323

En mouvementEn mouvement

• in motionin motion has partnered with the Saskatchewan Network has partnered with the Saskatchewan Network for Health Services infor Health Services in French French and is now being offered in and is now being offered in French and adapted to be culturally appropriate – coined French and adapted to be culturally appropriate – coined en mouvementen mouvement

• in motion/en mouvementin motion/en mouvement Francophone Action Committee Francophone Action Committee– Saskatoon Health RegionSaskatoon Health Region– Réseau Santé en français de la Saskatchewan Réseau Santé en français de la Saskatchewan – Association des parents fransaskois Association des parents fransaskois – Fédération des aînés fransaskois Fédération des aînés fransaskois – Conseil des Conseil des écoles fransaskoisesécoles fransaskoises

en mouvementen mouvement

• Goal: to increase the awareness and levels Goal: to increase the awareness and levels physical activity for health benefits within the physical activity for health benefits within the Francophone community of the Saskatoon Francophone community of the Saskatoon Health Region Health Region – aims to translate and adapt the aims to translate and adapt the in motionin motion program program

for the Francophone populationfor the Francophone population• e.g., resources, marketing and communication tools, e.g., resources, marketing and communication tools,

promotional items, evaluation toolspromotional items, evaluation tools

The Francophone population within the Saskatoon Health The Francophone population within the Saskatoon Health Region is being mobilized and energized to become Region is being mobilized and energized to become

more physically active for health benefits!more physically active for health benefits!