Local health departments are challenged by the issues of obesity and inactivity in their communities. In Cambridge, MA, the local health department has chosen an innovative strategy to improve public awareness about physical fitness and to support behavior change. In January of 2006, the Cambridge Public Health Department launched Cambridge Fitness Buddies: A Social Support Model for Getting a Community Active, a free, 10 week program utilizing social support to encourage physical activity.
Participants invite two "fitness buddies" to "get moving" twice a week in an activity chosen by the group. Buddy groups are offered a menu of resources supporting behavior change, including an orientation, a personalized FitKit Manual including a fitness log and physical activity and nutrition information and resources; lots of giveaways (t-shirts, water bottles, pedometers, etc.), and motivational support for getting started. The orientation is followed by 3 workshops on nutrition and exercise options conducted by nutritionists and certified Personal Fitness Trainers to support Fitness Buddies and keep them motivated and engaged. A Celebration event follows program completion to congratulate the Fitness Buddies, reward their successes, and encourage sustained behavior change.
Close to 300 residents and city workers registered for the initial program. A second iteration of the program involved choosing 5 community sites (an African-American church, 2 elementary schools, a senior community center, and a worksite) and training a staff person on site to be a Fitness Buddies Coordinator. The program provided funding and all the components of the program (manuals, product, professional support) and were able to teach all 5 sites to run a sustainable wellness initiative on site. Fitness Buddies was designed as a template that can be replicated easily in a broad range of settings with limited support from public health staff. This successful program provides an easy and inexpensive model for encouraging physical activity in diverse populations.
Fitness Buddies addresses the need to engage the community in taking responsibility for being physically active and healthy eating. Cambridge, like most communities, has an increasing rate of overweight and obese adults. Cambridge Fitness Buddies is not a weight loss program, but we know that healthy weight is directly correlated to getting physical activity and eating healthy.
A literature search of existing social support models revealed elements similar to those employed in Fitness Buddies; however, Fitness Buddies is a unique program specifically designed to engage the exercise community, the nutrition community, professional worksites, and the community at large in a collaborative process of achieving individual and community health.
Agency Community RolesPublic Health designed, marketed, and administered the program. Local Fitness Professionals and Health Clubs provided free or discounted memberships as incentives and prizes. Professional nutritionists were involved to make sustainable contact with the community. Businesses were engaged to encourage employees to join and to provide worksite support. An entire community began to talk about and see signs of the program taking place in many different venues. The program's collaboration with each of these partners was mutually beneficial. The program wants workers to be healthy, employers want the same. The program wants teachers to be healthy, schools want the same thing. The program wants anyone and everyone to live a healthier life, the community wants that for themselves.
Costs and ExpendituresThe implementation of this program involved a team of public health staff to create the program design and evaluation tools. The program in its first iteration cost less than $100 per person served. The second and third iteration of this project was increasingly less expensive and now averages approx. $30 per person. A small grant of $5,000 from the Massachusetts Department of Public Health allowed us to supplement the local investment and to provide a small stipend to sites that administered the Fitness Buddies Program (this generally offset the cost of staff time, healthy foods, and exercise specialists at each site). This program was initially funded by the Cambridge Public Health Department; a second iteration of this program was supported by the Massachusetts Department of Public Health.
ImplementationPrior to program implementation:
Identify the target audience,
Encourage social support and market this FREE program,
Engage, inform, and orient consumers,
Entice consumers with gifts, fun, and flexibility.
Encourage Buddies to attend 3 workshops over 10 week period of time,
Provide Motivation, Exercise and Nutrition sessions at each workshop,
Create incentives (door prizes, etc.) for participants to attend workshops,
Communicate with Fitness Buddies throughout the 10 weeks, emails/mail/yahoogroup, etc.,
Bring Fitness Buddies together for a celebration at the end of 10 weeks.
Preparation and marketing before the program implementation is about 2 months. Program runs 10 weeks with a celebration even at the end.
A pre-program and post-program survey were administered to all participants to collect data on the success of the program design.
Objective 1: Create excitement about the program and getting people to get involved with someone "they care about"
Performance Measures: Participation numbers and retention
Data Collection: Enrollment data and attendance data
Logistics: Orientations, workshops, and celebration event
Feedback: Attendance was based on work schedules and many people continued to participate even if they couldn't attend information sessions and workshops
Objective 2: All participants would understand the Healthy Living Cambridge 5-2-1 guidelines
Performance Measures: The program measured how many knew what "5-2-1" meant before the program started and how many knew what it meant at the end
Feedback: The 5-2-1 message was clearly conveyed and well understood.
Objective 3: Participants would increase their fruits and vegetable intake, increase their physical activity, and decrease tv viewing
Performance Measures: The program saw notable changes in each category
Data Collection: Extensive Survey data was collected and reflects a strong trend toward healthier living.
Logistics: Pre- and post-program surveys.
Feedback: The professional team reviewed results which reflected no need for program changes. Minor modifications continue to be made to address customization of specific populations being served.
SustainabilityThe program conducted a qualitative follow-up at 3 months after the first Fitness Buddies implementation. Program staff heard from many of the Fitness Buddies that they were continuing to achieve their healthier living goals. When the program conducted the second iteration, engaging specific populations by worksite, school, church, etc. - program staff found that they were able to work directly with site coordinators to assess the culture of wellness at their site and to create policy changes that fostered a greater wellness culture at the end of the program implementation.
Lessons LearnedA pre-program and post-program survey were administered to all participants to collect data on the success of the program design. Some of the lessons learned include:
Attendance was based on work schedules and many people continued to participate even if they couldn't attend information sessions and workshops.
The Cambridge Healthy Living 5-2-1 message was clearly conveyed and well understood.
The professional team reviewed survey results which reflected no need for program changes. Minor modifications continue to be made to address customization of specific populations being served.
Key Elements ReplicationData analysis of participants who completed Cambridge Fitness Buddies program surveys demonstrated the following:
Participants between the age category of 41-65 showed a higher percentage of program completion than other age groups,
>85% of participants said “Idea of having a Buddy appealed to me”,
>86% of participants had Buddies,
>60% of participants had 3 or more Buddies,
>87% of participants said “having Buddies helped them stick to the program”,
>85% of participants reported their Fitness Buddies made them feel confident,
>87% reported having a Fitness Buddy helped them stick to the program, and
>87% of participants reported an increase in their physical activity by the end of the program Participants (reporting both average minutes per day before the program and after the program).