Is There a Public Health Role for Fitness Professionals?
While public health officials are addressing the urgent need to make America healthier, fitness professionals are exploring exciting opportunities in public health.
Imagine the following scenarios:
- Friends of an overweight, inactive 35-year-old encourage him to join a team physical activity and weight loss challenge sponsored by their employer. He loses 12 pounds and joins a fitness club, with costs subsidized by his employer.
- A husband and wife, senior retirees, attend a community-sponsored fair and learn about an exercise program at a nearby church. Two weeks later they sign up for the fitness class, which is led by a certified group fitness instructor.
- A preschooler discovers the joy of physical fitness at her childcare center. The center recently upgraded its physical fitness activity curriculum using a guide developed by a statewide consortium. When she goes to elementary school next year, she and her classmates could become future fitness buffs because the school has revamped its physical education (PE) curriculum to emphasize lifelong health and fitness.
These are just three ways that public health initiatives are responding to America’s rising tide of obesity, diabetes and other chronic conditions. Fitness industry leaders have long supported public health efforts, but something new is happening on gym floors across the country: personal trainers, group instructors and other fitness professionals are becoming ever more involved in public health programs.
Unlike clinical health systems that treat individuals, public health programs aim to prevent health problems and to improve the health and wellness of local communities, states and the nation (ASPH 2011). In the United States, public health policy flows from the federal Centers for Disease Control and Prevention, filters down to state and local health departments and finds its way into schools, workplaces and homes.
While public health officials are addressing the urgent need to make America healthier, fitness professionals are exploring exciting opportunities in public health. A sampling:
New York City
When Carolann Valentino walks into a city fitness facility, her appreciative students greet her with loud cheers and clapping. Valentino, a group instructor for Equinox fitness clubs, leads classes for Shape Up NYC, a public health initiative run by the city of New York in partnership with Equinox and other sponsors. The fitness program offers free fitness classes at dozens of city parks and recreation facilities throughout New York’s five boroughs.
A wide array of fitness classes are available, including cardio workouts, African dance, kickboxing, chair aerobics and yoga. The exercise program keeps Valentino moving: she teaches six Zumba® and two IntenSati workout classes weekly. People travel across town to attend, some coming hours ahead of scheduled start times. “The classes have grown so much that the city had to cap some of them off,” says Valentino, who has a fine arts degree in musical theater and works professionally as a comic, singer, dancer and actress.
The multitalented, charismatic Valentino incorporates positive psychology and standup comedy into her fitness classes so that participants gain not only physical strength but emotional stamina—and enjoy a laugh or two as well. Appreciation for the exercise program is mutual. Valentino says the dedication and commitment of her students, and the results she sees, are inspiring. “Participating in the Shape Up NYC program has changed my life,” she says.
Teresa E. Brown, a professional fitness trainer and owner of Absolute Body Conditioning in Cleveland, gets excited when talking about people she works with in a new public health program at the Cleveland Clinic. “It’s so rewarding to be instrumental in changing the lives of individuals who had all but given up on healthy living,” says Brown. The program is a partnership between the clinic and the Canyon Ranch Institute (CRI), headquartered in Tucson, Arizona. Brown is a facilitator with the CRI Life Enhancement Program (LEP) and works for the Cleveland Clinic as a fitness consultant. LEP was developed by CRI and then expanded to underserved populations after evaluations demonstrated the program’s effectiveness in making people healthier (CRI 2011).
In each session, the Cleveland program enrolls up to 20 people over the age of 18 from Cleveland’s medically underserved neighborhoods. The 8- to 12-week program focuses on integrative medicine, nutrition, physical fitness, stress management and spirituality, defined as nurturing a sense of purpose. “You’re not going to be as interested in living a healthy lifestyle if you don’t have a sense of purpose in your life,” says Brown.
Working with a team of physicians, nurses, dietitians and social workers, Brown provides weekly fitness presentations and exercise classes, offers one-on-one counseling and performs before-and-after assessments. “Giving participants the tools necessary to empower them with a healthy mind, body and spirit is priceless, and I am truly blessed to be a part of this team,” says Brown.
April Wood knows what it’s like to be an overweight mom who would never go to a fitness club. She was one 8 years ago. Through a powerful faith and gritty determination, she shed 110 pounds. Then, energized by her success, she went on to become a multicertified fitness professional and more recently created an innovative public health program based in Nashville. Partnering with her local YMCA, Wood runs Hope for Health, an outreach program that offers fitness instruction and lifestyle coaching in locations where her clients—moms like her—feel comfortable: churches and community centers. Up to 25 clients per session enroll in a 12-week program where they learn to exercise and develop better nutrition habits. Clients take what they learn home so their children can also learn the benefit of exercise and eat more healthfully.
After the 12-week course, clients receive follow-up support to keep them on the right track. Operating from four locations, with each employing a fitness instructor and lifestyle coach, Hope for Health touched the lives of 400 women in its first year. Meanwhile, as an inspiring role model, Wood continues to spread the message of health and fitness through local media and as a public speaker.
Des Moines, Iowa
Since graduating with a degree in health promotion 6 years ago, Maggie Rooney has interned in a corporate wellness center, owned and managed a yoga studio and developed a successful fitness business that doesn’t wait for clients to come to her. Armed with her diverse experience, Rooney has knocked on doors at churches, nursing homes, worksites and childcare centers.
“The most effective methods to promote fitness are ‘grass-roots’ efforts,” says Rooney, who participates actively in Healthy Polk 2020, a public health initiative in metropolitan Des Moines. Her efforts are paying off for her business and her community. At EMC Insurance, a major property and casualty company in Iowa, Rooney offers fitness classes to company employees. Scheduled in the mornings and over the lunch hour, the 45-minute fitness sessions incorporate stretching, power yoga and relaxation. Rooney also has an interest in promoting fitness to kids. At a local childcare center, Rooney plays games, sings and teaches a yoga breathing technique (what her children call “the bunny breath”) to preschoolers as young as 2 years of age.
Her teaching is creative. The tots learn flexibility and proper stretching by picking up litter. All summer, Rooney and other local fitness professionals offer a free yoga class every Saturday in a popular public park. The yoga class attracted 400 people on one morning in the past year. “I’m very passionate about this,” says Rooney, who believes fitness is multifaceted. “My job allows me to get out and about and help people make a long-term commitment. You have to make a choice every day to be healthy.”
Since 1994, when he persuaded a local athletic club to donate space and fitness equipment, Willie Austin has been promoting better nutrition and fitness to Seattle’s youth population. Austin, a strength coach, personal trainer and former University of Washington football player, saw a growing need to create accessible fitness programs for young people.
To meet the need, he created the nonprofit Austin Foundation, which is helping to address the obesity and chronic-disease crisis by bringing life-changing health-and-fitness experiences to thousands of Seattle-area youth. Youth & Fitness, the foundation’s premier program, is a 6-week community-based course that teaches basic nutrition and fitness principles. Youth get to sample and learn activities and exercises that include cardio, strength and flexibility components.
In recent years, the foundation has expanded its offerings to include afterschool fitness programs, late-night programs for teens and in-school PE classes that let students earn credits toward graduation (Austin Foundation 2011). “I’ve seen kids’ lives transformed,” says Austin. “They not only get better conditioned physically, but also get better grades in school and stay out of trouble.” Austin actively participates in the King County Physical Activity Coalition and other local public health partnerships.
San Fernando, California
Professor Steven Loy, PhD, wanted to improve public health in a sustainable way and provide practical experience for his students. Loy, an exercise physiologist who teaches at California State University, Northridge, convinced the city of San Fernando to put eye-catching fitness equipment in city parks to spark citizen interest in physical activity.
Fliers posted on the fitness equipment invited residents to attend a free session to learn about the equipment and to participate in a project focused on health and exercise. Children, parents and grandparents showed up—and then passed the word. A new program—called 100 Citizens, San Fernando—was born.
Corina Martinez, a graduate student of Loy’s who helped design the initial program, and 20 student volunteers armed with extra exercise mats, resistance bands, medicine balls and other university equipment taught hundreds of citizens in San Fernando how to exercise. Loy says the program—a partnership of the university, the city of San Fernando and the Network for a Healthy California—demonstrates a low-cost/no-cost model that is sustainable and replicable. Meanwhile, his students, future fitness professionals, are learning how to apply their classroom studies in the real world to make an entire community healthier.
“The program has been a rewarding experience,” says Martinez. “Participants saw results they were not expecting.” Some lost weight; others were able to play with their kids or found out they no longer had diabetes.
Certifying agencies and researchers are seeing fitness professionals become key players in public health efforts. “Fitness professionals now have a broader role to play in getting people moving and improving their health and wellness,” says Todd Galati, director of credentials for the American Council on Exercise (ACE). An industry long focused on the fitness professionals and enthusiast is recognizing the bigger picture.
“Fitness is part of the healthcare continuum,” Galati says. “It offers preventive healthcare for people in postrehab and also for people who are not fitness enthusiasts.” ACE has expanded and adapted its training curricula and certification standards in recent years to align with this new reality.
“Fitness professionals have a tremendous opportunity to contribute to the health of the public,” says Jimmy Newkirk, executive director of the National Society of Physical Activity Practitioners in Public Health (NSPAPPH). The society was founded to promote a growing field of practitioners who work in state, county and local public health agencies. “Fitness professionals add perspective,” he adds. “They have expertise and resources that public health officials don’t have.” Fitness professionals interested in public health are eligible to join the society and may qualify for certification as physical activity public health specialists.
One expert has seen these changes up close. Since the late 1990s, Steven Hooker, PhD, has been speaking at conferences and in his classes about the expanding opportunities for fitness professionals in public health. Hooker, a professor in the exercise and wellness program at Arizona State University, worked in fitness clubs before earning his doctorate in exercise physiology, and then took a break from his academic career to direct physical activity and health initiatives for the California Department of Public Health.
Hooker says physical activity in public health is still “in its infancy,” and opportunities are likely to grow. He sees a lot of benefits for fitness professionals who get involved, including opportunities to build relationships with other professionals, to secure new funding and contracts, to create programs and to expand businesses to serve new populations.
To learn more about public health initiatives, contact local, regional or state health agencies. Many have a physical activity coordinator who knows about partnerships, programs and opportunities to get involved. Local YMCAs and other nonprofit agencies such as the American Heart Association are often active in local efforts and welcome inquiries. Fitness professionals can also contact the NSPAPPH (www.nspapph.org), which supports fitness professional participation in public health and can connect interested professionals to local programs. Contact the society toll-free at (855) 677-2774.
Peter N. Francis, PhD, is a social psychologist and certified personal trainer practicing in Tucson, Arizona. He works with faith communities, nonprofit agencies and healthcare organizations to promote physical activity and healthier lifestyles for adults. Before becoming a fitness professional, he worked as a government program manager and consultant. Contact him at firstname.lastname@example.org.
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The U.S. public health system is an elaborate patchwork of federal, state and local government agencies; academic and healthcare institutions; professional associations; philanthropic organizations; and local community agencies. Public health funding comes from a variety of sources, including federal grants, state appropriations and private donations (Levi et al. 2011).
Federal Funding and Leadership
The U.S. Centers for Disease Control and Prevention (CDC) leads federal efforts to promote physical activity and improve nutrition. Since the CDC created the Division of Nutrition, Physical Activity and Obesity (DNPAO) in 1999, the agency has been cooperating with states to increase physical activity and reduce the prevalence of obesity (CDC 2011). The CDC funds 25 state health agencies to promote health and wellness. States awarded DNPAO grants must develop plans that address nutrition, physical activity and obesity, and must monitor the effects of their plans (Levi et al. 2008).
A Sampling of State Efforts
- Wisconsin. A state worksite initiative spurred development of 30 partnerships to promote healthier living. The program supports physical activity strategies such as providing fitness assessments to employees, setting aside time for employees to exercise at work and offering subsidies for club memberships (WDHS 2010).
- Iowa. Iowa Sports Foundation sponsors Live Healthy Iowa, which encourages team activities that promote fitness and weight loss. Since 2002, the foundation says, more than 197,000 participants have lost weight and logged over 34 million miles of physical activity (ISF 2011).
- North Carolina. The state’s Eat Smart, Move More program is a wide-ranging effort to improve health outcomes. Community grants and other resources support programs for schools, workplaces, childcare centers and faith communities.
- Washington. State agencies are working with local communities to create “active community environments” that make it easier and more enjoyable to walk and exercise. In 2005, the Washington legislature enacted laws that require regional and local planners to consider the impact on physical activity when designing new transportation and building projects.
- Massachusetts. The Mass in Motion initiative is a comprehensive effort to promote healthy eating and active lifestyles in schools and businesses. The state’s Healthy Choices program, a partnership between the state public health agency and Blue Cross Blue Shield of Massachusetts, promotes efforts to improve nutrition and get children to be more active.
Federal Initiatives promoting physical activity date back to 1956, when President Dwight D. Eisenhower created the President’s Council on Youth Fitness. Today, the fitness industry supports its successor, the President’s Council on Fitness, Sports & Nutrition, and is a key partner implementing several federal efforts launched more recently.
In 1996, the National Coalition for the Promotion of Physical Activity (NCPPA) was formed to create a collaborative effort to inspire more Americans to adopt a physically active lifestyle. Representatives from the American College of Sports Medicine (ACSM, a founding partner of the coalition), the American Council on Exercise (ACE), IDEA Health & Fitness Association and the National Academy of Sports Medicine (NASM) serve on the coalition’s board of directors.
The NCPPA is leading the effort to implement the National Physical Activity Plan (NPAP). After publication of the federal Physical Activity Guidelines in October 2008, the Centers for Disease Control and Prevention partnered with more than 200 organizations, including ACSM, ACE and NASM, to begin developing a comprehensive effort to promote physical fitness and active lifestyles nationwide. The national plan promotes physical activity in eight key sectors of American life, including business and industry, education, healthcare and mass media. IDEA Health & Fitness Association will participate in implementing this effort (Davis & Davis 2011).
In March 2010, the Centers for Disease Control and Prevention awarded $230 million in federal grants to 30 communities nationwide to promote programs aimed at reducing and preventing obesity. The grants, from the American Recovery and Reinvestment Act economic stimulus funding, are being used to reduce risk factors associated with chronic disease and to promote wellness. Jurisdictions receiving grant funding are launching media campaigns and implementing evidence-based strategies to improve nutrition habits and increase physical activity. To accomplish the goals of the program, grantees are required to work with a wide range of entities, including schools, businesses, faith communities, healthcare organizations, academic institutions and community agencies.
Metropolitan regions receiving some of the largest awards are Chicago, Los Angeles, San Diego, Miami, San Antonio and Seattle. A complete list of grantees can be found at www.cdc.gov/chronicdisease/recovery/PDF/HHS_CPPW_CommunityFactSheet.pdf.
In 2009, the American College of Sports Medicine (ACSM) introduced a new specialty certification for those who promote physical activity in public health settings. According to ACSM, the physical activity public health specialist (PAPHS) educates decision-makers about the need for policies and programs that promote physical activity and provides leadership for the development of community partnerships and other population-based initiatives. Requirements for certification include a bachelor’s degree in a related field, such as exercise science, physical education, nutrition or public health, or a bachelor’s degree in any field plus 1,200 hours of work experience in a field that promotes physical activity.
Relevant work experience in education, afterschool programs, worksite health programs, healthcare organizations, parks and recreation, government agencies, colleges and universities, nonprofit organizations and commercial health clubs would qualify applicants for the specialty certification. The certification establishes a national standard for professionals working in public health and promotes continuing education and development.
If you are a fitness professional looking to grow your program, broaden your clientele base or take advantage of emerging trends, you may have an important stake in local public health initiatives. Successful efforts could improve your bottom line (Yancey 2010). Here’s how:
Public health policies and programs can increase demand for fitness services. For example, employer-sponsored subsidies for fitness facilitiy memberships, pay incentives linked to fitness benchmarks, and mandatory afterschool programs that encourage physical activity are strategies designed to encourage more people to exercise. Further, as positive media messages about physical activity saturate communities, more people will seek information. Some may take the next step and turn to the fitness industry for services.
Creation of New Markets
Because they are designed to target a wide and diverse population, public health efforts can create new markets for the fitness industry. For example, hard-to-reach sedentary and inactive people, a large demographic, are the target of many public health efforts. If these efforts are successful, inactive children and adults could become a growing market for fitness services.
Opportunities for Innovation
By advocating for policy and environmental changes, public health programs can make broad changes affecting life in neighborhoods and communities. These changes may create opportunities to bring fitness services to nontraditional or underused venues in innovative ways. As our success stories illustrate, churches, schools, worksites, health clinics and community facilities can become vibrant centers for promoting physical activity and healthier lifestyles.
National public health efforts aimed at increasing physical activity are fueled largely by concern over our nation’s obesity epidemic. Recently, however, the scientific community has recognized that physical activity has standalone benefits that are not necessarily tied to weight loss.
Anti-obesity campaigns are responding. The Strategies to Overcome and Prevent (STOP) Obesity Alliance is a collaboration of a broad array of consumer, provider, healthcare, labor, business, government and other groups that promote research, multicultural approaches and innovative best practices to combat obesity. The alliance operates out of the George Washington University Office of Health Policy in the School of Public Health and Health Services. In June 2011, the alliance issued the following official policy recommendation highlighting the important role of physical activity in improving the nation’s health (STOPOA 2011):
“Encouraging Physical Activity for Improved Health: Physical activity has significant and widespread benefits, regardless of one’s weight. Therefore, encouraging physical activity will improve health, independent of weight or weight loss, resulting in a healthier population. The Alliance encourages interventions and creating environments and systems that support active living as well as moderate-vigorous physical activity to improve health, independent of weight or weight loss.”
Why is this policy recommendation significant? Some public health experts argue that tying physical activity too closely to anti-obesity efforts could be a liability. Linking physical activity to weight loss does not give physical activity sufficient credit for an impressive array of health benefits, and it fails to recognize that some cultural groups are not motivated by a desire to lose weight (Yancey 2010).
Austin Foundation. 2011. Our programs. www.youthandfitness.org/programs.php; retrieved Sept. 6, 2011.
CDC (Centers for Disease Control and Prevention). 2011. CDC’s state-based nutrition and physical activity program to prevent obesity and other chronic diseases. www.cdc.gov/obesity/stateprograms/index.html; retrieved Sept. 6, 2011.
CRI (Canyon Ranch Institute). 2011. Canyon Ranch Institute Life Enhancement Program. www.canyonranchinstitute.org/partnerships-a-programs/cri-life-enhancement-program/cri-lep-overview; retrieved Sept. 6, 2011.
Davis, K., & Davis, P. 2011. A roadmap to get America moving. IDEA Fitness Journal, 8 (4), 11.
ISF (Iowa Sports Foundation). 2011. Live Healthy Iowa. www.livehealthyiowa.org/default.aspx; retrieved Sept. 6, 2011.
Levi, J., et al. 2008. F as in Fat 2008: How Obesity Policies Are Failing in America. http://healthyamericans.org/reports/obesity2008/Obesity2008Report.pdf; retrieved Sept. 30, 2011.
Levi, J., et al. 2011. Investing in America’s Health: A State-by-State Look at Public Health Funding and Key Health Facts. http://healthyamericans.org/assets/files/Investing%20in%20America%27s%20Health.pdf; retrieved Sept. 30, 2011.
STOPOA (Strategies to Overcome and Prevent Obesity Alliance). 2011. STOP Obesity Alliance determines physical activity may be as important as weight loss for achieving better health. www.stopobesityalliance.org/newsroom/press-releases/stop-obesity-alliance-determines-physical-activity-may-be-as-important-as-weight-loss-for-achieving-better-health; retrieved Sept. 30, 2011.
WDHS (Wisconsin Department of Health Services). 2010. Worksite Wellness Resource Kit. www.dhs.wisconsin.gov/health/physicalactivity/Sites/Worksitekit.htm; retrieved Sept. 6, 2011.
Yancey, T. 2010. Instant Recess: Building a Fit Nation 10 Minutes at a Time. Berkeley, California: University of California Press.
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