300-Mile Club

State: KY Type: Model Practice Year: 2004

The 300-Mile Club is a walking program designed to encourage lifestyle changes that promote healthier living for individuals who lack knowledge about nutrition and the effects of obesity and who cannot afford to join health clubs. The program will achieve its goal by introducing walking as a form of exercise by educating participants about good nutrition and by providing pertinent health information through literature and speakers. Northwest Louisville’s total population is 10,155, with an African American population of 9,664. The 300-Mile Club reached approximately 2 percent of African Americans and approximately 25% of that total population. The key elements of this program are a coordinator to organize activities, media coverage, data collection, incentives to encourage participation, and a newsletter for educational and promotional purposes.
Obesity is becoming the number one cause of death in America. In Louisville Metro, the obesity percentage of African Americans surpasses that of metro Caucasians and of the overall national percentage. In 2000, the obesity rate of African Americans in Louisville Metro spiked to 38 percent and the overweight rate was at 32 percent for African Americans. Caucasians in Metro Louisville have an overweight rate of 31 percent and an obesity rate of about 21 percent. Of African Americans in Louisville Metro, approximately 1 percent die from complications of obesity such as stroke and heart disease. In response, the 300-Mile Walking Club Program was created to encourage lifestyle changes that promote healthier living by promoting walking for exercise and educating participants about proper nutrition.
Agency Community RolesIt is important to choose partners that can bring components that are not necessarily needed but are desirable. The perks and incentives that the partners offer encourage participation and motivation and have come to be the heart of this walking program. All the administration work is done by the LMHD, including scheduling the walks, assessing the areas, and managing the data. LMHD also seeks partners who encourage physical activity and healthy living. LMHD also takes care of all the publicity for the 300-Mile Club (in which, incidentally, partners are always mentioned). The walking coach and owner of “Let’s Sweat,” aerobics instructor Renée Appling, assisted in the planning and implementation stages. She works closely with the coordinator on the walking schedule and is present at every walk as a constant motivator for participants. The American Heart Association provides speakers on special nights to discuss various subjects relating to obesity. They also provide incentives that the LMHD cannot purchase due to budget cuts. Shawnee Community School provides the venue for group celebrations of goal achievements and is also a place to walk during inclement weather. As partner, the school pays the salary of the walking coach, provides catering for the celebrations, bottled water for the weekend walks, t-shirts for participants in the summer, and sweatshirts in the winter. The community school also offers the walking club as a class. When possible, the University of Louisville Medical students will conduct the medical monitoring (i.e., blood pressure, pulse, and weight). ImplementationThe steps in developing the program are: Distribute surveys and interest forms in community (four-month process). Assess walking paths, parks and neighborhoods and measure for distance (six months).  Recruit an energetic and motivated walking coach who is devoted to fitness and understands the necessity to cross train. Find a partner that is willing to pay the walking coach and to purchase incentive items for the club. Find other partners that can pick up some cost of the perks (four months). Set a date and plan for kick-off (two months). Create schedule (two months). Establish short and long-term publicity opportunities (five months).   This program has many components, starting with a survey for all new members to answer. The program is built with the data received from the surveys. Members voiced concerns about lack of motivation, so a walking coach is provided to motivate the participants on all conditioning days and group walking days. A staff person is also present on those days to build a trusting relationship. Incentives are also given to encourage participants to maintain tracking forms for data. Once a month, a “Let’s Eat” night is scheduled. Club members bring in healthy dishes and the recipes for them. During this 90-minute event, speakers give presentations and literature is available and distributed. LMHD incorporated a day of hiking during the program for those who are physically able. This activity was in response to the high number of individuals who stated they get little to no physical activity on their jobs. A communication piece dedicated to the 300-Mile Walking Club is essential. All participants receive the quarterly newsletter, which contains accomplishments, general health information, special events, and articles on recurring questions. Blood pressure, body mass index, and pulse are taken monthly so that the participants can trace their progress. Weighing is done quarterly. This data is also used for the program’s outcomes report.
The community verbalized an interest in walking clubs. The surveys were issued at health fairs and any community events the Office of Minority Health attended. This was necessary to confirm and have document of interest. With motivation being a big issue to the respondents, it was necessary to hire a person who could encourage and motivate the participants. The walking areas in the city had to be assessed before walks to avoid injuries. Knowing that the LMHD budget could not carry that cost, it was crucial to speak with an agency that was already paying for a fitness instructor. Having a previous relationship with Shawnee Community School and Let’s Sweat, it was effortless to get their buy-in. The challenges of this program are few but significant. As the health department prepared to take the pilot program outside the pilot area, all of the pieces did not come together nicely. If there was a strong partner support, then there was no community interest. If community interest was there, there was not partner support. A good number of members became very dependent on the walking coach. The walking coach had to continuously reinforce the need for personal responsibility. When the walkers where taken too far outside their familiar environment, they were not as committed to completing that walk. Some, who were always in attendance, did not show up. As a result, a couple of the walks were scheduled. The collection of the data became too much for the walking coach. A captain was recruited in the middle of the program but the commitment was not there. It was decided to let the group choose a team captain during the kick-off. The medical students that volunteer are not able to conduct the vitals study on a consistent basis. To resolve this issue, staff regularly measure blood pressure and pulse. Staff will consider using a control group instead trying to gather information from all club members. It is also difficult to get participants to weigh in on a consistent basis.