Making Physical Activity a Community Priority: Research Helps Fuel a Sustainable Solution

Friday, June 18, 2010

From the Summer 2010 issue of the KCUMB Communicator

Making Physical Activity a Community Priority: Research Helps Fuel a Sustainable Solution

By Christopher Ryan

Not surprisingly, given that he is an exercise physiologist, Richard Suminski, Ph.D., is fit, trim and energetic. He is also enthusiastic because, thanks to a $100,000 grant from the Robert Wood Johnson Foundation, he has been able to continue and expand research he started while at Ohio State University.

A long-time advocate of physical activity for people of all ages, Dr. Suminski received a bachelor of science in psychology, a master of science in exercise physiology, a master of public health in epidemiology and a doctorate in exercise physiology from the University of Pittsburgh in Pittsburgh, Pa. He has served as an associate professor of physiology at Kansas City University of Medicine and Biosciences since 2005.

For a number of years, Dr. Suminski has been drawn to physical activity and its impact on human health and well-being. It was his unique approach that convinced Active Living Research, a national program office and funding arm of the Robert Wood Johnson Foundation at San Diego State University, to fund his research in Kansas City.

The objective of the study for which Dr. Suminski received the grant was to gain information about how opportunities for youth physical activity are supported. That knowledge will be used to develop community-level physical activity intervention that includes small-business involvement.

Carmen Cutter, deputy director of Active Living Research, points out that not much information is available about the role of small business in physical activity.

“We want to fund more research like this,” Cutter said. “We funded Dr. Suminski because economic data is important. We need to look at the economic impact of physical activity.”

Surprising Findings
Eight Kansas City-area neighborhoods were included in Dr. Suminski’s study, which is the first step in developing the community-level physical activity program, dubbed KC FIT (Fit In Time). The researchers gathered data about opportunities in the area for youth to become physically active and identified what small businesses were doing to support youth physical activity. They also located the sources of funding for activities, such as foundations or governments.

The opportunities included virtually anything kids could do to be active. The list included community centers, playgrounds and organized activities such as team sports. The inventory also recorded the condition and quality of the amenities and took note of “incivilities” – things like needles discarded by drug users and broken bottles.

Some of the most interesting data came from the small businesses. For example, only about 30 percent of them were doing anything to support youth physical activities. Yet, nearly all the business owners thought they should be providing support.

When asked why they did not support physical activities, the majority of business owners gave the same answer: “Nobody asked.”

Not being asked to help was the most surprising reason businesses were not supportive, but there were others. Some owners said they did not provide financial support because they did not know where the money was going. They were asked to give, but couldn’t tell what was being funded.

Based on this data and other findings, Dr. Suminski plans to submit another grant proposal to the Robert Wood Johnson Foundation in the future. The new research will be focused on ways to increase small business support.

Would businesses be more willing to give if a line item for prevention of childhood obesity were added to budgets? That would let owners see immediately and clearly where their money is going. How important is the public relations aspect of support? Would businesses be more responsive if they were better recognized for their contributions?

The work will be far from finished when Dr. Suminski and his colleagues know better how to increase small business support of youth physical activity. They plan to study more neighborhoods, try infusing KC FIT into existing programs, such as the Kansas City Chronic Disease Coalition, and help establish health networks to deliver health programs.

Dr. Suminski’s group has already met with the Kansas City Small Business Council and is working with that group to connect with about 9,000 small businesses throughout Kansas City. The Kansas City Parks & Recreation Department, local government leaders and the Jackson County Health Department will all be involved.

Along the way, “we want to measure what’s going on to see if it’s sustainable,” he said. “People have to adopt the program, make it their own, implement it, then sustain it. You can help them, but you can’t do everything for them. Once the grant money is gone, it’s over.”

Toward Sustainability
Dr. Suminski’s research at Ohio State University was closely related to his work on small business support of youth physical activity in the Kansas City area. The results of the Ohio State project, which involved neighborhoods in Columbus, Ohio, were published in 2009. The report, “Neighborhoods on the Move: A Community-Based Participatory Research Approach to Promoting Physical Activity,” clearly showed that evidence-based strategies to support physical activity could be developed.

Developed – not necessarily sustained. Dr. Suminski wants to take the time to see if an increase in small business support for youth physical activities can be made to last. The ultimate test of that support, as well as other initiatives aimed at increasing youth physical activity, is sustainability.

The five-year program Dr. Suminski launched in the Kansas City area is designed to measure not only progress, but also sustainability. It uses the proven techniques of community-based participatory research to develop a partnership that will give people in the community an ownership stake in increasing physical activity. The solutions will come from the bottom up instead of the top down and so, presumably, become part of the community’s culture.

This addition to the culture is not so hard to imagine. After all, as Dr. Suminski pointed out, people in some neighborhoods had to learn how to be afraid to take a walk. They had to learn how to lock themselves in a room with a TV and video game station. Given the opportunity, they can change their behavior and, eventually, their community’s culture.

But someone from the outside coming in and trying to change the culture without understanding it is a recipe for failure. Real and permanent change comes from within the community, he said.

Moving From Top Down to Bottom Up
To be felt and to have positive effects, an economic impact does not have to arise from something on the scale of a multinational corporation or, to put it in more physical activity-oriented terms, holding the Summer Olympics. It can be much more subtle, especially at the community level where small businesses operate.

Dr. Suminski and Tanya Tota, his project coordinator and research assistant, conduct their work using an approach called community-based participatory research. Simply put, they operate from the bottom up instead of from the top down.

“You need to work hand-in-hand with community people,” he said. “And you need someone like Tanya who can bridge the gap between academia and the community.”

The community itself can be as small as a neighborhood, and each community has its own unique culture. That culture has to be taken into consideration when working with businesses and community leaders to identify the resources needed to start activity programs.

For this kind of work, Dr. Suminski said Tanya Tota is eminently qualified. A community advocate, she works with youth, primarily in Kansas City’s urban core. She helps develop “edutainment” programs that encourage physical activity.

Tota is a firm believer in the community-based approach to research. Programming aimed at increasing physical activity has to be like a rubber band, she said. “It has to fit the contours of the community and make itself fit the area’s needs and circumstances. Then neighborhoods can teach each other.”

Tota not only develops physical activity programs, but she also works with businesses on ways to help support them. This, said Dr. Suminski, is where advocates like Tota can benefit greatly from an evidence-based approach. If she and other individuals and organizations involved in promoting physical activity can demonstrate with hard data that a program works, they are much more likely to raise the support they need.

Collaborating with businesses and community leaders to do research does not mean abandoning the science. Science is what people like Dr. Suminski are there to do. They handle the statistical models and evaluate data. But community members not only supply data, they can help collect it.

Perhaps the most important aspect of this collaboration is communication. “You can’t just impose what you think you know,” Dr. Suminski said. “You have to talk to people.”

With good communication and trust, the results of partnerships between community and academia can be community ownership of the research, a better understanding among community members of what the research says, and a stronger basis on which to build programming specifically tailored to the community’s culture. It is grass-roots action that enjoys the benefits of academic expertise.

For KC FIT to become sustainable, communities have to take it personally.

“We want people to take ownership and develop programs according to their needs,” Dr. Suminski said. “It has to be their accomplishment as a community.”

Perfect Timing?
The economy might be in the dumps, and grant funding might be scarce, but this could be exactly the right time for Dr. Suminski’s work. First Lady Michelle Obama has come out as a strong advocate for youth physical activity and the fight against childhood obesity. She has given the issue a much higher profile, and this increased attention will no doubt translate into some type of action at the community level.

At this point, there is no way to know how much impact Michelle Obama will have and how communities will respond. However, her position certainly lends credibility to the importance of the work Dr. Suminski, Tota and their colleagues are doing.

For his part, Dr. Suminski is already looking well into the future. He has many more questions he wants to answer. Based on his experiences in Ohio, he has a great deal of confidence in KC FIT.

“It’s an evidence-based program,” he said. “We know it works. Now, can we get it to work in more diverse communities? Can it be done in any city, anywhere?” If so, the First Lady might have found a champion.