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

Through a Physical Activity Health Promotion Strategy

CPHAHalifax, Nova Scotia

June 3, 2008

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

in motion In motion is a comprehensive community based

physical activity health promotion strategy.

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

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

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

How does in motion achieve its vision?

• Building partnerships• Building community awareness• Targeted community strategies• Measuring our success

Four Key Components:

Founding Partners of in motion

Saskatoon Health Region

City of Saskatoon

University of Saskatchewan

ParticipACTION Canada

Over 100 organizations collaborate with

in motion

• Physicians/Healthcare Profess.• School Divisions• Business Community• Non-Profit Organizations• Chronic Disease Groups• Local Media• Community Ambassadors

Building Community Awareness

• Branding - in motion• Consistent messaging:

• Regular public

awareness campaigns• Support of community

initiatives

• Advertising and signage

• Promotional products• Brochures &

newsletters• Information line• Website

Physical Activity…do it for life!

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

Targeted Community Strategies

• Children & Youth

• Workplace Wellness

• Older Adults

• Primary Prevention of Diabetes

• Healthcare Professional Referral

• Inactive Adults

Measuring Our Success

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

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

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

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

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

services – Are less responsive to messages and campaigns geared

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

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

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

Are Francophones less physically active and therefore more at risk

of ill health?

En mouvement

Physical Activity Survey 2007

En mouvement en français- Methodology

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

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

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

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

En mouvement en français- Baseline PA Survey - 2007

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

background (e.g. parents or grandparents)• 7 day physical activity recall (last 5 weekdays and 2 weekend days)

– Frequency, Intensity, Time and Type– Modified from Paffenbarger et al., 1978 & 1993

• Additional questions regarding:– demographics (e.g. age, location, SES) – perceptions (e.g. activity level, behaviour change, in motion awareness) – tobacco usage, fruit and vegetable consumption– health conditions

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

En mouvement en français- Methodology

• Interviewers began telephone survey in French (CATI System)

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

• 225 surveys occurred in French and 26 in English

• Response rate: 37%

En mouvement en français- Analysis-

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

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

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

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

Results of the Francophone survey

Caractéristiques des 201 répondants Adultes

• 133 femmes et 68 hommes• Âge entre 20 ans et 100 ans• 31% provenant de localités rurales• Éducation : 32% ( secondaire); 25% (diplôme

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

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

visibles

Caractéristiques des répondants (enfants et jeunes n= 50)

• 21 garçons et 29 filles• 0-4 ans = 14; 5-12= 20 ; 13-19 =16 )• 70% sont à l’école canadienne-française de

Saskatoon• 90% sont physiquement actifs

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

physiquement actifs

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

répondu au sondage

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 physique chez les enfants et jeunes se

disant physiquement actifs

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

participé au sondage

A few results from the preschoolers survey

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

being and health?

30'/day 1hr/day 1.5 hr/day 2 hr/day more than 2 hrs/day0

5

10

15

20

25

30

35

40

Petite enfance: quantité d'activité physique et de sport par jour, requis pour le bien-être et la santé de l'enfant

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

At a playground in the community

At school/preschool Organized PA In your own property At a neighbourhood green space/park

0

10

20

30

40

50

60

Petite enfance: Endroit ou l'enfant joue le plus souvent

Series1

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

none on weekday 30'/day 45'/day 1 hr/day 2 hr/day0

10

20

30

40

50

60

Petite enfance: temps passé à jouer dehors pendant la semaine

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

1hr/day 1.5 hr/day 2hrs/day more than 2 hrs/day0

10

20

30

40

50

60

70

Petite enfance: temps passé à jouer dehors en fin de semaine

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

none sometimes often very often0

5

10

15

20

25

30

35

Petite enfance: temps passé en activité physique organisée

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

you play active games or sports

21%

43%

36%

Petite enfance: temps passé à jouer de façon active avec l'enfant

sometimes often

very often

Influence of In motion messagesPercentage of Adults who think in motion

Advertising messages have prompted them to....

Anglophones 2006 (%)

FrancophonesURBAN (%)

FrancophonesRURAL (%)

Eat a healthier diet 45 37 41Reduce inactivity 41 35 29Encourage family, friends and co-workers to become

physically active 37 30 39

Provide opportunities for family to be active together 33 27 27Reduce screen time for yourself/your children 32 24 23

Look for information on health, recreation, nutrition 31 22 39

Visit a recreation facility 26 22 14Speak up for more physical activity opportunities in

your community 23 23 30

Contact a recreation department, seniors club, fitness centre or other service provider 17 16 16

Quit Smoking 12 9 7Purchase physical activity clothing/equipment 9 13 23

En mouvement

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

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

en mouvement• Goal: to increase the awareness and levels

physical activity for health benefits within the Francophone community of the Saskatoon Health Region – aims to translate and adapt the in motion program

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

promotional items, evaluation tools

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

more physically active for health benefits!