Robin Mockenhaupt

Broadening the focus: the need to address the social determinants of health.

ditures rose by 5.7%. 2 Annual per capita medical care expenditures in the U.S. are higher than those in any other nation, and if current trends continue medical care costs in the U.S. will reach more than 19% of the Gross Domestic Product by 2019. Although recent reforms should help many Americans obtain and keep coverage, the costs of medical care and insurance remain out of reach for many households. These costs also affect employers, threatening the bottom line of many American businesses and deterring job creation. Medical care spending at the local, state, and federal level limits government investments in other crucial areas including infrastructure and education. The rising costs of providing care to aging baby-boomers and the growing number of obese Americans will further strain public and private budgets. Despite spending more on medical care than any other

Results of the First Year of Active for Life: Translation of 2 Evidence-Based Physical Activity Programs for Older Adults Into Community Settings

OBJECTIVES Translating efficacious interventions into practice within community settings is a major public health challenge. We evaluated the effects of 2 evidence-based physical activity interventions on self-reported physical activity and related outcomes in midlife and older adults. METHODS Four community-based organizations implemented Active Choices, a 6-month, telephone-based program, and 5 implemented Active Living Every Day, a 20-week, group-based program. Both programs emphasize behavioral skills necessary to become more physically active. Participants completed pretest and posttest surveys. RESULTS Participants (n=838) were aged an average of 68.4 +/-9.4 years, 80.6% were women, and 64.1% were non-Hispanic White. Seventy-two percent returned posttest surveys. Intent-to-treat analyses found statistically significant increases in moderate-to-vigorous physical activity and total physical activity, decreases in depressive symptoms and stress, increases in satisfaction with body appearance and function, and decreases in body mass index. CONCLUSIONS The first year of Active for Life demonstrated that Active Choices and Active Living Every Day, 2 evidence-based physical activity programs, can be successfully translated into community settings with diverse populations. Further, the magnitudes of change in outcomes were similar to those reported in the efficacy trials.

Pandemic Influenza Planning in the United States from a Health Disparities Perspective

Preparedness plans must account for the fact that illness and death rates may differ for members of some socioeconomic and racial/ethnic groups during a pandemic.

The National Blueprint Consensus Conference summary report: Strategic priorities for increasing physical activity among adults aged ≥50

This report summarizes the outcome of the National Blueprint Consensus Conference that was held in October 2002. At this conference, representatives of more than 50 national organizations convened in Washington DC with the goal of identifying high-priority and high-feasibility strategies that would advance the National Blueprint and that could be initiated within the next 12 to 24 months. The National Blueprint Consensus Conference has identified an ambitious agenda of 18 strategies that will need to be implemented in order to overcome societal barriers to physical activity among the middle-aged and older adult population. National organizations charged with the task of implementing the high-priority strategies will use professional networks, established delivery channels, and communication systems to translate the blueprint strategies into action.

Validating a Health Consumer Segmentation Model: Behavioral and Attitudinal Differences in Disease Prevention-Related Practices

While researchers typically have segmented audiences by demographic or behavioral characteristics, psychobehavioral segmentation schemes may be more useful for developing targeted health information and programs. Previous research described a four segment psychobehavioral segmentation scheme—and a 10-item screening instrument used to identify the segments—based predominantly on peoples orientation to their health (active vs. passive) and their degree of independence in health care decision making (independent vs. dependent). This study builds on this prior research by assessing the screening instruments validity with an independent dataset and exploring whether people with distinct psychobehavioral orientations have different disease prevention attitudes and preferences for receiving information in the primary care setting. Data come from 1,650 respondents to a national mail panel survey. Using the screening instrument, respondents were segmented into four groups—independent actives, doctor-dependent actives, independent passives,and doctor-dependent passives. Consistent with the earlier research, there were clear differences in health-related attitudes and behaviors among the four segments. Members of three segments appear quite receptive to receiving disease prevention information and assistance from professionals in the primary care setting. Our findings provide further indication that the screening instrument and corresponding segmentation strategy may offer a simple, effective tool for targeting and tailoring information and other health programming to the unique characteristics of distinct audience segments.

The National Blueprint for Promoting Physical Activity in the Mid-Life and Older Adult Population.

The National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older was designed to develop a national strategy for the promotion of physically active lifestyles among the mid-life and older adult population. The Blueprint identifies barriers to physical activity in the areas of research, home and community programs, medical systems, public policy and advocacy, and marketing and communications. In addition, the Blueprint proposes a number of concrete strategies that could be employed in order to overcome the barriers to physical activity in society at large. This paper summarizes and reviews progress achieved in advancing each of the 18 strategies.

Developing Evidence for Structural Approaches to Build a Culture of Health A Perspective From the Robert Wood Johnson Foundation

We believe that reframing the conversation to creating a culture around health rather than focusing on discrete actions or activities will capture national consciousness and enable us to make new progress as a nation. Thus, in 2014, the Robert Wood Johnson Foundation (RWJF) announced a new vision to help build a “Culture of Health” to enable everyone in our diverse society to lead healthier lives now and for generations to come. In supporting the development of this supplement of Health Education & Behavior, RWJF sought to contribute to a better understanding of the ways in which policy, environmental, and financial approaches can contribute to such a Culture of Health. However, while this supplement issue of Health Education & Behavior stands as a testament to the fact that a broad evidence base, rather than a single approach to health improvement, is necessary to have an impact on social change, more empirical evidence is needed on structural approaches if we are to be successful in understanding and improving health outcomes for individuals, families, communities, states, and nations.