Fitness By Design: A Three Pronged Health Promotion Approach for Underserved Communities

Background: NC is 12th highest ranked state for obese adults in the 2009 “F as in Fat” report. With a failing grade for obesity, new targeted effective physical activity promotion methods are critical particularly for the poor with limited or no access to exercise facilities/fitness regimens. As a way of correcting this social injustice and promoting healthy living, Fitness by Design (FBD), a free regionally focused wellness project targets low income adults at a high risk for obesity, cardiovascular disease and diabetes from 3 rural NC Counties. Methods: The intervention included three fitness domains: Physical Activity, Nutrition and Social Support. Participants were enrolled based on a physician referral and low income status screening. Study participants were primarily African American (72%); on Medicaid (65%) with a mean beginning BMI of 38.6 (range: 32.4-55.2).

Preliminary Results: Participants lost a combined total of 900 inches from their waist circumference while BMI dropped to a range of 26.3-47.1 in one year. Self-reported data showed increased participation in high strength training (62%) and Physical Activity greater than 30 mins (54%). Dietary activity indicators showed more participants controlling their calorie intake (65%), and eating more vegetables (64%). An unexpected but significant result reported were participants being taken off their depression medications due to their improved health status by their physicians.

Discussion: This intervention shows the impact enabling factors like fitness buddies, free access to exercise equipment, nutrition workshops and a physician recommendation can have in creating significant healthy changes among low income at risk individuals.