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References

1 Vita J, Terry R, Hubert H, Fries J. Aging, health risks, and cumulative disability. N Eng J Med. 1998; 338:1035-1041.

2 Kushi L, Fee R, Folsom A, Mink P, Anderson K, Sellers T. Physical activity and mortality in postmenopausal women. JAMA. 1997; 277:1287-1292.

3 Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. 1996.

4 AARP. Exercise attitudes and behaviors: A survey of adults age 50-79. 2002; Washington DC: AARP.

5 Ibid.

6 Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey. 2002.

7 Brownson R, Baker E, Houseman R, Brennan L, Bacak S. Environmental and policy determinants of physical activity in the United States. Am J Public Health. 2001; 91:1995-2003.

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8 Sallis J, Hovell M, Hofstetter C, Elder J, Hackley M, Caspersen C, Powell K. Distance between homes and exercise facilities related to frequency of exercise among San Diego residents. Public Health Reports. 1990; 105:179-185.

9 King A. Interventions to promote physical activity by older adults. Journals of Gerontology: Series A. 2001; 56A (Special Issue II): 36-46.

10 Martinson B, O’Connor P, Pronk N. Physical activity and short-term all-cause mortality in adults with chronic disease. Arch Intern Med. 2001;161:1173-1180.

11 Balfour J and Kaplan G. Neighborhood environment and loss of physical function in older adults: Evidence from the Alameda County study. Am J Epidemiology. 2002; 155:507-515.

12 For a copy of the report, please see www.walknashville.org.

13 Nashville appropriated approximately $36.5 million in 2001-2002, compared with $11.4 million between 1990-2000. Priority areas for new sidewalks include schools, libraries, and urban centers. Although sidewalk funds seem small compared to highway or road construction budgets, they represent a strong commitment by the Nashville government to enhancing community design.

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14 Workshop sponsors included the Nashville Area Chamber of Commerce, metro health and planning departments, and the community health and wellness team.

15 Walk/Bike Nashville can be located at www.walkbikenashville.org.

16“Walkability Checklists” are published by the Partnership for Walkable America. This survey collects participants’ feedback on perceived limitations, personal walking habits, and program impressions.

17 In some neighborhoods, a neutral meeting place was critical; if a group chose a church for the meeting place, participation from non-parishoners would be minimal. Some of the groups chose multiple meeting areas.

18 Dishman R. Exercise Adherence. 1988. Champaign, IL: Human Kinetics.

19 Kahn E, Ramsey L, Brownson R, Heath G, Howze E, Powell K, Stone E, Rajab M, Corso P, and the Task Force on Community Preventive Services. The effectiveness of interventions to increase physical activity: A systematic
review. Am J Prev Med. 2002; 22(4S):73-107.

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20 Atkin C. Impact of public service advertising: Research evidence and effective strategies. 2001; Prepared for the Kaiser Family Foundation. “Media-plus” campaigns are defined as efforts that combine traditional advertising campaigns with other community activities. Traditional health education media campaigns typically fall into three categories: prevention (avoiding initiation of risky or detrimental behavior), cessation (stopping an existing behavior), and adoption (of new, healthy behaviors, such as drinking low-fat milk). A meta-analysis of 48 health-related media campaigns showed that on average, 7-10 percent of the target audiences change behavior as a result of the health messages. Effects such as behavior change were strongest in communities where the media exposure was the greatest (Snyder L. How effective are mediated health campaigns? In Rice R and Atkin C (Eds.), Public Health Communication Campaigns: pp.181-10. Thousand Oaks, CA: Sage). Studies find that interventions linking media campaigns with other community outreach efforts are often the most successful. The researchers leading Wheeling Walks also led a West Virginia initiative encouraging residents to switch to low-fat milk. The combination of paid advertisements, school-based interventions, community outreach, and involvement by workplaces, supermarkets, and community organizations proved effective; low-fat milk purchases more than doubled, and 38 percent of regular milk drinkers reported switching to low-fat milk (Reger B, Wootan M, Booth-Butterfield S. 1 percent or less: A community-based nutrition campaign. Public Health Reports. 1998; 113:410-419.)

The media-plus approach was also successful in several school and media anti-smoking efforts (Flynn B, Worden J, Secker-Walker R, Pirie P, Badger G, Carpenter J, Geller B. Mass media and school interventions for cigarette smoking prevention: Effects two years after completion. Am J Public Health. 1994; 84:827-834) (Bauman K, LaPrelle Brown J, Koch G, Padgett C. The influence of three mass media campaigns on variables related to adolescent smoking: Results of a field experiment. Am J Public Health. 1991; 81:597-604). A program promoting safe-sex practices among young gay men combined a publicity campaign with intensive peer counseling efforts; risky sexual practices decreased from 41 percent to 30 percent, and sex with non-primary partners dropped by half from 20 percent to 11 percent (Kegeles S, Hays R, Coates T, The Mpowerment project: A community-level HIV prevention intervention for young gay men. Am J Public Health. 1996; 86:1129-1136).

21 Ibid.

22 Snyder L. “How effective are mediated health campaigns?” In R. Rice & C. Atkin (Eds.), Public Communication Campaigns. 2000. Thousand Oaks, CA: Sage.

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23 Atkin C. Impact of public service advertising: Research evidence and effective strategies. 2001; Prepared for the Kaiser Family Foundation

24 The age ranges are as follows: 0-14 or 15 years, when children are dependent on adults for all needs; 14/15-38 or 39 years, known as the “apprentice” stage, when people are gaining skills and becoming more independent; 38/39-65 years, the “professional” stage when people have chosen their professional paths and spend their time working towards professional goals; and 65 years and older, or “retirement.” During this last stage, older adults can act as mentors and teach skills to younger people but begin to depend on younger generations to help with basic needs.

25 The Largo Juvenile-Oriented Business Services (JOBS) program provides unemployed youth with meaningful work during the summer. Established in 1998, JOBS seeks to link teens with adult mentors who can provide support and guidance on establishing good work habits.

26 Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. 1986. Englewood Cliffs, NJ: Prentice Hall.

27 King A. Interventions to promote physical activity by older adults. Journals of Gerontology: Series A. 2001;
56A (Special Issue II): 36-46.

28 Kahn E, Ramsey L, Brownson R, Heath G, Howze E, Powell K, Stone E, Rajab M, Corso P, and the Task Force on Community Preventive Services. The effectiveness of interventions to increase physical activity: A systematic review. Am J Prev Med. 2002; 22(4S):73-107.

29 Largo has adopted the Search Institute’s Assets Framework, based on the research of Kretzman and McNight.

30 Prohaska T, Peters K, Warren J. Sources of attrition in a church-based exercise program for older African-Americans. Am J Health Promo. 2000; 14:380-385.

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