The Healthy Environments Partnership (HEP), established in 2000, is a partnership among: Detroit-based community organizations (Chandler Park Conservancy, Detroit Hispanic Development Corporation, Friends of Parkside, Eastside Community Network); public health agencies (Detroit Health Department, Institute for Population Health); health service organizations (Henry Ford Health System); academic institutions (University of Michigan School of Public Health), and community members.
HEP uses a community-based participatory research (CBPR) approach to: conduct research to better understand the relationship between the environment and cardiovascular disease, and to develop, implement and evaluate interventions designed to improve the heart health of Detroit residents. Since our inception in 2000, we have examined: Social Determinants of Health; Food Environments; Air Quality; Stressful Life Conditions; Physical Activity Environment; and Promoting Physical Activity (Physical Activity Interventions).
We continue to work with community groups and organizations in Detroit to better understand conditions that influence health in the city. These efforts include working with community organizations to promote heart health through support for walkable neighborhoods; promote walking through our Walk Your Heart to Health walking groups; reduce air pollution and its adverse effects on health; and address underlying social determinants of health.
Questions & Answers
The locations for walking groups may be modified, provided they meet the criteria defined in the WYHH Handbook.
The WYHH program was specifically designed to address challenges encountered by residents of low to moderate income urban communities, who may encounter built environment and other environmental challenges to physical activity. It has been demonstrated to be effective in increasing physical activity and reducing indicators of cardiovascular risk in that population. Many of the components of the program - for example, the emphasis on social support, building a sense of community and the guidance of skilled and trained facilitators with whom one has a personal connection - are derived from the broader literature on promotion of behavior change, and thus likely broadly available to other groups. Components of the program may be less relevant for groups operating in different settings - for example, rural communities where there may be a lower density of organizations wtih the capacity to host an indoor walking group.
Walking group facilitators who are members of and committed to the health of the community, and training to assure knowledge and skills in group facilitation and safe walking protocols (e.g., how to identify safe walking routes, what to do in an emergency) are critical assets. Walking group facilitators with skills in building and mainaining group cohesion are key to maintaining walking group participation. Community groups and organizations who are able to provide space for walking groups to meet and, when necessary, to walk indoors are important components to successful implementation, particularly in areas where the climate or built environment may be less conducive to walking outdoors.
Addressing challenges in the built and physical environment can be a challenge for walkers, particularly in older urban communities and in rural communities which may lack the infrastructure to support walking. Many heatlh insurance policies do not cover costs associated with health promotion, such as support for a skilled facilitator or facility rental, which can be essential for sustaining safe and health promoting walking, especially in areas where the climate and built environment conditions may be challenging for walking. Addressing these challenges is particularly critical to address health inequities, as residents of low to moderate income neighborhoods, and rural neighborhoods may encounter built environments that are less conducive to physical activity. Those populations also tend to be those who stand to benefit disproportionately from increased physical activity: Hence such challenges are critical to address in order to reduce health inequities.
We encourage practitioners to use the resources provided in the WYHH manual to support the implementation and evaluation of the program. These resources include tips and tools for assessing the acceptability and the effectiveness of the program, and include templates for tracking attendance, guidance on choosing pedometers and other physical activity tracking (and incentivizing) devices, and tools for inviting participant feedback and encouraging leadership development.