The Mind Body Problem

Or Asch DA and Rosin R. Engineering Social Incentives for Health. N Engl J

Med 2016; 375(26): 2511-13.

5K Training Team October 2016

5K Training Team 2017

5K Training Team 2020

The Important Question

The National Academy of Medicine: “The challenge…is not to figure out which dose of physical activity to prescribe, but rather how to get more people to adopt the actions that researchers know work”

Pray L., ed. National Academy of Medicine. (2015, April 14). Physical Activity: Moving Toward Obesity Solutions: Workshop in Brief. http://www.nap.edu/catalog/21760/physical-activity-moving-toward-obesity-solutions-workshop-in-brief

An Important Answer

A New England Journal of Medicine “Perspective”:

The authors pointed out that convention has conceptualized health promotion as a physician-patient interaction. Instead… we should engineer social engagements that promote health and test their acceptability and effectiveness.

Asch DA and Rosin R. Engineering Social Incentives for Health. N Engl J Med 2016; 375(26): 2511-13.

Exercise: The Latest

Why Your Brain Needs Exercise

“The evolutionary history of humans explains why physical activity is important for brain health”

Raichlen, DA and Alexander, GE. Scientific Americanhttps://www.scientificamerican.com/article/why-your-brain-needs-exercise/

Exercise: The Latest

“Being physically fit may sharpen memory and lower risk of dementia, even if we do not start until we are middle-aged or older”

Gretchen Reynolds, The New York Times, November 6, 2019

People who were fit throughout the study period proved to be 50 percent less likely to develop dementia...those who had entered middle age out of shape but then gained fitness showed the same reduction in risk.

Tari AR, et al. Temporal changes in cardiorespiratory fitness and risk of dementia incidence and mortality: a population-based prospective cohort study. www.thelancet.com/public-health Vol 4 November 2019e565ArticlesLancet Public Health 2019; 4: e565–74

High-intensity interval training results in the greatest memory performance in inactive older adults compared to moderate continuous training or stretching.

Kovacevic A, et al. The effects of aerobic exercise intensity on memory in older adults. Appl Physiol Nutr Metab. 2019 Oct 30. doi:10.1139/apnm-2019-0495.

The Science of Participation in Exercise: Conceptual Framework and Practical Application Sarah%Ingersoll%MS%MBA2,%Jason%S.%Chen%BS1,%Michael%W.%Jakowec%PhD2%

1Keck%School%of%Medicine,%2Department%of%Neurology,%%Los%Angeles,%CA,%USA%Conflict%of%interest:%none,%all%authors%

Background+

Objec0ve+

Results++A7endance+and+Par0cipant+Feedback+(#1+Value)

References+

Exercise%promotes%health,%parLcularly%for%individuals%with%Parkinson%disease.%Nonetheless,%many%do%not%exercise.%The%5K%Training%Team,%for%individuals%with%Parkinson%disease—plus%family%and%friends—was%started%in%2010%without%a%specific%conceptual%framework,%but%modeled%on%team%programs%for%the%ableTbodied.%This%effort%has%been%refined%over%the%years,%expanded%to%include%individuals%who%are%recovering%from%stroke%or%dealing%with%other%challenges,%and%has%adopted%a%more%explicit%structural%framework.%%

The%NaLonal%Academy%of%Medicine%advises:%%“The challenge…is not to figure out which dose of physical activity to prescribe, but rather how to get more people to adopt the actions that researchers know work”

%

The%objecLve%is%to%arLculate%the%components%and%conceptual%framework%of%an%exercise%program%that%appeals%to%older%adults%with%neurologic%and%other%challenges%and%that%has%sustained%longTterm%parLcipaLon.%

Methods+ Discussion+

%KPCC%Interview: %%%%%%%%%%%%USC%IntegraLve%Health%Blog:%

The+“5K+Training+Team”+

The%intent%of%this%report%is%to%provide%specific,%acLonable%steps%that%will%encourage%the%development%of%healthTpromoLng%programs%for%individuals%with%neurologic%disease.%We%know%a%great%deal%about%barriers%to%exercise%and%about%programs%that%do%not%succeed%in%promoLng%longTterm%exercise.%We%describe%both%a%framework%and%a%longTterm%success%story.%

%%Conclusion+

1.  The%EAST%approach%focuses%on%drivers%of%behavior%that%health%systems%oXen%neglect.%%

2.  People%with%PD%and%others%with%challenges%respond%to%a%team%that%involves%an%engaging%coach,%a%common%goal,%compaLble%teammates,%and%shared%experience.%%

3.  This%approach%may%serve%as%a%model%for%exercise%programs%that%promote%the%health%and%wellbeing%of%those%who%seek%a%beZer%quality%of%life.%%

Acknowledgements+

Members%of%the%5K%Training%Team%USC%Department%of%Neurology%Marilyn%Jenson,%COO%Coach%Steve%Mackel%

1.  Behavioural%InsLghts%Team,%(n.d.).%Retrieved%January%17,%2017,%from%hZp://www.behaviouralinsights.co.uk/%

2.  Asch%DA%and%Rosin%R.%Engineering%Social%IncenLves%for%Health.%N%Engl%J%Med%2016;%375(26):%2511T13.%3.  Uc%EY,%Doerschug%KC,%MagnoZa%V,%et%al.%Phase%I/II%randomized%trial%of%aerobic%exercise%in%Parkinson%

disease%in%a%community%segng.%Neurology%2014;83:413T25.%4.  Sallis%R.%Exercise%is%medicine:%a%call%to%acLon%for%physicians%to%assess%and%prescribe%exercise.%Phys%

Sportsmed%2015;43:22T6.%5.  %Pray%L.,%ed.%NaLonal%Academy%of%Medicine.%(2015,%April%14).%Physical%AcLvity:%Moving%Toward%

Obesity%SoluLons:%Workshop%in%Brief.%hZp://www.nap.edu/catalog/21760/physicalTacLvityTmovingTtowardTobesityTsoluLonsTworkshopTinTbrief%

6.  States%RA,%Spierer%DK,%Salem%Y.%LongTterm%group%exercise%for%people%with%Parkinson's%disease:%a%feasibility%study.%J%Neurol%Phys%Ther%2011;35:122T8.%%

%

Our%team%uses%an%approach%arLculated%by%the%Behavioral%Insights%Team,%a%UK%social%purpose%consulLng%company%that%uses%a%framework%to%apply%behavioral%science%to%policy.%The%assumpLon%is%that%decisions,%such%as%the%decision%to%exercise,%are%primarily%influenced%by%environment%and%habit.%To+encourage+a+behavior+make+it+Easy,+A7rac0ve,+Social,+

and+Timely+(EAST).%%*Easy:%the%program%is%free.%“Everyone%Welcome”%*AZracLve:%sun%and%fresh%air%%*Social:%Lme%to%socialize%over%lunch.%Free%Lunch!%*Timing:%parLcipaLon%in%a%community%footrace%is%the%goal%for%every%session.%Timely%recogniLon.%