1. Physical Activity
Professor Fiona Bull
Director, Centre for Built Environment and Health,
School of Population Health, The University of Western Australia
Chair, Global Advocacy for Physical Activity, International Society for Physical Activity and Health

2. Key Messages
1. There is strong evidence on health benefits of PA
2. Our focus is on “how” to address PA not “if”
3. Public education is a „best buy‟ – however it is
„necessary but not sufficient‟ on its own
4. Must look for, evaluate and implement upstream
policy actions in multiple settings
5. Building an evidence base, capacity within different
sectors and cultural adaptation to meet the needs of
Arab region are important short term priorities

4. Dose response relationship
Source: Vouri I. Terveysliikunta. UKK Institute for Health Promotion
Research, Tampere, Finland, 1995.

5. Prevalence of physical inactivity in
adults by WHO Region and World
Bank income group. 2008

6. Benefits of PA extend
beyond just the big 3
• CVD
• Cance
• Diabetes
• Improvement in mental health
• Positive social health
• Community „connectedness‟ and
social capital
• Child development
• Education performance

7. Not “if”, not “why”, but “How”

8. HLM Political Statement
Sept 2011

9. Preventing NCD’s: addressing
the causes
the causes of the causes of chronic disease
UNDERLYING PROXIMAL PHYSIOLOGICAL
Death and & Disability
CAUSES BEHAVIORAL RISK FACTORS
RISK FACTORS
CHRONIC
Social DISEASES
Economic
Tobacco use Overweight/obesity
Diabetes
Employment Heart disease
Alcohol abuse High blood pressure
Educational Stroke
Cultural High blood glucose Cancer
Unhealthy diet
Respiratory
Political dis.
Abnormal blood
Built Physical
lipids
environment inactivity

10. Not “if”, not “why”, but
“How”
• Use available policy instruments
– Global recommendations on physical activity
– Global strategy (DPAS)
– Supporting DPAS implementation tools / guides
– Global target and indicator (forthcoming)
• Focus regional and national efforts in one or more
of 7 identified areas of best investment

11. Tailor to the Arab Region

12. Not “if”, not “why”, but
“How”
• Use available policy instruments
– Global recommendations on physical activity
– Global strategy (DPAS)
– Supporting DPAS implementation tools / guides
– Global target and indicator (forthcoming)
• Focus regional and national efforts in one or
more of 7 identified areas of best investment

15. 7 Investments that
work for physical activity
5. Public education, including
1. Whole-of-school’ programs mass media to raise
awareness and change social
2. Transport policies and norms on physical activity
systems that prioritise walking,
cycling and public transport
6. Community-wide programs
3. Urban design regulations and involving multiple settings and
infrastructure that provides for sectors & that mobilize and
equitable and safe access for integrate community
recreational physical activity, engagement and resources
and recreational and transport-
related walking and cycling
across the life course 7. Sports systems and programs
that promote ‘sport for all’
4. Physical activity and NCD and encourage participation
prevention integrated into across the life span
primary health care systems

16. Physical Activity Guidelines

17. Building blocks of successful
national action on physical activity
Mass media
campaigns
Communication
Strategy
Targets & Goals Intersectorial
buy in
PA Guidelines
Surveillance & Political
Monitoring Commitment

18. Guidelines: inform communication
campaigns and a catalyst to partnerships
New Zealand
„Agita‟
Brazil
Western
Australia

19. 7 Investments that
work for physical activity
5. Public education, including
1. Whole-of-school’ programs mass media to raise
awareness and change social
2. Transport policies and norms on physical activity
systems that prioritise walking,
cycling and public transport
6. Community-wide programs
3. Urban design regulations and involving multiple settings and
infrastructure that provides for sectors & that mobilize and
equitable and safe access for integrate community
recreational physical activity, engagement and resources
and recreational and transport-
related walking and cycling
across the life course 7. Sports systems and programs
that promote ‘sport for all’
4. Physical activity and NCD and encourage participation
prevention integrated into across the life span
primary health care systems

20. Schools – a best buy

21. Across the school setting
• Regular good quality PE curricula for all
students
• Play / recess time
• Before and after school
• Across the curricula
• Involve parents
• Link to community sports
• Travel to school (walk /cycle)
• Includes Policy AND Programs

22. 7 Investments that
work for physical activity
5. Public education, including
1. Whole-of-school’ programs mass media to raise
awareness and change social
2. Transport policies and norms on physical activity
systems that prioritise walking,
cycling and public transport
6. Community-wide programs
3. Urban design regulations and involving multiple settings and
infrastructure that provides for sectors & that mobilize and
equitable and safe access for integrate community
recreational physical activity, engagement and resources
and recreational and transport-
related walking and cycling
across the life course 7. Sports systems and programs
that promote ‘sport for all’
4. Physical activity and NCD and encourage participation
prevention integrated into across the life span
primary health care systems

23. Primary health care

24. Workplace Health

25. 7 Investments that
work for physical activity
5. Public education, including
1. Whole-of-school’ programs mass media to raise
awareness and change social
2. Transport policies and norms on physical activity
systems that prioritise walking,
cycling and public transport
6. Community-wide programs
3. Urban design regulations and involving multiple settings and
infrastructure that provides for sectors & that mobilize and
equitable and safe access for integrate community
recreational physical activity, engagement and resources
and recreational and transport-
related walking and cycling
across the life course 7. Sports systems and programs
that promote ‘sport for all’
4. Physical activity and NCD and encourage participation
prevention integrated into across the life span
primary health care systems

26. Create supportive environments

27. Create supportive environments
The solutions will be context specific
Example: Ciclovia

28. 7 Investments that
work for physical activity
5. Public education, including
1. Whole-of-school’ programs mass media to raise
awareness and change social
2. Transport policies and norms on physical activity
systems that prioritise walking,
cycling and public transport
6. Community-wide programs
3. Urban design regulations and involving multiple settings and
infrastructure that provides for sectors & that mobilize and
equitable and safe access for integrate community
recreational physical activity, engagement and resources
and recreational and transport-
related walking and cycling
across the life course 7. Sports systems and programs
that promote ‘sport for all’
4. Physical activity and NCD and encourage participation
prevention integrated into across the life span
primary health care systems

29. Building blocks of successful
national action on physical activity
Multiple Mass media Multiple
Strategies campaigns Strategies
Communication
Strategy
Multiple Intersectorial
Strategies Targets & Goals
buy in
PA Guidelines
Surveillance & Political Multiple
Monitoring Commitment
Strategies
Multiple
Strategies

31. Kuwait National Action
Plan for Physical Activity

32. Challenges
• Leadership
• Research evidence
from Arab region
• Stronger workforce
with knowledge and
skills to address PA

33. Turning round the risk factors:
Tobacco success Smoke free
SG Report workplaces National
campaigns
PH action groups
1950 1980 1990 2000

34. National Examples of increasing
population levels of physical activity
ParticipACTION – national action underpinned
by sustained social marketing campaign

35. THANK YOU