Active Ottumwa Podcast Episode 7

Hannah Shultz: Welcome to a Community on the Move: The Story of Active Ottumwa. Active Ottumwa is a community-based research project that encourages all adults to be more active. Ottumwa community members and the University of Iowa used the latest research to design this project. The research project for Active Ottumwa has concluded with the Active Ottumwa program continues under the leadership of Hy-Vee of Ottumwa and with the positive support of community organizations. In this series, we’re learning from people involved in the project about what worked well, what they learned along the way, and the impact Active Ottumwa had on the community. Over the next 10 episodes, we will talk about many aspects of the Active Ottumwa project. To learn about the successes, challenges, lessons learned, pride, and humility that went into this project. My name is Hannah Schultz, and I am the host for this series, and I’m learning about this program along with you. I work at the University of Iowa College of Public Health, but I have not been affiliated with Active Ottumwa until we started planning this podcast series. Working on this series has been a joy. I’ve been impressed every step of the way by the passion, commitment, dedication, and persistence of all involved in this project. And I am very excited to share this with you. One of the many reasons I’ve been impressed by this project and I’m so excited to share it with you is the active participation and inclusion of people representing many different communities, organizations, and interests in Ottumwa. The focus of Active Ottumwa was on physical activity which came out of a community survey highlighting that this was a need for the community. The project used community resources to promote and support active living and physical activity across the community.

We are lucky to be joined by Becky Bucklin, Sandy Berto, Becky Graeve, Lou LaRose, Barbara Baquero, for another episode of Active Ottumwa: Community on the Move. Becky Bucklin works with the Prevention Research Center at the University of Iowa College of Public Health. She is the project manager for Active Ottumwa. Sandy Berto was the field coordinator of activities of Active Ottumwa on the ground in Ottumwa. Barbara Baquero was with the Prevention Research Center when the project began and was the director of the project for four and a half years. She’s now at the University of Washington School of Public Health. We are grateful to have these guests join us today and talk about the early days of planning and implementing the project. And we also have two people from Ottumwa that got engaged with the project in Ottumwa. So Becky Graeve is a Hy-Vee dietitian and she’s the new field coordinator leading Active Ottumwa activities. Lou LaRose was very engaged in Active Ottumwa as a Physical Activity Leader; she led water walking and has found ways to stay active in a socially distant way throughout the COVID-19 pandemic. We’re now in our seventh episode of this Active Ottuwma series. We’ve talked about the science of Community Based Participatory Research, Community Advisory Boards, Physical Activity Leaders, spreading the word, and a whole lot more. Today we’re going to talk about the importance of community engagement and community ownership of the project. We’re starting today’s conversation with Dr. Baquero. We’re talking about the early engagement of Ottumwa. Several times throughout this series, we’ve mentioned that the researchers from the Prevention Research Center were getting to know Ottumwa and its people for quite a while before the project started. I really wanted to dive into that a bit more. So, to start today’s conversation, I asked Barbara how that early engagement impacted Active Ottumwa’s success, and how their relationships changed once the intervention stage of the program began.

Barbara Baquero: I definitely think that our relationships and in building our relationships way before we were funded, made a huge difference. Like we mentioned, I think maybe in Episode One, we built and designed the idea of Active Ottumwa together right with our community partners. And I think that that had a lot to do with the success, but also feeling the ownership and in knowing that this was something that we have done together, but also reflected the values and the needs of the community. So I think that that was really important. I think another piece that it makes, to me made a big difference is for the community to see our sort of commitment to the cause, right? Like we were there before the grant, we wrote the grant together and it’s a bidding process, right? So based on the science, on the available funding, and all that stuff, right, so it wasn’t 100% sure that we’re gonna get it. But from the beginning from the planning, we were committed to do the work right. So, we tried to make sure to remind our partners that if it weren’t getting, you know, if for some reason we didn’t get the funding, we were gonna pursue funding by other means to do the work. Right, and I think that that was something that was important, it was definitely true. We were fortunate to receive the funding and move on. To the second part of your question, I think it definitely changed the relationship in and I think it became stronger right, and evolve over time, it just didn’t necessarily just happen. After we received the award and you know, what’s great is going great, but I think you know every year sort of change and growth of relationships do, right. But I think instead of seeing the funding and seeing that for example, when we actually had an office you know, in like actual physical space, you know if it was another way to demonstrate that our commitment. But also, our sort of the mission, instead of speaking to where we were actually acting and where we were saying that we were going to do, so it definitely made it more clear, more sort of concrete I think many ways. Any help us to get going, right, like we had the funding now. So we’ve got to do the work. So I think it did, it did change, for better. And it grows over time. I think one piece that’s also important in terms of the involvement of the University and the College of Public Health and from Iowa is that it wasn’t one person, right, I was there. And it was one of the members. But it really is a team effort, right it’s Becky Bucklin, it was Edith Parker, Dean now, Dean of the College. So it’s many of us that represent, right? It’s not just it’s not one person, but it’s really the idea and institution, which I think is also makes that relationship stronger, hopefully.

Becky Bucklin: It’s really important to build relationships, I think a huge piece was just the mass number of relationships that we were able to build with organizations throughout the community. So we started out with this CAB of about 10 organizations, and they stayed with us this whole time, throughout the entire project. And they’re still involved today. But also, over time, we ended up getting support from over 80 organizations throughout the Ottumwa community, which is a pretty big number. And that continued to grow and a lot of that was through the efforts of Sandy. And, Lou, I know you were a big part of that too. She was one of our Physical Activity Leaders who really was a huge advocate for the program. Basically, Sandy and Lou are the people that if anybody even started talking to them about something, Active Ottumwa would come up and they would try to enlist support for the program. So, we couldn’t have made those relationships with that massive number of organizations throughout the community without their like constant support and their constant love of the program really showing through to these community organizations.

Sandy Berto: I think also what’s really important is just to believe in what you’re doing; I think and not to be afraid to reach out to different community organizations. I found that the more I reached out to the communities, the more the community reached back to me to be able to come and present it different organizations. Such as the Lions Group, United Way, the local hospitals, cardiac fairs, which is one place where Becky Graeve and I first met and did several of them together, because the whole idea of nutrition and physical health just goes hand in hand. I also think that if you set realistic goals for the PALs and for the different organizations, for their input and participation in a program like Active Ottumwa and say, we don’t expect you to be Michael Phelps, we just want you to come to water walking, just be more active. We don’t need you to run marathons or sprints, just come join our walking group. And you would be surprised when people are asked, when people are acknowledged, when people are recognized of their contribution to their own community, a surprising amount of people said yes. And Mary Lou was one who utilized her history in Ottumwa as a mail carrier faithfully delivering the mail but reached out and found the pool for us to initiate the water walking. And that was a struggle. Just because there’s liability issues and people want to charge and the whole premise of Active Ottumwa is to encourage people to do things that don’t cost a lot of money, especially because Ottumwa is a rural, lower income area. And the no cost was also a very big factor in people participating in Active Ottumwa. And Mary Lou was one of the most active Active Ottumwans. In fact, I think she received a couple of awards at our PALs dinner.

Hannah Shultz: Sandy just talked a bit about the Physical Activity Leaders, which we often call PALs, and Community Advisory Board, which we call the CAB. Throughout the past six episodes, we’ve heard a lot about how important these groups were in providing input, classes, advice, relationships, you name it. I was curious though, what sort of support they received from Sandy and the research team, and how those relationships changed as Active Ottumwa took flight and became more embedded in the community.

Sandy Berto: I think most importantly, was the ability to say to a Physical Activity Leader, what would you like to do? Not everybody wants to lead yoga, not everybody wants to do walking groups. Nobody wants, not everyone wants to do Tai Chi. So, I think it’s really important that you say, what would you like to do? How would you like to help Active Ottumwa? And when there’s ownership, I think it just makes that passion to encourage you to do what you want to do, to reach out to other people. And I think that’s the really big way that the participation numbers really reached an all-time high. I mean, we had an 89-year-old lady come to Tai Chi, it was only because her daughter came to Tai Chi.

Lou LaRose: As a PAL, in the very beginning, and this was before any of these people were here, it was a little more difficult because you didn’t get a whole lot of guidance. I really think that once, Sandy and especially Dr. Baquero, they really made a personal connection. Which then makes you know, I won’t call it the business end of it, but it just made it so much easier. Once you had that personal connection, you knew you could just pick up the phone, if you needed help with something. I won’t go into specifics, but it’s just something’s difficult, or you’re having a hard time, you know connecting with somebody, they gave the best advice. They just, they were terrific and very supportive. And I was originally just trying to get you know, women my age. And I ended up with from 16 to oh gosh, I don’t want to spill his age, but I want to say 80-year-old’s, both sexes. And we’re in swimming suits and we’re in a pool, that’s not comfortable for everyone. But we made it comfortable. Just kept encouraging people like we had a lady who could not swim. She wanted to do it, but she could not swim. Like it’s okay, you don’t have to swim, we’re in water that’s hip deep. I’ll put a life preserver on you. By the end of it she was swimming, I got her floating. It was unbelievable how excited she was that she could float and was so excited to go on a trip with her husband. And she was on an inner tube, and she got off the inner tube and floated and came back, just absolutely busting that she was able to do that from doing water walking and water aerobics. It was phenomenal. And she then carried on the program when I had a car accident, and I couldn’t do it. And she was leading her little group of women and I was so proud of her. It brought so much to that community. What we did, I know it’s just a little thing, but I mean, there was one point where we had 24 people in the pool. Yeah, and it was crazy, who would think I could lead 24 people, but I did.

Hannah Shultz: Becky Graeve brought up the existence of room groups, which is a great impact of the program. But as Becky Bucklin explains, that also makes it hard to evaluate the program, which is challenging when you’re doing a research project.

Becky Graeve: Active Ottumwa activities have then spun off into other networks of groups that no longer have a specific advertised timeframe to meet. But they’re now meeting on their own and have the support of their friends or peers that they’ve met and are continuing to do activity on their own because that is that’s huge. That’s what it’s all about to get people physically active and continuing to exercise beyond the scope of Active Ottumwa.

Becky Bucklin: I will say so that’s actually really hard for us to measure. So in all the numbers that we have for Active Ottumwa, some things we just, there’s so much we can’t measure. And like what Lou was just mentioning, I had no idea that these things were happening as a result of the social networks that Active Ottumwa did put together. But those are things as researchers, we may never know the true impact of what investing in these communities and like bringing these communities together on an issue like physical activity, what the ripple effects of something like that can be for the long term. And so I think that that’s great.

Hannah Shultz: I love hearing stories from people in Ottumwa. “Who would think I could lead that” is just such an empowering comment from Lou. For now, we’re gonna zoom out a bit and Barbara is going to talk to us about the core elements of the project. Given the dedication, so many of our guests in the Ottumwa community have to Active Ottumwa. It can be easy to forget that this was a research project, which I think speaks to the strength of the study design and to the strength of the community. But it was a research project, and Active Iowa will also be a research project, so it’s really important that we hear about the design.

Barbara Baquero: The core projects, the core components of Active Ottumwa are people like Mary Lou, which is great, great to see you, whatever. I don’t know if you are going to use this, but it’s good to see you. And Sandy right, and Becky, and all the Beckys right, in terms of being that the flavor. And get you know; sort of context and it makes it real for the community. Right, I think what we provide as sort of researchers and faculty from the university, is trying to put forward the best strategies really. So it says, the three buckets of strategies that we know, sort of work to promote activity. And again, people like some of the members that Mary Lou mentioned, to at least try it right? So we said that that kind of support, having the support of funding or showing up and in doing the work, right. But it’s really just to create those opportunities where people feel more comfortable doing it. That they you know, sort of to me that sounds like a spark, right? Like the little thing then so, initiate and then people feel more comfortable, then trying to next time, right. And that’s, for example, exactly what I saw happening in the water aerobics group, right. In terms of the strategies that we put forward. There were three buckets right, they were the the informational piece that are getting the word out there for people to know this is Active Ottumwa, everybody can be active, it doesn’t have to be runners you know. And that’s something that our advisory board was very clear from the beginning too and guide us in that process. Like we don’t want to portray the program or promote the program as this is for people that can already run, alright. We’re not running marathons, nobody’s gonna sweat or break a sweat in the middle of the day, right? But so it’s for everybody being inclusive and especially if with anything, the intention was to bring those that felt the least comfortable, right. In the community doing it outside or participating with others in feeling like they can move, right. So we wanted to bring everybody into the program. So we used many different sort of activities and strategies to get the word out there. So, if they saw the green t-shirts, they knew what it was about. And so they can ask, they can ask the family as well, right? So she can give him all the information. And then the other piece was the other bucket, is sort of the support that happened in the individual in at the group level, right, which is that when the Physical Activity Leaders became so important, that’s the core, the heart of Active Ottumwa, right? These natural leaders, these leaders already in their community that were trusted members of the community that people already knew. And if they say, hey, Mary Lou is doing water aerobics, I’ll try because I like her, because I believe her, because I see her. And I know that she’s not gonna lead me wrong, right? So, and then for us was to sort of support the Physical Activity Leaders through Sandy, and in other resources to make sure that they also felt comfortable doing their work, right. Sometimes these natural leaders, these leaders in the community, do the work, but they don’t see themselves as such right? And so how do we uplift their presence and in their value in their community, so they feel comfortable and then also continue doing the work right? And then sort of just spreading the word out and getting more and more people right. And I think that is the other piece that is so exciting, and it worked right, based on the evidence, it did work in Ottumwa. Where you know, sort of like some, Mary Lou found us and we were able to work with her and support her to do the water aerobics. And then her group, she created the other you know, sort of she found other natural leaders and other Physical Activity Leaders in their group, and they expanded and expanded, right. So it was almost like, I hate to use the analogy of the infection, because it’s not the right time to use that and so finding another one. But really, that’s sort of how it sort of spread right throughout the community. And then the last piece was sort of being involved in and paying attention to what happened at the environment level, right. So for example, making sure that we have more organizations that would, you know, allow us to use their physical space. Work with trails and parks to make sure that maybe we can connect Active Ottumwa to the already physical, in the built environment that was changing and growing in the community, right. So those three things were important. Making sure people knew about the program, making sure that they felt supported and welcome in the activities at the interpersonal level, and then having a physical environment that allows people to do the activities, right. So those are like the three main components, it took different shapes and forms in Ottumwa. And that’s also the beauty of Active Ottumwa, right in terms of being okay with whatever version the community wanted to do, and trusting that that was gonna work right, as long as we could, you know, continue support in the interpersonal relationships and doing the communication campaigns at the at the sort of larger level, but it was really the flavor and for us, trusting that the community members and the Physical Activity Leader knew better about how to go about that. What’s really important. One last thing that I say I don’t know if this can be used, is that wasn’t also very intentional not to have maybe we have said this before, not to have one kind of physical activity that we promoted. That was critical from the design time, even before we got the grant, right. Many of these programs is all about the club, walking clubs, or all about Zumba’s, or all about you know whatever here. And that’s what was harder than the beginning for us. Because when we identify these natural leaders, like what do you want to do? And they were like, what are you talking about? Right? They were waiting for more instructions, and was like, we don’t want to tell you what activity you want to do. Right. And so, again, I think also what Mary Lou was so awesome, you know, she came from disguise because we’re like, this is exactly what we need to replicate, right? Like, she had an idea, we went with her, we follow her blindly into the pool, and it’s like, we’re gonna make this work, right and it did. And when we trusted that that was, you know, we believe that that was maybe the way we should do it. And it worked. So that was also important, because again we didn’t want to prescribe the kind of activity was more about sort of implementing these larger strategies, any to it to sort of have some trust and faith that we could do the work and your work overtime. So I think that’s also something that we learn from the process.

Hannah Shultz: We have mentioned that the research team is pulling out of Ottumwa, but Active Ottumwa will continue on under the leadership of Becky Graeve at HyVee. Becky talked to us a bit about what the program will look like in the future and what elements may be changing. A quick note, she mentions that things were on pause for the last few months. We recorded this interview on the summer of 2020, so we were still very early in the COVID-19 pandemic.

Becky Graeve: It’s still evolving, actually, as I kind of got a really good start on leading the program. And then the last few months, we’ve had to kind of put everything on pause. And you know, I feel like there’s going to take a little bit of effort to get that nudged and going again. But there’ll be a combination of trying to keep everything going that’s worked very well the last few years and integrating that in with some of the things that I already do. I think that’s what makes it a really good fit for me as a Hy-Vee dietitian, is that my mantra, my goal is to help people lead you know, lead easier, healthier, happier lives. And, and so a lot of what I’m already doing fits very well with Active Ottumwa. And, you know, I can kind of use that as a launching pad to promote some of my programs, while keeping all of the water walking and outdoor walking and various programs, Tai Chi, you know. We want to keep all of what already works going and then just have that be well, what else can we add to this core group of things that really work well? We’ve mainly been on hold and a lot of that has to do honestly, with my role within the store. You know, had I had the flexibility to try to be creative and do some more virtual challenges. We were kind of already doing that during the winter, we came up with a couple of you know, we did a virtual walking challenge in December, and we tried to do this bingo challenge you know, in January and February. So, I think I very well could have kept doing those kinds of ideas during the pandemic, but the grocery store retail area has gone through such unbelievable changes with COVID. And trying to adapt and keep up with consumer demand, I haven’t done anything dietician related in over two months. So I have just been all hands-on deck, trying to make sure that we meet the basic need of feeding the community above some of those other things that we really would have liked to continue to do. But kind of just had to put that on the back burner for right now.

Lou LaRose: Taking me out of the pool, as any of them can tell you is a bad thing. I’m seriously think I’m part mermaid, and I need to be in the water. And I don’t have a bathtub in my house. Okay, so what I did is, I need that exercise purely for my, my mental health just to keep from being depressed, you need to keep moving. A lot of people don’t make that correlation. And it really is important. So some of the ladies from my water aerobics class we walked, keeping social distance, of course, but there are wonderful trails through Ottumwa, and we walked and talked and that alone, just you know, could help you get through the day and get through this crazy period that we are living through. It’s you know, truly unprecedented. I I never imagined I’d be living through something like this. I’m sure none of you did, either. But we are and we’re going to get through it. And I’m going to get back in the pool. Not yet, I’m not ready yet. But I know some of them are opening up. It’s just you know, I’m not ready yet. But I never wanted to give up the movement. A sedentary lifestyle just standstill, we don’t need to stay stuck, we need to be moving. Another thing for community, I thought this was really cool is one of the ladies in the water aerobics, she likes to sew, she knows I like to sew as well. We started making masks, and just donating them. And I know that she’s made over 500 masks, I’m probably down around the 200 range, but we’re still doing it. And if not for the relationships that we made through Active Ottumwa, we wouldn’t have done that. So I just thought that was so cool. That we walked and made masks, yay.

Hannah Shultz: The Ottumwa community really showed up and made sure that Active Ottumwa was a successful program.

Becky Bucklin: Kind of how the Ottumwa community showed up for the researchers throughout the entire process of this. I will say Lou came in during a time when we were having a huge dip in numbers like we had recruited all these Physical Activity Leaders, but we had had a transition of field coordinators, so for a while we didn’t have a field coordinator. And so there was a dip. We didn’t have that Sandy in the community to actually be rallying the Physical Activity Leaders around an issue. So, we were starting to see a dip. And then Lou comes out of nowhere to one day, this I think I just received an email from her one day. And she was like, I’m so excited I want to be a part of this, how do I be a part of it? And so we did a very mini like baby training for this to get her off the ground. And then she really like led the way as Sandy was beginning her role as field coordinator to really engage all this new group of physical activity leaders that were coming in. So, she showed up at this time that like, we were kind of again, we were seeing a little bit of lull. Not that that would have you know been terrible to see a little bit of a lull, that happens in community engagement, but she really revitalized the program. Kind of like as like a one-person PAL, which is pretty amazing. And the and she was so excited about water walking, and then the community got really excited about it. And so water walking and Tai Chi, I think are two, some of our biggest success stories as well as the mall walking. Those are probably I would say our three biggest success stories. And so she kind of came in and led that charge. Cause I was like, I don’t know how that’s gonna work. Water is dangerous, or it can be dangerous, who’s gonna agree to let us go in their pool, but she made it happen. And it wouldn’t have happened without her. And then I also, Becky Graeve kind of came in at this time and we’re like, okay, so who’s gonna take on this project? So we you know, the university has to start leaving, and Becky gravy was like, yeah, of course I’ll take it on, but it’s just kinda like every time we needed some we needed we were having a lull, or we were like, what are we going to do next? The Ottumwa community stepped up and they were there for us, which was I think, super, super beautiful thing about this project.

Becky Graeve: Just one, you know, the comment about me being excited and taking on the role. You know, I remember going to that meeting with the Community Advisory Board, and not kind of thinking that I was going to get pulled into the CAB, not really being prepared for what they were going to ask me to do. And I had to take a second. And because your initial reaction you’re asked to do something is I don’t want another role added on top of what I’m already doing. But just that it’s a, it was a very established group, thanks to Sandy. And it was a very easy decision to, to ask, I guess, my stores to support me in doing this. Because it fits very well with the other things that I’m doing and so yeah, I had that hesitation. For sure, though, because I know how much time Sandy’s invested, and all the others too. But Sandy, of course, I was connected to the most. And, you know, I don’t want to let her down or what let the team down by letting this falter. So I feel honored that I was even asked to be part of it.

Barbara Baquero: Something that I do agree with Becky, it felt like many of these were with the unexpected, like we didn’t plan it, you know, like Mary Lou calling or walking in, or Becky agreeing to do it, right. But at least you know, my last sort of year and in Ottumwa where we were talking about, you know, what’s going to be right. We know that this is important, and we don’t want to, we knew that we needed to withdraw, sort of in terms of the coordination of the program ourselves. But there was a lot of work that went into planning and thinking about what we’re going to do. And it was a strategic thinking among the advisory group committee like a what do we pitch, right? Who, what organizations could take on this on? So, we were doing some work. So I want to give credit to that in terms of, we didn’t go to Hy-Vee directly, or knew that Becky was gonna be the person, but we sort of were prepared to think that somebody could do this in the community, right. And sort of, and so the window was sort of clean and sort of open and then you know, we we saw this happening. And I think it’s the same thing with Mary Lou, right? Maybe she heard one of our movie advertisements, right? We were doing this sort of community communication campaign. So, she must have heard about Active Ottumwa from somewhere, right? And know that she needed to talk to Becky so because of all the flyers that we’ve been putting out there, right. So, it is natural, but we were sort of looking for those opportunities and ready to see it and go with an interest that that was gonna be right. But I will also say that what Active Ottumwa has become in the hands of Becky in Hy-Vee, which was my grocery store when I was there. And I still call the Hy-Vee when I go to my grocery store here now and then my husband looked, you mean this one, right? It’s like, yeah that, you know what I mean. It’s that it’s beyond what we planned, right? Like, we wanted this to continue, because we’re successful, but you know, the whole idea of Hy-Vee having Becky and doing continue doing the work and taking and making it her own and incorporating the diet piece, which is so important for health too, right? So those two main behaviors can really, you know, help it make a big difference in the health of the population is also beyond what we even thought or planned right. So, I am grateful then for that but also that took a lot of work and a lot of I know, a lot of work into also making sure that Becky had all the resources and information and all that. So, I guess also in part of me this no, we cannot measure that said researchers, I guess I would say a couple of things is that it’s true we want to measure that because we want to tell policymakers is you need to put this money into the community, right? That’s my only regret, is that we cannot necessarily continue sort of monitoring that because it’s to demonstrate you need to invest that. You need to keep investing, this is not a one-time thing and then suddenly it’s going to be supportive within error, right? And also, it needs to be a long-term investment, and these things can happen, and community can feel uplifted, equals who are seen and heard, and they can do this work, right. So that’s my regret. But at one point is we don’t need to be measuring this anymore right, because it’s happening and that’s beautiful. But that my only thing is like I wish we can you know, how do we tell these stories and how Active Ottumwa can continue supporting that, you know. The members of the groups and the physical activity are staying together right because that also was part of our goal. This is the mental health; this is their social support. They, strengthen the networks and the community that also is happening in the midst of you know, this very stressful time with a pandemic, so I just wanted to share that.

Lou LaRose: As far as the replicating I just I got so excited when it was Hy-Vee jumping in because you know, as far as Active Iowa, Hy-Vee’s everywhere. And one of the things that caught my eye I know it’s kind of crazy, but how I got into Active Ottumwa is this color. It’s my favorite color. So yeah, I’m wearing it now, that’s what caught my eye. That’s how the whole thing got started. Isn’t that silly the color? But it does catch your eye and in Hy-Vee a display something about that, that’ll get it started. That’s what got it started for me. And then it is simple, I know there’s a lot of work and that’s why it looks simply, because there’s a lot of work behind the scenes. But for me, it is simple, it’s just friendships and relationships. And if there were people who didn’t want to get in the water, they got water issues fine, then start walking. A couple that was in my water aerobics class, what did they walk, a million miles? And they walked a lot and they started so many groups, they were the most active thing in Active Ottumwa was all the walking groups that Remy and Betty were doing, it was crazy. It just blew up, that part of it gets simple. And I think having HyVee, everybody goes grocery shopping. I mean, everybody’s gonna be there, they’re gonna see it. I think this program can be replicated throughout Iowa, throughout the country.

Hannah Shultz: Barbara makes a really good point and one that bears repeating. Throughout this series, we’re looking back on the success of Active Ottumwa a bit nostalgically. But it’s really important to underscore that a lot of work went into this from all sides. Many of the pieces that seem to just happen naturally were made possible because of the groundwork that was laid by Sandy, the research team, PALs, and everyone else involved. Often when things look easy, there was a whole lot of behind-the-scenes work, and I want to make sure the team gets the credit they deserve. And equally importantly, I want to make sure other communities understand that Active Ottumwa was successful because of the work that went into it.

Thank you for joining another episode of Active Ottumwa: A Community on the Move. We’ve had another great conversation as we continue learning about this program. We look forward to sharing more with you in the remaining episodes. Thank you for tuning in. Thanks to the Midwestern Public Health Training Center for production support, the team at the University of Iowa Prevention Research Center for Rural Health, the Ottumwa community, and the many guests and contributors we talk with throughout these 10 episodes. See the podcast notes for more information about Active Ottumwa and to connect with our team. This podcast is a product of the Health Promotion and Disease Prevention Research Center, supported by cooperative agreement number U48DP006389, from the Centers for Disease Control and Prevention. The findings and conclusions in this podcast are those of the contributors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.