Active Ottumwa Podcast Episode 3
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 that the Active Ottumwa program continues under the leadership of HyVee 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 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 am 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.
My name is Hannah Shultz and I work at the University of Iowa College of Public Health. Today I’m talking with some of the Active Ottumwa team about that project. Active Ottumwa was a five-year initiative in the southeast Iowa town of Ottumwa. In the previous episode we learned about the Community Advisory Board, which is a really important group made up of community leaders in Ottumwa that helped guide and advise the project. Today, and in the next episode, we’ll hear from Physical Activity Leaders who were also key in guiding and advising the project. And they led activities. The Physical Activity Leaders are frequently called PALs and they were a key part of Active Ottumwa’s success. Our guest today is Twila Foster.
Twila Foster: I am a retired registered nurse, and at the time that I started with Active Ottumwa I worked at the McCurry Cancer Center and Ottumwa Regional Health Center, and I retired in 2017.
Hannah Shultz: Thank you for joining us today and talking about your experience with Active Ottumwa, and I’m not forgetting about Becky and Sandy who we hear from in every episode. Becky Bucklin works at the University of Iowa College of Public Health Prevention Research Center; she’s managed many aspects of Active Ottumwa from our home base in Iowa City. And Sandy Berto is the on the ground Field Coordinator for Active Ottumwa.
So in the previous episode we learned about the Community Advisory Board which we call the CAB, which is a really important group made up of community leaders in Ottumwa that helped guide and advised the project. Today we’re going to hear from Twila, Physical Activity Leader. And the Physical Activity Leaders were also key in guiding and advising, and they led activities. So the PALs were a really key part of the success of Active Ottumwa. I was curious about what was required of PALs, what they did, what kind of training and support they got, and why Sandy attributes so much of Active Ottumwa’s success to them.
Sandy Berto: The PALs in my opinion are the whole reason that Active Ottumwa was such a success. They are the people who reached out to the community of Ottumwa and were diligent in having the ownership for the activity that they lack. Most of the PALs led at least one activity, once a week, and it didn’t matter if it was a two-hour square dancing, or if it was an hour walking, or if it was a half hour walking, 45 minutes of dance fitness. The PALs are responsible for the success of Active Ottumwa by not only leading the activities, but the outreach into our community, which was very positive. It was exciting to be able to go to restaurants in town and see the waitress have the green Active Ottumwa pen that you knew, probably came from a PAL who was handing them out at an activity. Also, it was just also delightful to look out on the trail system and see PALs in their lime green t shirts. So, the PALs again, were the foundation of Active Ottumwa. Responsibilities included attending the two-day training with other PALs. We also encourage that PALs led at least one activity. They were also in very close communication with me, so if something came up in their lives and they weren’t able to be there at their activity that I could notify the people. The participants that I knew that were likely there, or sometimes I would go to the activity and let people know that the PAL wasn’t able to be there. They also sent in the sign-in sheets. And then also, for Active Ottumwa, we had what’s known as a PAR-Q, it’s a personal health questionnaire that we asked everybody to review and then sign to make sure that they were comfortable in participating in our activities, and they collected those and turned them into me. They also did the sign-in sheets. They were also in close contact with me to be able to hand out what we were able to give as incentives, which were an Active Ottumwa t-shirt, a backpack, or a fanny pack, those kinds of items. So, I don’t think that it was a burden on the PALs to be able to do that, they saw it is just an extension of being of that activity. We also invited them to monthly PAL lunches, which were a great success to be able to be part of that camaraderie of Active Ottumwa PALs. The training was a training on Active Ottumwa, what the program was about, where the research came from, why Ottumwa was picked. Also, to be able to encourage them to maybe think outside the box, as far as being able to share the word about Active Ottumwa within their own social group.
Becky Bucklin: It was a two-day training, two hours each day. And we did provide food at that training. We did want it to be interactive so we had some like interactive worksheets, and some activities that the PALs could learn how, or not learn, but they could, it gave them the opportunity to talk with one another. But some specific things that we did talk about like Sandy said the general overview of the Active Ottumwa program. We went a little bit over what evaluation is and why it’s important. Really to try to make sure that the Physical Activity Leaders knew why the sign-in sheets were so important for us to gather. We did talk about the role of the Physical Activity Leader, and what support was available from our offices to try to really lay out that groundwork of what we could provide the Physical Activity Leaders, so it wasn’t unclear. I mean, it may still have been unclear and Twila can definitely talk about that, but we did try to say these are the things that the University of Iowa Prevention Research Center can provide for the Physical Activity Leaders who agree to take on this responsibility. And then we have the second, that was all on the first day of the training, and then kind of in the second day we talked a little bit about the importance of physical activity, how to safely be physically active, and make sure that people are getting enough water. That they’re doing things to make sure that can reduce injury. We talked about the difference between light physical activity, moderate physical activity, and vigorous, and gave some examples on that. And then we went into the evidence-based strategies that are being adapted from that Community Guide, that are really the core of what makes us a research project. And kind of putting those into perspective for the Physical Activity Leaders so going over those informational strategies that we planned to initiate within the community to help promote the program, but we also got feedback from the Physical Activity Leaders on. What do you think that you need to promote your program? Then we have that motivational social support which we really, really focused on with the Physical Activity Leaders to talk about the strategies that they may be comfortable utilizing within their own programs and we kind of went over some scenarios that they could go through to really help them fully think about how that can actually work within their own programming. And then we went over a little bit the environmental approaches and what that might look like, though we didn’t get too far into that within the Physical Activity Leader training itself. So it was a pretty interactive training. I always had tons of fun giving the training. It was actually some of my favorite parts of the whole three years. Meeting new Physical Activity Leaders and getting them excited about the project.
Hannah Shultz: In the previous episode we mentioned that Ottumwa worked to become a Blue Zone community prior to Active Ottumwa. The experience of not achieving that designation as a part of Twila’s Active Ottumwa story
Twila Foster: Back in 2012, they had a Blue Zone initiative, and Ottumwa tried really hard to become a part of that. And we were one of the 11 finalists. And our county, Wapello County, was rated 94 out of 99 counties as far as being healthy goes, which, of course, is horrible. And unfortunately, we weren’t chosen. So then along comes the University of Iowa and this Active Ottumwa program. And I, cause I was upset that we weren’t accepted for the Blue Zones. So, when the University came in, I thought hey this is great. This is going to be good for the town. And so I got involved as an initial evaluation, with height and weight, etc. to study. And that’s how it evolved into becoming a PAL, and the training was very interesting because it gave you the background of what they were trying to do. And it was all about helping people become healthier, with the tools that were on hand in the community, and they involved the community leaders, and they really reached out. But the training made you feel confident and gave you ideas how to reach out to others.
Hannah Shultz: Becky is going to talk a bit more about the PALs. And in a few seconds she’s going to bring up Mary Lou, who was an amazing PAL and will be a guest in Episode Seven of this series.
Becky Bucklin: So our goal in the grant that we wrote to CDC was 50 PALs, and we did train 53 people. So throughout various trainings we kind of had a training about every six months, and then sometimes if a Physical Activity Leader was really excited, so Mary Lou was one of these, she was so excited to join she couldn’t wait until we had a group of people. So we did like a small mini training with her to get her started, and then she was able to join in, and she still did join in on that two-day training where some of it was review. But also, it really gave that interaction of where the PALs could meet one another and kind of start building friendships amongst one another. Which I think, of course Sandy did a phenomenal job with, and those PAL lunches that we had every month also did a really great job. But we have 53 trained pals, but then every month it kind of fluctuated how many people were leading, or leading actual activities. And so some months we had 20 people leading activities in one month, so we had 20 activities every single week, which is quite a few. And they were happening every single day in different locations throughout the community. And then some months we had eight people. Just, it kind of depended on PAL schedules, and it just kind of, it also depended on PAL commitments. So at some point some PALs had their time of being a Physical Activity Leader had ended, but many of them, even after they stopped leading official programs for us continued to participate in programs and stay engaged in the program. Which actually I know Twila you were one of those that we are so grateful for your continued involvement in the program, even when your other commitments kind of took over and you were no longer able to be a Physical Activity Leader on the calendar.
Hannah Shultz: After learning Twila was one of the first pals who got involved with Active Ottumwa, I was curious about how other Physical Activity Leaders joined the program.
Twila Foster: I know that Active Ottumwa did a lot of education with the community leaders, and that would result in some contacts there.
Becky Bucklin: So when we actually first came into the community, we did this social network analysis within the local businesses. So basically we went into the local businesses, had stakeholders agree to distribute a survey amongst their workers, and this survey had a few questions, basically asking these workers to identify people who were leaders in their organization. And then they would rank people based on this and we did an analysis, you know as researchers tend to do, we did analysis on the back end. And we identified people that were highly, highly connected to their, their coworkers, and to their community, as well as are people that other people would want to go to for health information. And so we identified a fairly big list, and we contacted all those people, and we did recruit quite a few of those individuals to go through the first very first training when we first started the program. And as great as that was at getting our name out, and we did get some really great initial Physical Activity Leaders from that list. We then also decided, well actually a lot of these people are really busy. One of the best things about Twila, and why I’m so excited she’s here is that she was our first self-nominated PAL. And so, and I think she was our longest lasting PAL. Sandy I need a nod yeah, so I’m seeing a nod from Sandy, so Twila was our longest active PAL. She was also our first self-nominated PAL, and basically that Twila became the, the model that I think we use for all of the other Physical Activity Leaders after her. We’re really, we let people decide in the community. Do I want to leave my own program? Do I have it in me to lead my, my own program? What would that program look like? And we help them develop that like vision of what their program would be based on their own self nomination, that they felt they could be a Physical Activity Leader instead of this social network analysis that we were doing previously, so Twila I don’t know if you know that, but you were our model that kind of set the ground for the rest of the Physical Activity Leaders after you who were nominated.
Sandy Berto: From the best of my memory, it seemed like people who attended the activities. Then said, oh, well we had one lady who came to our Tai Chi class on Saturday mornings here at the office, and she came to me and said, “you know I’m doing a yoga video at home by myself, I think there might be other people who are doing yoga or something by themselves.” So I assisted in obtaining the conference room with the local hospital and Tammy led video led yoga for quite some time. And I know that some of these activities were really kind of outside the box when you think about it. Typical physical activity such as Zumba or dance fitness where there’s a trained leader, leading the activity, and I think for Ottumwa so many of those options weren’t available. So it was truly people coming up with their own ideas. And I would say “sure, why not let’s try it.” So video lead yoga was quite popular for some time until our PAL had to stop doing it because of family concerns. Anytime I would go to an activity in the beginning, I led several walking groups myself. And I’m very eager to share the information about Active Ottumwa, so almost anybody who would stop to talk, I would talk. I know also that there was a lot of contact made and several PALs who joined. When I would send out our calendar in an email to various, a pretty good-sized list, but it also included John Deere and Ottumwa Regional Hospital and Indian Hills Community College. And each one of those organizations would send it out to their staff. So, we were really able to saturate Ottumwa, if you will, with the emails and information about Active Ottumwa. Also PALs, I know that there were two PALs that contacted me after I had been at the Ottumwa Currier at our local newspaper, Senior Expo. And at the home garden show that was sponsored by the Chamber of Commerce. And there were several people that when I would go and we would have a booth there, and we also had PALs who attended those events with us. So people were able to hear from the PALs themselves how much fun it was and why not be healthy, doesn’t cost anything, you get to meet other people in your community, just a lot of those positive reinforcements.
Hannah Shultz: I talked to Twila about her experience as a Physical Activity Leader and the impact she saw on her hometown.
Twila Foster: I did not know, but as a nurse, I, I wanted people to be healthier in my hometown and I didn’t want to just talk about it I wanted to act upon it, so Active Ottumwa gave me that opportunity. And I’m very grateful. I would say seeing Ottumwa come together and actually help out as far as locations go at the Y, at the hospital, at a nursing home facility, and seeing the town come together to try to help encourage everyone to become healthier. I’ve enjoyed that the most. As far as the outreach goes, I know that they would come and present what Active Ottumwa was about to my cancer support group. And I know they would go to the Chamber of Commerce and to John Deere because people had to be educated about it. I think everybody was so excited about being a Blue Zone. And then when that fell through, I know that the public health office got involved too with Active Ottumwa, and it just brought everyone together. It’s like we lost a game, but then we had something a lot more long lasting out of it with Active Ottumwa. I saw so many people get involved. And with the guidance that we had, they had so many different opportunities, we had swimming, yoga, Zumba, walking. I mean no matter what your physical condition is, they have something that everyone could participate in. And that’s what I really appreciated about it as well, is they helped encompass so many different ways to remind people you do not have to be built like a bodybuilder. Everybody can do something as some sort of exercise.
Hannah Shultz: In today’s episode and in others we hear about the positive experience PALs had. So I was curious how these relationships are nourished, and particularly how feedback was shared.
Twila Foster: I was always asked my opinion on things and I was always encouraged, so if I suggested anything, it would’ve just been part of a normal conversation because that’s how open they were.
Sandy Berto: It was always an open-door policy, if there was a concern or a positive thing to share, I wanted people to tell me. One of my very favorite phrases in my nursing career is that we would rather deal with a little can of worms than a great big blow out. So I always encourage not only the PALs to come and share something with me but the participants as well. And that’s a two-way street for sure. So, if I ever had any questions or concerns, Becky and the team in Iowa City were always available to me. So it was truly a real partnership that extended across communities.
Hannah Shultz: As we talk with people throughout the production of this series, we continually hear about how Active Ottumwa is so much more than just a physical activity program or a group exercise program. So I was curious, from Twila’s perspective how being a PAL in Active Ottumwa had impacted her life.
Twila Foster: When you feel like you can contribute to your hometown and to the help of people in it, that’s how it impacted my life. And the support was always there if I had a question or anything. But it was fun to see how people would participate and some would do it on their own, and some wanted the social interaction. But the important thing was it got them out doing something different. And they could not use an excuse of “I can’t afford it,” because everything was free. And so it really helped improve people’s lives I think. I saw people get involved. I saw, community leaders, saying, “Hey, we can offer you our facility at no charge.” It just, it just helps people act, instead of just talk, it really got people moving. And that’s what I love about it.
Sandy Berto: You know, Hannah, I’m a lifelong a Ottumwan. And I have to say, for me personally, while I enjoyed going to other meetings and chatting about Active Ottumwa. It was also like Twila; leads to just another healthy alternative for Ottumwa. For a long time, we’ve been identified as you know, we’re the poorest, we’re the unhealthiest, all those negative kinds of things. And I think Active Ottumwa really shined the light on some of the positive things that the community members can bring to Ottumwa. And I think once you have that ownership, I think then there’s more progress made and more positive outcomes for everybody.
Twila Foster: Exactly.
Becky Bucklin: Twila, I think you, or at least you were involved even if you weren’t leading classes every week. Because I think you’ve basically been involved the whole time, like you continue to support the program, even when you didn’t lead a class every week.
Twila Foster: I didn’t know it was, it was a prized project for me. Because it correlated with how I wanted to be able to help people become healthier and I didn’t have the avenue to do that until the University came along.
Hannah Shultz: 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.