A group of women spins, skips, weaves their legs, and waves their arms through the conference room at the Ottumwa Regional Health Center, working up a mild sweat to hip-hop and R&B tunes.
“Yeah, that’s it!” shouts instructor Dana Overturf, encouraging the participants to keep moving. “Now this way. Turn, and that way.”
And the dancers dance this way, then turn and dance that way.
Overturf’s class, Dance Fitness, is one of dozens of programs offered by Active Ottumwa, a partnership between the city of Ottumwa and the Prevention Research Center in the University of Iowa College of Public Health designed to get more Ottumwans moving. Working with numerous local organizations, Active Ottumwa promotes healthy lifestyles by creating and encouraging more research-tested physical activity opportunities for adults. Edith Parker, dean of the College of Public Health and director of the Prevention Research Center, says the program offers an array of activities every week to improve peoples’ health.
The outreach is part of a research project funded in part by the U.S. Centers for Disease Control and Prevention (CDC) to develop a model that communities can use to improve the physical fitness of their residents. In particular, the CDC’s goal is to help communities with poor scores on public health measures such as obesity, smoking rates, teen pregnancy, and physical activity.
Researchers and students from the UI College of Public Health (CPH) have worked on numerous initiatives in Ottumwa to improve the community’s health. Some of them include:
The Compre Saludable/Shop Healthy initiative, to help Latino owners of neighborhood grocery stores, or tiendas, improve their business model and offer healthier food options. Working with the Iowa Department of Public Health and Iowa State University Extension Service, UI researcher Barbara Baquero helped tienda owners in Ottumwa and eight other Iowa communities improve their store layouts, provided shelves and other infrastructure, and developed marketing strategies.
Two community forums in Ottumwa organized by the college’s Business Leadership Network (BLN), in 2013 and 2017. The forums brought together a cross-section of business owners and managers, economic development leaders, school administrators, elected officials, and the public to discuss health and economic issues facing the region.
The BLN also awarded two community development grants to Ottumwa organizations in 2017—Main Street Ottumwa, for a program that uses art as a beautification tool for community improvement, and the United Way of Wapello County, for a program that provides free cooking classes and a crock pot to help low income families prepare healthier meals.
Measuring the results of an initiative by Indian Hills Community College in Ottumwa to increase retention of its students who are pregnant or parenting. As a result, the college started programs offering those students a food bank, a take-home meal program from the cafeteria, and increased tutoring.
Evaluating the effectiveness of a federal program designed to reduce teenage pregnancies in Ottumwa that was implemented by the Iowa Department of Public Health. CPH researchers and students gathered data on a number of different metrics, including interviews with local high school students.
Parker says Ottumwa was chosen because Wapello County—of which it is the seat—historically ranks low on the Robert Wood Johnson County Health Rankings for overall health outcomes in Iowa. A community health survey conducted by the Prevention Research Center in 2013 found 55 percent of Ottumwa residents were classified as sedentary, or engaged in little to no physical activity on a regular basis. Less than 1 percent of residents engaged in regular, vigorous physical activity.
Ottumwa also was chosen because local leaders know this lack of fitness is a serious community health problem and have made solving it a priority.
“It’s a community where there are health needs, and a proactive and engaged leadership that was committed to working with us to fill those needs,” Parker says.
The southeast Iowa town of 24,000 also has a solid recreational infrastructure, so it’s easy to find places to host activities. Within a mile of downtown, the city has walking trails, bike paths, public parks, a public swimming pool, playgrounds, a YMCA, a private fitness facility, a skate park, fields and courts for numerous sports, and the Des Moines River.
What was missing was a concerted effort to develop programming using those assets, and a communication effort that tells residents about the opportunities and encourages their use.
Active Ottumwa has been operating since 2013, using a portion of the CDC grant that funds the Prevention Resource Center. The direct costs for the project, totaling more than $380,000, include a salary for a local field coordinator and materials for the program’s operations. Researchers conducted the community health survey in 2013 and started meeting with dozens of governmental and nonprofit leaders to see what kind of programs would interest residents. Activities were rolled out in April 2016, led by 45 specially trained physical activity leaders (PALs) recruited from the community and a scattering of weekly activities that attracted a handful of participants.
From the start, Parker says it was important that Active Ottumwa became a part of the community and that its programming was based on local interests. It couldn’t be seen as the university coming in and telling people what to do.
To build those local connections, the Active Ottumwa group formed a Community Advisory Board with representatives from 10 local government, business, and nonprofit groups they regularly consult. All of the PALs are local volunteers. The initiative is led from an office space rented in a downtown building and headed by a local field coordinator, Sandy Berto, a registered nurse. She recruits and trains the PALs, works with them to coordinate and schedule activities, represents Active Ottumwa at community events, and makes presentations at local organizations and civic groups, promoting the program and good health in general. Though her title is research assistant, she says she prefers “people wrangler,” and she’s an all-around dynamic champion for Active Ottumwa.
The work has paid off, as Active Ottumwa quickly became a hit in the community. By the end of 2017, more than 475 people had participated in 800 activity groups at 21 locations around town. By this spring, at least one activity was offered every day but Sunday, and some days had multiple activities. Observers have noticed an increase in the number of residents using local parks and recreational trails, and walking inside the Quincy Place Mall.
“It’s done a great job of activating a group of individuals who otherwise wouldn’t have been served by the current avenues for health and wellness in the community,” says Garrett Ross, marketing and membership director of the Ottumwa Family YMCA and a member of the Community Advisory Board. “They’re what we call ‘health seekers.’ They may not even own a pair of gym shorts, but they know they have to do something to stay healthy.”
The activities are mostly low impact, low intensity, and free—designed simply to get people moving by doing things such as walking in malls and city parks, water exercises, yoga, square dancing, tai chi, strength training, or dance fitness. The goal is having fun in a nonintimidating, nonjudgmental atmosphere.
“Like walking,” says Presley Caldwell, a 2016 UI graduate and Ottumwa native who now works as a data coordinator for the program and helps Berto as an organizer. “It’s inexpensive, it’s easy. You can walk outside if it’s nice, or in the mall if the weather is bad.”
The goal, she says, is to keep people moving.
“We want people active in a way that they can make their activity sustainable,” says Caldwell. “Sustainability is key. If people quit, then it won’t help in the long run. Active Ottumwa is free, convenient, and easy, so it’s something people can keep doing.”
For some, it serves as a gateway to a more intense fitness routine. Ross says some Active Ottumwa participants have gone on to join the YMCA, looking for more vigorous workouts.
“It’s a great partnership that we’ve formed with Active Ottumwa,” he says. “It’s an opportunity to expand the number of people interested in health and wellness in the community, and that benefits us.”
The program improves more than just physical health. Just getting out of the house, being social, and meeting new people improves mental conditioning, especially for older participants. Mary Hart, a PAL volunteer who teaches tai chi on Saturday mornings, typically has anywhere from seven to 15 participants per session, many of whom are elderly.
“They’re maintaining their flexibility and balance, it’s low impact, and it gets them out and moving around,” Hart says. “Tai chi also requires you to focus mentally, so they’re using their brains too. It really builds their confidence.”
One frequent mall walker, Remi Panlaqui, even credits his exercise program with helping him recover after he was hit by a vehicle while riding his bicycle last year.
Parker says the grant will continue to provide some infrastructure support as the project transitions to the control of a local organization. The college is talking with local groups about that transition, she says.
Meanwhile, organizers are making plans to increase their outreach to groups whose participation is not what they had hoped. Caldwell notes that only 10 percent of participants so far have been men, so they’re looking to develop new programs and educational tools to reach them.
Involving more Latinos also is a priority. Although the city’s Latino population has climbed to 14 percent in recent years, only a handful have participated in Active Ottumwa programs. Now that the program is off the ground, Ross says organizers can spend more time thinking about ways to encourage more Latino participants and develop classes specifically for non-English speakers. One priority, for instance, is to recruit more organizers and PALs who can speak Spanish, as only two PALs currently speak the language.
“We work hard at supporting Latino culture in our community, but we know we have to work harder,” Ross says. “We have to do a better job of reaching them culturally to see what they need, and to develop stakeholders and champions in their community.”
The Prevention Research Center also hopes to expand the program across the state, says Natoshia Askelson, assistant professor of Community and Behavioral Health and deputy director of the Prevention Research Center. She says that in the next funding cycle, the Prevention Research Center will recruit additional partner communities in Iowa to establish fitness programs similar to Active Ottumwa, called Active Iowa. She says researchers will work with communities to adapt the Active Ottumwa program with hope for further expansion to other areas of the Midwest, such as Nebraska, Kansas, and Missouri.