13.14: Case Study 1Wins Fitness
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This first case study illustrates the use of the social-ecological model in a health promotion program to promote physical activity in a community. At California State University, Northridge (CSUN), the Kinesiology department began a fitness intervention in an underserved community nearby - the City of San Fernando. This program provided free exercise classes instructed by undergraduate students from the university to participants at several local parks spaces in the city. The program brought some portable fitness equipment, and was awarded grant money to install permanent exercise equipment at one of the parks. Moreover, the program also partnered with other programs and local businesses to provide opportunities for nutritional education, physical therapy consults, and even video lectures on weight loss and mindfulness. The 3 Wins Fitness program ran for 12 years and involved over 400 participants over its duration. The idea of “3 Wins” in the program were that there were benefits to three stakeholders:
- the student - via professional skill development, experience and networking,
- the participant - by providing structure and coaching for exercise, and
- the community - by providing programs that improve health and well-being of community members as well as utilizing park space for health promotion (3 Wins Fitness, 2017).
The 3 Wins Fitness program had an effect on students at CSUN and citizens of San Fernando on multiple levels of the social-ecological model, as analyzed in several academic papers (Chaudhari et al., 2022, Derose et al., 2022).
Individual
Participants in the program reported improving health measures such as A1C levels (a measure of blood sugar management and risk for diabetes), lowered resting blood pressure, weight loss, and improved mental health. Additionally, many participants reported improved physical fitness including mobility, and stamina (Chaudhari et al., 2022).
Interpersonal
Both participants and student-instructors in the 3Wins program reported social-emotional benefits from the program. Participants were motivated to exercise by the instruction and encouragement of the student-instructors, and the comradery from their peers in the program. Student-instructors in turn, also developed a sense of community with other students and participants, which supported their academic and career goals. Lastly, family members of the participants could be affected by the increased focus on physical activity and health (Chaudhari et al., 2022).
Organizational
Several organizations were affected positively by the 3 Wins Fitness program. First, the parks and recreation system within the city had a continuous, no-cost exercise program to offer residents. Parks in underserved communities are notoriously underfunded, less maintained, and underutilized greenspace (Derose et al., 2022). One park in particular benefited with additional grant funding for exercise equipment installation. Local churches got involved with marketing and awareness efforts for the program. Many local religious organizations are neighborhood hubs for social gathering, and also have a vested interest in connecting their members with health-promoting programs (Derose et al., 2022). As an academic institution, CSUN benefitted from the program providing opportunities for research and as a source of internships for students in kinesiology and public health.
Community
The American Council on Exercise (ACE) supported research with 3 Wins Fitness, and provided scholarships and personal trainer certification opportunities for the student instructors. This connected these undergraduate students to the larger community of fitness professionals, and opened doors for them through certification and professional networking (American Council on Exercise, 2023). For the local community in the city of San Fernando, the 3 Wins program utilized the park system heavily, and helped to create demand for other health and fitness related programs offered by the city - including an annual 1-mile run event through the heart of the city. Local and large businesses sponsor this event, creating a public-private partnership for the community ( Recreation & Community Services , n.d.).
Policy
While the 3 Wins Fitness program offered by CSUN ended in the Fall of 2023, the City of San Fernando committed to expanding its own exercise offerings in parks and recreation for at least another year; creating part-time job opportunities for fitness instructors, and continuing exercise classes at no cost for community members. Additionally, research has been conducted on the program and calls for action by local, state and federal policymakers to prioritize funding community-based physical activity opportunities (3 Wins Fitness, n.d.).
While this example demonstrates a specific program that was implemented using the social-ecological model, it also highlights how each of these areas determines health behaviors and eventually affect health outcomes. The health of an individual is affected by their interpersonal relationships, the community in which the person lives, works, and plays. The health of those members in a community is affected by the organizations they are a part of, the built environment of their community, the economic and political landscape, as well as specific policies that directly or indirectly relate to health. There are stark disparities that exist in the opportunities that individuals and communities have to achieve health, that are not solely based on individual choices. A holistic approach that recognizes the social determinants of health and advances change at all levels of the social-ecological model is necessary (National Academies of Sciences, Engineering, and Medicine, 2023).