Walking campaign: a model for developing participation in physical activity? Experiences from three campaign periods of the Stockholm Diabetes Prevention Program (SDPP).

The Stockholm Diabetes Prevention Program (SDPP) is implementing a model for community-based intervention of type 2 diabetes in three municipalities, of which one has focused on increasing physical activity among the inhabitants. The purpose was to emphasize the integration of walking into daily routines. The campaign was promoted throughout residential areas, organizations and local media. Leaders for organized walking were recruited as volunteers by advertising in local media. After a short education in leadership, practice, and first aid, the 27 volunteers ran organized walking groups in several residential areas. During three of seven walking campaigns the participants were followed and evaluated. The study showed that those individuals who participated one to three times a week were predominantly married women with a good health and regular physical activity. Nevertheless, more important was that one third of the participants had never been exercising regularly before. Most remarkable was to find the voluntary leaders so easily recruited and their great interest to remain as leaders for walking tours.

The potential of community diagnosis as a tool in planning an intervention programme aimed at preventing injuries.

Injuries due to accidents are a serious public health problem in Sweden as in the rest of the world. In Sweden injuries are the most frequent cause of death among people under the age of 50. More than 75% of all injuries occur in the home or surrounding area. Most accidents strike children, teenagers, and the elderly. Many accidents can be avoided. Prevention is therefore important. A community intervention programme for the prevention of accidents has been developed in the municipality of Sollentuna in Stockholm County. During the planning phase, a basic analysis of the local community was found to be useful, i.e. a Community Diagnosis, which includes three stages: description, analysis, and a health action programme. This report concentrates on the first two stages. To make a community diagnosis, some basic data are needed. In this report the relevance of the existing registers to the Community Diagnosis model is discussed. It is also shown how the Community Diagnosis model helped in the planning phase: the community profile demonstrated whom the prevention should be aimed at, the health profile emphasized the importance of accident prevention, the health risk profile showed where to change the environment, and last, the organizational profile elucidated how preventive work should be organized.

The need of leadership for motivation of participants in a community intervention programme.

It is important to know if a community intervention programme actually exists. The level of programme development depends on the extent of participation. The community participation can not be assessed by only using quantitative methods, there is also a need even for qualitative evaluation in order to identity details about the participation process. The purpose of this paper is to describe analysis using data coming from interviews and diaries, demonstrating both how people participate in a community intervention programme aimed at preventing accidents and why. What is the significance of the leadership in maintaining a programme in the long run? The findings show that the leader or leaders are the most important factors in maintaining a community intervention programme. The study demonstrates the necessity of a leader supporting and stimulating participation. There are also some personal reasons why people participate. The involvement is very much correlated with the personality of the programme adopters. As long as an individual can perceive personal gains from participating in the programme, it is of interest to her/him.

Can a community development model be used for health programmes in an industrialized country?

Injury resulting from accident is a serious public health problem in Sweden, as it is in the rest of the world. Theoretically, almost all incidents can be prevented. However, in practice, injury-prevention is a complex problem. A community-level intervention programme for prevention of accidents was developed in the municipality of Sollentuna, Stockholm County. The primary strategy has been to involve the community through representatives as well as through local organizations and groups. Project organization has been built up in cooperation with the municipal primary health-care department, local authorities, voluntary organizations and citizen agencies. A common opinion is that it is the actual process in a community programme which is important, that alters the type of involvement from a 'top-down' to a 'bottom-up' approach. Can a local community take over responsibility for running such a programme which has been initiated by an external authority or organization? We think that, at least for Swedish circumstances, the community development approach is far too optimistic in its expectation that community members should and can stay actively involved in programme decisions. Based on our experience, it does not seem possible to maintain a broad self-sustained programme solely with input from community members.

Safety rounds in public environments: experience of a new tool for prevention of accidental injuries.

Accident prevention concerns everyone in society. A large number of organisations have the responsibility and the means to fight the increasing injury rate. Many preventive measures require changes and improvements to the physical environment. In Sollentuna, Sweden, the work concentrated on making inventories of the pedestrian physical environment and pressuring those responsible to take measures to correct deficiencies discovered through the municipal "safety round." The inventory of injury risk factors was documented in a report along with information about the type of risk-object, its geographical location, and those responsible for remedial measures. The environmental deficiencies were marked on a map and most of them were photographed. With the help of expert know-how and local knowledge, 88 risk factors were identified in the area of investigation, which covered slightly over 1 square kilometer. With the report as a basis, those responsible for countermeasures were contacted by letter and asked to take measures to eliminate the risk factors. The responsibility for eliminating these risk factors was divided among various authorities, organizations, and private persons. Despite a lack of legal support for the demand for countermeasures most of those responsible proved to have a positive attitude towards eliminating the accident risk factors that had been identified during the safety rounds. The method worked satisfactorily and the risk factors were eliminated after one or two contacts in almost all cases.