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Adults at Risk for Diabetes Double Activity Levels through Healthy Lifestyle Program

Adults at risk for type 2 diabetes or heart disease or both can substantially increase their physical activity levels through participating in a lifestyle intervention program developed at the University of Pittsburgh Graduate School of Public Health for use in community-settings, such as senior centers or worksites.

Previous studies have demonstrated that such programs decrease weight and reduce diabetes risk, but this National Institutes of Health (NIH)-funded evaluation is one of the first to document that these programs also result in significant increases in the participants’ physical activity levels. The results are reported in this month’s issue of the Translational Journal of the American College of Sports Medicine, coinciding with the organization’s 62nd annual meeting in Boston, the largest sports medicine and exercise meeting in the world.

The analysis also confirmed that season matters, with participants getting more physical activity in the summer, versus winter, months. “This may seem like an obvious finding, but this evidence that season influences the physical activity levels of participants in community-based lifestyle interventions will allow us to adjust these programs accordingly and offer extra encouragement and strategies to continue striving to meet physical activity goals during the winter,” said lead author Yvonne L. Eaglehouse, PhD, a postdoctoral researcher at Pitt Public Health.

Dr. Eaglehouse and her colleagues investigated the impact of the Group Lifestyle Balance program, modified from the lifestyle intervention program used in the highly successful U.S. Diabetes Prevention Program (DPP). The DPP was a national study which demonstrated that people at risk for diabetes who lost a modest amount of weight and sharply increased their physical activity levels reduced their chances of developing diabetes or metabolic syndrome, and outperformed people who took a diabetes drug instead.

Group Lifestyle Balance is a 22-session program administered over a one-year period aimed at helping people make lifestyle changes to lower their risk for diabetes and heart disease. The goals of the program are to help participants reduce their weight by 7 percent and increase their moderate intensity physical activity (such as brisk walking) to a minimum of 150 minutes per week.

As part of the Pitt community intervention effort, a total of 223 participants were enrolled to test the effectiveness of the Group Lifestyle Balance program at a worksite and three diverse community centers in the Pittsburgh area. The participants averaged 58 years of age and had pre-diabetes or metabolic syndrome or both.

Participants were surveyed to determine the amount of leisure physical activity they achieved each week. As a result of participating in the program, participants added an average of 45 to 52 minutes of moderate intensity activity similar to a brisk walk to their weekly routine, which was maintained after the program ended at one year.

“This is one of the few programs of its kind to report on physical activity-related outcomes in a large group and the only known diabetes prevention healthy lifestyle program to examine the effect of season and weather on changes in physical activity levels,” said senior author Andrea Kriska, PhD, professor in Pitt Public Health’s Department of Epidemiology and principal investigator of the NIH study. “Since increased physical activity is one of the primary targets of these programs, it is critical to know if it is working and what can be done to improve the chances that participants reach their goals.”

Additional authors on this research are Bonny J. Rockette-Wagner, PhD, Mary Kaye Kramer, DrPH, RN, Vincent C. Arena, PhD, Rachel G. Miller, MS, and Karl K. Vanderwood, PhD, MPH, all of Pitt.

This study was funded by NIH National Institute of Diabetes and Digestive and Kidney Diseases grant R18 DK081323-04.

Early Detection, Smaller Cancer Among Benefits of Skin Cancer Screening at Primary Care Visits

Skin cancer screenings performed by primary care physicians (PCPs) during routine office visits improve the detection of potentially deadly melanomas and find them in earlier stages, according to new research from the University of Pittsburgh School of Medicine.

The results will be presented today at the 52nd annual American Society of Clinical Oncology (ASCO) annual meeting in Chicago.

“Our findings suggest that PCP screening is an effective way to improve early detection of melanoma, which could potentially save lives,” said lead author Laura Ferris, MD, PhD, associate professor, Department of Dermatology, Pitt School of Medicine and member of the Melanoma Program, University of Pittsburgh Cancer Institute.

Rates of melanoma, the most dangerous form of skin cancer, are on the rise, and skin cancer screenings are one of the most important steps for early detection and treatment, said Dr. Ferris. Typically, patients receive skin checks by setting up an appointment with a dermatologist.

The goal of the new UPMC screening initiative, which was modeled after a promising German program, was to improve the detection of melanomas by making it easier for patients to get screened during routine office visits with their PCPs, explained Dr. Ferris.

PCPs completed training on how to recognize melanomas and were asked to offer annual screening during office visits to all patients aged 35 and older. In 2014, during the first year of the program, 15 percent of the 333,788 eligible UPMC patients were screened in this fashion.

On average, the melanomas detected in the group who received a screening at a primary care visit were nearly twice as thin as those detected in the group that was not screened by a PCP. Thinner melanomas have a better prognosis than thicker ones that are more advanced, so the new findings suggest PCP screening is able to find melanomas at an earlier, more treatable stage, said Dr. Ferris.

In addition, only 5 percent of people in the screening group had especially worrisome melanomas that were thicker than 1 millimeter—which are more likely to metastasize and require a biopsy of a nearby lymph node—while 20 percent of the unscreened group did.

“The PCP screenings prevented a lot of people from needing more aggressive therapy. Additionally, we did not see a high rate of false positive biopsies, in which no skin cancer was present, nor did we see a high rate of unnecessary dermatology referrals or skin surgeries, all of which suggest that the program did not simply drive up health care costs needlessly,” Dr. Ferris said.

Another important finding was that nearly half of the screened patients were men, who are more likely to get and die from melanoma than women but have been underrepresented in other skin cancer screenings published to date. “It’s exciting that our approach improves detection in this especially vulnerable population,” said Dr. Ferris.

Funding for this study was provided by a National Cancer Institute Specialized Program of Research Excellence (SPORE) grant in skin cancer (5P50CA121973-08).

Additional members of the research team included Melissa Saul, MS, Francis Solano, MD, Erica Neuren, BA, Jian-Min Yuan, MD, PhD, and John Kirkwood, MD, all of UPMC; Martin Weinstock, MD, PhD, of Brown University; and Allan Geller, MPH, RN, of Harvard University.

Immunotherapy Improves Survival, Quality of Life in Rapidly Progressing Head and Neck Cancer

Immunotherapy doubles overall survival and improves quality of life, with fewer side effects, in a treatment-resistant and rapidly progressing form of head and neck carcinoma, reports a large, randomized international trial co-led by investigators at the University of Pittsburgh Cancer Institute (UPCI). The new trial was considered so successful that it was stopped early to allow patients in the comparison group to receive the new drug.

Findings from the international CheckMate-141 phase III clinical trial were presented today at the 52nd annual American Society of Clinical Oncology (ASCO) meeting in Chicago. A subset of the results were previously presented at the American Association for Cancer Research meeting in April of this year.

“These exciting results indicate that there is a new standard of care option for a population of head and neck cancer patients with no other treatment options,” said the trial’s international co-chair Robert Ferris, MD, PhD, UPMC Endowed Professor, and chief of the Division of Head and Neck Surgery and co-leader of the Cancer Immunology Program at UPCI.

The new drug, nivolumab, which belongs to a class of drugs known as immunotherapeutics, enables the body’s immune system to destroy cancer cells. It currently is approved to treat certain types of cancers, including melanoma and lung cancer.

The trial enrolled 361 patients with recurrent or metastatic head and neck squamous cell carcinoma who had not responded to platinum-based chemotherapy, a rapidly progressing form of the disease with an especially poor prognosis, said Dr. Ferris. Patients were randomized to receive either nivolumab or a single type of standard chemotherapy until tumor progression was observed.

The nivolumab group achieved better outcomes than the standard chemotherapy group by all accounts. After 12 months, 36 percent of the nivolumab group was alive, compared to just 17 percent of the standard chemotherapy group.

Nivolumab treatment also doubled the number of patients whose tumors shrunk, and the number whose disease had not progressed after six months of treatment. Importantly, these benefits were achieved with just one-third the rate of serious adverse events reported in the standard chemotherapy group.

In addition, on average, patients receiving nivolumab reported that their quality of life remained stable or improved throughout the study, while those in the chemotherapy group reported a decline.

While nivolumab improved survival rates in the overall study population, it appeared to be most successful in patients whose tumors were positive for the human papillomavirus (HPV). This is important because the fraction of head and neck cancers attributable to HPV infection has increased by 250 percent over the past several decades, Dr. Ferris explained.

“Unfortunately, most patients in this trial still experienced a progression of their cancer, demonstrating that we still have a lot of work to do. But, the future appears brighter than ever before because there is a new class of agents, immunotherapies, which we now know can prolong survival and improve quality of life, with few side effects, in head and neck cancer,” said Dr. Ferris.

The research team currently is working to identify new biomarkers that will allow them to develop a better understanding of how drug resistance develops, and how to best design effective combinations of medications that may improve patient responses.

The trial’s other co-chair is Maura Gillison, MD, PhD, from Ohio State University. Additional U.S. institutions that participated in the trial include University of Texas MD Anderson Cancer Center, Stanford Cancer Institute, University of Chicago, University of Michigan, and Dana-Farber Cancer Institute. International collaborators are located at Centre Leon Berard, Centre Antoine Lacassagne, and Institut Gustave Roussy, all in France; Fondazione IRCCS Istituto Nazionale Tumori, in Italy; The Institute of Cancer Research, in the United Kingdom; University Hospital Essen, in Germany; and National Cancer Center Hospital East and Kobe University Hospital, both in Japan.

The trial was funded by the drug manufacturer, Bristol-Myers Squibb, who is now seeking FDA approval for the use of nivolumab in head and neck carcinoma.

Immunotherapy Effective Against Some Types of Sarcoma

An existing cancer immunotherapy drug reduces tumor size in some types of rare connective tissue cancers, called sarcomas, report researchers at the University of Pittsburgh Cancer Institute (UPCI). Additional analyses of tumor biopsies and blood samples, which will help the researchers better understand which sarcoma subtypes will benefit most from the new treatment, are underway.

Interim results from the phase II clinical trial were presented today at the 52nd annual American Society of Clinical Oncology (ASCO) annual meeting in Chicago by principal investigator Hussein Abdul-Hassan Tawbi, MD, PhD, formerly of UPCI and current associate professor, University of Texas MD Anderson Cancer Center.

Sarcoma is a rare disease, encompassing less than 1 percent of adult cancers, and the available treatments are limited, so the need for new therapies is high, explained the current lead investigator for the Pittsburgh site, Melissa Burgess, MD, assistant professor of medicine at UPCI.

“This is a pivotal trial for sarcoma, the first and largest trial to be conducted using this specific immunotherapeutic approach. What makes this trial special is that we collected biopsies and blood samples to really study how the treatment is working or not working in these patients. These immune monitoring studies will offer unique insights into the biology of immunotherapy in sarcoma,” Dr. Burgess said.

Immunotherapies work by using a patient’s own immune cells to target cancer cells. The new trial examined the safety and effect of pembrolizumab, which currently is approved for use in advanced melanoma and certain types of advanced lung cancer, on tumor size in four types of soft tissue sarcomas and three types of bone sarcomas.

UPCI, the first of 12 sites to enroll subjects, contributed approximately one quarter of the 80 total patients. Patients received the drug every three weeks. Tumor assessments began at eight weeks and were conducted every 12 weeks thereafter. The trial enrolled on a rolling basis, and is still in progress, so in these results, not all patients have received the drug for the same amount of time.

About 20 percent of patients in the combined soft tissue sarcoma group showed a reduction in tumor size during at least one time point. However, when the researchers looked at the sarcoma subtypes individually, they found one with especially promising results: 44 percent of patients with undifferentiated pleomorphic sarcoma experienced a reduction in tumor size. Encouraging improvements in tumor size also were found in two subtypes of bone sarcomas, osteosarcoma and chondrosarcoma, Dr. Burgess noted.

“Unfortunately, these early results suggest that there is limited efficacy of pembrolizumab in the patient population as a whole. However, it’s promising that the drug seems to be beneficial in specific sarcoma subtypes. Our ongoing immune monitoring studies will allow us to better characterize the patients who will most benefit from this therapy for future clinical trials,” said Dr. Burgess.

Additional co-authors of the trial trial include Denise K. Reinke, MS, NP, MBA, of SARC, which coordinated the trial; John Crowley, PhD, of Cancer Research and Biostatistics; Brian Van Tine, MD, PhD, of Washington University in St. Louis; James Hu, MD, of University of Southern California Norris Comprehensive Cancer Center; Scott Schuetze, MD, and Laurence Baker, DO, of University of Michigan; Sandra D’Angelo, MD, of Memorial Sloan Kettering Cancer Center; Steven Attia, DO, of Mayo Clinic Jacksonville, Dennis Priebat, MD, of MedStar Washington Hospital Center; Scott Okuno, MD, of Mayo Clinic, Rochester; Richard Riedel, MD, of Duke University Medical Center, Lara Davis, MD, of Oregon Health and Sciences University; Sujana Movva, MD, of Fox Chase Cancer Center; Damon Reed, MD, of Moffitt Cancer Center; Robert Maki, MD, PhD, of Tisch Cancer Institute; and Shreyaskumar Patel, MD, of University of Texas MD Anderson Cancer Center.

Funding for the trial was provided by Merck & Co., the maker of pembrolizumab, Sarcoma Alliance for Research Through Collaboration, Sarcoma Foundation of America and QuadW Foundation. Funding for the ongoing studies was partially provided by local philanthropic support group Pittsburgh Cure Sarcoma.

UPCI-Led International Trial Changing Standard of Care for Advanced Breast Cancer

Surgery to remove the primary tumor in women diagnosed with stage IV breast cancer, followed by the standard combination of therapies, adds months to the patients’ lives, compared with standard therapy alone, an international clinical trial led by a University of Pittsburgh Cancer Institute (UPCI) professor revealed.

The results of the phase III randomized, controlled trial will be presented Saturday at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago. The study was selected for the society’s “Best of ASCO,” an effort to condense the research “most relevant and significant to oncology” into a two-day program to increase global access to cutting-edge science.

“Our findings will change the standard of care for women newly diagnosed with stage IV breast cancer,” said principal investigator Atilla Soran, MD, MPH, clinical professor of surgery, University of Pittsburgh School of Medicine, and breast surgical oncologist with UPMC CancerCenter. “We’ve shown that surgery to remove the primary tumor—either through lumpectomy or mastectomy—followed by standard therapy, is beneficial over no surgery.”

Dr. Soran began the trial in 2007, ultimately recruiting a total of 274 women newly diagnosed with stage IV breast cancer from 25 institutions. Half the women received standard therapy, which avoids surgery and consists of a combination of chemotherapy, hormonal therapy and targeted therapy, while the other half first had surgery to remove their primary breast tumor, followed by the standard therapy.

At about 40 months after diagnosis, the women who received the surgery plus standard therapy lived an average of nine months longer than their counterparts who received standard therapy alone. Nearly 42 percent of the women who received surgery lived to five years after diagnosis, compared with less than 25 percent of the women who did not receive surgery.

The trial also showed that surgery in younger women with less aggressive cancers resulted in longer average survival than in women with more aggressive cancers that had spread to the liver or lungs.

“Our thinking is similar to how you might approach a battle against two enemies,” said Dr. Soran. “First you quickly dispatch one army—the primary tumor—leaving you to concentrate all your efforts on battling the second army—any remaining cancer.”

This research was primarily funded by the Turkish Federation of Societies for Breast Diseases. The study received scientific advisement from UPMC and assistance with statistical analysis from epidemiologists at the University of Pittsburgh Graduate School of Public Health.

UPMC Receives Nation’s Top Ratings for Heart Surgery

UPMC has been awarded top quality ratings by the Society of Thoracic Surgeons (STS). The health system recently received the maximum “three star” rating for coronary artery bypass grafting (CABG) procedures.

Based on a review of data that was compiled and publicly reported for the 2015 fiscal year, the score designates that UPMC is statistically better than the national average for this common cardiac procedure.

“We are very proud of the dedication displayed by our physicians and staff that led to consistently high quality across the board for CABG procedures as proven by these tremendous results,” said Thomas Gleason, MD, chief of the UPMC Division of Cardiac Surgery. “The UPMC Heart and Vascular Institute works hard to provide innovative cardiac care of the highest quality to patients throughout our system.”

The STS National Database was established to drive quality and safety improvements among cardiothoracic surgeons. It covers adult cardiac, general thoracic and congenital heart surgery.

The UPMC Heart and Vascular Institute is one of the world’s premier centers for comprehensive care, developing revolutionary devices and new models of treatment that improve the lives of those facing the most complex heart and vascular conditions.

UPMC to Develop Health Services on Hainan Island Through 3rd Partnership in China

UPMC and First Chengmei Medical Industry Group (FCMG) of Haikou, China, have signed an agreement to collaborate on the development of health care services to benefit the people of Hainan Island, the southernmost province in China.

Beginning this summer, UPMC will provide clinical training opportunities for FCMG physicians and nurses, both in Haikou and Pittsburgh, with an initial focus on medical, radiation and surgical oncology. In addition, a team of UPMC experts will visit Haikou to observe clinical practices and offer recommendations on hospital operations, including such areas as information technology, supply chain, patient satisfaction and quality.

FCMG, a subsidiary of First Investment Holding Group, solely owns three hospitals in the greater Haikou region, including the Hainan Cancer Hospital, an Orthopaedics Hospital and the newly built Chengmei International Medical Center. First Investment Holding is one of the oldest and most renowned local enterprises, founded when the Province of Hainan was established in 1988.

“First Chengmei Medical Industry Group conducted an exhaustive search for the best possible partner in creating our international collaboration, and we selected UPMC based upon its extensive international experience and its recognized reputation for clinical excellence,” said Lin Shi Quan, executive director-general of Hainan Cancer Hospital and chief executive officer of FCMG. “Most importantly, UPMC has proven its commitment to the development of health care programs of excellence in China. We expect this initial one-year agreement will grow into a long-term relationship covering a multitude of clinical services.”

Charles Bogosta, president of UPMC International, said, “UPMC is pleased to initiate this important new relationship, our third major agreement in China. Like UPMC, FCMG is committed to achieving international standards of clinical excellence so that patients can get the best possible care close to home.”

In addition to its work with KingMed Diagnostics in Guangzhou for the provision of second-opinion telepathology services, UPMC helped to develop and supports the operation of the Xiangya International Medical Center in Changsha.

UPMC Researchers Shine Light on Common Heart Complication After Lung Transplantation

Cardiac arrhythmia is a common complication following lung transplantation, and one that has a significant negative impact on long-term patient survival, reports a team of UPMC researchers in the largest study of its kind to date. The results, published online this week in the Journal of Thoracic and Cardiovascular Surgery, provide critical information that will hopefully lead to better care of transplant recipients.

Arrhythmia, a rapid and irregular heartbeat, can lead to chest pain, stroke and heart failure. In addition, the blood-thinning drugs often used to treat atrial fibrillation, the most common type of arrhythmia, carry risks of heavy bleeding.

“Arrhythmias present a lot of challenges for both physicians and patients. After noticing this complication in many of our lung transplant recipients, we decided to investigate how often and when it was happening, as well as any risk factors,” said lead researcher Jonathan D’Cunha, MD, PhD, associate professor, Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, and chief of Lung Transplantation, Department of Cardiothoracic Surgery, UPMC. “Now that we have a better understanding of these events, we can develop a standardized treatment plan, and better educate patients in advance.”

Performing 70 to 100 lung transplants per year, UPMC is one of the leaders for this procedure in the nation. In the new study, researchers examined the medical records of 652 UPMC patients who underwent a single or double lung transplant between 2008 and 2013.

They found that about 30 percent of patients developed arrhythmia, most often during the first week following surgery. Risk factors for a postoperative arrhythmia included being older and having had a previous heart surgery.

Researchers also found transplant recipients who developed an arrhythmia were 1.6 times more likely to die within 5 years than those who didn’t, a finding Dr. D’Cunha attributed more to the potential complications of treating arrhythmia than the abnormal heart beats themselves.

“Our study suggests that we may need to treat patients with blood thinners only for a short amount of time—until they are out of the window of highest risk—which will hopefully improve long-term outcomes,” Dr. D’Cunha explained.

In addition, because arrhythmia after lung transplant can be an anxiety-provoking experience for patients, the findings will allow surgeons to better prepare patients and families for what to expect.

“Most importantly, based on the results of this study, we can now predict, with a reasonable degree of certainty, when arrhythmia will happen,” Dr. D’Cunha said. “This allows us to begin to standardize our treatment approach and improve patient care in the postoperative setting.”

Other members of the research team include Alex D’Angelo, BA, Ernest Chan, MD, J. W. Awori Hayanga, MD, MPH, David Odell, M.D., MMSc, Joseph Pilewski, MD, Maria Crespo, MD, Matthew Morrell, MD, Norihisa Shigemura, MD, James Luketich, MD, Christian Bermudez, MD, and Andrew Althouse, PhD, all of UPMC.

Young Norfolk Girl Receives Liver Transplant in Unique Care Partnership between UVA Children’s Hospital and Children’s Hospital of Pittsburgh of UPMC

PrintA 13-year-old Norfolk girl is the first patient to receive a transplant in a unique pediatric liver transplant partnership between Children’s Hospital of Pittsburgh of UPMC and the University of Virginia Children’s Hospital.

India Johnson suffered from two rare genetic diseases that caused her liver and kidneys to fail. India needed a liver and kidney transplant, so on Feb. 11, her mother contacted the Charles O. Strickler Transplant Center at UVA, the only comprehensive transplant center in Virginia. Coincidentally, it was the same day that UVA’s partnership with Children’s Hospital of Pittsburgh of UPMC was announced.

The partnership was established to expand UVA’s pediatric liver transplant program and increase access to care for transplant patients throughout Virginia. Children’s Hospital of Pittsburgh of UPMC transplant surgeons consult with UVA counterparts and with Virginia-based patients via teleconsult. Once organs become available, a team of nurses, surgeons and specialists from Pittsburgh travel to UVA to perform the transplant alongside UVA transplant surgeons.

India and her mother, Melody Johnson, traveled to Charlottesville for evaluation with the UVA team in person and the Children’s Hospital of Pittsburgh of UPMC team via telemedicine.

“The team was so confident in what they could do, it made me confident,” Melody Johnson said. “I was really comfortable with the facility and the people.”

India received her new liver and kidney on May 17, two weeks after she was originally added to the national organ transplant waiting list. Physicians report that she is doing very well.

“We’re so pleased that India received her transplant closer to home with exceptional care from UVA and Children’s Hospital of Pittsburgh of UPMC,” said Kenneth Brayman, MD, PhD, FACS, division chief of transplant surgery and director of the Charles O. Strickler Transplant Center at UVA.

“We’re honored that India and her family entrusted her care to us and we’re very pleased with her progress so far,” said George V. Mazariegos, MD, director of pediatric transplantation at the Hillman Center for Pediatric Transplantation at Children’s. “She represents the beginning of an important collaboration between our transplant program and our colleagues at UVA. Working together, we plan to greatly enhance this region’s organ transplant capabilities so that families from Virginia can remain close to home and still get the highest level of pediatric transplant care available in the country.”

“India’s transplant experience is a remarkable example of UVA working with partners to provide the highest level of specialty care to the citizens of the commonwealth,” Richard P. Shannon, MD, executive vice president for health affairs at UVA.

Pitt Public Health Walking Advocate Receives National Award from America Walks

America Walks, a national advocacy organization that promotes walking and walkable communities, announced today that Carol Reichbaum, MSL, MSPA, of the University of Pittsburgh Graduate School of Public Health, has been awarded a Walking College Fellowship. Follow link for more information.

The Fellowship will enable Ms. Reichbaum and 24 other advocates from around the country to participate in a four-month training program designed to strengthen local efforts to make communities more walkable.

“We are delighted to welcome Ms. Reichbaum as a member of our 2016 Walking College class,” said Ian Thomas, state and local program director with America Walks. “This program was developed in response to our findings that access to technical assistance and a national peer network are among the most pressing needs for advocates working at the local level.”

Ms. Reichbaum is the program manager of WalkWorks, a collaboration between Pitt Public Health and the Pennsylvania Department of Health, funded through a grant from the US Centers for Disease Control and Prevention to the Department of Health. Through the fellowship, she will complete a six-module distance-education training program this summer and participate in the international Pro Walk, Pro Bike, Pro Place conference in Vancouver, British Columbia in September.

“I am thrilled and honored to have been selected as a fellow in the Walking College,” said Ms. Reichbaum. “This will afford me an incredible opportunity to enhance my knowledge of, and to be exposed to, strategies for expanding and strengthening walkable communities, thereby feeding my passion to improve the health status of the population.”

WalkWorks aims to increase opportunities for physical activity by developing walking routes and sustainable walking groups in communities with high rates of obesity and related chronic diseases. A critical component of the program is influencing policy – in particular, incorporating “health” and active transportation in policies and plans.

“Policy that promotes walking is essential to improving the health of community members,” said Ms. Reichbaum. “Participating in the Walking College will enable me to more effectively work and communicate with policymakers to create changes that help entire communities increase opportunities for physical activity.”

The Walking College curriculum has been designed to expand the capacity of local advocates to be effective community change agents.  Topics include the science behind the benefits of walking, evaluation of built environments, as well as communication skills and building relationships with stakeholders and decision makers.  At the conclusion of the Walking College, Fellows will develop a strategic plan for improving walkability in their communities.

To learn more, visit www.americawalks.org/news.

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