Need: To reduce obesity among adults in rural east central Ohio.
Intervention: Fit for Life Replication Project for Expansion was developed to make it possible to lose weight through practicing healthier lifestyle behaviors.
Results: Out of the 443 adults who have completed the program, 81% experienced weight loss, a tangible result of the program's overarching goal to enhance levels of health and fitness.
Demographics are just part of the reason for the
prevalence of poverty and health disparities in east
central Ohio. Some of the area's counties are considered
Health Professional Shortage Areas (HPSA). Exercise
facilities and diet programs are sparse, and the number
of obese adults is increasing yearly. As a result, the
area ranks high in obesity-related illnesses such as
heart disease, diabetes, and cancer.
In 2012, Trinity Hospital Twin
City (THTC) of Dennison, Ohio launched the
Fit for Life Replication Project for Expansion (FFL)
in Tuscarawas County that later expanded its services to
Carroll, Harrison, Holmes, and Jefferson Counties. FFL's
goal is to reduce the number of overweight and obese
adults through their health and wellness program. By
teaching healthy lifestyles in a class setting, FFL
believes that weight loss and, ultimately, disease
control will be a natural outcome for the population of
which at least 30% is obese.
A typical FFL course includes weekly classes and a
12-week curriculum that teaches realistic lifestyle
changes in order to achieve overall wellness. The classes
last 90 minutes and include nutrition, exercise, health
education, and personalized nutrition and fitness plans.
Some of the class topics include:
Stress Management
The Wellness Choice
Nutrition for Life
Eat to Live
Food Labels
Cardiovascular Fitness
Flexibility Fitness
Strength Fitness
Disease Prevention
Healthy Aging
Results
As a direct result of FFL, participants gain an awareness
of the impact that their healthy or unhealthy choices
have on their bodies, and act accordingly. The following
are the results from the 2012-2015 grant period:
443 adults completed FFL with an 81% average
attendance rate of each session
64.4% of participants increased the number of days
per week they engaged in at least 30 minutes of exercise
64.9% improved their daily intake of fruit and
vegetables
81% experienced a weight loss (an average of 6.7
pounds per participant)
The average participant experienced over a 9-point
decrease in total cholesterol
The following results are from the 2015-2018 Diabetes
Prevention Fit for Life Program grant period:
79% experienced weight loss (average of 11 pounds per
person); 36% lost 5% of their starting weight or more
34% of participants reduced their A1C level; 48%
reduced their cholesterol
59% increased their daily intake of fruits and
vegetables
66% increased the number of days per week they
engaged in at least 30 minutes of exercise; 31%
indicating they exercise 150 minutes or more each week
82% took advantage of the motivational counseling and
fitness training offerings as part of the program
About 15 people who were considered prediabetic at
the start of the program are now within normal A1C range
Reached the program goal of engaging 540 adults
through classes and mini seminars, 135 were low-income
1,018 adults received free Hemoglobin A1C health
screenings
Additional results from the Trinity Hospital Twin City's
Fit for Life Program has been published in this journal
article:
As a result of the Trinity Hospital Twin Cities FFL
program:
Project Director Dr. Tim McKnight was invited to
serve on the county-wide Obesity Committee Task Force.
Dr. McKnight was invited to participate on the White
House Council for Rural Health in November of 2009.
Testimonials from patients enrolled in Fit for Life from
January through April of 2015:
"FFL is a great program! I'm so impressed with the focus
on 'Total Wellness' each week providing new information
as if laying building blocks…At the end, I lost 15
pounds, lowered my blood pressure and total cholesterol,
and my C Reactive Protein dropped four points! I have
more energy and confidence! Thank you Dr. McKnight and
all the FFL staff who were very encouraging."
"Fit for life is more than the title to a program, it is
a mantra of a new beginning. I have always been told that
if you know the theory of operation you can fix
anything…For the first time in my life, I have lost over
30 pounds just by changing my eating habits and knowing
how the foods we eat affect the cells on my body to
create lasting results. Some people live to eat and
others eat to live - this program creates the paradigm
shift in the brain to know the difference."
Dr. Tim McKnight and Fit for Life participant Larry
Parrish.
FFL had an increasing number of low-income adults join
the program. Through a local church, funds were
provided to sponsor participants and provide
transportation for those who needed rides to their
classes.
Two grant partners withdrew from the project in 2013,
so FFL secured another partner to teach the curriculum.
Course leaders were trained week by week until a more
thorough training session was established.
Coordinating communication between all partners was
difficult initially, but the partners eventually
established an effective communication system, and
requests were responded to in a timely manner.
Attendance rates were lower than expected at
locations outside of Tuscarawas County. After using new
promotional ideas, one partner did experience an increase
in attendance during the last grant year.
Replication
Provide a holistic approach to your training. Expand
sessions to include thought pattern training through
journaling exercises, positive reinforcement,
testimonials, group discussion, and the arts.
Include positive behavior measurements (number of
servings of healthy foods consumed, amount of physical
activity, attitudes about healthy eating) along with your
standard health measurements (weight, BMI, fat
percentages, etc.) when tallying health results from
participants.
Measure participants throughout the course of the
program. Provide a follow-up letter to participants to
show their progress.
Create documents that can easily be followed for
replication purposes. Include things like expectations of
coordinators and guidelines for conducting measurements
with participants.
Explore sustainability for the program, especially in
recruiting new sites and businesses for alternative
funding.
The FFL curriculum and leadership training is available
for those interested in launching the program in their
own communities. To purchase the following materials,
contact Jennifer Demuth (contact information listed
below):
Customizable standardized curriculum workbook
Standardized guide for conducting a Fit for Life
program
Topics
Appalachia
Obesity and weight control
Physical activity
Wellness, health promotion, and disease prevention
States served
Ohio
Date added
October 30, 2015
Date updated or reviewed
November 19, 2018
Suggested citation: Rural Health Information Hub,
2018.
Trinity Hospital Twin City's Fit for Life [online]. Rural Health Information Hub. Available at:
https://www.ruralhealthinfo.org/project-examples/851
[Accessed 26 April 2024]
Please contact the models and innovations contact directly for the most complete and current information
about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The
programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
community should consider whether a particular project or approach is a good match for their community’s
needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.
In 2012, Trinity Hospital Twin
City (THTC) of Dennison, Ohio launched the
Fit for Life Replication Project for Expansion (FFL)
in Tuscarawas County that later expanded its services to
Carroll, Harrison, Holmes, and Jefferson Counties. FFL's
goal is to reduce the number of overweight and obese
adults through their health and wellness program. By
teaching healthy lifestyles in a class setting, FFL
believes that weight loss and, ultimately, disease
control will be a natural outcome for the population of
which at least 30% is obese.
