Paper Version and Forms

Spring 2013

Walking Challenge

April 8th –May 5th 2013

WEEKLY PRIZES & GRAND PRIZES

PROGRAM Healthy UND is coordinating a 4-week walking challenge designed for UND staff, faculty, students and their teammates (co-workers, spouses/partners, family members) to track steps for a healthier YOU! You can borrow pedometers from the Work Well program (staff and faculty) and the Wellness Center (students). We hope to encourage physical exercise to become an essential part of your every day. There is also a Smart phone application that you can use: http://www.accupedo.com or you can use an Ipod (Nike fitness feature).

If you have injuries that prevent you from walking regularly, have no fear, you can convert your minutes of “non-walking” activity into steps. You will see a conversion chart in this packet.

GETTING STARTED To participate and be eligible for prizes, you will need to:

Decide if you are going on your own, or get into a team of 2, 3 or 4.

FOR STUDENTS: Complete the attached registration, pre-assessment and pedometer rental agreement and mail to: Steph Hoffman, Mail Stop 8365 by April 4th, 2013

FOR STAFF/FACULTY: Complete the attached registration, pre-assessment and pedometer rental agreement and mail to: Kim Ruliffson, Mail Stop 8365 by April 4th, 2013.

LOGGING YOUR STEPS You will need to complete the step logs weekly and return them by Wednesday of the next week to be in the weekly drawing. Here are options: Mail Stop 8365 or fax: 777-6030.

Weekly Prizes: STUDENTS: $25 Gift Cards (Scheels, Finish Line, Cabelas, Ski and Bike Shop or Target)

One random individual will be drawn each week if they completed their walking and submitted/entered the on-line step log on time.

FACULTY/STAFF: $25 Gift Cards (Scheels, Finish Line, Cabelas, Ski and Bike Shop or

Target) One random individual will be drawn each week. If they are on a team, their entire team wins a

gift card too for walking and submitting /entering their on-line step log on-time.

For employees and on-line students who win who do not live in Grand Forks, we will find a sporting

goods store in your area.

Grand Prizes: Staff and Faculty: 2 FitBits, Students: 2 Timex Watches.

Eligibility for the Grand Prizes requires the participant to complete ALL four weeks of the Walking Challenge and submit your weekly step log on time.

Other Prizes:

Staff and faculty who complete ALL four weeks will receive a Work Well water bottle.

Points:

For staff and faculty using participating in this program, you can add this to your voucher

(downloadable from www.und.edu/workwell) and earn up to 6,000 points if you do 4 activities by

June 30th, 2013.

Vouchers are due to Work Well by August 15, 2013 and points will be added to HealthyBlue by

November 1, 2013.

If you don’t know about the program, contact Kim at: 701-777-0210 to get started or go to:

https://ndpers.healthybluend.com.

TIMELINE:

Registration: March 27-April 4th, 2013 Challenge dates: April 8th – May 5th, 2013 STAFF/FACULTY: Complete weekly step logs on-line (www.und.edu/workwell) or mail to Kim R.at Stop 8365. STUDENTS: Complete weekly step logs online (www.und.edu/wellness) or mail to Steph at Stop 8365.

Week 1: (4/8/2013 – 4/14/2013):

Weekly step log needs to be completed electronically or mailed by: 4/17/13 at 4:30pm.

Week 2: (4/15/13- 4/21/2013):

Weekly step log needs to be complete and mailed or mailed by: 4/24/13 at 4:30pm.

Week 3: (4/22/2013-4/28/2013):

Weekly step log needs to be complete and mailed or mailed by: 5/1/13 at 4:30pm.

Week 4: (4/29/13– 5/5/13):

Weekly step log needs to be complete and mailed or mailed by: 5/8/13 at 4:30pm.

ARE YOU READY FOR PHYSICAL ACTIVITY?

Physical activity is fun, healthy, and safe for most individuals, however, if you are new to exercise or

seldom participate in any physical activity, it is important to determine whether you should seek

consultation by a physician before increasing your physical activity. Below are questions from the PAR-Q, a

questionnaire designed to determine physical activity readiness for people ages 15-69. If you are older than

69 years old and not physically active, talk to your physician before you start exercising.

PAR-Q: Physical Activity Readiness Questionnaire

1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

2. Do you feel pain in your chest when you do physical activity?

3. In the past month, have you had chest pain when you were not doing physical activity?

4. Do you lose your balance because of dizziness or do you ever lose consciousness?

5. Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?

6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?

7. Do you know of any other reason why you should not do physical activity?

*** If you answered yes to any of the questions, it is important to talk with your

physician before you become more physically active. If you answered no to all of

them, it is likely you are ready to safely begin your exercise regimen. Source:

http://www.acsm.org/AM/Template.cfm?Section=Home

RESOURCES

This chart may be helpful in determining your activity level and to help set goals for yourself:

Steps per day Activity Level

<5,000 Sedentary

5,000 – 7,000 Low Active

7,500 – 9,999 Somewhat Active

10,000 – 12,500 Active

>12,500 Highly Active *Developed by C Tudor-Locke and DR Bassett Jr (2004)

Increasing your steps: For most people, increasing your average daily steps each week by 500 per day is a reasonable goal. For example, if you are currently averaging about 5,000 steps a day, your goal for the first week would be 5,500 steps. For week two, your goal would be 6,000 steps each day and so on. Your ultimate goal over time would be to reach 10,000 steps a day (or more!). You may not be able to achieve 10K-A-Day within the 4-week challenge, but we encourage you to continue the progression! Taken from http://www.thewalkingsite.com/10000steps.html

* 2,000 steps = 1 Mile * 10K/Day = 5 Miles

COUNTING STEPS FOR OTHER ACTIVITIES

Don’t forget: You can reach your step goals in other ways. With the following step conversion chart, you can calculate the number of steps equivalent to other activities you might take part in.

How to calculate: Simply, multiply the numbers of steps indicated next to the activity by the number of minutes you spent on the activity. For example, stacking firewood equals 2,670 steps (89 steps x 30 minutes). See next page for conversion chart.

Step Counter Conversions

• If your activity is not listed below, find the one(s) most similar to it on thelist and estimate the activity’s step value.

• You can also estimate steps by knowing that 2,000 steps equals one mile. • Remove your pedometer when choosing an activity other than walking,

but do not reset your pedometer to zero.• Use the step conversion chart to calculate your steps during a “non-walking”

activity and add those steps to the total number on your pedometer at theend of the day.

Number of steps per minute for selected activities

Aerobics, high impact 203 Orienteering 260

Aerobics, low impact 145 Painting 131

Aerobics, step 246 Pilates 101

Badminton, casual 131 Ping pong 116

Badminton, competitive 203 Racquetball, casual 203

Basketball, game 230 Racquetball, competitive 290

Basketball, recreational 174 Raking leaves 125

Bicycling, leisurely 116 Roller skating 203

Bicycling, stationary 203 Rowing, light 101

Bowling 87 Rowing, moderate 203

Boxing 348 Running, 10 mph (6 min/mile) 463

Canoeing, light 87 Running, 8 mph (7.5 min mile) 391

Chopping wood, around home 174 Running, 6 mph (10 min mile) 290

Circuit training 232 Running, 5 mph (12 min/mile) 232

Cross-country skiing, intense 260 Scuba diving 203

Cross-country skiing, moderate 232 Snow shoveling 174

Cross-country skiing, slow 203 Snowboarding, light 150

Dancing 131 Snowboarding, moderate 182

Downhill skiing 174 Soccer, recreational 203

Elliptical trainer 203 Soccer, competitive 290

Firewood, carrying 145 Softball 145

Firewood, sawing with handsaw 217 Squash 348

Firewood, stacking 145 Stair climbing, machine 260

If you keep track of miles or time, not steps, you can convert your miles to steps by using the following formula: • Walking or pushing a wheelchair at a moderate pace: 1 mile in 20

minutes = 2,000 steps. • Jogging or running: 1 mile = approximately 2,000 steps.• Swimming: 1 mile = approximately 4,000 steps. • Cycling: 3 miles = approximately 2,000 steps.

Football 260 Stair climbing, moderate 334

Gardening, light 116 Stair climbing, slow 232

Gardening, heavy 174 Stair climbing, vigorous 434

Gardening, weeding 131 Stretching 72

Golfing, without a cart 131 Swimming, backstroke 203

Golfing, with a cart 101 Swimming, breaststroke 290

Grocery Shopping 67 Swimming, butterfly 319

Handball 348 Swimming, freestyle 203

Hiking, 10-20 lb. load 217 Swimming, leisure 174

Hiking, 21-42 lb. load 232 Swimming, treading water 116

Hiking, general 172 Tae Kwon Do 290

Horseback riding 116 Tai Chi 116

Horseback riding, trotting 188 Tennis, doubles 174

Housework, light 72 Tennis, singles 232

Housework, mopping floors 101 Trampoline 101

Housework, scrubbing the floor 110 Volleyball, game 232

Housework, vacuuming 101 Volleyball, leisure 87

Housework, washing windows 87 Washing the car 87

Ice skating 203 Water aerobics 116

Judo 290 Water skiing 174

Jumping rope, fast 348 Waxing the car 131

Jumping rope, moderate 290 Weight lifting, moderate 87

Karate 290 Weight lifting, vigorous 174

Kickboxing 290 Yard Work 145

Mowing 160 Yoga 72

Number of steps per minute for selected activities

Walking Challenge Registration Form - Spring 2013

1. Name (first and last): ______

2. Employee/Student ID: ________________________________

3. Staff/Faculty Mail Stop/Address: ____________________________ _________ (Student can pick-up

pedometers at the Wellness Center front desk)

4. E-mail: __________ (This will be used to send weekly messages) 5. Phone: ____________________ (This will be used to contact you if you are a prize winner) 6. How did you hear about the Walking Challenge? (check all that apply)

UND Electronically

Word of Mouth

Print

Social Media - Facebook

Event: Information at an event (such as a health screening, Exercise as Medicine Referral, Healthy Campus Challenge)

Other: _________________________________

7. STAFF/FACULTY ONLY: If a co-worker encouraged you to sign-up, enter their name below and they will get

entered into a drawing for $20 Target gift certificate for encouraging wellness! _________________________________

8. Are you participating as an individual or member of a team?

Individual

Team Member 9. You may register up to 4 people per team (including yourself).

*If you are participating as an individual skip ahead to question number 14.

Team of 2 Team Name: _______________________________________________ Other Team Member’s name: ___________________________________

Team of 3 Team Name: _______________________________________________ Other Team Member’s name: ___________________________________ Other Team Member’s name: ___________________________________ (continued on next page)

Please complete the following registration, pre-assessment and pedometer rental agreement (if you would like to

borrow a pedometer) and mail to: Kim Ruliffson, Wellness Center, 801 Princeton St., Grand Forks, ND 58202.

Team of 4 Team Name: ________________________________________________ Other Team Member’s name: ____________________________________ Other Team Member’s name: ____________________________________ Other Team Member’s name: ____________________________________

10. Weekly emails will be sent with updated team and individual results to keep you motivated. Please indicate yes

or no about sharing your name and step totals to all Walking Challenge participants. You can withdraw permission at any time by contacting Kim Ruliffson (777-0210) if you are a staff or faculty member or Steph Hoffman if you are a student (777-2943).

Yes, you can share my name and step totals with all of the Walking Challenge participants.

No, do not share my name and step totals with all of the Walking Challenge participants.

11. Based on this FOUR week Walking challenge, what realistic goal do you hope to accomplish in this time frame? Aim for a SMART Goal: Specific, Measurable, Attainable, Realistic, and Timely. For example: Walk 30 minutes per day for 5 or more days a week.

12. Walking is ONE dimension of wellness: physical wellness. Please list another goal (if you choose) to keep yourself balanced with other dimensions* to achieve overall wellness during this challenge? (For example: Incorporate social wellness by walking with a partner; Pick-up trash when walking to engage in environmental wellness.)

*The 7 dimensions recognized by UND include: physical, social, intellectual, emotional, spiritual, environmental and occupational.

Walking Challenge Pre-Assessment Form: Spring 2013

1. Gender: Female Male Transgender/Other

2a. Age: 19 or younger 20-29 30-39 40-49 50-59 60-69 70+

2b. Class: Freshman Sophomore Junior Senior Graduate/Professional Student

Not a student

3. Status: Staff Faculty Student Graduate Student UND Affiliate

Non-UND participant (spouse/friend) NDUS employee 4. Do you engage in cardiovascular physical activity? This includes activity that makes your heart pump and you breathe harder (for example: fast walking, jogging, water aerobics, pushing a lawn mower, shoveling snow, playing basketball, jazzercise).

No, not regularly

Yes, less than 150 minutes per week (less than 2.5 hours a week)

Yes, 150 minutes or more a week (2.5 hours a week total or more a week) 5. What is the Center for Disease Control’s Physical Activity for Americans (2008) recommendation for moderate cardiovascular activity per week?

30 minutes a week

60 minutes a week

120 minutes a week (2 hours)

150 minutes a week (2.5 hours)

180 minutes a week (3 hours a week)

Don’t know

6. Do you engage in muscle-strengthening exercise weekly (examples include: yoga, sit-ups, push-ups, heavy gardening, pilates, lifting weights, etc.)

No, not regularly

Yes, at least 1 time a week

Yes, at least 2 times a week

Yes, at least 3 times a week

Yes, 4 or more times a week

7. What is the Center for Disease Control’s Physical Activity for Americans (2008) recommendation for muscle-strengthening for all muscle groups (legs, hips, back, abdomen, chest, shoulder, and arms).

1 time a week

2 times a week

3 times a week

4 or more times a week

Don’t know 8. Do you hope to change your walking/activity levels during the 4-week challenge?

Yes, increase levels

No, maintain levels

Yes, decrease levels

University of North Dakota Wellness Center’s Work Well Program

Pedometer Rental Agreement – STAFF AND FACULTY

INSTRUCTIONS: Please print, complete and mail to: Wellness Center, Mail Stop 8365 (Attn: Kim R.). Your pedometer will be

mailed to your mail stop or address. If you have your own pedometer, you do not have to sign this form.

Rental Agent: UND Wellness Center’s Work Well Program

Renter: Staff or Faculty of the University of North Dakota and/or their Walking challenge partner.

This agreement sets forth the terms for rental of an AE120LX Accusplit pedometer for use by the undersigned as a participant in the

University of North Dakota Walking Challenge. The undersigned agrees that the pedometer he/she rents will remain the property of

the Wellness Center’s Work Well Program. The undersigned will return the pedometer in good condition, on or before May 27th

,

2011. The undersigned agrees to pay the replacement cost (up to $15.50) of the pedometer if it is lost or materially damaged. Upon

receipt of this signed agreement, a pedometer will be mailed to the undersigned renter.

Please complete and mail to: Wellness Center, Mail Stop 8365 (Attn: Kim R.).

__________________________________ _____________________________________ __________________

Name of Renter (Please Print) UND EMPLID # (skip if non-UND employee) Date

___________________________________ _______________________________________________________

Signature Mail Stop (or address for off-campus participants)

If you have questions, contact Kim Ruliffson (701-777-0210).

University of North Dakota Healthy UND Healthy Campus Challenge

Pedometer Rental Agreement- STUDENT

INSTRUCTIONS: Please complete and return this agreement along with presenting your Student ID card to: Wellness Center

Guest Relations Desk. You can then receive the pedometer from the Wellness Center staff once the agreement has been signed.

Rental Agent: Healthy UND Healthy Campus Challenge

Renter: Students & Graduate Students of the University of North Dakota

This agreement sets forth the terms for rental of a Timex 5E011 pedometer for use by the undersigned as a participant in the

University of North Dakota Healthy Campus Walking Challenge. The undersigned agrees that the pedometer he/she rents will remain

the property of the Healthy UND Coalition. The undersigned will return the pedometer to the Wellness Center in good condition, on

or before May 10th

, 2013. The undersigned agrees that their student account will be charged for the replacement cost ($20) of the

pedometer if it is not returned or is returned materially damaged by May 10th

, 2013. Pedometers will not be accepted after this date

and your student account will be charged for the replacement. Upon receipt of this signed agreement, a pedometer will be issued

from the Wellness Center to the undersigned renter.

Please complete this form and return the agreement along with presenting your Student ID card to: Wellness Center Guest Relations

Desk to receive your pedometer.

__________________________________ _____________________________________ Student ID Verified

Name of Renter (Please Print) UND EMPLID #

___________________________________ __________________

Signature Date

___________________________________ ___________________________________

Employee Name (Please Print) Employee Signature

If you have questions contact Stephanie Hoffman (701-777-2943).

2013 Walking Challenge: Weekly Step-Log: WEEK 1

1. Name: ____________________________________

2. WALK and enter your daily totals below.

Day Mon.,

4/8

Tues.,

4/9

Weds.,

4/10

Thurs.,

4/11

Fri.,

4/12

Sat.,

4/13

Sun.

4/14

Number

of Steps

3. Total Steps: ____________ (please add your totals from above)

Please return form to: Wellness Center – Stop 8365, or 801 Princeton St., Grand Forks, ND 58202) by APRIL 17th, 2013 to be entered into the weekly drawing.

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2013 Walking Challenge: Weekly Step-Log: WEEK 2

1. Name: ____________________________________

2. WALK and enter your daily totals below.

Day Mon.,

4/15

Tues.,

4/16

Weds.,

4/17

Thurs.,

4/18

Fri.,

4/19

Sat.,

4/20

Sun.

4/21

Number

of Steps

3. Total Steps: ____________ (please add your totals from above)

Please return form to: Wellness Center – Stop 8365, or 801 Princeton St., Grand Forks, ND 58202) by April 24th, 2013 to be entered into the weekly drawing.

2013 Walking Challenge: Weekly Step-Log: WEEK 3

1. Name: ____________________________________

2. WALK and enter your daily totals below.

Day Mon.,

4/22

Tues.,

4/23

Weds.,

4/24

Thurs.,

4/25

Fri.,

4/26

Sat.,

4/27

Sun.

4/28

Number

of Steps

3. Total Steps: ____________ (please add your totals from above)

Please return form to: Wellness Center – Stop 8365, or 801 Princeton St., Grand Forks, ND 58202) by May 1st, 2013 to be entered into the weekly drawing.

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2013 Walking Challenge: Weekly Step-Log: WEEK 4

1. Name: ____________________________________

2. WALK and enter your daily totals below.

Day Mon.,

4/29

Tues.,

4/30

Weds.,

5/1

Thurs.,

5/2

Fri.,

5/3

Sat.,

5/4

Sun.

5/5

Number

of Steps

3. Total Steps: ____________ (please add your totals from above)

Please return form to: Wellness Center – Stop 8365, or 801 Princeton St., Grand Forks, ND 58202) by May 8, 2013 to be entered into the weekly drawing.

Walking Challenge Post-Assessment Form: Spring 2013

1. Gender: Female Male Transgender/Other

2. Age: 19 or younger 20-29 30-39 40-49 50-59 60-69 70+

2b. Class: Freshman Sophomore Junior Senior Graduate/Professional Student

Not a student

3. Status: Staff Faculty Student Graduate Student UND Affiliate

Non-UND participant (spouse/friend) NDUS employee 4. Do you engage in cardiovascular physical activity? This includes activity that makes your heart pump and you breathe harder (for example: fast walking, jogging, water aerobics, pushing a lawn mower, shoveling snow, playing basketball, jazzercise).

No, not regularly

Yes, less than 150 minutes per week (less than 2.5 hours a week)

Yes, 150 minutes or more a week (2.5 hours a week total or more a week) 4. What is the Center for Disease Control’s Physical Activity for Americans (2008) recommendation for moderate

cardiovascular activity per week?

30 minutes a week

60 minutes a week

120 minutes a week (2 hours)

150 minutes a week (2.5 hours)

180 minutes a week (3 hours a week)

Don’t know

5. Do you engage in muscle-strengthening exercise weekly (examples include: yoga, sit-ups, push-ups, heavy gardening, pilates, lifting weights, etc.)

No, not regularly

Yes, at least 1 time a week

Yes, at least 2 times a week

Yes, at least 3 times a week

Yes, 4 or more times a week

6. What is the Center for Disease Control’s Physical Activity for Americans (2008) recommendation for muscle-strengthening for all muscle groups (hips, abdomen, legs, arms, …)

1 time a week

2 times a week

3 times a week

4 or more times a week

Don’t know 7. Did you change your walking/activity levels during the 4-week challenge?

Increased levels

Maintained levels

Decrease levels

8. Did you succeed at the primary goal that you set at registration?

Yes

No

Can’t remember my primary goal

I did not set a primary goal

9. Which of the following dimensions of wellness did this challenge invoke in you? (Check any that apply)

Emotional wellness

Environmental wellness

Intellectual wellness

Occupational wellness

Physical wellness

Social wellness

Spiritual wellness

All of the above

None of the above

10. Please rate the following statements: A. Participating in the 4-week walking challenge, helped me develop the ability to set goals related to

physical exercise.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

B. Participating in the 4-week walking challenge, made me feel supported at UND in making healthy choices in regards to physical exercise.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

C. Participating in the 4-week walking challenge, allowed me to provide support to others to promote their physical exercise.

Strongly agree

Agree

Neither agree nor Disagree

Disagree

Strongly disagree

D. Participating in the 4-week walking challenge, provided a sense of community with others at UND.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

E. Participating in the 4-week walking challenge, helped me manage my time effectively to prioritize your physical exercise into my week.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree 11. Overall, how would you rate your experience with this challenge?

Extremely Satisfied Satisfied Neutral Dissatisfied Extremely Dissatisfied 12. Have you made any personal wellness changes as a result of the challenge? _____________________________________________________________________________ 13. Can you suggest any ideas for improving this challenge? ________________________________________________________________________________