WWE is available in two formats: self-directed or instructor-led. Both formats use the Walk With Ease Guidebook which is available at: www.afstore.org.  An e-book version of the Guidebook is also available from Amazon.  There is no need to own a Kindle, the book can be read on a smart device, using the free Kindle app, or directly downloaded and read on a computer. Strategies and resources for each format are discussed below.

The first chapter of the Guidebook provides the program schedule, which is used whether someone is participating in the group or self-directed format.  The schedule guides participants through the sequence of readings, when to incorporate walking strategies, use of self-assessment tools, when to do goal planning, and when to monitoring fitness levels and progress. This schedule also can be a useful tool when introducing potential participants to the program as it succinctly lays out what to expect throughout the six weeks.

Two other essential items in the Guidebook include the 5-Step Walking Pattern and the stretching and strengthening exercises.  These are both part of learning to walk safely and comfortably, an emphasis of the Walk With Ease program.  Again, you may want to include them in an introduction to the program when talking with potential participants, registered participants, or potential partners.

Self-directed Format

In this format, the participant reads the WWE Guidebook on their own. They can also do the walking on their own or through an “enhanced format,” where they walk one or more times/week with a buddy or group of their own choosing, or a group that a program administrator organizes.

Why select this format?

As a program administrator, you may find that offering the self-directed format is a practical approach, particularly if:

• participants are not interested in or unable to attend group sessions 3x/week
• you are unable to find leaders who can commit to teaching 3x/week for 6-weeks
• reserving classroom space and/or having adequate walking circuits is not feasible
• you are unable to meet in person due to restrictions related to COVID-19

It has also been found that the self-directed format is a good contingency option when some participants start off in the classroom format, but for whatever reasons, can no longer attend class; they can continue to do the program, but on their own. The self-directed format has also been an effective approach in worksite settings where employees can walk together over their lunch breaks or before or after work.

In choosing this format, program costs are limited to the cost of the WWE Guidebook, shipping/handling fees (if you need to mail the books to participants), and marketing and/or data collection expenses.

COVID-19

COVID-19/Coronavirus has greatly impacted the delivery of many community-based programs, particularly physical activity and self-management programs that are held in gyms, senior centers, parks and recreation facilities, etc.  If in-person programs are limited in your community or by organization, the self-directed Walk With Ease program can be a great way to continue to support and serve your constituents.

Enhanced Self-Directed WWE

Some organizations may want to offer the self-directed WWE, but still gather a cohort of self-directed participants during a weekly meeting either in-person or virtually (via webinars or conference calls).  During  the weekly meeting, the leader – who should be a trained WWE Leader –  can facilitate a conversation among participants, focusing on topics covered during the previous week’s reading assignments.  Once people have had a chance to discuss, the group members can take some time to set goals for the coming week or share where they plan to walk.   Alternatively, if the group is meeting in person, they may decide to just walk during the weekly meeting, and not discuss the reading or goal setting.  South Dakota State University Extension created an Enhance Self-Directed WWE Session Guidance document to help those organizations that may choose to offer this option, and the Arthritis Foundation developed a toolkit and PowerPoint to provide guidance and resources for enhanced Self-Directed WWE.

Engaging Self-Directed Participants

A way to help reduce attrition by those doing the program on their own is to provide weekly “engagement” emails. Examples of these emails are linked below and can be adapted for your own use.  The Arthritis Foundation toolkit mentioned above also includes a series of customizable email messages:

• Oregon State University Email Engagement for Self-Directed Walk With Ease*
• Northern Arizona Health Care Coaching Emails for Self-Directed Walk With Ease*

The Self-directed Walk With Ease Portal

To broaden access to the self-directed format, the OAAA has established an online registration portal – www.walkwitharthritis.org – where individuals can complete a brief, secure survey in order to receive a FREE Walk With Ease Guidebook. Everyone who registers through the portal also will receive weekly motivational emails to support their walking throughout the six weeks of the program.  If they don’t want to complete the survey, there is a nominal cost for the book and shipping. Individuals can also visit walkwitharthritis.org to learn more about the program.  The OAAA supports the costs of the Guidebooks only for those participants who register at our site and are included as numbers reached within our OAAA data collection processes.

If an organization would like to have their own self-directed WWE registration portal, we are also able to create customizable portals for a nominal fee.  For more information please click here or contact us at oaaction@unc.edu.  The purchasing of the WWE Guidebooks is an additional cost not included in the portal fee.

Instructor-led/Group Format

This format of WWE requires a certified WWE Leader, an appropriate classroom/meeting space set-up, and an appropriate walking area.

Certified WWE Leader

There are several tools available for marketing to and engaging potential WWE Leaders. These include:

• A short 7-minute video introduction to WWE produced by the OAAA (i.e. Class Zero video), available at https://www.youtube.com/watch?v=XYu7PFlZXYQ&t=53s, can be a useful marketing tool for introducing the program to potential leaders.
• A PowerPoint presentation – Walk With Ease Informational Webinar (12.20.2018) – produced by the OAAA with script of the WWE program: [slides] [recording]
• Sample engagement emails (sample 1 and sample 2) to WWE Leaders produced by the NC Center for Health and Wellness.

WWE Leader Training

A recently updated online Walk With Ease Program Leader training is available from the Arthritis Foundation, in partnership with the Athletics and Fitness Association of America.  The current cost is $89. The training typically takes 2.5 hours and is self-guided, so it can be paused and resumed at will. As part of the training, participants can download the Leader’s Guide and follow along with the instructional videos. Upon successful completion of the learner’s evaluation, a certificate of completion can be downloaded. This certificate, along with the individual’s CPR certification, should be sent to the Arthritis Foundation in order to receive an official WWE Leader’s Certificate and become an “certified” Walk With Ease Leader.   Although professional training and certification related to physical activity and/or health education is not a requirement, a WWE Leader must be willing to follow the curriculum (without adding or removing content), have excellent interpersonal skills, be able to manage groups of individuals with diverse backgrounds and needs, and communicate effectively.

Some program administrators report that a team-teaching approach of using two leaders can be very efficient and effective.  In this approach, leaders can take turns with the program responsibilities and with guiding participants through the exercise and walking segments of the program. If both leaders are participating at the same time – not alternating days – they may decide to position themselves at the beginning and end of the walking group to help assure safety of all participants.

Appropriate Classroom Set-up

 In this format, participants meet 3 times per week for class sessions that last 1 to 1 ½  hours each time. The meeting space should have a door, or otherwise be in a quiet area, so that participants can hear the leader and each other. The leader will need a table for posters, handouts and other program materials, as well as a flip chart or blackboard. Participant chairs should have NO horizontal rungs on the front legs that could impede their ability to slide their feet underneath while doing sitting exercises.  

Appropriate Walking Area

Both the Leader’s Guide and the WWE Guidebook discuss choosing a good place to walk. A good walking surface is one that is flat and free of loose gravel. Ideally, a path should be chosen that has benches if participants need to rest and is relatively near bathroom facilities. Leaders should carry their cellphones and have cellphone coverage in the event assistance is needed. Indoor or outdoor walking is appropriate, depending on weather.  If there is the likelihood for inclement weather, an alternate walking space should be secured prior to the start of the workshop, and all participants should be aware of these arrangements.

Additional Implementation Resources

WWE Program Administrator Guide and Training Video

The Arthritis Foundation has created a comprehensive WWE Program Administrator Guide that is available will be available soon. The Guide covers:

• an overview of the WWE program
• the purpose and structure of each classroom session
• marketing and management logistics
• supervision of WWE Leaders
• post-program strategies.

In addition, the OAAA has developed a WWE Administrator’s Training that includes a video recording with slides.   Please note, this is different from the Informational Webinar mentioned above (under “Community Partners”).  The WWE Administrator’s Training is much more detailed about the process and various tasks related to directly implementing the program.

Fidelity

Walk With Ease is an evidence-based health promotion program. It has been proven to reduce pain and increase strength, self-efficacy for managing arthritis symptoms and walking speed among other benefits. To ensure your participants gain these benefits, do NOT change, add or delete any content, sessions or movements. If you have questions about any of the content– contact the Arthritis Foundation.

The Walk With Ease Fidelity Tool is available to help assure the instructor-led format is being offered appropriately.  This tool can be used as a self-check, so that leaders can double-check their readiness and performance leading the class.  It can also be used by an administrator performing site visits and fidelity/quality checks.

The WWE Guidebook includes a diary for participants to use to record their walking, as well as walking challenges and successes. In addition, the Reading Health System has designed a pedometer log and walking journal that may also be adapted for your use.

Creating a Sustainability Plan

Planning for ongoing delivery of WWE should be addressed early on while planning for implementation. Often, securing program delivery funding is a key concern and challenge. Organizations implementing WWE have reported that an advantage of this program is its minimal costs:

• There is no licensure fee;
• The Leader training is online and relative to other programs, low-cost;
• There is no required equipment;
• Program posters once printed are reusable;
• The Guidebook costs are minimal.

Sample sustainability strategies

• Creating partnerships for helping with marketing and program implementation;
• Partnering with other community sectors such as Parks and Recreation Systems, Agencies serving Medicare and Medicaid participants, Wellness Centers, Employee Wellness programs
• Bundling/coordinating WWE delivery with other evidence-based programs, particularly Diabetes Self-Management, Chronic Pain Self-Management Program, A Matte of Balance (and other falls prevention programs), and Silver Sneakers. This helps create a steady demand for all bundled programs and maximizes efficient use of resources;
• Embedding WWE into worksite wellness initiatives and employee wellness benefits plans.
• Using technology to engage participants and to offer program by creating an online hub for program description and promotion, notice of upcoming workshops and registration, along with resources for WWE leaders;
• When appropriate to organizational policy, charging fees for the program and/or Guidebook.
• When building an ongoing network of partners, establish common goals and respective responsibilities at the beginning;
• Integrating WWE group-led and self-directed into other grant-funded programs such as the 5-year CDC Arthritis Grant, ACL Chronic Disease Self-Management Education grants, State funding, foundation grants, and bank grants.
• Assuring there is a program coordinator dedicated to WWE marketing.