Wheeling Walks Training Manual

Appendix 14E
Informed Consent Form

INFORMED CONSENT FORM
RELEASE OF CLAIM AND ASSUMPTION OF RISK

I have read and completed the Physical Activity Readiness Questionnaire (PAR-Q & You), which gives me general information about who may be at risk to begin regular moderate physical activity, exercise, and walking.  

I have consulted a physician, or determined there is no need to do so, fully independent of the “20 Weeks to the 20K Walking Clinic”, and I assume all risks that may result from my participation in the “20 Weeks to the 20K Walking Clinic”.  I, the undersigned, have thoroughly read this release and agree to all its terms.  I execute it voluntarily and with full knowledge of its significance.  I agree to exercise good judgment during my physical activity and walking.

I understand the “20 Weeks to the 20K Walking Clinic” provides information on walking, physical activity, exercise, nutrition, supplementation, hydration as well as the care and treatment of injuries.  I agree to consult with a physician before changing any drug use or medical treatment.  I agree to hold the following agencies harmless if any mishap occurs while I am walking: Ohio Valley Runners and Walkers Club, Wheeling-Ohio County Health Department, WVU Department of Community Medicine, and WHEELING WALKS.  I also understand that nothing said by the presenters at the “20 Weeks to the 20K Walking Clinic” may be construed as medical advice, and I will do nothing that has been contraindicated by my physician. 

 

______________________ 

Signature of applicant   

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Appendix 14F
Enrollment Form

WHEELING WALKS

Enrollment Form

 

NAME            ____________________________________________________

ADDRESS     ____________________________________________________

                     ____________________________________________________

PHONE          ____________________________________________________

E-MAIL          ____________________________________________________

 

Usual physical activity:

Walking:_______ minutes  _______ times per week

Other physical activity:

            specify______________ ;_______ minutes  _______ times per week

            specify______________ ;_______ minutes  _______ times per week

            specify______________ ;_______ minutes  _______ times per week

 

I am/am not (circle appropriate response) interested in walking the Ogden Newspaper 20 K Classic on May 25.

____I would like to walk with others.

Preferred time ______ and days of the week_______________

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Appendix 14G
Evaluation Form

 

Evaluation

Rate the following speakers using the scale provided:

February 5.  Walking is Good Medicine.
Dr. Jim Comerci	Excellent   Good    Fair   Poor
Dr. Catherine Hayes	Excellent   Good    Fair   Poor
February 12.  Dressing For and Train During Nasty Weather.
Kim Butler	Excellent   Good    Fair   Poor
February 19.  Avoiding injury, caring for minor aches and pains
Dick Lambie	Excellent   Good    Fair   Poor
Julie McGee	Excellent   Good    Fair   Poor
February 26 Stress Reduction.
Dr. Bill Reger	Excellent   Good    Fair   Poor
March 5.  Placing Your Feet on Cloud Nine:                This Shoe’s forYou!
Joe Winnesdorffer	Excellent   Good    Fair   Poor
March 12.  Strength Training for your Bones.
Kathy Campbell	Excellent   Good    Fair   Poor
March 19.  Training at the Dinner Table.
John Mihopulos, RD	Excellent   Good    Fair   Poor
March 26.  The Heart of a Good Workout
Dr. Bill Reger	Excellent   Good    Fair    Poor
April 2.  Walking your Dog to your good Health.
Dr. Adrian Bauman	Excellent   Good    Fair   Poor
April 9.  Walking for Life: Surviving Cancer
Nancy Toto	Excellent   Good    Fair   Poor
April 16.  Caffeine and Supplements to Boost Energy:                Hype or Health
John Nally	Excellent   Good    Fair   Poor
Dr. Felicia Greer	Excellent   Good    Fair   Poor
May 7.  Keeping at it: Consistency for Lifetime Enjoyment.
Hugh Stobbs	Excellent   Good    Fair   Poor
Dr Lee Jones	Excellent   Good    Fair   Poor
May 14.  A Word from Everyday Walkers.
Cheryl Fanning,	Excellent   Good    Fair   Poor
Jim Ferns	Excellent   Good    Fair   Poor
Cecile Steele	Excellent   Good    Fair   Poor
May 21.  Walking to Lift your Spirits.
Dr. Bill Reger	Excellent   Good    Fair   Poor

 

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Appendix 14H
Comments From Evaluations                                                                                         

Comments from Clinic Participants

 

COMMENTS:

• This has been great. I knew there was something wrong with me.  I had a physical I was fit but out of shape.  Then you had this clinic – I came.  Not having self-confidence or faith in myself.  This all changed over these past months.  I feel great and feel confident and I met great people.  Between the clinic and training its been wonderful. A great experience that will continue.  I’m a different person and will encourage more people to do so. Thanks to everyone.
• Bill, I like your wit and engaging style.  Thank you for these classes and encouragement! I have thoroughly enjoyed all of the sessions attended.  It has been informative, inspiring and enjoyable.  Thank you for the diverse agenda and interesting opportunity. I love walking and learning. This series was a winning combination. Challenge: time to devote to increasing time and distance. Suggestion: great as is.
• The fellowship with the walkers was beneficial.  The walking was most beneficial.  Our speakers brought forth helpful info. (very good selection) Hopefully our program will continue next year.
• 1. Walking, time for myself  2. Finding the time.  3. Bring in more young people
• Liked the variety of topics. Liked having 2 times to choose from (4:00 or 7:00). Liked the informality of the group – lots of laughter. Liked the location was great – near trail.
• Great Job On Clinics!  Series: like the presentation of complex discussions on a ‘street’ level.  Have working ‘graduates’ from this years clinic & race pack next year.
• Adrian Bauman was a great speaker, the highlight of the series.  Walking aspect – Dave Hoskins involvement.  Obstacle to walking – mental I can do it.
• Wish I would have had time to attend more.  Thanks for the Kin & Bill show.  Enjoyed the lecture series.  They were informative in a fun filled atmosphere.  It was great hearing the various testimonials and accomplishments.  The day (Tuesday) was a problem for me. Tennis. I am a runner, but receive the benefits of incorporating walking into my workout.
• I have gained more knowledge about nutrition and training.  Also, have a type of support group meeting weekly to share and exchange ideas and experiences.  Walking has improved my self esteem and self confidence in myself and also given me confidence in dealing with daily challenges and problems.
• I have gone from an injured runner who didn’t like walking, to someone who enjoys walking and getting back some of my endurance
• Dr. Reger, thank you for all of your efforts, speaking, program structure and speakers.  My experiences helped me set goals, feel great and much stronger, and over come limits.  Learned to do more and feel better.  I liked the challenge.  Enjoyed all of the speakers – learned much – all were timely.
• John Mihopulos – the number 1 program.  I just received my first issue of the Nutrition action health letter; I’m inclined to become a long-term subscriber.  I came here to prepare for my church’s 5k race in June; I’m prepared.  All the information about healthier lifestyles was a wonderful bonus.  If Whg city officials ever ask you how to make What a friendlier walking city, suggest repainting existing crosswalks.
• 1. Walking  2. Time
• Walking, made me feel good about myself in general.
• 1. the meetings gave me the opportunity to come and walk which I wouldn’t have done otherwise, so found both so helpful.  2. As always, finding time to walk after building up more than 10 minutes until time to mow grass.
• 1.  I most enjoyed the information I received from each speaker.  2.  Biggest difference was getting out and walk as often as I wanted.  3.  No other suggestions – keep up the good work!
• 1. Walking or seminar. Have been walking for years, seminars were very good. People who did not come lost out.  1. Biggest challenge: no diff.  3. Suggestions: none.
• I enjoyed the walking seminar because they have kept me motivated.  The program got me into an activity that I can do forever.  I found walking makes me feel as thought I have accomplished something.  I now include walking into my daily planning. The biggest obstacle with walking has been inclimate weather and fitting it into my schedule.
• 1. Enjoyed the people who gave presentations, appreciated their knowledge and encouragement.  I enjoyed being outside (year round) when walking. 3.  Dieting – fad diets, what people should watch out for.
• Thought the walking seminar was very informative.  Biggest difficulty was finding time each day to walk.  Would like more on exercising and foods to eat.
• 1. I’ve walked more since weather improved and outdoor walking is easier.  I do treadmill walking three times weekly year round. I’ve enjoyed the comraderie as well as the information concerning “common walking”. 2. Biggest challenge: The only problem I’ve has is time conflict that interfered with my attendance.  I would hope to do better next year. 3. Suggestions for new topics: This year’s topics bear repeating! Any health related is of interest.
• This seminar has really helped me develop a better life style with exercise. Bill- you have been great! Both you and Kim have made the meetings really enjoyable.  The “Saturday” walking events were really beneficial.  Thanks for everything.  –Linda.
• I enjoyed the seminars most; I already was a walker – but the seminars gave us such good information I feel that I am more able to do things differently to achieve better results.  Thank you for all the organization and time that went into these “20 weeks” – my only regret is that I went to FL. For 5 weeks and I missed some of the lectures.  Thank you so much!
• The seminars provided a good deal of teamwork and enthusiasm among all who were here.  An excellent spirit and much valuable, useful information.  Differently? Non – very well organized.  What next? – good speakers already – continue this, good publicity also – maybe more personal comments from the everyday walkers.
• I did not walk after the meetings because of other meetings.  I did enjoy the speakers, they were ex. I thought all the speakers talked on the subject at hand.  How you would ? on the speakers really don’t know.
• 1. The mental and physical feeling I get.  2.  Taking the time to do it.  3.  More on nutrition.
• Good job Bill! Good job Kim! I have enjoyed coming to the meetings and meeting new people.  I have gained so much from walking – the camaraderie of my friends and daughter has been most welcome.  Thank you for your time and effort Bill.  Remember – be nice to Kim. 
• This was very motivational.  I really enjoyed it. I felt more energized because I walked greater distances regularly.  I enjoyed the Saturday walks preparing for the race and the tips I picked up from other walkers.  The most difficult was going up and down 29th street – and getting things done that I neglected to do when walking.
• The lecture series was a lot of fun in addition to being very informative.  I walk everyday winter or summer to stay healthy and in shape! Feel good too!!! Too bad it has to end!!!
• Lectures: I enjoyed the lectures that had topics about health, for example: vitamins, fats in foods, yoga, etc. (clothes and shoes)  I really enjoyed the lectures.  I hope you have it again next year!  Walking: I like walking because it is easy and I can do it at my convenience most of the time.  It gives me time to think about things or to think about nothing at all.
• Motivation to walk more.  Enjoyed the speakers.
• Managing stress. I enjoyed the comradarie while walking with amigoes. I would enjoy a class on first aid – simple procedures for simple accidents.
• Made me feel better and less stressed.  Trying to keep motivated and trying to walk in bad weather.  Topics?
• What did you most enjoy about walking or walking seminar: I most enjoyed losing weight and feeling better.  And being active.  What’s biggest difficulty? Keeping at it. Suggestions for topics?
• 1. Lessons created an atmosphere of relaxation whether participant was going to participate in Ogden race or not.  2. Encouragement of just doing something (exercise) for your own enjoyment and benefits of doing what you can.  2.  Biggest Challenge: commitment to attend meetings after working everyday – friendship/walking buddy helped.  3. Topics for next year: more nutrition information.
• I most enjoyed the walking seminar – it was very motivational and felt energized.  Gave me an opportunity to be around wonderful people. Very enjoyable.  Excellent speakers and interesting.
• I enjoyed aspect of the seminar is the people I met.  I enjoy walking. It makes me feel good.  My biggest difficulty is the pain in my leg.  The walking helps this along with stretching.  I have enjoyed the seminars.  The speakers are excellent.  I wouldn’t change anything.  I hope you do have this again.