Management by Walking Around: An Evidence-based Best Management Practice

For much of my public health career, I’ve noticed something odd: I often solved work problems when I wasn’t officially “working.” Well actually, it is still happening to me now.

Sometimes it happens while mowing the grass. Sometimes it happens during a walk by myself. Sometimes it happened while fixing yet another irrigation problem at my house.

I also got into the habit of taking stakeholder meetings on the sidewalk. Instead of meeting in my office, I’d have a stakeholder meeting while walking around the Capitol complex. That loop took about a half hour. I found that we’d often solve problems faster on those walks than we did sitting across a table.

At the time, I just thought it worked for me. I didn’t know there was evidence behind it.

This week I ran across a 2014 study by Marily Oppezzo and Daniel Schwartz called “Give Your Ideas Some Legs: The Positive Effect of Walking on Creative Thinking.” It was in the Journal of Experimental Psychology: Learning, Memory, and Cognition.

The paper found that walking helped people come up with more creative ideas than sitting. In one part of the study, 81% of people were more creative while walking than while sitting. Across the experiments, walking increased creative output by about 60%.

You can read the article here: Give Your Ideas Some Legs: The Positive Effect of Walking on Creative Thinking.

The researchers even had people walking on a treadmill facing a blank wall. The benefit still showed up. They also assessed people outside, comparing walkers with people who moved through the same area in a wheelchair. Walking itself made the difference.

The study also found something useful for public health professionals… walking helps most when you’re trying to come up with ideas, not when you’re trying to pick the one right answer. Creativity.

Our work is full of problems that don’t have easy answers. How do we improve access to care? How do we build trust? How do we explain a complex policy in plain English? How do we collaborate with partners who don’t always see the issue the same way?

This doesn’t mean every meeting should become a hike. Arizona gets a vote in this matter, especially from June through September. But when the weather allows, walking meetings are an easy tool. No app. No consultant. No strategic retreat. Just shoes, a little time, and problem(s) to solve.

This week I learned that management by walking around isn’t just a leadership style that worked for me. It’s the best evidence-based best-management practice.

TB Control Depends on Public Health Tools

Maricopa County Public Health recently sent an advisory to clinicians about a cluster of genetically related infectious tuberculosis cases among county residents experiencing homelessness.

MCDPH is working to find and notify people who may have been exposed. Clinicians are being asked to keep TB in mind when seeing patients with compatible symptoms, especially people with unstable housing. Early testing and treatment are key, both for people with active TB disease and for those with latent TB infection who could develop active disease later.

Their advisory also gives clear infection control instructions for healthcare settings.

Now for the public health policy connection. TB control depends on public health authority. Authority that is on the precipice of being eliminated.

If HCR2056 makes it to the ballot and voters approve it, many of the tools needed to control outbreaks like this will be weakened or gone. It’s framed as a “right to refuse” medical mandates, but it goes way beyond school vaccines. It would place broad limits on the ability of counties to require medical treatment or interventions as a condition of access to public spaces or services. That would mean that a person with active TB who won’t take their medicine can just roam around town infecting people.

Resources:

Maricopa County Department of Public Health Tuberculosis

AZPHA Coffee & Conversations Trends in Cancer Screening among Arizona Medicaid Members: 2018-2024

AZPHA Coffee & Conversations

Trends in Cancer Screening among Arizona Medicaid Members: 2018-2024


Biography – Gloria D. Coronado, PhD

Dr. Gloria Coronado is an epidemiologist and cancer prevention researcher who serves as Associate Director for Population Sciences at the University of Arizona Cancer Center and Professor in the Department of Epidemiology and Biostatistics.

With over 25 years of experience in cancer research, Dr. Coronado specializes in developing community- and practice-based health innovations and leading disparities research across diverse healthcare settings. Her research focuses primarily on using electronic health records and risk-stratification tools to deliver targeted preventive care services—particularly colorectal cancer screening and follow-up—to high-need patient populations.

This work has fostered successful partnerships with integrated delivery systems, federally qualified health centers, Medicaid health plans, and rural practices. She has developed and tested digital tools and visual communication strategies to increase colorectal cancer awareness and screening uptake. Dr. Coronado serves as Vice-Chair of the National Colorectal Cancer Roundtable and is a workgroup member of NCI’s National Cancer Advisory Board.

She has published more than 250 peer-reviewed publications or book chapters and served as PI or co-I on more than 50 federally funded grants. In 2021, Dr. Coronado was named ‘Mentor of the Year’ by the Healthcare Systems Research Network.

Dr. Coronado earned her bachelor’s degree from Stanford University and her doctoral degree from the University of Washington. Before coming to the University of Arizona, Dr. Coronado held positions as Assistant and Associate Member at the Fred Hutchinson Cancer Center from 2004 to 2010, followed by roles as Senior and Distinguished Investigator at the Kaiser Permanente Center for Health Research from 2010 to 2023.

Arizona’s Legislative Session Still in the Hurry-Up-and-Wait Phase

Arizona’s legislative session is in its standard late-session opacity pattern. Budget talks are happening behind closed doors, and most other major work is waiting for the budget deal.

The players are the (R) House and Senate appropriations chairs (Montenegro & Petersen) along with Governor Hobbs.

Last week’s KJZZ’s recent interview with Capitol reporter Howard Fischer suggests a deal may be getting close.

This week at the Arizona Legislature: How close is a new budget deal?

Petersen told Howie that the parties are “probably 97% of the way” there. He also pointed out that Hobbs’ earlier revenue ideas, like gaming tax changes and voucher income limits, appear unlikely to survive, while the Legislature’s across-the-board cuts also appear less likely after Hobbs vetoed the earlier Republican budget plan.

There haven’t been any leaks that I know of about whether critical funding for hiring eligibility staff for AHCCCS and SNAP benefits is on the table. To me that’s the most important part of the budget.

Once the deal is released, things will probably move really fast. The House and Senate will likely vote on the budget package quickly. After that we can expect a “rapid fire” round of floor votes on bills that have been languishing for weeks.

Then there’s the ballot referrals. Unlike regular bills, legislatively proposed constitutional or statutory changes go straight to the ballot and can’t be vetoed. Once the budget is done legislative leaders will decide which of the roughly 30 proposed referrals get put on the floor for a final vote. If they pass, voters will see them on the 2026 ballot.

To be honest, Montenegro and Petersen have probably already decided which of the proposed ballot measures they’ll put on the calendar.

Potential 2026 Ballot Measures: A Public Health Perspective – AZ Public Health Association

One unresolved issue are agency director confirmations. It looks unlikely that there’ll be more director nomination hearings this year (there were none last week).

That could create a problem for keeping Debbie Johnston as acting ADHS director. Hobbs appointed Johnston in November, and like other agency heads, she needs Senate confirmation (her 1-year time clock ends on November 25, 2026, I think).

Maybe, just maybe, the governor will do a bit of brinksmanship & connect the budget deal to floor votes on her nominees.

By next Sunday I might be able to present a session hotwash…  but we’ll see.