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More than 17 million Americans—including 4.8 million children—suffer from asthma.

Throughout this year’s series of Marketing Tutorials, we have focused on programming for individuals who suffer from health conditions that can be prevented or minimized through regular, moderate exercise. These conditions include heart disease, osteoporosis and, most recently, stress, America’s No. 1 health problem. Although these health conditions and their relation to exercise receive a lot of attention, another very common problem is often overlooked: asthma.

Between 1980 and 1994 (the last reported period), asthma cases increased by 75 percent. In 1998, the estimated number of U.S. asthmatics was 17 million, including 4.8 million children.

These numbers carry a price. Treatment costs for asthma are approximately $9.2 billion annually in the United States. Combine the rise in asthma cases with the fact that any increase in an asthmatic’s cardiovascular level of fitness can dramatically improve his quality of life and you get a wonderful opportunity for health club programming.

This month’s Marketing Tutorial will focus on how your club can attract and safely accommodate asthmatics into an exercise program. Remember that in order to attract a niche of prospects, the marketing must appeal to a very specific consumer, must have a low barrier of entry and must be simple to achieve for the consumer.

Asthma: The Misunderstood Condition
Most individuals know little or nothing about asthma except that those afflicted with the condition have “attacks” in which they have difficulty breathing. True, asthma is an inability to breathe properly, but the problem is more complex than that. During inhalation, air passes into the lungs through millions of progressively smaller airways called bronchioles. Bronchioles lead to alveoli, which are microscopic sacs where oxygen and carbon dioxide are exchanged. Asthma is a chronic condition in which these airways, when stimulated by allergens or other environmental triggers, undergo changes that cause patients to cough, wheeze and experience shortness of breath. (The word asthma originates from an ancient Greek word meaning panting.) There are actually two primary stages of an asthma attack: the hyper-reactive response and the inflammatory response.

When an individual’s lungs are exposed to allergens or irritants, they respond by constricting. The asthmatic’s airways, however, constrict and narrow excessively. This is called the hyper-reactive response stage. The excessive narrowing is further magnified by the fact that an asthmatic —unlike an individual without asthma —is unable to breathe in deeply to relax the airways and rid the lungs of the irritants. As a result of this inability to breathe normally, asthmatics pant or gasp for breath.

The hyper-reactive response in asthmatics is then followed by the inflammatory response, in which the body’s immune system responds to allergens or other environmental triggers by delivering white blood cells to the airways. This results in the airways swelling, filling with fluid and producing a thick, sticky mucus. This in turn results in wheezing, breathlessness, an inability to exhale properly and a phlegm-producing cough. For many asthmatics, the only way to stop the body from responding is through medication, often referred to as an inhalator.

Although all asthmatic responses are similar, what most people don’t know is that there are essentially two different kinds of asthma: ordinary asthma and exercise-induced asthma (EIA). As the name suggests, EIA only results from exercise. However, exercise will also trigger some level of coughing, wheezing or shortness of breath in 40 to 90 percent of individuals with ordinary asthma. Although EIA has the same symptoms as allergic asthma, it is not dangerous and does not require hospitalization. Some people only have EIA, while others have both types. EIA occurs most often in children and young adults with ordinary asthma. Intense exercise in cold, dry air frequently triggers EIA.

Although asthmatic conditions are cardio-respiratory, an increase in lung strength or capacity—such as the increase associated with exercise—will improve the quality of life for an asthmatic. This means with the proper marketing, programming and management, clubs can attract a new niche market (i.e., asthmatics) through their doors.

Preparing for an Asthma Program Before embarking on a program for asthmatics, you should ready your club for any instance where an asthmatic comes unprepared for an attack. (Fortunately, most asthmatics are careful to have medication close at hand—in case of an emergency.) First, educate your staff with basic information about asthma. Also, make sure everyone knows that CPR training won’t help an asthmatic. CPR is designed for cardiac events and has no application to an asthma attack. Second, make sure your club has taken an appropriate inventory of its first aid materials as it relates to an asthma attack. One thing that should be on hand is a bronchiodilator (aerosol drug), which is inhaled to subdue an attack. Also, it is ideal if the club has oxygen, even if it is only a small 12-minute supply, which will provide enough time for the bronchiodilator to take effect. Furthermore, your kit should contain a plastic “spacer,” a simple tool that facilitates delivery of the bronchiodilator in the event that the individual can’t breathe deeply enough for the drug to get into his airways. Finally, you may also want to keep an Epipen, an adrenalin injection that can be delivered into the thigh muscle. Of course, you should seek the advice of your local doctors and/or any first aid organization on these issues to ensure your first aid kit is complete and up to date.

Type of Programs
As you design programs for asthmatics, keep in mind that you want to attract asthmatics who are not presently involved in exercise. (You would be surprised to know how many of your members are asthmatics. Of the 400 U.S. Olympic athletes in 1984, 97 were asthmatics, the majority suffering from EIA.) This way, you are reaching out to an entirely new market.

Since your club will be seeking inactive asthmatics, you will probably be dealing with deconditioned individuals who are intimidated about the prospect of beginning any type of exercise. Therefore, you will need to put together a very low-impact, easy-to-begin program. As was discussed in the June tutorial on stress programming, one of the best (and easiest) ways to attract a new niche market—without creating a management and programming nightmare—is to offer classes that are currently available at your club. In other words, any type of lowimpact class, such as tai chi, yoga or aqua aerobics, would suffice for asthmatics.

Yoga for Asthmatics
As illustrated by a recent cover story in Time magazine, yoga is one of the fastest-growing forms of exercise in the United States. The reason is that yoga offers a great workout which can be modified by the participants according to their fitness level. In addition, yoga offers a more holistic, total mind/body approach, which is growing in popularity with the aging baby boomers.

Yoga is a great choice for asthmatics for a number of reasons. First, this exercise teaches participants how to breathe deeply and to relax, giving asthmatics a greater feeling of control during attacks. Second, yoga will help participants increase their cardiovascular endurance, hence lung capacity. Finally, the breathing exercises help participants deal more effectively with stress, a common trigger for asthma.

Since most clubs already offer yoga, it’s simple to market this mind/ body program to asthmatics.

Aqua Aerobics
If your club has a swimming pool, your aquatics programs—such as aerobics, power walking or even water volleyball—make great choices for asthmatics.

As previously stated, you should try to reach deconditioned asthmatics with your asthma programs. Poolbased programs are perfect for these people. While aquatic programs can give a vigorous workout, water classes are popular with the deconditioned because participants can easily alter their intensity level without looking out of place.

There is another reason to bring asthmatics into your pool. Many doctors recommend swimming for people with asthma because the humidity helps to ease breathing. (Note: High levels of chlorine in pools can cause an allergic reaction in some asthmatics, triggering an asthma attack.)

Intermittent Activities
Any exercise with intermittent periods of exertion—such as volleyball, walleyball, walking or even line dancing —make good activities for asthmatics. These activities give participants natural rest periods or allow them to slow down or sit out if any respiratory agitation occurs.

Make the Programs Short-Term!
When establishing a program for asthmatics, remember what was discussed earlier: You are reaching out to people who don’t exercise regularly. Therefore, they probably won’t want to make a long-term commitment until they are confident that they will be able to participate fully. The “short-term” vs. “long-term” debate has always been present in the health and fitness industry. Skeptics opposed to short-term programs argue that, due to high dropout ratios, clubs can’t afford to let potential long-term members get away with a six- or eight-week commitment. This viewpoint, however, is unwarranted, especially as it relates to marketing to specific populations.

Remember that your club is NOT going to place a generic ad for a short-term membership to the club; you are going to advertise a specific type of class designed for individuals with asthma. Even if your intention is to put these individuals in your regularly scheduled classes, the advertising will not indicate this, preventing non-asthmatics from calling. Furthermore, as was discussed in June’s tutorial, these short-term programs actually generate revenue for the health club while, at the same time, drawing prospects who can eventually be converted to regular, full club memberships.

Corporate Outreach
Depending upon your club’s level of interest in niche marketing and the amount of work you are willing to do, you can attract asthmatics through corporate outreach. Specifically, you could set up yoga or tai chi classes at lunchtime at corporations. These classes could be part of a short-term program offered once a week, making it easy to fulfill while still attracting potential clients.

If you desire a simpler way to reach the corporate market—without any on-site responsibilities such as classes—you can distribute educational information on how asthmatics can exercise safely. This information could be something as simple as a one-page “Top 10 Tips for Asthmatics” sheet (see July). You could also create a more extensive brochure that discusses asthma in general and provides tips for prevention. Given that the information will be educational and specific, companies will be more inclined to distribute these materials in lieu of a promotional flyer for your club or class programs.

Running the Program
Although you don’t need to schedule an asthmatic program during a certain time to ensure a successful turnout, you should take a few things into consideration.

First, look at general traffic patterns at your club. Unless your facility has multiple group fitness rooms that are not being used during convenient class times, it would be advisable not to run any type of short-term program during the peak months of January, February and March. Naturally, you can hold the program during downtimes, but with this niche market, you will probably need to run the class at prime time. Unfortunately, most clubs can’t afford to have a specialty, nonmember program oust a member class during the early months of the year.

There’s another reason not to hold the asthma program in January, February and March. Remember: Cold air frequently triggers EIA, making the winter months less favorable. Therefore a better strategy would be to conduct the program during spring, summer or fall months when your health club can comfortably handle more bodies without annoying core members.

Where to Promote the Program
As mentioned throughout this tutorial series, you need to consider three distinct marketing areas when promoting any campaign: external marketing, internal marketing and community outreach.

For asthmatic programming, external marketing is imperative to attract nonmember non-exercisers to the club. This can be done through newspaper ads. You can also distribute flyers to local businesses (i.e., corporate outreach) and, even better, directly to doctors’ offices. In fact, well-organized clubs could mail an introductory letter and a packet of flyers to all local doctors, requesting that the information be placed in their waiting room. When successful, this strategy adds a tremendous amount of credibility to the program and your club in general. (See sample flyer on Adobe Acrobat download.)

Before doing any internal marketing, you will need to make a decision as to the focus of the program (i.e., do you want the class to have existing members or do you only want new, nonmember prospects?). As was the case with the free stress management study in June’s tutorial, you must determine the parameters of the program before you do any marketing —internal, external or otherwise —because members will find out about it and want to participate. If you don’t want members in the class, post the rules for participation and stick with them. If you decide to permit members into the class, know that they will participate, limiting the number of new prospects involved.

Your community outreach should entail a press release and follow-up phone calls to your media list. One way to make the press release more personal is to find a club member who has successfully managed her asthma or even improved her condition and quality of life through exercise participation. This will greatly increase the chances of free press, as reporters love personal interest stories.

Putting the Pieces Together
Because this month’s program is so specific, it’s much easier to choose the marketing vehicles and strategies.

1. External marketing through newspapers or flyers. Remember to follow the basic principles for putting together an effective advertising piece: create a compelling headline, state the benefits, pitch the offer, have a call to action and make the offer better than risk free.

2. Community outreach. By sending out a press release about asthma and, if possible, an existing member who has overcome asthma through regular exercise, you will greatly increase your chances of free publicity.

— A 16-year veteran of the club industry, Casey Conrad is president of Communication Consultants, a Wakefield, R.I.-based company that provides sales and communication seminars. She has also launched a national chain called Healthy Inspirations, Weight Loss & Lifestyle Centers. For more information about asthma programming, contact Conrad at (800) 725-6147.