Physical Activity Toolkit: Cover

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Physical Activity Toolkit Cover
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Aims of the session OHP 1
4. Overheads Facilitator Notes

• To increase knowledge and awareness of the
  benefits of physical activity amongst members of
  the primary health care team
• To support action planning to promote and develop
  physical activity initiatives that will benefit
  the health of the practice population

Objectives of the session

• At the end of this session you will
• Understand the importance of physical activity in
  promoting positive health
• Be knowledgeable about current activity levels
  and recommendations
• Be able to offer patients specific physical
  activity advice relating to the moderate message
• Be aware of what physical activity initiatives
  are happening in your area and how you can become
  involved in the promotion of physical activity
  in your practice

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Session Plan OHP 2

• Content Time Allocated
• Introduction planning 5 minutes
• Making the case for physical activity 10 minutes
• Current activity patterns 2 minutes
• Current recommendations 8 minutes
• Barriers to becoming more active 5 minutes
• Case studies 15 minutes
• Putting physical activity into practice 15
  minutes
• Total 1 hour

4
Small group discussions OHP 3

• What do you currently do to promote an active
  lifestyle with your patients? (try to be as
  specific as you can, listing any approaches that
  you take)

5
Attributable risk of CHD OHP 4

• Risk factors for coronary heart disease
• Death from CHD under 75 related risk factors
• Source Britton A and McPherson K (2000)

This diagram represents an estimation of how much
each risk factor contributes to death rates from
CHD. The overlapping areas represent those who
had more than one risk factor.
Britton, A., McPherson, K. (2000) Monitoring the
Progress of the 2010 Target for Coronary Heart
Disease Mortality Estimated Consequences on CHD
Incidence and Mortality from Changing Prevalence
of Risk Factors. National Heart Forum London (in
press).
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CHD risk factors OHP 5
CHD risk factors
Inactivity Smoking Hypertension Cholesterol Par.Hi
st. BMI27
Relative risk
Blair, 1996, JAMA
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Prevalence of CHD risk factors OHP 6

• CHD risk factors

Smoking Hypertension Cholesterol Inactivity
percentage
men women
BHF Coronary Heart Disease Statistics. 2000
Edition
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Brainstorm OHP 7

• What are the benefits of physical activity?
• List answers on a flip chart

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Cardiovascular health benefits of physical
activity OHP 8

• There is substantial evidence identifying the
  benefits of physical activity
• Prevention and management of obesity
• Prevention and management of diabetes
• Reduced risk of CHD, stroke and hypertension
• Improved blood lipid profile
• It is estimated that 33 of all CHD, 25 of
  strokes and Type 2 diabetes could be avoided with
  regular physical activity
• Health Education Authority (HEA) now the Health
  Development Agency (HDA), 1995.

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Additional health benefits of physical activity
OHP 9

• Improve functional capacity
• Reduce risk of osteoporosis
• Reduced risk of certain cancers
• Prevention and management of stress, anxiety and
  depression
• Improved psychological well-being (e.g.
  self-esteem)
• Prolonged independence among older adults
• Reduced risk of developing lower back pain
• It is estimated that 50 of all hip fractures
  could be avoided with regular physical activity
  (OLoughlin et al, 1993)

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Practical well-being benefits of physical
activity OHP 10

• Improves sleeping habits
• Maintains independence
• Feel more energetic
• Feel good about yourself

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Current patterns of activity in England OHP 11
MALESage group

• FEMALESage group

Supplementary OHPs for Scotland, Northern
Ireland and Wales.
percentage
percentage
BHF Coronary Heart Disease Statistics. 2000
Edition
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Implications of current patterns of activity
OHP 12

• Over 30 of men and 60 of women cannot maintain
  a walking speed of 3mph when walking up a
  moderate slope. This included most men over 55
  years of age and women over 35 years age (ADNFS,
  1992)
• 55 of women 55-64 years and 30 of men 65-74
  years are below the functional threshold for knee
  strength i.e. would have difficulty getting out
  of a chair unaided (ADNFS, 1992)
• Despite these findings
• 80 of adults perceive themselves to be
  physically active (ADNFS, 1992)

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OHP 13

• What are the current recommendations for
  physical activity?

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The physical activity message OHP 14

• The Health Education Authority recommend that
  for improved health and to help with weight
  management, adults should try to build up
  gradually to accumulate half an hour of moderate
  intensity physical activity on five or more days
  of the week.
• Activities like brisk walking, cycling, swimming,
  dancing and gardening are good options.
• Health Education Authority (HEA) now the Health
  Development Agency (HDA), 1995.

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OHP 15

• How does this message differ from the more
  traditional message?

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Key principles of the new message OHP 16

• Key principles Newof message
• Benefits Health
• Frequency Everyday (minimum of 5 days a week).
• Intensity Moderate e.g. brisk walking.
• Time Accumulate 30 minutes i.e can be done in
  bouts of 10-15 minutes.
• Type Anything from formal/structured activity to
  informal lifestyle activities (such as walking,
  cycling, manual labour, gardening).

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Types of activity OHP 17
Structured Football Tennis Golf Hiking
Spontaneous Looking for opportunities Use
stairs DIY
Continuous Cycling Dancing Swimming Brisk
walking Rowing
Routine Climbing stairs at work and at
home Walking - shops, work, children to school,
the dog Reduce sitting
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Brainstorm OHP 18

• What do you see as the advantages and
  disadvantages of the new message for you and your
  patients?

20
OHP 19

• What barriers prevent people from becoming more
  active?

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Barriers to activity OHP 20

• Lack of knowledge and information about how they
  could benefit from becoming more active
• Lack of time often due to other priorities (e.g.
  work and family commitments, other social or
  leisure options)
• Lack of an exercise partner or social support
• Not the sporty type, lack of perceived required
  skills
• Financial constraints
• Lack of available or welcoming facilities
• Lack of motivation and willpower
• Fear of injury, fear of embarrassment (elderly
  groups)
• Dont enjoy it
• Fear of overdoing it

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Key points for case studies OHP 21

• For each of the case studies discuss a course of
  action and explain
• the rationale behind and decisions. Consider the
  following
• Patients medical status and any
  contra-indications.
• Safety recommendations.
• Current lifestyle could patients build on
  (lengthen time or intensity) current activities
  rather than introduce new ones

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Putting physical activity into practice OHP 22

• Are you aware of what is currently happening to
  promote physical activity in your area?
• Working in pairs for a couple of minutes
• How could you and other members of the practice
  team become more involved in promoting physical
  activity?
• Which patients? What could you do?
• What training or information would you need in
  order to get the programme off the ground and
  feel more confident?

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Action planning OHP 23

• Draw up an action plan on the flip chart.
• Remember to take into account all the training,
  information and support needs identified earlier.
• Refer to the SMART principles
• Specific
• Measurable
• Agreed
• Realistic
• Time Specific

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Current patterns of activity in Scotland OHP 11
SCOTTISH SUPPLEMENT Overheads Facilitator Notes
MALESage group

• FEMALESage group

percentage
percentage
Scottish Executive Health Department (2000).
Scottish 1998 Health Survey 1998. Health
Education Board for Scotland (2000). HEBS
Indicators for Health Education in Scotland, 2000.
BHF Coronary Heart Disease Statistics. 2000
Edition
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Current patterns of activity in Wales OHP 11a
WELSH SUPPLEMENT Overheads Facilitator Notes
year
percentage
Source Health Promotion Division, 1996
Residents aged 16-64 undertaking moderate or
strenuous physical activity in their leisure time
on 3 or more occasions a week. Occasion defined
as at least 20 minutes in duration. Health
Statistics Wales 1999. A publication of National
Statistics. The National Assembly of Wales.
Hackman Printers Ltd. July 2000.
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The physical activity message OHP 14
SCOTTISH SUPPLEMENT Overheads Facilitator Notes

• The Health Education Board for Scotland
  recommends that for improved health and to help
  with weight management, adults should try to
  build up gradually to accumulate half an hour of
  moderate intensity physical activity on five or
  more days of the week.
• Activities like brisk walking, cycling, swimming,
  dancing and gardening are all good examples.
• Health Education Board for Scotland, 1998.

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The physical activity message OHP 14
WELSH SUPPLEMENT Overheads Facilitator Notes

• The Health Promotion Division of the National
  Assembly for Wales recommends that for improved
  health, adults should try to build up gradually
  to accumulate half an hour of moderate intensity
  physical activity on five or more days of the
  week.
• Moderate physical activity includes activities
  such as social dancing, heavy DIY activities,
  heavy gardening, heavy housework and long walks
  at a brisk or fast pace as ideal moderate
  activities.
• Health Promotion Division of the National
  Assembly for Wales (1999). Physical Activity and
  Primary Care.