Why Active for Life

1

• Why Active for Life?
• Physical activity brief intervention

2
Who we are

• Gladys Barr,
• Active Swindon co-ordinator,
• Active Swindon
• Swindon PC
• gladys.barr_at_swindon-pct.nhs.uk 01793 708775
• Carole Jones,
• Health and fitness development officer,
• Lifestyle Team
• Swindon BC
• cjones_at_swindon.gov.uk
• 01793 511033

3
Community outreach physical activity teams

• Active Swindon 3 year lottery funded project to
  raise physical activity levels through
• new programmes and volunteers
• health promotion and accessibility of information
• building the partnership in Swindon to increase
  participation
• Lifestyle a Swindon BC initiative developing
• sport
• sport programmes in the community e.g. BME,
  disabled children
• lifestyle programmes e.g. GP referral scheme,
  Activ8 classes
• activity classes for people with long term
  conditions e.g. COPD, Cardio care, Steps to
  Health (GP Referral scheme)

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Aim of this session

• Re-emphasise the importance of physical activity
• Share Active People survey results
• Brief intervention
• What we offer in Swindon

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Overall cost of inactivity in England is 8.2bn a
year
Source Natural Fit, RSPB, DR William Bird, 2004
6
The Cost of Inactivity

• A 10 increase in physical activity would benefit
  England by
• 500m each year

Game Plan A Strategy For Delivering The
Governments Sport And Physical Activity
Objectives, 2002
7
The Evidence

• What the Chief Medical Officer reported

8
Mortality

• Physical activity can halve the risk of
  developing major chronic diseases such as heart
  disease and strokes
• Adults who are physically active reduce the risk
  of a premature death by 20-30

Chief Medical Officer Report, At Least Five A
Week Evidence On The Impact of Physical
Activity And Its Relationship To Health, p1, 2004
9
Modifiable risk factors for CHD ( of population)
Source BHF Statistics, 2004
10
Blood Pressure

• High blood pressure can be both prevented and
  treated by
• physical activity

Chief Medical Officer Report, At Least Five A
Week Evidence On The Impact of Physical
Activity And Its Relationship To Health, p6, 2004
11
Stroke

• People who are highly active have a 27 lower
  risk of
• stroke incidence

Chief Medical Officer Report, At Least Five A
Week Evidence On The Impact of Physical
Activity And Its Relationship To Health, p40,
2004
12
Cancer

• Women with higher levels of physical activity
  have about a 30 lower risk of breast cancer than
  the least active
• Physical activity during puberty is associated
  with a lower risk of developing breast cancer
  later in life
• The most active individuals have a 40-50 reduced
  risk of contracting colon cancer

Chief Medical Officer Report, At Least Five A
Week Evidence On The Impact of Physical
Activity And Its Relationship To Health, p65,
2004
13
Obesity

• Obesity doubles the risk of
• all-cause mortality, coronary heart disease,
  stroke and type 2 diabetes

Chief Medical Officer Report, At Least Five A
Week Evidence On The Impact of Physical
Activity And Its Relationship To Health, p45,
2004
14
Obesity

• 43 (32,570) men and 32 (24770) women in Swindon
  are overweight
• 22 (16740) men and 23 (17,530) women in Swindon
  are obese

DoH and APHO, 2005
15
Childhood obesity

• Nationally 16 of children aged between 2 and 15
  are obese
• Sept 06 - measurements in Swindon - obesity was
  10.5 for reception children and 18 for year 7s
  

The health of children and young people. London
The Stationary office. Sproston K and Primatesta
P. (2003) Health Survey for England, 2002. and
local data from Swindon PCT
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Diabetes

• Physical activity can reduce the risk of
  developing type 2 diabetes by
• 33-50 when compared to
• inactive people
• In Swindon Practice Based Registers - 6126 (3.1)
  patients diagnosed March 2005, (3.2 March 06)
  rising to 3.88 predicted by 2010

Chief Medical Officer Report, At Least Five A
Week Evidence On The Impact of Physical
Activity And Its Relationship To Health, 2004
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National Diabetes survey results 2007 for Swindon

• 0nly 30 reported that they always discussed
  personal advice about physical activity when
  receiving care.
• 39 wanted more advice about physical activity
• 44 reported that they were not active

National Diabetes Survey results for Swindon PCT,
Quality Health, 2007
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Mental Health

• Physical activity helps people feel better
  through improvement in mood, reduced anxiety and
  enhanced self-perceptions.
• Active people report having fewer symptoms of
  anxiety or emotional distress than inactive
  people

Chief Medical Officer Report, At Least Five A
Week Evidence On The Impact of Physical
Activity And Its Relationship To Health, p6, 2004
19

• What are the recommended levels of physical
  activity?

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Recommended Exercise

• Adults should do 30 minutes of moderate physical
  activity at
• least five days a week

How much physical activity should we do? The case
for moderate amounts and intensities of physical
activity. Health Education Authority and
Strategic Statement on Physical Activity.
Department of Health, 1995
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(No Transcript)
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Recommended Exercise

• Children should do one hour of moderate physical
  activity
• every single day

Young and active? Young people and health
enhancing physical activity-evidence and
implications. Health Education Authority, 1998
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National Target

• By 2020 half the population are exercising to a
  level that has health benefits.
• to increase participation in physical activity
  by 1 every year.

Sport England National Framework for Sport, 2005
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The Challenge
20 sporty types
20 Turned off to Sport
44 on subs bench
16 mild enthusiasts
Could be persuaded if accessible and attractive
Keen to stay
Negative attitude to physical activity
Keen could do more
Sport England National Framework for Sport, 2005
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Brief intervention

• Involves opportunistic advice, discussion,
  negotiation or encouragement and are delivered
  by a range of primary and community care
  professionals. Varies from basic advice to more
  extended, individually focused attempts to
  identify and change factors that influence
  activity levels
• Discussion between individuals and GPs, nurses
  etc are effective and cost effective in
  encouraging individuals to be more active (PHIAC)

NICE Public Intervention Guidance No.2, March 2006
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4 NICE recommendations

• Primary care professionals should use every
  opportunity where possible to identify inactive
  adults and offer advice on reaching recommended
  levels. They should use a validated tool such as
  the GP Physical activity questionnaire to
  identify inactive individuals
• Goals should be agreed, written information about
  the benefits of activity and local opportunities
  to be active should be given and the advice
  should followed up over a 3-6 month period

NICE Public Intervention Guidance No.2, March 2006
27
4 NICE recommendations

• Strategies to promote physical activity should be
  monitored by policy makers, commissioners and
  practitioners
• Systems to promote physical activity should
  ensure that the needs of the hard to reach and
  disadvantaged communities e.g. disabled and BME
  are considered.

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Why implement NICE guidance?

• The Health care commission now assesses the
  performance of NHS organisations in meeting
  standards set by the DH in Standards for better
  health. Standard D13 states that healthcare
  organisations should work towards implementing
  effective programmes to improve health and reduce
  health inequalities

NICE Public Intervention Guidance No.2, March 2006
29
The GP Physical Activity Questionnaire

• The DH launched the GPPAQ in Dec 2006
• Self completed questionnaire for use with adults
  16-74 in routine General practice to provide a 4
  level Physical activity index (inactive,
  moderately inactive, moderately active and
  active)
• Recorded on clinical record at least every 5
  years
• Used to inform the decision as to when
  intervention might be appropriate

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Limitation in role of GPs

• Your own level of exercise
• Knowledge of current messages on physical
  activity
• Lack of time in consultation
• Lack of perceived importance of physical activity
• Lack of systems in place

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Programmes in Swindon

• Steps to Health GP referral scheme
• COPD
• Falls prevention
• Cardio Care
• Healthy ageing
• Dietbusters

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Steps to Health- GP referral programme Positive
changes base line measurements - April 07
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Steps to Health- GP referral programme Positive
changes in self reported feeling of well being -
April 07
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New programmes

• MEND
• Walking to health
• Health trainers
• Community cycling project

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Support

• Active Swindon 01793 617782
• 01793 708775
• Lifestyle Team 01793 511033
• www.swindon.gov.uk/activeswindon

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Elements that make up an effective brief
intervention

• Feedback of personal risk
• Individual tailored advice
• Goal setting for behaviour change and self
  monitoring
• Emphasis on personal responsibility for change
• Clear advice to change
• A menu of alternative change options
• Exploring behaviour factors
• Empathy as a counselling style
• Encouragement of self efficacy (the positive
  reasons why change seems possible)
• Providing ongoing follow up and support 6 weeks
• Review progress after completion of the
  intervention
• Moderate intensity activity, such as walking
• Not requiring to attend a facility

Source The effectiveness of public health
interventions for increasing physical activity
among adults a review of reviews, HDA Evidence
briefing 2nd edition, Feb 2005