Promoting Physical Activity with

1

• Promoting Physical Activity with
• Older People
• A Guide to Leading Edge Practice
• Seminar programme - Spring 2008

2

• Themes and content of the programme
• Update on evidence
• BHF NC Guidelines on older people and physical
  activity
• Active for Later Life resource
• Policy and partnerships

3

• Why Leading Edge Practice ?
• In the last few years older people and physical
  activity has begun to move up the agenda but ..
• We need to move from innovation and short termism
  to sustained activities and opportunities by
  implementing effective interventions and
  programmes

4
BHF NC Guidelines on older people and physical
actvity

• How much is physical activity is enough and how
  do we communicate this ?
• What works in practice ?
• www.bhfactive.org.uk

5
Issues relating to evidence guidelines and older
people

• I.e. What works ?
• Different levels of evidence required and used
  e.g. Meta analysis, RCTs, Single Studies. Grey
  literature, Expert opinion
• Translational theory and dissemination - how do
  we turn a research project/evidence into a real
  world community programme - e.g. primary care
  brief interviews or the US Champs Programme ?

6
Evidence of effectiveness
Can we help to change matters?

• From a critical review of 29 physical activity
  interventions
• Increased activity levels over a longer period of
  time 18 months (75)
• Group/class-based and home-based activity were
  both effective
• Tailored to individual needs
• Cognitive-behavioural strategies and goal-setting
• Accessible choices
• Telephone support and continued contact
• More likely than young adults
• (King et al, 1998)

7
BHF NC Guidelines -
interventions and programming

• Making sense of all the evidence
• Effective interventions and older people
• Population wide
• Programme
• 0ne to one
• Physical activity programming
• (Owen. N 1994, Sallis J. 1998, CDC 2000, NICE
  2007)
• Identifies components of best practice

8
Evidence based guidance on
population wide interventions

• Environmental (e.g. Building design, urban
  environment, natural environment e.g. parks
• Crime and personal safety
• Transport and planning
• Policy change
• Campaigns and communications
• Safe and physical activity friendly environments
  for the older person

9
Evidence based guidance on Community and locality
based programmes e.g.

• Walking the Way to Health
• Inclusive Fitness Initiative
• Ageing Well
• Physical activity At Home Kirklees MC.
• Next Steps Wigan MBC
• Walk From Home Keighley
• Go 50 - Age Concern Surrey

10
Community or locality based programmes
Target populations, communities and settings

• Time for design and planning
• Partnership development
• Engage participant groups
• Audit current practice
• Marketing and promotion

• Ensure choice
• Build support strategies
• Exit strategies
• Support through change
• Plan for evaluation
• Plan for sustainability

11
Evidence based guidance on1 to 1 interventions
to initiate physical activity

• Practice nurses and GPs,
• Senior health mentors on befriending schemes,
  providers of day care centres, managers of
  sheltered and supported living schemes, health
  and care professionals in residential care and
  nursing homes, fitness instructors
• (Community) physiotherapists or community
  nurses/practitioners.

12
Components of best practice 1 1
interventions with older people

• Use of a health educator and extended
  consultation time
• Agreement of problem areas
• Goals agreed by both older person and
  professional
• Identification and recognition of social and
  environmental barriers
• Tailored action plan
• Choice and range of accessible local activities
• Supplementary educational materials
• Systematic follow-up and support over time
• (BHF 2007)

13
Components of best practice Effective programming

• Overcoming the barriers
• Involve participants
• Ensure accessibility
• Provide appropriate induction
• Assess needs and motivation
• Quality leadership
• Components of fitness

• Develop belonging and ownership
• Recognise achievement and progress
• Educate participants
• Provide social support
• Ensure there are exit routes and opportunities
  for change
• (BHF 2007)

14
Effective health promotion for older people and
physical activity

• What works ?
• Ecological models that recognise multilevel
  components e.g.
• Population wide interventions
• Community interventions and programmes
• 1 to 1 interventions
• (Owen, N 1994, Sallis J1998, CDC 2000, NICE 2007)

15
Discussion

• Select one of the guidelines -
• Use components of best practice and
  recommendations to bench mark/measure your
  planning processes or a current programme
• How would you use these ?

16
Common themes

• Engage and involve participants
• Understand and resolve barriers
• Accessible choices
• Support strategies
• Tailoring to individual needs
• Education of participants
• Exit strategies and sustainability

17
Support strategies

• All literature provides strong evidence that they
  are effective (NICE, HDA, CDC, Campbell, FAME)
• Communication strategies (telephone, email,
  letter)
• Technologies (diaries, prompts)
• Activities (buddying, social events)
• What do/could you use to support people who are
  making the change ?

18
Otago Exercise Programme - Schedule
19
Accessible choices

• How can we provide
• accessible choices ?
• Whats available ?

20
Further information

• BHF NC Guidelines for older people
  and physical activity
• Benchmarking your own practice
• Section 4 of the Active for Later Life Resource
• The Working Papers
• www.bhfactive.org.uk