The Local Exercise Action Pilot in Dudley STEPS TO HEALTH The Promotion of Activity in Parks The Sto

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The Local Exercise Action Pilot in Dudley
STEPS TO HEALTH The Promotion of Activity in
Parks The Story So Far
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Why Parks?

• Barrier to Activity
• Cost
• Transport to facilities
• Aimed at sporty types
• Programmes targeted at specific age groups

• Parks
• Free
• Accessible for all
• A comfortable venue for sedentary people
• Facility for the whole family

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Aims

• To increase and encourage the use of parks and
  open spaces as physical activity venues
• Pilot a referral pathway from Primary Care to
  existing activity stations and the Parks
  Programme.
• Target people from disadvantaged groups
• Secure long term sustainable funding

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Objectives

• Promote the parks as physical activity venues to
  members of local communities.
• To encourage service reform within the Parks
  Department to proactively provide and deliver
  physical activity opportunities.
• To encourage service reform within Leisure
  Services Department to view parks and open spaces
  as a viable alternative to existing bricks and
  mortar facilities.
• Modernisation of the Park Keeper role into a
  Parks Physical Activity Leader (PPAL).
• Provide a link for Primary Care to activity
  stations around the borough.

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Partners

• Primary Care Trust
• Knowledge and skills in the promotion of
  physical activity, and health improvement.
• Dudley MBC Parks Department
• Knowledge and resources around the chosen
  sites and provider of key staff.
• Dudley MBC Sports and Leisure Department
• Knowledge, skills and resources for the
  provision of physical activity for all
• Action Heart Cardiac Rehabilitation Programme
• Knowledge, skills and resources to provide
  physical activity opportunities for patients with
  health risk factors
• Friends of Parks
• Knowledge of the targeted user groups

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The Steps to Health Parks

• Links to TYS
• Staff
• Areas of Deprivation
• Geographical Spread

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What we wanted

• Well lit, clean and secure
• Staffed by Park Keepers with a modernised role
• Informative signage
• Emergency First Aid and Telephone
• Clean toilets
• Shelter
• Seating
• Well surfaced footpaths

• Modern, clean play equipment
• Sports areas with goals and nets
• Hire of sports equipment
• Programmed activities for all ages and abilities
• Health information points, linking to other
  physical activity services
• Way marked walking routes

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What we had

• Limited staff presence delivering an historical
  remit
• No or poor play equipment
• No emergency first aid or telephone
• No toilet facilities
• Uneven footpaths, poorly maintained

• No Shelter
• Poor or non existent signage
• No information points
• No way marked walking routes
• No provision for equipment hire
• No activity programmes
• No provision of refreshments

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What Happened Next Planning

• We audited provision and identified gaps.
• Set up Stakeholder Interagency partnerships and
  steering teams at both Strategic and Operational
  Level.
• Community involvement and empowerment via Friends
  of Parks and other user groups was critical and
  was gained.
• Allocation of funding was identified for both
  capital and revenue.
• Proposed physical improvements and delivery
  programmes were matched with audits and community
  needs.
• The need for a hands on deliverer to support the
  Project Co-ordinator was identified and
  eventually recruited.

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The Audit Process

• Developed a physical activity audit tool in
  partnership with stakeholders that assessed the
  park against a range of factors which affect the
  promotion of physical activity.
• Audit was facilitated by a number of groups
  including project partners, Friends of the Parks
  and Community Groups.
• Gaps in service provision were highlighted.
• Audit results led to the development of a
  physical activity strategy for each park, to be
  driven by a physical activity task group.
• The above process instigated the majority of
  subsequent development.

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What Happened Next - Delivery

• Provision of Free activities in each of the
  parks. Suitable for all ages and abilities. Young
  people were offered coaching sessions in cricket,
  tennis, football basketball and multi sports.
  Adults were targeted mainly through health walks
  and very popular exercise sessions in parks.
• A discount leisure scheme in parks and leisure
  centres, offering a wide range of activities at
  50 of normal price for patients referred by
  GPs.
• Encouraged lifestyle change and promoted the 5 x
  30 minutes message.
• Improved the capacity of staff to deal with a
  range of people, and actively encourage physical
  activity.

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Challenges

• Referral rates from some practices were quite
  low, and in some cases non existent.
• Low adherence rate from the discount leisure
  scheme. There were also some initial teething
  problems with the logistics of the scheme.
• Modernising the role of the Park keeper has
  proved difficult.The infrastructure to support
  this has moved at a slower rate, than individuals
  within the partnership would have wanted. This
  often left the programme overly reliant on one or
  two members of staff.
• The parks junior sports coaching programme has
  attracted a predominantly male audience.
• Weather and seasonal changes have a significant
  bearing on the Parks based programme.
• Monitoring / evaluating whether more people are
  using Parks outside of organised activities.

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Successes

• The discount leisure scheme has generated over
  3000 new starters, with the highest percentage
  coming from Dudleys most deprived areas. The
  scheme has been well supported in Primary Care
  settings. Still over 600 registered as regular
  participants.
• In its entirety the Parks based programme has
  benefited over 4000 people, and has expanded
  outside the original 5 pilot parks.
• The Parks holiday sports coaching programmes have
  generally been well attended over the three
  years. Average attendance was between 15-20
  participants per session.
• A programme of regular health walks has emerged.
  Currently there are 8 walks a week taking place
  in Parks. The walks attract a lot of female
  participants, particularly in the 50 age group.
• The most successful parts of the Parks programme
  have tended to occur when community partners have
  been fully engaged at all stages.
• Posts to support the programme within the PCT and
  the Parks department (PPAL) have been
  mainstreamed.

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Present Situation

• Service reform in Parks and Leisure Departments
  starting to happen a joint holiday coaching
  programme has been established.
• Training programme, funded by the PCT, is now in
  place for Parks keepers to move towards the
  modernised role. Some Park Keepers have been
  involved in delivering health walks.
• Improvements have been made on a number of parks,
  such as signage, play areas and multi use games
  areas installed, with further improvements
  planned.
• Discount leisure scheme still operating without
  any problems from LA or PCT perspective.

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Learning Summary

• Partners need to be fully engaged and fully aware
  of roles, responsibilities and projected outcomes
  from the start.
• Communication needs to be open and transparent at
  all times and at all stages.
• User engagement , in this case Friends of Parks
  and young people is critical to the success of
  Parks based programmes at the pre, delivery and
  post intervention stages.
• The park setting did work as a venue for
  predominantly sedentary people from disadvantaged
  areas, as well as attracting people who travelled
  to the programme.
• Formal evaluation forms such as IPAQ and BAD do
  not work with people in the parks setting. By the
  nature of the targeted approach within
  disadvantaged communities, some participants
  could not read or write, some were suspicious of
  official looking forms, forms were rarely if ever
  returned on time, and there was a general
  reluctance to formal processes.

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Learning continued

• Never assume that partners are as committed as
  you, or will be willing and/or able to work at a
  pace that best suits the programme.
• Be realistic from the outset about working
  practices and partner agendas, this will
  hopefully lessen frustrations along the way.
• When working with community groups, dont be
  afraid to be honest about your limitations and
  the bureaucracy that affects day to day work,
  community groups need to know why things cannot
  happen tomorrow.
• Primary Care can be a positive setting for the
  promotion of physical activity provided the
  system is simple and not reliant on too much
  staff time, but outcomes will always be
  determined by personalities not processes in
  primary care.
• When making physical environmental change to
  promote increased activity, this is very often
  the hardest intervention to measure, even though
  it may be the most effective.
• When aiming for service reform, two years is not
  enough!

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And finally.

• Before LEAP Dudley had no parks programme,
  disengaged friends of Parks, a perception that
  parks were places that were unsafe , dirty and
  in disrepair, generally a hugely underused
  resource.
• We now have an established parks programme,
  supported by a mainstreamed post, and strategic
  commitment within the Local authority, plus core
  PCT funding to enable continued training of Park
  keepers into the vision of a modernised Physical
  activity leader.
• Although we are not there yet, and the process to
  this stage as been difficult, we feel that we are
  now starting to reap the benefits of the parks
  programme.
• We would like to leave the final word to one
  of the parents of a participant.
• What a fantastic way to keep children
  entertained .Keeping fit and enjoyment rolled
  into one. Please continue you have saved the mums
  sanity

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Balraj JohalPhysical Activity AdvisorDudley
PCT01384 366611balraj.johal_at_dudley.nhs.uk