Transcript Bob Laventure (British Heart Foundation)

Healthy and Active Ageing in the Workplace
Active Ageing in the UK
Bob Laventure - July 2012
Role of the BHF NC
To develop and translate research evidence to
improve and extend the practice of promoting
physical activity in the UK
Through professional support, training and education
Summary of presentation
• Overview – evidence
and policy
• Practice - Active Ageing
promotion - what do we
know?
• Our audience – what do
we know?
• Issues and questions for
Active Ageing and the
workplace
Physical activity evidence - 1 - benefits
• London bus drivers and
conductors (Morris1949 - 53)
• Harvard Alumni Study
(Paffenbarger 1978)
• US Surgeon General (1996)
• WHO (1997, 2002) ACSM
(1998), CMO (2005)
Marcus Cicero, 65 BC, "It is
exercise alone that supports the
spirits, and keeps the mind in
vigour”
Older adults and evidence - 2
• BHFNC Evidence briefing
(2012)
• Summary of what we know
about physical activity and
older adults.
• Based on strong evidence
(research and practice)
• For use with
commissioners, policy
makers and practitioners
• Designed for those who
need to “make the case”
Physical activity and older adults
• BHFNC Evidence briefing
(2012)
• Physical and psychological
outcomes
• Sedentary behaviour and
health outcomes
• Current levels of physical
activity
• Factors affecting
participation
• UK public health guidelines
• Interventions to increase
physical activity
Physical activity evidence – 3
UK wide CMO Physical Activity Recommendations
• For older adults – 1st time
• Headlines
– Accumulating 150 mins per
week (10 min bouts)
– + Strength and balance 2 x
per week
– Decreasing sedentary
behaviour
• NB Very limited
dissemination
Why is strength important?
Balance activities
• Challenge!!!!!!!!
• Standing or
moving about
whilst standing
and …..
• Reduced base of
support
• Movement of
centre of mass
• Reduced holding
Policy direction and drivers for Active Ageing
• Major players
• Government physical
activity policy “on hold?”
• Multiple stakeholders,
everyone’s interest but ….
• Who is responsible?
• Falling between the
cracks without strong
leadership
Physical
activity
Adult and
social
care
Active
Ageing
Sport
Health
Policy direction and drivers for Active Ageing
• Broader view of
stakeholders
• DWP - Concerned with
a wider model of Active
Ageing
• Voluntary sector –
increasing contribution
• Do they see their role
and contribution?
Communities
and Local Govt.
Physical
activity
Adult and
social
care
Employment
Active
Ageing
Sport
Transport
and
planning
Health
Life-long
learning
Policy direction and drivers for Active Ageing
• Broader view of
stakeholders
• Concerned with a wider
model of Active Ageing
• Do they see their role
and contribution?
Older people
Communities
and Local Govt.
Physical
activity
Adult and
social
care
Employment
Active
Ageing
Sport
Transport
and
planning
Health
Life-long
learning
Active Ageing promotion – what works?
Ecological models of health
promotion – multi-level
– Broader (supportive)
environment
– Appropriate programme
design
– Motivation and entry
(Owen. N 1994, Sallis J. 1998 NICE
2007, CDC 2008)
• Components of best practice
www.bhfactive.org.uk
FAAF NWest
13
These levels are inter-related
• Environments - A
neighbourhood/community
where it is safe to walk
• Programmes - Accessible
walking programmes or
opportunities with support
• Motivation - e.g. peer mentors,
GPs, health/social care,
advisors to encourage people
to make a start and support
through change
FAAF NWest
14
Successful interventions
•
•
•
•
•
•
•
•
•
Engage participants at each stage of the process
Educational component
Behaviour change model and intrinsic motivation
Cognitive behavioural strategies (incl. goal
setting and review of progress)
Build self-efficacy
Assessment and negotiation of barriers
Target and tailoring
Access and choice
Support strategies throughout the change process
(NICE 2008,9 BHF NC 2008, 2012)
The older population - not a homogenous group
The Actives - Those who are already active, either
through daily walking, an active job and/or who
are engaging in regular recreational or sporting
activity..
In transition -Those whose function is declining due to low levels
of activity, too much sedentary time, and who may have lost
muscle strength, and/or are overweight but otherwise remain
reasonably healthy.
Frail elderly - Those who are frail or have very low physical or
cognitive function perhaps as a result of chronic disease such
as arthritis, dementia, or very old age itself.
(WHO 1997, DH 2001, 2011)
The Actives - those entering old age • Making activity choices (to
be active and the activity of
their choice)
• Active living, physical activity
or sport?
• To maintain, extend or
change their current
interest(s)
• Demands upon the providers
(leisure, fitness, sport,
dance) - high quality,
appropriate and accessible
• Generation that has
experienced the leisure,
fitness Sport for All boom
(accepted or rejected?)
Actives – the boomers?
• See life differently to previous
older generations
• Singles - living alone is increasing
• Gender differences – Mars and
Venus
• Redefining retirement – WealthBuilders, Leisure Lifers, Anxious
Idealists, Dinkies, Skiers
• Choices to make, eg, new
jobs/careers, active grandparenting, volunteering, caring for
parents, SAGA gap lives
• Will bowls and tea dancing be
sufficient?
This audience – priorities
• Independence, mobility and being
connected in later life
• Changing identities – who am I?
• Major concerns, major illness, entering a
nursing home, fear of dementia - not
dying
• Significant inequalities in health status,
income and quality of life
What do we know- who doesn’t take part?
• Physical activity declines with
age (only 9% men and 7%
women meet CMO recs by 75)
• Men always more active
• Lower amongst
– minority ethnic groups
– Single people
– Lower educational attainment
• But UK trend data reveal 65 –
74 increases
Issues and questions for active ageing
and the workplace
• 3 issues
• Sedentary behaviour in
the workplace
• Long enough? - time to
change
• Clarity - what are we
promoting?
• 3 questions
• How do we combine
best practice in Active
Ageing and
Workplace?
• How do we join up
local agents, policies?
• Evidence - what
outcomes are we
seeking?
The sedentary work environment
Sedentary behaviour
• Sedentary behaviour refers to a group of behaviours
that occur whilst sitting or lying down and that
typically require very low energy expenditure.
• A risk factor for poor health independent of physical
activity
• Consequences - loss of muscle function, mobility and
bone health
• High levels of sedentary behaviour among older adults
• Increasing in workplace
• Alarming levels of sedentary behaviour in residential
and nursing homes and hospitals
Planning - enough time to change?
Adoption weeks
1- 8
• Getting started
• (Initiate physical activity and
participation)
Transition weeks • Learning to be active
• Consolidate behaviour and
9 - 24
achieve (measurable?) outcomes
Maintenance
Beyond 25
weeks
• Active for Life
• Physical activity as a lifetime
habit (measurable outcomes?)
Different stages require different activties (Espelande et al 2007)
24
Active Ageing – clarity what are we promoting?
Activity
Physical
activity
Exercise
Workplace health promotion – best practice
4 recommendations
Public Health Guidance 13
(2008) and 22 (2009)
•
•
•
•
5 recommendations
•
• Workplace health promotion:
how to encourage employees
to be physically active
• Promoting mental wellbeing
through productive and
healthy working conditions:
guidance for employers
Policy and planning
Implementing a programme
Components of the programme
Supporting employer
•
•
•
•
strategic and coordinated
approach to promoting employees’
mental wellbeing
assessing opportunities for
promoting employees’ mental
wellbeing and managing risks
flexible working
the role of line managers
supporting micro, small and
medium sized businesses
Evidence and outcomes
Engaged in life
Purpose, meaning and
occupation
Active Ageing
Activity
Physical
activity
Any bodily
movement
Exercise
Planned
Structured
Repetitive
Philosophy, purpose, skills , outcomes and prejudices
An exciting time for Active Ageing
The 8th World Congress
on Active Ageing
SECC – Glasgow
August 13th – 17th 2012
Will we see you there ?