Transcript Physical Activity & Cancer Prevention

Physical Activity & Diabetes:
Getting Patients Active
Shirley O’Shea
Senior Health Promotion Officer
Overview
• Evidence of physical activity and type 2
diabetes
• National Physical Activity Guidelines
• Promoting Physical Activity in Primary
Care
• How can patients be supported to become
active?
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Key message
Physical activity is for everyone and any level is better for your health
than none
For adults with disabilities – Aim for guideline or as much as ability allows.
How do we measure physical activity?
• 1. “ I run around after the children all day long,
am always on the go”
• 2. “I have a sedentary job but I cycle 3 times a
week for up to 2 hours”
• 3. “I walk to town at lunch time a few days a
week”
• 4.”I go to the gym twice a week for an hour each
time”
Types of Activity
• 4 major domains for Activity in daily life
• For transport – cycling or walking to work,
school, shops
• At work – manual labour
• At home – housework, DIY, gardening
• Leisure time – sport, exercise &
recreation
What are the
recommendations?
F.I.T.T. Principle
1. How often?
2. How hard?
Frequency
3. How long?
Intensity Moderate Level 60-80% M HR
4. What type?
Time
Most days of the week
30 minutes
Type Select activity that you enjoy & is
convenient e.g. walking or cycling
Moderate Intensity (pbt’s)
Moderate Intensity Physical Activity is
described as a level that causes your:
Beat a little faster
Breathe deeper and faster
(but not out of breath)
Brings a little sweat to your
brow
Evidence
Participation in regular physical activity
• Improves blood glucose
• Prevent or delay Type 2 diabetes
• Positively affecting lipids
• Blood Pressure
• Cardiovascular events
• Mortality & quality of life
Limitation in role of Primary Care
Staff
• 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
Within the practice
Learn about PA
GP/PN develop skills
Practice-specific leaflets
‘Prescription’ forms
Peer counselling
PA specialists for specific groups
Referral/H-P ‘clinics’
Opportunistic practice
Follow-ups and feedback
‘Modelling’ your own PA
Using waiting room time
Receptionists
Longer consultations
REWARDS?
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Get Ireland Active
• The National Physical Activity
Guidelines for Ireland provide clear,
concise and user friendly guidance to
support the public, professionals and
policy makers to Get Ireland Active.
• Website:
– Promoting the guidelines
– Benefits of PA
– Guidelines for children and young people,
adults and older adults, people with
disabilities and weight management.
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
Ref: Public Health Intervention Advisory Committee
NICE Public Intervention Guidance No.2, March 2006
•1 to 2 hours Physical
Activity and Health
•Delivered to on site
practices
•Free of charge
•Useful Resources for
promoting PA in your
practice
PACE Programme – Patient
Assessment & Counselling for
Exercise
•Based on stages of behaviour change
•Provides screening tools
•Appropriate advice and follow up for patients
•Addresses barriers, motivation, goal setting
•Ideal following Brief Intervention training
Provides a safe pathway for people with
various health
conditions to get them physically active, their
way, everyday.
You Recommend
• GP Refers
• Patient Meets Local Coordinator
• The patient then begins a twelve week physical
activity programme
• Health professional handbook
[email protected]
Patient
Request
(website, publicity,
word-of-mouth)
GP Recommend Health Prof.
Recommend
(brief intervention)
GP-Patient Consultation
Referral Form received
by Local Coordinator
Local Events
(health walks,
cycle days)
Ongoing Support
Initial Assessment
(telephone, email,
website, facility staff)
Workshops
(healthy eating,
smoking cessation,
stress management)
Mid-way Assessment
Final Assessment
Signposting
(condition-specific
pathways, local
support networks)
Exit, 6, 12 & 24 Month
Follow-up & Aftercare
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Inclusion & Exclusion Criteria
Patients must be
Exclusion Criteria
 currently sedentary
× Cardiac Conditions
 over 18 years of age
× Uncontrolled conditions
 interested in becoming
more physically active
A fully detailed criteria list is available in the
Health Professionals Handbook
Walking
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Walking for Health Workshops
IHF Walking Leaders Training
Community Walking Groups
Meet n’Mingle Walks
Walking Leaders Refresher Training
• Trail Walking Workshop
• IHF Walking Leaders Training 2
HPD Training Calendar
• Physical Activity in Primary Care (2hrs)
• PACE- Patient –Centred Assessment &
Counselling for Exercise (3 hrs)
• Promoting The National Physical Activity
Guidelines for Ireland “Get Ireland Active”
(2hrs)
• Obesity: A Health Promotion Perspective
(1 day)
• Supporting Change: Skills for Health
(formerly Brief Interventions) (2 days)
Research…..
• Prevention of type 2 diabetes mellitus by changes in
lifestyle among subjects with impaired glucose tolerance.
N Engl J Med
• Physical Activity, cardiovascular risk factors and mortality
among Finnish adults with diabetes
• Diabetes and Physical Activity: Joint position statement
of Diabetes Australia on the role of PA and risk reduction
of and management of diabetes
• A RCT of resistance exercise training to improve
glycemic control in older adults with diabetes
Further support and info
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Email - [email protected]
Tel: - 021 4921643
www.healthpromotion.ie
www.gpexercisereferral.ie
www.getirelandactive.ie