Strategies for Seniors and Sports

Paul Stonebrook

Health Improvement and PreventionDepartment of Health

Choosing Health? ConsultationGame PlanActivity Co-ordination TeamWanless ReportChoosing Health (ends 30th June)Choosing Activity (ends 30th June)Public Health White Paper - Autumn 04

Game Plan Recommendations Establish a cross government Activity Co-ordination Team (ACT)Identify / co-ordinate existing pilot projectsJointly plan and commission further pilots and establish an innovation fund Facilities databaseNational methodology for collecting participation and fitness data + bi-annual surveysElderly identified as a priority

Activity Co-ordination Team Cross Government Team (13 Departments and Agencies)Jointly led by Health and Culture, Media and SportTo raise mass participation in sport and physical activity, particularly among economically disadvantaged groupsschool leaverswomenolder people

Wanless Report We need annual report about the state of peoples health and of the major determinants - national and local authority levels.Need to know more about the effectiveness and cost effectiveness of interventions.Where there is significant risk to public health go ahead!Spread the message and stop doing things that do not work!

ACT Monitoring Evaluation and ResearchTo provide rigorous evidence of current patterns and trends in physical activity and sport building on current government survey work MONITORINGTo provide rigorous evidence of what works and to move evidence into practice EVALUATIONTo support innovation and information sharing and strengthen the academic research network focusing on physical activity and health - RESEARCH

Monitoring Health Survey for England Adults (1994, 1998 and 2002 CVD)Older people (2000 Separate sample of older people aged 65 + and resident in care homes) Future health survey of older people 2005Objective Fitness MeasuresStep TestFunctional tests in older people

Proportion of older adults who are active enough to benefit their health (participation in at least five occasions of at least 30 minutes of moderate intensity physical activity)

Health Survey for England 1998

Functional tests in older peopleProposalBuild upon links between English Longitudinal Study of Ageing (ELSA) and Health Survey for EnglandShort Performance Battery (Guralnik et al.)Handgrip strength(Measure of life-space mobility)

National Evaluation

Local Exercise Action Pilots (LEAP)Health Development Agency Collaborating CentreHealthy Communities Collaborative National Falls Collaborative

Health Development Agency Collaborating Centre

HDA builds the evidence base and transfers that evidence into practice as the means of achieving health developmentEvidence and Guidance Collaborating Centre for the Promotion of Physical Activity (3 year contract)Maintain HDA Evidence BriefingProduce Effective Action BriefingEvidence not conventionally included in systematic reviews

Health Development Agency Evidence into Practice

Evidence briefings

Practical advice

Change support with individuals/organisations

Evidence from practice

International reviews of research findings

Research gaps

Analysis of practice implications

Dissemination

Appraisal of current practice

Analysis of change needs

Evidence into Practice Cycle

Collaboratives

Healthy Communities CollaborativeNew partnerships to tackle inequalitycitizen-led approachFalls PilotNational Falls Collaborativeservice-led approach

ResearchChief Medical Officers ReportBeneficial effects on cardiovascular disease, type 2 diabetes and obesity Can improve muscle strengthReduces incidence of fallsImproves emotional and mental well beingCan benefit cognitive function

Among 65-74 year olds in England only 17% of men and 125 of women reach the the current physical activity recommendations52% of men and 61% of women are inactiveAmong those aged 75 and above, only 7% of men and 4% of women reach current recommendations 72% of men and 82% of women are inactiveLEAP

North West Pilot - Ashton, Leigh and Wigan

Focus on older people 50 plus

HDA Briefing on evidence:

Interventions designed specifically for the 50+ aged group are effective in producing short term changes and are likely to be effective in producing mid to long term changes also.

Longer term changes in behaviour: behavioural approachestelephone supportcombination of group and home-based exercise

Long term behaviour change:Interventions that promote moderate and non-endurance physical activities, such as flexibility exercisesHDA Briefing on evidence:

Interventions designed specifically for the 50+ aged group are effective in producing short term changes and are likely to be effective in producing mid to long term changes also.

Longer term changes in behaviour: behavioural approachestelephone supportcombination of group and home-based exercise

Long term behaviour change:Interventions that promote moderate and non-endurance physical activities, such as flexibility exercisesHCCP commenced in September 2002

Falls chosen as a topic for piloting - catalyst to focus communities of interestKey element of HCCP is the participation of the community in the scheme, building upon the principles of community developmentThree PCTs, each of which identified 5 ward or neighbourhood teamsEvaluation at 6 months demonstrated a 32% reduction in fallsAs a result funding for a second wave.

Falls collaborative - arose from large number of high quality bids for the Healthy Communities Collaborative pilot

20 sites selected

Collaborative Approach

Expert Design PanelPresent in conjunction with change management methodsDisseminating the learning - successes and failures