healthy and active ageing in the workplace active ageing in the uk bob laventure - july 2012
TRANSCRIPT
Healthy and Active Ageing in the Workplace
Active Ageing in the UKBob Laventure - July 2012
Role of the BHF NCTo 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
Active Ageing
Physical activity
Health
Sport
Adult and social care
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?
Active Ageing
Physical activity
Health
Sport
Adult and social care
Transport and planning
Life-long learning
Employment
Communities and Local Govt.
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?
Active Ageing
Physical activity
Health
Sport
Adult and social care
Transport and planning
Life-long learning
Employment
Communities and Local Govt.
Older people
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 practicewww.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 – Wealth-
Builders, Leisure Lifers, Anxious Idealists, Dinkies, Skiers
• Choices to make, eg, new jobs/careers, active grand-parenting, 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?
• Getting started• (Initiate physical activity and
participation)
Adoption weeks 1- 8
• Learning to be active• Consolidate behaviour and
achieve (measurable?) outcomes
Transition weeks 9 - 24
• Active for Life• Physical activity as a lifetime
habit (measurable outcomes?)
Maintenance
Beyond 25 weeks
24
Different stages require different activties (Espelande et al 2007)
Active Ageing – clarity what are we promoting?
Activity Physical activity
Exercise
Workplace health promotion – best practice
Public Health Guidance 13 (2008) and 22 (2009)
• Workplace health promotion: how to encourage employees to be physically active
• Promoting mental wellbeing through productive and healthy working conditions: guidance for employers
4 recommendations• Policy and planning• Implementing a programme• Components of the programme• Supporting employer
5 recommendations• 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
Active Ageing
Activity
Physical activity
Exercise
Engaged in life Purpose, meaning and occupation
Any bodily movement Planned
Structured Repetitive
Philosophy, purpose, skills , outcomes and prejudices
An exciting time for Active Ageing
The 8th World Congress on Active AgeingSECC – Glasgow
August 13th – 17th 2012Will we see you there ?