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

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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

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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 ?