We hope our latest edition of Health Matters – on the subject of getting every adult active every day – will help you and other health professionals by compiling key facts, figures and evidence of effective interventions.
Where we can, we’re also committed to answering your questions and taking on your feedback. In this blog we’ve published the answers to a number of Health Matters adult physical activity questions we received from professionals across the UK at the launch teleconference (podcast available here).
We’d love to hear from you at firstname.lastname@example.org.
Question 1 (Liaison with Centres of Excellence)
Have you discussed these physical activity recommendations with two of the leading centres of excellence in the country, in Leeds and in Loughborough?
We work closely with the National Centre for Sports and Exercise Medicine, which is a partnership between Loughborough, Sheffield and the Institute for Sport and Exercise Health at University College London Hospital. The National Centre forms the hub for all academics in the country who are involved in research and building the evidence base about what works in terms of physical activity and how we support people to become more active.
As we referred to in some of the background documents, we published ‘Everybody Active Every Day’ a couple of years ago, which set out a national framework for how we move adults to become more active and colleagues from the centres you mention were involved in commenting and helping to shape that to make sure that the policy suggestions we were making were based very much on the evidence and the best of the research we have, not only in this country but also abroad. I hope that reassures you that those academics are very much involved in shaping our thinking and informing it, as are many practitioners in the field who have been giving us their feedback both from local government and from sports, leisure and fitness providers about the reality of turning evidence into practice.
Question 2 (Identifying inactive groups)
Where can I find data on an LSOA (lower layer super output areas) level to find out where we can target our initiatives?
The information on where the inactive population is based comes through the survey Public Health England and Sport England do called Active People and is presented in the public health outcomes framework; it will soon become the Active Lives survey. It’s not presented at super output area so that very small street level area can be seen, but we are getting better data now at ward level within local authorities.
Many local authorities have been working with us over the last year as we have been doing work around evaluation and data collection, to help people access data better. We have just published a blog about tools that people can use to understand better, at local level, their levels of physical activity. It doesn’t just direct people to the tools in terms of knowing what your local statistics are in terms of the number of people who are inactive and the number of people who are achieving the Chief Medical Officers’ guidance, it also highlights tools that show you how you can plan and make the case. It includes really good guidance on online return on investment tools. There’s a link to the tools in the toolkit blog.
Question 3 (Strategies for physical activity)
Does the national PHE team see the Sport England strategy as the main national strategy for physical activity or are we to expect another strategy from the Department of Health or from PHE?
Sport England’s ‘Towards an Active Nation’, the government’s Sporting Future strategy, the forthcoming childhood obesity strategy, and the Walking and Cycling Infrastructure Investment Strategy (forthcoming from the Department for Transport) will fit together as a kind of jigsaw across different government policies.
We know from the engagement that we did around ‘Everybody Active Every Day’, particularly at a local level, that people want joined-up government and that no single departmental strategy was going to give the societal shift that we need to make the nation active every day. So the overarching spread of strategies and the jigsaw as they fit together will help the local system.
The Sports Strategy was critically important, in that it signalled a really powerful shift in moving from just sport to a focus on physical activity, and that’s a reflection of that joining up across government. We really just want everyone to be moving more, more often, and that across government it is seen as a cross - government objective; so we are producing policy and frameworks that connect the dots.
Question 4 (Role of community groups)
On your Call to Action slide, I wanted to know how specific you are intending the assignment of the roles you have indicated to be. Some roles are clear whereas others are a little unclear, eg community groups and parks and green spaces. My experience of community groups is that they can work across the whole spectrum of physical activity.
The call to action slide depicts just a sample of some of the key roles that different stakeholders can take. Please look at the ‘Everybody Active Every Day’ framework and the accompanying evidence guide, which provides more detail. These are more specific about the range of opportunities for actions that each of the stakeholder groups have. Community groups in particular are critical. We know from international evidence the importance of grassroots in getting individuals, families and communities to shift the culture and get people more active.
Question 5 (Getting the working age population more active within the workplace)
I am interested in how we can get the working age population more active within the workplace. What initiatives are considered nationally to be more effective to implement this and is there any available data? What can we do to speed up and monitor culture change in office space utilisation?
In terms of what employers and workplaces can do, the evidence base is emerging very quickly. We know that there is reasonable evidence around changing the attractiveness of staircases so that people don’t automatically get into the lift as the staircase is more interesting and engaging. We have seen large companies changing the way they design their office space to create more landings and more inviting staircases, as they value those staircase conversations that spark innovation and new ideas.
There are other things like pooling printers and bins so that people get up from their desks and break up long periods of sitting. There are some companies that are using walking meetings and standing desks to change the environment, and change the culture towards physical activity. In the recent CQUIN (Commissioning for Quality and Innovation) guidance about quality improvement in NHS workforce health and wellbeing, a key part is around physical activity amongst NHS staff.
We will be producing some resources over the summer with NHS England to support hospitals in looking at how they can do that effectively. We have also been talking to trusts across the country, seeing some of the innovations such as taster sessions on-site of different types of physical activity, discounts available for NHS staff (eg for gym and leisure providers) and reaching out to the County Sports Partnerships to understand what the local physical activity offers are. What’s really interesting from a national level, is that so many of the national governing bodies for sport and leisure and fitness providers desperately want to talk to employers. They’ve got opportunities to be physically active where they don’t feel they are getting enough people through the door and actually employers can help that conversation and help the connection. The County Sports Partnerships are really key to that
Question 6 (Role of leaders in supporting physical activity at the workplace)
What can leaders in the workplace do to build the culture of physical activity?
One of the important things we know about workplace health is how crucial leadership is. You have got to practise what you preach from the top and it’s got to be through every level of line management. It’s not just about paying lip service, it’s about enabling line managers to have conversations about staff health and wellbeing: understanding what the volunteering policy, so that if someone wants to be a community sports coach for their child’s football league it’s okay or have flexible working arrangements to take an extended lunchtime to go to a sports centre.
They should know what their active travel policy is, such as the cycle to work scheme. Then there are activities like the county sports partnerships’ workplace challenge where you can form teams within your organisation and leadership is a key part of that.
Within PHE we have really encouraged national executive members to form their own team and to outstep the rest of us in the Challenge for Rio at the moment. It is important that we enable those managers to support their conversations with staff about getting more active every day. We are seeing the culture change gradually, with more and more business organisations interested in promoting the health and wellbeing of employees.
Question 7 (Physical activity in the over 60s)
Are there any plans for PHE to do insight and social marketing work with inactive people? I’m particularly thinking about the 60+ age group, how we communicate with them, the words we use. Will there be any resources available for local authorities?
We are looking at physical activity insight work as part of our work to support the One You campaign, which is focused on 40-60 year olds, but has resonance with the over 60s as well. We also know that a lot of the national governing bodies and also Sport England have been doing insight research as well. The Sports Strategy committed PHE to work more closely with Sport England on sharing social marketing research and insights. Those conversations have started and we hope that later in the year we will be able to share some of that insight research. Also that you will start to see new products and resources coming through One You to promote physical activity for adults. We are also keen to link across partners like Age UK and others to mobilise for older adults because at every age, being active every day is important – up until the end of your life it can make a difference.
Question 8 (Investing resources into physical activity)
What is the status of investment in increasing physical activity in light of reducing public health spend that I read about in the newspapers?
You raise a very important point. In these challenging times we need to do things differently. Are there strategic partnerships that we can bring to the table that will bring in new resources? Many local authorities across the country are doing partnerships with businesses, with the leisure industry, with voluntary sector organisations, to build the human resource capability as well - as the financial resource capacity - that can be invested in physical activity.
We need to think also about other assets that we have in the community that can be leveraged at much lower cost, such as the power and enthusiasm of community organisations and groups, using the built environment and green spaces we have - or if you are by the sea blue spaces - to think about we can work in partnership with communities. From our perspective it is recognising both the reality of the financial constraints but also about local authorities changing their business models and thinking differently about how to achieve the outcomes that we want.
Question 9 (Protecting resources in local authorities)
What is PHE doing at national level to try to protect what resources exist in local authorities around sport. Is PHE talking to local authorities at a national level on this subject?
We are certainly talking with the Local Government Association to understand what’s happening on the ground, both in terms of public health funding and also about leisure, culture and recreational funding. In local authorities across the country we are seeing real innovation bridging funding across silos.
Changing conversations so that we are demonstrating that doing things like active travel not only promote the health of individuals, but also the health of communities and - because there’s some evidence that people who cycle locally also shop locally- , that keeps high streets alive and local communities alive.
So the challenge is how we change the conversation so that this is not siloed funding; there are joined up solutions with pooled funding to find sustainable solutions. We are also seeing more public-private partnerships and initiatives where people are looking for ethical partners to join with to support community initiatives.
Question 10 (Role of volunteering)
How do you see volunteers as facilitators in supporting inactive people becoming more active?
Sport and physical activity is the sector where we have the most volunteers. Walking for Health is an excellent example of this, and we know that volunteers are from their community and so know their community better than anyone. They know their community needs and their community assets, and can represent their communities. It’s important that they are engaged both in terms of delivery of services, but also in representation during planning of services.
PHE is working with the Department of Culture, Media and Sport and other partners around the skills escalator within the sports industry and how we can skill up more volunteers. PHE is also working with charities like the Richmond Group and the British Heart Foundation and Macmillan, who have a lot of volunteers to see how we can skill up those people to help with physical activity. Later this year and early next year you will see more skill development resources coming through from a range of partners, either working with us or independently, to promote the physical activity conversations that we need to have.
Question 11 (Use of smartphones to support physical activity)
How do we utilise the technology that people are wearing nowadays to see if we can get good local data to help evaluate the impact of programmes and can you facilitate conversations nationally with the manufacturers?
They are mostly commercial providers so that one challenge is getting them to hand over their data. As we have seen with the immense growth of Pokémon Go, which we have blogged about, there is really valuable data.
The good news is that through One You and Change4Life, we are increasingly able to direct gathered information back to local areas. An important point is that anyone who is carrying a smartphone is carrying a pedometer now – almost all the phones now have an accelerometer that can measure our steps and apps that can nudge us into physical activity. How can we persuade people to use them more effectively to nudge them into increased physical activity?
Question 12 (Muscle strengthening activity)
Do you have specific recommendations regarding what muscle strengthening activities can be employed?
Muscle strengthening activities are regarding on two days per week for adults and we know that you only need about 12-14 repetitions to build up muscle strength on each occasion, so that’s why the recommendations are not very prescriptive. Anything that puts weight regularly onto your muscles and bones, and you are doing such activities on two days per week should be sufficient.
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