1. Healthy and Active Ageing in the Workplace Active Ageing in the UK Bob Laventure - July 2012

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. Why is strength important?

9. Balance activities Challenge!!!!!!!! Standing or moving about whilst standing and ….. Reduced base of support Movement of centre of mass Reduced holding

10. Policy direction and drivers for Active Ageing Major players Government physical activity policy on hold? Multiple stakeholders, everyones interest but …. Who is responsible? Falling between the cracks without strong leadership

11. 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? Transport and planning Life-long learning Employment Communities and Local Govt.

12. 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? Transport and planning Life-long learning Employment Communities and Local Govt. Older people

13. 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 NWest13

14. 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 NWest14

15. 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)

16. 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)

17. 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?)

18. 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?

19. 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

20. What do we know- who doesnt 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

21. 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?

22. The sedentary work environment

23. 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

24. Planning - enough time to change? 24 Different stages require different activties (Espelande et al 2007)

25. Active Ageing – clarity what are we promoting?

26. 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

27. Evidence and outcomes Engaged in lifePurpose, meaning and occupation Any bodily movement Planned Structured Repetitive Philosophy, purpose, skills, outcomes and prejudices

28. An exciting time for Active Ageing The 8 th World Congress on Active Ageing SECC – Glasgow August 13 th – 17 th 2012 Will we see you there ?