SEPACT JUNE 2010SEPACT JUNE 2010

Naturally Active Presentation Naturally Active Presentation Brian WhittakerBrian Whittaker

Naturally ActiveNaturally Active – its inception – its inception

Naturally Active is run by the North West Kent Countryside Partnership who deliver conservation projects for schools, communities and parish and district councils etc.

•Naturally Active jointly developed by North West Kent Countryside Partnership and the West Kent PCT.

•It was conceived in 2005 but not started until 2008!

Naturally Active-Naturally Active- what it delivers what it delivers

•A three-year pilot project funded by the BIG Lottery Programme chances4change.

•Aims to improve people’s health and well-being in Dartford & Gravesham, through healthy activities in the countryside and local green spaces of North West Kent.

•Provides and promotes a range of activities suitable for all ages, abilities and backgrounds

•Activities range from health walks, sports activities, enviro-gyms, tai chi and residential work

•Target 795 beneficiaries over three-year period

Naturally Active-Naturally Active- how it delivers how it delivers

•Project started by creating posters/adverts/flyers which were left in community halls, surgeries etc- low take-up

•Best results through partnership working with organisations who already engage with a group

•These include GP Surgeries/Livingwell Centres, VSU, Diabetes Unit, Mind, Sikh Temple etc.

•Takes a while to get to be known and trusted including presentations & talks

•Once established drop-off rate by participants is minimal

•“Health by stealth”- people come for a fun time that provides much valued social interaction and also provides a health benefit!

Naturally Active-Naturally Active- evidence of need evidence of need

•60% of men and 47% of women in Dartford, Gravesham and Swanley PCT area classified as overweight or obese

•In Dartford life expectancy is more than eight years less for men living in the most deprived areas than least deprived areas

•Within Kent & Medway, least exercise taken in Dartford, Gravesham and Swanley PCT area

•Kent & Medway NHS estimate upto190,000 people with common mental health problems e.g. depression

•2016 - 1,700 extra people with severe mental illness

Naturally Active-Naturally Active- evidence for outdoor evidence for outdoor

1. Strength of evidence of effectiveness

2. Potential impact on health and/or reducing inequalities

3. Cost effectiveness (for NHS and public sector)

4. Balance of risks and benefits

5. Intervention could be easily implemented

NICE 2006 guidelines regarding value of interventions in exercise referral schemes & community-based exercise programmes for walking, cycling to increase physical activity..

Naturally Active-Naturally Active- value of outdoor value of outdoor

•“The landscape should be regarded as functional green infrastructure, recognising the wide range of benefits from healthy recreation to wildlife protection”Thames Gateway Strategic Vision

•“Physical activity can be used effectively to manage and prevent over 20 conditions and diseases”.DH Commissioning Guidelines for Let’s Get Moving

“There is a growing evidence base for the relationship between the environment and physical activity”

South East England Public Health Authority

Facts And Figures.Facts And Figures.

The project has three target outcomes to achieve, The project has three target outcomes to achieve,

these are:these are:

• Improve mental well-being by developing preventative approaches to common mental health problems.

• Encourage those who have most sedentary lifestyles to increase their activity levels.

• Promote increased physical activity in daily life.

• Step 1Step 1: : One-off taster sessions, introducing significant numbers of people to easily try the service

Monitoring: Monitoring: Basic evaluation and data collection..

• Step 2Step 2: : Multi-session activities generating increased engagement and on-going participation.

Monitoring: Monitoring: Pre- and post-activity data collection which includes levels of health and mental wellbeing.

• Step 3Step 3: : Multi session in-depth activities for smaller groups identified with specific needs/referrals.

Monitoring: Monitoring: Higher level of evaluation including professional medical assessment and focus groups.

Three step strategy.Three step strategy.

Results so far….Results so far….

BIG 3 Year Targets

ActualsBIG Target Numbers % Achieved

Step 1 419 645 65%

Step 2 491 130 378%

Step 3 8 20 40%

Total Steps 1-3 918 795 115%

Number of participants who have increased energised scores 59%

Number of participants have increased relaxation scores 46%

Number of participants have increased positivity scores 45%

Step two participant survey. Step two participant survey. (sample size 160)(sample size 160)

Number who found this activity enjoyable as ittook place in countryside. 71%Number who would consider using thecountryside for an activity in future. 75%Number who would not have undertakenactivity if not for Naturally Active. 33%Number who said they had never used greenspace before but say will use in future. 73%

B.H - really enjoyed the walks, it motivated her to visit some of the places again. BP moved from 150/80 – 146/70 and remained stable. She lost 1kg and 2cm from her waist.

K.H – as a couple originally he went to keep B.H company but he really enjoyed the walking. BP improved from 150/80 – 133/82 and remained stable when exercising. He lost 1kg and 3cm from his waist. The couple were very inactive before the walks.

S.C – she enjoyed the walks and found time to go in her busy schedule. Her BP was unchanged, she lost 1kg and an inch from her waist.

Source: Nurse Practitioner for Naturally Active project

Participant feed backParticipant feed back

• Naturally Active proposed by National Social Marketing Centre as one of ten UK Beacon Partnership Projects

•Opportunity and funds to carry out significant primary and secondary research on users/funders/stakeholders.

Aims:

1.Explore opportunities for longer term project sustainability

2.Explore barriers to health commissioning/ professional referral

Research to lead to proposed interventions;Pilot projects with two local authority teams summer 2010

Full report and feedback available Autumn 2010

Beacon Status insightsBeacon Status insights

•Naturally Active well regarded among current stakeholders, provides a needed service to a range of audiences, and generates useful data.

•Project well known at ground level but needs more awareness at strategic/commissioning levels

•Among non-participants physical and emotional barriers to participation, include time, transport & motivation: there was an appetite for activities that were social, fit with busy lives and included transportation

•Non- participants didn’t know why they had not heard of it.

•GPs are time poor and very hard to communicate with – recommendations include ways to make face-to-face contact- using other practice staff/ team slots of ten minutes etc. Danger of no reward/no action!

Beacon Status research findingsBeacon Status research findings

Regular long- term walking groupRegular long- term walking group

The weekly walking group from Temple Hill

Living Well Centre, Dartford

A six-week programme of activities in partnership with a Dartford GP surgery and Charlton Athletic

Oakfield Surgery/Charlton Athletic.Oakfield Surgery/Charlton Athletic.

A variety different health walks with a Men and Women's group.

Asian mental health charity, Re-thinkAsian mental health charity, Re-think

Back To Basics Day.

Out On A Night

Walk!

Clearing The Woods.Setting Up Camp.

Site Maintenance.

Healthy Eating.

Summer residential partnership with VSU and Temple Hill Youth Group, from Dartford.

Residential programmeResidential programme

Christmas & New Year in the snow!

Christmas Pudding walk!

Lullingstone

A very snowy Cobham wood.

Even the weather need not be a barrier to participation!

1.Partnership working invaluable2.Social side is a real incentive3. Monitoring important but sometimes many models and too complex to use on the ground with participants4. Evidence base strong so why so difficult to engage GPs etc?

Concluding thoughts…Concluding thoughts…