“someone like me !” training senior peer mentors to promote physical activity

““Someone Like Me !”Someone Like Me !”

Training Senior Peer Training Senior Peer Mentors to Promote Mentors to Promote

Physical ActivityPhysical Activity

Presentation overviewPresentation overview

1.1. What is Senior Peer Health What is Senior Peer Health Mentoring ?Mentoring ?

2.2. Why physical activity ?Why physical activity ?3.3. Planning a local programmePlanning a local programme4.4. Training and supporting mentorsTraining and supporting mentors5.5. Does it work ?Does it work ?6.6. National development and National development and

supportsupport

““Someone Like Me !”Someone Like Me !”

1. What is Senior Peer 1. What is Senior Peer Health Mentoring ?Health Mentoring ?

What is Senior Peer Health Mentoring?What is Senior Peer Health Mentoring?

A programme to provide support & A programme to provide support & encouragement to either groups or encouragement to either groups or individuals.individuals.

Encouragement for older people to Encouragement for older people to make their own decisions about the make their own decisions about the enhancement of the quality of their enhancement of the quality of their liveslives

Uses older people who are trained to Uses older people who are trained to carry out their taskcarry out their task

What it is not!What it is not!

A replacement for professional A replacement for professional servicesservices

An answer to everythingAn answer to everything A counselling serviceA counselling service A cheap or quick optionA cheap or quick option A programme to train exercise A programme to train exercise

leaders or teachersleaders or teachers

Why use Seniors as Peer Mentors?Why use Seniors as Peer Mentors?

They :-They :- Have similar experiences in life and Have similar experiences in life and

are empatheticare empathetic Have time to investHave time to invest Have an interestHave an interest Are reliable, trained and skilledAre reliable, trained and skilled Want to help and contributeWant to help and contribute Are an untapped resourceAre an untapped resource

Is this something new?Is this something new?

No – Senior Peer Mentors have been No – Senior Peer Mentors have been around for a very long timearound for a very long time

Idea developed from original work Idea developed from original work from USAfrom USA

Growing field of work in UKGrowing field of work in UK Not just used by voluntary sector, Not just used by voluntary sector,

although it began therealthough it began there

Early experiences and learningEarly experiences and learning

Age Concern began using the concept in Age Concern began using the concept in 19931993

Training and “tooling up” of primary Training and “tooling up” of primary importanceimportance

Support structure needs to be in place Support structure needs to be in place Much underused resourceMuch underused resource Complimentary to professional servicesComplimentary to professional services Reaches the parts others do notReaches the parts others do not Can provide excellent partnership Can provide excellent partnership

opportunitiesopportunities

Engaging older people in Engaging older people in health promotion health promotion

They’ve been there, read the book, They’ve been there, read the book, got the T shirtgot the T shirt

They can help interpret the messageThey can help interpret the message They can lead by exampleThey can lead by example They can take time out to explainThey can take time out to explain They can share common concerns They can share common concerns

and identify solutionsand identify solutions

What do they do?What do they do?

Point other older people in the right Point other older people in the right directiondirection

Are a positive role modelAre a positive role model Share informationShare information Provide a listening earProvide a listening ear Understand concerns and may have Understand concerns and may have

the same point of viewthe same point of view

What they don’t doWhat they don’t do

Give medical advice or replace the Give medical advice or replace the professionalprofessional

MakeMake people healthy by making people healthy by making decisions for othersdecisions for others

Provide counsellingProvide counselling Teach or lead exercise classes Teach or lead exercise classes

Early development workEarly development work

BHF NC and Ageing Well BHF NC and Ageing Well partnershippartnership

Joint planning and development Joint planning and development since 2001since 2001

Development of training resource Development of training resource and supporting materialsand supporting materials

Cascade model adopted – Spring Cascade model adopted – Spring 20022002

Learning from practiceLearning from practice Development and support networkDevelopment and support network

Early development workEarly development work

What did we learn ?What did we learn ? Lack of Lack of understandingunderstanding about about

targeting and targeting and recruitment recruitment of of mentorsmentors

Lack of Lack of strategic supportstrategic support and and development from providersdevelopment from providers

Potential for Potential for variedvaried role of mentors role of mentors VariedVaried models of models of evaluationevaluation

ComplimentingComplimenting and supporting other services and supporting other services and Interventions with older peopleand Interventions with older people

Primary Health Primary Health CareCare

GP’s an GP’s an authoritative sourceauthoritative source

Medical modelMedical model

Senior Peer Senior Peer MentoringMentoring

Listening to Someone Listening to Someone Like Me !Like Me !

Meets a range of Meets a range of needsneeds

Other health and care professionals e.g. those undertaking home visits, those in residential and

hospital settings

may lack time, skills, not experienced in physical activity

““Someone Like Me “ !Someone Like Me “ !

2. Why physical activity ?2. Why physical activity ?

Evidence based practice Evidence based practice is on our sideis on our side

Physical activity related to :-Physical activity related to :- Range of benefits for the older Range of benefits for the older

personperson Outcomes and effectivenessOutcomes and effectiveness Levels of inactivity and functional Levels of inactivity and functional

abilityability Understanding the processUnderstanding the process

Benefits of physical activityBenefits of physical activity

Physical, psychological and socialPhysical, psychological and social Disease preventionDisease prevention Disease managementDisease management Complications of immobilityComplications of immobility Independence and quality of life Independence and quality of life

Evidence of outcomesEvidence of outcomes

Adherence (King et al 1998)Adherence (King et al 1998) Community, group and home (JAPA Community, group and home (JAPA

2001)2001) Functional capacity (BHF 2003) Functional capacity (BHF 2003) CHAMPS (1997 – 2000)CHAMPS (1997 – 2000) Short and long term benefitsShort and long term benefits

Evidence of inactivityEvidence of inactivity

All measures, including sports, All measures, including sports, walking and exercisewalking and exercise

Decrease in “Half an Hour a Day” Decrease in “Half an Hour a Day” national recommendationsnational recommendations

Decline in strength and flexibilityDecline in strength and flexibility Significant increase in sedentary Significant increase in sedentary

behaviour in residential settings and behaviour in residential settings and nursing homesnursing homes

Older people in care and Older people in care and residential settingsresidential settings

86% of women and 78% of men in care 86% of women and 78% of men in care homes are inactivehomes are inactive

Inactivity levels in care homes are Inactivity levels in care homes are double those in private households (65 double those in private households (65 and over)and over)

Half of all men and women in Local Half of all men and women in Local Authority residential homes never or Authority residential homes never or very occasionally take trips outside the very occasionally take trips outside the homehome

(Health Survey for England 2000)

Evidence is not on our side !Evidence is not on our side !a resistant group ?a resistant group ?

Intrinsic barriers Intrinsic barriers (Beliefs, attitudes, (Beliefs, attitudes, perceptions)perceptions)

Lack of confidence “no-Lack of confidence “no-one to go with”one to go with”

Perception of what it is Perception of what it is to be to be activeactive

Possible dangers of Possible dangers of “overdoing” it“overdoing” it

““I’m not fit enough”I’m not fit enough” ““It’s too late for me !”It’s too late for me !”(HEA 1997)(HEA 1997)

Extrinsic environmental Extrinsic environmental barriersbarriers

Safe, reliable and Safe, reliable and accessible transportaccessible transport

Confidence in using public Confidence in using public places, e.g. parks, places, e.g. parks, footpaths, footpaths,

Access to appropriate Access to appropriate facilities and services facilities and services

Attitudes of others Attitudes of others especially GPs, health especially GPs, health Professionals and peersProfessionals and peers

Evidence for advice and counselling Evidence for advice and counselling approaches with older peopleapproaches with older people

Physical activity Physical activity advice/counselling can increase advice/counselling can increase physical activity physical activity

King et al (1995)King et al (1995) Stewart et al (1997)Stewart et al (1997)

Riddoch (1998)Riddoch (1998) Eakin (2001)Eakin (2001)

Distillation of practice - 1.Distillation of practice - 1.

Recommendations.Recommendations. Use of a “Health Educator” and an Use of a “Health Educator” and an

extended counselling/consultation timeextended counselling/consultation time Assessment of problem area(s)Assessment of problem area(s) Recognition of readiness to changeRecognition of readiness to change Goals agreed by both patient and Goals agreed by both patient and

professionalprofessional Identification and recognition of social and Identification and recognition of social and

environmental barriers (environmental barriers (BHF NC 2003)BHF NC 2003)

Distillation of practice – 2. Distillation of practice – 2.

Recommendations (cont)Recommendations (cont) Tailored action plan (specifies Tailored action plan (specifies

activity)activity) A choice (range) of accessible local A choice (range) of accessible local

opportunities including lifestyle opportunities including lifestyle activitiesactivities

Supplementary educational materialsSupplementary educational materials Systematic follow up and support Systematic follow up and support

over a period of time over a period of time (BHF 2003)(BHF 2003)


3. Planning a local 3. Planning a local programmeprogramme

10 steps to planning a programme10 steps to planning a programme1.1. Establish aims Establish aims

and objectivesand objectives2.2. Identifying the Identifying the

target grouptarget group3.3. RecruitmentRecruitment4.4. Induction and Induction and

trainingtraining5.5. Matching Matching

mentors and mentors and menteesmentees

6.6. Targets, Targets, standards and standards and goalsgoals

7.7. Administration Administration and supportand support

8. Feedback and 8. Feedback and supportsupport

9. Monitoring 9. Monitoring progressprogress

10. Evaluation 10. Evaluation (NMN 2002)(NMN 2002)

The phases of planning a local The phases of planning a local programmeprogramme

Phase 1.

Planning

Strategic fit

and

partnership

development TargetingRecruitmentInduction

Phase 2.

Course delivery

Training activities and evaluation

Phase 3.

Implementation

MatchingTargets and standards Administration andsupportMonitoring andevaluation

Lessons for programme planningLessons for programme planning

Clarity for all concerned concerning the Clarity for all concerned concerning the role role of a Senior Peer Physical Activity of a Senior Peer Physical Activity MotivatorMotivator

Strategic link to Strategic link to mainstream policiesmainstream policies for for successful and healthy ageingsuccessful and healthy ageing

Engage older peopleEngage older people in all aspects of in all aspects of programme planning, delivery and evaluation programme planning, delivery and evaluation to maximise their skills and experiencesto maximise their skills and experiences

Audit all localAudit all local experience, skills, experience, skills, opportunities and players opportunities and players (BHF NC 2003)(BHF NC 2003)

Lessons on allocation of resourcesLessons on allocation of resources Human resourcesHuman resources must include must include a a

combination ofcombination of training, health promotion, training, health promotion, older people, volunteering and physical older people, volunteering and physical activityactivity

Roles and functionsRoles and functions must include must include programme co-ordination, education and programme co-ordination, education and training, support for mentors and evaluationtraining, support for mentors and evaluation

Financial resourcesFinancial resources must include training must include training activities, educational materials and activities, educational materials and expenses to cover volunteering activityexpenses to cover volunteering activity

12 months is a 12 months is a minimum timeminimum time for impact for impact of a local programme of a local programme (BHF NC 2003)(BHF NC 2003)

Lessons on working with volunteersLessons on working with volunteers

Support work through local volunteering Support work through local volunteering policies, strategies and networkspolicies, strategies and networks

Be clear as to the Be clear as to the valuesvalues as well as the as well as the potential and limitationspotential and limitations of volunteers of volunteers

Ensure that volunteers are Ensure that volunteers are adequately adequately covered and preparedcovered and prepared for the tasks for the tasks that they are expected to undertake that they are expected to undertake (ACE (ACE 2003)2003)

Evaluating programmes - 1Evaluating programmes - 1

Evaluation of programmes must be Evaluation of programmes must be agreedagreed by all partnersby all partners at the planning at the planning stagestage

Evaluation must Evaluation must meet the needs of allmeet the needs of all those involvedthose involved,, including stakeholders, including stakeholders, partners, mentors and mentees.partners, mentors and mentees.

Negotiation of evaluation with mentors Negotiation of evaluation with mentors and participantsand participants

Identify the Identify the different outcomesdifferent outcomes that may that may be required.be required.

Evaluating programmes - 2Evaluating programmes - 2

Changes in Changes in knowledge andknowledge and understandingunderstanding among mentors (and among mentors (and levels of physical activitylevels of physical activity

Mentoring activityMentoring activity (reach and (reach and frequency)frequency)

Impact of mentoringImpact of mentoring (intention to (intention to become active, frequency and type of become active, frequency and type of activity behaviour)activity behaviour)

Evaluation of Evaluation of partnershippartnership


4. Training and 4. Training and supporting mentorssupporting mentors

The Senior Peer Mentor Physical Activity Motivator The Senior Peer Mentor Physical Activity Motivator course has been designed to be:course has been designed to be:

ParticipatoryParticipatory – most activities are designed for use in – most activities are designed for use in paired work which most closely reflects the style of paired work which most closely reflects the style of mentoring to be employed by Senior Peer mentorsmentoring to be employed by Senior Peer mentors

EducationalEducational – there are occasions when information needs – there are occasions when information needs to be shared that may well be new to participantsto be shared that may well be new to participants

PracticalPractical – it is based upon developing listening and other – it is based upon developing listening and other mentoring skills that can be used in the Senior Peer mentoring skills that can be used in the Senior Peer Mentoring processMentoring process

ExperientialExperiential – it is based upon participant’s own – it is based upon participant’s own experiences of physical activityexperiences of physical activity

MotivationalMotivational – the listening, talking and mentoring – the listening, talking and mentoring process empowers the mentee to make a decision about his process empowers the mentee to make a decision about his or her own lifestyle and take up physical activity.or her own lifestyle and take up physical activity.

Senior Peer Mentoring Senior Peer Mentoring Course structureCourse structure

1.1. An introduction to the Senior Peer An introduction to the Senior Peer Mentor Physical Activity Motivator Mentor Physical Activity Motivator Course – Course – What is it ?What is it ?

2.2. Motivating others – Motivating others – listening andlistening and talkingtalking

3.3. Physical Activity “Matters” Physical Activity “Matters” - - knowledge and understandingknowledge and understanding

4.4. The next steps – The next steps – taking actiontaking action

Session 1 Learning Session 1 Learning objectivesobjectives

By the end of the session, participants should be By the end of the session, participants should be able to:-able to:-

Describe the rationale for the Senior Peer Mentor Describe the rationale for the Senior Peer Mentor approach to promoting physical activity.approach to promoting physical activity.

List the skills of a good Senior Peer Mentor.List the skills of a good Senior Peer Mentor.

Describe the lifetime model of physical activityDescribe the lifetime model of physical activity

Describe their own life-time experience of physical Describe their own life-time experience of physical

activityactivity

Session 2 Learning objectivesSession 2 Learning objectives


Understand how to motivate othersUnderstand how to motivate others

Understand ways of helping othersUnderstand ways of helping others

Demonstrate how to talk and listen to others about Demonstrate how to talk and listen to others about

physical activityphysical activity



List the benefits of physical activityList the benefits of physical activity

List the consequences of being inactiveList the consequences of being inactive

Identify choices and opportunities to being activeIdentify choices and opportunities to being active

Identify information and ideas about being physically Identify information and ideas about being physically

active.active.


By the end of the session participants should be able By the end of the session participants should be able to:-to:-

Describe strategies to initiate physical activityDescribe strategies to initiate physical activity

Demonstrate a posture checkDemonstrate a posture check

Identify next actions for initiating personal peer Identify next actions for initiating personal peer mentoring activitymentoring activity

Additional trainingAdditional training

Supplement and customise to local Supplement and customise to local needs e.g.needs e.g.

Visiting local opportunities and Visiting local opportunities and venuesvenues

Taking part in activities e.g. walking Taking part in activities e.g. walking or exercise classor exercise class

Visiting local expert speakersVisiting local expert speakers

Supporting mentorsSupporting mentors

Build support strategies into Build support strategies into initial initial programme planningprogramme planning

Strategies need to be Strategies need to be clear, pro-clear, pro-activeactive as well as as well as responsive responsive and and include additional education and include additional education and training needstraining needs

Ensure a Ensure a balancebalance between between appropriate supportappropriate support and guidance and guidance and and dependency dependency (BHF NC 2003)(BHF NC 2003)

Providing support for MentorsProviding support for Mentors

One to one meetingsOne to one meetings Initial briefing Training

Support pack

Ongoing support: telephone (Monday - Friday)access to weekly drop inexpensesactivity passsupervisory sessions

Support Group: newslettersharing opportunitiestraining programmesworkshop opportunitiesinformation/advicequarterly meetings


5. National development 5. National development and supportand support

““Someone Like Me !”National Someone Like Me !”National DevelopmentDevelopment

Partnership between BHF National Partnership between BHF National Centre and Age Concern – Ageing Centre and Age Concern – Ageing Well (2000)Well (2000)

Supported by Department of Health Supported by Department of Health and Department for Education and and Department for Education and Skills (2001 – 3)Skills (2001 – 3)

Training delivered by Later Life Training delivered by Later Life Training Ltd, a national training Training Ltd, a national training providerprovider

Continued developmentContinued development

Ongoing programme of training and Ongoing programme of training and development coursesdevelopment courses

Customising local programmes Customising local programmes through local bespoke trainingthrough local bespoke training

Support through electronic network Support through electronic network and updates at and updates at www.bhfactive.org.ukwww.bhfactive.org.uk

Continuing work on impact Continuing work on impact assessment and evaluationassessment and evaluation


Exploring new mentoring rolesExploring new mentoring roles Physical activity Physical activity mentorsmentors Physical activity Physical activity buddiesbuddies Physical activity Physical activity ambassadorsambassadors


Exploring new mentoring Exploring new mentoring scenarios e.g .scenarios e.g .

CHD and diabetes patientsCHD and diabetes patients Buddying within exercise referral Buddying within exercise referral

schemesschemes Working within falls prevention Working within falls prevention

programmesprogrammes

Support for trainingSupport for training

Cascade courses for local Cascade courses for local professionalsprofessionals

Course manual and materialsCourse manual and materials Support materials for mentorsSupport materials for mentors Practice guide published 2003Practice guide published 2003 Dedicated pages and documentation Dedicated pages and documentation

at at www.bhfactive.org.ukwww.bhfactive.org.uk

Physical Activity Motivators - CommentsPhysical Activity Motivators - Comments

““I don’t know what I used to do with my time I don’t know what I used to do with my time before I became a PAM”before I became a PAM”

“Exercise is like money in the bank, it will pay you back with interest”

“It’s a lovely feeling to be able to put something back into the community”

“I never thought I had the confidence to speak to one person I didn’t know, never mind a small group”

“My daughter can’t believe how much I now know about physical activity”

“The T-shirt and the handbook are great I don’t think I’ve ever felt so important”

““I was a little apprehensive at first but was I was a little apprehensive at first but was supported by the project team and other mentors - supported by the project team and other mentors -

now my confidence has improved tremendously now my confidence has improved tremendously but it is nice to have that support network as/when but it is nice to have that support network as/when

I need it”I need it”

Physical Activity Motivators - Comments (Cont.)

“I feel that because of age and personal experiences PAMs have a sympathetic and extremely encouraging

approach”

“As a mentor I can encourage others to have a healthier lifestyle, just as I was encouraged and supported

by the project team”

“I feel I have contributed to society being a mentor - it’s the best thing I’ve ever done”

““Someone Like Me !”Someone Like Me !”Programme planningProgramme planning

Next steps –Next steps –

Where do we Where do we go from here ? go from here ?

“someone like me !” training senior peer mentors to promote physical activity

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