Physical Activity & Diabetes: Getting Patients Active Shirley O’Shea Senior Health Promotion...
Transcript of Physical Activity & Diabetes: Getting Patients Active Shirley O’Shea Senior Health Promotion...
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Physical Activity & Diabetes: Getting Patients Active
Shirley O’Shea
Senior Health Promotion Officer
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Overview
• Evidence of physical activity and type 2 diabetes
• National Physical Activity Guidelines
• Promoting Physical Activity in Primary Care
• How can patients be supported to become active?
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Key message
Physical activity is for everyone and any level is better for your health than none
For adults with disabilities – Aim for guideline or as much as ability allows.
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How do we measure physical activity?
• 1. “ I run around after the children all day long, am always on the go”
• 2. “I have a sedentary job but I cycle 3 times a week for up to 2 hours”
• 3. “I walk to town at lunch time a few days a week”
• 4.”I go to the gym twice a week for an hour each time”
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Types of Activity
• 4 major domains for Activity in daily life
• For transport – cycling or walking to work, school, shops
• At work – manual labour
• At home – housework, DIY, gardening
• Leisure time – sport, exercise & recreation
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What are the recommendations?
1. How often?
2. How hard?
3. How long?
4. What type?
Frequency Most days of the week
Intensity Moderate Level 60-80% M HR
Time 30 minutes
Type Select activity that you enjoy & is convenient e.g. walking or cycling
F.I.T.T. Principle
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Moderate Intensity (pbt’s)
Moderate Intensity Physical Activity is
described as a level that causes your:
Beat a little faster
Breathe deeper and faster (but not out of breath)
Brings a little sweat to your brow
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Evidence
Participation in regular physical activity
• Improves blood glucose
• Prevent or delay Type 2 diabetes
• Positively affecting lipids
• Blood Pressure
• Cardiovascular events
• Mortality & quality of life
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Limitation in role of Primary Care Staff
• Your own level of exercise• Knowledge of current messages on physical
activity• Lack of time in consultation• Lack of perceived importance of physical activity• Lack of systems in place
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Within the practiceWithin the practiceLearn about PALearn about PA
GP/PN develop skillsGP/PN develop skills
Practice-specific leafletsPractice-specific leaflets
‘‘Prescription’ formsPrescription’ forms
Peer counsellingPeer counselling
PA specialists for specific groupsPA specialists for specific groups
Referral/H-P ‘clinics’Referral/H-P ‘clinics’
Opportunistic practiceOpportunistic practice
Follow-ups and feedbackFollow-ups and feedback
‘‘Modelling’ your own PAModelling’ your own PA
Using waiting room timeUsing waiting room time
ReceptionistsReceptionists
Longer consultationsLonger consultations
REWARDS?REWARDS?
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Get Ireland Active• The National Physical Activity Guidelines
for Ireland provide clear, concise and user friendly guidance to support the public, professionals and policy makers to Get Ireland Active.
• Website:– Promoting the guidelines– Benefits of PA– Guidelines for children and young people, adults
and older adults, people with disabilities and weight management.
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Brief intervention
Involves opportunistic advice, discussion, negotiation or
encouragement and are delivered by a range of primary and
community care professionals. Varies from basic advice to more
extended, individually focused attempts to identify and change
factors that influence activity levels
Discussion between individuals and GPs, nurses etc are effective
and cost effective in encouraging individuals to be more active
Ref: Public Health Intervention Advisory Committee
NICE Public Intervention Guidance No.2, March 2006
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•1 to 2 hours Physical Activity and Health
•Delivered to on site practices
•Free of charge
•Useful Resources for promoting PA in your practice
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PACE Programme – Patient Assessment & Counselling for
Exercise
•Based on stages of behaviour change
•Provides screening tools
•Appropriate advice and follow up for patients
•Addresses barriers, motivation, goal setting
•Ideal following Brief Intervention training
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Provides a safe pathway for people with various health
conditions to get them physically active, their way, everyday.
You Recommend • GP Refers • Patient Meets Local Coordinator• The patient then begins a twelve week physical activity
programme• Health professional handbook [email protected]
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Patient Request(website, publicity, word-of-mouth)
GP Recommend Health Prof.Recommend(brief intervention)
GP-Patient Consultation
Referral Form receivedby Local Coordinator
Initial Assessment
Mid-way Assessment
Final Assessment
Exit, 6, 12 & 24 Month Follow-up & Aftercare
Workshops(healthy eating, smoking cessation, stress management)
Local Events(health walks, cycle days)
Signposting(condition-specific pathways, local support networks)
Ongoing Support(telephone, email, website, facility staff)
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Inclusion & Exclusion Criteria
Patients must be Exclusion Criteria
currently sedentary
over 18 years of
age
interested in
becoming more
physically active
× Cardiac Conditions
× Uncontrolled
conditions
A fully detailed criteria list is available in the Health Professionals Handbook
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Walking• Walking for Health Workshops• IHF Walking Leaders Training • Community Walking Groups• Meet n’Mingle Walks• Walking Leaders Refresher Training
• Trail Walking Workshop• IHF Walking Leaders Training 2
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HPD Training Calendar
• Physical Activity in Primary Care (2hrs)
• PACE- Patient –Centred Assessment & Counselling for Exercise (3 hrs)
• Promoting The National Physical Activity Guidelines for Ireland “Get Ireland Active” (2hrs)
• Obesity: A Health Promotion Perspective (1 day)
• Supporting Change: Skills for Health (formerly Brief Interventions) (2 days)
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Research…..
• Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med
• Physical Activity, cardiovascular risk factors and mortality among Finnish adults with diabetes
• Diabetes and Physical Activity: Joint position statement of Diabetes Australia on the role of PA and risk reduction of and management of diabetes
• A RCT of resistance exercise training to improve glycemic control in older adults with diabetes
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Further support and info
• Email - [email protected]
• Tel: - 021 4921643
• www.healthpromotion.ie
• www.gpexercisereferral.ie
• www.getirelandactive.ie