Are current guidelines the best targets for older people across - PowerPoint PPT Presentation

Are current guidelines the best targets for older people across Ireland? Dr Mark Tully UKCRC Centre of Excellence for Public Health (NI) Centre for Public Health Queen’s University Belfast

Guidelines Over a week, activity should add up to at least 150 minutes (2½ hours) of moderate intensity activity in bouts of 10 minutes or more Older adults should also undertake physical activity to improve muscle strength on at least two days a week HSNI, 2012

Current Levels SPORT NI, 2011

Target the behaviour not the outcome

SLOTH MODEL OF PHYSICAL ACTIVITY S leep L eisure O ccupation T ransportation H ousehold

SPORT NI, 2011

Work Home Sport Getting about 0% 10% 20% 30% 40% 50% 60% SPORT NI, 2011

Significant associations were observed between overall psychological wellbeing and • active travel and public transport when compared to car travel • time spent (per 10 minute change) walking and driving • switching from car travel to active travel

Correlates of Active Travel Sex Disability Urban/rural Happiness Area deprivation BMI Social class Health Car ownership Home ownership No. people on house Qualifications Retired (y/n) SPORT NI, 2011

Correlates of Active Travel Active Travel No AT Some AT Chi sq (n=886, 64%) (n=507, 36%) (p-value) Gender Male 43.0% 42.4% 0.86 Female 57.0% 57.6% Urban/Rural Urban 78.6% 91.5% 0.00 Rural 21.4% 8.5% Deprivation classification Most deprived 36.3% 45.0% 0.01 Mid third 29.5% 24.9% Least deprived 34.2% 30.2% Disability Has a disability 51.2% 39.6% 0.00 No disability 48.8% 60.4% Cars No car 27.2% 37.5% 0.00 1 car 56.8% 48.1% 2+ car 16.0% 14.4% Health Very good 16.6% 18.7% 0.00 Good 27.3% 36.7% Average 28.1% 30.2% Poor or worse 28.0% 14.4% SPORT NI, 2011

Correlates of Active Travel OR 95% CI p-value Urban/Rural 2.67 1.77-4.03 0.00 Urban (ref: rural) 1.36 1.00-1.85 0.05 Most deprived Deprivation classification 0.90-1.76 (ref: least deprived) Mid third 1.26 0.18 Social class 0.88-1.63 1.20 0.25 ABC 1 (ref: C 2 DE) 0.72 0.45-1.15 0.17 No formal qualifications Qualifications (ref: uni degree) 0.96 0.60-1.55 0.88 GCSE or equivalent Marital status 0.94 0.69-1.26 0.66 Married/civil partnership (ref: single/widowed/divorced) Retired Yes 0.91 0.64-1.29 0.59 (ref: No) 1 car 0.56 0.34-0.93 0.03 Cars (ref: no car) 0.54 0.39-0.75 0.00 2+ car SPORT NI, 2011

Correlates of Active Travel OR 95% CI p-value 1.08 0.68-1.71 0.75 Unhappy (1-5) How happy would you say you are? (ref: very happy) Happy (6-7) 1.09 0.80-1.48 0.58 Disability 0.72 0.54-0.97 0.03 Has a disability (ref: No disability) BMI Overweight or obese 0.87 0.67-1.13 0.31 (ref: normal weight) 2.12 1.31-3.44 0.00 Very good Health status Good 2.29 1.52-3.45 0.00 (ref: poor or worse) 2.03 1.38-2.99 0.00 Average SPORT NI, 2011

Ongoing work in Northern Ireland • Northern Ireland's long-term study of ageing in the over 50’s • 8500 men and women aged 50 years and above

Tailor the target to the individual

BEHAVIOUR CHANGE: INDIVIDUAL APPROACHES (NICE 2014) Develop acceptable, practical and sustainable behaviour change interventions and programme Use proven behaviour change techniques when designing interventions Goals and planning Feedback and monitoring Social support Ensure interventions meet individual need https://www.nice.org.uk/Guidance/PH49

The Lancet 2012; 380:272-281

• 12 week walking programme • Group 1 – self-set targets • Group 2 – 2,500 steps/day above baseline • Follow-up telephone calls at 1, 2, 6 and 11 weeks • Activity measured with 7 day pedometer assessment

Address the context or the behaviour

Fig. 3 How being ‘out and about’ and ‘active’ are co-associated with key variables in 14 focus group discussions.

Ongoing work in Northern Ireland “Walk With Me Study” AIM Feasibility and of a community delivered, peer-led physical activity intervention that promotes physical activity in older adults Funded by the NIHR Project:12/133/04

Target the behaviour Tailor the target Address the context

Thanks for Listening Dr Mark Tully UKCRC Centre of Excellence for Public Health (NI) Centre for Public Health Queen’s University Belfast m.tully@qub.ac.uk @marktully_qub