Active4Health – Cumbria – Rehabilitation Centre, Wigton Hospital, Cumbria May to November 2017 Author: Becky Blake, Occupational Therapist Progress so far: Concept mapped and shared with stakeholders (GP, Practice Managers, AHP Colleagues, Allerdale Borough Council Physical Activity Coordinator). Support gained from GP practices, discussions with current exercise providers both within and out with of current scheme and support gained to offer supported access to various facilities Agreed to set up trial in Wigton & Solway area (subsection of Allerdale). Funding pot to support trial applied for from combination of Sport England and Allerdale Borough Council to fund for 12 months, allow evaluation and gathering of evidence to bid for longer term funding for project, awaiting to hear outcome! Next Steps: Recruitment to post for scheme coordinator to be hosted within NHS services Engage service user stakeholder to assist shaping of services Logistical organisation of service delivery including setting outcome measures and processes Meeting with GP to identify patient groups for referral Work with exercise providers to ensure skill levels appropriate for working with service users. Review project at 12 months alongside review of change in Chance to Change outcomes where appropriate also comparison to uptake and completion of previous Exercise on Referral scheme. Objectives: The project was devised to pull together provider partners and the current exercise on referral scheme to offer a more comprehensive, inclusive and engaging service. Commence exercise on referral scheme to provide support and where necessary supervision to users to commence or continue exercise participation to embed change to exercise participation. Exercise on referral scheme to offer increased bespoke support to individuals making changes to activity participation. Measure change in physical activity participation amongst users via current Chance to Change outcome procedures (Incremental and Endurance shuttle walk test, Quality of Life Measures, waist and thigh circumference and weight) . Increase skill set amongst exercise providers in area to support exercise regimes of those with restrictions in ability to undertake exercise. 90 Day Improvement Process Concept mapped alongside evidence gathering from C2C programme outcomes Consultation with partner organisations Proposal pulled together Funding application to Sport England/Cumbria County Council Recruitment and training for project Publicity Outcomes reviewed Partners consulted on project outcomes Consultation on increasing area of project spread Why this project is needed The Rehabilitation Centre team had observed reliable results from the Chance to Change programme of Education, Physical activity and Nutrition advice focussed upon weight loss and lifestyle change over the past 5 years but a decline in outcomes at 12 month follow-up. This was partially attributed to a lack of support for participants to transition into community exercise providers for ongoing physical activity and partially the need for further resilience building amongst attendees to self-monitor more effectively. The first element of this needed to be addressed in collaboration with providers within the area. In addition obesity and physical health levels within the Allerdale area continue to be worse than the national average as shown: Obesity levels within Allerdale (those over 16 years of age, with a BMI of 30kg/m2) are estimated at 24.8%. Active people survey recorded adult excess weight to affect 68.3% of the population within Cumbria compared with a national average of 63.8%. Physical inactivity leads to 37,000 premature deaths in the UK every year and costs the national economy in healthcare, premature deaths and sickness absence £7.4bn each year. Habit formation is found to vary enormously from one individual to another but for a 95% formed simple habit takes between 66 and 254 days for change to become embedded. The current course provision was 12 weeks/84 days (with follow up for 12 months/365 days) falling towards the lowest end of embedding change at the completion of which there was a significant switch from NHS based exercise to community/self led based exercise participation. 30 days References: Healthy Living and Lifestyles Chapter, Joint Strategic Needs Assessment, 2015 onwards (Oct 2015) How are habits formed: Modelling habit formation in the real world, Lally et al, European Journal of Social Psychology, 2009 Acknowledgements: Chance to Change Team, Wigton Hospital, Cumbria, & Rebecca Stamper, Allerdale Borough Council 60 days 90 days