1. Welcome Coventry Healthy Lifestyle Conversations Health Development Service October 2011

2. To increase the number of brief interventions offered to patients, families and communities in Coventry. By attending this course participants will have an opportunity to: Gain information about seven healthy lifestyle topics. Obtain the Healthy Conversation Cards and review how to use the cards in day to day contact with individuals and families. Aims and Objectives

3. To review their current approach to helping patients, families and communities to consider their lifestyle. Identify the evidence that supports offering brief advice. Practice the basic skills of raising the issue. Reflect on what they may do as a result of this training. Aims and Objectives

4. “To make the most of the millions of encounters that the NHS and other frontline workers have with people every week and ensure that all staff have training and support to embed health improvement in their day-to-day work with patients.” DOH, 2004 Policy Context

5. Health and Well-being in Coventry

6. “Many inequalities in health are a preventable consequence of the lives people lead, the behaviours and lifestyles that cause ill health, many of which show stark relationship with social-economic factors.” Health Inequalities Department of Health (2008) Health Inequalities: Progress and Next Steps.

7. Coventry Ward Map on Postcode Map Cheylesmore Wainbody Westwood Earlsdon Binley and Willenhall St Michael’s Wyken Bablake Lower Stoke Upper Stoke Woodlands Henley Holbrook Longford Foleshil l Radford Whoberley Sherbourne

8. Coventry % of Smoking 33.3 to 44.0 27.8 to 33.2 22.9 to 27.7 19.7 to 22.9 11.0 to 19.6

9. Coventry % Binge Drinking 22.0 to 29.9 19.5 to 19.9 18.0 to 19.4 16.1 to 17.9 11.9 to 16.0

10. Coventry % of Obesity 28.3 to 32.0 27.2 to 28.2 25.6 to 27.1 23.8 to 25.5 16.1 to 23.7

11. Coventry % Pop on 5+ Fruit & Veg 26.9 to 36.8 24.6 to 26.8 23.3 to 24.5 20.1 to 23.2 16.8 to 20.0

12. There is overwhelming evidence that changing people’s health-related behaviour can have a major impact on some of the largest causes of mortality and morbidity. NICE (2007) Why A Behavioural Approach?

13. For every eight people who receive simple alcohol advice, one will reduce their drinking to within lower-risk levels. (Moyer et al. 2002) The Evidence

14. The Quiz ! Public Health Messages

15. Adults should eat no more than 6g of salt a day. Children should have even less. Most of the salt we eat is already in everyday foods such as bread, breakfast cereal, pasta sauce and soups. Multiply Sodium by 2.5 to find out salt level. Salt Intake

16. Eat a wide variety of fruit and vegetables. Aim for at least five portions a day. If you eat one or two portions with each meal and have the occasional fruit snack you might be surprised at how easy it is to eat five-a-day. Fruit and Vegetables

17. Base your meals on starchy foods Eat lots of fruit and Vegetables Eat more fish Cut down on saturated fats and sugars Try to eat less salt – no more than 6g per day Get active and try to be a healthy weight Drink plenty of water Don’t skip breakfast 8 Tips for eating well

18. It's not a good idea to be either underweight or overweight. Eating too much and being inactive can lead to weight gain, which increase a person’s chance of developing heart disease, high blood pressure, some cancers and type II diabetes. Healthy Weight

19. HDC Health Development Consultancy19 Physical Activity At least 30 minutes moderate activity 5 days a week. This often gets forgotten. Hmm… What does this mean? Does that include washing my car? I do one episode of 10 mins and one of 20 mins! So there is no point as I can only do my exercise at weekends!

20. Smoking Low-birth weight baby Cervical cancer Bladder cancer Ulcer Pancreatic cancer Lung cancer Chronic obstructive pulmonary disease Coronary heart disease Cancers of the larynx Cancers of the mouth, throat and oesophagus Stroke Peripheral vascular disease

21. Women can drink up to 2 to 3 units of alcohol a day and men up to 3 to 4 units a day, without significant risk to their health. Avoid binge drinking. If you have drunk too much, you should avoid alcohol for at least 48 hours to give your body a chance to recover. Alcohol

22. Try to connect with others be active take notice of your surroundings keep learning give to neighbours and communities 5 Tips for Positive mental health

24. Many of us take risks with our health – it’s a normal part of human behaviour. Many risky behaviours meet needs. For example smoking reduces stress chocolate is a comfort alcohol increases confidence Our view of risk is influenced by our knowledge, past experiences, beliefs and attitudes. Why do we take Risks?

25. Traditional (Educational) Approach Information Understanding Change

26. We should aim to be: Non judgemental Supportive Empathetic Genuine How then should we approach healthy lifestyles?

27. Brief Advice pro-actively raises awareness of and explores a person’s willingness to engage in further discussion about healthy lifestyles. It is opportunistic and lasts around 3 minutes and involves actively listening to a person’s needs and concerns. NICE, 2007 Brief Advice

28. Raising the Issue without building resistance The context Why you are speaking about healthy lifestyles. Ask permission This begins the client centred approach: Would you mind if we talked about your smoking for a couple of minutes? Use open questions to explore the issue: Have you ever tried to stop smoking or have you never really thought about it? Reflect back So you have been thinking about it?

29. If you get a Negative response? What do you do next? If a person responds positively. What can you do next?

30. In your pairs label yourselves A and B ‘A’ your task is to find out if ‘B’ eats a healthy Diet (2 minutes) ‘B’ your task is to find out if ‘A’ is active! (2 minutes) Let’s Try It!

31. Using the cards with families, and community groups!

32. Thank you for listening and taking part. Any questions?