1. Promoting Physical Activity in Jamaica Dr Deanna Ashley

2. Healthy Lifestyle Programme Baseline Lifestyle Survey conducted yr 2000 Baseline Lifestyle Survey conducted yr 2000 Healthy Lifestyle Policy and Healthy Lifestyle Policy and Strategic Plan approved yr 2004 Strategic Plan approved yr 2004 Programme implementation initiated 2004/05 Programme implementation initiated 2004/05 Repeat Life Style Survey conducted yr 2008 Repeat Life Style Survey conducted yr 2008

3. Background Jamaican Healthy Lifestyle Survey 2000-2001 (15- 74 yrs old ) showed prevalence estimate of Jamaican Healthy Lifestyle Survey 2000-2001 (15- 74 yrs old ) showed prevalence estimate of Hypertension 20.8% Hypertension 20.8% Diabetes mellitus 7.2% Diabetes mellitus 7.2% Obesity 19.7% Obesity 19.7% Wilks et al 2002 Wilks et al 2002 These health conditions are associated with a high economic cost 3 These health conditions are associated with a high economic cost 3 3 Ward E and Grant A, 2003

4. Lifestyle Survey 2007/08 -Study Design Wilks et al Nationally representative cross-sectional survey Nationally representative cross-sectional survey Interviewer administered questionnaire Interviewer administered questionnaire Target Group: 15- 74 year olds Target Group: 15- 74 year olds Field Work: November 2007 - March 2008 Field Work: November 2007 - March 2008 Sample size: 2914 Sample size: 2914

5. Changes in Nutritional Status: 2000- 2008 Nutritional Status JHLS-2000JHLSII-2008 JHLS-2000(CI)JHLSII-2008(CI) Underweight (<18.5kg/m 2 ) 4.9(3.4-6.4) 4.7(3.9- 5.6) 4.7(3.9- 5.6) Normal (18.5-24.99 kg/m 2 ) 49.4(46.2-52.5) 43.6 (40.8- 46.3) Overweight (25-29.99 kg/m 2 ) 26.1(23.5-28.7) 26.4 (24.5- 28.6) Obese (≥30 kg/m 2 )*** 19.7(17.4-22.0) 25.3 (22.8- 27.4) Increased WC 35.6 (32.8-38.5) 45.2(43.3-47.1) ***P< 0.001

6. Changes in PAL of Jamaicans in Seven Years

7. Nutritional Status & Activity Levels

8. Summary Almost 40% of Jamaicans reported having low physical activity levels Almost 40% of Jamaicans reported having low physical activity levels Obesity appears to be the driver of this epidemic Obesity appears to be the driver of this epidemic

9. Work Place Study 2003 Ashley D.V. et al Sample taken from 2 Private Sector Companies Sample taken from 2 Private Sector Companies Public Sector Health Workers Public Sector Health Workers

10. MOH vs. Private Sector Mean BMI and Waist Circumference ANTROPOMETRYMOH Private sector BMI (Kg/m2) 26.0025.12 Waist Circumference (cm)Female84.4877.40 Male88.8387.06

11. Self – reported Frequency of Exercise Taken for >30mins FrequencyVigorous (%)Moderate (%) Daily 3.924.3 3-6/week14.220.4 1-3 /week18.419.9 2-4 /month6.4 1-3 /month5.26.2 Once/month18.110.3 Never33.812.5

12. Physical Activity Level – Staff at High Risk for CVD

13. Factors Influencing Physical Activity Behaviour Lack of Motivation (44%) Lack of Support (34%) Safety (31%) Lack of Time (44%) Affordability (43%) Lack of Habit 22%) Sedentary leisure activities (88%)

14. Integrated Healthy Lifestyle Programme St. Ann’s Bay H/C Dr. Calixto Orozco Muñoz et. al Objective Objective To assess the impact of an integrated Healthy Lifestyle Programme on the Management of Chronic Diseases To assess the impact of an integrated Healthy Lifestyle Programme on the Management of Chronic Diseases

15. Integrated Healthy Lifestyle Programme St. Ann’s Bay H/C Target group : Target group : Patients attending the Chronic Disease Clinic Patients attending the Chronic Disease Clinic No. of participants 122 No. of participants 122 58% were over age of 60 yrs 58% were over age of 60 yrs

16. Integrated Healthy Lifestyle Programme – St. Ann’s Bay H/C Methods Methods Two Year Integrated Lifestyle Programme (August 2002-September 2004): Two Year Integrated Lifestyle Programme (August 2002-September 2004): Health Promotion Health Promotion Prevention Prevention Curative Care Curative Care Rehabilitation Rehabilitation Exercise Programme Exercise Programme

17. Integrated Healthy Lifestyle Programme St. Ann’s Bay H/C Mean No. Risk Factors Before and After Intervention DiseaseBeforeAfter Mean Difference (95% CI) Diabetes (N=54, p=0.000) 2.31.3 -1 (0.7 to 1.2) Hypertension (N=98, p=0.000) 2.21.3 -0.9 (0.7 to 1.0)

18. Integrated Healthy Lifestyle Programme St. Ann’s Bay H/C Other Results: Other Results: 23% of obese patients reduced their BMI to overweight 23% of obese patients reduced their BMI to overweight 44% of overweight patients achieved normal weight 44% of overweight patients achieved normal weight

19. Clinic Patients

21. Youth Camp

22. Aerobics in the Park