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  1. Physical Activity Interventions Caroline Gordon Sport Wellington

  2. Topics • Physical Activity and colon cancer prevention • Push Play, HEHA and Physical Activity promotion • Examples of community interventions – Green Prescription - adults; Active Families - families and children

  3. Physical Activity A sedentary lifestyle linked in some [73,74] but not all [75] studies with an increased risk of colorectal cancer. There are numerous observational studies that have examined the relationship between physical activity and colon cancer risk. [76] Most of these studies have shown an inverse relationship between level of physical activity and colon cancer incidence. The average relative risk reduction is reportedly 40 to 50%. However, it is not known if or to what degree the observed association is due to confounding variables, such as diet or a genetic predisposition to colon cancer. In a population-based case control study of colorectal cancer among Chinese men and women in Western North America and China, colon and rectal cancer risk was elevated among men employed in sedentary occupations in both continents.[77] Further, the association between colorectal cancer risk and saturated fat was stronger among the sedentary than among the active population. Perhaps related to physical activity, body mass was found to be correlated with rectal cancer in men in an Australian study [75] and with colorectal cancer in men in Sweden.[78]

  4. N.Z. Physical Activity Levels • 48.2 percent (women, 44%; men, 52%) of adults achieved New Zealand’s national physical activity guideline, that is they participated in at least 30 minutes of moderate intensity physical activity on five or more days of the week. • Compared with the New Zealand population, a similar percentage of adults in each ethnic group achieved the national physical activity guidelines, but inactivity levels were higher among Asian adults. • ‘2007/08 Active NZ Survey Findings’ SPARC

  5. The 20 Most Popular Sport and Recreation Activities Participated in Over 12 Months-SPARC

  6. HEALTHY EATING - HEALTHY ACTION:ORANGA KAI - ORANGA PUMAU Move more, reduce screen time and sitting time

  7. Introduction • HEHA Strategy • 2003 HEHA Implementation Plan • 2004 - 2010 Health Select Committee Inquiry into Obesity and Type 2 Diabetes 2007 • Revised HEHA Implementation Plan- • SOCIAL MARKETING; REGIONAL PROGRAMMES AND CO-ORDINATORS

  8. HEHA Key Messages (2003 onwards) • Eat a variety of nutritious foods • Eat less fatty, salty and sugary foods • Eat more vegetables and fruits • Fully breastfeed infants for at least six months • Be active for at least 30 minutes in as many ways as possible • Add some vigorous exercise for extra benefit and fitness • Aim to maintain a healthy weight throughout life. Promote and foster the development of environments that support healthy lifestyles

  9. HEHA- Key Messages (2008/09) - NEW • Move more, reduce screen time and sitting time • Choose food and physical activity options that support a sustainable future • Breastfeeding Feeding Our Futures- H.R.C

  10. 30 minutes a day, 60 minutes a day - children • SPARC (formerly Hillary Commision) • Social marketing • Promotion/programmes through RSTs, TLAs etc

  11. PARENTS Most Kiwis know that it’s important for adults to Push Play for at least 30 minutes a day.  For children and young people aged 5 to 18 years old, the aim is to be active for 60 minutes each day.

  12. Sport Wellington • One of 17 RSTS in New Zealand • Not for profit charitable trust • Promotion sport, Active Movement, physical Activity • Primary deliverer for SPARC programmes • Funding from SPARC, community trusts, Halberg, gaming, Health, TLAs • Making Wellington the most active region in New Zealand

  13. What is a Green Prescription (GRx)? A tool to improve the overall health and well-being of New Zealanders increase levels of P.A. in the population considered by General Practitioners to be *inactive. • Currently annual SPARC Target: 30,000 • Contract Holders Target: 30,180 • *inactive = less than 30 minutes of moderate physical activity on five or more days of the week

  14. What is a GRx? • Written advice for patient to be more active as part of health management • Phone, face to face and group support is provided by trained personnel • GRx proven to be effective over 12 months and cost effective • Funded by MOH • 17 GRx Area Managers in RSTs and PHOs • NZ’s only GP /PN referral scheme • Nationwide since 1998

  15. The Green Prescription Journey

  16. Green Prescriptions- patient research

  17. Green Prescriptions-Physical Activities

  18. Respondents cont’d

  19. Ethnicity 2009 2008 2007 2006 2005 Ethnicity NZ European 68% 71% 67% 66% 65% Maori 18% 14% 17% 16% 16% Samoan 2% 2% 2% 3% 2% Cook Island Maori 1% 1% 1% 1% 2% Tongan 1% 0% 0% 1% 0% Niuean 0% 0% 0% 0% 0% Chinese 1% 0% 1% 1% 1% Indian 1% 1% 1% 2% 1% Other Asian 1% 1% 1% 1% 1% Other Pacific 0% 0% 0% 0% n/a British/European 5% 7% 7% 7% 8% Other 1% 1% 2% 2% 2% Did not say 1% 1% 1% 1% 2% Base: All respondents 1464 1569 1377 2413 1888

  20. Community based programme to support, educate and encourage families to set goals for lifestyle change and physical activity levels in children and young people • Target Age Group: 5 to 18 year olds • Target Populations: Lower Socio Economic Families, Maori and Pacific Island populations • Address childhood obesity, weight issues and other health problems which would benefit from physical activity. • holistical approach to health – P.A., Nutrition

  21. What Is Provided To The Families • Weekly Activity Sessions • Fortnightly or Monthly home visits • Nutritionist or Dietician advice and assistance • Discounted access to recreation and sporting opportunities within Wellington and Porirua • Bridging the gap to ensure Families have access to other health and wellbeing providers • Completely FREE Service

  22. Based in Family homes History Physical activity Daily Nutritional Intake Screen time Set SMART Goals Develop realistic exercise routine Establish family rules around eating and screen time Continuous support and Education Anthropometric Measurements Family Meetings

  23. Evaluation of Active Families • 18 month Evaluation currently following programmes in the following areas: • Wellington • Waitakere • North Harbour • This research is being completed through The University of Auckland, Faculty of Medical and Health Sciences.

  24. Family Study Continued… Lifestyle Changes over the 9 months Reduction of 7 x 1.5 litres of coke a week down to 1 a week Weekly visits to Vegetable and Fruit market Reduction of buying takeaways 4 times a week to walking down to the fish and chip store once a fortnight Family all participating in weekend physical activities Child 1 now plays Volleyball at School and plays competitive Rugby Father and child run once a week together Mother now participates in weekly aqua aerobics classes (funded through Green Prescription) Reduction in screen time from 49 hours a week ( average 7 hours a day) to 21 hours a week (average 3 hours a day)

  25. Graduation of a 10 week GRx healthy lifestyle community programmeWe make it a big deal…..for some it is.

  26. Physical Activity and Cancer • Research evidence • Intervention programmes • Community programmes- Green Prescriptions and Active Families

  27. 73 White E, Jacobs EJ, Daling JR: Physical activity in relation to colon cancer in middle-aged men and women. American Journal of Epidemiology 144(1): 42-50, 1996. • Slattery ML, Schumacher MC, Smith KR, et al.: Physical activity, diet, and risk of colon cancer in Utah. American Journal of Epidemiology 128(5): 989-999, 1988. • 75 Kune GA, Kune S, Watson LF: Body weight and physical activity as predictors of colorectal cancer risk. Nutrition and Cancer 13(1-2): 9-17, 1990. • Friedenreich CM: Physical activity and cancer prevention: from observational to intervention research. Cancer Epidemiology, Biomarkers and Prevention 10(4): 287-301, 2001. • Whittemore AS, Wu-Williams AH, Lee M, et al.: Diet, physical activity, and colorectal cancer among Chinese in North America and China. Journal of the National Cancer Institute 882(11): 915-926, 1990. • Gerhardsson de Verdier M, Hagman U, Steineck G, et al.: Diet, body mass and colorectal cancer: a case-referent study in Stockholm. International Journal of Cancer 46(5): 832-838, 1990.

  28. Caroline Gordon Active Communities Manager SPARC HEHA ANA