Do changes to the local street environment alter behaviour and quality of life of older adults? The ‘DIY Streets’ intervention

<p>Background: The burden of ill-health due to inactivity has recently been highlighted. Better studies on environments that support physical activity are called for, including longitudinal studies of environmental interventions. A programme of residential street improvements in the UK (Sustrans ‘DIY Streets’) allowed a rare opportunity for a prospective, longitudinal study of the effect of such changes on older adults’ activities, health and quality of life.</p> <p>Methods: Pre–post, cross-sectional surveys were carried out in locations across England, Wales and Scotland; participants were aged 65+ living in intervention or comparison streets. A questionnaire covered health and quality of life, frequency of outdoor trips, time outdoors in different activities and a 38-item scale on neighbourhood open space. A cohort study explored changes in self-report activity and well-being postintervention. Activity levels were also measured by accelerometer and accompanying diary records.</p> <p>Results: The cross-sectional surveys showed outdoor activity predicted by having a clean, nuisance-free local park, attractive, barrier-free routes to it and other natural environments nearby. Being able to park one's car outside the house also predicted time outdoors. The environmental changes had an impact on perceptions of street walkability and safety at night, but not on overall activity levels, health or quality of life. Participants’ moderate-to-vigorous activity levels rarely met UK health recommendations.</p> <p>Conclusions: Our study contributes to methodology in a longitudinal, pre–post design and points to factors in the built environment that support active ageing. We include an example of knowledge exchange guidance on age-friendly built environments for policy-makers and planners.</p&gt

Effect of a health-improvement pilot programme for older adults delivered by a professional football club: the Burton Albion case study

Older adults are a priority within policy designed to facilitate healthy lifestyles through physical activities. Golden Goal is a pilot programme of physical activity-led health improvement for older adults, 55 years and older. Activities were delivered at Burton Albion Football Club. Sessions involved weekly moderate to vigorous intensity exercise sessions including exer-gaming (exercise-orientated video-games), indoor bowls, cricket, new age curling, walking football, and traditional board games and skittles. Secondary analysis of data collected through the original programme evaluation of Golden Goal investigated the impact of the intervention on participants. Older adults completed self-reports for demographics, health screening/complications and quality of life. Attendees, n = 23 males (42.6%) and n = 31 females (57.4%) with a mean age of 69.38 (±5.87) (n = 40), ranging from 55-85 years took part. The mean attendance was 7.73 (±3.12) sessions for all participants, (n = 51). Older adults with two or more health complications (n = 22, 42.3%) attended fewer sessions on average (6.91 ± 3.322) compared to those reporting less than two health complications (8.65 ± 2.694). Self-rated health was higher for women (87.32 ± 9.573) vs. men (80.16 ± 18.557), although this was not statistically significant (U = 223.500, p = 0.350). Results support the potential of football-led health interventions for recruiting older adults, including those reporting health problems. © 2014 © 2014 Taylor & Francis

Home-based cardiac rehabilitation: A review

Cardiac rehabilitation has positive effects on mortality, morbidity, quality of life and many cardiac risk factors. Cardiac rehabilitation is usually delivered within a hospital or 'centre' setting, however, home-based programmes may offer greater accessibility and choice to patients. While there have been fewer studies of home-based cardiac rehabilitation, the available data suggest that it is acceptable, safe and effective and has comparable results to hospital-based programmes. Furthermore, home-based cardiac rehabilitation results in longer-lasting maintenance of physical activity levels in patients compared with hospital programmes. It has the potential to be more cost-effective for patients who cannot easily access their local hospital or centre. Home-based cardiac rehabilitation may be particularly useful in patients in a remote or rural setting. Despite the options available and the evidence based benefits, the uptake of cardiac rehabilitation remains low. It is the responsibility of all cardiac health-care workers to ensure that the uptake of cardiac rehabilitation improves

Using the affective priming paradigm to explore the attitudes underlying walking behaviour

Objectives. Walking is poorly represented in memory, making it difficult to measure using self-report and even harder to predict. To circumvent this, we used the affective priming paradigm (Fazio, Sanbonmatsu, Powell, & Kardes, 1986) to assess implicit attitudes towards walking. Methods. Royal Air Force trainee aircraftsmen (N ¼ 188) wore pedometers for 1 week prior to completing the affective priming paradigm, questionnaire and interview. The affective priming paradigm involved a computer-based response latency task containing physical activity words as primes followed by adjectives as targets to be evaluated. Targets were drawn from two bipolar dichotomies, good–bad (the original Fazio et al. items) and happy–sad (mood). Results. Priming for mood items was related to levels of physical activity with high frequency participants priming for the positive (happy) pole and low frequency participants priming for the negative (sad). Both groups primed for the negative element of the Fazio (good–bad) dichotomy. Regarding walking and running, there was no differentiation on the basis of participation level. Instead, facilitated responses to happy targets contrasted with inhibited responses to sad targets for both types of locomotion. There was weak evidence that intentions to run were associated with priming of positive target items, irrespective of category. Conclusions. The relationship between implicit attitudes and behaviour is complex. Whereas implicit attitudes were related to overall exercise participation, they were not related to the specific activity of walking, despite the behaviour being mainly under automatic control.</p

Sharing risk management: an implementation model for cardiovascular absolute risk assessment and management in Australian general practice

Purpose: Despite considerable work in developing and validating cardiovascular absolute risk (CVAR) algorithms, there has been less work on models for their implementation in assessment and management. The aim of our study was to develop a model for a joint approach to its implementation based on an exploration of views of patients, general practitioners (GPs) and key informants (KIs). Methods: We conducted six focus group (three with GPs and three with patients) and nine KI interviews in Sydney. Thematic analysis was used with comparison to highlight the similarities and differences in perspectives of participants. Results: Conducting CVAR was seen as more acceptable for regular patients rather than new patients for whom GPs had to attract their interest and build rapport before doing so at the next visit. GPs' interest and patients' positive attitude in managing risk were important in implementing CVAR. Long consultations, good communication skills and having a trusting relationship helped overcome the barriers during the process. All the participants supported engaging patients to self-assess their risk before the consultation and sharing decision making with GPs during consultation. Involving practice staff to help with the patient self-assessment, follow-up and referral would be helpful in implementing CVAR assessment and management, but GPs, patients and practices may need more support for this to occur. Conclusions: Multiple strategies are required to promote the better use of CVAR in the extremely busy working environment of Australian general practice. An implementation model has been developed based on our findings and the Chronic Care Model. Further research needs to investigate the effectiveness of the proposed model

A Whole School Approach to Supporting Children and Young People’s Mental Health

Purpose Supporting the mental health of children and young people is a global priority. The issue is not specific to England. However, evidence suggests that one in ten children and young people in England has a mental health need. This represents approximately three students in every classroom. The purpose of this paper is to highlight the role of schools in supporting children and young people’s mental health. Whilst the paper acknowledges that teachers are not trained health professionals, it is argued that a whole-school approach to mental health can support individuals in schools to remain mentally healthy. The elements of a whole-school approach are identified and discussed and some of the challenges in relation to implementation are considered. Critical to the development of a whole-school approach is the commitment from the school leadership team to promoting student and staff wellbeing. Design/methodology/approach This is a policy paper not an empirical study. Findings This paper has outlined the policy context in the UK in relation to children and young people’s mental health. It has addressed the risk and protective factors which can cause or mitigate against mental ill health and it has outlined the elements of a whole-school approach to mental health. Originality/value This paper explores the contribution that schools can make to supporting students’ mental health. There is limited research which addresses mental health in young people from a non-therapeutic angle

A Review of Risk Matrices Used in Acute Hospitals in England.

In healthcare, patient safety has received substantial attention and, in turn, a number of approaches to managing safety have been adopted from other high-risk industries. One of these has been risk assessment, predominantly through the use of risk matrices. However, while other industries have criticized the design and use of these risk matrices, the applicability of such criticism has not been investigated formally in healthcare. This study examines risk matrices as used in acute hospitals in England and the guidance provided for their use. It investigates the applicability of criticisms of risk matrices from outside healthcare through a document analysis of the risk assessment policies, procedures, and strategies used in English hospitals. The findings reveal that there is a large variety of risk matrices used, where the design of some might increase the chance of risk misprioritization. Additionally, findings show that hospitals may provide insufficient guidance on how to use risk matrices as well as what to do in response to the existing criticisms of risk matrices. Consequently, this is likely to lead to variation in the quality of risk assessment and in the subsequent deployment of resources to manage the assessed risk. Finally, the article outlines ways in which hospitals could use risk matrices more effectively

‘It brings the lads together’: A critical exploration of older men’s experiences of a weight management programme delivered through a Healthy Stadia project

Older men whose weight is considered unhealthy may experience particular barriers that can restrict their adoption of health improvement interventions. Despite promising findings recommending the use of sports settings to facilitate health promotion with men, little evidence has addressed older men’s health needs for, or experiences of, these settings. Using a qualitative methodology, this study explored the experiences of 14 ageing men attending a football-led weight management programme delivered at a community sports setting. The thematic analysis of semi-structured interviews elucidates important insights regarding the provision of sports-led health improvement interventions for this population. Men especially valued the opportunity to play sports and do physical activity in an environment that promotes ‘inclusive’ competition and caring interpersonal relationships. Implicit in the findings is the key role of practitioners in promoting social engagement. We conclude the paper with key practical implications of this research