1. Strong well established
relationships existed between
Camden Active Health Team
and NHS Camden due to
a history of joint working.
Contact was established with:
• The Assistant Director of
public health
• The Assistant Director of
primary care
• A newly assigned project
manager
• NHS health trainers
• Health check professionals
• GP’s.
Challenges encountered
centred on:
1. The development of the
software package for the
health check
2. Venues for health checks
and programme
3. The focus on the priority
wards
Thus the challenges were not in
any way related to engaging the
primary care professionals; the
key challenge was to engage
the public in health checks as
a pathway to referral to the
programme.
To address this, working
with the project manager, we
expanded the criteria to
include participants from across
the borough rather than just
the four wards, and included
those with a less than 10% risk
of developing cardio vascular
disease. This helped to engage
groups of people who would
not normally have accessed our
existing service.
Future benefits of this
programme will be a closer
working relationship with:
1. Healthy eating team
2. Smoking cessation team
3. Public health and alcohol
team
4. Health promotions team
Recommendations
1. Establish a relationship with your local NHS service provider to link with the various
services they provide i.e. healthy eating, smoking cessation, public heath and alcohol,
obesity etc, as these are a good sources for your referrals.
2. Be flexible with referral sources and engage with your local exercise on referral scheme.
3. Run evening and weekend courses for those with work commitments and also try to
choose venues that are easily accessible to participants.
ICanChange Programme
Camden Active Health Team
Description:
A six week self management course consisting of one
two hour session per week including:
• one hour discussion (brainstorming)
• one hour physical activity tailored to the participant’s
abilities and venue’s facilities.
Subjects in discussion include:
1. Self management and physical activity
2. Goal setting and managing relapses
3. Overcoming barriers to physical activity
4. Barriers to healthy eating and solutions
5. Stress management.
Inclusion criteria:
1. Adults aged 40-74 years old (or 30-74 years if South Asian)
2. Residence in four priority wards in the borough of
Camden (determined by health deprivation levels
e.g. high mortality rate).
3. Judgement that the individual is at 10-20% CVD risk
(Framingham). Participants were engaged either via NHS
Camden’s vascular health checks or a specific GP referral.
Objective:
Deliver an accessible, high quality and evidence based self
management physical activity programme flexible to the need
and interests of the participants.
Outcomes:
1. An understanding of the variety of physical activity options.
2. More physically active on completion and long term
incorporation into their lifestyle.
3. Some participants take advantage of the reduced gym
membership offer.
So far 94 participants have been referred, of which 58
(61.8%) of these started and 48 (81%) completed.
EOR (2009/10)1908 referred, 1330(70%) started and
of these 788(59%) completed.
Partnerships with primary careOutline of Project:
Aim:
Initiate a lifestyle change in individuals at risk of developing
cardiovascular disease (CVD), using a physical activity
and behaviour change intervention.
Evaluation
I Can Change compared to Exercise on Referral
0
10
20
30
40
50
60
70
80
90
100
Referred Starters Completers
Status
EOR
ICC
Percentage
The project was contracted by NHS Camden for two years
We used two methods to
evaluate the programme:
1. An accelerometer. Data was
collected two weeks prior and
during the six weeks of the
programme.
2. A case report form: 44 tick
box questions categorised
into medical history, diet and
physical activity over the
last four weeks. These were
completed pre, post and nine
months (by telephone) after the
programme.
The project has engaged new
groups of residents in the
borough who might not have
accessed other physical activity
opportunities.
At nine months, 70% of the
participants are maintaining
the Chief Medical Officer’s
recommendation of at least 5 x
30 minutes of moderate physical
activity weekly.
Lessons learned include:-
1. Using an accelerometer
is excellent for motivation
and provides an accurate
measurement of physical
activity. Information collected is
displayed as either a bar chart
or a graph so participants can
see how they are doing.
2. However, there is an
uncertainty to working with
online resources especially
if the equipment used relies
on internet access for the
presentation of data.
3. Goal setting and behaviour
change sessions work well as:
• Participants gain an
understanding about
setting SMART goals and
the difference between
short, intermediate and
long term goals.
• Participants can change
behaviour to incorporate
physical activity as part
of their lifestyle. This is
demonstrated by the high
percentage of individuals
managing 5 X 30 minutes
of physical activity weekly at
nine month follow up.
4. Involving GPs in identifying
suitable clients from their
databases and referring them
is important.
5. The programme targeted only
medium to high risk clients
in the four priority wards and
some clients at lower risk
in other wards of Camden
could have benefited. Broader
inclusion criteria could increase
uptake.
6. Many in the target group
have work commitments and
were unable to attend regular
sessions. A more flexible
programme might be able to
meet the needs of this group
more effectively.