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Part of the Movement 2
Activators Workshop
Joanne Taylor & Eloise Glithero – Active Cheshire
Dr. Chris Lowry – GP & Activator
Part Of The MOVEment 2 workshop slides: Activators
The Challenge
80% of GPs are unfamiliar
with national physical
activity guidelines Lack of appointment time
means health practitioners
struggle to understand
individual inactivity and
barriers to physical activity
Mixed messages,
recommendations, and
advice on physical activity
causes confusion. We are most influenced by
people like us. Role models
who we see on a day-to-day
basis are family, colleagues,
community champions.
Blueprint Ambitions
Examples & Case Studies
• Dr Chris Lowry
OBESITY
INACTIVITY&
An Activators approach
Dr ChrisLowry
GP &Activator
drchrislowry@gmail.com
The Challenges
The Challenges
1. Our clients are obese.
The Challenges
1. Our clients are obese.
2. Our clients are inactive.
The Challenges
1. Our clients are obese.
2. Our clients are inactive.
3. This is making them (more) ill.
The Challenges
1. Our clients are obese.
2. Our clients are inactive.
3. This is making them (more) ill.
4. We aren’t brilliant at addressing either problem.
Adultsin Warrington
NormalBMI
Overweight
Obese
Our Clients are Obese
WarringtonPublic Health AnnualReport 2015
Adultsin Warrington
Inactive
Active once aweek
3+ timesperweek
Our Clients are Inactive
WarringtonSport &Physical Activity Profile 2014
This is Making them Ill
“There is clear scientific evidence proving the benefit of regular physical activityon both
the primary and secondary prevention of diabetes, hypertension, cancer (particularly
breast and colon cancer), depression, osteoporosis and dementia.
Furthermore, regular physical activityhas been shown to be essential in achieving and
maintaining weight control.
Finally, there is a clear correlation between physical activityand all-causemortality”
PhysicalActivity andHealth: AReport of the Surgeon General.
Center forChronic Disease Prevention andHealth Promotion, 1996.
Physical inactivity: the biggest publichealth
problem of the 21st century.
British Journal ofSportsMedicine, Volume 43, Issue 1
We are Not Addressing IT
“72% ofGPs donotspeak aboutthe benefits of
physical activity with patients”
Clinical champion GPs getphysical
BMA Practice Blog April2016
Only17% of overweight and 42% of obese respondents
recalled ever having received HP advice to lose weight.
HP advice was associated withattemptingto lose weight
(OR=3.53, 95% CI 2.44 to 5.10).
Theimpact of a health professional recommendation on
weight loss attempts in overweight and obeseBritish
adults.
BMJ Open 2013
.
Talking about these
Issues is effective
Physician weight loss adviceandpatient weight loss behavior
change: aliterature review and meta-analysis of survey data
International Journal of Obesity (2013) 37
“PCP advice on weightloss appears to have a significantimpact on
patientattemptsto change behaviours related to their weight.(OR
3.98)
Providers should address weightloss withtheir
overweight and obesepatients.”
Comparison with METFORMIN
“In comparisons between metformin monotherapy and placebo,
metformin reduced mean HbA1c level by 12”.
How Much Does Metformin Lower
HbA1c Level?
Diabetes Care 2012 Feb.
Physical Activity AdviceOnly or Structured
Exercise Training andAssociation With
HbA1c Levelsin Type 2 Diabetes
JAMA 2011 ;305(17)
“In comparisons between metformin monotherapy and placebo,
metformin reduced mean HbA1c level by 12”.
“Structured exercise duration of more than 150 minutes per
week was associated with a reduction in HbA1c of 9.7”.
How Much Does Metformin Lower
HbA1c Level?
Diabetes Care 2012 Feb.
Physical Activity AdviceOnly or Structured
Exercise Training andAssociation With
HbA1c Levelsin Type 2 Diabetes
JAMA 2011 ;305(17)
Weight loss of 15kg led to40% of study participants
maintaininga non diabeticHbA1c for the entire 6
months followupperiod.
“T2DM is a potentially reversible
condition.”
Very-Low-Calorie Diet and6 Months of Weight
Stabilityin Type2 Diabetes: Pathophysiologic
Changes in Responders and Nonresponders
Diabetes Care 2016 Mar
A brief Intervention
A brief Intervention
1. Understand the client
A brief Intervention
1. Understand the client
2. Understand the science
A brief Intervention
1. Understand the client
2. Understand the science
3. Understand the options
A brief Intervention
1. Understand the client
2. Understand the science
3. Understand the options
4. Make every contact count.
• Understand their motivations and barriers- softer GP skills are definitely
usefulhere
• Motivational interviewing orelements of it can be helpfulin behaviour
change.
• Languagechoices
• Exampleofpatientmisconceptions.
UNDERSTAND the CLIENT
• Calories is the most important
• Activity levels needed – 30 mins, 5 timesa week, but generally… just
MOVE MORE.
• Most diet styles willwork, because most lead to calorie restriction
UNDERSTAND the Science
• www.nhs.uk/livewell
• Dietician
• GP for Medication
• Weight Watchers & SlimmingWorld
• LiveWire
• WarringtonWellbeing
UNDERSTAND The Options
A brief Intervention
1. Understand the client
2. Understand the science
3. Understand the options
4. Make every contact count.
Any Questions?
Dr Chris Lowry
GP & Activator
drchrislowry@gmail.com
Group Discussions
Activators – Educating and empowering community leaders,
allied health professionals and front line community workers
to promote active lifestyles consistently through ONE YOU
• Ambitions of the Pillar
• What can we do/need to be done to achieve?
Key Messages/Feedback

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Part Of The MOVEment 2 workshop slides: Activators

  • 1. Part of the Movement 2 Activators Workshop Joanne Taylor & Eloise Glithero – Active Cheshire Dr. Chris Lowry – GP & Activator
  • 3. The Challenge 80% of GPs are unfamiliar with national physical activity guidelines Lack of appointment time means health practitioners struggle to understand individual inactivity and barriers to physical activity Mixed messages, recommendations, and advice on physical activity causes confusion. We are most influenced by people like us. Role models who we see on a day-to-day basis are family, colleagues, community champions.
  • 5. Examples & Case Studies • Dr Chris Lowry
  • 6. OBESITY INACTIVITY& An Activators approach Dr ChrisLowry GP &Activator drchrislowry@gmail.com
  • 8. The Challenges 1. Our clients are obese.
  • 9. The Challenges 1. Our clients are obese. 2. Our clients are inactive.
  • 10. The Challenges 1. Our clients are obese. 2. Our clients are inactive. 3. This is making them (more) ill.
  • 11. The Challenges 1. Our clients are obese. 2. Our clients are inactive. 3. This is making them (more) ill. 4. We aren’t brilliant at addressing either problem.
  • 12. Adultsin Warrington NormalBMI Overweight Obese Our Clients are Obese WarringtonPublic Health AnnualReport 2015
  • 13. Adultsin Warrington Inactive Active once aweek 3+ timesperweek Our Clients are Inactive WarringtonSport &Physical Activity Profile 2014
  • 14. This is Making them Ill
  • 15. “There is clear scientific evidence proving the benefit of regular physical activityon both the primary and secondary prevention of diabetes, hypertension, cancer (particularly breast and colon cancer), depression, osteoporosis and dementia. Furthermore, regular physical activityhas been shown to be essential in achieving and maintaining weight control. Finally, there is a clear correlation between physical activityand all-causemortality” PhysicalActivity andHealth: AReport of the Surgeon General. Center forChronic Disease Prevention andHealth Promotion, 1996.
  • 16. Physical inactivity: the biggest publichealth problem of the 21st century. British Journal ofSportsMedicine, Volume 43, Issue 1
  • 17. We are Not Addressing IT
  • 18. “72% ofGPs donotspeak aboutthe benefits of physical activity with patients” Clinical champion GPs getphysical BMA Practice Blog April2016
  • 19. Only17% of overweight and 42% of obese respondents recalled ever having received HP advice to lose weight. HP advice was associated withattemptingto lose weight (OR=3.53, 95% CI 2.44 to 5.10). Theimpact of a health professional recommendation on weight loss attempts in overweight and obeseBritish adults. BMJ Open 2013 .
  • 21. Physician weight loss adviceandpatient weight loss behavior change: aliterature review and meta-analysis of survey data International Journal of Obesity (2013) 37 “PCP advice on weightloss appears to have a significantimpact on patientattemptsto change behaviours related to their weight.(OR 3.98) Providers should address weightloss withtheir overweight and obesepatients.”
  • 23. “In comparisons between metformin monotherapy and placebo, metformin reduced mean HbA1c level by 12”. How Much Does Metformin Lower HbA1c Level? Diabetes Care 2012 Feb. Physical Activity AdviceOnly or Structured Exercise Training andAssociation With HbA1c Levelsin Type 2 Diabetes JAMA 2011 ;305(17)
  • 24. “In comparisons between metformin monotherapy and placebo, metformin reduced mean HbA1c level by 12”. “Structured exercise duration of more than 150 minutes per week was associated with a reduction in HbA1c of 9.7”. How Much Does Metformin Lower HbA1c Level? Diabetes Care 2012 Feb. Physical Activity AdviceOnly or Structured Exercise Training andAssociation With HbA1c Levelsin Type 2 Diabetes JAMA 2011 ;305(17)
  • 25. Weight loss of 15kg led to40% of study participants maintaininga non diabeticHbA1c for the entire 6 months followupperiod. “T2DM is a potentially reversible condition.” Very-Low-Calorie Diet and6 Months of Weight Stabilityin Type2 Diabetes: Pathophysiologic Changes in Responders and Nonresponders Diabetes Care 2016 Mar
  • 27. A brief Intervention 1. Understand the client
  • 28. A brief Intervention 1. Understand the client 2. Understand the science
  • 29. A brief Intervention 1. Understand the client 2. Understand the science 3. Understand the options
  • 30. A brief Intervention 1. Understand the client 2. Understand the science 3. Understand the options 4. Make every contact count.
  • 31. • Understand their motivations and barriers- softer GP skills are definitely usefulhere • Motivational interviewing orelements of it can be helpfulin behaviour change. • Languagechoices • Exampleofpatientmisconceptions. UNDERSTAND the CLIENT
  • 32. • Calories is the most important • Activity levels needed – 30 mins, 5 timesa week, but generally… just MOVE MORE. • Most diet styles willwork, because most lead to calorie restriction UNDERSTAND the Science
  • 33. • www.nhs.uk/livewell • Dietician • GP for Medication • Weight Watchers & SlimmingWorld • LiveWire • WarringtonWellbeing UNDERSTAND The Options
  • 34. A brief Intervention 1. Understand the client 2. Understand the science 3. Understand the options 4. Make every contact count.
  • 35. Any Questions? Dr Chris Lowry GP & Activator drchrislowry@gmail.com
  • 36. Group Discussions Activators – Educating and empowering community leaders, allied health professionals and front line community workers to promote active lifestyles consistently through ONE YOU • Ambitions of the Pillar • What can we do/need to be done to achieve?

Editor's Notes

  1. .