The document summarizes a pilot study on developing a fitness therapy and nutritional guidance program for looked after young people (YP) in residential care. The study found that over 3 to 9 months of participating in the "Get Fit for Life" program, which included weekly personal training sessions, bi-monthly activity days, and nutritional seminars every 6 weeks, the YPs showed significant improvements in various physical fitness and mental wellness measures. However, the study had limitations such as a small sample size and lack of a control group, so causal conclusions cannot be drawn. The results provide initial support for regular fitness programs to benefit the physical and mental health of looked after YPs.

1. Andrew Sheppard and Noelle Fitzgerald

2. Item
1
Physical fitness and mental wellbeing
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2 Health needs of Young People
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3 Social and emotional needs of Young People
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4 Addressing these needs
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5 The Fresh Start “Get fit for life” programme
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6 Developing a Fitness Therapy and Nutritional Guidance Programme for
Looked After Young People: A pilot study
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7 Results, Conclusion and summary

3. Item
1
What is fitness?
Fitness or cardiovascular fitness is defined as capability of the body
of distributing inhaled oxygen to muscle tissue during increased
physical effort. Demonstration.
The World Health Organization (WHO) defined health in its constitution of 1948 as
"a state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity".
The link between fitness and mental wellbeing for YP’s
Extended physical activity can have a positive effect on the self-image and
physical and psychological well-being of adolescents (Kirkcaldy et al. 2002)
High BMI and increased levels of sedentary behaviour correlated with
depression in a study of YPs (Anton et al. 2006) and there is evidence to
support that physical activity is a significant predictor of levels of depression in
adolescence (Annesi 2004; Terwiliger 2008; Hong et al. 2009).
Sport and physical activity has been found to play a positive role in self-
esteem and perceived competence of YPs (Kalogiannis 2006) and exercise
has a protective effect on stress and has been shown to reduce anger
(Roemmich et al. 2008).

4. Item
2
Many YPs entering residential care have experiences of physical and emotional
trauma, abuse, neglect, and/or destructive relationships (Christian 2003).
These experiences have a detrimental effect on YPs’ development and heighten the
risk for developing physical, emotional, social, and behavioural problems.
Almost one-third of looked after YPs suffer from physical health problems which
limits participation levels or types of activities in which they engage (Gay et al.
2011).
Physical fitness has a powerful effect on health for all YPs. It combats cardiovascular
disease, increases skeletal infrastructure, and increases self-worth, self-esteem and
self-perception and decreases depression (Ortega et al. 2007).
One study on environmental determinants of activity reported that only 26% of children
in residential care recalled playing a sport during the previous 4 weeks (Gay et al.
2011). Another study found that only 4% of looked after children in the UK are enrolled
in schemes for excelling in sport, art, and learning (Browne & Lynch 1999). These
studies indicate low levels of physical activity for looked after YPs.

5. Item
3
YPs in residential care struggle with poorer mental health and are at higher
risk to develop mental disorders through their experiences of risk factors such
as neglect and/or abuse (Zetlin et al. 2006).
10% YPs within the general population will experience a mental disorder
(Green et al. 2005), however figures for looked after YPs are much higher,
approaching 50% for those living in foster care and rising to 70% for those in
residential care (Golding 2010)
Many looked after YPs do not have access to extra-curricular learning and
activity opportunities that could help combat this (Vacca 2006). The
Department of Health (2011) in UK emphasised the importance of physical
activity, healthy eating, emotional health, and well-being on the mental health
of looked after YPs.

6. Item
3B
Four maladaptive coping mechanisms have been identified and are used by
looked after YPs (Goodwin 2006):
Emotional coping
Substance use
Aggressive behaviour coping
Physical activity
The former three coping behaviours resulted in a likelihood of
increased depression in YPs whereas physical activity was linked with
lower levels of depression

8. Item
4
In a move to combat this trend and enhance the level of
health and wellbeing of YPs in their care, Fresh Start Fitness
Exercise Therapists created the “Get fit for life” health
programme.
The “Get fit for life” programme is a comprehensive health
package specifically tailored to meet the needs of young
persons in residential care.
Fresh Start Fitness Exercise Therapists carry out a unit based
personal training session with each young person a minimum
of once per week and deliver a seminar on Nutrition Once
every six weeks.
We also run an Activity day every two months for all our young
people to promote the fun element of exercise while
encouraging peer and social interaction.

9. Item
5
The program concept and design, different to PT
Tracking progress through Fitech V5 and session
reports/monthly reports
Social and peer interaction through exercise groups
Links with Occupational Therapist
Nutritional guidance

10. Nutritional Guidance
Program layout
Part What is Healthy Eating?
1
Functions and R.D.A of carbohydrates, proteins, fats, vitamins & minerals
Part Fats and Sugar in the diet
2
(Functions, dangers, visual exercise with sugar and fat)
Part The benefits of being physically active
3 The dangers of a sedentary lifestyle: Heart Disease,
Diabetes, cancer etc.
Part The dangers of smoking, alcohol and substance
4
abuse. Exercise as a beneficial adjunct.

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6
Participants – 8 young people* ranging 14 to 16years
living in residential care homes
Measurements (3,6,9 months)
Fitech V5: Physical Fitness & Quick Stress Survey
Physical Fitness: Body Mass Index/ Resting Heart Rate /
Lung Capacity / Aerobic Capacity / Flexibility / Lower Body
Strength
Quick Stress Survey (Well-being): Tension / Anxiety /
Anger / Depression

12. Item
7
Mean scores and significant values of 8 young people after 3 months
Baseline 3 months p value
Resting Heart Rate (b/m) 81.4 74.6 .011*
Lung Capacity (l/min) 382 520 .001*
Aerobic Capacity 40 48.5 .025*
(ml/kg/min)
Flexibility (cm) 37 45.3 .026*
Lower Body Strength 34.4 52.6 .003*
Results of 4 young people across 9 months of physical activity programmes
Baseline 3 months 6 9 p value
months months
Resting Heart Rate 83.3 76.8 76.8 73.8 .006*
Lung Capacity 363 490 495 612 .048*
Aerobic Capacity 41.8 49.1 53 54.2 .001*
Flexibility 32.5 39 47.8 54.5 .012*
Lower Body 32.5 48 56.3 69.8 .003*
Strength

13. Item
7
Means and significance values for 4 young people over 9 months.
Baseline 3 months 6 months 9 months p value
Tension 4.15 2.6 2.25 1.5 .002*
Anxiety 4.65 2.8 2.5 1.75 .000*
Anger 4.5 3.6 2.6 2.55 .005*
Depression 4.1 3.45 2.5 2.15 .034*

14. - Initial insight into how regular fitness therapy programmes with
nutritional guidance can be appropriate and popular for looked
after YPs and benefit both their physical health and mental
wellness.
- Mild integration into the fitness therapy programme was a major
strength and allowed for greater participation levels.
- Limitations: Does not account for other interventions limiting
inferences to associations for fitness therapy and does not allow
for direct causal interpretations.
- This study did not have scope for using a control group and any
inferences made from the data cannot be directly attributed
directly to the fitness therapy programmes.
- Suggestions: Include a focus on more physically active and
healthier environments & fitness directors within care services
and/or designated staff members for physical fitness to be part
of the structural environment within residential care homes.

15. Thank you!