1. Opportunity to intervene?
Firstly, the appropriate timing to carry out the intervention is important – the physical setting and emotional setting needs to be right e.g. approach the subject with sensitivity in a quiet, confidential area of the workplace.
Furthermore, significant events or transition points in people’s lives present an important opportunity for intervening at some or all of the levels, because it is then that people often review their own behaviour and contact services. Typical transition points include: leaving school, entering the workforce, becoming a parent, becoming unemployed, retirement and bereavement.
An example of prompts that you can use to raise the issue of physical activity would be looking at the individuals symptoms.
Are they complaining of:
- Being unhappy with their weight
- Shortness of breath
- Excessive tiredness
- Mobility problems
- Depression/stress
- Difficulty in sleeping
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(top)
2. Raising the issue
Raise health issues in a friendly, non-threatening manner which uses indirect questions to start with.
Q: We are raising awareness of recommended levels of physical activity – would you like any advice or help with this?
Q: Have you seen our promotion/advertisement for a healthy lifestyle consultation?
Doing brief interventions requires good communication skills. It is important to:
- listen to what people say
- notice what they do not say
- watch what they do
- think about their situation
- think about what you know about them
- talk with them in a way which is not threatening
- avoid giving a lecture about health behaviour
A warm, reflective, and understanding style of delivering brief intervention is more effective than an aggressive, confrontational, or coercive style. (top)
3. How to complete the Physical Activity Quiz
Using the quiz, ‘So How Active Am I?’ in the British Heart Foundation leaflet (30 mins a day – any way), allow the individual to self-complete the quiz. (top)
4. How to score the Physical Activity Quiz
Using the instructions within the leaflet, add up the total number of minutes of physical activity undertaken for the week. Compare the total for the week to the categories in the leaflet. E.g.
Less than 150 minutes – You are an inactive person. We suggest you make a start on page 6 (Benefits of physical activity)
150 minutes or more, but you are active on less than five days a week – You need to increase your activity level. We suggest you start on page 10 (What sort of things should I be doing?)
150 minutes or more, and you are active on more than five days a week – That’s good, but you need to keep it up. To help you keep up your level of activity see pages 10 (What sort of things should I be doing?) & 16 (Getting started) (top)
5. Discussing the Physical Activity Quiz
Ask the individual how theyfeel about their physical activity score OR begin a discussion using the following;
Your score suggests you might need to increase your level of activity. What do you think?
Do they have all the information they need to decide what to do for the best? Follow on to talk about recommended activity levels and benefits of increasing physical activity levels (see below). (top)
6. Recommendations
Chief Medical Officer’s recommendation (5 times a week x 30mins):
Frequency - At least FIVE or more days of the week
Intensity – At least MODERATE intensity (‘Moderate’ means any activity which involves; breathing a little faster, having slightly faster heart beat and feeling warmer.
Time - Initially this could be 3 x 10 minute sessions or 2 x 15 minutes sessions, aiming for 1 continuous session of at least 30 MINUTES (top)
7. What are the benefits of Physical Activity?
Increasing activity levels can contribute to the prevention and management of over 20 conditions and diseases, including coronary heart disease, diabetes, cancer, positive mental health and to ongoing weight management. Cardiovascular disease (including heart disease and stroke) and cancer are the major causes of death in England, together accounting for almost 60% of premature deaths.
Inactive and unfit people have almost double the risk of dying from coronary heart disease, against which physical activity is an independent protective factor. Increasing activity levels also has beneficial effects on musculoskeletal health, reducing the risk of osteoporosis, back pain and osteoarthritis. (top)
8. Stages of change model – Are they ready to change?
Brief interventions can help instigate a natural process, from pre-contemplation, to contemplation to action. The Stages of change model is a useful tool to describe the process that people will go through en route to health behaviour change.
Follow the links to the stages of change model (click here) in relation to carrying out and a brief intervention around physical activity.
However, are they ready to commit to change?
As well as exploring readiness, it’s useful to explore the importance of changing by using a question such as:
How important is it for you to do more physical activity? If 0 was ‘not important’ and 10 was ‘very important’, what number would you give yourself?
Also, explore the individual’s confidence in changing to a healthier lifestyle by using a question such as:
If you decided right now to increase your level of physical activity, how confident do you feel about succeeding with this? If 0 was ‘not confident’ and 10 was ‘very confident’, what number would you give yourself?
The response to the above questions will help you understand exactly what someone feels about change. Follow the link to some useful questions which can help you further Explore Importance and Build Confidence.
Useful Questions (click here) (top)
9. Barriers
The following are examples of possible reasons for not being active, and will need to be addressed by the individual before they can move towards making changes. Page 14 in the British Heart Foundation ’30 Mins a Day – Any Way’ leaflet may help provide some solutions.
- Lack of time
- I need to rest and relax in my spare time
- I feel OK anyway
- There is no one to do it with
- I’m too fat
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10. Top tips for doing Physical Activity
- Take the stairs instead of the lift of escalator
- Get off the bus or train one stop earlier and walk the rest of the way
- Leave the car at home and walk to school, shops etc
- Take a walk in the lunch hour
- Take up an active hobby such as dancing, cycling or walking
- Set activity goals and reward yourself once you have achieved them
- Try to change an inactive choice for an active one: take the stairs instead of the lift; walk to the next bus stop on the way home; wash the car by hand instead of taking it to the car wash
- Walk or cycle for short errands rather than taking the car (e.g. cycle to the paper shop)
- Be active to music - it’s amazing how quickly the time will go
- Choose activities that you enjoy doing - physical activity should never be a chore.
- Watch only the TV programmes you really want to see and do something active in between
- Throw away the remote control!
- Hang your coat upstairs so that you go up again to get it
- Take the dog for an extra walk
- Remember that the best time for you to exercise or be active is always the most convenient time for you
- Write down how good you felt the last time you did some physical activity and keep it on hand to read whenever you feel that you’re too tired to get motivated
- Don’t lose your routine when you go on holiday. Walk to explore the area, swim in the sea, go dancing at night
- Stick reminders in key places (refrigerator, computer) to remind you to do activity or ask a friend to send email or phone reminders
- Keep comfortable shoes and clothes in a place that you spend a lot of time - the car, work, and even a friend’s house. That way, you’ve never got an excuse not to be active
- If you are unwell it may be best to avoid doing a lot of activity during this period. Once you have recovered gradually build up your activity again. (top)
11. Making a SMART Plan
If the individual appears ready to change use the ‘Getting Started – Making an Action Plan’ tool in the leaflet (page 27) to assist the individual in deciding upon some goals which will work for them, allow the individual to take the lead.
Remember to assist the individual in making the goals SMART –
Specific - vague terms are not useful and can easily be confusing.
Measurable - how will you know if the goal has been achieved?
Achievable - don't set impossibly high targets for yourself.
Realistic - you know yourself, what can you actually do?
Time-limited - set a period in which this will be achieved.
If the individual doesn't succeed at their goal, they need to examine why not, re-frame the goal and then try again. If they do succeed, it is important to acknowledge it. Rewarding themselves with an appropriate treat, such as going to see a favourite film, buying a new CD, perhaps, or going for a swim is important, they deserve it! (top)
12. Links to local and national support services
Local
www.leapactive.org - LEAP
www.pedalbacktheyears.info – Cycling for all in Cornwall, the scheme provides guided cycle events on a number of our beautiful cycle routes across the county
National
NHS Direct 0845 4647
www.activeplaces.com – this website can direct you to sports facilities in your area.
www.bhfactive.org.uk
www.whi.org.uk - Walking to Health
www.sustrans.org.uk – Information on safe cycle routes (and more) in Cornwall and the rest of the UK
(top)
13. Leaflet available for ordering or downloading
30 mins a day - anyway Produced by the British Heart Foundation
available from the Health Promotion Information Service
also availabe to be downloaded - Cover (click here) Inside (click here)
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