An educational strategy for healthcare professionals to assist their clients in becoming more active.

1. for
Movement
Change
Education Strategy for Increasing Physical Activity:
Community and and Health Care Professionals
The potential health gain by increasing physical activity, choosing
healthier foods, moderate weight
increasing population
loss, and improving social supports,
physical activity levels is the incidence of chronic conditions Contents:
arguably today’s best bet in and/or complications can be
public health. J.Morris prevented or delayed. There are Strategy Overview 2
also social and cultural conditions
Physical activity, healthy eating 1-2-3- Move! 4
and living tobacco free are that shape and constrain health -
cornerstones in the prevention and particularly for those with limited Group Interventions 5
resources.
management of chronic diseases 1:1 Counseling 6
This strategy will provide VCH
such as Type 2 Diabetes, heart
disease, hypertension, some staff with the resources to assist their
cancers, osteoporosis, and obesity. clients in building self-efficacy and
increasing their physical activity.
Evidence has shown that with
modest behaviour changes such as
Ask•Assess•Advise•Assist•Arrange•Follow-up
2009
Healthy Living Program-Active Living Coordinator
Vancouver: Mary Clark 604.267.4430

2. Why do we need a
Strategy for staff?
There are many barriers
that prevent health care
professionals from
discussing and
encouraging clients to be
physically active.
1. Many don’t see physical activity as
a priority.
2. There is a perception that smoking
and nutrition are easier to address Overview:
than physical activity.
This strategy responds to evidence of growing levels of physical inactivity
and the corresponding impact on the health and well-being of British
3. Priority of time. Columbians. Using the 21 Core Programs as reference, it aims to increase the
Health care professionals focus on the
specific issue they are seeing the client
awareness and understanding of the health and related benefits of
for ie. wound care, prescriptions. participation in physical activity, and provides the structure and tools that will
assist in developing the skills, resources, and supports central to a physically
4. Many health care professionals
active lifestyle.
don’t perceive they have a role to play
in behavioural change.
This strategy is part of the overall improvement needed in public policy
for physical activity. The promotion, development, and support for policy that
5. The referral criteria or public
recreation access protocols are facilitates and encourages physical activity happens at the population health
confusing. level and can be supported by the work of all VCH staff.
From: “Toolkit for the Design,
The main goal is to increase the health sector’s capacity for sustained and
Implementation, and Evaluation of
Exercise Referral Schemes”, coordinated action on physical activity by:
Loughborough University, 2009. • strengthening staff skills
• strengthening staff competencies
• conveying information and influencing community attitudes and knowledge
• building a supportive VCH system and infrastructure for physical activity as part
of health care delivery, including leadership development.
Fact: VCH staff are potentially well placed to provide assessment, practical
Being physically inactive
information, support, and interventions for people who may need assistance
has many costs:
to get started or to maintain physical activity.
• 31% of all premature
deaths,
• 59% of deaths from It is recognized that VCH staff face limitations on what can be done given
Cardiovascular disease, pressures of time, knowledge, and scope. This strategy attempts to address
• 21% of deaths from this issue by having 3 levels of training and intervention techniques offered
cancer, and and supported. These levels are: 1-2-3 Move!, Group Interventions, and 1:1
• costs the Canadian Physical Activity Counseling.
taxpayer over $211 million
dollars annually in direct Once this overall strategy is approved, specific indicators and timelines
health care costs. will be developed as part of the implementation plan.

3. 1-2-3-Move! Group 1:1 Physical
Movement for Change Interventions Activity
Counseling
Strategy Overview
Brief 1 Hour 1 Hour
Intervention techniques Intervention and leisure
Intervention training given to all VCH counseling training given to
Intervention techniques professionals and interested interested VCH professionals.
training given to all interested community professionals*. 2 3 hours of staff training.
VCH staff and community hours of staff training.
workers/professionals. 1 hour
of staff training.
Goal: Goal: Goal:
Reach all VCH Clients. Reach “High Risk” VCH Reach “High Risk” VCH clients
Reach target population Clients and people in the who require 1:1 interventions
through training non VCH community who would benefit and support.
service providers. from group support.
Outcomes: Outcomes: Outcomes:
Reach high numbers of Reach approx. 750 people Reach approx. 250 people per
people. Increased physical per year. Increased physical year. Increased physical
Activity. Reduction in Chronic Activity. Reduction in Chronic Activity. Reduction in Chronic
Diseases. Diseases. Diseases.
Fact: Fact:
Being physically inactive The greatest health
is as bad for you as benefit goes to those who
smoking. are currently inactive
becoming active.

4. Movement for
1-2-3 Move!
Change
Strategies
Physical Activity
Description: • Uniformity and consistency in methods
being used to assess physical activity
Using the VCH tobacco reduction and readiness for change Facts:
strategies as a model, this component • Support individuals and families to
teaches interested VCH staff and overcome barriers to physical activity
• Increased levels of physical activity
Fact: Adults should aim
community members
how to introduce • Reduction in risks for chronic disease for 60 minutes of
behavioural change moderate activity, most
support to their clients
using brief motivational
Next Steps: days of the week. Health
Canada
interviewing • Needs assessment of VCH
techniques. professionals re: their level of
Initially led by VCH Active Living understanding of physical activity and
coordinators, there will be a train-the- their perception of the Heath
trainers component for interested staff to Authority’s role in its improvement Fact: Physical inactivity
become trainers of their colleagues and • Development of Project Plan, (and poverty) is higher
co-workers. including the outcomes, evaluation
plan, course content, Train-the Trainers among:
Course. women,
older persons,
persons with disabilities,
Target Audience: aboriginal peoples, and
persons who are members of ethnic
Front line VCH staff, including groups.
recreation therapists, dietitians, nurses,
occupational therapists, social workers,
Timeline:
physiotherapists, drug and alcohol Training and pilot to begin in
counsellors, and physicians. November, 2009.
Community service providers who
work with the HLP target populations. Fact: Less than 3% of
A training plan would need to be
developed that includes targeted staff, people with a
targeted community groups, train the diagnosed disability
trainer opportunities, etc.
meet Health Canada’s
Physical Activity
Guidelines.
Outcomes:
• Increased awareness and
understanding of the health and
related benefits of participation in
physical activity

5. Movement for
Change
Physical Activity
Strategies Group Interventions
Physical Activity
Description:
This training gives interested Facts:
clinicians and community workers the
Next Steps:
necessary tools to provide effective • Offer Phase 2 training in Fall, 2009 Fact: Being overweight
interventions to increase physical activity • Group sessions offered across VCH, to
among the at-risk groups they work with. primary care clinics, CHC’s, and at and active is healthier
other community venues.
Using the Stages of Readiness model than being a normal
with specifically designed tools and
group intervention strategies, these
weight and inactive
sessions can be run in a variety of (see graph).
settings and with all ages and abilities.
Target Audience:
• VCH staff, focussing on professional
groups that have experience
facilitating groups.
• Community based professionals.
Fact: Less than 47% of
people in Vancouver
Outcomes: meet Health Canada’s
• Increased awareness and
understanding of the health and
Physical Activity
related benefits of participation in Guidelines.
physical activity
• Uniformity and consistency in methods
being used to assess physical activity
and readiness for change Fact: Many people find
• Individuals and families overcome it hard to maintain
barriers to physical activity
• Increased levels of physical activity changes in physical
• Develop skills to be active as part of activity unless it is part
daily life
• Reduction in risks for chronic disease of their daily routine.

6. Movement for
Change 1:1 Physical
Strategies Activity Counseling
Physical Activity
Description:
For clinicians and community workers Facts:
who have completed Group Next Steps:
Interventions, concepts of the
“Developmental/Behavioural” Leisure
Develop project plan with course
content. Training to begin in February, 2010.
Fact: Poverty is bad for
Counseling protocol will be introduced. your health. Low
It is best suited for
Recreation Therapists income, social status,
working with clients and low educational
who required more
intensive interventions attainment are
or who do not benefit associated with poor
from groups. This level
of training will be
Fact: health.
offered once per year. Increasing physical activity
helps with adherence to
healthcare treatments for
issues such as:
Target Audience: • clinical depression
Therapists who have completed the
• pre-diabetes
• smoking cessation Fact: Ensuring
Group Intervention Training.
• addictions access to physical
• physical rehabilitation activity for people
Outcomes: living in poverty will
• Increased awareness and
help reduce negative
understanding of the health and health impacts that are
related benefits of participation in
physical activity linked to socioeconomic
• Individuals and families overcome disparities.
barriers to physical activity
• Increased levels of physical activity
• Develop skills to be active as part of
daily life Fact: 10 minutes of
• Reduction in risks for chronic disease moderate physical
activity at a time is fine!