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The Local Exercise Action Pilot in Dudley STEPS TO HEALTH “The Promotion of Activity in Parks” The Story So Far……. Barrier to Activity Cost Transport to facilities Aimed at “sporty types” Programmes targeted at specific age groups. Parks Free Accessible for all
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The Local Exercise Action Pilot in DudleySTEPS TO HEALTH “The Promotion of Activity in Parks” The Story So Far……
Barrier to Activity Cost Transport to facilities Aimed at “sporty types” Programmes targeted at specific age groups Parks Free Accessible for all A comfortable venue for sedentary people Facility for the whole family Why Parks?
Aims • To increase and encourage the use of parks and open spaces as physical activity venues: • Pilot a referral pathway from Primary Care to existing activity stations and the Parks Programme. • Target people from disadvantaged groups • Secure long term sustainable funding
Objectives • Promote the parks as physical activity venues to members of local communities. • To encourage service reform within the Parks Department to proactively provide and deliver physical activity opportunities. • To encourage service reform within Leisure Services Department to view parks and open spaces as a viable alternative to existing bricks and mortar facilities. • Modernisation of the Park Keeper role into a Parks Physical Activity Leader (PPAL). • Provide a link for Primary Care to activity stations around the borough.
Partners • Primary Care Trust Knowledge and skills in the promotion of physical activity, and health improvement. • Dudley MBC Parks Department Knowledge and resources around the chosen sites and provider of key staff. • Dudley MBC Sports and Leisure Department Knowledge, skills and resources for the provision of physical activity for all • Action Heart Cardiac Rehabilitation Programme Knowledge, skills and resources to provide physical activity opportunities for patients with health risk factors • Friends of Parks Knowledge of the targeted user groups
The Steps to Health Parks • Links to TYS • Staff • Areas of Deprivation • Geographical Spread
Well lit, clean and secure Staffed by Park Keepers with a modernised role Informative signage Emergency First Aid and Telephone Clean toilets Shelter Seating Well surfaced footpaths Modern, clean play equipment Sports areas with goals and nets Hire of sports equipment Programmed activities for all ages and abilities Health information points, linking to other physical activity services Way marked walking routes What we wanted
Limited staff presence delivering an historical remit No or poor play equipment No emergency first aid or telephone No toilet facilities Uneven footpaths, poorly maintained No Shelter Poor or non existent signage No information points No way marked walking routes No provision for equipment hire No activity programmes No provision of refreshments What we had
What Happened Next – Planning • We audited provision and identified gaps. • Set up Stakeholder Interagency partnerships and steering teams at both Strategic and Operational Level. • Community involvement and empowerment via Friends of Parks and other user groups was critical and was gained. • Allocation of funding was identified for both capital and revenue. • Proposed physical improvements and delivery programmes were matched with audits and community needs. • The need for a hands on deliverer to support the Project Co-ordinator was identified and eventually recruited.
The Audit Process • Developed a physical activity audit tool in partnership with stakeholders that assessed the park against a range of factors which affect the promotion of physical activity. • Audit was facilitated by a number of groups including project partners, Friends of the Parks and Community Groups. • Gaps in service provision were highlighted. • Audit results led to the development of a physical activity strategy for each park, to be driven by a physical activity task group. • The above process instigated the majority of subsequent development.
What Happened Next - Delivery • Provision of ‘Free’ activities in each of the parks. Suitable for all ages and abilities. Young people were offered coaching sessions in cricket, tennis, football basketball and multi sports. Adults were targeted mainly through health walks and very popular exercise sessions in parks. • A discount leisure scheme in parks and leisure centres, offering a wide range of activities at 50% of normal price for patients referred by GP’s. • Encouraged lifestyle change and promoted the 5 x 30 minutes message. • Improved the capacity of staff to deal with a range of people, and actively encourage physical activity.
Challenges • Referral rates from some practices were quite low, and in some cases non existent. • Low adherence rate from the discount leisure scheme. There were also some initial teething problems with the logistics of the scheme. • Modernising the role of the Park keeper has proved difficult.The infrastructure to support this has moved at a slower rate, than individuals within the partnership would have wanted. This often left the programme overly reliant on one or two members of staff. • The parks junior sports coaching programme has attracted a predominantly male audience. • Weather and seasonal changes have a significant bearing on the Parks based programme. • Monitoring / evaluating whether more people are using Parks outside of organised activities.
Successes • The discount leisure scheme has generated over 3000 new starters, with the highest percentage coming from Dudley’s most deprived areas. The scheme has been well supported in Primary Care settings. Still over 600 registered as regular participants. • In it’s entirety the Parks based programme has benefited over 4000 people, and has expanded outside the original 5 pilot parks. • The Parks holiday sports coaching programmes have generally been well attended over the three years. Average attendance was between 15-20 participants per session. • A programme of regular health walks has emerged. Currently there are 8 walks a week taking place in Parks. The walks attract a lot of female participants, particularly in the 50+ age group. • The most successful parts of the Parks programme have tended to occur when community partners have been fully engaged at all stages. • Posts to support the programme within the PCT and the Parks department (PPAL) have been mainstreamed.
Present Situation • Service reform in Parks and Leisure Departments starting to happen – a joint holiday coaching programme has been established. • Training programme, funded by the PCT, is now in place for Parks keepers to move towards the modernised role. Some Park Keepers have been involved in delivering health walks. • Improvements have been made on a number of parks, such as signage, play areas and multi use games areas installed, with further improvements planned. • Discount leisure scheme still operating without any problems from LA or PCT perspective.
Learning Summary • Partners need to be fully engaged and fully aware of roles, responsibilities and projected outcomes from the start. • Communication needs to be open and transparent at all times and at all stages. • User engagement , in this case Friends of Parks and young people is critical to the success of Parks based programmes at the pre, delivery and post intervention stages. • The park setting did work as a venue for predominantly sedentary people from disadvantaged areas, as well as attracting people who travelled to the programme. • Formal evaluation forms such as IPAQ and BAD do not work with people in the parks setting. By the nature of the targeted approach within disadvantaged communities, some participants could not read or write, some were suspicious of official looking forms, forms were rarely if ever returned on time, and there was a general reluctance to formal processes.
Learning continued • Never assume that partners are as committed as you, or will be willing and/or able to work at a pace that best suits the programme. • Be realistic from the outset about working practices and partner agendas, this will hopefully lessen frustrations along the way. • When working with community groups, don’t be afraid to be honest about your limitations and the bureaucracy that affects day to day work, community groups need to know why things cannot ‘happen tomorrow’. • Primary Care can be a positive setting for the promotion of physical activity provided the system is simple and not reliant on too much staff time, but outcomes will always be determined by personalities not processes in primary care. • When making physical environmental change to promote increased activity, this is very often the hardest intervention to measure, even though it may be the most effective. • When aiming for service reform, two years is not enough!
And finally…. • Before LEAP Dudley had no parks programme, disengaged friends of Parks, a perception that parks were places that were unsafe , dirty and in disrepair, generally a hugely underused resource. • We now have an established parks programme, supported by a mainstreamed post, and strategic commitment within the Local authority, plus core PCT funding to enable continued training of Park keepers into the vision of a modernised Physical activity leader. • Although we are not there yet, and the process to this stage as been difficult, we feel that we are now starting to reap the benefits of the parks programme. We would like to leave the final word to one of the parents of a participant. “What a fantastic way to keep children entertained .Keeping fit and enjoyment rolled into one. Please continue you have saved the mums sanity”
Balraj JohalPhysical Activity AdvisorDudley PCT01384 366611balraj.johal@dudley.nhs.uk
