During the LEAP in Wandsworth, 597 referrals were made
to PACs leading to 462 attendances. The average age was 54.8 years and 55% were from black and ethnic minority groups. A local analysis showed that 74% of those attending were inactive at baseline and of those 60% had made a positive change in physical activity behaviour three months later.
The national evaluation The National Evaluation of LEAP was carried out by the Carnegie Research Institute, Leeds Metropolitan University (in association with Matrix RCL and Ipsos MORI) and the results were moderately encouraging (5). Among those attending the MI interventions and inactive
at baseline, 89.3% were achieving the CMO recommended level of physical activity at three months follow-up. The increase in physical activity was 360 MET-minutes/week – the equivalent of 120 additional minutes of brisk walking. The research showed that MI was effective in facilitating an increase in the physical activity levels of adults or older adults. However, the authors pointed out that the sample size was small and that further research was required over a longer time frame. Even so, the lessons from LEAP have lead to another physical activity initiative.
Let’s Get Moving initiative Let’s Get Moving (LGM), is the new adult clinical care pathway for physical activity delivered through the NHS, which utilises motivational interviewing to support behaviour change to increase physical activity levels. Launched by the Department of Health in 2009, LGM is
available for PCTs to commission across England. It is up to each PCT whether they choose to commission LGM, which patient population is targeted by the service and who is commissioned to deliver it. Prior to rollout, LGM was evaluated by the BHF National Centre for Physical Activity at Loughborough University through a feasibility trial in 14 GP surgeries across 11 PCTs in London. The results were very positive. LGM is based on NICE Public Health Guidance 2, Four
Commonly Used Methods to Promote Physical Activity published in 2006, which endorsed brief interventions in physical activity in primary care as being both clinically and cost effective. The initiative also draws on NICE Public Health Guidance 6 on behaviour change and other best practice including the Local Exercise Action Pilots (2004). LGM allows health practitioners to systematically identify
adults not meeting the Chief Medical Officer’s recommendations for physical activity (using the GP Physical Activity Questionnaire). It then uses an MI approach to providing feedback and supporting the patient to become more active, including signposting them to local activity opportunities. Setting a physical activity goal is based on patient choice, and is a collaborative agreement between the patient and the health professional. To help support this initiative, there is a new national search
tool for physical activity opportunities available on the NHS Choices website
www.nhs.uk/letsgetmoving. Health professionals delivering Let’s Get Moving must
be trained using the national training materials. For more information on this programme please go to
http://bit.ly/ LetsGetMoving where you can find out more information including the commissioning guidance and patient resource pack.
22
References 1. Prochaska JO, DiClemente CC. Stages and Processes of Self-Change of Smoking: Toward an Integrative Model of Change. Journal of Consulting and Clinical Psychology 1983;51:390-395 2. Rollnick S, Miller WR, Butler CC. Motivational Interviewing in Healthcare: Helping Patients Change Behaviour. Guilford Press 2008. ISBN-10:1593856121 3. Miller WR, Rollnick S. Motivational Interviewing: Preparing People for Change. Guilford Press 2002. ISBN-10:1572305630 4. National Institute for Health and Clinical Excellence. Four commonly used methods to increase physical activity: brief interventions in primary care, exercise referral schemes, pedometers and community- based exercise programmes for walking and cycling. NICE 2006
www.nice.org.uk 5. Department of Health. Local Exercise Action Pilots (LEAPs)
http://tinyurl.com/5lmhff
THE AUTHORS
Charlotte Hilton is currently co-ordinating the evaluation of the PACP pilot. Charlotte is a member of the Motivational Interviewing Network of
Trainers (MINT) and an MI practitioner and trainer. For more information about MI and MI training contact Charlotte Hilton. E-mail
charlotte.hilton2@ntu.ac.uk For more information on MI visit
www.motivationalinterview.org.
Edward (Ted) Poulter started his work in physical activity with a career shift from the world of media in 2000 and now works as Physical Activity Lead in the Public Health Department of Wandsworth
Primary Care Trust in SW London. He is a qualified specialist exercise instructor (NVQ 3) and holds an MSc from Bristol University in exercise and health sciences. For more information about the work in Wandsworth PCT please contact
Edward.Poulter@wpct.nhs.uk.
ANSWER THE FOLLOWING QUESTIONS ONLINE TO EARN CPD POINTS
Please login to the members area of the REPs website to give your answers
Q1 Q2 harm.
b. The desire to order things correctly. c. The desire to always start a movement with the right side of the body.
Q3
Does OARs stand for? a. Open questions, affirmations,
reflections, summaries. b. Order, articulate, reason and simplify. c. Offer help, allow self-correction, re-affirm decisions and solidify resolutions.
NB. Do not attempt to answer the questions in the interactive version of this magazine
The REPs Journal 2010;16(March):19-22
a. 3 b. 4 c. 5
Does MI work by?
a.Contributing to our understanding of
how we can facilitate behaviour change in practice. b. Giving coping strategies. c. Teaching people how to order their desires.
Is the Righting Reflex? a. The desire to direct someone away from
a. 2 b. 3 c. 4
a. 3-4 b. 5-6 c. 7-8
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