Motivational DVD improves health of a city
The annual costs of obesity and physical inactivity in England are estimated at £10.7 billion (Department of Health, 2004). The challenge in getting individuals to become more active remains a public health priority. This case study describes the impact of a behaviour change DVD designed to increase physical activity in sedentary individuals in deprived communities. The DVD is now part of NHS local authority standard care in Barnsley and has contributed to a population-level rise in physical activity.
The research
In July 2008, researchers at Sheffield Hallam University were awarded a National Institute for Health Research grant, in partnership with University of Sheffield (UoS) to explore the effectiveness of physical activity 'Booster' sessions, telephone-based motivational interviewing or full-booster face-to-face motivational interviewing to help improve physical activity in deprived communities in Sheffield. As part of this Prof. Copeland, Dr Breckon and Dr Crank from Sheffield Hallam designed an innovative behaviour change DVD as a brief intervention designed to increase physical activity in the target population.
After watching the DVD, 79% of eligible participants successfully increased their physical activity by at least 30-minutes per week, making them eligible for the booster interventions. In the main trial managed by UoS, three months after receiving the DVD, 50.8% successfully increased their physical activity. The study provided a robust evidence-base that supported the use of the DVD tool to access hard-to-reach populations in need of brief health intervention.
In order to meet policy and practice needs, members of the Sheffield Hallam team drew on their physical activity research expertise further to inform the design of the DVD. Breckon’s expertise as an international motivational interviewing trainer and Copeland’s expertise in behaviour change interventions in overweight and obesity research ensured that only peer- reviewed content and behaviour change techniques consistent with NICE guidance were adopted.
The Be Active programme not only demonstrated a significant impact on those who were in receipt of the programme but also on those who are connected to the delivery of physical activity services across Barnsley... Providers and commissioners of services in Barnsley are working differently as a result of ‘Be Active’ and this is one of the key achievements of the programme.
Senior Health Improvement Specialist from Barnsley MBC
The impact
The 'Booster' trial research evidence led Prof. Copeland and Dr. Crank to produce another DVD intervention as part of a Barnsley NHS/local authority commissioned service in 2009. The service, 'Be Active' represented a community based behaviour change intervention to increase physical activity in overweight individuals and their families in nine of the most deprived areas of Barnsley. The 2008/9 Active People Survey ranked Barnsley in the bottom 25% nationally for participation in regular activity.
The primary objective of 'Be Active' was to increase the physical activity of overweight adults and to reduce their cardiovascular risk. A total of 7,206 individuals from 4,815 households in the most deprived areas of Barnsley received a copy of the DVD. 92% of individuals self-reported watching the DVD, of whom 93% confirmed they were more active as a result. Data also revealed a significant and beneficial effect over time, equating to a mean weight loss per person of 3kg, a reduction in waist circumference of over 4cm, and a fall in BMI of 0.95 units. The DVD which has been translated into an on-line format, by Copeland and Crank and was embedded within Barnsley MBC's leisure services programme.
In broader terms, data from Sport England's Active People Survey highlight the contribution 'Be Active' made towards adult physical activity participation in Barnsley. The data for Barnsley showed an increase from 19.1% to 22.4% of adults participating in 3 x 30 minutes physical activity per week. To strengthen this evidence, trend data from Department of Health (2011) taken between 2009 and 2011 (the time period of 'Be Active') confirms physical activity in adults increased from 8.3% to 12.1%. This places Barnsley above the national average for the first time.
The DVD approach had a positive and significant impact on the reach of local service providers (ie NHS Barnsley, Active Barnsley, Barnsley FC, Barnsley MBC) by providing each of these with a tool to engage typically hard-to-reach communities and meet national health improvement targets.
The impact of the research informing the 'Be Active' DVD also has a broader reach, driven by publication in a practice-based journal Practice Nursing, via presentations at national and local conferences and via a publically available service evaluation report by the authors of the research. Finally, a workforce wellbeing programme to increase physical activity in the NHS supported by the Yorkshire and Humber Academic Health Science Network utilises elements of the DVD.