Well, good evening everybody. Thank you so much indeed for coming along. Good evening to colleagues who, friends and colleagues who are joining us online in, the West coast of America and Canada, in Switzerland and Spain. It's a very good morning to colleagues. Good Thursday morning to our colleagues who are joining us in China and also in Australia. Thank you so much indeed for coming along. And thank you so much indeed for such a fantastic, turnout and also to tenacious for such a generous introduction. So, I'm just going to get straight on with this if this is okay.
So as with all good inaugural, so you've got to start with a picture of the London bus. And some people know exactly where I'm going with this. Not just anyone. The number 73. And the number 73 is important because it goes down from, Highbury and Islington in north London, all the way down Kings Cross, realistic, Stoke Newington and me.
My dad and my brother would often catch the number 73 bell off at London. Saint Patrick's probably or hostelry somewhere. And but it also the number 73 is important because it's been 73 years since the venerable godfather of physical activity research, sir Jerry Morris, conducted his seminal research comparing the physical activity levels of London bus drivers and London bus conductors. And Morris identified that the more physically active conductors who are up and down the stairs taking fares and helping people off the steps will much more physically active and therefore had a protective effect afforded to them in terms of the prevention of coronary heart disease.
Morris was followed by many great, men and women who researched in this space Ralph Puff and Barker and his work with longshoreman or Dockers, who identified that very short, intense bouts of physical activity could provide that protective effect around coronary heart disease. And and they were they charted the course for research that was undertaken by many men and women in this space, right the way through to our current chief medical officers.
Physical activity guidelines, in 2019, that identified the convincing role of physical activity in the prevention and management of well over 20 conditions. And I'm really pleased that members of the 2019 update join us this evening. So it's great to have you here. So what's in the title? Well, physical activity not only adds years to life, it adds lives to life. Two years. It's a story of maximizing human potential, of doing all the things we want and need to do in everyday life. But it's it's more than the it's the interventions that we implement to get people active and the physical activity interventions that we implement to get people physically active, recognizing that there might be the might be, not the same thing as really important.
What needs to go into the physical activity engine, the frequency of the intensity, the time, the time, the venue, the stuff and how people get there. The team you serve, it's got to be Yorkshire City.
Of course, the Kate and so on and so forth is about that physical activity and what needs to go into the design mix. So it's been great revisiting, I guess, content from really what's going into its fourth decade. My goodness, don't I start to feel old? But just kind of choosing what to, what to talk about.
And it's been fantastic reconnecting with people, in some cases after 30 years, most recently, Jed Garbutt, who gave my maybe first chance of lecturing at the university. Someone recently got in touch. And it's been fantastic to reconnect with people. It's been incredibly difficult choosing what to talk about.
But I'm going to talk about, probably the most challenging piece of work I was involved in the national evaluation of the local Exercise action pilots. But it set the tone for what followed in my career. I'm joined by people who survived leap, and live to tell the tale. Probably the most enjoyable piece of work was Premier League Health, a national program of men's health improvement and 16 Premier League football clubs. And then what I felt just incredibly honored to be part of which was the city of most physical activity guidelines. And linked to that, the role of healthcare professionals. Some of our more recent work here at the University Derby and promoting activity. I'll then talk about the environment, and physical activity, infrastructure and conflict. Sorry, I was the spoiler. But I'll finish on a positive, talking a little bit about some of our current work here at the University of Derby. And across all this, I'll talk about the key implementation factors. I'll give you a kind of a bit of the headlines around some of these projects, as well as some, some of the narrative around the key implementation factors. But I didn't want this just to be about the research.
We are on the School of Sport and Exercise Science at the University of Derby, and we are absolutely about maximizing human potential across our students. Our partners, who we work with in their local communities are staff teaching, research, professional practice, and across sport, exercise science. Right the way through the physical activity, we are about maximize maximizing human potential.
And my story is one of achieving human potential. I think it's fair to say my fruit, the professorship is less than conventional and I think no one saw it coming. So I hope that maybe my a fairly unconventional route through the professorship might offer, some inspiration to lots of people. So, I will talk about some of my family and formative influences that my lens around, physical activity in and implementation.
So as nossas mentioned, I was born in Middlesbrough, but dad was a Geordie. My mum was a Smokey from Middlesbrough, and he was keen to get his back up on Tyneside. And here we are, at Newcastle upon Tyne, the banks of the River Tyne. And on the north bank we have the Newcastle Quayside. I think some of us have had a night out there on Newcastle's key side. And of course on the cultural side, on the Gateshead side, we have the Baltic and the sage, the magnificent Seven Bridges across the time. But it didn't always look like that 100 years ago. The key side looked very, very different. And, my route through the professorships started nearly a hundred years ago. Newcastle grew up around its industrial heritage, around shipbuilding. And that was inextricably linked with coal, the export of coal from the Northumberland Coalfield, and sea and coal would become important influences in my life, and kind of shipped a lot of what we did. Now, let me introduce you to another influential man in my life. This is my dad, Ken. Now, some of you know, can you be for a drink with him? You may well have been the football and live to survive the tail. So Ken had was born in Newcastle in 1931. Very, very impoverished background. He grew up during the Great Depression. He remembers the Jarrow marches. And he was evacuated, out of Newcastle to the countryside during the Second World War. And it's that he learns his early engineering skills because he grew up on a farm. And that's where he began to get his, develop his engineering skills. Upon return at the Tyneside, he became a mining severe. But he didn't really like the subterranean nature of the work. So his friends and black them were course started going out with a pool at a time of house household coal. And it's that he learned his, his skills as a marine engineer working his way up to first engineer. And this is the sort of thing he worked on. Great, big Herculean engines. He would work, work on them at sea. When we would strip engines down, he'd work at the, on the dry dock, but he just got it. He had that vision about what the engine was, what were the constituent parts, what needed to go into it, how he made them work. Now, when I left school in Alnwick in 1985, I think it's fair to say that the country was at a time of change. And I think, the decline of the traditional manufacturing industrial base that really prospects for young men and women were somewhat bleak, really. But like a lot of young men and women at the time, they followed their parents into that profession, that the parents profession. And I was no different. So I drag my sorry backside into the central station in Newcastle, down the Biscuit Road. This building here to the left is the house where I was interviewed, for my apprenticeship with British Rail as a Traction Trinity. Now, traction trainees learn to fix trains or they learned to drive them.
It's a lovely picture here, taken by my very good friends, Dave Stacy, who joins us this evening of the British Rail Engineering Works and Derby. This is the area that's occupied by Derby College now. But I was just terrible at Stem subjects, so I didn't get taken on. And I did get taken on by Dave, who was building an engineer and working out of this blacksmith in north Northumberland. But I was really terrible at the job. And he said, I'm sorry, son, I'm going to have to let you go. I mean, dad said, well, you've done the 30 for that bank holiday, so I wouldn't worry about it, son. Now left school without any O-levels or GCSEs and new money. So it did give me the opportunity to go back to school. And I had some great teachers who knew I was interested in sport, and they kind of harnessed my my potential. I was very grateful for what they what they did, but it raised the prospect of going to college. The first person in my family to go to college, and it's a steel looking building here, is affectionately known as Ashton Tech. So this is set up by the Coal Board for miners and the families to get some education, but that it was the prospect of going to university. And in 1988 I set sail for Stoke on Trent, just 30 miles up the road where I started, a PR honors in sport recreation studies that was predominately interested in sport. Lots of great tutors. Thomas, Nigel Gleason, who went on to be profs at Queen Margaret University at Edinburgh. How do you get people physically active? What are the best interventions? How do you design them? What needs to go into the mix? And by the time I'd left, stuff's probably in 1991, I had the choice of a job, funnily enough, in Wales as a, follow in my dad's footsteps as a health promotion officer or had a funded postgraduate diploma in health education at the University of Manchester with a local authority grant. Remember then? So thanks to Northumberland County Council for kind of providing the money for that. And by the time I left there, as you can see, the building has got better and better.
I washed up in my birthplace. Here we are, on the Tees, the magnificent transport, the bridge, the Middlesbrough transport, a bridge on the north bank of the river. We've got County Durham and on the south bank of the river we've got North Yorkshire. But then it was very much Middlesbrough and Cleveland. And what are the first? So you got a job as a health promotion, officer working in the health authority. They said, Andy, you can do anything you want. Just do it in Middlesbrough, which was the area where the football stadium is kind of that sort of area, the Riverside. So one of the first projects I worked on was in South Middlesbrough, of course, and one of the first calls I made was to my very good friend Stephen Robson, who worked for Middlesbrough Council Sports development units, and we set up Healthy Hamilton, which is a suite of test programs to get people who are sedentary or inactive doing some activity. And we began to pore over. We spent hours thinking about how do you design the intervention, what needs to go into the intervention mix? What about the venue, the Stafford? What about the activity? How are people going to find out about this? So we spent loads of time kind of thinking about the key design characteristics, but at that time a lovely kind of letter in the BMJ. It was talking about healthy alliances between the health and the leisure sector. And there was a lovely, kind of, letter in the BMJ in response to Mike Osborne, Mike Osborne set up for us this project. What are the first GP exercise referral schemes in this country? And we in the letter they have, they go on to say I've argued for exercise counseling sessions to take place outside the surgery in village holes, leisure facilities and educational establishments. How revolutionary was that? And we were no different. And Stephen and I worked together on setting up Middlesbrough's first GP exercise referral scheme, where GP's, and other health care professionals could refer people who are sedentary or inactive into a program of physical activity at a local leisure center. And we spent hours thinking about how do we put this thing together, how best do we get people's views? Do we get something up and running and use that as an operation, a means of actually having that dialog around the key design characteristics?
Now, I didn't do an undergraduate dissertation, and my first really foray into doing research and evaluation was when I did my master's in health promotion were evaluated. The gaps in that would become quite important later on. So in 1996 I set sail for Leeds Beckett University. Then it was Leeds met. Here we are at the Beckett Park campuses, campus. And as some of you know, the campus well, where I joined the team as a senior lecturer in physical activity, setting up one of the first physical activity degrees. And it was very much about getting the applied practice into the curriculum. And I didn't do much research, but around 2002, some more senior colleagues had, secured the contract to evaluate the national evaluation of the local exercise action pilots. And this is the most challenging piece of work I've been involved in. And I'm joined by colleagues who are part of this and live to survive and tell the tale. So leap was set up by Sport England, the Department of Health and Countryside, to establish which are the most effective interventions for getting people active, what are the most cost effective ways of doing that, and how do we put that in practice? And the findings would inform how 50 million pounds that was set aside in the chosen Health White Paper would be spent on physical activity. So no pressure. And I probably, and I would probably kind of, didn't appreciate the gravity kind of associated with kind of this piece of work. But having said that, I didn't really I didn't have, hadn't done much research. And my really my first experience was doing a master's dissertation. I'd very soon found myself managing this multi-million pound national evaluation across ten sites. And there was pressure at every single level from, a cabinet, cabinet minister all the way down to the sites. And what you saw was the pressure coming down the line to deliver. So this was a classic mixed methods, national evaluation.
So we looked at effectiveness. So change in physical activity levels. We use self-report. But clearly we do use objective measures now efficiency. So we built a cost effectiveness analysis to identify which interventions were cost effective in getting people active. What were the potential savings to the NHS. And if that was not enough, we did 300 interviews with key stakeholders. I kind of think we we probably overdid it there around the key implementation characteristics. So the design factors and if that was not enough, we got Ipsos Mori to do a community wide survey and put in for good measure. We also interviewed the delivery managers on the evaluation around the value ability. So a particularly, ambitious piece of work. So I'll give you the headlines and I'll talk a little bit about some of the key design characteristics. So the headlines would lead was set up to look at which interventions got people who were sedentary or inactive doing some physical activity. Yeah, 60, 60% of the people who were recruits had reported meeting the guidelines already. So we questioned to what extent it had been successful. That said, 40% words and 28% of those increased the physical activity category. So there was kind of a fairly positive story there. And then when we look at the cost, the the economic evaluation, the cost per participant who improved on category ranged from £260. So just short of three grants. So cost effective. And the the cost per quality adjusted life year again. So that's a year at least three three of of disease. So in this case coronary heart disease, type two diabetes depression and colon cancer was between £50 and 510 pounds, the cost effective with potential savings to the NHS. So when the the public health minister stood up at the Emirates Stadium, there was a positive story to tell. But what about some of the key implementation factors?
Well, from our 300 interviews, I think we probably overdid it a little bit. These were some of the headlines around key implementation. So what needed to go into the kind of design of interventions to make them work? So dialog with stakeholders, work in partnerships, a strategic approach, outreach work with local groups, tailoring the interventions to needs, understanding some of those barriers and determinants familiar in local environments, but delivering that trained and skillful staff building capacity evaluation. Well, probably nothing new by today's standards. So I'm just going to pick out a couple of things, which then leads into the next section. So the first thing to say is that dialog with stakeholders is so important. And there's a lot is made of that in contemporary physical activity and interventions now. And that's great. But it's nothing new. It's been called for for well over four decades. But it's it's acknowledged as being important. And what's fantastic is the acknowledgment of quality of inquiry, having a chat with people about their likes, dislikes, their preferences, this preferences, what their determinants are as being a valid and reliable form of, of, of data capture. So it's really great that that's kind of taken on grit, a kind of importance, I think, in contemporary physical activity and intervention.
There are lots of amazing examples of why it was really important to have that dialog with stakeholders. But one emerges from the Yorkshire pilots, Yorkshire local Exercise Action pilot. And this is in Kirklees. So if you don't know the area, this is the M62 corridor. So kind of west of Leeds going out to Batley, Huddersfield. And we're joined by Ali who was kind of really kind of important as part of that, kind of that pilot. So it's a group of South South Asian women that went to an exercise to music class. They did dancing to listen to westernized music on a regular day at a regular time. And then one morning they said, we can't come along to this session anymore because we are being put under pressure. And our male family members, our fathers, our brothers, our husbands, our partners, etc. are being put under pressure by more influential members of the community. To say what you are doing is not in line with our cultural values, but fortunately, because of the relationship between the delivery staff and the women, they were able to have that dialog. They were able to have that conversation and to kind of identify what what are the the barriers of what might be some of the solutions to overcome that. So the fact that they could alternate the day an alternate at the time and that they could use their own cultural music and make their own song and dance, and that was a means of actually keeping that group of women active. Now, had it not been for that dialog, a trusted relationship between skillful staff and the participants, the means of having that conversation together and the approach, we would have lost that group. But as it was, it was a really nice example. And you don't get that out of a book. You get that from that conversation. The other thing I wanted to focus on was evaluation, and that is where I think some of the most significant learning is around, the Leap project. And I think this is relevant today, as it is relevant now as it was back in 2007.
So I mentioned this was one of the most challenging pieces of work I kind of was involved in. And we should see evaluation as part of the intervention design. It's what needs to go into the intervention mix. So we should see evaluation as part of that intervention. And we should have point evaluators at the start. One of the big challenges was leap with Leap was that the evaluators were appointed nine months after the ten delivery sites. So expectations had already been set about what the national evaluation was. And in reality, when we bolded nine months after, the sites have been kind of appalling, said the expectation on the sites as a partnership evaluation design was much greater. And I think it's fair to say they were miffed with us. To say the least. But I think the opportunity was lost because I think if you're point your evaluators early, you're in and you could have that regular dialog with those stakeholders about what is what the evaluation is, what is possible, what are the barriers, how you might be overcome those, and that that conversation is so important. And I think tied in with that is the importance of having skillful evaluate as a one of those skills is being able to kind of work with the delivery sites. And I think it's fair to say we had colleagues who, were brilliant researchers, but they weren't very good at communicating with the sites. And so subsequently, the sites got the hump. So we had to work incredibly hard to build up the relationship and the trust between the delivery sites. And that took a long time. And we covered hundreds of miles going out with the ten sites. We spent a lot of time in the sites trying to build up that relationship. But I think that's a really important, design characteristic. By having that dialog, you begin to think about adopting practical and validated instrumentation. So there's no point in giving someone a questionnaire if they can't read or write. And we came across people who couldn't read or write or where English wasn't the first language, or people who had incredible concerns around surveillance of filling in a consent form. So all these were particular challenges. And I think committing the resources to the evaluation now, in this case, the Department of Health put in a decent amount of funding. But so often I kind of hear, Andy, can you do an evaluation and can you do it next week? And by the way, we haven't gotten anybody can maybe do get a couple of students. And and whilst that might be appropriate in some circumstances, I think it is important to invest in the evaluation. So after three and a half hard years and it was hard years, we'd built up the relationship with the site. We delivered the national evaluation. I stood up at the Emirates Stadium in front of 300 people, and I a little bit nervous tonight, but I was really nervous then, and delivered the findings. The Department of Health was happy. And we've actually got there pretty good relationships with the ten delivery sites. The extent to which they asked us to do some follow on work. So but I think some of the most significant learning is around the evaluation, how to evaluate or how not to do that. So the two things which came out of this, firstly, I knew would get the next big gig would come along soon. And it was I was very much committed that we, we, we, we built on the learning from the evaluation and put that into practice. So more on that in a bit. But secondly, we needed to get the learning out there. And we had to work quite hard with the commissioners to kind of talk about some of the challenges and the difficulties of doing evaluation. So we did get that into the national report, the summary report, if you want to read that, you see the more colorful version of kind of implementing the national evaluation and some of the challenges. But we wrote a couple of, chapters and handbooks, which kind of reflected some of the key learning what to do or what not to do. Now. Growing up, working in the northeast of England, in the early 1990s, Kevin Keegan was the manager, and really, kind of getting Newcastle back up into the Premier League. And so that was then now the First Division. And we've got a group of men who are engaged in injurious lifestyle behaviors. So they're drinking so much, too much brown ale. They're having too many, too much curd and chips, as we said in Newcastle. So, that kind of not smoking that got an unhealthy BMI. The don't say that health behavior is a problem. In fact, the rate the health is good that subsequently incubated for health problems down the line and reducing that treatment options. How do we get this group of men into health improvement interventions? Maybe we could use the hook of professional sport now growing up in three generations of Newcastle fans, you've got to do the right thing, haven't you? You've got to follow the the follow the path, which of course is to support Manchester United. Most of my family's disappointments now and maybe some of your disappointment as well actually, now they're not going very well at the moment. I think it's fair to say both and probably one of their most dramatic evenings. In recent time, we are in, 26th of May, 1999. Scores of one, one in the champions League final by Munich. One Manchester United one called it Ryan Giggs, Ryan Giggs, Sheringham and all the salsa scores in the 92nd minute. United go on to win their second European Cup and an unprecedented that treble. And as you can tell, I'm into this. Yeah and that's the point. So can we use the power of professional sport football, rugby, cricket to connect with people around their health. So this is Premier League health, the national program, men's health Improvement and 16 Premier League football clubs. It's only going to sell. Who's then the reserve team manager at Manchester United. The more humble surroundings of women. Sure. As part of the Manchester United iteration of Premier League Health. Now, I mentioned the opportunity to do a big national evaluation and put our learning from leap in. The practice would come round quickly. And so it did within 18 months, we had this big national evaluation. So this was funded by the Premier League Chances program 1.6 million, which matched by 16, the 416 sites. So the football club Community Trust, plus their partners focus. That meant 18 to 35 years. But all men really engage the intervention. And it was very much targeted at that kind of group of men that I've mentioned, delivered by and, an NHS health train model. So these are gentlemen, here are two of the health trainers that worked up the Newcastle United men's health projects. They're dressed in the tracksuit. If you don't know how trainers are. I like health professionals trained in behavioral change techniques. They led the men's health interventions, and they were delivered through three different types of interventions.
So clusters and groups. So here we are at the KSI Stadium filming for match of the day. Two clusters of groups involved in physical activity, usually football but not exclusively over physical activities were also done with educational sessions grafted onto the back of those activities to raise men's awareness around health, behaviors. So in this case, we've got one of the one of the chefs at the football club, Sean Ben, how to prepare well, healthy snacks. So classes and groups matched events and promotions. So, here we are at Fulham with, some of the activities of the match, the promoted men's health awareness, but also the men's health program and then outreach work with local groups of men. So I mentioned the Newcastle project. So Steven and Nick Powell will work it when the West end of Newcastle with restaurateurs, taxi drivers. Now there are at least two people have been in this set establishment. So this is north maybe more. This is North Ormesby work and men's club now forms be as effectually known as doggy market. So I mentioned that the health traders I don't know why it's called doggy market but they're. But there's a man here who can tell us. Now I mentioned the health trend as well, tracksuits. And there was a couple of the guys who were working at the Middlesbrough project who got into working men's club to raise awareness of the men's health work, project because of all that outreach work. So they're in there with the club tracksuits on. At the time, Gareth Southgate was the Middlesbrough manager. So they walk in and there's a couple of guys in there getting stuck in the club beer. What are you two adopted here? You're two shouldn't be in here if you've got a game tomorrow night. It's a disgrace. Now what are you so bad that we're from the Men's Health Project? But the guys would sit there, given up beer mats, polo and the men's health project. But the kit provided a nice break. And so therefore they were able to have that conversation. So the importance of kind of that more informal approach and the hook of sport and the hook of the football club, was kind of part of kind of connected in with, with the group of men. So again, classic mixed methods, sort of, evaluation design. We look at effectiveness and change in lifestyle behaviors, engagement. So with this group of men, use of health advice services where they go into their GP implementation. We didn't do 300 interviews. In this case. It was much more kind of conservative. And then interviews with the men around the acceptability of the men's health intervention to try and pull out some of those key design characteristics. But here we tried to clear it around the design characteristics that help men learn about the program, start stick with it. And if they dropped out, come back.
So what about, some of the headlines, what some of the half thousand men engage the Premier League health interventions? Four and a half engage the evaluation. So again, we got that data loss. And then and then we have data loss associated from demographics to adoption to change in lifestyle behaviors, but predominantly white British. But in some areas it was, kind of a more diverse kind of group of men engaged men 18 to 44. But we had men right the way up to 79 who kind of engage the intervention. Roughly two thirds were, were employed, but 61% were hosts. They were fans of the host club. So you had city fans going to the United, as strange as that might sound, the United fans going to City and Liverpool going to Everton and so on and so forth. But what about change? Well, 85% of the men reported having combinations of lifestyle risk factors, but 58% said the health was good and they didn't think they had a problem. And over half had never used the health advice service. In fact, one of the interviews we did, we had one guy who described the symptoms of having a stroke and he said, well, at that point I might go and say BGT, so and Nonattendance had worse health profiles. Nonattendance of health, he said health advice service had worse health profiles than attenders, but we found that through intention, the treatment, the protocol analysis, we there were improvements in number of lifestyle behaviors. But what about the key design factors.
So I've talked a bit about using the club badge. The power of football male friendly communication was really important here. Football sports exercise your club. It wasn't about health, it wasn't about weight loss, but certainly branding around the club itself, using some of the players to get the message across. And some of the literature. The picture in the middle here we have some of the health trainers at Manchester United. The gentleman on the far right, bottom right is Steve Harvey, the real McCoy. He's a former professional wrestler. He just had a great relationship with the guys in a very informal kind of will work with them to try and improve their health. The gentleman at the top right hand corner is Brett Handler and he was the men's health ambassador. He was the, the the Fulham, the Fulham first team captain. And so he would be identified by Bible by a younger group of men. But the gentleman who's just behind him is George Cohen. Now, George Cohen was a, part of the England World Cup winning team, and he has been a Fulham footballer for many years. So he would be relatable by a an older generation of gentlemen. So male friendly communication was really important familiar, local in familiar environments, non-clinical environments.
Here we are in Middlesbrough, at the Riverside, and one of the interviews the guy said, well, you know, you could be go on the football ground. It could be going for tickets, it could be going for a shirt, or it could be going to get your kit and caboodle checked. Nobody knows. It's non-clinical, clinical, it's anonymous. And so that kind of that local familiarity, that kind of informality was also really important. And at the borough, as a number of the clubs, they use the ground for delivering some of the activity. So some of the men's health program took place in the first team, changing room. When they did kickboxing, they'd run out onto the pitch. So it became quite, an interesting, intriguing kind of setting for the delivery of men's health interventions. Very different from going to GP practice, a range of physical activity options. So it wasn't just football, it was a range of, of modes of activity and also the importance of the health trainers and the skills that they had, and male and female have. Trainers were also important in improving the health of men. So that's kind of a bit of a snapshot around it. But the following findings challenged the notion that men are hard to engage or resist, resistant to change their lifestyles. And in essence, they were hard to avoid when men's health interventions were delivered in football clubs. And there was a lovely kind of editorial that was undertaken in public health. Now, Public Health is the peer reviewed journal of the Royal Society of Public Health. And John Mackey and Seb, who were the editors, wrote, public health provides a template that can and should be replicated in other sports, around the world. And in a sort of roundabout way, that kind of happened, really, because, the findings from our work subsequently inform the second and third generation of, men's health interventions and funding made available for the Premier to create and chances program a fund of over 111,000,000 in 2014. But it our outputs had also been cited in interventions which, looked at men's health and ice hockey Australian rules as well as for pools. By 25 researchers from 25 different countries.
Well, for me, it set the tone of what followed a program of research around the role of football, community trust as a vehicle for health improvement. So we audited health improvement across the English Football League. We replicated that in LaLiga. We've worked in the East Midlands, Surbiton, Nottingham Forest, the best of the best, of course. Notts County Foundation and Notts County Foundation connected it with Notts County FC. But an important charity in their own right who very much tried to improve the health and lives of people using the power of sport and physical activity. So it's not just physical activity, it's health improvement, it's education and engagement. And we're very much, really proud to partner with, Notts County Foundation. And just one of the projects we've worked on is evaluating the care program, the cancer Rehabilitation and Exercise program. So for people who have a cancer diagnosis, they can engage in a program of physical activity delivered at the Portland Center, which is their leisure center run by the County Foundation, and engage in a program of activity with social support. We've done a number of pieces of work, and we kind of build on this, relationship. So my learned colleague Jack Parker, who's joining us this evening, we're kind of working with Notts County Foundation and a number of other football club community trust and delivering a program of education and physical activity for children with ADHD. So we're really proud to kind of partner and I know, Diane Jackson, our chair of trustees at Notts County Foundation, Joys, and joins us online this evening. So, I'll just take a quick drink of water if I never catch my breath. So just moving on to our physical activity guidelines, we often think of these as being fairly recent developments, but actually it was our ancient Greeks who first came up with our, the importance of our physical activity guidelines. What a piece of work I was just incredibly proud to be part of. And Rob and Dave, who were also on the, 2019 update, it was just a real privilege. I felt so proud to kind of be selected, as part of this. So just a little bit of kind of background on this. So, we have six expert working groups, which for the first time were made up of academics, researchers, policymakers, practitioners. So a real nice mix as part of the Expert working group. And they reviewed the evidence at that point in time, right the way through from early years, children, young people, adults, older adults, and for the first time, communication and surveillance. So previously, just before we kind of published the 2019 update, the American guidelines had been, had been kind of circulated and it been criticized for the lack of information around the communication strategy. How do you get the message around the guidelines? So it is great that way in the UK were one of the first to start thinking about how do we get the message out, what is the communication, the best way to communicate the guidelines. So the groups kind of review the evidence is a scientific and kind of physical activity. Community consultation, a number of events that took place. The technical reports are then kind of rewritten. That goes into the final report. And then typically we have infographics which get the message across, but we've never really had a communication strategy. Now, Charlie Foster, who led the 2019 update and modernized, I think the review of the guidelines, set a shift in the number of people working towards the guidelines will not happen because we have a guideline. It will happen if we genuinely invest and it's been communicated.
And then let me see who led. The Expert working Group on Communication and Surveillance said every previous guideline is failed to have a communication plan. So it's good that we looked at this particular area. So I'll kind of just give you some of the headlines. No surprise, a comprehensive communication strategy is needed to get the guidelines out. And as part of that we should have excellent social marketing. You know, as academics, we're not always great at kind of communicating the message. And so why aren't we use an expert skills around social marketing, the need for strap lines and catchphrases, which are important across the physical activity continuum. So some is good, more is better. Thinking about different messages for different groups and thinking about different messaging around moderate to vigorous strength. Balance is also important. And at the time when we were working on this, mental health was across the BBC, all the platforms. So it was on TV, it was on radio, it was on the website, it was on the I think it was it was in the documentaries, it was in the sitcoms. We should be doing the same. We should have physical activity across every platform, multimedia, both channels. But to have that, it needs serious political support and proper investment. Now, I don't really think we achieved this aspiration well. We didn't achieve this aspiration kind of going forward, but there was some excellent work that was undertaken in Bristol and also in Edinburgh, and also for the City of Moz expert working group communication, communicating the guidelines. So we started the process.
Now I don't know for sure, but I suspect that maybe in the next few years we might be into the review of the guidelines again. I think we'll be in, what, 24 hour guideline it will be. Would be physical activity. It will be sedentary time, it will be sleep, it will be screen time, and it will look very different. So we really do need to think about the messaging that's associated with all those components and getting that across. So the work has been started and I think we've got a lot to build upon. Going forward. So linked to the same old guidelines and the importance of health care professionals in promoting physical activity. They're very much identified as being really important conduits for getting that message across. And in some cases, people will talk about that. They will be more active if the GP encourage them to do so. So we often do see some of the criticism in the media, but some health care professionals, some of our GP's, our nurses are physios, are Ortiz do all the guidelines that they don't know, that no sort of us feel confident and given the information that they are subject to incredible structural pressures around workload and time. So since coming to the University of Derby, I've kind of built on this body of work with a number of colleagues. And so just wanted to kind of talk a little bit about some of the barriers and facilities that health care professionals face in promoting physical activity. So in the study at the top, this is Nikki came the invitation to Bala, a visiting professor in sport and exercise medicine, who joins us this evening. Stevens, Polinsky and myself. We looked at the preparedness of health care professionals, doctors and nurses to promote physical activity for patients with diabetes. And some of the barriers were they didn't always feel confidence, particularly when it came to type one diabetes, and often would avoid the conversation. And felt that they often struggled with time or had poor training. That undergraduate and postgraduate level. Instead from the University of Leeds and Leeds Metropolitan University. Alex as a physio this is working with Dan and also Kim. A new car from the University of Leeds that some of our physios didn't know all components of the physical activity guidelines, so they might have known moderate to vigorous but didn't necessarily know what the guidelines were around sedentary time. So this kind of work to be done there and again worries about giving, being fearful about giving the wrong advice. A new Brookhaven from the University of Leeds. And I've looked at nurses preparedness and promoting physical activity. Some of the barriers were kind of time, pressures of work lot and physical activity being seen as an afterthought. And then also in dance paper, which is with doctors, like a patient engagement, as well as lack of knowledge around the guidelines though. So these were some of the common and reoccurring barriers. And we've done similar work with midwives as well.
What about some of the facilitators? Well, in Nikki's study, in the time study, our GP's and nurses said it would be great to have knowledge of how physical activity interventions available in the community in one central place, so it's accessible, so we're not scrabbling over multiple kind of sources for information, particularly problematic when time is a pressure, as well as under undergraduate and postgraduate trained and CPD opportunities of physios talked about the importance of behavioral change techniques, goal setting, as well as again ongoing training, postgraduate trained and CPD. And then with our nurses, they talked about the availability of online resources that are available in one place. So it's great that we've got the movement medicine resource students here. A number of my colleagues were involved in building medicine, a suite of online resources available from the zero minutes consultation.
So the more minutes of consultation for a range of different conditions, and then intense for we identified the importance of staff training at undergraduate and postgraduate level. That was some great work that's gone on in this area. The Moving Health Care Professionals program. And helping our healthcare professionals enhance their preparedness. So we've got undergraduate and postgraduate trained in the medical curriculum. We've got the Health Care Professionals program, which also includes CPD, the Clinical Physical Activity Champions program, as well as the movement medicine kind of, suite of resources. But it's great that we continue the conversation because that is a key design characteristic in building up our, I guess, our knowledge about how we can best support what is really a really important key conduit for promoting advice and guidance on activities. So our work continues in this area. Okay, so Jackie Kerr in her book chapter often refers to the environment being the greatest barrier in fiscal activity. And here we have a lovely picture here on the colder navigation of Wakefield with some paddleboarders. And it's fantastic to see some of our physical activity infrastructure being repurposed. So here we have one of our old coal mineral railways that I used to call out with a coal mine in Barnsley, South Yorkshire, for transportation. It's great. The burnt out cars have been shifted, the fridges have been moved, its speed, Victorian drainage has been put in, it's wide, it's come Vivien, it's social. This is Bruno the dog making a cameo appearance, but there are no effects without side effects. And increasingly, some of the literature talks about conflict in the physical activity infrastructure. Now, this is not to say one group is to blame in one group. Isn't this to say that this is interesting? It's important because it has implications for in severe feeding. And we should begin to understand this. So I know we've got a number of cyclists here in the room, but we've got conflict between cyclists and pedestrian. And so in this case, this gentleman looks as if he's gone through the zebra crossing where he should have stopped and he's been manhandled by a member of the public. So you shouldn't do that. And also conflict between within groups, so mechanical cyclists as cyclists, etc..
So we've done some work with as part of the active study. So actives of people who are meeting the physical activity guidelines of what helps and hinders them to keep active, particularly during Covid 19 and beyond. So we've begun to pull out some of the different layers of conflict, and I think there's probably more that can be added here, but it ranges from disagreements and arguments to verbal and non verbal abuse to deliberate or unintentional obstruction of the infrastructure. Oops. The threats of digital health and safety and acts of danger. So let's put a bit of meat on the bone here. So in this case you can just about the topics. You can just about, say, a cyclist who's got a head, a helmet. Come on. And he's stopped. He's doing absolutely the right thing. Rather than go through what is probably a 60 or 70 gap between the curb and the truck can't go anywhere. The psychopaths plot. But what you don't see in this video, here, is that he's getting a law degree from another cyclist for not going through the gap, and because it was caught on camera, the conversation continued for several miles down the road, and there was liberal exchange of Anglo-Saxon and industrial language. And that's kind of fairly commonplace, kind of in terms of how the space is being used, who's using it, when's it being used, etc.. So we see often see blocking and obstruction of the infrastructure. Now in some case, it's kind of a group of people who are cycling and walking. They're in conversation but having a frothy coffee and they're just not paying attention. And subsequently people get a little bit dissatisfied with how the infrastructure is being used in more kind of, I suppose, sinister kind of approaches. You see objects or things being put into obstruct the infrastructure. So in this case, we've got some branches put across.
Probably one of the more sinister examples I saw was a dog being put in the way of a lady cyclist who was trying to get passed on the national cycling network. And then when the lady outfoxed the runner, it really paid off. And she shut off down the path. There was a kind of a liberal exchange of Anglo-Saxon, and then kind of you see examples like this. This path leads down at the National Cycle Network, which is for walkers and wheelers of all time. So the delivery vans come down from Hartlepool with the kippers to service some of the restaurants at the bottom of the bank. And they typically would reverse down on the pavements. So if you've got a wheelchair or if you keep pushing the buggy, you're forced onto the couples and that's kind of difficult to get traction. So the council have subsequently put in these bollards to kind of kind of stop them doing that. A day after I took this picture, one of these bollards had been stopped over by a truck that had just reversed down. So we've got kind of that kind of, intentional, unintentional obstruction of the infrastructure, then threats of danger. Now, this might be cyclist riding too close to horses, dogs that, kind of, out of control. The worst case I saw was 24 dogs rolling around as a pack. Just being loud with an outhouse. So if you push in a problem, the National Cycle Network, that's a really scary prospect of a dog jumps up on you and knocks you over. But lots of dog owners. How do actually, control their dogs? They're very kind of considerate as well, so we need to balance that out.
Probably the most interesting one I had was that I had a fishing hook. Someone had cast the line that got stuck in my derriere like, unintentional. And then we have kind of acts of danger. So pedestrians be knocked over by cyclists. Cyclists be knocked over by dogs. And this probably more sinister example whereby on an er road in South Yorkshire, the rear door, the rear passengers open the door on a cyclist for about 50 miles an hour. Now the cyclist was okay because they sheltered enough after this event. And this is not really the kind of a one groups to blame, and one group is that it's the. So this is interested. It has implications for physical activity. You know if you are a novice exerciser and you are using the infrastructure and you kind of have a poor experience, that takes a bit of process and you may not come back. And even if you're an experienced exerciser that you know, and you know, you've been subject to threats of violence or intimidation, then that takes a bit of dealing with as well. So this is work that's that continues. Okay. Let's finish on some positives. Now I mentioned the intervention doesn't necessarily have to be a physical activity intervention here. We've just had part of the national cycling that we've had. Some of the vegetation cut back. So it just makes it wider. So if you've got a horse and someone's on a bike, the cyclists can get out with the road. So it's just a simple way of kind of try and make the environment a bit more accessible, a bit more manageable. Here we are in North Yorkshire and York, so you can see the picture on the left hand side. The path is to be used by cyclists and all sorts of wheeling and pedestrians. It's narrow. So during Covid 19 they took out one of the parking bays and use it as a pop up cycle lane. But it was used by all sorts of wheelers post Covid divided in the path. So there's more space, it's a little bit more better for negotiates and has a bit more room, and then shift the lampposts on the other side of the car park. So just kind of simple ways of trying to change the environment. And one of my favorites, you'll see here a picture on the left hand side. We are 327 miles from Derby, and we're in red brick upon Tweed, so brick upon Tweed is equidistant between Edinburgh and Newcastle. So we're about to start our cycle journey to Derby 327 miles. We come about 30 miles further south, the of mouth, equidistant between Barrett and Newcastle. This is the main coastal road down through the north east of England. Now for Northumberland. The route here is 50 miles an hour. There's no to walk if you're on a bike. There's not much room. It's twisty and certainly so.
It's a really nice example. With Sustrans. I've worked with a landowner to repurpose the farmland for all forms of wheeling and Pedestrianization, and it's traffic free, so that's a really nice example. Okay. And above all, physical activity should be fun. So I guess this is my opportunity to say if you've thank you's before, I kind of just talk about some of our current work. So very special. Thank you to my lovely partner Janette Aaronson, who is still smiling even though I've dragged her up this great big hill on the climb from Reston. Neale, you know, this this location really well, is still smiling, even though I've drugged up the hill.
So thank you very much. And also thank you to my siblings, Marty and Helen, who are listening in from all over parts of the world today. And of course, my parents, Pam and Kevin, who are still in the Long Beach, still my friends from university property and who very much kept my feet on the ground. And of course, my good friends from York and of Yorkshire, Neil Gibson and David Stacey, who join us this evening. Thank you so much. I saw your colleagues, Professor Business, Rob Copeland, David Broome, Catherine Woods, David Morley and the esteemed professor Pierce Neff of the University of Sunderland. I blessed Steve's Walensky and Nikki kind, and I should say a very big thank you to my teacher, Archie Jenkins, who taught me at the Duchess's high school in Alnwick. So Archie put in a lot of time into young men and women who, and by getting them into sport and physical recreation, including athletics, and he was a great influence on me and he would take us to all sorts of events, particularly athletics. And when you're standing at a start of a road race and you've got an Olympic, a will champion on either side of you, it raises your aspirations of what might be possible in life. So for me, my kind of connection in around sport was about something much bigger. And then also, thank you to my learned friends and colleagues who I worked at at my previous institutions, Stephen Robson and Professor Alford of Jonathan Long, and Lindsay, doctor who was by external examiner at for my undergraduate degree, but also my PhD, and the venerable public venture from and I've trained and who I've worked with for well over three decades and who joins us online this evening. And then my lovely colleagues here at the University of Derby, but in particular Claire Roscoe, sugars and sugar, I know is listening from Hunan in China. This evening, visiting Professor David Double and also from the University of Leeds, Jack Paul, cat of the Jack Parker and then Andy, who to the head of school, who you'll hear from in a bit. So it's almost the end of the road but not the end of the journey. And, Radford said they'll definitely be at least one picture of my bike. So not wanting to disappoint, we've written from Northumberland, we are in, look in East Lothian, looking north towards Edinburgh and over to the right, we've got the kingdom of faith. So just some examples of work that we are kind of involved in. So we've been evaluating, Deji Beats, which is about for managing type one diabetes by children, young people and families. We're doing some work. We've been commissioning this work later on this year looking at a mental health component of the app. So that's great. But the GP app has been rolled out across hundred and 63 pediatric diabetes services. In this country. Working with children. Claire on Compassion. We've got a paper coming out in the British Journal of Health Psychology on the role of self-compassion as a media for physical activity. But I also think there is something around compassion and how that can be used to manage conflict in the physical activity environment. Working with class group around fundamental movement skills and physical activity. Levels of children and young people in particular mentioned the messaging and how we need to work on the messaging, of the physical activity guidelines for particular groups. So, PhD student Robert Flynn looking at messaging around, how we get that message out to kind of families around the physical activity guidelines. What's the best way of doing that? What's the different media? And then our work continues around the, promote understanding the promotion of physical activity with health care professionals. Working with Dan and Camilla and other colleagues at the University of Leeds, as well as well as lots of other projects that we are involved in. So I started I I'll talk about my dad, Ken, and my dad was a great marine engineer. He just got it. And for me I would have been a terrible mechanical engineer. But for me, it's just about finding your engine to work on and the physical activity engine and the investigation into that is my engine. What needs to go into the design mix, because that's really important. And getting people physically active, which of course is a design for life.
So thank you for listening. And of course, keep active. I think.
Andy Pringle's Inaugural Lecture: The Impact and Implementation of Physical Activity Interventions. video
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