Active Choice

Background

Active Choice developed and implemented three interventions designed to increase physical activity in children and young people. The project also evaluated the programmes.

What is the problem you are trying to solve?

The project was based within Durham Dales Primary Care Trust, South West of County Durham in the North East of England. The total population of the Durham Dales is approximately 89 000 people, predominately rural in nature with a population density of less than 250 people per square km. However Durham Dales has intense pockets of urban deprivation, with nearly half the wards in the worst 25% in terms of deprivation in the country. Incidences of key conditions such as coronary heart disease are above the national average.

In recent years the prevalence and impact of childhood obesity has been at the forefront of both media interest and academic research. By 2002 the prevalence of obesity became a Government concern ¹ .

The primary aim of the pilot was to research the effectiveness of different physical activity interventions for young people, which would increase their overall levels of activity and prevent sedentary lifestyles, and have an impact on the incidence of obesity and other health issues in these population groups.

What local organisations are involved?

The project was delivered as a partnership at all levels. At a national level the partners included the Department of Health, Sport England and the Countryside Agency. At a local level partners included Wear valley District Council, Teesdale District Council, County Durham Local Education Authority, School Sports Coordinator partnership, local school meals contractor Scolarest, individual schools, Wear Valley Sports Action Zone.

How many people are running this project and who are they?

Durham Dales Primary Care Trust hosted the project. The team consisted of one full time coordinator and a part time administrator. A public health specialist also dedicated some time to the project.

What local population are you targeting?

The target population was all school aged children in Durham Dales, with intensive, detailed interventions and research targeted at young people aged 11-14 years.

How many people are you targeting?

The three programmes targeted approximately 1250 people in total.

Interventions

What interventions are you using to address the problem?

Active Choice implemented three programmes:

1) Speed, agility and quickness (SAQ): This is a system of exercise which develops core physical activity skills not directly related to sport. Training and equipment for this system of exercise was provided to every primary school in the Durham Dales area. At least one teacher per school was trained to deliver this programme as part of the two hours per week physical education programme currently being provided. Selected schools had playground markings based on the SAQ programme to allow children to continue to use SAQ techniques and develop their skills as part of their unstructured play.

2) Summer activity camps: A cohort of young people were selected from local schools by a range of professionals who had regular contact with the pupils, for example teachers, school nurses and school mentors. These young people were given the opportunity to participate in a week long summer activity camp that was held at a local outdoor pursuit centre over the summer holidays. Whilst at the camp the young people were supported by a range of staff from diverse backgrounds with a focus on building self esteem and self efficacy in individuals as well as the group. It also enabled the young people to have a positive experience of physical activity. Participants on each camp were given the opportunity to remain in contact with the project as part of a focus group, regularly getting together and taking part in events in their own schools or communities.

3) Community/schools programme: Following on from the delivery of SAQ and the summer camps, a range of alternative physical activities were introduced and supported in schools and other community based venues. Through the use of an incentive scheme, involving participants having a personal attendance card stamped for each visit and a series of awards that reflected their level of attendance, young people continued to maintain their engagement.

Is the project design based on evidence? If so, please state reference.

No.

Outcome

What outcomes or planned outcomes are you measuring?

Principally, we measured the overall energy expenditure of the individuals identified as sedentary, as well as the larger groups of children. Any change in attitudes towards physical activity in young people was also measured against a baseline.

Reliable evaluation and quantification of physical activity levels in children is notoriously difficult to achieve ² . Recognising this, a modified version of a relatively new self report questionnaire for measuring physical activity ³ was employed. The physical activity scale used pictorial representations of nine different metabolic equivalent levels which it was felt could be adapted for use with young people.

Do you have any outcomes or results yet? If so, what are they?

This information is currently being analysed and will be presented as a local evaluation report, to be published in March 2007.

Is your project relevant to a government target or guideline?

Yes, it is relevant to Public Service Agreement 1: Enhance the take-up of sporting opportunities by 5-16 year olds so that the percentage of school children who spend a minimum of two hours each week on high-quality PE and school sport within and beyond the curriculum from 25% in 2002 to 75% by 2006 and 85% by 2008 ⁴ .

Feedback

What obstacles did you have to overcome to set up this project?

In the first instance, the role of key partners in the Local Education Authority was extremely important as it was through these links that it became possible to be formally introduced to head teachers and staff at prospective schools. Without that initial introduction we would not have had access to individual schools.

As a great majority of project activities were delivered internally by school staff, the more successful programmes were in schools which had proactive, enthusiastic leaders who embraced the concept of Local Exercise Action Pilots and had the full support of the head teacher.

What have you learned about the project so far?

It cannot be underestimated the amount of time and effort it takes to develop and sustain multi-agency partnerships. With this in mind it is crucial that a dedicated coordinator is in place with the resources and capacity to deliver and develop the programme of interventions.

What would you do differently?

It would be interesting to consider an alternative target age group, as the crossover period from primary to secondary school provided challenges with regard to accessibility of access to pupils. A younger age group, perhaps 8-11 years, may be a more appropriate target group for which to promote a positive health message.

Detailed analysis of the data and information collected throughout the project is currently underway which will produce some specific recommendations for the future. These will be presented as part of the local evaluation report.

References:

1. Chief Medical Officer. Healthcheck: Annual report of the state of public health. London: Department of Health. 2002.
2. Armstrong, N. Young people’s physical activity patterns as assessed by heart rate monitoring. Journal of Sports Sciences. 1998; 16: S9-S16.
3. Aadahl, M. and Jorgensen, T. Validation of a new self –report instrument for measuring physical activity. Medicine and Science in Sport and Exercise. 2003; 35(7): 1196-1202.
4. Public Service Agreement 1: joint target for Department of Culture, Media and Sport, and Department for Education and Skills. 2004. http://www.dfes.gov.uk/psa2002/TechnicalNotesFinalPSA.rtf (accessed 13 April 2007).