Lifestyle groups A new way for disease prevention in Central Finland Health Care District. Riitta Liisa Hasu

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1 Lifestyle groups A new way for disease prevention in Central Finland Health Care District Riitta Liisa Hasu

2 CENTRAL FINLAND HEALTH CARE DISTRICT Responsible for the special health care of the inhabitants of the region (= 5 % of the entire population of Finland) CFHCD belongs to the management area of the University Hospital of Kuopio.

3 The Primary Health Care Unit offers expert services to professionals of specialized and primary health care and other municipal actors. The unit lowers interface barriers, initiates cooperation and supports health promotion by strengthening professional skills and developing new methods for addressing lifestyle factors. The goal is to make early risk recognition an initial part of every health care contact.

4 Health Promotion and Prevention Professor of primary care (University of Eastern Finland) Professor of health promotion (50 %) (University of Jyväskylä) Head Nurse Health promotion coordinator Nutrition therapist Physical activity coordinator Nurse

5 Background information In Finland health-oriented group counseling is traditionally conducted in disease-specific groups In small municipalities forming diagnosis-based groups is difficult The new group-based lifestyle counseling model is designed to bring health promotion activities into municipal context. The model includes material for group testing, evaluation and operation all designed to support the success of lifestyle changes. All municipal groups will be constructed according to local needs and aim at comprehensive health promotion of group members.

6 Lifestyle group in action Each group consist of person (+ family members) and they meet at local health centers t All together 6-10 group meetings 2 follow up meetings (after 6-8 months and 12 months) Individuality in the group Scoping the group needs and selecting the most relevant themes Instructors; Multiprofessional team of specialised nurses, physiotherapist, doctor, pharmasist, dental hygienist, dietician, municipal physical activity coordinator

7 Identifying individual needs

8 Structure of a lifestyle group Initial survey Designing of the group program according to group needs Final survey, 6-8 kk, 12 kk, Health café : Physical activity and nutrition Basics of healthy nutrition Selecting the right foods Physical activity, personal goals Scoping the local exercise possibilities Individual dietary guiding session Survey results and individual excercise plan Alternative themes designed according to group needs Salaatteja yhdessä tehden Kaupassa käynti; valinnat ENE Lääkä -rin kyselytunti Ylipaino ja polviongelmatiikka Mielen hyvinvointi jaksaminen Ihmissuhde asiat / apteek -kari Paikalliset liikunta- / toiminta mahdollisuudet Suun hyvinvointi Lääkeasiat Ravitsemuksen erityiskysymykset Riippuvuudet ; Alkoholi Tupakka

9 Indicators and monitoring Initial survey + measurements 8 month follow-up 12 month follow-up Exercise Nutrition Nautinto aineet Dental health Mental wellbeing FIT-index and pedometer Weight, weight change Alcohol BDI 3-questions 6 Min BMI Audit C-test Questions Walking test; (heart rate, blood pressure) Waist circumference Tobacco SOC Laboratory tests P-GT, fp-gluk, fp-trigly,p-sldl, P-kol-HDL, P-Kol, P-Alat, P-Krea

10 The lifestyle group process Planning group activities Starting up the group -scoping the needs and execution Follow up and assessments - Final survey and after 6 and 12 months Group counseling of the clinical staff Group Control Skills and attitudes survey (questionnaire)

11 Lifestyle groups of the municipality Viitasaari ja Pihtipudas Lifestylegroup Karstula Lifestylegroup Tikkakoski GDM Familygroup Laukaa Lifestylegroup Saarijärvi Lifestylegroup Äänekoski Lifestylegroup Suolahti Lifestylegroup Keuruu Lifestylegroup Jämsä Lifestylegroup Hankasalmi, Pilotgroup 2009, Lifestylegroup 2010 and 2011 Toivakka Lifestylegroup Joutsa Lifestylegroup Kuhmoinen Lifestylegroup

12 Marketing Person can be referred to a group by; - doctor - nurse - diabetes nurse - occupational health personnel - physiotherapist

13 Nutrition theme Designed to support healthy eating habits Mapping of thoughts related to eating habits Scoping the star-up situation: Weight, weight change, BMI, waistline, lab. Results, perceptions on one s eating habits Observing personal eating habits, setting up goals Adopting health promoting eating habits: eating foods with good nutritional value, controlled amount of sugar Follow up and encouragement Final measurements and individual assessment

14 Salad-buffet Learning by doing How to include vegetables, berries and fruits in a everyday diet.

15 Grocery shopping The goal is to familiarize the group members with the wide selection of different food items and to educate how to make better choices in terms of fat, sugar, salt and fiber contents.

16 Progress of the physical activity theme Striving towards physically active lifestyle Mapping of thoughts related to exercise habits Scoping the star-up situation; physical activity tests, Step-diary, 6MWT Setting personal goals Physical Experimentation and self-motivated training Final measurements and individual assessment

17 Pedometer

18 2009/RL-Hasu

19 2009/RL-Hasu

20 2009/RL-Hasu

21 Good experiences Counselors: Group counseling and team work improved coping at work, better exploitation of municipal resources and increased cooperation. The group: Empowerment; good, remarkable lifestyle changes at individual level, peer support of other group members (swimmers, gymgroup), new social relationships, tutors K-S SHP: Tool for medical staff, updating lifestyle group data enables turning the new know-how into functional tools. New contents areas: Dental wellbeing Depression Nutritional tools and physical activity

22 2010 /RL- Hasu

23 2010 /RL- Hasu

24 Results - Individual level

25

26 Municipality of LAUKAA; Physical activity FIT-index

27 Total Weight loss of the group 31 kg (3,1 kg per person) = 62 packages of butter

28 kg 160,0 140,0 Weight change of women and men during 6 months observation period p=0.023 p= ,0 100,0 80,0 60,0 0 kk 6 kk 40,0 20,0,0 Nainen Mies

29 Pistettä Change in FIT-index of women and men during 6 months observation period p < p = kk 6 kk Nainen Mies

30 Change in the 6 minute walking test of women and men during the 6 months observation period m p=0.075 p= kk 6 kk 100 Nainen Mies

31 Positive feedback

32

33 Thank You

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