Sally Leach, Health and Wellbeing Advisor at Tonbridge and Malling Borough Council and Health Promotion Adviser for Health Action Campaign, explains how holistic approaches to health and wellbeing can empower people to make positive lifestyle changes.

For the past two years I have been working as a Health and Wellbeing Advisor for Tonbridge and Malling Borough Council - as part of the nationwide One You health campaign. It’s one of many health initiatives in the UK focusing on prevention by talking to adults directly about the small steps they can take to improve their health. Here’s what I and my colleagues feel has been effective.

What is the One You health campaign?

One You was launched in the UK by Public Health England (PHE) in 2016 to help adults across the country avoid future diseases caused by modern life. Increased technology is just one factor among many, meaning we often spend 8 hours a day sat at work with a long commute either side, making it difficult to make healthier choices. This helps explain why:

• 77% of men and 63% of women in middle age are overweight or obese
• 8 out of 10 of the middle aged either weigh too much, drink too much or don’t exercise enough

As a result, although we are living longer, many more of us are spending our retirement years living in poor health. Yet Public Health England has identified that living healthily in midlife can double our chances of being healthy at 70 and beyond.

What have we found to work well and why?

Taking a holistic approach is important. Our initial assessment considers physical, mental, emotional, social and environmental factors. This helps identify the possible causes and effects of lifestyle behaviours. For example, alcohol and sugary snacks may have become the coping mechanism for someone in financial difficulties. To empower and motivate this individual to make a change, the source of the problem needs addressing first, as this case study illustrates:

Case Study: 60-year-old male referred to One You for help with weight loss.

Concerns: (after completing holistic assessment): Overweight, not physically active, poor mental health, financial concerns and socially isolated.

Actions:

• Signposted to mental health organisations West Kent Mind and Samaritans – and discussed suicide plan to keep client safe.
• Joint working with the local council to assist him make a hardship claim.
• Signposted to the Royal British Legion (RBLI) for help seeking employment.
• Signposted to Crosslight debt advice service.
• Signposted to Walking for Health and social activity groups (Men in Sheds and Community Cuppa)
• Signed up to 4 healthy weight (Kent County Council’s weight loss programme). 

Outcomes:

• Client has lost 3 stones in weight.
• Reduced financial worries.
• Regularly attends Community cuppa and has now started to volunteer.
• Improved mental health score, preventing a possible suicide.
• Exercising several times a week after attending exercise on referral (water therapy).

Collaborative working:

This has been really successful. We have linked in with not only social prescribers at Involve but also many local community and charitable organisations such as Communigrow, West Kent Mind, Crosslight, and Leisure services at Tonbridge and Malling Borough Council. This not only helps to create shared personalised support but also helps to build more flexibility within our lifestyle programmes resulting in better outcomes for the individual.

Feedback we’ve received from clients

Positive feedback has included:

“Would highly recommend this service”

“An excellent service which is supportive and helpful”

“Really helped me to make small manageable changes”

“Not judgemental in anyway, supported me to see where I was going wrong”

Behaviour Change – some final thoughts

Highlighting the dangers of unhealthy behaviour is important and should be standard practice to ensure we are making every contact count. However, ultimately the change must be self-initiated. We often find an individual doesn’t see their behaviour as unhealthy until they themselves are faced with a health scare. So, identifying when each person is ready for change is vital if health promotion is to be successful. This can be time consuming, as an individual may spend a long time in pre contemplation. As health professionals we need to recognise this more and be more flexible with our approach so it enables individuals to access the service when they are ready and not when we as health professionals feel they are ready. 

Ultimately disease prevention can only really work if the environment in which we live is one that makes the healthy choice the easy choice. We feel that empowering people to make a change can only happen if the appropriate support is in place in settings that suit the public.